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Association Of Glycemic Variability In Type 1 Diabetes With Progression Of Microvascular Outcomes In The Diabetes Control And Complications Trial

Association of Glycemic Variability in Type 1 Diabetes With Progression of Microvascular Outcomes in the Diabetes Control and Complications Trial

Association of Glycemic Variability in Type 1 Diabetes With Progression of Microvascular Outcomes in the Diabetes Control and Complications Trial

OBJECTIVE The Diabetes Control and Complications Trial (DCCT) demonstrated the beneficial effects of intensive versus conventional therapy on the development and progression of microvascular complications of type 1 diabetes. These beneficial effects were almost completely explained by the difference between groups in the levels of HbA1c, which in turn were associated with the risk of these complications. We assessed the association of glucose variability within and between quarterly 7-point glucose profiles with the development and progression of retinopathy, nephropathy, and cardiovascular autonomic neuropathy during the DCCT.
RESEARCH DESIGN AND METHODS Measures of variability included the within-day and updated mean (over time) of the SD, mean amplitude of glycemic excursions (MAGE), and M-value, and the longitudinal within-day, between-day, and total variances. Imputation methods filled in the 16.3% of expected glucose values that were missing.
RESULTS Cox proportional hazards models assessed the association of each measure of glycemic variation, as a time-dependent covariate, with the risk of retinopathy and nephropathy, and a longitudinal logistic regression model did likewise for cardiovascular autonomic neuropathy. Adjusted for mean blood glucose, no measure of within-day variability was associated with any outcome. Only the longitudinal mean M-value (over time) was significantly associated with microalbuminuria when adjusted for the longitudinal mean blood glucose and corrected for multiple tests using the Holm procedure.
CONCLUSIONS Overall, within-day glycemic va Continue reading

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HEALTH: Managing Diabetes in Pro Wrestling

HEALTH: Managing Diabetes in Pro Wrestling

According to the American Diabetes Association, in 2012, 29.1 million Americans had diabetes. 1.4 million Americans are diagnosed every year.
Also according to the American Diabetes Association, diabetes was the 7th leading cause of death in the U.S. in 2010.
There is a stereotype that everybody in professional wrestling is so jacked-up and healthy that they couldn’t possibly have health issues. This stereotype, like many others, is false.
Those in the professional wrestling industry are not immune to diseases such as diabetes. In fact, in this article we will take a look at three individual cases of personalities in the industry battling diabetes.
Jesse Hernandez, Jacob Tarasso, and myself have all been diagnosed with diabetes. Hernandez is a retired pro wrestler and referee, turned promoter (Empire Wrestling Federation). Jacob Tarasso is an active professional wrestler. I am a play by play commentator.
Hernandez was diagnosed with Type-II Diabetes in 1992 when he went in for a drivers license for a city job. Tarasso’s diagnosis came at age 15 when lab results showed sugar in his urine. My diagnosis was in July 2010 after lab tests.
Symptoms that I was told to look out for were frequent thirst, increased fatigue, and blurred vision.
» CHECK YOUR BLOOD SUGAR
Make sure to check your blood sugar levels so you know how to plan accordingly, and take appropriate steps in either bringing up levels or bringing them down.
Tarasso now has a portable meter to check his blood sugar, at which he checks it before breakfast and dinner.
“I check my levels everyday before breakfast, Continue reading

diabetes mellitus in children

diabetes mellitus in children

1. Duhok Pediatrics Diabetes center
2. Definition • It’s a chronic metabolic disorder characterized by hyperglycemia as a cardinal biochemical feature, caused by deficiency of insulin or its action, manifested by abnormal metabolism of carbohydrates, protein and fat
3. Epidemiology • Peaks of presentation occur in 2 age groups: at 5-7 yr of age (infectious) and at the time of puberty (gonadal steroids ). • Girls and boys are almost equally affected • There is no apparent correlation with socioeconomic status.
4. Incidence rates of type 1 diabetes mellitus by region and country
5. Diagnosis of diabetes is made when: • Symptoms + • random BGL ≥ 11.1 mmol/L (≥200 mg/dl) (or) • Fasting BGL ≥ 7mmol/L (≥ 126 mg/dl)
6. ETIOLOGIC CLASSIFICATIONS OF DIABETES MELLITUS Type I diabetes: (β-cell destruction, usually leading to absolute insulin deficiency) -Immune mediated. -Idiopathic. Type 2 diabetes: (may range from predominantly insulin resistance with relative insulin deficiency to a predominantly secretory defect with insulin resistance). Other specific types : Genetic defects of β-cell function:Chromosome 7, glucokinase (MODY2) Genetic defects in insulin action:Rabson-Mendenhall syndrome Diseases of the exocrine pancreas: Pancreatitis Endocrinopathies: Cushing disease Drug- or chemical-induced : Glucocorticoids Infections:Cytomegalovirus Uncommon forms of immune-mediated diabetes :Stiff-man” syndrome Other genetic syndromes sometimes associated with diabetes :Down syndrome Gestational diabetes mellitus Neonatal diabetes mellitus
7. Physiology • The ma Continue reading

New approaches to Diabetes management could transform healthcare in Saudi Arabia

New approaches to Diabetes management could transform healthcare in Saudi Arabia

Saudi Arabia has a high prevalence (17.6%) of type 2 diabetes.
26 February 2017
- Boehringer Ingelheim sponsors the fourth International Conference of Endocrinology and diabetes conference in Riyadh
- Saudi Arabia has a high prevalence (17.6%) of type 2 diabetes. It is forecasted that the incidence of the disease will increase to 45.36% in 2030[1]
Kingdom Saudi Arabia – Riyadh – The Saudi Society of Endocrinology and Metabolism (SSEM) recently organized Fourth International Conference of Endocrinology and Diabetes Conference (ICED), which was held in Al Faisaliah Hotel, Riyadh.
Boehringer Ingelheim, one of the world’s leading pharmaceutical companies, participated as a co-sponsor in the event, which was attended by leading endocrinologists, diabetologists, cardiologists as well as pediatricians.
The ICED aims to provide an update and comprehensive review across the fields of endocrinology, diabetes and metabolism for both adults and pediatrics. Industry professionals came together to find new ways of changing the paradigm around diabetes management, with an objective of driving a better quality of healthcare delivery.
According to the International Diabetes Federation, the rate of type 2 diabetes in the Middle East North Africa (MENA) region will rise by 96.2% by 2035. [2] There were 3.4 million cases of diabetes in Saudi Arabia in 2015 alone. Diabetes is also the second highest cause of death after road injuries in the Kingdom.[3]
Dr. Atallah Al-Ruhaily, President of Saudi Society of Endocrinology and Metabolism; Consultant Endocrinology at the King Abdulaziz Univers Continue reading

Mastery in Diabetes Management: HbA1c's Role in Diabetes Readmission

Mastery in Diabetes Management: HbA1c's Role in Diabetes Readmission


Mastery in Diabetes Management: HbA1c's Role in Diabetes Readmission
Hirva Bakeri, MD, MS, on how HbA1c levels were not predictive of 30-day hospital readmissions
Patients with a primary diagnosis of diabetes were found to have significantly higher HbA1c levels than those with a secondary diagnosis of diabetes.
Note that patients with multiple readmissions within 30 days had a higher HbA1c when compared to those with one readmission.
Hirva Bakeri, MD, MS, of the University of Connecticut, spoke with MedPage Today at ENDO 2017, the annual meeting of The Endocrine Society in April, when she presented a poster on how mean HbA1c was higher among patients with multiple readmissions compared to those with only 1-readmission, despite HbA1c levels not being significantly associated with overall readmission. Her full poster may be downloaded by clicking here .
Following is a transcript of her remarks:
The research that we did was about the role of hemoglobin A1c on readmission rates for patients with diabetes. To give you a little bit of background, hospital readmission is a high-priority healthcare quality measure and a target for cost reduction. In this current era of major healthcare reform, this is of growing importance.
In 2012, in the month of October, the Centers for Medicare and Medicaid Services came up with a program called Hospital Readmission Reduction program that decreases payments for hospitals if they have higher-than-expected numbers of readmissions. And when I say readmissions, I'm usually talking about early readmissions of patients who were discharged wi Continue reading

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