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Recommendations For Antihyperglycemic Therapy In Type 2 Diabetes

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Treatment Of T2dm | Outpatient.aace.com

Every patient with documented type 2 diabetes (T2D) should have a comprehensive care plan (CCP), which takes into account the patients unique medical history, behaviors and risk factors, ethnocultural background, and environment. The ultimate goal of the CCP is to reduce the risk of diabetes complications without jeopardizing patient safety. To achieve this goal, the CCP should include the following components:1 The multidisciplinary team typically oversees the medical management of T2D, including the prescription of antihyperglycemic therapy and the delivery of diabetes self-management education (DSME) . DSME is used to educate the patient on the components of therapeutic lifestyle changes, namely medical nutritional therapy (MNT) and physical activity. Each patients understanding of and participation in the CCP is essential to its success.1 The components of therapeutic lifestyle change include:1 Nutritional medicine for diabetes involves counseling about general healthful eating, MNT, as well as nutritional support when appropriate (eg, in patients receiving enteral or parenteral nutrition in which medications provided for glycemic control must be synchronized with carbohydrate Continue reading >>

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Popular Questions

  1. neckhole

    Should I see a doctor?
    I know the answer to this, it's Yes! However, I thought I'd seek some advice first.
    I'm a Type 1 Diabetic, but otherwise I've been blessed with very good health, I'm hardly ever sick. However, for some reason starting today around 11:00 AM, I started having lots of trouble with Hypoglycemia. I kept eating candy and drinking apple juice every 20-30 minutes, but I was still testing out below 70 (typically 50-60).
    Eventually, I just turned suspended my basal insulin and was perplexed why I wasn't bouncing back up when I suddenly fell quite ill. I've been regularly throwing up now for almost 4 hours as well as having other unpleasant bathroom experiences.
    I'm hesitant to go to the hospital for two reasons:
    My company was just acquired by another and my transition to the new benefits is probably complete, but we haven't yet received any of our id cards or anything along those lines.
    The last time I got sick I went to the hospital (food poisoning, they suspected) and it was a terrible experience. I was out of town on vacation, so I got treated as "uninsured" and they did an atrocious job of managing my diabetes. They wound up taking me off my pump and managing me on a sliding scale, but never gave me enough insulin and I wound up having high blood sugar that caused them to not want to release me. Eventually I think I had to tell the doctor that either he let me manage my disease or I was never going to get discharged, sure enough a day later I had everything under control. But it literally took a week to get to that point.
    I'm just trying to avoid a repeat of what I experienced last time. Based on my experience, the best way to avoid that today is to avoid going to the hospital. But, I admit this may not be the wisest approach.
    How about you guys? How long of vomiting/diarrhea and not being able to keep food down before I should head to the hospital? I'm not running a temperature at all, but I do feel a bit feverish. If my pre and post-diagnosis health is any indication at all I'd have this licked overnight.

  2. cyjake111

    if you're not digesting food cuz it goes out b4 it can be digested you're not getting sugars. This sounds like a ticking time bomb waiting to happen. all hospitals are the same. If you have a reputable one close to you, go there. I have several close ones where I live and 2 are my go to hospitals if I ever go to the ER.
    Just go in there and say you can't keep your food down or in and your bg is hypo so you need fluids. they'll hook you up to an iv with sugar and make sure you don't die and keep track of your bg.

  3. wumsel

    Eventually, I just suspended my basal insulin
    It is not still suspended, is it? That can easily lead to DKA.
    Is your blood sugar still low? Are you monitoring ketones? (If they are high, is it because of a ketogenic diet?)
    I know I would try to avoid going to the hospital, but that may not be very wise. (When diagnosed, I was in a very bad shape and had Kussmaul breathing due to avoiding doctors for so long.)

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Prevention of microvascular and macrovascular complications rests on timely institution of drug therapy by the prescribing physician, usually a general practitioner (GP), and the patient's compliance with the treatment regimen and willingness to make lifestyle changes. Optimal use of clinical practice guidelines (CPGs) in general practice demands specific implementation strategies aiming at the reduction of barriers to high-quality care. Clinical practice guidelines are potentially useful for health services and health workforce planning, but would be more valuable for this aim if they contained more detail about care protocols and specific skills and competencies especially for general practitioners who would be expected to have reduced capacity for effective high-quality care.Subsequently, many patients will not receive such level of care despite the availability of international treatment guidelines describing the supposed optimal management of patients with diabetes. Hence, a clear understanding on how to overcome this knowledge-action gap in diabetes seems to be lacking, despite previous studies which outlined the obstacles that prevent GPs from following the CPGs. So the only winner in such battle field is the pharmaceutical companies. Because we as healthcare professionals control the market for products that we neither pay for nor consume, and whose unwanted consequences are experienced by patients.

Ada/easd New Hyperglycemia Management Guidelines

ADA/EASD New Hyperglycemia Management Guidelines ADA/EASD New Hyperglycemia Management Guidelines Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach: Position Statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Inzucchi SE, Bergenstal RM, Buse JB, et al. Glycemic targets and glucose-lowering therapies must be individualized. Diet, exercise, and education remain the foundation of any type 2 diabetes treatment program. Unless there are prevalent contraindications, metformin is the optimal first-line drug. After metformin, there are limited data to guide us. Combination therapy with an additional 12 oral or injectable agents is reasonable, aiming to minimize side effects where possible. Ultimately, many patients will require insulin therapy alone or in combination with other agents to maintain glucose control. All treatment decisions, where possible, should be made in conjunction with the patient, focusing on his/her preferences, needs, and values. Comprehensive cardiovascular risk reduction must be a major focus of therapy. Antihyperglycemic therapy in type 2 diabetes: general recommendations, b Continue reading >>

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Popular Questions

  1. Santosh Anand

    Insulin plays a key role in helping sugar (glucose) enter your cells, thus providing them energy. When your cells don't get the glucose they need for energy, your body begins to burn fat for energy, which produces ketones. Ketones are acidic and so when they build up in the blood, they make the blood more acidic, leading to the condition called diabetic ketoacidosis (DKA).
    Now, in type-1 diabetes, there is no insulin production whereas in type-2, there is impairment of insulin production. Thus why Type-2 diabetic people hardly get DKA.
    Note: Diabetic ketoacidosis is a serious condition that might lead to diabetic coma or even death.

  2. Lucas Verhelst

    In order for the cells in your body to access the glucose in your bloodstream so they can use it as energy they need insulin. Insulin acts like a key, opennin the cell door to allow the entry of glucose. Type 1 diabetics produce no insulin and need to inject it, thus the amount of insulin they have is strictly limited. Once they run out of insulin the glucose remains in the blood stream. If this occurs over a long period of time their blood glucose levels will rise due to the release of glucose from the liver. High blood sugar levels causes ketoacidosis which leads to coma and death.

  3. Keith Phillips

    Although type 2 diabetics suffer from insulin resistance, the condition rarely has an absolute negative effect on the bodies ability to convert glucose to usable energy. Type 1 diabetics have little or no ability to produce insulin. With the exception of neural cells, the rest of the body which without insulin is experiencing starvation, will consume its own tissues. (this is how people have endured periods of famine). This process however produces by products that eventually overwhelm the body's ability to process toxins.

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Oral Antihyperglycemic Treatment for Gestational Diabetes Azeez Farooki, MD Memorial Sloan-Kettering Cancer Center June 12, 2014, 8:30am Conference Room B

Oral Antihyperglycemic Therapy For Type 2 Diabetesscientific Review

Oral Antihyperglycemic Therapy for Type 2 Diabetes Customize your JAMA Network experience by selecting one or more topics from the list below. Challenges in Clinical Electrocardiography Clinical Implications of Basic Neuroscience Health Care Economics, Insurance, Payment Scientific Discovery and the Future of Medicine United States Preventive Services Task Force Inzucchi SE. Oral Antihyperglycemic Therapy for Type 2 DiabetesScientific Review. JAMA. 2002;287(3):360372. doi:10.1001/jama.287.3.360 Scientific Review and Clinical Applications ContextCare of patients with type 2 diabetes has been revolutionized throughoutthe past several yearsfirst, by the realization of the importance oftight glycemic control in forestalling complications, and second, by the availabilityof several unique classes of oral antidiabetic agents. Deciphering which agentto use in certain clinical situations is a new dilemma facing the primarycare physician. ObjectiveTo systematically review available data from the literature regardingthe efficacy of oral antidiabetic agents, both as monotherapy and in combination. Data SourcesA MEDLINE search was performed to identify all English-language reportsof unique, ra Continue reading >>

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Popular Questions

  1. PinkCupcake

    Fever can be a later symptom which would cause the warm skin and usually when people have a fever they "feel" cold.

  2. KatePasa

    Hot and dry, sugar's high. (Hyperglycemia) Cold and clammy, need some candy. (Hypoglycemia)

  3. garnetgirl29

    Oh that's a great way to remember it KatePasa! Thanks!
    In DKA, will the person feel cold even tho their skin is hot to anyone who touches them? Just trying to understand why my sister said she was cold when her sugar was high. (but, she doesn't have a pancreas at all, so her case is extreme)

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