How to use diabetes medication uk,type 2 diabetes caused by childhood obesity statistics,diabetes type 2 meal plans queens - PDF Review

Use these free images for your websites, art projects, reports, and Powerpoint presentations! Winter.  For those who will be experiencing cold weather over the next few months, do not fall into the misunderstanding that your children, with diabetes, will use less energy in the winter than when the weather is warm. On the other side of the spectrum, colder days can translate to less activity because children are not out running around in the warmer weather.  So just when you think you have their day figured out, their numbers seem askew again. Blood sugars tend to be higher in cold weather as well.  The physical response is not too unlike what happens to blood pressure and heart rates which also rise in colder weather. If anyone else has any tips, please feel free to chime in—-we could all learn something new.
Diabetics tend to have too much glucose circulating in their blood, which, if left unregulated, can lead to blindness, heart attacks, stroke, nerve damage, amputations and even death. With medication and monitoring, diabetics attempt a delicate balancing act to keep their blood glucose within the normal range.
If you have diabetes, check your blood regularly and consider enrolling in the Houston Methodist Diabetes Education Program. About Latest Posts Sheshe GiddensSenior Editor at Houston MethodistSheshe champions the hospital system's brand. LANTUS is indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus.
LANTUS is a recombinant human insulin analog for once daily subcutaneous administration with potency that is approximately the same as the potency of human insulin. In patients with type 1 diabetes, LANTUS must be used in regimens with short-acting insulin. The intended duration of activity of LANTUS is dependent on injection into subcutaneous tissue [see Clinical pharmacology (12.2)]. As with all insulins, injection sites should be rotated within the same region (abdomen, thigh, or deltoid) from one injection to the next to reduce the risk of lipodystrophy [See Adverse Reactions (6.1)].
In clinical studies, there was no clinically relevant difference in insulin glargine absorption after abdominal, deltoid, or thigh subcutaneous administration.
The recommended starting dose of LANTUS in patients with type 1 diabetes should be approximately one-third of the total daily insulin requirements.
If changing from a treatment regimen with an intermediate-or long-acting insulin to a regimen with LANTUS, the amount and timing of shorter-acting insulins and doses of any oral anti-diabetic drugs may need to be adjusted. If transferring patients from once-daily NPH insulin to once-daily LANTUS, the recommended initial LANTUS dose is the same as the dose of NPH that is being discontinued.
If transferring patients from twice-daily NPH insulin to once-daily LANTUS, the recommended initial LANTUS dose is 80% of the total NPH dose that is being discontinued.
In patients with hypersensitivity to LANTUS or one of its excipients [See Warnings and Precautions (5.4)]. Changes in insulin strength, manufacturer, type, or method of administration may result in the need for a change in insulin dose or an adjustment in concomitant oral anti-diabetic treatment. As with all insulin preparations, the time course of action for LANTUS may vary in different individuals or at different times in the same individual and is dependent on many conditions, including the local blood supply, local temperature, and physical activity. Intravenous administration of the usual subcutaneous dose could result in severe hypoglycemia [see Warnings and Precautions (5.3)].
Do not share disposable or reusable insulin devices or needles between patients, because doing so carries a risk for transmission of blood-borne pathogens. The timing of hypoglycemia usually reflects the time-action profile of the administered insulin formulations.
Early warning symptoms of hypoglycemia may be different or less pronounced under certain conditions, such as longstanding diabetes, diabetic neuropathy, use of medications such as beta-blockers, or intensified glycemic control. Severe, life-threatening, generalized allergy, including anaphylaxis, can occur with insulin products, including LANTUS. Due to its long duration of action, Lantus is not recommended during periods of rapidly declining renal function because of the risk for prolonged hypoglycemia. Due to its long duration of action, Lantus is not recommended during periods of rapidly declining hepatic function because of the risk for prolonged hypoglycemia. Some medications may alter insulin requirements and subsequently increase the risk for hypoglycemia or hyperglycemia [See Drug Interactions (7)]. Thiazolidinediones (TZDs), which are peroxisome proliferator-activated receptor (PPAR)-gamma agonists, can cause dose-related fluid retention, particularly when used in combination with insulin.


Because clinical trials are conducted under widely varying designs, the adverse reaction rates reported in one clinical trial may not be easily compared to those rates reported in another clinical trial, and may not reflect the rates actually observed in clinical practice.
The frequencies of treatment-emergent adverse events during LANTUS clinical trials in patients with type 1 diabetes mellitus and type 2 diabetes mellitus are listed in the tables below. Hypoglycemia is the most commonly observed adverse reaction in patients using insulin, including LANTUS [See Warnings and Precautions (5.3)].
Table 7 displays the proportion of patients experiencing severe symptomatic hypoglycemia in the Lantus and Standard Care groups in the ORIGIN Trial [see Adverse Reactions (cardiovascular safety)]. Retinopathy was evaluated in the LANTUS clinical studies by analysis of reported retinal adverse events and fundus photography. LANTUS was compared to NPH insulin in a 5-year randomized clinical trial that evaluated the progression of retinopathy as assessed with fundus photography using a grading protocol derived from the Early Treatment Diabetic Retinopathy Scale (ETDRS).
Intensification or rapid improvement in glucose control has been associated with a transitory, reversible ophthalmologic refraction disorder, worsening of diabetic retinopathy, and acute painful peripheral neuropathy. Long-term use of insulin, including LANTUS, can cause lipodystrophy at the site of repeated insulin injections.
Weight gain can occur with insulin therapy, including LANTUS, and has been attributed to the anabolic effects of insulin and the decrease in glucosuria.
Insulin, including LANTUS, may cause sodium retention and edema, particularly if previously poor metabolic control is improved by intensified insulin therapy. As with any insulin therapy, patients taking LANTUS may experience injection site reactions, including redness, pain, itching, urticaria, edema, and inflammation. Rotation of the injection site within a given area from one injection to the next may help to reduce or prevent these reactions. Severe, life-threatening, generalized allergy, including anaphylaxis, generalized skin reactions, angioedema, bronchospasm, hypotension, and shock may occur with any insulin, including LANTUS and may be life threatening. The objective of the trial was to demonstrate that LANTUS use could significantly lower the risk of major cardiovascular outcomes compared to standard care. Overall, the incidence of major adverse cardiovascular outcomes was similar between groups (see Table 9).
Mucormycosis is a fungal infection of the sinuses, brain, or lungs that occurs primarily in people with immune disorders. Causes Mucormycosis is caused by common fungi frequently found in the soil and in decaying vegetation. Unlike type 1 diabetes, people with type 2 diabetes can still make insulin, but they develop insulin resistance.
As the process of producing more and more insulin continues, the pancreas is unable to meet the demand as the blood glucose levels remains too high and type 2 diabetes occurs. As an avid technology enthusiast, Sheshe's (pronounced shay shay) personal mission is to stop the rampant misuse of the em dash and to promote becoming computer savvy in the 21st century. LANTUS exhibits a relatively constant glucose-lowering profile over 24 hours that permits once-daily dosing. As for all insulins, the rate of absorption, and consequently the onset and duration of action, may be affected by exercise and other variables, such as stress, intercurrent illness, or changes in co-administered drugs or meal patterns. Short-acting, premeal insulin should be used to satisfy the remainder of the daily insulin requirements. The dosage of LANTUS should be individualized under the supervision of a healthcare provider in accordance with the needs of the patient. This dose reduction will lower the likelihood of hypoglycemia [see Warnings and Precautions (5.3)].
Changes to an insulin regimen should be made cautiously and only under medical supervision. Patients being switched from twice daily NPH insulin to once-daily LANTUS should have their initial LANTUS dose reduced by 20% from the previous total daily NPH dose to reduce the risk of hypoglycemia [see Dosage and Administration (2.3)]. The patient's ability to concentrate and react may be impaired as a result of hypoglycemia. These situations may result in severe hypoglycemia (and, possibly, loss of consciousness) prior to the patient's awareness of hypoglycemia.
Tables 5, and 6 and 7 summarize the incidence of severe hypoglycemia in the LANTUS individual clinical trials. In the pediatric phase 3 clinical trial, children and adolescents with type 1 diabetes had a higher incidence of severe symptomatic hypoglycemia in the two treatment groups compared to the adult trials with type 1 diabetes.
The numbers of retinal adverse events reported for LANTUS and NPH insulin treatment groups were similar for patients with type 1 and type 2 diabetes.


Patients had type 2 diabetes (mean age 55 yrs) with no (86%) or mild (14%) retinopathy at baseline. However, long-term glycemic control decreases the risk of diabetic retinopathy and neuropathy.
Lipodystrophy includes lipohypertrophy (thickening of adipose tissue) and lipoatrophy (thinning of adipose tissue), and may affect insulin absorption.
In some instances, these reactions may be related to factors other than insulin, such as irritants in a skin cleansing agent or poor injection technique.
The presence of such insulin antibodies may increase or decrease the efficacy of insulin and may require adjustment of the insulin dose. People with prediabetes have elevated blood glucose (sugar), but it isn’t high enough to be classified as diabetes.
That means that the body doesn’t properly use the insulin hormone that the pancreas produces, which leads to it making more insulin.
In some instances, the cells that produce the insulin become severely impaired or destroyed and the diabetic requires insulin to help regulate blood glucose. The symptoms of low blood glucose happen quickly and can include symptoms such as shakiness, confusion, unconsciousness or dizziness. When LANTUS and regular human insulin were mixed immediately before injection in dogs, a delayed onset of action and a delayed time to maximum effect for regular human insulin was observed. This may present a risk in situations where these abilities are especially important, such as driving or operating other machinery. Patients treated with insulin, including LANTUS, and a PPAR-gamma agonist should be observed for signs and symptoms of heart failure. In phase 3 clinical trials of LANTUS, increases in titers of antibodies to insulin were observed in NPH insulin and insulin glargine treatment groups with similar incidences.
The first co-primary endpoint was the time to first occurrence of a major adverse cardiovascular event defined as the composite of CV death, nonfatal myocardial infarction and nonfatal stroke.
Symptoms of rhinocerebral mucormycosis are most likely to occur among immunosuppressed people. Depending on where the symptoms are, CT scans or MRIs may be done. If their blood glucose is too high, then its more devastating effects usually occur over prolonged periods of time, but immediate symptoms include excessive thirst and frequent urination. The total bioavailability of the mixture was also slightly decreased compared to separate injections of LANTUS and regular human insulin. Severe hypoglycemia can lead to unconsciousness or convulsions and may result in temporary or permanent impairment of brain function or death.
If heart failure develops, it should be managed according to current standards of care, and discontinuation or dose reduction of the PPAR-gamma agonist must be considered.
The primary outcome was progression by 3 or more steps on the ETDRS scale at study endpoint. The second co-primary endpoint was the time to the first occurrence of CV death or nonfatal myocardial infarction or nonfatal stroke or revascularization procedure or hospitalization for heart failure.
Severe hypoglycemia requiring the assistance of another person or parenteral glucose infusion or glucagon administration has been observed in clinical trials with insulin, including trials with LANTUS. Patients with pre-specified post-baseline eye procedures (pan-retinal photocoagulation for proliferative or severe nonproliferative diabetic retinopathy, local photocoagulation for new vessels, and vitrectomy for diabetic retinopathy) were also considered as 3-step progressors regardless of actual change in ETDRS score from baseline. Surgical removal of infected tissue may be disfiguring because it may involve removal of the palate, parts of the nose, or parts of the eye. The mean change in body weight from baseline to the last treatment visit was 2.2 kg greater in the LANTUS group than in the standard care group. Withoutt his aggressive surgery, however, chances of survival are greatly decreased. Outlook (Prognosis) Mucormycosis has an extremely high mortality rate even with aggressive surgical intervention. The results for the primary endpoint are shown in Table 8 for both the per-protocol and Intent-to-Treat populations, and indicate similarity of Lantus to NPH in the progression of diabetic retinopathy as assessed by this outcome. For patients with type 2 diabetes, 59% were treated with a single oral antidiabetic drug, 23% had known diabetes but were on no antidiabetic drug and 6% were newly diagnosed during the screening procedure. Fifty nine percent of participants had had a prior cardiovascular event and 39% had documented coronary artery disease or other cardiovascular risk factors.



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