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Diabetes And Hypertension Pathophysiology

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Pathophysiology Of Diabetic Nephropathy

Diabetic nephropathy is a devastating chronic microvascular diabetic complication, which represents the major cause of end stage renal failure today. The mechanisms leading to the development and progression of this most feared diabetic complication are mainly poor metabolic and haemodynamic control. We should direct all our efforts into achieving good glycaemic and blood pressure control. Prevention of diabetic nephropathy is our only tool to beat this disease currently. The prevention and management of diabetes and its renal complication is a huge global challenge: the global number of diabetic patients is believed to be around 180 million and is set to increase to 350-400 million in the next two decades. Patients with type 2 diabetes will account for 90% of all cases, and we expect an increase of new cases of diabetic nephropathy (DN) within the current decade, given the predicted 30-40% prevalence of renal disease in the diabetic population. The concomitant increase in associated cardiovascular mortality and morbidity (nearly 40 times higher in patients with nephropathy than in patients without nephropathy), and end stage renal disease (ESRD) will result in significant social a Continue reading >>

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Popular Questions

  1. Greyeagle

    I began insulin about two months ago once nightly. I'm still learning to inject where it doesn't hurt like crazy when I inject. Generally I do pretty good. I started on a lower dosage and increased it until my numbers are where they should be.
    ​My concern is the expense. I get a box of 7 pens. They will last me 15 days. I am on United Health Care (AARP Medicare Complete). I am at a stage where a box of 7 pens costs $213.00 every 15 days. I cannot get a discount from Lantus because I am on Medicare Advantage. I sure would like to find an organization that could help with the cost. Living on disability pay makes this very difficult. My wife still works. She works in medical records (ART Certified) at a local hospital. The State also pays her for the time she assists our daughter each day. Our daughter Melanie has Multiple Sclerosis and is bound to a power chair). But she can't help with my insulin cost.
    ​Do any of you have suggestions as to where I could go to get help with the cost of insulin?
    Sincerely,
    ​Ken W.

  2. Goodgirl08

    Ken, did you investigate your mail order Pharmacy? I found that's the cheapest price. Also, if you can lose some weight, it will be easier to control your diabetes. Then, you will need less insulin or non at all.

  3. mollythed

    Greyeagle‍ , I'm having trouble putting together information to help you.
    Lantus pens come five to a box.
    Each pen has 300 units, so a box has 1500 units
    Adding two units for an air shot increases your daily need to 72 units.
    Dividing 1500 units by 72 tells me each box of pens should last you for twenty days with 60 units left over.
    How much you pay for your prescription depends in part on what your overall prescription costs have been so far this year. Are you still in the original part of prescription coverage or have you reached the donut hole or zipped right past the donut hole into catastrophic coverage. (The information I usually see online usually says that in the catastrophic category, you pay only a small part of the full cost, but it fails to tell you that the "small part" of the cost is 7% of the full retail cost, not the reduced cost that Medicare pays the pharmacy.) In any case, those categories start over again for the new year in January.
    Will your insurance still cover Lantus next year? Mine will no longer cover it, so I will need to shift to the newer version of glargine insulin called Basaglar instead. Both are glargine, but for technical reasons, Basaglar is not considered a generic Lantus. That could render information for this year completely out of date.

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