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New Diabetes Interventions

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 >>

Final Recommendation Statement

Final Recommendation Statement

Importance Cardiovascular disease (CVD) is the leading cause of death in the United States, and nearly one quarter of deaths caused by CVD are considered to be preventable. Modifiable cardiovascular risk factors include abnormal blood glucose, hypertension, hyperlipidemia or dyslipidemia, smoking, overweight and obesity, physical inactivity, and an unhealthy diet. Type 2 diabetes mellitus is a metabolic disorder characterized by insulin resistance and relative insulin deficiency, resulting in hyperglycemia. Type 2 diabetes typically develops slowly, and progression from normal blood glucose to glucose abnormalities that meet generally accepted criteria for diabetes (Table) may take a decade or longer. Glucose abnormalities that do not meet the criteria for diabetes include impaired fasting glucose (IFG), an impaired response to oral glucose intake (impaired glucose tolerance [IGT]), or an increased average blood glucose level as evidenced by increased levels of hemoglobin A1c (HbA1c). Abnormal glucose metabolism is a risk factor for CVD and, in some individuals, may progress to meet the threshold for the diagnosis of diabetes. According to national data estimates from 2012, approximately 86 million Americans aged 20 years or older have IFG or IGT.1 Approximately 15% to 30% of these persons will develop type 2 diabetes within 5 years if they do not implement lifestyle changes to improve their health.1 Modifiable risk factors for abnormal glucose metabolism (manifested as either diabetes or abnormal glucose levels below the threshold for diabetes) include overweight and obesity or a high percentage of abdominal fat, physical inactivity, and smoking. Abnormal glucose metabolism is also frequently associated with other cardiovascular risk factors, such as hyperlipidemia and Continue reading >>

Lifestyle Interventions For Patients With And At Risk For Type 2 Diabetes: A Systematic Review And Meta-analysis Free

Lifestyle Interventions For Patients With And At Risk For Type 2 Diabetes: A Systematic Review And Meta-analysis Free

Article, Author, and Disclosure Information Author, Article, and Disclosure Information From the University of Alberta Evidence-based Practice Center and Alberta Research Centre for Health Evidence, University of Alberta, Edmonton, Alberta, Canada. Disclaimer: The findings and conclusions in this article are those of the authors, who are responsible for its content, and do not necessarily represent the views of the Agency for Healthcare Research and Quality. No statement in this article should be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services. Acknowledgment: The authors thank the following persons for their contributions: Carol Spooner (screening, data extraction, and research support), Tamara Durec (searching), Andrea Milne (searching), and Teodora Radisic (article retrieval). Grant Support: By the Agency for Healthcare Research and Quality (contract 290-2007-10021-I). Potential Conflicts of Interest: Mr. Vandermeer: Grant: Agency for Healthcare Research and Quality. Dr. Korownyk: Grant: Agency for Healthcare Research and Quality. All other authors have no disclosures. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-0950 . Requests for Single Reprints: Christina Korownyk, MD, CCFP, Department of Family Medicine, 1706 College Plaza, 8215 112 Street, University of Alberta, Edmonton, Alberta T6G 2C8, Canada; e-mail, [email protected] . Current Author Addresses: Ms. Sumamo Schellenberg: Edmonton Clinic Health Academy, 4-88D, University of Alberta, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada. Dr. Dryden: Edmonton Clinic Health Academy, 4-474, University of Alberta, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada. Mr. Van Continue reading >>

"make Beta Cells Great Again:" Type 1 Diabetes Interventions At Ada 2017 - Medcity News

2 Comments / Jun 13, 2017 at 3:57 PM From the perspective of patients and their families, Type 1 diabetes can feel like a sudden onset disease. Symptoms arise seemingly out of nowhere, as the body becomes increasingly hyperglycemic. The person frequently still a child becomes extremely thirsty and urinates frequently as his or her body tries to rid itself of the excess blood glucose. Its a losing battle. The person is eventually diagnosed and prescribed a life-long plan for insulin replacement therapy. It turns out that the patients experience is the proverbial tip of the iceberg. Biological mechanisms and autoimmunity are at play for years before symptoms appear. That raises the possibility of early intervention, prevention, or possibly even reversal of the disease if it can be caught in the earliest stages. To that end, researchers have been piecing together the hidden progression of type 1 diabetes, as theimmune system stealthily destroys the patients insulin-producing beta cells. Those findings and the latest intervention studies were presented on Monday at the 77th Scientific Sessions of the American Diabetes Association (ADA) in San Diego, California. During the well-attended symposium, different researchers shared data from three separate therapeutic interventions, spanning decades and using trial sites around the world. The studies looked at preventive treatment with insulin, to try to desensitize the immune system to the hormone. Another studied the use of Gleevec (imatinib), a long-standing cancer drug with immunosuppressive properties. Finally, a team looked at the use of GAD, another important antigen that in animal models has shown an ability to help build immune tolerance (the opposite of autoimmunity). The studies are impressive, to say the least. Two of Continue reading >>

Intensive Medical Treatment Can Reverse Type 2 Diabetes

Intensive Medical Treatment Can Reverse Type 2 Diabetes

Follow all of ScienceDaily's latest research news and top science headlines ! Intensive medical treatment can reverse type 2 diabetes Intervention induced several months of remission in up to 40 percent of clinical trial participants Type 2 diabetes can be reversed with intensive medical treatment using oral medications, insulin and lifestyle therapies, according to a study. One in 10 American adults has type 2 diabetes, according to experts. The condition occurs when an individual doesn't produce enough insulin or the pancreas isn't making insulin as efficiently as it could. One in 10 American adults has type 2 diabetes, according to experts. The condition occurs when an individual doesn't produce enough insulin or the pancreas isn't making insulin as efficiently as it could. Type 2 diabetes can be reversed with intensive medical treatment using oral medications, insulin and lifestyle therapies, according to a study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism. Type 2 diabetes is typically thought of as a chronic condition. As it progresses, individuals with type 2 diabetes often need to use a healthy diet, exercise and an increasingly complex combination of medications to manage the condition. "By using a combination of oral medications, insulin and lifestyle therapies to treat patients intensively for two to four months, we found that up to 40 percent of participants were able to stay in remission three months after stopping diabetes medications," said the study's first author, Natalia McInnes, MD, MSc, FRCPC, of McMaster University and Hamilton Health Sciences, in Hamilton, Ontario, Canada. "The findings support the notion that type 2 diabetes can be reversed, at least in the short term -- not only with bariatric surgery, but Continue reading >>

Overview

Overview

The importance of both diabetes and these comorbidities will continue to increase as the population ages. Therapies that have proven to reduce microvascular and macrovascular complications will need to be assessed in light of the newly identified comorbidities. Lifestyle change has been proven effective in preventing or delaying the onset of type 2 diabetes in high-risk individuals. Based on this, new public health approaches are emerging that may deserve monitoring at the national level. For example, the Diabetes Prevention Program research trial demonstrated that lifestyle intervention had its greatest impact in older adults and was effective in all racial and ethnic groups. Translational studies of this work have also shown that delivery of the lifestyle intervention in group settings at the community level are also effective at reducing type 2 diabetes risk. The National Diabetes Prevention Program has now been established to implement the lifestyle intervention nationwide. Another emerging issue is the effect on public health of new laboratory based criteria, such as introducing the use of A1c for diagnosis of type 2 diabetes or for recognizing high risk for type 2 diabetes. These changes may impact the number of individuals with undiagnosed diabetes and facilitate the introduction of type 2 diabetes prevention at a public health level. Several studies have suggested that process indicators such as foot exams, eye exams, and measurement of A1c may not be sensitive enough to capture all aspects of quality of care that ultimately result in reduced morbidity. New diabetes quality-of-care indicators are currently under development and may help determine whether appropriate, timely, evidence-based care is linked to risk factor reduction. In addition, the scientific evid Continue reading >>

What's New In Endocrinology And Diabetes Mellitus

What's New In Endocrinology And Diabetes Mellitus

The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc. All topics are updated as new evidence becomes available and our peer review process is complete. The following represent additions to UpToDate from the past six months that were considered by the editors and authors to be of particular interest. The most recent What's New entries are at the top of each subsection. DIABETES MELLITUS ACE inhibitors and statins do not prevent moderately increased albuminuria or progression of retinopathy in type 1 diabetes (November 2017) Angiotensin inhibition and statin therapy have been proposed as treatments to prevent microvascular complications in patients with type 1 diabetes mellitus, although evidence has not supported this hypothesis. In a 2x2 placebo-controlled trial of quinapril and atorvastatin in 443 normoalbuminuric and normotensive adolescents with type 1 diabetes, neither drug reduced the incidence of moderately increased albuminuria (primary outcome), and neither drug significantly reduced the progression of retinopathy (an exploratory outcome) [1]. Thus, UpToDate continues to recommend that angiotensin inhibition and statin therapy not be used for primary prevention of microvascular complications in type 1 diabetes. (See "Moderately increased albuminuria (microalbuminuria) in type 1 diabetes mellitus", section on 'ACE inhibitors or ARBs' and "Diabetic retinopathy: Prevention and treatment", section on 'Prevention'.) Continuous glucose monitoring in patients with type 2 diabe Continue reading >>

New Thesis About Treatments And Interventions In Type 2 Diabetes And Prediabetes

New Thesis About Treatments And Interventions In Type 2 Diabetes And Prediabetes

Department of Molecular Medicine and Surgery Published 2016-11-10 09:19. Updated 2016-11-10 09:27 Denna sida p svenska Henrik Wagner , at the group Growth and Metabolism, will defend his thesis"Factors potentially influencing pathogenetic mechanisms and hyperglycemia in pre-diabetes and type 2 diabetes :clinical studies in human" on November 11, 2016. Main supervisor is Associate ProfessorMichael Alvarsson. We have investigated the effects and mechanisms of some interesting treatments and interventions in type 2 diabetes and prediabetes. Combined treatment with physical exercise and acarbose, an -glucosidase inhibitor, was superior than exercise alone in mild type 2 diabetes, regarding the effects on hyperglycemia and the total risk factor profile. Further, expression of the important angiogenetic factor VEGF in muscle could be important for the individual response to exercise, measured as insulin sensitivity and glycemic control. In individuals with insulin resistance, endothelin-1 receptor blockade resulted in an increased glucose uptake in muscle. In cultured muscle cells, endothelin-1 seemed to inhibit glucose uptake directly by a receptor dependent mechanism. Finally, we did not find any effect of high-dose vitamin D treatment on insulin secretion or insulin resistance, in subjects with prediabetes or diet treated type 2 diabetes. How can this new knowledge contribute to the improvement of people's health? The combined treatment with physical exercise and acarbose seem to be an interesting treatment option in mild type 2 diabetes. VEGF and endothelin-1 could constitute future 'drug-targets' with the possibility to affect insulin resistance. On the other hand, we found no support for vitamin D treatment in prediabetes or diet-treated type 2 diabetes. I hope be able 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 >>

New Interventions And Emerging Trends In The Treatment Of Diabetes

New Interventions And Emerging Trends In The Treatment Of Diabetes

Obesity, Body Mass Index, Childhood Obesity, Drinking water, Blood pressure Diabetes is a persistent ailment with complex reasons, manifestations, complication, and administration. It is a continual disease which is considered a predominant motive of demise, ailment and shrink best of life. Diabetes is step by step fitting a worldwide wellbeing predicament. The disease imposes massive public wellbeing and fiscal burdens that have an effect on the society earlier than the members [ 1 ]. Glycaemic control is most often disturbed by means of iatrogenic hypoglycaemia thus of intensive cure and generally is a fundamental barrier to most effective glycaemic management. This threat of hypoglycaemia acts like a deterrent to the patient from reaching euglycaemia [ 2 ]. Diabetes mellitus in transplant recipients widely raises the already accelerated hazard profile of cardiovascular sickness, graft loss and demise. The criteria for the analysis of diabetes mellitus within the posttransplant interval are the same as those set out by way of the American Diabetes association (ADA) for the definition of diabetes mellitus in clinical practice [ 3 ]. Type 2 diabetes (T2D) is a complex metabolic sickness with an growing incidence worldwide. The sickness is characterized by way of a combination of impairment in insulin secretion from pancreatic beta cells and insulin resistance of peripheral tissues, exceptionally muscle and liver, resulting from interaction between multiple environmental and genetic motives [ 4 ]. Medicinal crops were proposed as rich but unexploited talents sources for antidiabetic medicinal drugs, despite the fact that used because ancient times for the medication of diabetes mellitus. A few of the artificial medicines had been learned both directly or indirectly from Continue reading >>

The Quiet Research That Led To A Resounding Success In Diabetes Prevention

The Quiet Research That Led To A Resounding Success In Diabetes Prevention

The Upshot |The Quiet Research That Led to a Resounding Success in Diabetes Prevention A scene from a diabetes prevention program at the Bronx Y.M.C.A. on Castle Hill Avenue. Lourdes Ventura, the lifestyle coach there, weighs the participants at the end of each class. Credit Benjamin Norman for The New York Times More than 86 million people , including 22 million people 65 or older, have pre-diabetes, which increases their risk of heart disease, strokes or diabetes. As weve watched that number grow, it has somehow felt that despite billions of dollars of research and intervention, theres little we can do. That feeling shifted last week when Sylvia Mathews Burwell, the secretary of health and human services, announced that Medicare was planning to pay for lifestyle interventions focusing on diet and physical activity to prevent Type 2 diabetes. Its an example of small-scale research efforts into health services that have worked and that have expanded to reach more people. Articles appear every day on major breakthroughs, which later never pan out, while this one, full of successes, rarely made the news. This is the curse of health services research , which seeks to improve population health through improvements in access or delivery of care. When most people think of diabetes research, theyre thinking about a cure or a new medication. Those grand slams are exciting, but they rarely happen. Nevertheless, people want to see them. Donors want to support them. Organizations hire people to go after them. Health services research is more about hitting singles, day after day. Theres no billion dollar payoff, no fame, no Nobel Prize. But it gets the job done, and its often more likely to change the health of most Americans. This announcement is based on work at an Indianapolis Continue reading >>

1. Strategies For Improving Care

1. Strategies For Improving Care

A patient-centered communication style that incorporates patient preferences, assesses literacy and numeracy, and addresses cultural barriers to care should be used. B Treatment decisions should be timely and based on evidence-based guidelines that are tailored to individual patient preferences, prognoses, and comorbidities. B Care should be aligned with components of the Chronic Care Model to ensure productive interactions between a prepared proactive practice team and an informed activated patient. A When feasible, care systems should support team-based care, community involvement, patient registries, and decision support tools to meet patient needs. B Diabetes Care Concepts In the following sections, different components of the clinical management of patients with (or at risk for) diabetes are reviewed. Clinical practice guidelines are key to improving population health; however, for optimal outcomes, diabetes care must be individualized for each patient. The American Diabetes Association highlights the following three themes that clinicians, policymakers, and advocates should keep in mind: Patient-Centeredness: Practice recommendations, whether based on evidence or expert opinion, are intended to guide an overall approach to care. The science and art of medicine come together when the clinician is faced with making treatment recommendations for a patient who would not have met eligibility criteria for the studies on which guidelines were based. Recognizing that one size does not fit all, these Standards provide guidance for when and how to adapt recommendations. Because patients with diabetes have greatly increased risk for cardiovascular disease, a patient-centered approach should include a comprehensive plan to reduce cardiovascular risk by addressing blood pressu Continue reading >>

Diabetes Prevention: Interventions Engaging Community Health Workers

Diabetes Prevention: Interventions Engaging Community Health Workers

Mean total cholesterol: median decrease of 5.7 mg/dL (6 studies; median duration: 6 months) Mean LDL: median decrease of 5.0 mg/dL (6 studies; median duration: 6 months) Mean HDL: median increase of 0.3 mg/dL (4 least suitable design studies; median: 5.5 months) Mean triglycerides: median decrease of 13.8 mg/dL and an increase of 3.8 mg/dL (2 least suitable design studies; 6 and 12 months respectively) Mean SBP: median decrease of 2.6 mg/dL (8 studies; median duration: 6 months) Mean DBP: median decrease of 2.4 mg/dL (8 studies; median duration: 6 months) Physical activity (19 studies): 5 studies reported significant improvements (median duration: 7 months), 8 reported non-significant improvements (median duration: 6 months), 5 showed no change, and 1 reported decreases in physical activity (median duration: 12 months), Nutrition (15 studies): 4 studies reported significant improvements (median duration: 4.5 months), 6 reported non-significant improvements (median duration: 6 months), and 5 showed no change (median duration: 12 months). Most included studies engaged community health workers to work with underserved groups suggesting these interventions can be effective in improving minority health and reducing health disparities related to populations at risk for diabetes (19 studies). One study evaluated access to service (i.e., insurance coverage) and reported a favorable increase in the number of insured participants after community health worker engagement. Economic evidence indicates that interventions engaging community health workers for diabetes prevention are cost-effective. All monetary values are reported in 2015 U.S. dollars. The economic review included 7 studies (6 from the United States, 1 from the United Kingdom). Most patients in the studies came from Continue reading >>

New Interventions In Diabetes With Medical Nutrition Therapy - Sciencedirect

New Interventions In Diabetes With Medical Nutrition Therapy - Sciencedirect

Volume 13, Issue 2 , March 2002, Pages 78-81 Author links open overlay panel EileenPaulRD, CD, CDE Get rights and content Nutrition therapy has been the focus of diabetes management since before insulin was discovered.1 Many theories and approaches have been recommended and reemerged over the years. Since the Diabetes Control and Complications Trial (DCCT) results were released in 1993, nutrition is considered the most critical and pivotal component of diabetes care in achieving blood glucose goals. We have seen increased emphases on individualized nutrition therapy and the dietitian as a true partner in diabetes care, research, and management.1 Advances in nutrition therapy now center on methods to improve behavioral change because it is the major challenge facing people with diabetes. Access to nutrition therapy and self-management training is critical to improve clinical outcomes and reduce health care costs otherwise spent on clinic visits, expensive medications, emergency room visits, and hospitalizations.1 Continue reading >>

School-based Diabetes Interventions And Their Outcomes: A Systematic Literature Review

School-based Diabetes Interventions And Their Outcomes: A Systematic Literature Review

School-Based Diabetes Interventions and Their Outcomes: A Systematic Literature Review Institute of Communication and Health, Faculty of Communication Sciences, University of Lugano, Switzerland Institute of Communication and Health, University of Lugano, Via G. Buffi 6, 6900 Lugano, Switzerland. +41.58.666.4487 - Fax: +41.58.666.4647. [email protected] Contributions: BP, conception and design of the systematic literature review, search strategy, screening and selection of the articles, analysis and interpretation of data, drafting of the article; PJS, critical evaluation of the article. Conflict of interest: the authors declare no potential conflict of interest. Received 2014 Nov 28; Accepted 2015 Feb 18. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Type 1 diabetes is one of the most common chronic childhood diseases, while type 2 diabetes in children is increasing at alarming rates globally. Against this backdrop, the school is a critical environment for children with diabetes. They continue to face barriers to education that may lead to depression, poor academic performance, and poor quality of life. To address these challenges, diabetes interventions have been implemented in school and the goal was to systematically review these interventions and their outcomes between 2000 and 2013. Fifteen studies were included in the narrative synthesis. Education of school personnel was the main focus before 2006. Studies reported gains in knowledge and perceived confidence of school staff. Since 2006, more comprehensive interventions have been developed to p Continue reading >>

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