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Type 2 Diabetes: Mastering Injectable Combination Therapies To Individualize & Optimize Outcomes

Type 2 Diabetes: Mastering Injectable Combination Therapies to Individualize & Optimize Outcomes

Type 2 Diabetes: Mastering Injectable Combination Therapies to Individualize & Optimize Outcomes

For clinicians, the treatment of diabetes can be challenging. Because type 2 diabetes is progressive, a key to successful therapy is the need for additional agents over time. It is critical to have the clinical ability to individualize therapy by patient and medication characteristics. With the availability of injectable combination therapies, there are more opportunities than ever to accommodate patient preferences while improving glycemic control while harnessing the extraglycemic benefits of additional agents to open the door for successful management.
As a value added-resource, a specialized toolkit will also be included as a supplement to the webcast. The toolkit will provide for clinicians the latest treatment guidelines and updated reference guide. In addition, the toolkit will provide helpful information and resources for families and caregivers.
Delineate the factors that should be considered when selecting agents to individualize therapy in type 2 diabetes;
Understand current evidence regarding the efficacy, safety, and limitations of the most recently approved classes of agents for patients who require treatment intensification;
Apply evidence- and guideline-based recommendations to individualize combination therapy when treatment intensification is indicated;
Incorporate effective communication techniques and educational tools to improve the patient’s knowledge of type 2 diabetes and treatment.
Faculty:
John (Jack) L. Leahy, MD
Professor of Medicine
Chief of Endocrinology, Diabetes and Metabolism
University of Vermont
Colchester, Vermont
Moderator:
John J. Rus Continue reading

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Diabetes in the Elderly

Diabetes in the Elderly

Chapter Headings
Key Messages
Diabetes in the elderly is metabolically distinct from diabetes in younger people and the approach to therapy should be different.
Sulphonylureas should be used with caution because the risk of hypoglycemia increases exponentially with age.
Long-acting basal analogues are associated with a lower frequency of hypoglycemia than conventional insulins in this age group.
In elderly people, if mixture of insulin is required, the use of premixed insulins as an alternative to mixing insulins minimizes dose errors.
Introduction
The definition of “elderly” varies, with some studies defining the elderly population as ≥60 years of age. Administrative guidelines frequently classify people >65 years of age as elderly. Although there is no uniformly agreed-upon definition of elderly, it is generally accepted that this is a concept that reflects an age continuum starting sometime after age 65 and is characterized by a slow, progressive impairment in function that continues until the end of life (1).
Diagnosis
As noted in the Definition, Classification and Diagnosis of Diabetes, Prediabetes and Metabolic Syndrome chapter (p. S8), glycated hemoglobin (A1C) can be used as 1 of the diagnostic tests for type 2 diabetes in adults. Unfortunately, normal aging is associated with a progressive increase in A1C, and there is a significant discordance between fasting plasma glucose–based and A1C-based diagnosis of diabetes in this age group, a difference that is accentuated by race and gender (2). Pending further studies to define the role of A1C in the diagnosis Continue reading

The Link Between Diabetes and Depression

The Link Between Diabetes and Depression

Depression and diabetes are two conditions that can sometimes go hand-in-hand. First, diabetes can increase the risk of depression, according to a growing body of research. In fact, having diabetes doubles the risk of depression, compared to people who don't have the disease. Conversely, depression also can increase the risk of Type 2 diabetes, research shows.
It's often a vicious cycle. Depression can get worse as the complications of diabetes get worse, and be depressed can stop people from managing their diabetes as effectively as they need to, which can lead to increased incidence of long-term complications such as retinopathy, neuropathy or nephropathy.​
Depression can color everything in a person's life. The ability to do everyday activities can become overwhelming, and this includes taking care of diabetes, such as taking medications, eating right and exercising. Fatigue and lack of enthusiasm can cause people to withdraw from the things they used to like to do. Emotions become flat and thoughts can turn to sadness, anxiety or even suicide.
Unfortunately, a large proportion of people suffering from depression and diabetes never receive help for the depression. Sometimes it's not recognized by healthcare professionals, and sometimes people who are depressed don't communicate to their doctors about their thoughts and feelings or don't realize that they are depressed.
Symptoms of Depression
Recognizing the symptoms of depression is important for getting the help that's needed.
Feeling sad for a prolonged period of time.
Feeling restless or anxious for no apparent reas 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

Background: Type 2 diabetes (T2D) is typically managed with a reduced fat diet plus glucose-lowering medications, the latter often promoting weight gain.
Objective: We evaluated whether individuals with T2D could be taught by either on-site group or remote means to sustain adequate carbohydrate restriction to achieve nutritional ketosis as part of a comprehensive intervention, thereby improving glycemic control, decreasing medication use, and allowing clinically relevant weight loss.
Methods: This study was a nonrandomized, parallel arm, outpatient intervention. Adults with T2D (N=262; mean age 54, SD 8, years; mean body mass index 41, SD 8, kg·m−2; 66.8% (175/262) women) were enrolled in an outpatient protocol providing intensive nutrition and behavioral counseling, digital coaching and education platform, and physician-guided medication management. A total of 238 participants completed the first 10 weeks. Body weight, capillary blood glucose, and beta-hydroxybutyrate (BOHB) levels were recorded daily using a mobile interface. Hemoglobin A1c (HbA1c) and related biomarkers of T2D were evaluated at baseline and 10-week follow-up.
Results: Baseline HbA1c level was 7.6% (SD 1.5%) and only 52/262 (19.8%) participants had an HbA1c level of <6.5%. After 10 weeks, HbA1c level was reduced by 1.0% (SD 1.1%; 95% CI 0.9% to 1.1%, P<.001), and the percentage of individuals with an HbA1c level of <6.5% increased to 56.1% (147/262). The majority of participants (234/262, 89.3%) were taking at least one diabetes medication at baseline. By 10 weeks, 133/234 (56.8%) individuals had one o Continue reading

Homeopathic Treatment For Diabetes: Remedies To Control Blood Sugar And Nerve Damage

Homeopathic Treatment For Diabetes: Remedies To Control Blood Sugar And Nerve Damage

Diabetes is a growing concern in the world, with an estimated 30.3 million Americans suffering from it. What’s worse is that about 84.1 million Americans are thought to have prediabetes, which means their blood sugar levels are high enough to pose a risk of diabetes.1 Over time, high blood sugar can cause a range of problems from heart disease and eye problems to kidney disease and nerve damage.
So what can you do to deal with diabetes? Conventionally, medication to lower your blood sugar, insulin treatment, as well as lifestyle changes like having a healthy diet and exercising regularly are recommended to help manage this condition. Natural and alternative remedies can be used to fight diabetes as well. For instance, homeopathy, an alternative medical system that originated in Germany over 200 years ago, offers many solutions for dealing with diabetes.2 Here’s a detailed look at what homeopathy recommends.3 4
Homeopathic Treatment Is Tailored To The Individual
In a departure from conventional medicine, homeopathy uses a process known as “individualization” for treatment. According to this concept, a homeopathic doctor will first draw a detailed pathophysiological profile of the patient and then select a remedy based on that. They take a detailed history covering various factors like individual preferences, emotions, family history, sleep habits, and the way a person reacts mentally as well as physically to things. In other words, homeopathy treats the patient not the disease. And since treatments are tailored for each individual, different people suffering from the Continue reading

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