Type 2 diabetes mellitus metabolic syndrome symptoms,diet nutrition and the prevention of type 2 diabetes,medical errors in jordan - Easy Way

Every patient with documented type 2 diabetes mellitus (T2DM) should have a comprehensive care plan (CCP), which takes into account the patient’s unique medical history, behaviors and risk factors, ethnocultural background, and environment.
The multidisciplinary team typically oversees the medical management of T2DM, including the prescription of antihyperglycemic therapy and the delivery of diabetes self-management education (DSME). Either the physician or a registered dietitian (RD) should discuss healthful eating recommendations in plain language at diagnosis of T2DM and then periodically during follow-up office visits (Table 1). MNT involves a more detailed discussion of calories, grams, and other metrics, as well as intensive implementation of dietary recommendations aimed at optimizing glycemic control and reducing the risk for complications.
Patients should be advised that any physical activity is better than none, and that they should make every effort to increase their activity level. An exercise prescription should be developed for each patient according to both goals and limitations. Antidiabetic treatment should be promptly intensified to maintain blood glucose at individual targets.
Selection of agents should be based on individual patient medical history, behaviors, and risk factors, ethnocultural background, and environment. Self-monitoring of blood glucose (SMBG) is a vital tool for day-to-day management of blood sugar in all patients using insulin and many patients not using insulin. Most patients with an initial A1C level greater than 7.5% will require combination therapy using agents with complementary mechanisms of action.
Antihyperglycemic agents may be broadly categorized by whether they predominantly target FPG or PPG levels (see Table 3).
The choice of whether to target FPG or PPG should be based primarily on the individual patient’s glycemic profile obtained by self-monitoring of blood glucose (SMBG).
Intensification of pharmacotherapy requires glucose monitoring and medication adjustment at appropriate intervals when treatment goals are not achieved or maintained. Long-acting basal insulin is generally the initial insulin choice, and the insulin analogues glargine and detemir are strongly preferred over human NPH insulin because they have relatively peakless time-action curves and a more consistent effect from day to day, resulting in a lower risk of hypoglycemia. Basal insulin is usually added to existing noninsulin therapy, and many antihyperglycemic agents are approved for use with insulin: DPP-4 inhibitors, glinides, GLP-1 receptor agonists (but not exenatide XR), metformin, pramlintide, sulfonylureas, and TZDs. The risk of hypoglycemia is increased when combining insulin with sulfonylureas, glinides, DPP-4 inhibitors, and GLP-1 receptor analogues. GLP-1 receptor analogues and DPP-4 inhibitors have not been studied with prandial insulin. Using insulin with TZDs may increase the risk of weight gain, edema, and congestive heart failure. Rapid-acting insulin analogues are preferred over regular human insulin because they have a more rapid onset and offset of action and are associated with less hypoglycemia. Premixed insulin analogue therapy may be considered for patients in whom drug regimen adherence is an issue; however, these preparations lack component dosage flexibility and may increase the risk for hypoglycemia compared with basal insulin or basal-bolus insulin.
This approach (ie, transitioning to insulin after noninsulin agents fail to maintain glycemic targets) is supported by the recently published results of the Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial.
Several new classes of agents are under investigation for the treatment of T2DM, and some new agents within existing classes may represent improvements over currently available options.17 The listing in Table 4 should be considered representative and not necessarily all-inclusive.
For complete descriptions of the devices and accompanying technology themselves, click on the links above.
CSII is recommended mainly for patients with type 1 diabetes mellitus (T1DM), but patients with advanced T2DM who are absolutely insulin-deficient, take 4 or more insulin injections a day, and assess their blood glucose levels 4 or more times daily are candidates for CSII.
Safety—particularly the risk of hypoglycemia—should be the primary concern when choosing an antidiabetic therapy. Table 3 lists the major safety risks associated with currently available antidiabetic agents. Severe hypoglycemia stimulates sympathetic adrenergic discharge, causing arrhythmias or autonomic dysfunction (or both) and has long been recognized to have potential for causing mortality. In addition to increased mortality, hypoglycemia negatively affects adherence to therapy and quality of life and also contributes to morbidity.
Management of hypoglycemia involves appropriate choice of antihyperglycemic therapy, tailoring of insulin treatment to minimize risks, and patient education in the recognition and treatment of acute hypoglycemia (Table 5).40 It is important to remember that the features listed in Table 5 occur along a continuum, and glycemic thresholds and symptom manifestations may vary widely among individuals. For T2DM patients, most of whom are overweight or obese, the risk of additional weight gain must be balanced against the benefits of the agent itself.
Once T1DM and monogenic diabetes have been ruled out and a T2DM diagnosis has been definitively established for a child or adolescent, diet and lifestyle modification are always the first treatment choices. Children born to women with any form of diabetes are at greater risk of developing T2DM themselves.
Older adults are more likely to have an increased number of comorbid conditions (eg, frailty, dementia, depression, urinary incontinence) that can complicate their diabetes management. Fasting is a common religious practice that can pose a challenge to diabetes management, particularly if the fast occurs over an extended time, such as Ramadan, a holy month of Islam in which all healthy adults consume no food or fluids between sunrise and sunset. The risk of these outcomes depends on the severity and complications of T2DM according to the categories in Table 7. For the management of glycemia during extended fasts, general principles and recommendations are listed below. Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas.
Insufficient production of insulin (either absolutely or relative to the body’s needs), production of defective insulin (which is uncommon), or the inability of cells to use insulin properly and efficiently leads to hyperglycemia and diabetes. In response to the increased glucose level, the pancreas normally releases more insulin into the bloodstream to help glucose enter the cells and lower blood glucose levels after a meal.
As outlined above, in patients with diabetes, the insulin is either absent, relatively insufficient for the body’s needs, or not used properly by the body. From an economic perspective, the total annual cost of diabetes in 1997 was estimated to be 98 billion dollars in the United States.

Diabetes is the third leading cause of death in the United States after heart disease and cancer. I can tell you that I experienced three of these and it seemed to me that they started almost overnight. So, it was off to the doctor for me so I could get the official answer and, of course, I did have diabetes.
A family history of diabetes, you are over the age of 45 or you are under the age of 45 and are overweight. In addition to your current blood sugar level, which the doctor can check right in his office, the blood test will give your doctor (and you) additional information about your blood sugar that can be traced back 90 days.
If you have any reason to believe that you have Diabetes Symptoms it is better to find out sooner rather than later. A Celebration of Women™ Foundation Inc., was born to shape a better world through building residential homes that are mandated to enable the education of young women, support self sustainable programs, graduating future women leaders.
Table 2 shows studies that compare the prevalence of IFG and IGT (28,31–34,36,37,45,48).
Insulin resistance syndrome, or metabolic syndrome, increases your risk of diabetes and early heart disease. OBJECTIVES: High fructose feeding induces insulin resistance and hyperinsulinemia in rats. Englisch-Deutsch-A?bersetzung fA?r insulin resistant im Online-WA¶rterbuch dict.cc (DeutschwA¶rterbuch). The ultimate goal of the CCP is to reduce the risk of diabetes complications without jeopardizing patient safety.
DSME is used to educate the patient on the components of therapeutic lifestyle changes, namely medical nutritional therapy (MNT) and physical activity.
These recommendations are suitable for the general population, including people without diabetes, and focus on foods that can promote health vs foods that may promote disease or complications from disease. Recommendations should be personalized, and in general, evaluation and teaching should be conducted by an RD or knowledgeable physician. Overweight individuals with type 2 diabetes should strive for a 5% to 10% reduction in weight and should avoid weight gain. Unstructured activities include walking up or down stairs instead of using elevators, using parking spaces farther from building entrances, and the like. Degludec, a new ultra-long–acting basal insulin, is currently undergoing review by the U.S. This 6-year study, which included over 12,000 patients, compared the use of insulin glargine with standard care in patients with cardiovascular risk factors plus either prediabetes or recent-onset T2DM (mean T2DM duration at baseline: 5 years).
These patients must also be motivated to achieve tighter plasma glucose control and be intellectually and physically able to undergo the rigors of insulin pump therapy initiation and maintenance.
While individual agents may have contraindications or carry increased risks for specific populations, in general, hypoglycemia and weight gain are the primary limiting factors in diabetes treatment.
American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for developing a diabetes mellitus comprehensive care plan.
Effects of aerobic and resistance training on hemoglobin A1C levels in patients with type 2 diabetes: a randomized controlled trial. Exercise training improves glycemic control in long-standing insulin-treated type 2 diabetic patients. Continuous low- to moderate-intensity exercise training is as effective as moderate- to high-intensity exercise training at lowering blood HbA(1c) in obese type 2 diabetes patients. Effect of noninsulin antidiabetic drugs added to metformin therapy on glycemic control, weight gain, and hypoglycemia in type 2 diabetes. Lower baseline glycemia reduces apparent oral agent glucose-lowering efficacy: a meta-regression analysis.
Ultra-long-acting insulin degludec has a flat and stable glucose-lowering effect in type 2 diabetes. Insulin degludec, an ultra-longacting basal insulin, versus insulin glargine in basal-bolus treatment with mealtime insulin aspart in type 2 diabetes (BEGIN Basal-Bolus Type 2): a phase 3, randomised, open-label, treat-to-target non-inferiority trial.
A new-generation ultra-long-acting basal insulin with a bolus boost compared with insulin glargine in insulin-naive people with type 2 diabetes: a randomized, controlled trial. Renal sodium-glucose transport: role in diabetes mellitus and potential clinical implications. The effects of salsalate on glycemic control in patients with type 2 diabetes: a randomized trial.
Statement by the American Association of Clinical Endocrinologists Consensus Panel on insulin pump management.
Statement by the American Association of Clinical Endocrinologists Consensus Panel on continuous glucose monitoring. Benefits of self-monitoring blood glucose in the management of new-onset type 2 diabetes mellitus: the St Carlos Study, a prospective randomized clinic-based interventional study with parallel groups. Structured self-monitoring of blood glucose significantly reduces A1C levels in poorly controlled, noninsulin-treated type 2 diabetes: results from the Structured Testing Program study.
ROSES: role of self-monitoring of blood glucose and intensive education in patients with Type 2 diabetes not receiving insulin. Restoration of normal glucose tolerance in severely obese patients after bilio-pancreatic diversion: role of insulin sensitivity and beta cell function. The Diabetes Surgery Summit consensus conference: recommendations for the evaluation and use of gastrointestinal surgery to treat type 2 diabetes mellitus. Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. The effects of baseline characteristics, glycaemia treatment approach, and glycated haemoglobin concentration on the risk of severe hypoglycaemia: post hoc epidemiological analysis of the ACCORD study.

Hypoglycemia in type 2 diabetes: pathophysiology, frequency, and effects of different treatment modalities. The absolute lack of insulin, usually secondary to a destructive process affecting the insulin producing beta cells in the pancreas, is the main disorder in type 1 diabetes. Glucose is an essential nutrient that provides energy for the proper functioning of the body cells. When the blood glucose levels are lowered, the insulin release from the pancreas is turned down.
These types of damage are the result of damage to small vessels, referred to as microvascular disease. I had a family history of diabetes that went directly back to my father and his mother, so the chances of my getting diabetes were always pretty good. If you think you have any of the Diabetes Symptoms mentioned above, a simple blood test will give you the answer. Well over 60,000 searches are done online each and every month for the term insulin resistance.
Read about insulin resistance is causes, symptoms, treatment (like diet), risk factors and more. Explains how insulin resistance develops and offers natural symptom relief for women who are insulin resistant. Certain food groups have been shown in reliable studies to decrease the risk of various conditions. Recommendations should be personalized on the basis of a patient’s specific medical conditions, lifestyle, and behavior.
To date, metformin remains the only oral medication approved by the FDA for use in children with T2DM. Elevated levels of blood glucose (hyperglycemia) lead to spillage of glucose into the urine, hence the term sweet urine. When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level.
In type 2 diabetes, there also is a steady decline of beta cells that adds to the process of elevated blood sugars. Carbohydrates are broken down in the small intestine and the glucose in digested food is then absorbed by the intestinal cells into the bloodstream, and is carried by the bloodstream to all the cells in the body where it is utilized. It is important to note that even in the fasting state there is a low steady release of insulin than fluctuates a bit and helps to maintain a steady blood sugar level during fasting.
Diabetes is also an important factor in accelerating the hardening and narrowing of the arteries (atherosclerosis), leading to strokes, coronary heart disease, and other large blood vessel diseases. The reason for this is that the symptoms can be so mild and develop so gradually that you do not even notice them or you do not even have any symptoms. Wow, for as bad as it was I might as well have pitched a tent in my bathroom and brought along a cooler full of drinks. I mean, even if you are not experiencing the above symptoms, there are still reasons to have your blood sugar tested anyway. Patients unable to maintain a healthy weight on their own should be referred to an RD or weight-loss program that has a proven success rate. Insulin use in the prediabetic patients did reduce the incidence of T2DM (see detailed discussion in Prediabetes), but there was no difference in cardiovascular outcomes between treatment groups after 6 years. In patients with diabetes, the absence or insufficient production of insulin causes hyperglycemia.
Essentially, if someone is resistant to insulin, the body can, to some degree, increase production of insulin and overcome the level of resistance. However, glucose cannot enter the cells alone and needs insulin to aid in its transport into the cells. In normal individuals, such a regulatory system helps to keep blood glucose levels in a tightly controlled range. Fortunately there is one condition that will always improve with dietary and lifestyle modifications, and that is Insulin Resistance, a common condition which is estimated to affect at least one in four people!
Median FPG and A1C levels were lower in the glargine group, but the incidence of hypoglycemia and weight gain were modestly increased.
Diabetes is a chronic medical condition, meaning that although it can be controlled, it lasts a lifetime. After time, if production decreases and insulin cannot be released as vigorously, hyperglycemia develops. Without insulin, the cells become starved of glucose energy despite the presence of abundant glucose in the bloodstream. Diabetes affects approximately 17 million people (about 8% of the population) in the United States. In addition, an estimated additional 12 million people in the United States have diabetes and don’t even know it.
Nevertheless, knowing I had this family history, whenever my doctor would have me get a blood test, the first thing I always asked was, “how is my blood sugar?” and I was always relieved when the answer came back “good”. I am far sighted, but all of a sudden I could not see things 10 feet away, they were all blurry. It’s funny or sad, depending on how you look at it, here I am concerned over the results of my blood sugar test, but not concerned enough to do anything about my eating habits. I guess a better way to characterize my concern would be to say I was relieved, that way I could keep on with my bad eating habits and feel alright about it.

Nice type 2 diabetes management guidelines
Stress oxydatif et diab?te de type 2 pdf let?lt?s
15.12.2014 Ictm Diabetes


  1. ilkin

    Response to a very low carb however, some people may be able low-carb.



    Energy in fat, and those in the low-carb group.


  3. Xariograf

    Morning empty stomach daily for a month.You can also weight-reduction plan.


  4. Torres

    Index is important in that some foods trigger sugar ranges are one of the are looking.