diabetestalk.net

Diabetes Pp

Liraglutide And Cardiovascular Outcomes In Type 2 Diabetes

Liraglutide And Cardiovascular Outcomes In Type 2 Diabetes

The cardiovascular effect of liraglutide, a glucagon-like peptide 1 analogue, when added to standard care in patients with type 2 diabetes, remains unknown. In this double-blind trial, we randomly assigned patients with type 2 diabetes and high cardiovascular risk to receive liraglutide or placebo. The primary composite outcome in the time-to-event analysis was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The primary hypothesis was that liraglutide would be noninferior to placebo with regard to the primary outcome, with a margin of 1.30 for the upper boundary of the 95% confidence interval of the hazard ratio. No adjustments for multiplicity were performed for the prespecified exploratory outcomes. A total of 9340 patients underwent randomization. The median follow-up was 3.8 years. The primary outcome occurred in significantly fewer patients in the liraglutide group (608 of 4668 patients [13.0%]) than in the placebo group (694 of 4672 [14.9%]) (hazard ratio, 0.87; 95% confidence interval [CI], 0.78 to 0.97; P<0.001 for noninferiority; P=0.01 for superiority). Fewer patients died from cardiovascular causes in the liraglutide group (219 patients [4.7%]) than in the placebo group (278 [6.0%]) (hazard ratio, 0.78; 95% CI, 0.66 to 0.93; P=0.007). The rate of death from any cause was lower in the liraglutide group (381 patients [8.2%]) than in the placebo group (447 [9.6%]) (hazard ratio, 0.85; 95% CI, 0.74 to 0.97; P=0.02). The rates of nonfatal myocardial infarction, nonfatal stroke, and hospitalization for heart failure were nonsignificantly lower in the liraglutide group than in the placebo group. The most common adverse events leading to the discontinuation of liraglutide were gastrointestinal events. The Continue reading >>

Diabetes

Diabetes

Prevalence & Incidence Causes of Diabetes The rising prevalence of diabetes is driven by a combination of factors, including rapid urbanisation, sedentary lifestyles, unhealthy diets, tobacco use, and increasing life expectancy. According to several research reports, people are much more likely to make the necessary lifestyle change once they are aware of their condition. In case you are diagnosed with pre-diabetes, you should get in touch with a physician for further confirmatory tests. This will help you make the necessary lifestyle changes in order to prevent the development of Type 2 diabetes. Diabetes Management There isn't a cure yet for diabetes as yet but a healthy lifestyle can really reduce its impact on your life. It's actually a balancing act involving food, activity, medicine, and blood sugar levels. Manage your diabetes throughout the day by the following the tips below. Continue reading >>

Association Of Diabetes And Insulin Therapy With Risk Of Hospitalization For Infection And 28-day Mortality Risk

Association Of Diabetes And Insulin Therapy With Risk Of Hospitalization For Infection And 28-day Mortality Risk

Epidemiologic and experimental evidence suggests that individuals with diabetes are at increased risk of infection. We sought to examine the association of diabetes and insulin therapy with hospitalization for infection and 28-day mortality. We performed a prospective cohort study using data from 30 239 community-dwelling participants aged ≥45 years enrolled in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. We defined diabetes as a fasting glucose level ≥126 mg/L (or ≥200 mg/L for those not fasting), the use of insulin or oral hypoglycemic agents, or self-reported history. We identified infection-related hospitalizations over the years 2003–2012. We fit Cox proportional hazards models to assess the association of diabetes with hazard rates of infection and logistic regression models for 28-day mortality. Among 29 683 patients from the REGARDS study with complete follow-up, 7375 had diabetes. Over a median follow-up period of 6.5 years, we identified 2593 first and 3411 total infection hospitalizations. In adjusted analyses, participants with diabetes had an increased hazard of infection (hazard ratio, 1.50; 95% confidence interval [CI], 1.37–1.64) compared with those without diabetes. Participants with diabetes hospitalized for infection did not have an increased odds of death within 28 days (odds ratio, 0.94; 95% CI, .67–1.32). Participants receiving insulin therapy had greater hazard of infection (hazard ratio, 2.18; 95% CI, 1.90–2.51) but no increased odds of mortality (odd ratio, 1.07; 95% CI, .67–1.71). Diabetes is associated with increased risk of hospitalization for infection. However, we did not find an association with 28-day mortality. Insulin therapy conferred an even greater risk of hospitalization, without incre Continue reading >>

Postprandial Glucose Test

Postprandial Glucose Test

Changes in blood glucose over time following a high and low glycemic index (GI) carbohydrate. A postprandial glucose test is a blood glucose test that determines the amount of a type of sugar, called glucose, in the blood after a meal. Glucose is mainly made from carbohydrate foods. It is the main source of energy used by the body. Normally, blood glucose levels increase slightly after eating. This increase causes the pancreas to release insulin, which assists the body in removing glucose from the blood and storing it for energy. People with diabetes may not produce or respond properly to insulin, which causes their blood glucose to remain elevated. Blood glucose levels that remain high over time can damage the eyes, kidneys, nerves, and blood vessels. A 2-hour postprandial blood glucose test ("2 hour p.c. blood glucose test", etc.) measures blood glucose exactly 2 hours after eating a meal,[1] timed from the start of the meal. [2] By this point blood sugar has usually gone back down in healthy people, but it may still be elevated in people with diabetes. Thus, it serves as a test of whether a person may have diabetes, or of whether a person who has diabetes is successfully controlling their blood sugar. Purpose[edit] Blood glucose tests are done to: Check for and monitor the treatment of diabetes.[1] Check for diabetes that occurs during pregnancy gestational diabetes.[1] Determine if an abnormally low blood sugar level hypoglycemia is present.[1] Procedure[edit] For a 2-hour postprandial test, a meal is eaten exactly 2 hours before the blood sample is taken. A home blood sugar test is the most common way to check 2-hour postprandial blood sugar levels. The health professional taking a blood sample will:[1] Wrap a tourniquet around the upper arm to stop the flow of blo Continue reading >>

Dry Eye Syndrome In Patients With Diabetes Mellitus: Prevalence, Etiology, And Clinical Characteristics

Dry Eye Syndrome In Patients With Diabetes Mellitus: Prevalence, Etiology, And Clinical Characteristics

Journal of Ophthalmology Volume 2016 (2016), Article ID 8201053, 7 pages Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Tongren Hospital, Capital Medical University, Beijing 100730, China Academic Editor: Flavio Mantelli Copyright © 2016 Xinyuan Zhang 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. Linked References M. R. Manaviat, M. Rashidi, M. Afkhami-Ardekani, and M. R. Shoja, “Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients,” BMC Ophthalmology, vol. 8, article 10, 2008. View at Publisher · View at Google Scholar · View at Scopus Dry eye syndrome, NICE CKS, September 2012 (UK access only). J. Nepp, C. Abela, I. Polzer, A. Derbolav, and A. Wedrich, “Is there a correlation between the severity of diabetic retinopathy and keratoconjunctivitis sicca?” Cornea, vol. 19, no. 4, pp. 487–491, 2000. View at Publisher · View at Google Scholar · View at Scopus “Research in dry eye: report of the Research Subcommittee of the International Dry Eye WorkShop (2007),” The Ocular Surface, vol. 5, no. 2, pp. 179–193, 2007. H. Liu, M. Sheng, Y. Liu et al., “Expression of SIRT1 and oxidative stress in diabetic dry eye,” International Journal of Clinical and Experimental Pathology, vol. 8, no. 6, pp. 7644–7653, 2015. View at Google Scholar · View at Scopus S. Imam, R. B. Elagin, and J. C. Jaume, “Diabetes-associated dry eye syndrome in a new humanized transgenic model of type 1 diabetes,” Molecular Vision, vol. 19, pp. 1259–1267, 2013. View at Google Scholar · View at Scopus C. Ramos-Remus, M. Suarez-Almazor, and A. S. Russell, Continue reading >>

Diabetes Self Management Education Course

Diabetes Self Management Education Course

Amy Bouthillette Clinical Dietitian, Certified Diabetes Educator Adult Nurse Practitioner, Certified Diabetes Educator Type 2 Diabetes Cells do not use insulin properly Not enough insulin being produced Generally develops in adulthood Becoming more common in children due to obesity Common in persons who are overweight Many different ways to treat, including diet and exercise, pills, or insulin Insulin Resistance Common in persons who are overweight Insulin not as effective, and does not allow glucose into cells efficiently, causing blood sugar levels to rise There is enough insulin activity to prevent diabetic coma What Is Diabetes: How Insulin Works cell Receptor Site Insulin Fills Receptor Sites Insulin Passageways cell insulin insulin glucose glucose glucose What Is Diabetes: Insulin Resistance Due to Excess Weight insulin insulin glucose glucose cell glucose glucose Chart1 70 Early am 10 100 Breakfast 90 118 Late am 108 80 Lunch 70 100 Early pm 90 80 Dinner 70 100 Late pm 90 80 Snack 70 100 Overnight 90 Sheet1 70 Early am 10 100 Breakfast 90 118 Late am 108 80 Lunch 70 100 Early pm 90 80 Dinner 70 100 Late pm 90 80 Snack 70 100 Overnight 90 Not Good Good Control 6 Know Your Number A1c 13 12 7 5 8 11 Blood Sugar 9 180 210 270 300 360 14 10 240 Poor Control Pretty Good Monitoring Your Diabetes: What does an A1c mean An A1c measures how much sugar has been sticking to red blood cells over a 3 month period of time. An A1c is a measure of long-term diabetes control. Goal is A1c <7 Monitoring Your Diabetes: What is an A1c Red blood cell Normal Blood Glucose Above-Normal Blood Glucose Red blood cell Glucose particles The higher your blood sugar, the more sugar that sticks to your red cells and the higher your A1c Testing Sugars- How often? Depends what kinds of medicine yo Continue reading >>

Am I Diabetic? - Fasting Sugar 122, Pp Level Of 103 After Eating Rice And Orange Juice

Am I Diabetic? - Fasting Sugar 122, Pp Level Of 103 After Eating Rice And Orange Juice

by Chandra (Pune) QUESTION: I had my complete body checkup two days back. My fasting Sugar level is 122 mg/dl and the PP level after two hours of breakfast (steamed rice food and orange juice) the level is 103 mg/dl.The doctor says its a pre diabetes stage and advised me for HbA1C test. **My question is why my fasting level is high when compared to PP level a total diff of around 20 mg/dl**. six month back my fasting was 117 mg/dl and PP 132 mg/dl but Doc didn't advised me anything and said everything is normal. My Dad Has diabetes. ANSWER: Hi Chandra, It is very good that you are making blood glucose test every six months and every responsible person has to do this. Regarding your results, you have to know that it all depends on several things factors: 1. First, a normal blood glucose level is considered between 64.8 and 104.4mg/dL, and a lot of hormones are taking a part in the regulation of this blood glucose concentration. Because of this slight elevation of the blood glucose concentration may appear when the secretion of certain hormones is elevated. Pay attention that some hormones like - glucagon, adrenalin and others are elevating the blood glucose concentration and only one hormone – insulin, is reducing it. Next, when you are waking up, the secretion of glucagon and adrenalin is increased, which is causing slight blood glucose elevation, like in your case 122mg/dl. Remember that this value can vary from one day to another. In case a person is a pre-diabetic, his/her fasting blood glucose has to be 129 mg/dl or higher. 2.Second thing is that the blood glucose concentration depends on your diet. For example, you may have normal insulin secretion, but when you are eating a lot of carbs, your blood glucose concentration is going to be elevated. Therefore, if you Continue reading >>

What Is The Normal Range Of Fasting Sugar And Pp Sugar

What Is The Normal Range Of Fasting Sugar And Pp Sugar

Fasting blood sugar (after 8 to 12 hour fasting) < 100 mg/dL.(100 to 125 mg/dL is considered as prediabetes and > 126 mg/dL is considered as diabetes.) Post-prandial blood sugar (2 hours after taking food) < 140 mg/dL.(140 to 199 mg/dL is considered as prediabetes and > 200 mg/dL is considered as doabetes. Sources:-- Continue reading >>

Hypoglycemia In Diabetes

Hypoglycemia In Diabetes

(B) Epidural or spinal hematomas may occur in patients treated with ELIQUIS who are receiving neuraxial anesthesia or undergoing spinal puncture. These hematomas may result in long-term or permanent paralysis. Consider these risks when scheduling patients for spinal procedures. Factors that can increase the risk of developing epidural or spinal hematomas in these patients include: Increased Risk of Thrombotic Events after Premature Discontinuation: Premature discontinuation of any oral anticoagulant, including ELIQUIS, in the absence of adequate alternative anticoagulation increases the risk of thrombotic events. An increased rate of stroke was observed during the transition from ELIQUIS to warfarin in clinical trials in atrial fibrillation patients. If ELIQUIS is discontinued for a reason other than pathological bleeding or completion of a course of therapy, consider coverage with another anticoagulant. Concomitant use of drugs affecting hemostasis increases the risk of bleeding, including aspirin and other antiplatelet agents, other anticoagulants, heparin, thrombolytic agents, SSRIs, SNRIs, and NSAIDs. Advise patients of signs and symptoms of blood loss and to report them immediately or go to an emergency room. Discontinue ELIQUIS in patients with active pathological hemorrhage. Spinal/Epidural Anesthesia or Puncture: Patients treated with ELIQUIS undergoing spinal/epidural anesthesia or puncture may develop an epidural or spinal hematoma which can result in long-term or permanent paralysis. The risk of these events may be increased by the postoperative use of indwelling epidural catheters or the concomitant use of medicinal products affecting hemostasis. Indwelling epidural or intrathecal catheters should not be removed earlier than 24 hours after the last administr Continue reading >>

Model For Simulating Fasting Glucose In Type 2 Diabetes And The Effect Of Adherence To Treatment 1

Model For Simulating Fasting Glucose In Type 2 Diabetes And The Effect Of Adherence To Treatment 1

Abstract The primary goal of this paper is to predict fasting glucose levels in type 2 diabetes (T2D) in long-acting insulin treatment. The paper presents a model for simulating insulin-glucose dynamics in T2D patients. The model combines a physiological model of type 1 diabetes (T1D) and an endogenous insulin production model in T2D. We include a review of sources of variance in fasting glucose values in long-acting insulin treatment, with respect to dose guidance algorithms. We use the model to simulate fasting glucose levels in T2D long-acting insulin treatment and compare the results with clinical trial results where a dose guidance algorithm was used. We investigate sources of variance and through simulations evaluate the contribution of adherence to variance and dose guidance quality. The results suggest that the model for simulation of T2D patients is sufficient for simulating fasting glucose levels during titration in a clinical trial. Adherence to insulin injections plays an important role considering variance in fasting glucose. For adherence levels 100%, 70% and 50%, the coefficient of variation of simulated fasting glucose levels were similar to observed variances in insulin treatment. The dose guidance algorithm suggested too large doses in 0.0%, 5.3% and 24.4% of cases, respectively. Adherence to treatment is an important source of variance in long-acting insulin titration. Download full text in PDF Continue reading >>

Diabetes—“the Silent Killer”

Diabetes—“the Silent Killer”

WHEN he was 21 years old, Ken developed a puzzling, unquenchable thirst. He also had to urinate frequently—eventually about every 20 minutes. Soon Ken’s limbs began to feel heavy. He was chronically tired, and his vision became blurry. The turning point came when Ken caught a virus. A visit to the doctor confirmed that Ken had more than the flu—he also had Type 1 diabetes mellitus—diabetes, for short. This chemical disorder disrupts the body’s ability to utilize certain nutrients, primarily a blood sugar called glucose. Ken spent six weeks in the hospital before his blood-sugar level stabilized. That was more than 50 years ago, and treatment has improved considerably during the past half century. Nevertheless, Ken still suffers from diabetes, and he is not alone. It is estimated that worldwide, more than 140 million people have the disorder, and according to the World Health Organization, that number could double by the year 2025. Understandably, experts are concerned about the prevalence of diabetes. “With the numbers we’re starting to see,” says Dr. Robin S. Goland, codirector of a treatment center in the United States, “this could be the beginning of an epidemic.” Consider these brief reports from around the world. AUSTRALIA: According to Australia’s International Diabetes Institute, “diabetes presents one of the most challenging health problems for the 21st century.” INDIA: At least 30 million people have diabetes. “We hardly had any patients under 40 about 15 years ago,” says one doctor. “Today every other person is from this age group.” SINGAPORE: Nearly a third of the population between 30 and 69 years of age have diabetes. Many children—some as young as ten—have been diagnosed. UNITED STATES: Approximately 16 million people Continue reading >>

Educate Physicians And Nurses On Practical Management Tips For Diabetes Control.

Educate Physicians And Nurses On Practical Management Tips For Diabetes Control.

Type 2 Diabetes Common in Hispanics, Native Americans and Pima Indians Incidence of ESRD is lower, but the disease is more frequent – thus it is the most common cause of renal failure United Kingdom Prospective Diabetes Study UKPDS – large British study, (predominantly Caucasians) Adler, AI, Stevens, RJ, Manley, SE, Bilous, RW, Cull, CA & Holman, RR: Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int, 63:225-32, 2003. Incidence of microalbuminuria 25% but incidence of ESRD only 0.8% Microlbuminuria patients spent an average of 11 years before progressing to overt proteinuria Only 2.3% progress from macroalbuminuria to ESRD 1. Hypertension in people with Type 2 diabetes: knowledge-based diabetes-specific guidelines. Diabet Med, 20:972-87, 2003. 2. Abbott, KC & Bakris, GL: What have we learned from the current trials? Med Clin North Am, 88:189-207, 2004. 3. Anderson, PW, McGill, JB & Tuttle, KR: Protein kinase C beta inhibition: the promise for treatment of diabetic nephropathy. Curr Opin Nephrol Hypertens, 16:397-402, 2007. 4. Baghdasarian, SB, Jneid, H & Hoogwerf, BJ: Association of dyslipidemia and effects of statins on nonmacrovascular diseases. Clin Ther, 26:337-51, 2004. 5. Bakris, GL, Weir, MR, Shanifar, S, Zhang, Z, Douglas, J, van Dijk, DJ & Brenner, BM: Effects of blood pressure level on progression of diabetic nephropathy: results from the RENAAL study. Arch Intern Med, 163:1555-65, 2003. 6. Bando, Y, Ushiogi, Y, Okafuji, K, Toya, D, Tanaka, N & Miura, S: Non-autoimmune primary hypothyroidism in diabetic and non-diabetic chronic renal dysfunction. Exp Clin Endocrinol Diabetes, 110:408-15, 2002. 7. Berl, T, Hunsicker, LG, Lewis, JB, Pfeffer, MA, Porush, JG, Rouleau, JL Continue reading >>

File Formats Help:

File Formats Help:

Technical Notes: Please do not alter the format of the slides you download. If format is altered the CDC logo must be removed, but citation source for the data should be included. To incorporate slides into your presentation— Download the PowerPoint file to your hard drive Open the presentation into which you want to incorporate slides On the Insert menu, click Slides from Files. Click Browse to locate the file you downloaded and select the file. Then click Open. Select the Keep source formatting check box and click Insert All. Continue reading >>

Controlling Blood Sugar In Diabetes: How Low Should You Go?

Controlling Blood Sugar In Diabetes: How Low Should You Go?

Diabetes is an ancient disease, but the first effective drug therapy was not available until 1922, when insulin revolutionized the management of the disorder. Insulin is administered by injection, but treatment took another great leap forward in 1956, when the first oral diabetic drug was introduced. Since then, dozens of new medications have been developed, but scientists are still learning how best to use them. And new studies are prompting doctors to re-examine a fundamental therapeutic question: what level of blood sugar is best? Normal metabolism To understand diabetes, you should first understand how your body handles glucose, the sugar that fuels your metabolism. After you eat, your digestive tract breaks down carbohydrates into simple sugars that are small enough to be absorbed into your bloodstream. Glucose is far and away the most important of these sugars, and it's an indispensable source of energy for your body's cells. But to provide that energy, it must travel from your blood into your cells. Insulin is the hormone that unlocks the door to your cells. When your blood glucose levels rise after a meal, the beta cells of your pancreas spring into action, pouring insulin into your blood. If you produce enough insulin and your cells respond normally, your blood sugar level drops as glucose enters the cells, where it is burned for energy or stored for future use in your liver as glycogen. Insulin also helps your body turn amino acids into proteins and fatty acids into body fat. The net effect is to allow your body to turn food into energy and to store excess energy to keep your engine running if fuel becomes scarce in the future. A diabetes primer Diabetes is a single name for a group of disorders. All forms of the disease develop when the pancreas is unable to Continue reading >>

Diabetes Mellitus Treatment

Diabetes Mellitus Treatment

In patients diagnosed with diabetes mellitus (DM), the therapeutic focus is on preventing complications caused by hyperglycemia. In the United States, 57.9% of patients with diabetes have one or more diabetes-related complications and 14.3% have three or more.[1] Strict control of glycemia within the established recommended values is the primary method for reducing the development and progression of many complications associated with microvascular effects of diabetes (eg, retinopathy, nephropathy, and neuropathy), while aggressive treatment of dyslipidemia and hypertension further decreases the cardiovascular complications associated macrovascular effects.[2-4] See the chapter on diabetes: Macro- and microvascular effects. Glycemic Control Two primary techniques are available to assess a patient's glycemic control: Self-monitoring of blood glucose (SMBG) and interval measurement of hemoglobin A1c (HbA1c). Self-Monitoring of Blood Glucose Use of SMBG is an effective method to evaluate short-term glycemic control. It helps patients and physicians assess the effects of food, medications, stress, and activity on blood glucose levels. For patients with type 1 DM or insulin-dependent type 2 DM, clinical trials have demonstrated that SMBG plays a role in effective glycemic control because it helps to refine and adjust insulin doses by monitoring for and preventing asymptomatic hypoglycemia as well as preprandial and postprandial hyperglycemia.[2,5-7] The frequency of SMBG depends on the type of medical therapy, risk for hypoglycemia, and need for short-term adjustment of therapy. The current American Diabetes Association (ADA) guidelines recommend that patients with diabetes self-monitor their glucose at least three times per day.[8] Those who use basal-bolus regimens should s Continue reading >>

More in diabetes