Treating To Target In Type 2 Diabetes
The main objectives are: In year one; to determine the degree to which the randomised addition to existing oral therapies of long-acting analogue insulin once-daily (or twice if needed) prandial rapid-acting analogue insulin thrice-daily pre-mixed long and rapid acting (biphasic) analogue insulin twice-daily In years two and three; to determine the degree to which HbA1c values less than 6.5% can be achieved when existing sulphonylurea therapy is replaced by a second insulin preparation. To derive algorithms that predict likely starting and adjustment doses of insulin for Type 2 diabetic patients with inadequate glycaemic control on oral agents. Diabetes is serious disease which can shorten life by 5-10 years and has major complications such as loss of sight, kidney failure and amputations. The UK Prospective Diabetes Study (UKPDS) has shown that improved glycaemic control can substantially reduce the risk of complications. This is difficult to achieve in practice as progressive loss of pancreatic insulin secretory ability means that oral treatments become less effective with time. Despite the increasing need for insulin therapy in people with Type 2 diabetes, there remains considerable uncertainty as to how best to start or to adjust insulin doses. The situation is different to Type 1 diabetes because substantially larger doses of insulin are needed as many patients are obese and also have insulin resistance associated with Type 2 diabetes. Managing Type 2 diabetes in primary, rather than secondary care, means that Practices are for the first time being required to initiate and adjust insulin therapy in large numbers of patients without clear guidance as to when to commence insulin, whether to give it in addition to or instead of existing oral agents, or how to optimis Continue reading >>
- New target emerging for treating diabetes-related blood vessel damage
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- The gut microbiome as a target for prevention and treatment of hyperglycaemia in type 2 diabetes: from current human evidence to future possibilities
Honest Review Of The Diabetes Protocol Program
Honest Review of the Diabetes Protocol Program Diabetes Protocol Review While most people are aware of the seriousness of diabetes, few are exposed to the regular annoyances that diabetics face – the monitoring of food intake, the insulin shots, the oral medication, the side effects, and so on. To say their lives are easy would be a very misguided statement. So when a product is marketed as a cure for the effects of diabetes, heads will naturally turn. The product I’m speaking of is Diabetes Protocol. The major appeal of Diabetes Protocol is its claims to drastically lower glucose levels and reverse the effects of diabetes in only 19 days. Skepticism is always present when such claims are made, but I’m willing to give someone the benefit of the doubt when I hear something that appeals to me. And this product appealed to me. So below, I wanted to share with you a bit of what I know about Diabetes Protocol – including what it is, who created it, and how it works. And hopefully, what I share with you will help you make an informed decision on whether to buy this product. What is Diabetes Protocol? Diabetes Protocol is a guide/meal plan created by Dr. Kenneth Pullman that focuses on reversing the effects of diabetes via lowering the liver and kidney’s production of glucose. However, it’s more than just another meal plan guide. It seeks to rid your body of diabetes while freeing you to live a more normal life – which means eating “good stuff” again (pizza, ice cream, fries, etc.), no insulin shots, and no oral medication. The guide itself outlines the specific 19-day process that Dr. Pullman used to lower his own blood sugar levels from a reported 270 to 100. This plan is his contribution to helping increase diabetics’ resistance to diabetes-related issue Continue reading >>
Diabetes Protocol Claims To Cure Type2 Diabetes
The Diabetes Protocol Review
Hai! Today Iam going to discuss about a product which helps to control diabetes with only natural methods to reversing diabetes. It is Diabetes Protocol program which was designed by a health researcher Dr. Kenneth Pullman. By using this Diabetes protocol we can overturn both Type 1 and Type 2 Diabetes without side effects .Friends let us see some details about what is diabetes and symptoms of diabetes, how many types of diabetes are there in medical dictionary before we are going to discuss about the product The Diabetes Protocol program. Diabetes is called as Diabetes Mellitus referred by doctors usually is a metabolic disease and a long term condition that causes high blood sugar levels. Diabetes can be classified into Type 1,Type 2,Gestational Diabetes. If the body does not produce insulin called as Type 1 Diabetes. 10 % of all diabetes cases are come under Type -1. Usually it develops before 40th year of a individual or often in early adulthood or teenage years.But Type 2 diabetes peoples body can make insulin but either their pancreas does not make enough insulin or the body cannot use the insulin well enough.In this type -2 diabetes the cells in the body can not react to insulin and risk factor is also greater as we get older. Men whose testosterone levels are low have been found to have higher risk with this type 2 Diabetes. Gestational Diabetes generally affects females during pregnancy. Majority of patients with Type 2 Diabetes initially has Pre-diabetes and these are different types of diabetes. Diabetic Ketoacidosis is a medical emergency and life threatening complication in patients with diabetes mellitus usually happens in both type1 and type 2 diabetic patients. All problems can be controlled by regular diet and lifestyle modifications and Dr.Kenneth Pul Continue reading >>
Jdrf Calls For Open Protocols In Diabetes Technology
JDRF Creates 'Open Protocols Initiative' Pushing Industry to Embrace Patient Innovation! Written by Mike Hoskins on October 25, 2017 For those who've been pushing for more support of do-it-yourself diabetes technology over the last five years or so (crystallized as the #WeAreNotWaiting movement), a huge endorsement came last week when JDRF announced a new initiative encouraging the pharma and device industry to be more collaborative with patient innovators. On Oct. 18, JDRF announced this new initiative calling for open protocols in emerging Artificial Pancreas (AP) technology as part of its ongoing aim to accelerate the development and commercialization of AP systems that automate insulin delivery. This will include both legal support and financial incentives to motivate the industry to follow Dexcom's recent lead in taking steps toward opening their back-end tech, so that innovators from around the Diabetes Community can build the functionality and apps best suited to patients' lives. OK, that all may sound like mumbo-jumbo to a lot of people... we get it. Think of it this way: Instead of the closed systems we have now, where each company makes their own "proprietary" devices that work only with their own hardware, software and apps, companies would go open-source and create code and documentation freely available to the public. This would allow partners and independent developers to build upon their tech, and encourage interoperability of devices and data systems. Many in our community have been championing this cause for years now , and while JDRF's initiative is focused specifically on closed loop systems, it's a great step forward. Image source: Howard Look, Tidepool / slideshare.net/amytenderich/howard-look-tidepool-diabetesmine-innovation-summit-20131115 In the Continue reading >>
Can Diabetes Protocol Guide Help Cure Your Diabetes?
Diabetes Protocol makes some lofty promises. Diabetes Protocol promises to cure your type 2 diabetes or type 1 diabetes. Thats right: cure it. Not just treat the symptoms or temporarily regulate your blood glucose levels. So it makes sense that people are skeptical. Whats the truth behind Diabetes Protocol? Is Diabetes Protocol a scam? Or is it a revolutionary solution that is being suppressed by Big Pharma like its creator wants you to think? The truth is somewhere in between. But I will tell you one thing: Diabetes Protocol can change the lives of anyone who suffers from type 2 diabetes, type 1 diabetes, or has been diagnosed as pre-diabetic. Today, Im going to explain how it works, if it works, and help you decide if its worth spending $40. Diabetes Protocol is an 138 page downloadable guide that lists various health, fitness, and lifestyle tips you can use to cure diabetes. The guide is available in the form of a PDF eBook. You buy it online and its instantly sent to your email inbox. There are three modules included within the guide, including: Core Module: The Core Module will tackle the root cause of your diabetes, including the exact natural systems you can activate within your body to beat diabetes (well talk about how it works below). Module 2: In this module, youll learn a vast collection of natural, safe, and effective remedies to control blood sugar, including basic natural ingredients like rosemary and oregano. Module 3: This module explains the dangers of certain popular diabetes medications which many people take every day to treat their diabetes, when in reality, theyre making symptoms worse. You also get two bonus modules, including 500 Delicious Diabetic Recipes and 7-Day Energy Booster. Those extra books are tossed in for free, which is a nice added Continue reading >>
What Was Your Experience With The Diabetes Protocol Program By Dr. Kenneth Pullman?
I'm a retired medical specialist doc who has treated lots of diabetics, both type I and type II. I haven't read the book, just visited its fan page. Claiming that too high an internal glucose production is the underlying problem in both type I and type II diabetes for me already marks this out as a scam. Type I diabetes is due to auto-antibodies to the insulin producing cells in the pancreas, destroying them in the process so there is a (eventually total) lack of insulin production, making external insulin a life saving medicine, without which the patients would die. So saying not to use insuline, just his method, is putting gullible patient's life in mortal danger. In type II diabetes one's body's sensitivity to insulin has been lowered, and the pancreas (at least in the beginning) reacts to that by raising endogenous insulin production. If one is able to minimize internal glucose production Gluconeogenesis this would be helpful, and might be helpful in the first phase on the disease, and in theory if the patient lost weight so not be overweight anymore, type II diabetes as we see it now being a disease of fat (triglycerides) infiltration in the pancreas, liver etc. that causes local inflammation and thus damages the pancreas leading to later on insufficient insulin production could avoid this problem and so keep diabetes at bay, as long as monitored well without the therapeutic recommendations having adverse effects (which not having read the book I wouldn't know) it isn't such a bad idea. However, his stance that nobody will ever need any anti-diabetic drug is so unrealistic and dangerous that I'm much afraid of his "followers" could endanger their wellbeing by blindly following his recommendations. Continue reading >>
Insulin Protocols For Hospital Management Of Diabetes
Most patients with diabetes admitted to community hospitals have their conditions managed by family physicians. Outpatient management of diabetes uses evidence-based guidelines for management and stresses tight glycemic control.1–3 However, traditional hospital practice has been very ad hoc and there are currently no specific guidelines to help with inpatient management. The most frequently used treatment regimen has been the ubiquitous “sliding scale,” with regular insulin given before meals. Because of the unpredictable absorption kinetics of regular insulin and the reactive nature of the efforts at glucose control, the sliding scale is unphysiological and ineffective in controlling postprandial glucose and prone to inducing delayed hypoglycemia.4 Not surprisingly diabetes “control” has been erratic and efforts at management are often a hit-or-miss exercise in frustration for physicians, nursing staff, and patients. A growing number of studies confirms that aggressive management of hyperglycemia in hospital reduces morbidity, mortality, infection rates, and length of stay.5,6 Historically, attempts to manage diabetes in hospital have met with variable success not only because of fear of hypoglycemia, but also because of the absence of several factors: consistency in the management approach, appreciation of the importance of better glucose control, and confidence in using the more physiological basal-bolus system of insulin replacement.5 Go to: Basal-bolus approach Three years ago some colleagues encouraged me to introduce preprinted protocols at Kelowna General Hospital, a 350-bed tertiary care referral centre in Central Okanagan with a large complement of specialists and subspecialists but no endocrinologist. This centre has more than 100 primary care physi Continue reading >>
Diabetes Protocol Is Recipe For Success In Telehealth Case Management Program
Home Diabetes Protocol is Recipe for Success in Telehealth Case Management Program Diabetes Protocol is Recipe for Success in Telehealth Case Management Program Diabetes program combines disease management, case management | Single Article A telehealth program has case managers who follow a diabetes insulin adjustment protocol to better manage patients disease. Nurse case managers were trained before they could use the protocol. The protocol showed positive health improvement results. Providers responded positively to the program. Case management can be combined with treatment-specific protocols to quickly react to patients medical problems, resulting in better chronic disease maintenance, administrators of a telehealth program found. A diabetes insulin adjustment protocol, used with a virtual case management program, helps reduce average blood sugar levels among at-risk diabetic patients. RN case managers were trained to use the protocol, which resulted in a reduction of average baseline A1c from 9.646 to an average of 7.685 A1c post-protocol use among about 150 patients, says Nancy Brown, MSN, ARNP, ANP-BC, advanced registered nurse practitioner at Mann-Grandstaff VA Medical Center in Spokane, WA. With diabetic patients we can manage them, and even adjust their insulin, over the phone, says Freta L. Leddige, BSN, RN, nurse manager for home telehealth at Mann-Grandstaff VA Medical Center. Before developing the protocol, the VA medical center had difficulty improving multi-complex patients diabetes, Brown says. Previously, insulin adjustments could take weeks or months because physicians might wait until they saw the patient in their offices to make changes. Im a provider, and before I started working with home telehealth nurses, Id be in clinic, busy seeing patients a Continue reading >>
Diabetes Protocol By Dr Kenneth Pullman Review | Scam Or Legit?
DIABETES PROTOCOL BY DR KENNETH PULLMAN REVIEW | SCAM OR LEGIT? The issue of diabetes is growing at a high rate globally each day. And it has resulted in many things, to some amputation and to some death. This disease also has put tears in so many families even fear in some people. One of these people is a health researcher by the name Dr Kenneth Pullman who dedicated his vast knowledge of science to finding the cure to this disease. After years of hard work he came up with a protocol that reverses the disease. This protocol he called the Diabetes Protocol Program. Dr Kenneth Pullman discovered that many people dont look for the cause of the disease all they pay attention to is nurturing and controlling it. This has resulted in people spending huge amount of money on expensive medications that does not really deal with the original cause of this disease. This is not the best way of treating this disease, he then came up with his own belief that increasing insulin or those insulin shots you take is not necessary and another method entirely can be used. He discovered that if you are pre-diabetic or you have either the type 1 or type 2 diabetes and you carefully follow the Diabetes Protocol you can be 100% free from diabetes in about 19 days. Dr Kenneth Pullmans research showed that various enzymes and protein in the liver and kidney are responsible for the production of glucose into the bloodstream. Many researches has shown that insulin is responsible for the glucose produced in the body, he discovered that insulin is not really responsible for all glucose production, he then discovered other protein and enzymes that can reverse diabetes. Dr Kenneth Pullmans research helped to naturally control sugar production by certain organs in the body; over 40,000 diabetics have u Continue reading >>
Cost-effectiveness Of The Diabetes Care Protocol, A Multifaceted Computerized Decision Support Diabetes Management Intervention That Reduces Cardiovascular Risk.
OBJECTIVE: The Diabetes Care Protocol (DCP), a multifaceted computerized decision support diabetes management intervention, reduces cardiovascular risk of type 2 diabetic patients. We performed a cost-effectiveness analysis of DCP from a Dutch health care perspective. RESEARCH DESIGN AND METHODS: A cluster randomized trial provided data of DCP versus usual care. The 1-year follow-up patient data were extrapolated using a modified Dutch microsimulation diabetes model, computing individual lifetime health-related costs, and health effects. Incremental costs and effectiveness (quality-adjusted life-years [QALYs]) were estimated using multivariate generalized estimating equations to correct for practice-level clustering and confounding. Incremental cost-effectiveness ratios (ICERs) were calculated and cost-effectiveness acceptability curves were created. Stroke costs were calculated separately. Subgroup analyses examined patients with and without cardiovascular disease (CVD+ or CVD- patients, respectively). RESULTS: Excluding stroke, DCP patients lived longer (0.14 life-years, P = NS), experienced more QALYs (0.037, P = NS), and incurred higher total costs (euro 1,415, P = NS), resulting in an ICER of euro 38,243 per QALY gained. The likelihood of cost-effectiveness given a willingness-to-pay threshold of euro 20,000 per QALY gained is 30%. DCP had a more favorable effect on CVD+ patients (ICER = euro 14,814) than for CVD- patients (ICER = euro 121,285). Coronary heart disease costs were reduced (euro-587, P < 0.05). CONCLUSIONS: DCP reduces cardiovascular risk, resulting in only a slight improvement in QALYs, lower CVD costs, but higher total costs, with a high cost-effectiveness ratio. Cost-effective care can be achieved by focusing on cardiovascular risk factors in type Continue reading >>
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- Olive oil in the prevention and management of type 2 diabetes mellitus: a systematic review and meta-analysis of cohort studies and intervention trials
Type 1 Diabetes Protocol
Home Student Services Health Services Type 1 Diabetes Protocol These standards were obtained from the agencies and organizations listed in California Education Code section 49414 and represent the standard of care determined by health and medical experts in this field. Parents and nursing team will discuss plan for designated times for glucose testing and insulin administration. At designated time and place, student will collect supplies and test blood glucose with the assistance or supervision of trained staff. Trained staff will document time and result immediately on student log to be kept in students binder. If insulin administration is required and the student is able to self-administer but not independent, trained staff will observe student administer insulin per physicians authorization. If student is independent, student is still encouraged to check in with health office for daily care. If student requires assistance with insulin administration, the licensed care will determine dose and administer insulin per physicians authorization. Parent will be contacted for any irregularities or problems, and procedures will be changed as needed with written physicians authorization. Teachers will access health conditions via Infinite Campus (IC) class roster (substitute teachers via the sub binder). The itinerant staff (music and PE teachers, bus drivers, classroom aides, yard duty staff, and librarians) will be alerted to those students with a diagnosis of anaphylaxis. Teachers will review the Emergency Care Plan for their student and the Student Health Emergency Procedure. The teacher includes the following information in the Substitute Binder: If a student notifies staff that he or she is not feeling well, staff is instructed to compare the symptoms with those listed Continue reading >>
Diabetes Protocol Program Review: Does Dr Kenneth Pullman Diabetes Protocol Work?
The issue of diabetes is growing at a high rate globally each day and it has resulted in many things, to some amputation and to some death. This disease also has put tears in so many families even fear in some people. One of these people is a health researcher by the name Dr Kenneth Pullman who dedicated his vast knowledge of science to finding the cure to Diabetes. After years of hard work he came up with a protocol that reverses the disease, this protocol he called the Diabetes Protocol Program. If you are already familiar with Dr Pullman Diabetes Protocol program and only here to download it, you can do so by clicking the link below What is Diabetes Protocol Program? Dr Kenneth Pullman discovered that many people don’t look for the cause of the disease all they pay attention to is nurturing and controlling it. This has resulted in people spending huge amount of money on expensive medications that does not really deal with the original cause of diabetes. He noted that increasing the body insulin is not the best way of treating diabetes. He then came up with his own belief that increasing insulin or those insulin shots you take is not necessary and that another method entirely can be used. He discovered that if you are pre-diabetic or you have either the type 1 or type 2 diabetes and you carefully follow the Diabetes Protocol program you can be 100% free from diabetes in about 19 days. Dr Kenneth Pullman’s research showed that various enzymes and protein in the liver and kidney are responsible for the production of glucose into the bloodstream. Many researches has shown that insulin is responsible for the glucose produced in the body. He discovered that insulin is not really responsible for all glucose production, he then discovered other protein and enzymes that c Continue reading >>
The Diabetes Remission Clinical Trial (direct): Protocol For A Cluster Randomised Trial
The Diabetes Remission Clinical Trial (DiRECT): protocol for a cluster randomised trial BMC Family PracticeBMC series open, inclusive and trusted201617:20 Despite improving evidence-based practice following clinical guidelines to optimise drug therapy, Type 2 diabetes (T2DM) still exerts a devastating toll from vascular complications and premature death. Biochemical remission of T2DM has been demonstrated with weight loss around 15kg following bariatric surgery and in several small studies of non-surgical energy-restriction treatments. The non-surgical Counterweight-Plus programme, running in Primary Care where obesity and T2DM are routinely managed, produces >15kg weight loss in 33% of all enrolled patients. The Diabetes UK-funded Counterpoint study suggested that this should be sufficient to reverse T2DM by removing ectopic fat in liver and pancreas, restoring first-phase insulin secretion. The Diabetes Remission Clinical Trial (DiRECT) was designed to determine whether a structured, intensive, weight management programme, delivered in a routine Primary Care setting, is a viable treatment for achieving durable normoglycaemia. Other aims are to understand the mechanistic basis of remission and to identify psychological predictors of response. Cluster-randomised design with GP practice as the unit of randomisation: 280 participants from around 30 practices in Scotland and England will be allocated either to continue usual guideline-based care or to add the Counterweight-Plus weight management programme, which includes primary care nurse or dietitian delivery of 12-20weeks low calorie diet replacement, food reintroduction, and long-term weight loss maintenance. Main inclusion criteria: men and women aged 20-65years, all ethnicities, T2DM 0-6years duration, BMI 27-45kg/m Continue reading >>
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- Diabetes Remission Possible With Significant Weight Loss: DiRECT
- Diabetes Care Management Teams Did Not Reduce Utilization When Compared With Traditional Care: A Randomized Cluster Trial
Portland Diabetes Protocols
Portland diabetes protocols area finely tuned set of orders for intravenous insulin infusions in hospitalized diabetic patients, for use both in the intensive care units and on the wards. The Portland Protocol has been in use since 1992, and it has been successfully used at institutions throughout the world to control hyperglycemia. Since that time The Portland Protocol has been repeatedly modified and honed to provide what we believe is the tightest, most efficient, and safest tight glycemic control of any insulin protocol available. Request The Portland Protocol . Beginning in 1987, Portland Diabetes Project's research team, based at Providence Heart and Vascular Institute , has been investigating the relationship between inpatient hyperglycemia (high blood glucose levels) and hospital outcomes in diabetic cardiac surgery patients. Our team was the first to show that hyperglycemia was the significant casual factor for the increased risks of death, infection and length of hospital stay in the diabetic patient population. Conversely, we were also the first to show that the elimination of hyperglycemia with the use of an intravenous insulin infusion forthree perioperative days eradicates the incremental increases in these complications, that were previously ascribed to the risk factor diabetes. Continue reading >>
- JDRF Calls for Open Protocols in Diabetes Technology
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
- Leeds diabetes clinical champion raises awareness of gestational diabetes for World Diabetes Day