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Recommendations For Antihyperglycemic Therapy In Type 2 Diabetes

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Is Combination Antihyperglycemic Therapy Superior To Monotherapy As An Initial Type 2 Diabetes Treatment?

Is Combination Antihyperglycemic Therapy Superior to Monotherapy as an Initial Type 2 Diabetes Treatment? Karin Sterl, MD, and Kim A. Carmichael, MDSeries Editor Q.What is the rationale behind starting initial combination therapy in patients with type 2 diabetes? A.Since type 2 diabetes is associated with multiple physiologic abnormalities, combination therapy may help address many of these concerns concomitantly so as to minimize side effects and provide rapid metabolic balance. Understanding the mechanisms of action of the differing agents will help the clinician choose the optimal regimen for any given patient. Q.What are the most common oral hypoglycemic agents used in the initial therapy of type 2 diabetes? A.The American Diabetes Association (ADA) recommends biguanides (eg, metformin in the United States), if not contraindicated, as the initial agent for treatment of type 2 diabetes.1 Metformin works by decreasing glucose production by the liver and increasing glucose uptake into the muscles. It can decrease hemoglobin A1c (HbA1c) values by 1.5% to 2%. It is contraindicated in patients with renal insufficiency (creatinine levels >1.4 mg/dL in females and >1.5 mg/dL in males) Continue reading >>

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  1. TheCommuter

    You can post this question on this site's Nursing Student Assistance Forums and perhaps get an answer. One of our frequent users, Daytonite, loves to give detailed answers to these types of questions.
    http://allnurses.com/forums/f205/

  2. ICRN2008

    Here is the formula for anion gap:
    Agap = Na + K - Cl -CO2
    I would think that the doctor would be monitoring the glucose level (not the agap) to determine when to stop the insulin drip. Anyone else have an idea?

  3. P_RN

    One of our wonderful members Mark Hammerschmidt has a great FREE MICU site:
    http://www.icufaqs.org/
    Check section 4.2
    It's all acidosis/alkalosis

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WATCH FULL VIDEO: https://goo.gl/APNPrA?42453

Management Of Hyperglycemia In Type 2 Diabetes: A Patient-centered Approach Developed By The American Diabetes Association And The European Association For The Study Of Diabetes

Your browser does not support the NLM PubReader view. Go to this page to see a list of supporting browsers. Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach Developed by the American Diabetes Association and the European Association for the Study of Diabetes J Korean Diabetes. 2012 Dec;13(4):172-181. J Korean Diabetes. 2012 Dec;13(4):172-181. Korean. Published online December 27, 2012. Copyright 2012 Korean Diabetes Association Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach Developed by the American Diabetes Association and the European Association for the Study of Diabetes Division of Endocrinology and Metabolism, Department of Internal Medicine, Gangneung Asan Hospital, Ulsan University School of Medicine, Gangneung, Korea. Corresponding author (Email: [email protected] ) In 2012, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) published new guidelines for the management of type 2 diabetes, emphasizing the need to individualize treatment goals with preference, need and cost-effects compared with the 2008 ADA/EASD algorithm. These ADA/EASD recommendations provided charac Continue reading >>

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  1. Alisonjane10

    Hello folks
    I've been following a low carb diet, moderate fat intake for 2 months now. After asking tons of questions on this marvellous forum, I've learnt how this way of eating works. Via testing, I know I am consistently in nutritional ketosis. I am currently losing about a 1LB a day in weight...which is great. But, is it normal? I'm aware other members have achieved huge weight loss whilst eating LCHF. But I'm unsure of the overall timescale. Recent blood screening shows I don't have thyroid problems. All advice gratefully received.
    Ali. X

  2. jack412

    do you want to slow it down?
    how are you feeling, do you see any diet like symptoms?
    how much more weight do you want to lose?
    it is a lot a week and twice that is recommended
    www.youtube.com/watch?v=2KYYnEAYCGk

  3. AndBreathe

    Alisonjane10 said: ↑
    Hello folks
    I've been following a low carb diet, moderate fat intake for 2 months now. After asking tons of questions on this marvellous forum, I've learnt how this way of eating works. Via testing, I know I am consistently in nutritional ketosis. I am currently losing about a 1LB a day in weight...which is great. But, is it normal? I'm aware other members have achieved huge weight loss whilst eating LCHF. But I'm unsure of the overall timescale. Recent blood screening shows I don't have thyroid problems. All advice gratefully received.
    Ali. X
    Click to expand... So, in two months you have lost 4 stones? At the outset, how much did you have to lose, and how close are you now to your target?

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Antihyperglycemic Therapy In Elderly Diabetics

Antihyperglycemic Therapy in Elderly Diabetics Adopting an individualized approach is the cornerstone of much of modern medicine, and nowhere is that more true than in the care of older patients with type 2 diabetes (T2DM).1 Older patients represent a highly variable population. Some may have no health problems other than T2DM, while others may suffer from multiple health issues that complicate treatment. Longstanding diabetes increases the risk for microvascular and macrovascular complications, yet those with well controlled disease may need a different treatment approach than those whose disease has been difficult to manage. Patients who are newly diagnosed later in life with T2DM may need yet another strategy. In recent years, guidelines have recognized the variability in this age group by emphasizing the importance of balancing the risks of hypoglycemia vs the benefits of adequate glucose control. Although guidelines differ, in general they recommend less intensive treatment and more relaxed HbA1c targets in certain circumstances, especially for frail patients and those with cardiovascular disease. These guidelines follow on the heels of research suggesting the existence of a Continue reading >>

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Popular Questions

  1. Punkin

    I think I need to start using one, especially since I have some dietary challenges
    Does anyone have one that is recommended. Also where can I get one and how much do they cost approximately.
    I don't know anything about them.

  2. Mobear

    I'm not an expert on this since I just purchased mine this last week . I think the only 2 available are from Precision and NovaMax. Precision tends to be a little more accurate but the strips are REALLY expensive. NovaMax doesn't seem to be quite as accurate (at least with glucose readings) but the strips are a little more reasonable. I usually look up this kind of thing on amazon. Some people have reported good prices from american diabetes wholesale so you might want to look there also.
    Just remember that the meter has to check blood ketones - not just glucose. Any strips you are looking at must check blood ketones - not the urine ketones (those strips are very inexpensive).
    Others will chime in with more info I'm sure

  3. UnstrungHarp

    I'm no expert either, but I got my Precision reader for free. We can't post links here, but I think if you Google "free Precision Xtra meter" the top search result should be the right one. It's totally legit - straight from the manufacturer. Also, the fact that the form asked for insurance info freaked me out, but apparently that's nothing. They didn't even have my insurance company in their selection list, so I chose a random one. I got my meter delivered via FedEx within a week!
    When it comes to the strips, it's not so easy or cheap. I found a Canadian pharmacy online where I've been ordering my strips. The price there is $19.99 for a box of 10, plus approximately $7 shipping to the U.S. It seems like the shipping takes forever, but I'm not sure if that's a fault of the specific pharmacy or the fact that it's coming from Canada and I'm simply impatient. I just tried a Google search for "Precision Xtra ketone strips" and the pharmacy I've been using was the third search result. You may have better luck finding a cheaper/faster pharmacy if you keep looking. I've just been sticking with the familiar!
    The only problem I've had with that pharmacy was that my second order of strips was very delayed because for some reason they had to talk to me on the phone to verbally confirm my order. And they didn't let me know this until several days after I placed my order. On the phone I asked them, why didn't I have to do this with my first order? They said that it was standard practice on all orders, and it was unusual that I didn't have to the first time. Well, when I got ready to place my third order, I crossed my fingers and tried it online again without calling...turns out no phone call was necessary that time either.
    Whichever meter you choose - good luck!!!

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    Is Combination Antihyperglycemic Therapy Superior to Monotherapy as an Initial Type 2 Diabetes Treatment? Karin Sterl, MD, and Kim A. Carmichael, MDSeries Editor Q.What is the rationale behind starting initial combination therapy in patients with type 2 diabetes? A.Since type 2 diabetes is associated with multiple physiologic abnormalities, combination therapy may help address many of these concerns concomitantly so as to minimize side effects a ...

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