Postprandial HypoglycemiaPOSTPRANDIAL HYPOGLYCEMIABaschieri l, antonelli a, del guerra p, fialdini.
Objectives Discuss the main principles of therapy for type 1 diabetes including diet, exercise, blood glucose monitoring, oral hypoglycemic agents and insulin administration Discuss the management of type 2 diabetes including diet, exercise, blood glucose monitoring, oral hypoglycemic agents and insulin Review steps of insulin administration Compare the mechanisms of action of the available types of oral hypoglycemic agents. Carbohydrate Counting What is carbohydrate counting and how is it used in the management of diabetes? If Julie’s CHO ratio is 1:10, how much rapid-acting insulin should she take with her lunch? Lifestyle Modification What recommendations would you give Julie in regards to diet and exercise?
Exercise and Type 1 Diabetes Moderate to high levels of physical activity is associated with substantial reduction in morbidity and mortality in both men and women with type 1 and type 2 diabetes.
Exercise and Type 1 Diabetes Hypoglycemia may be prevented by Increasing CHO intake Reducing meal time insulin prior to exercise Altering basal insulin for insulin pump users Performing resistance exercise immediately prior to aerobic exercise Exercise performed late in the day or in the evening can be associated with increased risk of overnight hypoglycemia. Driving Guidelines Measure BG level immediately before and at least every 4 hours (more often in cases of hypoglycemia unawareness) during long drives.
TZD-Mechanism of Action Enhances insulin sensitivity in peripheral tissues and liver by activation of ppar- gamma receptors Eg. Secretagogues-Mechanism of Action Sulfonylureas bind to SU receptor inhibiting an efflux of K. Treatment with metformin usually starts with daily intake of 250 mg of the drug, twice a day.
Meglitinide analogues such as repaglinide and nateglinide work by increasing insulin production. Acarbose belongs to a category of anti-diabetic medication called alpha-glucosidase inhibitor. These anti-diabetic drugs work by improving the sensitivity of the muscles and adipose tissues to insulin. Introduction ? the prevalence of diabetes mellitus (DM) is rapidly increasing throughout the world ? physicians will be confronted with an increasing population of diabetic patients undergoing anesthesia and surgery ? A significant number with type 2 DM are unaware that they are diabetic until the time of surgery.
HEMOGLOBIN A1c ? provides a valuable assessment of long-term glycemic control ? Erythrocyte hemoglobin is nonenzymatically glycosylated by glucose ? HbA1c is stable glycosylated hemoglobin ? Its percentage concentration indicates average plasma glucose ? concentration during the preceding 60 to 90 days.
GLUCOTOXICITY: high levels of glucose causes ? nonenzymatic glycosylation reactions that lead to the formation of abnormal proteins which weaken endothelial junctions and decrease elastance, which is responsible for the stiff joint syndrome (and difficult intubation secondary to fixation of the atlanto-occipital joint), as well as decrease wound-healing tensile strength.
DM TYPE I ? Constitutes 5-10% of DM diagnosed ? Mostly appears in children and young adults ? caused by a T cell–mediated autoimmune destruction of beta cells of the pancreas.


TREATMENT OF DKA Managing diabetic ketoacidosis (DKA) in an intensive care unit during the first 24-48 hours always is advisable. Correction of Fluid Loss Rehydration alone reduces plasma glucose by 30-50% Initial correction of fluid loss is either by isotonic sodium chloride solution or by lactated Ringer solution. Correction of Acid-Base Balance Bicarbonate typically is not replaced as acidosis will improve with the other treatments alone. Fatty liver or hepatic lipidosis is a deadly dangerous condition in cats ought on by not eating for over 24 hours. She was diagnosed at the age of 7 when she developed symptoms of polyuria, polydipsia and polyphagia. Basal-Bolus Approach *Insulin effect images are theoretical representations and are not derived from clinical trial data.
Patients are encouraged to always review the pattern of their glucose levels to determine if correction factors or boluses are working appropriately. Not all carbohydrate foods are created equal The glycemic index (GI) describes this difference by ranking carbohydrates according to their effect on our blood glucose levels.
In type 1 diabetes, there is little or no endogenous insulin secretion and no physiological regulation of insulin levels.
What advice should be given to people with diabetes in regards to glucose monitoring and driving? Always carry BG monitoring equipment and supplies of rapidly absorbable carbohydrate within easy reach (e.g. It works by increasing sensitivity of the body tissues to insulin and reducing hepatic glucose production.
It acts by obstructing the activity of the enzyme alpha-glucosidase, which breaks down the carbohydrates oligosaccharides and disaccharides into simple sugars or monosaccharides, which are then absorbed through the intestine. Acarbose is usually used for reducing the blood sugar level after meals. Sugar Free Fruit Cake Recipes Uk Adults High Blood Glucose Symptoms nutrient-dense leafy greens and higher levels of Omega-3 found in salmon can help decrease diabetes risk. Often people with type 2 diabetes can still Sugar Free Fruit Cake Recipes Uk Adults High Blood Glucose Symptoms make their own insulin in the pancreas but the insulin that is produced is not used as effectively by the body. Diabetics are prone to anxiety disorders and panic attacks which are often linked to vertigo. Home Homesteading Dietary Wellness Tree nuts good for blood sugar levels in people with Type 2 diabetes. Type 1 diabetes: - teach how to match insulin to CHO intake - maintain regularity in timing and spacing of meals -low glycemic index foods 3.


The treatment starts with the lowest dosage of the drug that is gradually improved until the desired blood sugar control is attained. The anti-diabetic medication is taken 15 to 30 minutes before meal. As the hypoglycemic effect of acarbose is not as powerful as that of other oral anti-diabetic medications such as metformin or sulfonylurea, it is usually combined with any of these drugs. Are glucose levels diabetes type 2 recipes canadian muffin association bananas good for a diabetic person to eat (October 19 what to eat before gestational diabetes test during pregnancy feet keeping warm 2011). Ethnicity particularly when a close relative had type 2 diabetes or gestational diabetes: certain groups such as African Americans Native Must Read Articles Related to Diabetes (Mellitus Type 1 and Type 2). Sucrose and sucrose-containing foods can be substituted for other CHOs as part of mixed meals up to a maximum of 10% of total daily energy, provided adequate control of BG and lipids is maintained.
In addition to improving the blood sugar level, metformin helps to reduce low-density cholesterol and triglycerides levels and body weight. It may be combined with another anti-diabetic drug such as metformin or acarbose or insulin. Diarrhea, abdominal discomfort, bloating and flatulence are possible side effects of acarbose.
Glucose-induced vasodilation prevents target organs from protecting against increases in systemic BP. CADTH suggested that in adults with type 2 diabetes using basal insulin self-monitoring of blood glucose should be Sugar symptoms of insulin resistance with pcos would acidic urine more make mellitus Free Fruit Cake Recipes Uk Adults High Blood Glucose Symptoms individualized but testing of up to 14 times per A co-payment will not be applied to diabetic supplies purchased (co-payment means the portion of the cost paid by you to the pharmacy). However, a sulphonylurea drug should not be combined with meglitinide analogue or another sulphonylurea. Adults: no more than 7% of total daily energy from saturated fats and should limit intake of trans fatty acid.
Dear Alice What nephrogenic diabetes insipidus pathophysiology complications death causing is diabetes mellitus?
Diarrhea, vomiting, photosensitivity and weight gain are possible side effects of sulphonylureas. T1DM: informed of delayed hypoglycemia resulting from alcohol consumed with or after the previous evening’s meal.



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Comments

  1. 03.11.2014 at 11:41:25


    All of us learn in the hypoglycemia treatment acarbose niereninsuffizienz discussion martin says the upper a1C of 5.7% to 6.4.

    Author: Alisija
  2. 03.11.2014 at 12:59:49


    Mg/dL (11.1 mmol/L) after report on the role of the should be closer. For.

    Author: Nikotini
  3. 03.11.2014 at 15:44:45


    Month blood sugar average) disease encountered.

    Author: WANTED
  4. 03.11.2014 at 11:15:35


    Seated low to the ground to prevent.

    Author: KAMILLO