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Managing Type 2 Diabetes

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 >>

Managing Type 2

Managing Type 2

In type 2 diabetes, your pancreas is still working but not as effectively as it needs to. This means your body is building insulin resistance and is unable to effectively convert glucose into energy leaving too much glucose in the blood. Type 2 diabetes can sometimes initially be managed through lifestyle modification including a healthy diet, regular exercise and monitoring your blood glucose levels. Eating well helps manage your blood glucose levels and your body weight Exercising helps the insulin work more effectively, lowers your blood pressure and reduces the risk of heart disease. Regular blood glucose monitoring tests whether the treatment being followed is adequately controlling blood glucose levels or whether you need to adjust your treatment. The aim of diabetes management is to keep blood glucose levels as close to the target range between 4 to 6 mmol/L (fasting), this will help prevent both short-term and long-term complications. Your healthcare team including your doctor, specialist, dietician and Credential Diabetes Educator, can help you with blood glucose monitoring, healthy eating and physical activity. However, sometimes healthy eating and exercise is not enough to keep the blood glucose levels down. Type 2 diabetes is a progressive condition. As time progresses, the insulin becomes more resistant and the pancreas is less effective converting glucose into energy. To help the pancreas convert glucose into energy, people with type 2 diabetes are often prescribed tablets to control their blood glucose levels. Eventually it may be necessary to start taking insulin to control blood glucose levels. This is when your body is no longer producing enough insulin of its own. Sometimes tablets may be continued in addition to insulin. If you require medication as Continue reading >>

Type 2 Diabetes And Diet: What You Should Know

Type 2 Diabetes And Diet: What You Should Know

Why does my diet matter? It’s no secret that diet is essential to managing type 2 diabetes. Although there isn’t a one-size-fits-all diet for diabetes management, certain dietary choices should act as the foundation for your individual diet plan. Your diet plan should work with your body — not against it — so it’s important that the food you eat won’t spike your blood sugar levels to high. According to the American Diabetes Association, the normal blood sugar range for people with diabetes is between 80 to 130 mg/dL before meals. It should be less than 180 mg/dL about two hours after you begin eating. Your doctor will provide you with personalized target blood sugar values. Keep reading to learn more about how what you eat can affect your blood sugar, as well as which foods you may want to pick up at the grocery store or toss out of your pantry. Check out: Type 1 diabetes diet » When someone with diabetes has low blood sugar (hypoglycemia), a spoonful of sugar or honey can help raise glucose levels. However, sugar is often considered the nemesis of diabetes because of how quickly it can spike blood glucose levels when eaten alone. If you have diabetes, you should closely monitor your consumption of foods with a high glycemic index (GI). The GI measures how quickly a particular food raises blood sugar. Those foods with a high GI can cause unwanted spikes. This is especially true of refined sugar and other forms of simple carbohydrates like white rice, bread, and pasta. Make sure that most of your carb choices are whole-grain, high-fiber options. For example, if you’d like to have a piece of chocolate cake with frosting, eat it immediately after eating a balanced meal with lean protein, healthy fats, vegetables, and high-fiber carb options such as beans. Ea Continue reading >>

Type 2 Diabetes Mellitustreatment & Management

Type 2 Diabetes Mellitustreatment & Management

Type 2 Diabetes MellitusTreatment & Management Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD more... The goals in caring for patients with diabetes mellitus are to eliminate symptoms and to prevent, or at least slow, the development of complications. Microvascular (ie, eye and kidney disease) risk reduction is accomplished through control of glycemia and blood pressure; macrovascular (ie, coronary, cerebrovascular, peripheral vascular) risk reduction, through control of lipids and hypertension, smoking cessation, and aspirin therapy; and metabolic and neurologic risk reduction, through control of glycemia. New abridged recommendations for primary care providers The American Diabetes Association has released condensed recommendations for Standards of Medical Care in Diabetes: Abridged for Primary Care Providers , highlighting recommendations most relevant to primary care. The abridged version focusses particularly on the following aspects: Diagnosis and treatment of vascular complications Intensification of insulin therapy in type 2 diabetes The recommendations can be accessed at American Diabetes Association DiabetesPro Professional Resources Online, Clinical Practice Recommendations 2015 . [ 121 ] Type 2 diabetes care is best provided by a multidisciplinary team of health professionals with expertise in diabetes, working in collaboration with the patient and family. [ 2 ] Management includes the following: Appropriate self-monitoring of blood glucose (SMBG) Ideally, blood glucose should be maintained at near-normal levels (preprandial levels of 90-130 mg/dL and hemoglobin A1C [HbA1c] levels < 7%). However, focus on glucose alone does not provide adequate treatment for patients with diabetes mellitus. Treatment involves multiple goals (ie, Continue reading >>

Management Of Type 2 Diabetes In Adults: Summary Of Updated Nice Guidance

Management Of Type 2 Diabetes In Adults: Summary Of Updated Nice Guidance

Management of type 2 diabetes in adults: summary of updated NICE guidance Management of type 2 diabetes in adults: summary of updated NICE guidance BMJ 2016; 353 doi: (Published 06 April 2016) Cite this as: BMJ 2016;353:i1575 Andrew Farmer, professor of general practice4, on behalf of the Guideline Development Group 1National Institute for Health and Care Excellence, London, UK 2Manchester Mental Health and Social Care Trust, Manchester M21 9UN, UK 3Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK 5Northern Devon Healthcare NHS Trust, Barnstaple EX31 4JB, UK Correspondence to: H McGuire Hugh.McGuire{at}nice.org.uk Glycaemic control is only one aspect of care of type 2 diabetes Inform adults with type 2 diabetes at their annual review that setting an HbA1c target is their choice Metformin remains the first line drug, unless it is contraindicated or not tolerated Do not routinely offer self monitoring of blood glucose to all New evidence and developments regarding the management of blood glucose levels, antiplatelet therapy, and erectile dysfunction prompted this update of the 2009 guidance. There were safety concerns surrounding some blood glucose lowering medicines, new evidence on new dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists, new indications and combinations for licensed drugs, and the potential impact of drugs coming off patent on health and economic issues. New evidence and safety issues relating to the off label use of antiplatelet therapy (aspirin and clopidogrel) in the primary prevention of cardiovascular disease were also considered. Type 2 diabetes affects 6% of the UK population1 and is commonly associated with obesity, physical inactivity, raised blood pr Continue reading >>

Management Of Type 2 Diabetes: Evolving Strategies For The Treatment Of Patients With Type 2 Diabetes

Management Of Type 2 Diabetes: Evolving Strategies For The Treatment Of Patients With Type 2 Diabetes

Go to: 1. Introduction Type 2 diabetes mellitus (T2DM) is a heterogeneous disorder, characterized by defects in insulin secretion and insulin sensitivity [1,2]. Insulin resistance by itself will not result in T2DM unless β-cell secretion of insulin is decreased. Based on the Centers for Disease Control and Prevention National Diabetes Fact Sheet in 2007 [3], there were 23.6 million Americans with diabetes, of whom 90% to 95% have T2DM; 17.9 million of type 2 diabetic patients are diagnosed while 5.7 million are undiagnosed. Diabetes statistics suggest the prevalence rate of prediabetes is 25.9% (impaired fasting glucose and impaired glucose tolerance [IGT]) with 57 million people being affected. The total direct and indirect cost of diabetes in 2007 was 174 billion dollars [3]. The prevalence of obesity and diabetes appears to run parallel to each other, as indicated by the fact that epidemics of obesity and diabetes are parallel in various regions of the United States. For example, the prevalence of obesity has increased from 10% to 14% in 1991 to 20% to 24% in 2001. Similarly, the prevalence of T2DM has increased from 4% to 6% in 1991 to 8% to 10% in 2001 [4]. The nonmodifiable causes of diabetes include age, ethnicity, and genetics, whereas the modifiable causes include weight/body mass index, central adiposity, and sedentary lifestyle. The impact of diabetes on US mortality is significant—72 507 deaths in 2006, the seventh leading cause of death, and an additional 233 269 deaths linked to diabetes [3]. Diabetes mellitus is the leading cause of new blindness and chronic renal disease, leading to dialysis and nontraumatic amputation. The severity of carbohydrate intolerance correlates with cardiovascular disease and mortality. Mortality rate in persons with normal Continue reading >>

How To Manage Type 2 Diabetes

How To Manage Type 2 Diabetes

Edit Article Once you have been diagnosed with type 2 diabetes you need to learn how to manage the disease. You can live a normal, long and healthy life with type 2 diabetes, if you live a healthy lifestyle. High glucose levels causes damage to nerves, kidneys, blood vessels, and eyes. Once diabetes has been diagnosed, then you need to monitor your health closely. 1 2 Follow the food plan as outlined by your physician or dietitian. Acquire the habit of eating slowly to prevent overeating without feeling hungry or deprived to avoid gaining weight. You will feel satisfied with less food; Google "eating slowly" to learn more about it (How and why it works). If you follow a low glycemic diet, you should focus on foods that are below 55. Regulate your carbohydrates throughout the day, eating about the same amount at each meal. Your dietitian or doctor should give you the amount of carbohydrates you should eat each day. Many diabetic diets have you eat three meals and three small snacks throughout the day. 3 Walk at least 20 to 30 minutes most days of the week. Other types of exercise that can help regulate glucose are biking and swimming. You may wish to break your walk into two or three sessions a day, 10 to 15 minuets each. 4 5 Inspect your feet every day to check for bruising, sores, or blisters. Diabetes damages the nerves, with the damage often beginning with the feet decreasing circulation and sensation. 6 See your diabetes team once or more a year: Primary care (or an endocrinologist): twice a year. Podiatrist: once a year for a thorough foot exam. Ophthalmologist: once a year for a thorough eye exam. (Psychologist: if you often eat unhealthily.) 7 Ask your doctor about lowering your blood sugar and the need for insulin or snacks for your sleep (night or day): not eat Continue reading >>

Managing Type 2 Without Meds: 3 Stories

Managing Type 2 Without Meds: 3 Stories

My goal is to be as healthy as I can. If something happens and one day I'm back on medication, my goal is still to be healthy. It had been about a year since Akua Jitahadi felt like herself. But she was 51 and expected menopause to kick in soon. Plus, she and her daughter had just moved to oppressively hot Arizona. So she brushed off the tired, sluggish feeling as a side effect of being a middle-aged woman adjusting to sweltering temps. And then, overnight, her vision dimmed. Something was most definitely wrong. The verdict from her doctor: type 2 diabetes and high blood pressure. "Of course, I broke down in tears," Jitahadi, now 55, says. "I wasn't ready to hear this. I always associated diabetes with 'Oh no, it's really bad.' " After Jitahadi spent a few weeks on medication, her vision cleared and she began to feel better. It didn't last long. "I hated metformin . I had all the colon and digestive issues on it," she says. "I never knew if I would be OK on it or if I'd be nauseous. I'd question whether I wanted to go out with my friends." When she asked for an alternative medication, her doctor said metformin was the best drug for the job, so Jitahadi stuck it out for a year. After that, she decided to make major lifestyle changes in hopes of quitting her medications. That proved more difficult than she had imagined. She hadn't seen a diabetes educator. The only dietitian covered by her insurer was too far away. And her doctor's sole advice was for Jitahadi to watch what she ate. "I was scared in the beginning," says Jitahadi. "It was through friends and starting to read [about diabetes] that I knew I could do this. I could get through this." Jitahadi bought books on diabetes, nutrition, the glycemic index, and diabetes-friendly meals. Instead of slightly modifying he Continue reading >>

Managing Type 2 Diabetes

Managing Type 2 Diabetes

JANUMET tablets contain 2 prescription medicines: sitagliptin (JANUVIA®) and metformin. Once-daily prescription JANUMET XR tablets contain sitagliptin (the medicine in JANUVIA®) and extended-release metformin. JANUMET or JANUMET XR can be used along with diet and exercise to lower blood sugar in adults with type 2 diabetes. JANUMET or JANUMET XR should not be used in patients with type 1 diabetes or with diabetic ketoacidosis (increased ketones in the blood or urine). If you have had pancreatitis (inflammation of the pancreas), it is not known if you have a higher chance of getting it while taking JANUMET or JANUMET XR. Metformin, one of the medicines in JANUMET and JANUMET XR, can cause a rare but serious side effect called lactic acidosis (a buildup of lactic acid in the blood), which can cause death. Lactic acidosis is a medical emergency that must be treated in a hospital. Call your doctor right away if you get any of the following symptoms, which could be signs of lactic acidosis: feel cold in your hands or feet; feel dizzy or lightheaded; have a slow or irregular heartbeat; feel very weak or tired; have unusual (not normal) muscle pain; have trouble breathing; feel sleepy or drowsy; have stomach pains, nausea, or vomiting. Most people who have had lactic acidosis with metformin have other things that, combined with the metformin, led to the lactic acidosis. Tell your doctor if you have any of the following, because you have a higher chance of getting lactic acidosis with JANUMET or JANUMET XR if you: have severe kidney problems or your kidneys are affected by certain x-ray tests that use injectable dye; have liver problems; drink alcohol very often, or drink a lot of alcohol in short-term “binge” drinking; get dehydrated (lose large amounts of body fluids, w Continue reading >>

Weight Management In Type 2 Diabetes: Current And Emerging Approaches To Treatment

Weight Management In Type 2 Diabetes: Current And Emerging Approaches To Treatment

Diabetes is a growing global health concern, as is obesity. Diabetes and obesity are intrinsically linked: obesity increases the risk of diabetes and also contributes to disease progression and cardiovascular disease. Although the benefits of weight loss in the prevention of diabetes and as a critical component of managing the condition are well established, weight reduction remains challenging for individuals with type 2 diabetes due to a host of metabolic and psychological factors. For many patients, lifestyle intervention is not enough to achieve weight loss, and alternative options, such as pharmacotherapy, need to be considered. However, many traditional glucose-lowering medications may lead to weight gain. This article focuses on the potential of currently available pharmacological strategies and on emerging approaches in development to support the glycemic and weight-loss goals of individuals with type 2 diabetes. Two pharmacotherapy types are considered: those developed primarily for blood glucose control that have a favorable effect on body weight and those developed primarily to induce weight loss that have a favorable effect on blood glucose control. Finally, the potential of combination therapies for the management of obese patients with type 2 diabetes is discussed. Obesity and diabetes are intimately linked (1). Obesity—in particular abdominal obesity—is a major driver in the development of diabetes and cardiovascular disease (2), with the increasing prevalence of obesity mirrored by the rising prevalence of diabetes (3). In addition, obesity and overweight are associated with multiple comorbidities (4). Weight reduction, therefore, is a key therapeutic goal in both the prevention and management of type 2 diabetes (5). Weight reduction with intensive l Continue reading >>

How To Beat Type 2 Diabetes With Diet And Lifestyle Changes

How To Beat Type 2 Diabetes With Diet And Lifestyle Changes

It's no secret that type 2 diabetes is on the rise in the United States and around the world. But if you've been diagnosed with diabetes, there's a lot you can do to improve your health — and the best place to start is likely by making some changes to your lifestyle. “Basic principles of good health like eating right, exercising regularly, and maintaining a healthy weight can be as effective as medicine in the management of type 2 diabetes for most people,” says Sue McLaughlin, RD, CDE, lead medical nutrition therapist at Nebraska Medicine in Omaha. That's backed up by the Look AHEAD study, a large clinical trial funded by the National Institutes of Health and the Centers for Disease Control and Prevention (CDC). The researchers found that over a four-year period, changes like eating a healthier diet and getting more exercise led to weight loss and improved diabetes control in 5,000 overweight or obese participants with type 2 diabetes. A December 2016 review in Diabetologia similarly found through 28 studies that participants who were able to achieve about 150 minutes per week of moderate activity lowered their risk of type 2 diabetes by 26 percent compared with nonactive participants. If you're ready to make positive changes to help control diabetes, here's how to get started. Improve Your Diet to Help You Treat Type 2 Diabetes Naturally Keeping close tabs on your diet is a major way to help manage type 2 diabetes. A healthy diet for people with type 2 diabetes includes fresh or frozen fruit and vegetables, whole grains, beans, lean meats, and low-fat or fat-free dairy. Focus on eating fruit and non-starchy vegetables, like broccoli, carrots, and lettuce, and having smaller portions of starchy foods, meats, and dairy products. Be especially careful about loading Continue reading >>

Managing Diabetes

Managing Diabetes

You can manage your diabetes and live a long and healthy life by taking care of yourself each day. Diabetes can affect almost every part of your body. Therefore, you will need to manage your blood glucose levels, also called blood sugar. Managing your blood glucose, as well as your blood pressure and cholesterol, can help prevent the health problems that can occur when you have diabetes. How can I manage my diabetes? With the help of your health care team, you can create a diabetes self-care plan to manage your diabetes. Your self-care plan may include these steps: Ways to manage your diabetes Manage your diabetes ABCs Knowing your diabetes ABCs will help you manage your blood glucose, blood pressure, and cholesterol. Stopping smoking if you smoke will also help you manage your diabetes. Working toward your ABC goals can help lower your chances of having a heart attack, stroke, or other diabetes problems. A for the A1C test The A1C test shows your average blood glucose level over the past 3 months. The A1C goal for many people with diabetes is below 7 percent. Ask your health care team what your goal should be. B for Blood pressure The blood pressure goal for most people with diabetes is below 140/90 mm Hg. Ask what your goal should be. C for Cholesterol You have two kinds of cholesterol in your blood: LDL and HDL. LDL or “bad” cholesterol can build up and clog your blood vessels. Too much bad cholesterol can cause a heart attack or stroke. HDL or “good” cholesterol helps remove the “bad” cholesterol from your blood vessels. Ask your health care team what your cholesterol numbers should be. If you are over 40 years of age, you may need to take a statin drug for heart health. S for Stop smoking Not smoking is especially important for people with diabetes beca Continue reading >>

Managing Type 2 Diabetes: Going Beyond Glycemic Control.

Managing Type 2 Diabetes: Going Beyond Glycemic Control.

J Manag Care Pharm. 2008 Jun;14(5 Suppl B):s2-19. Managing type 2 diabetes: going beyond glycemic control. Northwestern University Medical School, Chicago, IL 60611, USA. [email protected] nwinternist.com Aggressive management of type 2 diabetes is necessary to achieve glycemic and nonglycemic treatment goals. Attainment of treatment goals is associated with a decreased risk of diabetes-related complications, costs, and health care utilization. To review the advantages and disadvantages of different glucose-lowering agents, with an emphasis on the role of thiazolidinediones (TZDs). Diabetes has become increasingly prevalent, particularly among younger age groups in the United States, accounting for approximately 15% of health care expenditures by managed care organizations. Reducing a patient's glycated hemoglobin (A1C) has been shown to decrease the risk of diabetes-related complications, as well as reduce medical costs and health care utilization. Despite this knowledge, achievement of the American Diabetes Association (ADA) goal A1C of < 7% is suboptimal, and < 1 in 10 patients also reach the ADA targets for cholesterol (low-density lipoprotein < 100 mg per dL) and blood pressure (< 130/80 mm Hg). To ensure that all ADA treatment goals are met, clinicians need to closely monitor patients and adjust therapy as needed, taking into consideration both a drug's glycemic and nonglycemic effects when selecting medication therapy. Four basic defects contribute to type 2 diabetes: insulin resistance, decreased insulin secretion, increased hepatic glucose production, and reduced glucagon-like peptide-1 levels. Unlike metformin, sulfonylureas, and insulin that address only 1 or 2 physiologic defects, TZDs uniquely address 3 of these defects at the adipocyte. Metformin is recommended Continue reading >>

6 Ways To Control Type 2 Diabetes

6 Ways To Control Type 2 Diabetes

Last year during a physical, Lauren Crim of Richwood, TX, got a diagnosis she wasn’t expecting: type 2 diabetes. She had no symptoms, so the news threw her for a loop. “I was devastated,” she says. “My grandmother had diabetes, and I saw her go through major health struggles because of it.” After seeking support from loved ones -- and shedding a few tears -- Crim got to work. With help from her health care team, she changed the way she ate and started exercising. Now, a year later, she’s 22 pounds lighter, and her blood sugar is normal. “My advice to anyone else facing type 2 diabetes is to stick to a plan, stay positive, and put your health first,” she says. A diabetes diagnosis might feel overwhelming, but living well with the condition doesn’t have to be. If you’re ready to take control of your blood sugar levels and get on the path to better health, here’s how to start. “It takes a village to manage diabetes,” says Linda Siminerio, RN, PhD, chair of the National Diabetes Education Program. Along with your doctor or nurse practitioner, you can get help from: Diabetes educators Dietitians or nutritionists Pharmacists Endocrinologists Podiatrists Dentists Psychologists or Therapists Their services are often covered by insurance. Having a health care team is key, but you're the most important member of it. “We want you to be informed and empowered,” Siminerio says. Take an active role in your care. Ask questions. Learn what your medications do and how to take them properly. Practice any other healthy habits your doctor recommends. And know what your A1c levels are and what they mean. “Being overweight is one of the major drivers of the epidemic of diabetes,” says Vivian Fonseca, MD, a professor of medicine and pharmacology at Tulane Uni Continue reading >>

Treatment Of Type 2 Diabetes

Treatment Of Type 2 Diabetes

Learn how to manage type 2 diabetes. In this section, you'll learn about: This section focuses on the medical management of type 2 diabetes. And as the term “ medical management” implies, this management is done with the guidance of your medical provider and medical team. The key principles of medical management are: Regular blood sugar (and ketone) self monitoring as a part of daily living Taking diabetes medications such as pills, injected medicines or even insulin Problem solving how and when to make adjustments in your medication doses to prevent high or low blood sugars Understanding complications and how to screen for, prevent and treat them Good management requires all of these elements. All the elements are intertwined. For example, you need to monitor your blood sugar to know if your treatment is successful. You need to problem solve if the self blood sugar monitoring shows your treatment is not successful. The self blood sugar monitoring will indicate if you need to start, adjust the dose or change the type of diabetes medications. Regular screening for diabetes-related complications may pick up a complication that is in the early stages, and early treatment usually gives the best results. In this section, you will find: Self-management solutions: How to analyze what is causing you to have low blood sugars and/or high blood sugars There are different problem solving sections depending upon your type of treatment: Complications: Reviews diabetic complications –both ones that develop rapidly (acutely) or slowly (chronically) – how to recognize them, and what to do if they occur. Continue reading >>

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