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Compliance With Treatment Regimens In Diabetes

Type 1 Diabetes

Type 1 Diabetes

Print Diagnosis Diagnostic tests include: Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells (hemoglobin). The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates diabetes. If the A1C test isn't available, or if you have certain conditions that can make the A1C test inaccurate — such as pregnancy or an uncommon form of hemoglobin (hemoglobin variant) — your doctor may use these tests: Random blood sugar test. A blood sample will be taken at a random time and may be confirmed by repeat testing. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst. Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. If you're diagnosed with diabetes, your doctor may also run blood tests to check for autoantibodies that are common in type 1 diabetes. These tests help your doctor distinguish between type 1 and type 2 diabetes when the diagnosis is uncertain. The presence of ketones — byproducts from the breakdown of fat — in your urine also suggests type 1 diab Continue reading >>

Treatment Compliance With Fixed-dose Combination Of Vildagliptin/metformin In Patients With Type 2 Diabetes Mellitus Inadequately Controlled With Metformin Monotherapy: A 24-week Observational Study

Treatment Compliance With Fixed-dose Combination Of Vildagliptin/metformin In Patients With Type 2 Diabetes Mellitus Inadequately Controlled With Metformin Monotherapy: A 24-week Observational Study

Treatment Compliance with Fixed-Dose Combination of Vildagliptin/Metformin in Patients with Type 2 Diabetes Mellitus Inadequately Controlled with Metformin Monotherapy: A 24-Week Observational Study 1Novartis Hellas S.A., 12th klm National Road 1, Metamorfosis, 14451 Athens, Greece 2Foundation for Economic and Industrial Research (IOBE), 11 Tsami Karatatsi Street, 11742 Athens, Greece 3University Hospital of Ioannina, Stavros Niarchos Avenue, 45500 Ioannina, Greece Received 26 August 2014; Accepted 26 September 2014 Copyright 2015 Grigorios Rombopoulos et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To evaluate the differences in treatment compliance with vildagliptin/metformin fixed-dose versus free-dose combination therapy in patients with type 2 diabetes mellitus (T2DM) in Greece. Design. Adult patients with T2DM, inadequately controlled with metformin monotherapy, (850 mg bid), participated in this 24-week, multicenter, observational study. Patients were enrolled in two cohorts: vildagliptin/metformin fixed-dose combination (group A) and vildagliptin metformin free-dose combination (group B). Results. 659 patients were enrolled, 360 were male, with mean BMI 30.1, mean T2DM duration 59.6 months, and mean HbA1c at baseline 8%; 366 patients were assigned to group A and 293 to group B; data for 3 patients was missing. In group A, 98.9% of patients were compliant with their treatment compared to 84.6% of group B. The odds ratio for compliance in group A versus B was (OR) 18.9 (95% CI: 6.2, 57.7; ). In group A mean HbA1c decreased from 8.1% at baseline to 6.9% ( ) at the study end and fro Continue reading >>

Treatment Non-compliance And Mortality In Patients With Type 1 Diabetes

Treatment Non-compliance And Mortality In Patients With Type 1 Diabetes

Treatment Non-compliance and Mortality in Patients with Type 1 Diabetes The extent to which patients are compliant with their type 1 diabetes treatment may have an effect on their all-cause mortality risk, according to the results of a study. Researchers at Cardiff University in the United Kingdom recently explored the effects of non-compliance (both medication non-compliance, and not showing up for scheduled medical appointments) on all-cause mortality rates in people living with type 1 diabetes. Their study, The impact of treatment non-compliance on mortality in people with type 1 diabetes, was published online ahead of print in November 2012. It appears in the Journal of Diabetes and its Complications. The researchers relied on data from The Health Improvement Network (THIN) database which contains information on patients seen at more than 350 facilities in the United Kingdom. Only participants who had diagnostic codes that indicated type 1 diabetes were included in the study. Treatment non-compliance was defined as missing medications or missing one or more scheduled medical appointments. The results of the study showed that 29.4% of the patients included in the study (867 out of 2,946) were non-compliant in their medication regimen, or missed medical appointments during the 30-month assessment period. After controlling for confounding factors, the researchers found that patients who were not compliant with their treatment had a mortality rate of 1.462 (95% CI 0.954-2.205), and that treatment non-compliance was linked to a heightened risk of all-cause mortality in these patients. The researchers conclude that their findings demonstrate an association between all-cause mortality and treatment non-compliance (both medication non-compliance and missing scheduled medic Continue reading >>

Diabetes: Insulin, Treatment Regimens And Patient Adherence

Diabetes: Insulin, Treatment Regimens And Patient Adherence

Diabetes: Insulin, treatment regimens and patient adherence Tresiba, a basal insulin, was recently launched by NovoNordisk in Japan(the drug was approved in Europe in October 2012). The company has hailed the drug as better than existing insulin products, with a lower risk of hypoglycaemia, and as offering the promise of a better quality of life. In-spite of this hoopla there are many facets of treatment paradigm, often overlooked, within diabetes with patient adherence being at the top. Insulin, injected subcutaneously, is the last option in the diabetic treatment pathway. It is normally used by all patients with type-1 diabetes and when diet and other oral drugs have failed to manage the blood sugar in the body for patients with type-2 diabetes. However, there is a growing trend amongst specialists for adopting the early use of insulin in type-2 diabetes treatment pathways. in addition, there is a renewed drive towards aggressively managing the blood glucose, and maintaining it within specified limits, to minimise the CV related risk of the disease. In spite of this aggressive treatment strategy, there are some fundamental challenges which need immediate attention to make the treatment more effective and engaging. Ever evolving insulin therapy and adherence Over the years, the evolution of insulin production and administration has been quite astonishing. Initially, pork or beef pancreases were used in insulin production. Then, scientists came up with technological breakthrough to prepare recombinant human insulin in E.coli bacteria--commonly known as synthetic insulin. The FDA gave its approval to recombinant insulin in 1982. The evolution of insulin is not only limited to the method of production but also to the mode of delivery. It has undergone a tremendous change Continue reading >>

Compliance Of Diabetic Patients With The Prescribed Clinical Regimen Attyia Aa, El Bahnasy Re, Abu Salem Me, Al-batanony Ma, Ahamed Ar - Menoufia Med J

Compliance Of Diabetic Patients With The Prescribed Clinical Regimen Attyia Aa, El Bahnasy Re, Abu Salem Me, Al-batanony Ma, Ahamed Ar - Menoufia Med J

This study aimed at studying the prevalence of noncompliance among diabetic patients in Gharbia governorate in Egypt as well its causes, its effect on glycemic control, and factors affecting it. There is growing evidence suggesting that because of the alarmingly low rates of compliance, increasing the effectiveness of compliance interventions may have a great impact on the health of the population. Promotion of therapeutic compliance is considered an integral component of patient care. It has been shown that despite effective methods of treatment, many diabetic patients fail to achieve satisfactory glycemic control, which leads to accelerated development of complications and increased mortality. A total of 339 diabetic patients who fulfilled the inclusion criteria were recruited in the present study. Compliance to treatment was evaluated during patients visits to health units in Gharbia governorate. Medication compliance was assessed during a personal interview with each patient using a multiple-choice questionnaire. Blood samples were obtained for measurement of glycated hemoglobin (HbA1c). In the study population, the compliance rates were observed to be suboptimal. The most important social factors that significantly affected compliance rates included age, income, and educational level. Among the factors that significantly affected compliance rates were duration of treatment, presence of diseases other than diabetes, and the number of prescribed drugs. Another factor that played an important role was diabetes care costs. The most common reasons for low rates of compliance were forgetfulness and high cost of treatment. An improvement in the compliance level may be achieved through improvement of patients economic levels as well as reduction in the cost of medication. Continue reading >>

Recommendations For Improving Adherence To Type 2 Diabetes Mellitus Therapy-focus On Optimizing Oral And Non-insulin Therapies

Recommendations For Improving Adherence To Type 2 Diabetes Mellitus Therapy-focus On Optimizing Oral And Non-insulin Therapies

Recommendations for Improving Adherence to Type 2 Diabetes Mellitus Therapy-Focus on Optimizing Oral and Non-Insulin Therapies Supplements > Improving Adherence in the Treatment of Type 2 Diabetes Mellitus: Opportunities for Managed Care Published on: April 20, 2012 Recommendations for Improving Adherence to Type 2 Diabetes Mellitus Therapy-Focus on Optimizing Oral and Non-Insulin Therapies Adherence to therapy in patients with type 2 diabetes mellitus is contingent upon a number of variables, including variables specific to the patient, to the provider, and to the treatment. While treatment selection will involve consideration to maximize effectiveness and minimize side effects, the physician must also take into account the priorities and preferences of each individual patient. For some patients, the risk of weight gain may exert a significant influence on adherence, while for others the risk of hypoglycemia or the cost of medications may be more important factors. It is incumbent upon physicians to discuss these issues with patients and to develop a patient-centric treatment plan to achieve optimal adherence and therapeutic outcomes. The nature of the clinical setting can also influence the likelihood of patient adherence to treatment. A multidisciplinary team approach to diabetes management has been shown to improve outcomes and to have a neutral or beneficial effect on costs. The treatment plan itself plays an additional role in the likelihood of a patient adhering to treatment. Less complex treatment regimens with fewer pills are associated with higher rates of adherence, as are fixed-dose combinations for those patients requiring combination therapy. Frequency and timing of dosing are also important aspects of adherence, as once-daily dosing is associated with hi Continue reading >>

Factors Influencing Patient Acceptability Of Diabetes Treatment Regimens

Factors Influencing Patient Acceptability Of Diabetes Treatment Regimens

Factors Influencing Patient Acceptability of Diabetes Treatment Regimens Jayant Dey, MD, Lawrence Blonde, MD, and Richard Guthrie, Jr., MD Helping patients adhere to often complex treatment regimens and achieve tight blood glucose control can be a challenge. With the appearance during the past few years of several new antidiabetic agents, the task of choosing the most appropriate therapy for patients has become more complex. Various aspects of medication regimens can influence diabetic patients long-term adherence to treatment programs. These include side effects, hypoglycemia, and frequency of administration. This paper attempts to assess oral antidiabetic agents with respect to features that can directly or indirectly affect therapy adherence. Editor's note: This article includes a discussion of the thiazolidinedione troglitazone (Rezulin). Rezulin was withdrawn from the U.S. market as this issue was going to press. The linkage between hyperglycemia and complications of diabetes has firmly established the need for maintenance of blood glucose within a recommended range in individuals with diabetes. Helping patients adhere to often complex treatment regimens and achieve tight blood glucose control is a challenge that must be addressed during all phases of diabetes treatment.1 Complications of diabetes, including diabetic eye disease, nephropathy, neuropathy, and peripheral vascular disease, are common in patients with type 2 diabetes. Moreover, type 2 diabetes is a major risk factor for cardiovascular disease. Two landmark studies, the Diabetes Control and Complications Trial2 and the United Kingdom Prospective Diabetes Study (UKPDS),3 have clearly established that tight blood glucose control in both type 1 and type 2 diabetes can decrease the risk of developing secon Continue reading >>

Non-compliance With Treatment Regimens Among Clients With Diabetes Mellitus In University Of Maiduguri Teaching Hospital, North-eastern Nigeria

Non-compliance With Treatment Regimens Among Clients With Diabetes Mellitus In University Of Maiduguri Teaching Hospital, North-eastern Nigeria

Journal of Research in Nursing and Midwifery (JRNM) (ISSN: 2315-568) Vol. 5(1) pp. 011-020, January, 2016 Available online Copyright 2016 International Research Journals Non-compliance with treatment regimens among clients with diabetes mellitus in university of Maiduguri 1Chutiyami Muhammad, 2Umar N Jibril, 3Salihu Dauda* 1Department of Nursing Services, Yobe State Hospitals Management Board, Nigeria 2Department of Nursing Science, University of Ilorin, Nigeria 3Department of Nursing Services, Yobe State Hospitals Management Board, Nigeria Corresponding authors E-mail: [email protected], +447443076385 This study investigates into factors responsible for non-compliance of treatment regimens among clients with diabetes mellitus in University of Maiduguri Teaching Hospital (UMTH), Borno State, Nigeria. A descriptive study design was adopted. 135 clients were sampled using a convenient sampling technique. A structured questionnaire was administered to 135 clients, and analysis was based on 125 clients that participated fully in the study. The instruments sought information on socio- demographic, knowledge and attitude towards compliance and factors responsible for non-compliance to diabetic treatment regimen. Null hypotheses were set and tested using chi-square () at 0.05 level of significance. The result showed that 57.6% of clients opined that non-compliance to treatment regimens was as a result of high cost of drug, while, lack of family support and poor attitude of health personnel was expressed by 37.6% and 51.2% of clients respectively. The study concluded that financial, family support and poor attitude of health care personnel which hindered clients compliance to diabetes mellitus treatment regimen be remedy, thus recommendations were made to enhance compliance Continue reading >>

Journal Of Public Health And Epidemiology - Compliance To Treatment Regimen Among Diabetic Patients Attending Outpatient Department Of Selected Hospitals In Benin City, Edo State

Journal Of Public Health And Epidemiology - Compliance To Treatment Regimen Among Diabetic Patients Attending Outpatient Department Of Selected Hospitals In Benin City, Edo State

Compliance to treatment regimen among diabetic patients attending outpatient department of selected hospitals in Benin City, Edo State Department of Nursing Science, School of Basic Medical Sciences, University of Benin, Ugbowo Benin City, Edo State, Nigeria. Department of Nursing Sciences, Faculty of Health Science and Technology University of Nigeria, Enugu campus, Enugu State, Nigeria. Department of Nursing Sciences, Faculty of Health Science and Technology University of Nigeria, Enugu campus, Enugu State, Nigeria. Department of Nursing Sciences, Faculty of Health Science and Technology University of Nigeria, Enugu campus, Enugu State, Nigeria. Diabetes is a global health issue as it is a metabolic disease that affects individuals of all ages. The success of long term maintenance therapy for diabetes mellitus depends largely upon the patients compliance with a therapeutic plan. This study investigated the level of compliance with treatment regimen among clients with diabetes mellitus in selected hospital in Benin City, Edo state. A descriptive cross sectional design was used, A total of 300 hundred and six (306) diabetic patients were selected using the convenient sampling technique. The instrument for data collection was a self-structured questionnaire. Data collected were analyzed using descriptive statistic in Statistical Package for Social Sciences (SPSS) version 21. Results from the study showed that 59.3% of the respondents had good knowledge of diabetes while 37.7% of the respondents had fair knowledge, and 3.0% of the respondents had poor knowledge. Majority 184 (61.3%) of the respondent had poor compliance to their treatment regimen. Significant relationship between the level of compliance and demographic characteristics of the respondents like sex (p=0.001 Continue reading >>

Improving Adherence In The Treatment Of Type 2 Diabetes

Improving Adherence In The Treatment Of Type 2 Diabetes

Improving Adherence in the Treatment of Type 2 Diabetes US Pharm. 2010;36(4)(Compliance & Adherence suppl):11-15. Former Surgeon General C. Everett Koop, MD, has often been cited for making the obvious but very poignant statement: Drugs dont work in patients that dont take them.1 There is a lot of wisdom in this remark that health care providers would do well to recognize and consider when choosing medications for their patients. While this statement was directed at pharmacotherapy in general, it is more likely to be a problem with the management of chronic disease, and may be at its worst, with the management of diabetes. Type 2 diabetes is a chronic, often silent condition that co-exists with a myriad of other medical problems. Hence, the patient may be taking multiple medications to treat several conditions such as diabetes, hyperlipidemia, and hypertension. This creates a complex situation that is likely to result in low adherence to the medication plan. It seems reasonable that the provider could employ some technique or method in this population that would uniformly enhance adherence. Unfortunately, a recent scientific analysis of interventions to enhance patient adherence to medication prescriptions concluded that current methods of improving medication adherence for chronic health problems are mostly complex, labor-intensive, and not predictably effective.2 Still, even though no single method is predictably effective, there are methods that have been successful and clearly some common-sense tactics that can be applied, particularly when choosing medications to manage hyperglycemia in patients with type 2 diabetes. This article will provide a succinct overview of the problem of nonadherence, an appraisal of its impact on the management of diabetes, and a common Continue reading >>

Keys To Diabetes Control? Patience, Persistence, And Perseverance

Keys To Diabetes Control? Patience, Persistence, And Perseverance

Diabetes treatment largely has been a matter of waiting for failure: Eat healthily and exercise, and if blood glucose isn't controlled, try drug therapy. If that doesn't work, add a drug to the treatment regimen. Add another if need be. In time, a patient may end up taking multiple medications to control the disease. Diabetes is insidious and, when advanced, is never effectively treated — but this progression of care may not necessarily be inevitable. Constantly altering a therapeutic regimen comes with baggage. Side effects of a new drug or combination of drugs could, in turn, reduce patients' adherence to a treatment plan. Studies document costs associated with starting, stopping, and switching therapies. And no head-to-head trials have been conducted on antihyperglycemic agents to determine which are most effective. That's not to say that if a therapy isn't working a change isn't warranted, but for some chronic diseases, careful adherence to a treatment plan and a holistic approach to patient care might have a more beneficial effect on clinical outcomes than an arbitrary change in regimens. Adherence and persistence with diabetes medications* From a retrospective meta-analysis of published studies Therapy type in study Adherence Persistence rate Average days persistent Acarbose — 16−20% 83−105 Glipizide 52−61% 36−44% — Monotherapy 49% 36% — Monotherapy 35% — 300 OA — 39%† — OA 85±15% — OA monotherapy 79% 58% 83±71 Polytherapy 36% 22% — Polytherapy 27% — — *Cramer analyzed 15 studies; for comparative purposes, only those with 12-month follow-up are shown. †6-month persistence. OA=oral antihyperglycemic agent Source: Cramer JA, Diabetes Care. 2004;27:1218−1224 "We prefer to focus on educating members about the importance of dietary Continue reading >>

Type 1 Diabetes Mellitustreatment & Management

Type 1 Diabetes Mellitustreatment & Management

Type 1 Diabetes MellitusTreatment & Management Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD more... Patients with type 1 diabetes mellitus (DM) require lifelong insulin therapy. Most require 2 or more injections of insulin daily, with doses adjusted on the basis of self-monitoring of blood glucose levels. Long-term management requires a multidisciplinary approach that includes physicians, nurses, dietitians, and selected specialists. In some patients, the onset of type 1 DM is marked by an episode of diabetic ketoacidosis (DKA) but is followed by a symptom-free honeymoon period in which the symptoms remit and the patient requires little or no insulin. This remission is caused by a partial return of endogenous insulin secretion, and it may last for several weeks or months (sometimes for as long as 1-2 years). Ultimately, however, the disease recurs, and patients require insulin therapy. Often, the patient with new-onset type 1 DM who presents with mild manifestations and who is judged to be compliant can begin insulin therapy as an outpatient. However, this approach requires close follow-up and the ability to provide immediate and thorough education about the use of insulin; the signs, symptoms, and treatment of hypoglycemia; and the need to self-monitor blood glucose levels. The American Diabetes Association (ADA) recommends using patient age as one consideration in the establishment of glycemic goals , with targets for preprandial, bedtime/overnight, and hemoglobin A1c (HbA1c) levels. [ 5 ] In 2014, the ADA released a position statement on the diagnosis and management of type 1 diabetes in all age groups. The statement includes a new pediatric glycemic control target of HbA1c of less than 7.5% across all pediatric age groups, replacing e Continue reading >>

From Compliance To Concordance In Diabetes

From Compliance To Concordance In Diabetes

From compliance to concordance in diabetes Correspondence to: MrJustin Sanjay Chatterjee MRCSEd MRCS(Glasg), 42 Badger Park, Broxburn, Edinburgh, West Lothian, Scotland, EH52 5GZ, UK; [email protected] Received 2005 Mar 4; Revised 2005 Nov 2; Accepted 2005 Nov 8. Copyright 2006 BMJ Publishing Group Ltd & Institute of Medical Ethics. This article has been cited by other articles in PMC. Compliance is a key concept in health care and affects all areas of health care including diabetes. Noncompliance has previously been a label attached to many patients without much thought having been given to the causes of poor compliance. Over the last few decades there has been a large volume of research focusing on compliance that has exposed the multitude of factors affecting compliance. Even the definition is not clear cut and so comparability between studies is not without difficulties. A better understanding of the factors affecting compliance, including the doctor/patient relationship, has allowed the evolution of concordance. Concordance views the patient as being the equal of the healthcare provider and as having a right to make informed decisions. In a condition such as diabetes, which has many potential long term complications, it is vital that concordance is embraced in the healthcare system in order to improve care. Keywords: compliance, concordance, diabetes Compliance has been the focus of significant research and clinical interest in the past two decades. At a basic level, compliance is the term used for following a recommended treatment regimen. 1 It is important in terms of health care, economics, and research. Compliance to treatment is a key factor between process and outcome in medical care. 2 It is relevant to all aspects of medical care, including diabetes Continue reading >>

Systematic Review Of Adherence Rates By Medication Class In Type 2 Diabetes: A Study Protocol

Systematic Review Of Adherence Rates By Medication Class In Type 2 Diabetes: A Study Protocol

Abstract Introduction Treatment options for type 2 diabetes are becoming increasingly complex with people often prescribed multiple medications, and may include both oral and injectable therapies. There is ongoing debate about which drug classes provide the optimum second-line and third-line treatment options. In the real world, patient adherence and persistence determines medication effectiveness. A better understanding of adherence may help inform the choice of second-line and third-line drug classes. Methods and analysis This systematic review will compare adherence and persistence rates across the different classes of medication available to people with type 2 diabetes. It will include all identified studies comparing medication adherence or persistence between two or more glucose-lowering medications in people with type 2 diabetes. Research databases (MEDLINE, EMBASE, The Cochrane Library, The Register of Controlled Trials, PsychINFO and CINAHL) will be searched for relevant articles, using a comprehensive search strategy. All identified medication trials and observational studies will be included which compare adherence or persistence across classes of diabetes medication. The characteristics and outcomes of all the included studies will be reported along with a study quality grade, assessed using the Cochrane Risk Assessment Tool. The quality of adjustment for confounders of adherence or persistence will be reported for each study. Where multiple (n ≥3) studies provide compare adherence or persistence across the same 2 medication classes, a meta-analysis will be performed. Ethics and dissemination No ethics approval is required. This review and meta-analysis (where possible) will provide important information on the relative patient adherence and persistence, w Continue reading >>

Adherence To Therapies In Patients With Type 2 Diabetes

Adherence To Therapies In Patients With Type 2 Diabetes

Go to: Introduction The prevalence of type 2 diabetes mellitus is increasing globally and has become a major public health problem. In the USA, a study of 17,306 people over 20 years of age showed that those diagnosed with diabetes increased significantly from 6.5% in the 1999–2002 period to 7.8% in 2003–2006 [1]. In 2011, 366 million people worldwide had diabetes and it is predicted that by 2030, this figure will be 552 million [2]. Diabetes is currently among the top five causes of death in most high-income countries and resulted in 4.6 million deaths globally in 2011. The majority of cases of diabetes mellitus are type 2, and the greatest numbers of people with this disease are aged from 40 to 59 years [2]. The increase in type 2 diabetes is associated with obesity, hypertension, and an increasingly elderly population. Over the last 18 years in the USA, the proportion of adults in the age group 40–74 years with a body mass index ≥30 kg/m2 has increased from 28% to 36%, while the proportion undergoing physical activity 12 times a month or more has decreased from 53% to 43%, exacerbating the obesity problem [3]. However, despite strong clinical recommendations for individuals with a history of diabetes to adopt a healthier lifestyle, adherence to improved diet and exercise is poor [3]. Although type 2 diabetes usually occurs in people over the age of 40 years, it is becoming increasingly common in children, adolescents and young adults due to reduced physical activity and unhealthy eating patterns, leading to obesity [4]. The majority of patients with type 2 diabetes fail to control glycemia with diet and exercise and require pharmacotherapy—in general, initially monotherapy with an oral hypoglycemic agents (OHA); however, owing to the progressive nature of t Continue reading >>

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