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Type 2 Diabetes Evaluation

Development And Evaluation Of Written Medicines Information For Type 2 Diabetes | Health Education Research | Oxford Academic

Development And Evaluation Of Written Medicines Information For Type 2 Diabetes | Health Education Research | Oxford Academic

The Consumer Involvement Cycle, theorized by the Centre for Health Information Quality, illustrates how consumers and HPs can work in partnership to develop high-quality written consumer information that better meets consumer needs. Thus, the overall aim of this project was to employ the Consumer Involvement Cycle in an effort to develop appropriate and consumer friendly WMI for Type 2 diabetes. The specific objectives of this study were 4-fold: (i) to explore consumers' experiences with medicines information, (ii) to investigate consumer perspectives on the utility of WMI in diabetes consumer education, (iii) to identify consumers' specific and unmet WMI needs regarding medications used in the management of Type 2 diabetes and associated conditions and complications and (iv) to develop appropriate WMI for Type 2 diabetes based on the acquired information. The study used qualitative methods for the in-depth exploration of its objectives. Semi-structured interviews were conducted. Ethical approval to conduct the study was granted by the Human Research Ethics Committee, University of Sydney, Australia. A convenience sample of people with Type 2 diabetes was recruited from five community pharmacies located in the North, East and South-East of Sydney, Australia. Inclusion criteria were as follows: age 18 years, a diagnosis of Type 2 diabetes, taking at least one oral medication for diabetes or associated conditions and complications and adequate language and comprehension skills in English. Eligible participants were invited by community pharmacists to participate in the study. Twenty-four in-depth, semi-structured face-to-face interviews of people with Type 2 diabetes were conducted in Sydney, 2003. Three carers (partners of the participants) volunteered to co-participate Continue reading >>

Diet Quality And Therapeutic Targets In Patients With Type 2 Diabetes: Evaluation Of Concordance Between Dietary Indexes

Diet Quality And Therapeutic Targets In Patients With Type 2 Diabetes: Evaluation Of Concordance Between Dietary Indexes

Diet quality and therapeutic targets in patients with type 2 diabetes: evaluation of concordance between dietary indexes This study aimed to evaluate the concordance between two dietary indexes, the Healthy Eating Index (HEI) and the Diabetes Healthy Eating Index (DHEI), in evaluating diet quality and its possible association with therapeutic targets in patients with type 2 diabetes. Cross-sectional study of outpatients with type 2 diabetes mellitus treated at a university hospital. Dietary information was obtained from a quantitative food frequency questionnaire (previously validated for use in patients with type 2 diabetes) and converted into daily intakes. Diet quality was assessed using two dietary indexes: HEI (12 components, nine food groups and three moderation components) and DHEI (10 components, six food groups, three nutrient groups, and one for variety of diet). In both indexes, the sum of the scores for each component yields an overall score converted on a scale from 0 to 100%; diet quality is subsequently ranked as low (<51%), needing improvement (5180%), or high (>80%). Patients underwent clinical and laboratory assessment. Those with fasting blood glucose values 70130mg/dL, A1c < 7%, total cholesterol <200mg/dL, LDL-cholesterol <100mg/dL, and triglycerides <150mg/dL were considered to meet therapeutic targets. All analyses were conducted in PASW Statistics 18.0, and p < 0.05 deemed significant. We analyzed 148 patients with type 2 diabetes (73% white, mean age 63.2 9.4years, median diabetes duration 10 [IQR 519] years, mean A1c% 8.4 2.0%, and mean BMI 30.5 4.2kg/m2). Mean energy intake was 2114 649kcal/day. DHEI scores were 17.0 (95%CI -6.8 to 41.0) points lower than HEI scores (55.9 14.2% vs. 72.9 10.7%, respectively; P < 0.001), suggesting there is no Continue reading >>

Evaluation Of The Web-based Diabetes Interactive Education Programme (diep) For Patients With Type 2 Diabetes - Sciencedirect

Evaluation Of The Web-based Diabetes Interactive Education Programme (diep) For Patients With Type 2 Diabetes - Sciencedirect

Evaluation of the web-based Diabetes Interactive Education Programme (DIEP) for patients with type 2 diabetes Author links open overlay panel EvelienHeinrichab The objective in this study was to evaluate a web-based type 2 diabetes self-management education programme aimed at improving knowledge, encouraging active patient participation and providing supportive self-management tools. (1) An effect evaluation was conducted using a randomized controlled trial with a pre-test and post-test design (n=99) and a knowledge questionnaire. (2) A user evaluation was conducted using an online questionnaire (n=564) and one-on-one interviews (n=11) to examine the perceived quality, use of functionalities and use of the programme as a supportive tool in education. The effect evaluation showed a significant intervention effect (p<0.01) on knowledge. The user evaluation showed high satisfaction with the programme's content, credibility and user-friendliness. However, functionalities and self-management tools were used by less than half of the participants. The programme can improve knowledge, but it is not fully used as intended. A more optimal use of the programme is necessary for higher efficacy. The use of mostly spoken text instead of written text was highly appreciated and could be used more often for educational websites. Furthermore, health care practitioners need support in implementing new educational programmes during consultations. Continue reading >>

Lifestyle Interventions To Prevent Type 2 Diabetes: A Systematic Review Of Economic Evaluation Studies

Lifestyle Interventions To Prevent Type 2 Diabetes: A Systematic Review Of Economic Evaluation Studies

Lifestyle Interventions to Prevent Type 2 Diabetes: A Systematic Review of Economic Evaluation Studies Koffi Alouki ,1 Hlne Delisle ,1 Clara Bermdez-Tamayo ,2and Mira Johri 3,4 1TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Development, Department of Nutrition, Faculty of Medicine, University of Montreal, 2405 Chemin de la Cte Sainte-Catherine, Montreal, QC, Canada H3T 1A8 2Institut de Recherche en Sant Publique de lUniversit de Montral (IRSPUM), University of Montreal, 7101 Avenue du Parc, 3e tage, Montral, QC, Canada H3N 1X9 3Centre de Recherche du Centre Hospitalier de lUniversit de Montral (CRCHUM), Tour Saint-Antoine, 850 Rue Saint-Denis, Montral, QC, Canada H2X 0A9 4Department of Health Administration, School of Public Health (ESPUM), Faculty of Medicine, University of Montreal, 7101 Avenue du Parc, 3e tage, Montral, QC, Canada H3N 1X9 Received 17 July 2015; Revised 13 October 2015; Accepted 19 October 2015 Copyright 2016 Koffi Alouki et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To summarize key findings of economic evaluations of lifestyle interventions for the primary prevention of type 2 diabetes (T2D) in high-risk subjects. Methods. We conducted a systematic review of peer-reviewed original studies published since January 2009 in English, French, and Spanish. Eligible studies were identified through relevant databases including PubMed, Medline, National Health Services Economic Evaluation, CINHAL, EconLit, Web of sciences, EMBASE, and the Latin American and Caribbean Health Sciences Literature. Studies targeting obesity were also included. Data were extracted Continue reading >>

Optimized Transient Insulin Infusion In Uncontrolled Type 2 Diabetes: Evaluation Of A Pragmatic Attitude - Em|consulte

Optimized Transient Insulin Infusion In Uncontrolled Type 2 Diabetes: Evaluation Of A Pragmatic Attitude - Em|consulte

Optimized transient insulin infusion in uncontrolled type 2 diabetes: evaluation of a pragmatic attitude O. Dupuy(1), H. Mayaudon(1), M. Palou(1), D. Sarret(1), L. Bordier(1), B. Bauduceau(1) (1)Department of Endocrinology, Hpital Bgin, 69 avenue de Paris, 94160 Saint-Mand, France. Glucotoxicity generated by hyperglycemia creates a vicious circle worsening the imbalance of diabetes mellitus. A pump-optimized transient insulin treatment can be used to break this fate and restore some degree of insulin sensitivity in uncontrolled type 2 diabetes. The aim of this retrospective study was to evaluate type 2 diabetics with a secondary failure to a maximal oral antidiabetic therapy, treated with a transient subcutaneous insulin therapy during 3 days. The following criteria were analysed: delay before permanent insulin treatment, prognosis factors of evolution, weight evolution and glucose control in patients maintained under oral treatment. We studied 250 type 2 diabetics, and 515 insulin infusions. The average follow-up was 3.5 years. At the end of the follow-up 63 patients required insulin from the inception of the study (Group 1), 76 secondarily resumed insulin (Group 2), and 111 remained with oral treatment (Group 3). Patients in Group 1 were significantly older, with higher HbA1c and a lower body mass index (BMI). On average, the patients in Group 3 were submitted to less than 2 insulin infusions, their BMI from the beginning to the end of the follow-up remained stable, while HbA1c improved. We conclude that transient optimized insulin treatment during 3 consecutive days is effective. Thus, 45 % of the initial global population remain under oral therapy after 3.5 years with a better glucose control and a stable weight. Key words : temporary intensive insulin therapy. , T Continue reading >>

Evaluation Of The Costs And Outcomes From Changes In Risk Factors In Type 2 Diabetes Using The Cardiff Stochastic Simulation Cost-utility Model (diabforecaster)

Evaluation Of The Costs And Outcomes From Changes In Risk Factors In Type 2 Diabetes Using The Cardiff Stochastic Simulation Cost-utility Model (diabforecaster)

Evaluation of the costs and outcomes from changes in risk factors in type 2 diabetes using the Cardiff stochastic simulation cost-utility model (DiabForecaster) Evaluation of the costs and outcomes from changes in risk factors in type 2 diabetes using the Cardiff stochastic simulation cost-utility model (DiabForecaster) Get access/doi/pdf/10.1185/030079906X80350?needAccess=true Aims: The aim of this study was to determine the mean costs and outcomes associated with modifiable risk factors in patients with type 2 diabetes and to determine equivalent changes to these risk factors in terms of financial costs and health outcomes. Methods: The Cardiff Stochastic Simulation Cost-Utility Model (DiabForecaster), which evolved from the Eastman model, was used to follow a cohort of 10 000 patients over 20 years. Results: Costs were affected most significantly by changes in the total cholesterol to HDL cholesterol (TotalC:HDLC) ratio and in HbA1c. Unit increases in TotalC:HDLC increased discounted costs by 200 per patient; for ratios > 8 units, unit increases led to cost increases of 300 per patient. Unit increases in HbA1c increased per patient discounted costs from 200 (56%) up to 2900 (1011%). Similar patterns were observed for QALYs. Estimates of equivalence showed that a 1% reduction in HbA1c was equivalent to an 0.4 increment in QALYs, which was equivalent to a reduction of 44 mmHg in SBP, 18.2 mg/dL in HDL, 100 mg/dL in total cholesterol or 1.8 units of TotalC:HDLC ratio. A 1% reduction in HbA1c was also equivalent to 108 less cost, which was equivalent to a 13.0 mmHg decrease in SBP or a 0.57 unit decrease in the TotalC:HDLC ratio. Conclusions: This model provides reliable utility estimates for diabetic complications and may eliminate uncertainty in cost-effectiveness ana Continue reading >>

Jcm | Free Full-text | Evaluation Of Two-diabetes Related Micrornas Suitability As Earlier Blood Biomarkers For Detecting Prediabetes And Type 2 Diabetes Mellitus

Jcm | Free Full-text | Evaluation Of Two-diabetes Related Micrornas Suitability As Earlier Blood Biomarkers For Detecting Prediabetes And Type 2 Diabetes Mellitus

J. Clin. Med. 2018, 7(2), 12; doi: 10.3390/jcm7020012 Evaluation of Two-Diabetes Related microRNAs Suitability as Earlier Blood Biomarkers for Detecting Prediabetes and type 2 Diabetes Mellitus Department of Molecular Medicine, College of Medicine and Medical Sciences and Al-Jawhara Centre for Molecular Medicine, Genetics and Inherited Disorders, Arabian Gulf University, Manama, Kingdom of Bahrain Author to whom correspondence should be addressed. Received: 31 December 2017 / Revised: 17 January 2018 / Accepted: 23 January 2018 / Published: 26 January 2018 Increased the incidence of prediabetes and type 2 diabetes (T2D) worldwide raises an urgent need to develop effective tools for early disease detection to facilitate future preventive interventions and improve patients care. We evaluated the suitability of diabetes-related miR-375 and miR-9 as earlier biomarkers for detecting prediabetes and T2D.TaqMan-based RT-qPCR was used to quantify the expression of miRNAs in peripheral blood of 30 prediabetes patients, 30 T2D patients and 30 non-diabetic healthy controls. Compared to controls, miR-375 and miR-9 were expressed at higher levels in prediabetes patients and progressively more enriched in T2D patients. Both miRNAs were directly associated with the presence of prediabetes and T2D independently of known risk factors to T2D and miR-375 was independently associated with the development of T2D. Both miRNAs were positively correlated with the glycemic status and other T2D risk factors. The ROC analysis indicated good diagnostic abilities for miR-375 to distinguish overall patients from control and prediabetes from T2D patients. Whereas, miR-9 showed lower values and borderline significance in discriminating the subject groups. The combination of miRNAs enhanced the predic Continue reading >>

Evaluation Of Guideline Recommendations On Oral Medications For Type 2 Diabetes Mellitus: A Systematic Review

Evaluation Of Guideline Recommendations On Oral Medications For Type 2 Diabetes Mellitus: A Systematic Review

Article, Author, and Disclosure Information Author, Article, and Disclosure Information Note: This article is based on research conducted by the Johns Hopkins University Evidence-based Practice Center under contract to AHRQ. Disclaimer: The authors of this article are responsible for its contents, including any clinical or treatment recommendations. No statement in this article should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. Acknowledgment: The authors thank Dr. Steven Fox for his assistance as the task order officer on the original contract and Dr. Deepan Dalal for his assistance reviewing guidelines. Financial Support: By contract 290-02-0018 from AHRQ. Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-1625 . Requests for Single Reprints: Wendy L. Bennett, MD, MPH, The Johns Hopkins University School of Medicine, 2024 East Monument Street, Room 2-611, Baltimore, MD 21205; e-mail, wbennet[email protected] . Current Author Addresses: Dr. Bennett: The Johns Hopkins University School of Medicine, 2024 East Monument Street, Room 2-611, Baltimore, MD 21205. Dr. Odelola: Department of Internal Medicine, Albert Einstein Medical Center, 5501 Old York Road, Philadelphia, PA 19141. Ms. Wilson: The Johns Hopkins University School of Medicine, 1830 East Monument Street, Baltimore, MD 21287. Dr. Bolen: MetroHealth/Case Western Reserve University, Center for Health Care Research and Policy, 2500 MetroHealth Drive, Rammelkamp Building, Room R234A, Cleveland, OH 44109. Ms. Selvaraj: The Johns Hopkins University School of Medicine, 1830 East Monument Street, Room 8066, Baltimore, MD 21287. Dr. Robinson: The Johns Hopkins University School of Medicine, 1 Continue reading >>

An Evaluation Of The Current Type 2 Diabetes Guidelines: Where They Converge And Diverge

An Evaluation Of The Current Type 2 Diabetes Guidelines: Where They Converge And Diverge

An Evaluation of the Current Type 2 Diabetes Guidelines: Where They Converge and Diverge Evelyn Tan , PharmD, Jennifer Polello , MHPA, MCHES, and Lisa J. Woodard , PharmD, MPH Evelyn Tan, PharmD, is a pharmacy resident at Kaiser PermanenteOakland in Oakland, Calif. Jennifer Polello, MHPA, MCHES, is a clinical transformation specialist at the Inland Northwest Health Services Beacon Program and an adjunct faculty member of the Washington State University College of Pharmacy in Spokane. Lisa J. Woodard, PharmD, MPH, is a clinical associate professor at the Washington State University College of Pharmacy in Spokane. Author information Copyright and License information Disclaimer Copyright 2014 by the American Diabetes Association. In providing the best care for patients, health care providers (HCPs) rely on clinical experience and judgment, published literature, and evidence-based clinical guidelines to direct decisions and serve as benchmarks for achieving optimal patient outcomes. Several published guidelines are available to support HCPs in caring for patients with type 2 diabetes. These include recommendations from the American Diabetes Association (ADA), 1 the World Health Organization (WHO), 2 the American Association of Clinical Endocrinologists (AACE), 3 the Indian Health Service (IHS), 4 and the Center for Medicaid and Medicare Services (CMS). 5 These guidelines are kept current through periodic review of available literature and research to ensure that they are up to date and based on the latest available evidence. Practicing clinicians and the various guideline development committees have diverse perspectives regarding how best to incorporate published research findings into clinical practice when managing patients with a disease as complex as type 2 diabetes. W Continue reading >>

Psychometric Evaluation Of Dietary Habits Questionnaire For Type 2 Diabetes Mellitus

Psychometric Evaluation Of Dietary Habits Questionnaire For Type 2 Diabetes Mellitus

Paper The following article is OPEN ACCESS Psychometric evaluation of dietary habits questionnaire for type 2 diabetes mellitus W Sami1,2, T Ansari3, N S Butt4 and M R Ab Hamid1 Published under licence by IOP Publishing Ltd 1 Faculty of Industrial Management, Universiti Malaysia Pahang, 26300 Gambang, Kuantan, Pahang, Malaysia 2 Department of Public Health & Community Medicine, College of Medicine, Majmaah University, Kingdom of Saudi Arabia 3 Department of Family Medicine, College of Medicine, Majmaah University, Kingdom of Saudi Arabia 4 Department of Family & Community Medicine, College of Medicine in Rabigh, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia This research evaluated the psychometric properties of English version of dietary habits questionnaires developed for type 2 diabetic patients. There is scarcity of literature about availability of standardized questionnaires for assessing dietary habits of type 2 diabetics in Saudi Arabia. As dietary habits vary from country to country, therefore, this was an attempt to develop questionnaires that can serve as a baseline. Through intensive literature review, four questionnaires were developed / modified and subsequently tested for psychometric properties. Prior to pilot study, a pre-test was conducted to evaluate the face validity and content validity. The pilot study was conducted from 23 October 22 November, 2016 to evaluate the questionnaires' reliability and validity. Systematic random sampling technique was used to collect the data from 132 patients by direct investigation method. Questionnaires assessing diabetes mellitus knowledge (0.891), dietary knowledge (0.869), dietary attitude (0.841) and dietary practices (0.874) had good internal consistency reliability. Factor analysis conducted on diet Continue reading >>

Evaluate The Effects Of Dapagliflozin In Patients With Type 2 Diabetes (cintique Dapa)

Evaluate The Effects Of Dapagliflozin In Patients With Type 2 Diabetes (cintique Dapa)

Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information Change from baseline the rate of production of VLDL Apo B [TimeFrame:15 days before treatment initiation, Day 0, Day 90 and Day 180] Change from baseline the rate of production of IDL Apo B [TimeFrame:15 days before treatment initiation, Day 0, Day 90 and Day 180] Change from baseline the rate of production of LDL Apo B [TimeFrame:15 days before treatment initiation, Day 0, Day 90 and Day 180] Change from baseline the rate of production of HDL Apo A1 [TimeFrame:15 days before treatment initiation, Day 0, Day 90 and Day 180] Change from baseline the Fractional Catabolic Rate of VLDL1 Apo B [TimeFrame:15 days before treatment initiation, Day 0, Day 90 and Day 180] Change from baseline the Fractional Catabolic Rate of VLDL2 Apo B [TimeFrame:15 days before treatment initiation, Day 0, Day 90 and Day 180] Change from baseline the Fractional Catabolic Rate of IDL Apo B [TimeFrame:15 days before treatment initiation, Day 0, Day 90 and Day 180] Change from baseline the Fractional Catabolic Rate of LDL Apo B [TimeFrame:15 days before treatment initiation, Day 0, Day 90 and Day 180] Change from baseline the Fractional Catabolic Rate of HDL 'Apo A1 [TimeFrame:15 days before treatment initiation, Day 0, Day 90 and Day 180] Continue reading >>

Liver Function Tests And Risk Prediction Of Incident Type 2 Diabetes: Evaluation In Two Independent Cohorts

Liver Function Tests And Risk Prediction Of Incident Type 2 Diabetes: Evaluation In Two Independent Cohorts

Liver Function Tests and Risk Prediction of Incident Type 2 Diabetes: Evaluation in Two Independent Cohorts Affiliations Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands Affiliation Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Affiliation Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Affiliation Center for Nutrition and Health, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands Affiliation Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Affiliation Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Affiliation Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands Affiliation Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands Affiliation Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Affiliation Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Affiliation Center for Prevention and Health Services Research, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Ne Continue reading >>

Metformin And Cancer In Type 2 Diabetes: A Systematic Review And Comprehensive Bias Evaluation

Metformin And Cancer In Type 2 Diabetes: A Systematic Review And Comprehensive Bias Evaluation

Background: Existing observational studies provide conflicting evidence for the causal effect of metformin use on cancer risk in patients with type-2 diabetes, and there are concerns about bias affecting a number of studies. Methods: MEDLINE was used to identify observational studies investigating the association between metformin and overall or site-specific cancer in people with type-2 diabetes. A systematic data extraction and bias assessment was conducted, in which risk of eight bias domains (outcome, exposure, control selection, baseline confounding, time-dependent confounding, immortal time, missing data, censoring methods) were assessed against pre-defined criteria, and rated as unlikely, low, medium or high. Results: Of 46 studies identified, 21 assessed the effect of metformin on all cancer. Reported relative risks ranged from 0.23 to 1.22, with 12/21 reporting a statistically significant protective effect and none a harmful effect. The range of estimates was similar for site-specific cancers; 3/46 studies were rated as low or unlikely risk of bias in all domains. Two of these had results consistent with no effect of metformin; one observed a moderate protective effect overall, but presented further analyses that the authors concluded were inconsistent with causality. However, 28/46 studies were at risk from bias through exposure definition, 22 through insufficient baseline adjustment and 35 from possible time-dependent confounding. Conclusions: Observational studies on metformin and cancer varied in design, and the majority were at risk of a range of biases. The studies least likely to be affected by bias did not support a causal effect of metformin on cancer risk. The reported hazard ratios for two of the 46 papers included in this systematic review were inco Continue reading >>

Diabetes Mellitus Type 2

Diabetes Mellitus Type 2

Diabetes mellitus type 2 (also known as type 2 diabetes) is a long-term metabolic disorder that is characterized by high blood sugar, insulin resistance, and relative lack of insulin.[6] Common symptoms include increased thirst, frequent urination, and unexplained weight loss.[3] Symptoms may also include increased hunger, feeling tired, and sores that do not heal.[3] Often symptoms come on slowly.[6] Long-term complications from high blood sugar include heart disease, strokes, diabetic retinopathy which can result in blindness, kidney failure, and poor blood flow in the limbs which may lead to amputations.[1] The sudden onset of hyperosmolar hyperglycemic state may occur; however, ketoacidosis is uncommon.[4][5] Type 2 diabetes primarily occurs as a result of obesity and lack of exercise.[1] Some people are more genetically at risk than others.[6] Type 2 diabetes makes up about 90% of cases of diabetes, with the other 10% due primarily to diabetes mellitus type 1 and gestational diabetes.[1] In diabetes mellitus type 1 there is a lower total level of insulin to control blood glucose, due to an autoimmune induced loss of insulin-producing beta cells in the pancreas.[12][13] Diagnosis of diabetes is by blood tests such as fasting plasma glucose, oral glucose tolerance test, or glycated hemoglobin (A1C).[3] Type 2 diabetes is partly preventable by staying a normal weight, exercising regularly, and eating properly.[1] Treatment involves exercise and dietary changes.[1] If blood sugar levels are not adequately lowered, the medication metformin is typically recommended.[7][14] Many people may eventually also require insulin injections.[9] In those on insulin, routinely checking blood sugar levels is advised; however, this may not be needed in those taking pills.[15] Bariatri Continue reading >>

Evaluation And Management Of Diabetes Mellitus

Evaluation And Management Of Diabetes Mellitus

Diabetes mellitus is a major public health problem with tremendous medical and economic burdens. It is the seventh leading cause of death and the number one cause of end-stage renal disease, adult blindness, impotence, and nontraumatic lower-limb amputation in the United States. People with diabetes are 2 to 4 times more likely to suffer from stroke or from cardiovascular disease, and are twice as likely to die compared with age-matched individuals without diabetes. Diabetes cost the United States around $174 billion in 2007, $58 billion of which was related to disability, work loss, and early mortality. Although there is currently no known cure for diabetes, much progress has been made over the past 2 decades to improve the diagnosis and management of diabetes. Evidence has shown that applying aggressive interventions early can prevent or delay progression to microvascular complications that increase the mortality rate in diabetes. The authors review the guidelines for optimal evaluation of diabetes mellitus and discuss the current and emerging therapeutic options available in the United States. [ADHB. 2008;1(8):39-48.] Diabetes mellitus is a chronic and devastating disease, affecting 8% of the US population.1 Despite recent advances in diagnostic and therapeutic options, the incidence of diabetes continued to rise in 2007. According to the Centers for Disease Control and Prevention, approximately 24 million Americans are currently diagnosed with diabetes, an increase of 3 million over the past 2 years, and another 57 million are classified as having prediabetes.1 About one third of the people with diabetes remain undiagnosed. Worldwide, the prevalence of diabetes is projected to reach 366 million people by the year 2030.2 Major increases in both macrovascular and mic Continue reading >>

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