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Medications For Prediabetes

Pre-diabetes

Pre-diabetes

What Is It? In pre-diabetes, blood sugar levels are slightly higher than normal, but still not as high as in diabetes. If diabetes is "runaway blood sugar" think of pre-diabetes as blood sugar that is "halfway out the door." People almost always develop pre-diabetes before they get type 2 diabetes. The rise in blood sugar levels that is seen in pre-diabetes starts when the body begins to develop a problem called "insulin resistance." Insulin is an important hormone that helps you to process glucose (blood sugar). If usual amounts of insulin can't trigger the body to move glucose out of the bloodstream and into your cells, then you have insulin resistance. Once insulin resistance begins, it can worsen over time. When you have pre-diabetes, you make extra insulin to keep your sugar levels near to normal. Insulin resistance can worsen as you age, and it worsens with weight gain. If your insulin resistance progresses, eventually you can't compensate well enough by making extra insulin. When this occurs, your sugar levels will increase, and you will have diabetes. Depending on what a blood sugar test finds, pre-diabetes can be more specifically called "impaired glucose (sugar) tolerance" or "impaired fasting glucose." Impaired fasting glucose means that blood sugar increase after you haven't eaten for a while – for example, in the morning, before breakfast. Impaired glucose tolerance means that blood sugar levels reach a surprisingly high level after you eat sugar. To diagnose impaired glucose tolerance, doctors usually use what is called a "glucose tolerance test." For this test you drink a sugary solution, and then you have blood drawn after a short time. Having pre-diabetes does not automatically mean you will get diabetes, but it does put you at an increased risk. Pre- Continue reading >>

7 Natural Treatments Of Prediabetes Symptoms

7 Natural Treatments Of Prediabetes Symptoms

We know that diabetes is a major problem in the U.S., and prediabetes is not less of an issue — but it’s also a wakeup call that can jolt someone into action. Prediabetes symptoms may go unnoticed, but the first sign is that you no longer have normal blood sugar levels. A prediabetes diagnosis is a warning sign to people who will develop diabetes if they don’t make serious lifestyle changes. The Centers of Disease Control and Prevention National Diabetes Statistics Report says that 37 percent of United States adults older than 20 years and 51 percent of those older than 65 exhibit prediabetes symptoms. When applied to the entire population in 2012, these estimates suggest that there are nearly 86 million adults with prediabetes in the United States alone. Furthermore, the International Diabetes Federation projects an increase in prevalence of prediabetes to 471 million globally by 2035. (1) Luckily, research shows that lifestyle intervention may decrease the percentage of prediabetic patients who develop diabetes from 37 percent to 20 percent. (2) What Is Prediabetes? Prediabetes is a condition defined as having blood glucose levels above normal but below the defined threshold of diabetes. It’s considered to be an at-risk state, with high chances of developing diabetes. Without intervention, people with prediabetes are likely to become type 2 diabetics within 10 years. For people with prediabetes, the long-term damage to the heart and circulatory system that is associated with diabetes may have started already. (3) There are several ways to diagnose prediabetes. The A1C test measures your average blood glucose for the past two to three months. Diabetes is diagnosed at an A1C of greater than or equal to 6.5 percent; for prediabetes, the A1C is between 5.7 percent Continue reading >>

Prediabetes Treatments That Can Help You Avoid Type 2 Diabetes

Prediabetes Treatments That Can Help You Avoid Type 2 Diabetes

Prediabetes Treatments That Can Help You Avoid Type 2 Diabetes Heres what to know if youre worried about your health. Hearing the word prediabetes from your doctor can be confusing, scary, and overwhelming, which makes sense. This health condition is often a precursor to type 2 diabetes and also raises your risk of issues like heart disease and stroke , so yes, it deserves your attention. But the conversation around prediabetes should also include hope, because getting this diagnosis in no way means your health is set in stone. You can actually reverse prediabetes, which then lowers your risk of getting serious health conditions in the future. Heres exactly what you need to know to take control. Prediabetes happens when your blood sugar levels are higher than normal, but not quite high enough to actually warrant a type 2 diabetes diagnosis. Since all of this stuff can be pretty confusing, lets have a quick refresher. Type 2 diabetes happens when the levels of glucose (aka sugar ) in your blood are routinely too high, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). You get glucose from food, and its your bodys primary source of energy, so processing it correctly is incredibly important. Your pancreas is supposed to produce enough insulin, a hormone that helps control how your cells use glucose for energy, in order to filter enough sugar from your blood. But if your pancreas either doesnt make enough insulin or your body resists the insulin, your blood sugar can remain too high, which can eventually lead to type 2 diabetes. Many people with type 2 diabetes first have prediabetes, often without realizing it. While 80.1 million adults in the United States have prediabetes, 90 percent dont know about it, according to the Centers fo Continue reading >>

Treating Prediabetes With Metformin

Treating Prediabetes With Metformin

Go to: Abstract To determine if the use of metformin in people with prediabetes (impaired glucose tolerance or impaired fasting glucose) would prevent or delay the onset of frank type 2 diabetes mellitus. MEDLINE was searched from January 1966 to the present, and articles meeting the selection criteria were hand searched. Randomized controlled trials that involved administration of metformin to delay or prevent type 2 diabetes in individuals with impaired glucose tolerance or impaired fasting glucose were included. Development of diabetes was a required outcome measure; follow-up time of at least 6 months was required. Three studies met these criteria. The 3 studies varied in ethnicity of the population studied, in the rates of conversion to diabetes from prediabetes, and in the dose of metformin used. In general the studies were well done, although 2 of the 3 did not do true intention-to-treat analyses. A sensitivity analysis was completed by converting all data to intention-to-treat data and assuming a worst-case scenario for the people who were lost to follow-up. Metformin decreases the rate of conversion from prediabetes to diabetes. This was true at higher dosage (850 mg twice daily) and lower dosage (250 mg twice or 3 times daily); in people of varied ethnicity; and even when a sensitivity analysis was applied to the data. The number needed to treat was between 7 and 14 for treatment over a 3-year period. Summary of results from reviewed trials: Development of diabetes outcomes. STUDY OUTCOME EER n/N (%) CER n/N (%) RRR % (95% CI) ARR % (95% CI) NNT N (95% CI) YATES CORRECTED P VALUE COMMENTS Li et al,22 1999 (Primary analysis of 70 participants) Development of diabetes at 12 mo 1/33 (3.0) 6/37 (16.2) 81.3 (−9.5 to 97.0) 13.2 (−0.9 to 17.9) 7.6 (5.5 to infinit Continue reading >>

Prediabetes

Prediabetes

Prediabetes definition and facts Prediabetes means your blood sugar is higher than normal, but not high enough to diagnose type 2 diabetes. Prediabetes typically has no symptoms or signs; however, it has been associated with being overweight. Usually, blood sugar is high because of insulin resistance, meaning glucose can't get into the cells to be used for energy. Prediabetes is diagnosed with blood tests. Prediabetes levels of blood sugar fall in the range of 100-125 when blood glucose is measured fasting. Prediabetes is reversible by getting healthier. Treatment for prediabetes begins with getting more physically active. All exercise helps reverse prediabetes, especially exercise that helps build muscle. Following a low glycemic index, low carb diet, and following a healthier lifestyle helps reverse prediabetes. Medications and dietary supplements also can be used in reverse prediabetes management. Without making lifestyle changes (or taking medication), the "side effect" of prediabetes is that it is likely to progress to type 2 diabetes. Prediabetes is the term used to describe elevated blood sugar (glucose) that has not yet reached the threshold of a type 2 diabetes diagnosis. Consider pre-diabetes a warning sign that it is time to take your health more seriously. What is the difference between prediabetes and type 2 diabetes? Prediabetes occurs when there is too much sugar (glucose) in the blood. It is an early warning sign that the body has more sugar in the blood then it can use. Type 2 diabetes is a condition that occurs slowly over time. The pancreas cannot produce enough insulin to keep up with the increased need to move sugar into the cells for energy. Medication and lifestyle changes are necessary to manage blood sugar levels and avoid diabetes complications Continue reading >>

Prediabetes

Prediabetes

Prediabetes means you have blood glucose, or blood sugar, levels that are higher than normal but not high enough to be called diabetes. Glucose comes from the foods you eat. Too much glucose in your blood can damage your body over time. If you have prediabetes, you are more likely to develop type 2 diabetes, heart disease, and stroke. Most people with prediabetes don't have any symptoms. Your doctor can use an A1C test or another blood test to find out if your blood glucose levels are higher than normal. If you are 45 years old or older, your doctor may recommend that you be tested for prediabetes, especially if you are overweight. Losing weight - at least 5 to 10 percent of your starting weight - can prevent or delay diabetes or even reverse prediabetes. That's 10 to 20 pounds for someone who weighs 200 pounds. You can lose weight by cutting down on the amount of calories and fat you eat and being physically active at least 30 minutes a day. Being physically active makes your body's insulin work better. Your doctor may also prescribe medicine to help control the amount of glucose in your blood. NIH: National Institute of Diabetes and Digestive and Kidney Diseases Continue reading >>

Oral Antidiabetics Drugs: From Prediabetes To Normoglycemia

Oral Antidiabetics Drugs: From Prediabetes To Normoglycemia

Background: Impaired glucose tolerance, impaired fasting glucose, and elevated hemoglobin A1c are intermediate stages, considered prediabetes, a precursor to overt type 2 diabetes mellitus. Prediabetes is associated with increased risk for cardiovascular disease, independent of diabetes development. Data have shown that various oral antidiabetic drugs can help people regress from prediabetes to normoglycemia. Objective: To evaluate the efficacy of oral antidiabetic drugs in promoting regression from prediabetes to normoglycemia. Methods: MEDLINE (1950-November 2011), EMBASE (1990-November 2011), and Cochrane Central Register of Controlled Trials (indexed September 2011) were systematically searched. A manual search of references from reports of clinical trials and review articles was performed to identify additional relevant studies. Randomized controlled trials 12 weeks or more in duration evaluating any of the oral antidiabetic drugs and studying regression from prediabetes to normoglycemia were included. A random-effects model was used to calculate pooled odds ratios with 95% confidence intervals. Results: Thirteen studies (N = 11,600 participants) were included in the metaanalysis. Use of oral antidiabetic drugs in prediabetic patients was shown to double the odds of achieving normoglycemia compared to controls (OR 2.03, 95% CI 1.54 to 2.67). When individual classes of oral antidiabetic drugs were evaluated, use of thiazolidinediones (OR 2.33, 95% CI 1.93 to 2.81) and -glucosidase inhibitors (OR 2.02, 95% CI 1.26 to 3.24) was associated with significantly increased odds. However, biguanides (OR 2.04) and sulfonylureas (OR 1.84) failed to reach statistical significance (p = 0.06 and p = 0.39, respectively). Conclusions: In patients with prediabetes, oral antidiabeti Continue reading >>

What Is Prediabetes?

What Is Prediabetes?

This sneaky health condition has no symptoms. But it’s almost always present before you get type 2 diabetes. It means your blood sugar level is higher than normal, but not yet high enough for you to be diagnosed with the disease. About 86 million people in the U.S. over age 20 have prediabetes. And doctors see the need to diagnose it more often. Treating it can prevent more serious health problems later on. These range from type 2 diabetes to problems with your heart, blood vessels, eyes, and kidneys. By the time you’re diagnosed with diabetes, many of these problems have already taken hold. You’re most likely to get this disease if you: Had gestational diabetes or gave birth to a baby weighing more than 9 pounds Are African-American, Native American, Latino, or Pacific Islander Are overweight or obese, especially around the middle (belly fat) Have high cholesterol, high triglycerides, low HDL cholesterol, and a high LDL cholesterol Don't exercise Are older; people over age 45 are most likely to get it. You should get tested for prediabetes if you meet the criteria above and you: Had an abnormal blood sugar reading in the past Have heart disease Show signs of insulin resistance, which means your body produces insulin, but doesn't respond to it like it should Although most people with prediabetes have no symptoms, you might notice you're extra thirsty, pee a lot more, or have blurred vision or extreme fatigue. Your doctor can perform one of three different blood tests -- the fasting plasma glucose test, the oral glucose tolerance test, or the hemoglobin A1c test. The fasting plasma glucose test measures your blood sugar after an 8-hour fast. If your blood sugar level is higher than normal after the test, you may have prediabetes. The oral glucose tolerance test rec 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 >>

Treatment Of Prediabetes

Treatment Of Prediabetes

Core tip: Behavioral changes (dieting plus exercising) are effective in preventing impaired glucose tolerance (GT)-type 2 diabetes mellitus (type 2 DM) conversion as well as impaired fasting glucose (FG) - type 2 DM conversion but loosing weight is hard and also difficult to maintain. Pharmacological interventions (plus dieting and exercising) improving and preserving beta-cell function and enhancing insulin sensitivity may be suitable choices for high-risk IGT patients. Troglitazone in Prevention of Diabetes Study, Pioglitazone in Prevention of Diabetes Study, Diabetes Reduction Assessment with ramipril and rosiglitazone Medication Trial, Actos Now for the prevention of diabetes study and Diabetes Prevention Program have proven that thiazolidinediones obviously prevent the development of type 2 DM in IGT subjects as well as IFG subjects. In Diabetes Prevention Program and Indian Diabetes Prevention Program, metformin slowed down the progression of IGT to type 2 DM, and eventually American Diabetes Association Consensus Conference Statement proposed metformin usage in high-risk IGT individuals. However, the efficacy of pioglitazone and rosiglitazone efficacy in preventing IGT progression to type 2 DM nearly doubles metformin’s efficacy (31% vs 72% and 62%, respectively). Rosiglitazone (low dose = 2 mg/d) together with metformin (850 mg/d) was proven to slow down IGT progression to type 2 DM as well as being more tolerable. Insulin secretion/insulin resistance (disposition) index (defined as change in insulin/change in glucose/insulin resistance) in individuals with normal glucose tolerance, impaired glucose tolerance, and type 2 diabetes mellitus as a function of the 2-h plasma glucose concentration in lean (closed circles) and obese (open circles) subjects. IGT: Impa Continue reading >>

Experts Recommend Two-pronged Approach To Treating Prediabetes

Experts Recommend Two-pronged Approach To Treating Prediabetes

According to the most recent data compiled by the CDC, 57 million U.S. adults have prediabetes, a figure that has reached pandemic levels. “In an ideal world, you want to diagnose high-risk people early in order to prevent progression to full-blown diabetes and its associated complications,” Glenn Matfin, MD, clinical associate professor at New York University and senior staff physician at the Joslin Diabetes Center, told Endocrine Today. Whether prediabetes progresses to diabetes depends on a number of variable factors, including lifestyle changes, genetics and treatment practices, which have some physicians supporting the use of medication and others vehemently against it. “We draw lines in order to differentiate between normal glucose tolerance, prediabetes and diabetes, but it is an interlinked, continuous chain,” Matfin said. “The clock is ticking, and the health risks rise significantly as prediabetes goes untreated.” To examine the current state of prediabetes treatment, Endocrine Today spoke with a number of experts to best understand how lifestyle and pharmacological approaches should be utilized to reverse glucose functions to normal levels. The issue is also examined from a financial aspect, as the ability to keep patients with prediabetes from turning into patients with diabetes translates into hundreds of millions of dollars saved in health care costs. Ralph DeFronzo, MD, and diabetes experts discuss preferred therapeutic approaches for people with prediabetes. Perhaps due to its subtle set of symptoms, the identification and diagnosis of patients with prediabetes has proved to be a challenge. Research has shown that although 30% of the U.S. population had prediabetes in 2005 to 2006, only 7.3% were aware that they had it. A consensus from diabe Continue reading >>

What Are Biguanides For Diabetes? Metformin For Diabetes

What Are Biguanides For Diabetes? Metformin For Diabetes

They could come back if your doctor raises your dose. Taking metformin with food can help. While doctors used to avoid prescribing this drug to people who've had kidney trouble, it may be OK for someone with mild or moderate kidney disease . When you use metformin for a long time, it could lower the amount of vitamin B-12 in your body too much. Your doctor may want to check your B-12 level, especially if you have anemia or nerve damage in your feet or hands ( peripheral neuropathy ). One large study has linked long-term metformin use to higher chances of getting Alzheimer's dementia and Parkinson's disease . But we need more research to understand the connection better and what it means. Some people who take metformin can get a lactic acid buildup in their blood. It's rare and more likely to happen if you: Continue reading >>

A Complete List Of Diabetes Medications

A Complete List Of Diabetes Medications

Diabetes is a condition that leads to high levels of blood glucose (or sugar) in the body. This happens when your body can’t make or use insulin like it’s supposed to. Insulin is a substance that helps your body use the sugar from the food you eat. There are two different types of diabetes: type 1 diabetes and type 2 diabetes. People with both types of diabetes need medications to help keep their blood sugar levels normal. The types of drugs that can treat you depend on the type of diabetes you have. This article gives you information about drugs that treat both types of diabetes to help give you an idea of the treatment options available to you. Insulin Insulin is the most common type of medication used in type 1 diabetes treatment. It’s also used in type 2 diabetes treatment. It’s given by injection and comes in different types. The type of insulin you need depends on how severe your insulin depletion is. Options include: Short-acting insulin regular insulin (Humulin and Novolin) Rapid-acting insulins Intermediate-acting insulin Long-acting insulins Combination insulins NovoLog Mix 70/30 (insulin aspart protamine-insulin aspart) Humalog Mix 75/25 (insulin lispro protamine-insulin lispro) Humalog Mix 50/50 (insulin lispro protamine-insulin lispro) Humulin 70/30 (human insulin NPH-human insulin regular) Novolin 70/30 (human insulin NPH-human insulin regular) Ryzodeg (insulin degludec-insulin aspart) Amylinomimetic drug Pramlintide (SymlinPen 120, SymlinPen 60) is an amylinomimetic drug. It’s an injectable drug used before meals. It works by delaying the time your stomach takes to empty itself. It reduces glucagon secretion after meals. This lowers your blood sugar. It also reduces appetite through a central mechanism. Most medications for type 2 diabetes are o Continue reading >>

Metformin For Prediabetes

Metformin For Prediabetes

Prediabetes is, for many people, a confusing condition. It’s not quite Type 2 diabetes — but it’s not quite nothing, either. So how concerned should you be about it? For years, the jargon-filled names given to this condition — impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) — may have made the task of taking it seriously more difficult. But in 2002, the American Diabetes Association (ADA), along with the U.S. Department of Health and Human Services, inaugurated the term “prediabetes” to convey the likely result of not making diet or lifestyle changes in response to this diagnosis. In 2003, the threshold for prediabetes was lowered from a fasting glucose level of 110 mg/dl to one of 100 mg/dl. Then, in 2008, the American Diabetes Association (ADA) began recommending the drug metformin for some cases of prediabetes — specifically, for people under age 60 with a very high risk of developing diabetes, for people who are very obese (with a body-mass index, or BMI, of 35 or higher), and for women with a history of gestational diabetes. The ADA also said that health-care professionals could consider metformin for anyone with prediabetes or an HbA1c level (a measure of long-term blood glucose control) between 5.7% and 6.4%. But according to a recent study, metformin is still rarely prescribed for prediabetes. The study, published in April in the journal Annals of Internal Medicine, found that only 3.7% of people with prediabetes were prescribed metformin over a three-year period, based on data from a large national sample of adults ages 19 to 58. According to a Medscape article on the study, 7.8% of people with prediabetes with a BMI of 35 or higher or a history of gestational diabetes were prescribed metformin — still a very low rate for t Continue reading >>

Management Of Prediabetes

Management Of Prediabetes

Treatment Goals The primary goal of prediabetes management is to normalize glucose levels and prevent or delay progression to diabetes and associated microvascular complications (1,2). Management of common prediabetes comorbidities such as obesity, hypertension, dyslipidemia, cardiovascular disease, and chronic kidney disease is also essential. Therapeutic Lifestyle Management Given its safety and the strength of evidence for its effectiveness in improving glycemia and reducing cardiovascular disease (CVD) risk factors, the preferred treatment approach for prediabetes is intensive lifestyle management (1,2). Therapeutic lifestyle management should be discussed with all patients with prediabetes at the time of diagnosis and throughout their lifetimes. Therapeutic lifestyle management includes medical nutrition therapy (MNT; the reduction and modification of caloric and saturated/hydrogenated fat intake to achieve weight loss in individuals who are overweight or obese), appropriately prescribed physical activity, avoidance of tobacco products, adequate quantity and quality of sleep, limited alcohol consumption, and stress reduction (2). While lifestyle modifications may be difficult to maintain, the following strategies have been shown to increase the likelihood of patient success (1,2): Patient self-monitoring Realistic and stepwise goal setting Stimulus control Cognitive strategies Social support Appropriate reinforcement Primary care providers (PCPs) often take on the responsibility of encouraging behavior changes. The Avoiding Diabetes Through Action Plan Targeting (ADAPT) trial has developed a system that combines evidence-based interventions for behavioral change with existing health record technology to improve primary care providers’ ability to effectively couns Continue reading >>

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