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Early Treatment Of Diabetes

Early Detection Of Type 2 Diabetes Reduces Death Caused By Cardiovascular Disease

Early Detection Of Type 2 Diabetes Reduces Death Caused By Cardiovascular Disease

Home / Conditions / Type 2 Diabetes / Early Detection of Type 2 Diabetes Reduces Death Caused by Cardiovascular Disease Early Detection of Type 2 Diabetes Reduces Death Caused by Cardiovascular Disease Early detection and treatment of type 2 diabetes may be more beneficial than aggressive control of blood glucose, blood pressure and cholesterol Screening to identify type 2 diabetes followed by early treatment could result in substantial health benefits, according to new research that combined large scale clinical observations and innovative computer modelling. The study, led by researchers at the University of Michigan Medical School and the MRC Epidemiology Unit, University of Cambridge, used data from the ADDITION-Europe study of diabetes screening and treatment, which it combined with a computer simulation model of diabetes progression. This approach revealed that screening followed by treatment led to a reduced risk of cardiovascular disease or death within a five-year follow-up period when compared to patients having no screening. Diabetes can be debilitating for patients and costly for healthcare, says William Herman, M.D., lead author of the paper and a professor at the University of Michigan Medical School. This research shows that the early identification of diabetes has major health benefits, and supports the introduction of measures such as screening to reduce the time between development of Type 2 diabetes and its treatment. Professor Nick Wareham, senior author on the paper and director of the MRC Epidemiology Unit, University of Cambridge, added: This work shows the value of public health modelling to assess impacts and interventions for diseases such as type 2 diabetes that pose an increasing public health challenge. At 10 years after baseline, the simul Continue reading >>

Treating Diabetes With Diet And Exercise

Treating Diabetes With Diet And Exercise

Recently, I was reading some of the readers’ postings on this Web site. Some of these postings expressed fairly strong opinions about how one should best manage his or her diabetes. Of course, one of the many good things about living in the United States is our right to freedom of speech, and postings such as these certainly get people thinking. However, it’s all too common for misconceptions about diabetes to abound. Whether it’s the belief that eating sugar causes diabetes, or that starting on insulin can make you go blind, or that having to start taking diabetes pills or insulin means that you’re a “bad diabetic,” as a dietitian and diabetes educator, I feel compelled to set the record straight whenever I can. So, what’s the best way to control diabetes? When it comes to Type 1 diabetes, which accounts for 5% to 10% of all diabetes cases, that’s a no-brainer. A person with Type 1 diabetes must take insulin to survive. His pancreas has—to put it simply—”pooped out,” meaning that it no longer makes enough insulin. Of course, a person with Type 1 diabetes has choices as to how he takes insulin. The choices nowadays range from the traditional vial and syringe to an insulin pen to an insulin pump to an inhaler. The future holds more possibilities for insulin delivery as well. People with Type 1 diabetes must still incorporate meal planning and physical activity into their daily management. About 90% to 95% of people with diabetes have Type 2. But Type 2 diabetes is a little less clear-cut in terms of how it’s best managed. The reason is that Type 2 diabetes is a progressive condition. When someone is first diagnosed with Type 2 diabetes, the cornerstones of management are often, initially, what many health-care professionals term “diet and exer Continue reading >>

Treating Diabetes: 1921 To The Present Day

Treating Diabetes: 1921 To The Present Day

The lives of people with diabetes has changed considerably in 50 years. They now have specific tools and easier access to information than ever before. The healthcare professionals who treat them also know more about the complexity of the disease, and which treatments work best. Pending the next medical revolution, Diabetes Québec is demanding the implementation of a national strategy to fight diabetes – a strategy founded on education, prevention, support and treatment. The last 60 years have clearly demonstrated that people with diabetes who are well informed, properly supported and treated appropriately live longer lives in better health. The discovery of insulin and glycemic control Insulin, discovered in 1921 by the legendary Banting, Best and MacLeod collaboration, is nothing short of a miracle. Worldwide, it has saved thousands of patients from certain death. Before the discovery of insulin, diabetics were doomed. Even on a strict diet, they could last no more than three or four years. However, despite the many types of insulin and the first oral hypoglycemic agents that came to market around 1957 in Canada, glycemia control – the control of blood glucose (sugar) levels – still remains an imprecise science. In the 1950s, the method a person used to control his blood glucose levels was to drop a reagent tablet into a small test tube containing a few drops of urine mixed with water. The resulting colour – from dark blue to orange – indicated the amount of sugar in the urine. Even when they monitored their patients closely, doctors realized that blood glucose levels had to be much better controlled in order to delay the major complications significantly affecting their patients’ lives: blindness, kidney disease, gangrene, heart attack and stroke. A disc Continue reading >>

Diagnosis

Diagnosis

Print The American Diabetes Association (ADA) recommends that blood glucose screening for adults begin at age 45, or sooner if you are overweight and have additional risk factors for prediabetes or type 2 diabetes. There are several blood tests for prediabetes. Glycated hemoglobin (A1C) test This test indicates your average blood sugar level for the past two to three months. Specifically, the test 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. In general: An A1C level below 5.7 percent is considered normal An A1C level between 5.7 and 6.4 percent is considered prediabetes An A1C level of 6.5 percent or higher on two separate tests indicates type 2 diabetes Certain conditions can make the A1C test inaccurate — such as if you are pregnant or have an uncommon form of hemoglobin (hemoglobin variant). Fasting blood sugar test A blood sample is taken after you fast for at least eight hours or overnight. In general: A fasting blood sugar level below 100 milligrams per deciliter (mg/dL) — 5.6 millimoles per liter (mmol/L) — is considered normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 7.0 mmol/L) is considered prediabetes. This result is sometimes called impaired fasting glucose. A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher indicates type 2 diabetes. Oral glucose tolerance test This test is usually used to diagnose diabetes only during pregnancy. A blood sample is taken after you fast for at least eight hours or overnight. Then you'll drink a sugary solution, and your blood sugar level will be measured again after two hours. In general: A blood sugar level less than 140 mg/dL (7.8 mmo Continue reading >>

Can Early Diabetes Be Controlled Or Completely Stopped?

Can Early Diabetes Be Controlled Or Completely Stopped?

Type 2 or adult-onset diabetes is one of the most significant threats to health today. Most cases are linked to the epidemic of obesity. The long-term consequences of diabetes include cardiovascular diseases such as stroke, heart attack and peripheral vascular disease. Diabetes is also a leading cause of blindness, kidney failure and leg amputation. Attention to diet, exercise and even a small weight loss can help someone with diabetes, or especially pre-diabetes. This is a metabolic disease, meaning it is an issue of energy balance. In normal physiology, when the amount of food energy consumed, measured in calories, exceeds the amount of energy burned, the body converts and saves the excess energy as fat. Type 2 diabetes mellitus is a resistance to the hormone insulin, which causes sugar or glucose to enter muscle and organs of the body. For reasons that are poorly understood, some people's tissues become less sensitive to insulin as the body stores more fat. The results are a rise in blood sugar levels and the long-term consequences described above. I prefer to think of diabetes as a disease with a white-to-black spectrum of severity and a broad gray area. For those who have pre-diabetes or even mild diabetes, one can take steps to move toward the lighter gray or white area of the spectrum, with small improvements in diet, small increases in activity and loss of just a few pounds. I am hesitant to say that diabetes is cured, but it can often be controlled, and one can return to normal blood sugars without the need for diabetes medicines, and the risk of diabetic complications are significantly reduced. This is rare and more difficult but not impossible for severe diabetics. Many who progress to diabetes could have prevented it by maintaining a lower and not necessaril Continue reading >>

Prediabetes

Prediabetes

What Is Prediabetes? Prediabetes is a “pre-diagnosis” of diabetes—you can think of it as a warning sign. It’s when your blood glucose level (blood sugar level) is higher than normal, but it’s not high enough to be considered diabetes. Prediabetes is an indication that you could develop type 2 diabetes if you don’t make some lifestyle changes. But here's the good news: . Eating healthy food, losing weight and staying at a healthy weight, and being physically active can help you bring your blood glucose level back into the normal range. Diabetes develops very gradually, so when you’re in the prediabetes stage—when your blood glucose level is higher than it should be—you may not have any symptoms at all. You may, however, notice that: you’re hungrier than normal you’re losing weight, despite eating more you’re thirstier than normal you have to go to the bathroom more frequently you’re more tired than usual All of those are typical symptoms associated with diabetes, so if you’re in the early stages of diabetes, you may notice them. Prediabetes develops when your body begins to have trouble using the hormone insulin. Insulin is necessary to transport glucose—what your body uses for energy—into the cells via the bloodstream. In pre-diabetes, your body either doesn’t make enough insulin or it doesn’t use it well (that’s called insulin resistance). If you don’t have enough insulin or if you’re insulin resistant, you can build up too much glucose in your blood, leading to a higher-than-normal blood glucose level and perhaps prediabetes. Researchers aren’t sure what exactly causes the insulin process to go awry in some people. There are several risk factors, though, that make it more likely that you’ll develop pre-diabetes. These are Continue reading >>

Early Insulin Treatment In Type 2 Diabetes

Early Insulin Treatment In Type 2 Diabetes

What are the pros? The prevalence of diabetes in the world is growing at an unprecedented rate and rapidly becoming a health concern and burden in both developed and developing countries (1). In addition, we are now witnessing an upsurge in the incidence of type 2 diabetes in children and adolescents, with the potential of translating into a future catastrophic disease burden as vascular complications of the disease begin affecting a younger population. Although there may be contention regarding the impact of lowering glycemia on macrovascular disease risk, there is strong consensus of the definite benefits of lowering blood glucose to reduce the risk of retinopathy and nephropathy in either type 1 or type 2 diabetes (2,3). Despite supporting data and multiple guidelines advanced by professional organizations, overall glycemic control falls far below expectations (4). Overall, <36% of individuals with diabetes are at recommended glycemic targets, with the most difficult-to-control cases represented by insulin-deficient individuals on insulin therapy to manage their diabetes (4). Furthermore, as β-cell dysfunction progresses over time, many patients with type 2 diabetes, treated with oral agents, fail to achieve or maintain adequate glycemic control. Unfortunately, in many of these cases, antiglycemic therapy is not adjusted or advanced, thereby exposing patients to prolonged hyperglycemia and the increased risk of diabetes-related complications. The term “clinical inertia,” which has come to define the lack of initiation, or intensification of therapy when clinically indicated (5), is most pronounced in the setting of insulin initiation. Subjects with type 2 diabetes, managed in a large integrated health care system, were initiated on additional blood glucose–low Continue reading >>

Supplement Review The Early Treatment Of Type 2 Diabetes

Supplement Review The Early Treatment Of Type 2 Diabetes

Abstract The growing epidemic of type 2 diabetes is one of the leading causes of premature morbidity and mortality worldwide, mainly due to the micro- and macrovascular complications associated with the disease. A growing body of evidence suggests that although the risk of developing complications is greater with glucose levels beyond the established threshold for diagnosis – increasing in parallel with rising hyperglycemia—individuals with glucose levels in the prediabetic range are already at increased risk. Early intervention, ideally as soon as abnormalities in glucose homeostasis are detected, is of great importance to minimize the burden of the disease. However, as the early stages of the disease are asymptomatic, diagnosing prediabetes and early overt type 2 diabetes is challenging. The aim of this article is to discuss these challenges, the benefits of early intervention—with emphasis on the prevention trials showing that progression to type 2 diabetes can be delayed by addressing prediabetes—and the existing evidence-based guidelines that have been drawn to optimize the standards of care at the prediabetes and overt type 2 diabetes stages. Funding: The publication of this article was funded by Novo Nordisk Inc. Conflict of Interest: REP has received Research/Clinical Trial Support from GlaxoSmithKline, Lilly, Mannkind, Merck, Novartis, Novo Nordisk, Pfizer, Roche, Sanofi and Takeda; and has attended Advisory Panel/acted as a Consultant or Speaker for AstraZeneca/Bristol-Myers Squibb, Eisai, GlaxoSmithKline, Lexicon, Mannkind, Merck, Novo Nordisk, Novartis, Roche, Sanofi and Takeda. As of June 2011, all honoraria are directed to a nonprofit foundation. Authorship: Writing support was provided by Watermeadow Medical. The author takes responsibility for th Continue reading >>

Type 2 Diabetes

Type 2 Diabetes

Print Diagnosis To diagnose type 2 diabetes, you'll be given a: 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 hemoglobin, the oxygen-carrying protein in red blood cells. 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 you have diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes. Normal levels are below 5.7 percent. If the A1C test isn't available, or if you have certain conditions — such as if you're pregnant or have an uncommon form of hemoglobin (known as a hemoglobin variant) — that can make the A1C test inaccurate, your doctor may use the following tests to diagnose diabetes: Random blood sugar test. A blood sample will be taken at a random time. 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. Oral glucose tolerance test. For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood s Continue reading >>

Prediabetes - Treatment Overview

Prediabetes - Treatment Overview

Your treatment for prediabetes will focus on losing weight, eating healthy foods, and getting active. This is your chance to reverse prediabetes so it doesn't turn into type 2 diabetes. Doing these things will also help you avoid other health problems, such as heart disease and stroke, that are linked to diabetes. You may also need to take diabetes medicine along with doing these things. Most people who have prediabetes are overweight and have a body mass index (BMI) of 25 or higher. To find out your BMI, use the Interactive Tool: Is Your BMI Increasing Your Health Risks? If you have a BMI of 25 or higher, try to lose 5% to 10% of your body weight. For example, if you weigh 200 pounds, aim to lose 10 to 20 pounds. A healthy weight helps your body use insulin the way it should. Losing weight can also lower insulin resistance in people who have prediabetes. The more you lose, the more you benefit, as long as you do it in a healthy way. How you do it is up to you. One way to start is by making healthy eating changes that you can keep doing over time. Try reducing the number of calories you eat and drink and adding more activity to your day. For help, see the topic Weight Management. One Man's Story: Jerry, 54 Jerry signed up for a weight-loss program and started a daily food diary to track what and when he ate. He added walks around the neighborhood and visits to the gym to his routine. In 7 months, he dropped 25 pounds-about 10% of his body weight. "It hasn't been easy. I've had some ups and downs, especially over the holidays. Hey, I love to eat. Sometimes it's hard to stay focused. But tracking what, when, and why I eat helps me to eat less."-Jerry Eating a balanced diet is one of the best things you can do for yourself and for your health. Try to: Limit the amount of u Continue reading >>

The Early Treatment Of Type 2 Diabetes

The Early Treatment Of Type 2 Diabetes

Abstract The growing epidemic of type 2 diabetes is one of the leading causes of premature morbidity and mortality worldwide, mainly due to the micro- and macrovascular complications associated with the disease. A growing body of evidence suggests that although the risk of developing complications is greater with glucose levels beyond the established threshold for diagnosis – increasing in parallel with rising hyperglycemia—individuals with glucose levels in the prediabetic range are already at increased risk. Early intervention, ideally as soon as abnormalities in glucose homeostasis are detected, is of great importance to minimize the burden of the disease. However, as the early stages of the disease are asymptomatic, diagnosing prediabetes and early overt type 2 diabetes is challenging. The aim of this article is to discuss these challenges, the benefits of early intervention—with emphasis on the prevention trials showing that progression to type 2 diabetes can be delayed by addressing prediabetes—and the existing evidence-based guidelines that have been drawn to optimize the standards of care at the prediabetes and overt type 2 diabetes stages. Continue reading >>

The Early Treatment Of Type 2 Diabetes.

The Early Treatment Of Type 2 Diabetes.

Abstract The growing epidemic of type 2 diabetes is one of the leading causes of premature morbidity and mortality worldwide, mainly due to the micro- and macrovascular complications associated with the disease. A growing body of evidence suggests that although the risk of developing complications is greater with glucose levels beyond the established threshold for diagnosis--increasing in parallel with rising hyperglycemia-individuals with glucose levels in the prediabetic range are already at increased risk. Early intervention, ideally as soon as abnormalities in glucose homeostasis are detected, is of great importance to minimize the burden of the disease. However, as the early stages of the disease are asymptomatic, diagnosing prediabetes and early overt type 2 diabetes is challenging. The aim of this article is to discuss these challenges, the benefits of early intervention--with emphasis on the prevention trials showing that progression to type 2 diabetes can be delayed by addressing prediabetes--and the existing evidence-based guidelines that have been drawn to optimize the standards of care at the prediabetes and overt type 2 diabetes stages. KEYWORDS: Complications; Diabetes prevention trials; Diagnosis; Early intervention; Prediabetes Continue reading >>

Early Detection And Treatment Of Type 2 Diabetes Reduce Cardiovascular Morbidity And Mortality: A Simulation Of The Results Of The Anglo-danish-dutch Study Of Intensive Treatment In People With Screen-detected Diabetes In Primary Care (addition-europe)

Early Detection And Treatment Of Type 2 Diabetes Reduce Cardiovascular Morbidity And Mortality: A Simulation Of The Results Of The Anglo-danish-dutch Study Of Intensive Treatment In People With Screen-detected Diabetes In Primary Care (addition-europe)

OBJECTIVE To estimate the benefits of screening and early treatment of type 2 diabetes compared with no screening and late treatment using a simulation model with data from the ADDITION-Europe study. RESEARCH DESIGN AND METHODS We used the Michigan Model, a validated computer simulation model, and data from the ADDITION-Europe study to estimate the absolute risk of cardiovascular outcomes and the relative risk reduction associated with screening and intensive treatment, screening and routine treatment, and no screening with a 3- or 6-year delay in the diagnosis and routine treatment of diabetes and cardiovascular risk factors. RESULTS When the computer simulation model was programmed with the baseline demographic and clinical characteristics of the ADDITION-Europe population, it accurately predicted the empiric results of the trial. The simulated absolute risk reduction and relative risk reduction were substantially greater at 5 years with screening, early diagnosis, and routine treatment compared with scenarios in which there was a 3-year (3.3% absolute risk reduction [ARR], 29% relative risk reduction [RRR]) or a 6-year (4.9% ARR, 38% RRR) delay in diagnosis and routine treatment of diabetes and cardiovascular risk factors. CONCLUSIONS Major benefits are likely to accrue from the early diagnosis and treatment of glycemia and cardiovascular risk factors in type 2 diabetes. The intensity of glucose, blood pressure, and cholesterol treatment after diagnosis is less important than the time of its initiation. Screening for type 2 diabetes to reduce the lead time between diabetes onset and clinical diagnosis and to allow for prompt multifactorial treatment is warranted. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properl Continue reading >>

History Of Diabetes: Past Treatments And New Discoveries

History Of Diabetes: Past Treatments And New Discoveries

Diabetes is a condition characterized by high blood sugar levels. It affects millions of people around the world. Research into diabetes is ongoing but diabetes is simple to manage for most people. Since diabetes was first discovered, there have been huge improvements in the way it is treated. This article looks at the history of diabetes and how these treatments developed. Contents of this article: Diabetes affects blood sugar levels The body gets energy from sugar (glucose), which is broken down from the food people eat. Diabetes affects insulin. Insulin is a hormone produced in the pancreas that helps in the process of using this sugar efficiently. People with type 1 diabetes do not produce insulin. People who have type 2 diabetes do produce insulin, but their body is unable to use it efficiently. When a person has diabetes, the lack of insulin or the body's inability to use it properly, causes sugar to stay in the blood rather than entering the cells to be used for energy. This excess sugar in the blood results in higher than normal blood sugar levels. Having high blood sugar levels for an extended period can cause serious and even life-threatening problems. However, there are many ways the condition can be managed so that these problems are avoided. Early science around diabetes Understanding the history of diabetes and how it was first treated can help us to appreciate how well it is understood and managed today. Discovery of diabetes The full name for diabetes is diabetes mellitus. This term comes from the Greek word "diabetes" (to siphon or pass through) and the Latin word "mellitus" (honey or sweet). The first use of the term "diabetes" can be traced back to Apollonius of Memphis around 250 BC. The first English record of diabetes in a medical text occurred aro Continue reading >>

The History Of Diabetes

The History Of Diabetes

Scientists and physicians have been documenting the condition now known as diabetes for thousands of years. From the origins of its discovery to the dramatic breakthroughs in its treatment, many brilliant minds have played a part in the fascinating history of diabetes. Diabetes: Its Beginnings The first known mention of diabetes symptoms was in 1552 B.C., when Hesy-Ra, an Egyptian physician, documented frequent urination as a symptom of a mysterious disease that also caused emaciation. Also around this time, ancient healers noted that ants seemed to be attracted to the urine of people who had this disease. In 150 AD, the Greek physician Arateus described what we now call diabetes as "the melting down of flesh and limbs into urine." From then on, physicians began to gain a better understanding about diabetes. Centuries later, people known as "water tasters" diagnosed diabetes by tasting the urine of people suspected to have it. If urine tasted sweet, diabetes was diagnosed. To acknowledge this feature, in 1675 the word "mellitus," meaning honey, was added to the name "diabetes," meaning siphon. It wasn't until the 1800s that scientists developed chemical tests to detect the presence of sugar in the urine. Diabetes: Early Treatments As physicians learned more about diabetes, they began to understand how it could be managed. The first diabetes treatment involved prescribed exercise, often horseback riding, which was thought to relieve excessive urination. In the 1700s and 1800s, physicians began to realize that dietary changes could help manage diabetes, and they advised their patients to do things like eat only the fat and meat of animals or consume large amounts of sugar. During the Franco-Prussian War of the early 1870s, the French physician Apollinaire Bouchardat noted Continue reading >>

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