Type 1 diabetes articles 2013,therapy diabetes type 2 x0,type 2 diabetes vs type 1 diabetes 101 - Reviews

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This site contains information, news and advice for healthcare professionals.You have informed us that you are not a healthcare professional and therefore we are unable to provide you with access to this site. Diet, exercise, and education remain the foundation of all type 2 diabetes treatment programmes. After metformin, it is reasonable to consider combination therapy with an additional 1-2 oral or injectable agents with the objective of minimising side-effects where possible.
For many patients insulin therapy alone or in combination with other agents will ultimately be required to maintain glucose control. All treatment decisions, where possible, should take into account the patient’s preferences, needs and values.
Diabetes may be diagnosed based on HbA1c criteria or plasma glucose criteria, either the fasting plasma glucose (FPG) or the 2-h plasma glucose (2-h PG) value after a 75-g oral glucose tolerance test (OGTT). For all patients, particularly those who are overweight or obese, testing should begin at age 45 years. Two primary techniques are available to assess the effectiveness of glycaemic control: Patient self-monitoring of blood glucose (SMBG) or interstitial glucose and A1C.
Patients on multiple-dose insulin or insulin pump therapy should perform SMBG prior to meals and snacks, occasionally postprandially, at bedtime, prior to exercise, when they suspect low blood glucose, after treating low blood glucose until they are normoglycaemic, and prior to critical tasks such as driving.
Initial therapy: Most patients should begin with lifestyle changes – healthy eating, weight control, increased physical activity, and diabetes education.
Advancing to dual combination therapy: If the HbA1c target is not achieved after ~3 months with metformin, there are six drug choices including a second oral agent (sulfonylurea, TZD, DPP-4 inhibitor, or SGLT2 inhibitor), a GLP-1 receptor agonist, or basal insulin. Advancing to triple combination therapy: Evidence suggests that there is some advantage in adding a third noninsulin agent to a two-drug combination not achieving the glycaemic target.
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HbA1c is a term often used in relation to diabetes and this guide explains what HbA1c is, how it's used for diabetes diagnosis and how it differs from blood glucose levels.
When glucose sticks to these molecules it forms a glycoslated haemoglobin molecule, also known as A1c and HbA1c.
Due to the fact that red blood cells survive for 8-12 weeks before renewal, by measuring HbA1c, an average blood glucose reading can be returned. For people with diabetes, an HbA1c level of 6.5% is considered good control, although some people may prefer their numbers to be closer to that of non-diabetics. How often HbA1c levels should be taken depends on the person with diabetes and their history of control and treatment objections. There is little point in having HbA1c checked regularly if you are not making efforts to control your diabetes.
Although HbA1c level alone does not predict diabetes complications, good control is known to lower the risk of complications. In well-controlled diabetes without a high level of glucose in the blood, a lower level of glycosylated haemoglobin will be returned. In the case of poor control, with more glucose, a higher level of glycosylated haemoglobin will be returned. There is a new report out by the Economic Research Service called ‘Healthy Vegetables Undermined by the Company They Keep’ that really surprised me. In a nutshell, the report said that eating more fruit is associated with healthier weight but that Americans who eat more vegetables may actually increase their calorie and sodium intake. The report found that when many Americans eat vegetables they prepare them in ways that add calories and sodium while reducing fiber.
I think the disconnect is that when I recommend eating more vegetables I am thinking roasted sweet potatoes or Brussels sprouts, raw baby carrots, spinach salads, steamed green beans, raw broccoli and cauliflower florets, etc. I am drinking raw broccoli, tomato and baby spinach with water every day and seem to put on more weight than if I ditched the veggies.


Diabetes may be identified in seemingly low risk individuals who happen to have glucose testing, in symptomatic patients, and in higher-risk individuals who are tested because of a suspicion of diabetes. When lifestyle efforts alone have not achieved or maintained glycemic goals, metformin monotherapy should be added at, or soon after, diagnosis (in patients intolerant, or with contraindications for, metformin, select initial drug from other treatment options).
But some people hear this recommendation and automatically think about the vegetables they are used to eating such as French fries, cheesy potatoes, green bean casserole, 7 layer salad, zucchini bread, hash browns, pizza with mushrooms, spinach dip, etc. Most of us need to eat twice as many vegetables as we do.  But all vegetables are not created equal. Shared decision making with the patient is important to help in the selection of therapeutic option. Since diabetes is associated with progressive beta-cell loss, many patients, especially those with long-standing disease, will ultimately need to be transitioned to insulin. Calorie labeling will soon be available in restaurant chains with 20 or more establishments and you can ask managers to provide the information in local restaurants. The choice is based on patient and drug characteristics, with the over-riding goal of improving glycaemic control while minimising side-effects. Update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Fresh tomatoes or canned tomatoes with no salt added are healthier choices than tomatoes cooked into pizza and spaghetti sauce which are typically high in sodium.
In using triple combinations the essential consideration is obviously to use agents with complementary mechanisms of action.




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