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About Speaking of DiabetesSpeaking of Diabetes is produced by Joslin Diabetes Center for people with diabetes and those who care for them.. Joslin Diabetes Center, a teaching and research affiliate of Harvard Medical School, is a one-of-a-kind institution on the front lines of the world epidemic of diabetes - leading the battle to conquer diabetes in all forms through cutting-edge research and innovative approaches to clinical care and education. This entry was posted in Diabetes Day2Day, Guideline, Type 2 Diabetes and tagged a1c, type 2 a1c targets, Type 2 Diabetes. A joint position paper by American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) questions the veracity of a one size fits all specific A1C target for non-pregnant patients with type 2 diabetes. The table below indicates the order and intensity of importance of factors to consider when deciding on individual patient treatment goals. The report appearing in the April 19 2012 issue of Diabetes Care also re-emphasized the importance of dietary and physical activity approaches and suggested that highly motivated patients who are initially diagnosed with an A1C under 7.5% be given a 3 to 6 month trial of lifestyle before initiating drug therapy.
In addition, while noting that the available oral pharmaceutical agents have some variation in their ability to lower A1C, the authors concluded that all of the agents available are in the same ball park in their efficacy. Diet, exercise, and education remain the foundation of any type 2 diabetes treatment program. Ultimately, many patients will require insulin therapy alone or in combination with other agents to maintain glucose control. The authors also made a number of recommendations about treatment for patients with type 2 diabetes who have many other medical problems.
For people with heart failures, while recommending the avoidance of thiazolidinedones (TZDS) such as Actos® and Avandia® (since they can potentate fluid overload) they suggested that metformin may not be as problematic a choice of medication in this population as previously believed. Main DocumentA doctor might order a test of the sugar level in a person's blood if there is a concern that they may have diabetes, or have a sugar level that is either too low or too high. Popular InformationDisability Loans & GrantsLoans and grant information for low income singles, families, seniors, and disabled. This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community.
The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. Please note that we are unable to respond back directly to your questions or provide medical advice.
Welcome back to our weekly advice column, Ask D'Mine, hosted by veteran type 1, diabetes author and educator Wil Dubois.
If we had a dollar for every time "What the heck??" was uttered in managing diabetes, we'd probably have enough funds to find the cure ourselves! When reusing pen needles do we need to worry about bacteria migrating from the needle tip up into the pen during the hours the pen is not being used?
Introduction: Type 2 Diabetes is a lifestyle related disease and a major risk factor for Cardio Vascular Diseases (CVDs).
Objectives: To estimate the prevalence of Type 2 Diabetes and Prediabetes among adults (aged 30 years and above) residing in Neyyattinkara taluk of South Kerala and to identify the diabetes Case Detection Rates across different age groups. Whereas rest of India is still grappling with communicable diseases and malnourishment, the state of Kerala stands out, with non-communicable diseases (NCDs) emerging as a major public health challenge. To estimate the prevalence of Type 2 Diabetes and Prediabetes among adults (aged 30 years and above) residing in Neyyattinkara taluk of South Kerala. To study the fasting plasma glucose levels as an indicator of diabetes control in the community.
Data Collection Tools: Structured questionnaire and Blood Sugar examination using Glucometer (DiabeCHECK- Jitron).
Ethical clearance was obtained from Institutional Ethical Committee, Trivandrum Medical College.
Diabetes Case Detection Rates across different age groups were examined and was highest (76%) between 60 and 69 years. 81 (18%) persons had blood sugar values above 125 mg%.  Of these 42 were already diagnosed and was on treatment.
A national study9 to determine the prevalence of Diabetes and Prediabetes in India done in three states (Tamil Nadu, Maharashtra and Jharkhand) and one union territory (Chandigarh) showed that the weighted prevalence of Diabetes was 10.4% in Tamil Nadu, 8.
Studies from Kerala  also emphasized the need for life style modifications and community based programmes for early detection and preventive measures.1, 12  Diabetes Case Detection Rate in the present study was 50% in persons less than 50 years of age and more than 75% above the age of 50 years. Prediabetes is a significant risk factor for the development of type 2 diabetes, micro vascular, and macro vascular disease.
LMC is looking for individuals with Type 1 Diabetes to participate in a research study involving an experimental insulin medication that may help lower meal-time glucose levels. We have over 40 years of combined & trusted experience conducting clinical research studies to thoroughly test new medications or medical devices for safety and efficacy. British Columbia is home to the healthiest Canadian population, while residents in Newfoundland and Labrador and the three territories are the least healthy, according to report card released Thursday by the Conference Board of Canada. Newfoundland and Labrador earned the lowest score of all the provinces with a D-minus because of disease rates and infant mortality. By submitting a comment, you accept that CBC has the right to reproduce and publish that comment in whole or in part, in any manner CBC chooses.
The Diabetes Forum - find support, ask questions and share your experiences with 209,001 people.
It is not always obvious which type of diabetes someone may have and it may be necessary for your health to carry out specific tests to find out which type of diabetes you have.
In some cases, people initially diagnosed with one type of diabetes may be given a re-diagnosis at a later date. There is a distinct difference between type 1 and type 2 diabetes, although it may not be evident without the correct tests. If your health team are in doubt about which type of diabetes you have, you may need to have one or more tests to deduce which type of diabetes you have.
The following flowchart shows how tests can be carried out to distinguish between different types of diabetes. In the UK, it is not standard practice to carry out tests to specifically diagnose which type of diabetes you have but it may be required if, for example, your blood glucose levels are not responding well to tablet medications. The most important aspect of getting the right diagnosis is in ensuring you’re on an appropriate medication regimen to adequately control your diabetes. It is relatively common for people with confirmed type 2 diabetes to move onto insulin injections.
However, in some cases, people diagnosed initially with type 2 diabetes may be re-diagnosed by their doctors as having a form of type 1 diabetes. There can sometimes be grey areas and in some cases specific diagnostic tests may be required to confirm which type of diabetes you have. Find support, ask questions and share your experiences with 209,001 members of the diabetes community. 10 week (free) low-carb education program developed with the help of 20,000 people with T2D and based on the latest research.
The first comprehensive, free and open to all online step-by-step guide to improving hypo awareness. Published in March 2014, The South Asian Health Solution provides a health-based wellness plan culturally tailored to South Asians.
Past studies have suggested a relationship between neighborhood characteristics and obesity, as well as a connection between obesity and advertisements on television and in magazines.  Now, new research from University of California, Los Angeles (UCLA) has identified a possible link between outdoor fast food ads and a tendency to pack on pounds. An original investigation by the Palo Alto Medical Foundation (PAMF) Research Institute has found that two lifestyle interventions for overweight and obese patients at high risk of developing type 2 diabetes and heart disease lead to significant, sustainable weight loss and improved cardiometabolic risk factors. A report on the research was published online on December 10, 2012, in JAMA Internal Medicine (formerly Archive of Internal Medicine).


Nearly 70 percent of American adults are overweight or obese, putting them at a higher risk for developing type 2 diabetes and heart disease. Free Preventive Health Screening: Up to eight members of each participating family are screened at a local Safeway pharmacy for preventive health goals, BMI and blood pressure.
Follow Up: Before the end of the school year, families will be encouraged to repeat their online WAY2GO! Data for Schools: Each participating school receives aggregate data (gathered through the WAY2GO! The first school to participate in the project is Landels Elementary School in Mountain View, Calif., with many other local schools slated to participate soon. About This BlogThis newsroom provides timely news resources for journalists, and gives people useful information about health care, research, education and wellness. Register for our monthly newsletter:This form needs Javascript to display, which your browser doesn't support.
Instead it suggests focusing on individually targeted glycemic goals based on a series of patient attributes including patient desires and attitudes toward treatment, potential for hypoglycemia, disease duration, life expectancy, co-morbidities, vascular complications and patient resources. In addition to glycemic control the position statement recommends clinicians and patients take into account cardiovascular risk management due to the high morbidity load this places on patients with type 2 diabetes. Therefore, the decision of second or third drug to add as should be based on patient co-morbidities and drug side- effect profiles. Combination therapy with an additional 1–2 oral or injectable agents is reasonable, aiming to minimize side effects where possible. In patients with minimal to moderate ventricular dysfunction, stable cardiovascular status and normal renal function, it could be considered. The body naturally tightly regulates blood glucose levels as a part of metabolic homeostasis. The test, which is also called a check of blood sugar, blood glucose, fasting blood sugar, fasting plasma glucose, or fasting blood glucose, indicates how much glucose is present is present in a person's blood.When a person eats carbohydrates, such as pasta, bread or fruit, their body converts the carbohydrates to sugar - also referred to as glucose.
Loan programs include grants, low income home ownership, mortgage information, vehicle modification loans, personal loans, and education funding sources.Disability ScholarshipsScholarships, bursaries and financial aid programs for students with disabilities. Welcome back to Ask D'Mine, our weekly advice column hosted by veteran type 1, diabetes author and community educator Wil Dubois. A very limited number of published studies indicate high prevalence of Type 2 Diabetes in the state of Kerala. Ltd).  Calibration was done daily to ensure reliability and new pairs of DC cells were used every day. All Prediabetic were educated regarding lifestyle modifications for Diabetes prevention and motivated to follow up in local Primary Health Centres. Lifestyle change in Kerala, India: needs assessment and planning for a community-based diabetes prevention trial. Report of the Committee on the classification and diagnostic criteria of diabetes mellitus. Evaluation of non communicable disease control pilot programme of National Rural Health Mission in Thiruvananthapuram district. High prevalence of type 2 diabetes mellitus and other metabolic disorders in rural Central Kerala. Prevalence and risk factors of diabetes in a community-based study in North India: the Chandigarh Urban Diabetes Study (CUDS). Cluster randomised controlled trial of a peer-led lifestyle intervention program: study protocol for the Kerala diabetes prevention program.
Screening Performance of Diabetes Risk Scores Among Asians and Whites in Rural Kerala, India. We are one of the largest networks of fully-owned and integrated outpatient clinical research sites in North America.
By submitting your comments, you acknowledge that CBC has the right to reproduce, broadcast and publicize those comments or any part thereof in any manner whatsoever. For example, someone initially diagnosed with type 2 diabetes may be told they actually have a form of type 1 diabetes. For simplicity, the flowchart does not attempt to differentiate between LADA and juvenile forms of type 1 diabetes. Ultimately, neither is 'worse' as each person is unique and diabetes affects people in different ways. Sinha is a recipient of the 2013 Silicon Valley Business Journal Health Care hero award, and he specializes in helping patients of South Asian heritage moderate heart disease risk factors and obesity trends with a comprehensive lifestyle modification approach that has delivered evidence-based results. Ma and colleagues launched a three-year, randomized, controlled clinical trial named E-LITE, short for Evaluation of Lifestyle Interventions to Treat Elevated Cardiometabolic Risk in Primary Care.
Preteen Family project that educates preteens and their families about the importance of making good food choices and maintaining a healthy Body Mass Index (BMI). The screening helps families prioritize health goals and provides resources, including information on low-cost clinics for families without health insurance.
Preteen Family tool is based on the teen version of the program that is free for schools and doctors’ offices to use to assess teenagers’ health and motivate healthy decision making.
Preteen Family project is part of $2 million in grants that the Safeway Foundation is giving back to community health programs and hospitals to launch grass-roots projects for the prevention and treatment of childhood obesity in the Bay Area and across the United States.
Many oral agents are cleared through the kidneys and doses need to be reduced for those with renal impairments. All materials contained on this site are protected by United States copyright law and may be used for personal, noncommercial use only. Glucose travels through the blood to supply energy to the cells, to include muscle and brain cells, as well as to organs. Many companies, as well as private organizations, award scholarship money to ensure students with disabilities are able to achieve their schooling and college goals.Famous People with DisabilityHave a disability? For the first post of November, Wil puts his finger on a universal question for PWDs: Should we really poke our pinky finger with lancets? That being said, you should be deciding all of your healthcare issues including cost; not an insurance company and especially not the Government. This study was done in the Neyyattinkara taluk of south Kerala by including coastal, mid land and high land regions to make it representative of the geographical profile of the state. Please note that comments are moderated and published according to our submission guidelines.
Sinha provides evidence-based case studies and patient success stories, as well as a comprehensive family-oriented approach to lifestyle changes that can make positive health impacts. He also works closely with employers in Silicon Valley to help reduce heart disease and diabetes risk in their employee communities, and gives corporate health lectures to promote wellness in the workplace.
The Diabetes Prevention Program (DPP) lifestyle intervention targeting modest weight loss and increased physical activity has been shown to reduce the incidence of type 2 diabetes among high-risk adults by nearly 60 percent. Lee, M.D., a family medicine doctor at PAMF’s Palo Alto Center, provided a medical review of the WAY2GO! They then receive a report based on their answers and access to their online dashboard where they can set health goals or track behavior. Glyburide, a drug which stays in the body for a long time, should be avoided in this population due to its potential to cause sustained hypoglycemia.
Blood sugar levels usually fluctuate depending upon what a person eats and how long it has been since they last ate. He also opines on the state of the market in comparing insulin pens versus syringes.{Need help navigating life with diabetes?
He hosts a bi-monthly radio program on South Asian health and wellness, and blogs at  southasianhealthsolution.org.


Lifestyle interventions work but need to be implemented in the primary care setting, a goal that has not yet been achieved.
All of the participants continued to receive standard medical care from their primary providers, who were not involved in the conduct of the study. You may not alter or remove any trademark, copyright or other notice from copies of the content.
There are also millions of people worldwide who may not be famous, but still live with and overcome their disabilities every single day of their lives. Millar Award for Innovative Approaches to Adolescent Health Care and is being used by more than 400 teenagers through doctors’ offices and high schools in the U.S. What this means is a person will not be able to drink or eat for 8-10 hours before the test, or the doctor may order the test for a random time or right after the person eats.
Why is that? I have used all my fingers for sticks and the only thing I've noticed is that I usually get a much better blood flow whenever I use a little finger. Medical Centers in Palo Alto, Mountain View, Santa Cruz, Fremont & surrounding San Jose areas.
If a woman is pregnant, her doctor might order a, 'glucose-tolerance test,' which involves drinking glucose solution and having blood drawn a specified amount of time later. A doctor who is concerned might order additional testing at 1,2 and 3 hours after a person drinks glucose.
Then there were many rounds of editing, tweaking, re-writing, reading, revising, re-reading, proofing, re-re-reading. I'm very proud of the final product, of course, but by the time it was done, I was sick to death of it. Additional causes of hypoglycemia include hypothyroidism, hypopituitarism and having taken certain kinds of medications. A1C test levels of greater than 7% reveal poor diabetes management and the need for changes in the future. Usually, high blood sugar levels have to do with a poor diet, but even more often they have to do with a person's lack of exercise and physical activity.A number of medical studies have shown a dramatic relationship between elevated blood sugar levels and insulin resistance in people who are not very active on a daily or regular basis. Many of the same studies have also shown that the most efficient way of improving insulin resistance is to increase the amount of physical activity. In fact, I didn't give a reason at all, and the truth is there is no valid medical reason whatsoever to avoid it. Doing so helps a person to achieve weight loss, increase blood flow and circulation, as well as lower blood sugar levels.Deciding to begin exercising and become active also involves beginning to eat better.
The capillary blood there is just as good as it is in any other finger, and as you yourself noted, blood flow from the little finger is no problem.
Changing eating habits alone will help, yet doing both together will supercharge a person's efforts. But for most people, the pinky has the densest concentration of nerve endings of all the fingers. Try to find a cookbook filled with quality foods and meal plans that are ideal for people with diabetes, people with pre-diabetes, as well as those with high blood sugar levels who might be insulin resistant.
Or at least is more likely to hurt than poking any of the other fingers.Back then (the book was written during 2007 and 2008) I never used my pinkies at all. Now that my other eight fingers are more callused, worn out, and covered with little black badges of honor, I do find myself going to the pinky more, especially for nocturnal tests in low lighta€”to make sure I have enough blood and don't waste one of my $1.30 iBG Star test strips like happened last night. I think if you're still new to the party, or testing lightly, avoiding the little fingers is a good idea. But as you become a seasoned vet, and if you test a lot, pinky pokes become less bothersome.
The more you put it off, the harder it can be to get blood while at the same time, the more painful it can get. And, of course, some lancing devices are just plain better than others.Oh, and thanks for the kind words, I'm glad you found the book helpful, and it was nice for me to revisit it. I use between 2 and 3 syringes per week, but have been questioned as to why I do not use a new syringe at least daily. The pens are used over multiple injections, so I don't feel too bad about using my syringes more than once. I suspect that as things progress, the old system of vials and syringes may not always be available, thus becoming more expensive? This summer I attended the Keystone Conference, a clinical education program for medical professionals, and the pens vs.
The delegation from China couldn't believe their ears in their country, pen use stands at about 98%.So why do Americans love their syringes so much? That means Lantus in vials costs about 12 cents per unit, while in pens it costs about 15 cents. If you shot a typical type 2 dose of 80 units a day of Lantus at three cents a unit, your insurance company can save themselves $72 per month, or $864 per year, by making you use syringes rather than pens. When you consider how many people use insulin, these kinds of savings add up to a princely sum indeed.
Fully a quarter of the 18.8 million diagnosed people with diabetes in the USA take some sort of insulin. Ka-ching!Not that I'm accusing the health plans of being greedy or anything.So, trust me, pens are in no danger of "taking over the marketplace" any time soon. The marketplaceis ruled by the laws of economics, not by what may or may not be best for patients.
There are technological advances happening in the old system, with syringe needles getting shorter and thinner with each passing year.
The people who make syringes are quite confident that they will be in the game for years to come and are betting on it with their pocketbooks.Actually, to be honest, I'm amazed that the price gap between vials and pens is as narrow as it is. Pretty much a miniature version of the technology that's been around since they started bottling Coke back in 1894.
It's a lot more complicated and expensive to make than a doll-sized Coke bottle.But beyond cold, hard cash, there's something else that we need to think about.
If you remove the human factors (which, arguably, in this case you shouldn't) the two devices are equally accurate. It isn't really fair to say that because preloaded pens are used for multiple injections that syringes should be treated the same way. You screw on, or snap on, a separate, disposable, allegedly one-shot-use pen needle on the tip of the pen for each injection.
So both platforms are intended for one-time use, and the people who make both tell you to use each one time and one time only. But of course, that's not what happens.Personally, I couldn't care less if you use your syringes several times.
I use a single pen needle on my Luxura all day long, taking on average 7 injections with it. My feeling is you should change the needle when it hurts.In a perfect world, it should be left up to the PWD and their medical team to make the choice of pen vs. Not their doctor.I hear a lot of people lately wailing, rubbing their hands, and worrying about big government being in their healthcare.
We are PWDs freely and openly sharing the wisdom of our collected experiences a€” our been-there-done-that knowledge from the trenches.



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