Utilizing Current Diagnostic Criteria and Treatment Algorithms for Managing Type 2 Diabetes Mellitus DOI: 10.3810/pgm.2011.07.2304 (Postgraduate Medicine)

Within the past 2 years, the American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) and the American Association of Clinical Endocrinologists (AACE)/American College of Endocrinology (ACE) have revised their guidelines for the diagnosis and treatment of type 2 diabetes mellitus (T2DM). Both organizations recommend a diagnostic glycated hemoglobin (HbA1c) of > 6.5% (based on a new appreciation of the relationship between glycemia and complications) and fasting plasma glucose levels or an oral glucose tolerance test. Findings from major trials of glucose control in patients with T2DM and the approval of novel medications have prompted revised treatment algorithms from both organizations. While both treatment guidelines recommend starting metformin in most patients on diagnosis of T2DM, they differ in terms of the “trigger” for treatment intensification (HbA1c ≥ 7% and > 6.5%, respectively) and which agents are preferred as second-line therapies. The ADA/EASD recommends a tiered approach to treatment, starting with well-validated second-line agents, such as sulfonylureas and basal insulin for patients unable to achieve target glucose levels with metformin. The AACE/ACE recommendations are based on the patient’s HbA1c level and include a broader range of first- and second-line therapies and combinations. In addition to metformin, the ACCE/ACE treatment algorithm includes dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 agonists, thiazolidinediones, α-glucosidase inhibitors, sulfonylureas, and glinides. Both organizations advocate individualizing therapy to meet patient needs. This review highlights recent changes in the guidelines and uses a case-based format to illustrate how the current guidelines may be tailored to fit individual patient characteristics and circumstances.

Original Publication Date: July 2011

 

The Everything Parent’s Guide To Children With Juvenile Diabetes: Reassuring Advice for Managing Symptoms and Raising a Happy, Healthy Child (Everything (Parenting)) by McCarthy, Moira, Kushner, Jake 1st (first) Edition (4/2/2007)

 

The Everything Guide to Managing and Reversing Pre-Diabetes: Your Complete Guide to Treating Pre-Diabetes Symptoms (Everything®)

Your ten-week plan to avoid the onset of diabetes!

A diagnosis of pre-diabetes is certainly a wakeup call, but it is not a life sentence of daily medication and having to live without your favorite foods. Managing pre-diabetes is about common sense and moderation, not deprivation. The Everything Guide to Managing and Reversing Pre-Diabetes, 2nd Edition can help you find ways to alter your lifestyle and avoid type 2 diabetes. Inside, you’ll find helpful tips on lifestyle changes, along with recipes for delicious, healthy meals your whole family will love, like:

  • Buttermilk pancakes
  • Rich and creamy sausage-potato soup
  • Soy and ginger flank steak
  • Grilled haddock with peach-mango salsa
  • Walnut chicken with plum sauce
  • Kasha-stuffed red peppers
  • Cranberry pecan biscotti
  • Chocolate cheesecake mousse

This trusted resource also includes a ten-week plan to help you see results immediately. Certified Diabetes Educator Gretchen Scalpi also provides you with techniques for helping children with pre-diabetes gain control of their health. With this expert guide, you can recognize unhealthy behaviors and eating habits–and stop diabetes in its tracks!

 

Managing the Diabetic Foot

Written by the BMA award-winning author team of Mike Edmonds and Alethea Foster

Aimed at podiatrists, nurses, physicians, surgeons, orthotists and all other members of the multidisciplinary diabetic foot team, Managing the Diabetic Foot, Second Edition, remains a “must-have” for all those interested in diabetes and the diabetic foot.


New features of this Second Edition include:

  • Chapter on amputation has been expanded as has the overall surgical focus
  • Metabolic control and all other aspects of management have also been extensively updated
  • New introductory chapter which describes the assessment of the diabetic foot, incorporating an illustrated section on differential diagnosis
  • Content aids the implementation of the NICE guidelines and the ‘National Service Framework for Diabetes’

 

Managing Gestational Diabetes: A Patient’s Guide to a Healthy Pregnancy

This booklet is part of the NICHD’s research portfolio in women’s health. The information is intended for women who have been diagnosed with gestational diabetes, a type of diabetes that only pregnant women get. The booklet explains gestational diabetes, its causes, and its symptoms. It also provides a general treatment plan for the condition that patients and health care professionals can use to set up a treatment regimen that addresses the woman’s specific needs.

 

Managing Type 2 Diabetes: Balancing HbA1c and Body Weight (Postgraduate Medicine)

Abstract: Most patients with type 2 diabetes present with comorbid overweight or obesity. Reaching and maintaining acceptable glycemic control is more difficult in overweight and obese patients, and these conditions are associated with increased risk for cardiovascular and other diseases. Glycemic management for these patients is complicated by the fact that insulin and many of the oral medications available to treat type 2 diabetes produce additional weight gain. However, an increasing number of therapeutic options are available that are weight neutral or lead to weight loss in addition to their glycemic benefits. This article evaluates the evidence from clinical trials regarding the relative glycemic benefits, measured in terms of glycated hemoglobin change, versus the impact on body weight of each medication currently approved for type 2 diabetes. In general, the sulfonylureas, thiazolidinediones, and D-phenylalanine derivatives have been shown to promote weight gain. The dipeptidyl peptidase-4 inhibitors are weight neutral, while the biguanides, incretin mimetics, and amylin mimetics promote weight loss. Trials examining the glycemic benefits of the weight loss agents orlistat and sibutramine are also examined. Awareness of this evidence base can be used to inform medication selection in support of weight management goals for patients with type 2 diabetes.

Original Publication Date: May 2010

 

Managing Diabetes BVL35048 FFH Films for Humanities & Sciences

A disease that frequently goes unnoticed for years, diabetes can lead to blindness, loss of limbs, even death. The good news, as this program clearly demonstrates, is that diabetes is neither inevitable nor unmanageable. Illustrating ways for patients to take a proactive approach to their health, the video details changes in diet, exercise, and attitude that can stop the progression of the disease and in some cases prevent its occurrence in the first place. Personal testimony from patients and expert commentary from physicians are included. The result is an empowering guide to managing and minimizing a formerly debilitating illness.

 

The Mind-Body Diabetes Revolution: The Proven Way to Control Your Blood Sugar by Managing Stress, Depression, Anger and Other Emotions (Marlowe Diabetes Library)

Diabetes is quickly becoming one of the world’s most serious health epidemics, and researchers are continually searching for new ways to manage the condition beyond the traditional realms of diet, exercise, and medication. Now, Dr. Richard S. Surwit, a leader in the field of the psychology of diabetes, adds the vital fourth component to treating diabetes: a revolutionary mind-body program that lowers blood sugar levels and dramatically reduces diabetes’ serious and damaging side effects. In The Mind-Body Diabetes Revolution, Dr. Surwit reveals how stress, depression, and anger affect blood sugar levels and offers a step-by-step six-week program—based on twenty years of study—to help the millions of people with diabetes effectively manage their condition. He clearly explains how our moods and emotions can translate into chronic anger, anxiety, and depression—all of which increase blood sugar levels. He provides compelling case studies and a powerfully effective six-week program designed to teach patients how to manage emotions and stress, as well as self-tests and reflective quizzes to help patients determine the best and easiest psychological techniques to help keep blood sugar levels down. By bringing the powers of mind and body together, this is a powerful—and unprecedented—tool for effective diabetes control.
The idea of stress contributing to poor health is an old one, but often patients are simply told to “relax”–and it’s even rarer that researchers take the time to carefully study how relaxation can improve physical conditions. Tackling both these issues, Dr. Richard Surwit combines specific relaxation techniques with a solid research background in an effort to help control blood sugar levels. The first few chapters are rather technical but are explained in an approachable manner. He identifies several chemicals such as cortisol and growth hormone that are related to blood sugar management and discusses how depression, hostility, and anxiety can affect these chemicals. He refers to specific research, both with mice and with humans, and includes simple tests to help you analyze these problems and develop a combination of techniques to combat them. Later chapters explain these techniques in detail, particularly progressive relaxation therapy (similar to biofeedback, but without the machine) and cognitive behavior therapy. Each routine is broken down into simple daily steps, and pages can be used as workbook sheets –much of the daily effort involved is simply tracking your progress. While nowhere does Dr. Surwit suggest these as a total replacement for diet control and insulin treatments, the specific steps aren’t difficult to add to your daily routine and may make just the difference you’ve been hoping for. –Jill Lightner

 

Diabetes: Managing a 21st Century Lifestyle Disease (NCME Video 769)

Diabetes mellitus affects nearly 6% of the U.S. population, making it one of the most common medical problems seen by physicians. Each year, diabetes costs the nation nearly $100 billion in treatment and disability. Preventing complications, such as kidney failure, cardiovascular disease, blindness, and nerve damage, is an important component of regular care. Equally critical to successful treatment is effective patient selfmanagement and education. Often, this means a coordinated and collaborative healthcare effort. Dr. Bernstein reviews the rising prevalence and pathophysiology of diabetes, including the disturbing rise in Type 2 diabetes among children. In addition, he discusses how associated syndromes, such as insulin resistance, are joining diabetes as major lifestyle diseases of the 21st century

 

The Everything Guide to Managing Type 2 Diabetes: From Diagnosis to Diet, All You Need to Live a Healthy, Active Life with Type 2 Diabetes – Find Out What … Diet and Discover the (Everything Series)

Diabetes is a complex disease–but learning about it shouldn’t be!

A Type 2 diabetes diagnosis can be daunting, but it is also manageable. With this all-in-one guide, you will get expert advice on establishing a healthier lifestyle and getting control of your diabetes. The Everything Guide to Managing Type 2 Diabetes provides easy-to-follow advice on all aspects of living with diabetes, and helps you:

  • Recognize the symptoms of prediabetes and diabetes
  • Monitor your blood glucose levels
  • Learn about the types of insulin and insulin-delivery systems
  • Understand the importance of nutrition and exercise
  • Reduce the short- and long-term effects of diabetes

Filled with reliable advice and the latest information on medication, therapies, blood sugar monitoring, and more, this invaluable guide shows you how to take control of your diabetes and enjoy your life!

 

Type 1 Teens: A Guide to Managing Your Diabetes

Type 1 diabetes might be part of some teens lives, but it doesn t have to run their lives. Type 1 Teen gives teens a slew of strategies and tips to manage their day-to-day lives with Type 1 diabetes. This book gives teens honest and straightforward facts and advice on issues including dealing with family and friends; navigating school and future plans; relationships and sex; and alcohol and drugs. This primer on the basics of life with Type 1 empowers teens to be their own best advocates and helps them acquire the psychological and social tools to prevent diabetes burnout and prepare for a long, healthy life.

 

The Joslin Guide to Diabetes: A Program for Managing Your Treatment (Fireside Books (Fireside))

An indispensable, up-to-date resource for managing your diabetes from the global leader in diabetes research, care, and education

Finding out that you have diabetes immediately raises questions about the condition, its treatment, and its impact on your future. Why did I get diabetes? What will I have to do to treat it? How will my future health be affected by having diabetes? What will my life be like? Getting accurate answers to these and many other questions will determine how well you are able to live with diabetes.

This completely updated edition of The Joslin Guide to Diabetes will help provide the answers you need. It’s an easy-to-understand resource that explains not only the types of diabetes treatment but also every aspect of diabetes self-management, including:

• Meal planning and carbohydrate counting

• Monitoring blood glucose

• Administering insulin and taking oral medications

• Treating high and low blood glucose

• Using physical activity to help control diabetes, maintain good health, and reduce the chances of future problems

• Successfully fitting diabetes into your lifestyle

Based upon research and the clinical experience of the world-renowned Joslin Diabetes Center and written by physician and diabetes expert Richard S. Beaser, M.D., and nutritionist and diabetes educator Amy Campbell, R.D., M.S., C.D.E., this book will help those with diabetes integrate the medical treatments and lifestyle changes necessary to learn how to live healthfully with this condition.

 

The Best of Diabetes Self-Management: The Definitive Commonsense Guide to Managing Your Diabetes (7 Day Meal Planner Included)

From the most trusted magazine in its field, this is the only book that addresses the health-care topics that every person with diabetes needs to know. Written in straightforward, easy-to-understand language, The Best of Diabetes Self-Management

 

Mayo Clinic on Managing Diabetes

“Mayo Clinic on Managing Diabetes” offers sound advice on controlling the disease and living as normal a life as possible. In this book, readers will learn: the different types of diabetes; symptoms, risk factors, and how diabetes is diagnosed; the best ways of monitoring your condition; how to develop a healthy eating plan; the latest cutting edge therapies; and what complication to watch for, and how they can be prevented.

 

The New Glucose Revolution for Diabetes: The Definitive Guide to Managing Diabetes and Prediabetes Using the Glycemic Index (Marlowe Diabetes Library)

The New Glucose Revolution for Diabetes is the first comprehensive guide to using the glycemic index to control type 1 diabetes, type 2 diabetes, prediabetes, and more. The book features the latest, most accurate information with new findings by the authors. It includes GI-based recipes and menus for type 1, type 2, prediabetes, gestational diabetes, and juvenile diabetes, as well as related conditions like obesity and celiac disease, plus practical dietary guidance on sugar, sweeteners, alcohol, snacking, and eating out.

 

The Everything Guide to Managing and Reversing Pre-Diabetes: Your complete plan for preventing the onset of Diabetes (Everything Series)

A pre-diabetes diagnosis is a wake-up call. And with this book, you can make the lifestyle changes you need to ensure your good health. The book guides you not only through what to eat and when, but how to prepare delicious, healthy meals such as:

  • Honey–Oat Bran Bread
  • Layered Veggie Casserole
  • Cold Roasted Red Pepper Soup
  • Roasted Garlic Mashed Potatoes
  • Strawberry-Banana Sorbet

Reversing a diagnosis can be daunting, but with this guide, you learn to take the process one step–and one meal–at a time.

 

Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin–Completely Revised and Updated

Few diabetes books focus specifically on the day-to-day issues facing people who use insulin. In this fully updated and revised edition, diabetes educator Gary Scheiner provides the tools to “think like a pancreas”—to successfully master the art and science of matching insulin to the body’s ever-changing needs. Comprehensive, free of medical jargon, and packed with useful information not readily available elsewhere, this new edition covers the many strides taken in diabetes education and management since the first edition seven years ago.

Think Like a Pancreas includes critical information, such as day-to-day blood glucose control and monitoring, designing an insulin program to best match your lifestyle, up-to date medication and technology, and new insulin formulations and combinations.

Few diabetes books focus specifically on the day-to-day issues facing people who use insulin. In this fully updated and revised edition, diabetes educator Gary Scheiner provides the tools to “think like a pancreas”—to successfully master the art and science of matching insulin to the body’s ever-changing needs. Comprehensive, free of medical jargon, and packed with useful information not readily available elsewhere, this new edition covers the many strides taken in diabetes education and management since the first edition seven years ago.

Think Like a Pancreas includes critical information, such as day-to-day blood glucose control and monitoring, designing an insulin program to best match your lifestyle, up-to date medication and technology, and new insulin formulations and combinations.

 

Managing Type 2 Diabetes in Young People

After outlining what type 2 diabetes is and the five parts of a treatment plan, this program takes young viewers through the steps that will keep them feeling better and on the road to self-managing their diabetes. Teens with diabetes (from ages 11 to 18) share their healthy food selections and snacking tips. They encourage other young people with diabetes to find exercises they enjoy and incorporate them into their busy teen life. Viewers are also encouraged to educate themselves about type 2 diabetes, monitor their blood glucose regularly and take medications as prescribed. Approx. 20 minutes long.

 

The Diabetes Handbook: A Brief Guide to Treating and Managing Type 1 and Type 2 Diabetes

Almost everyone knows someone who has diabetes. An estimated 23.6 million people in the United States—7.8 percent of the population—have diabetes, a serious, lifelong condition. Of those, 17.9 million have been diagnosed, and 5.7 million have not yet been diagnosed. In 2007, about 1.6 million people ages 20 or older were diagnosed with diabetes.

Diabetes is a disorder of metabolism— the way the body uses digested food for growth and energy. Most of the food people eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body.

After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.

When people eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into the cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body in the urine. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.

The three main types of diabetes are type 1 diabetes, type 2 diabetes and gestational diabetes.

Type 1 diabetes is an autoimmune disease. An autoimmune disease results when the body’s system for fi ghting infection—the immune system—turns against a part of the body. In diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. The pancreas then produces little or no insulin. A person who has type 1 diabetes must take insulin daily to live.

The most common form of diabetes is type 2 diabetes. About 90 to 95 percent of people with diabetes have type 2. This form of diabetes is most often associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and certain ethnicities. About 80 percent of people with type 2 diabetes are overweight or obese.

Some women develop gestational diabetes late in pregnancy. Although this form of diabetes usually disappears after the birth of the baby, women who have had gestational diabetes have a 40 to 60 percent chance of developing type 2 diabetes within 5 to 10 years. Maintaining a reasonable body weight and being physically active may help prevent development of type 2 diabetes.
About 3 to 8 percent of pregnant women in the United States develop gestational diabetes. As with type 2 diabetes, gestational diabetes occurs more often in some ethnic groups and among women with a family history of diabetes. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin. Women with gestational diabetes may not experience any symptoms.

 

The Everything Guide to Managing Type 2 Diabetes: From Diagnosis to Diet, All You Need to Live a Healthy, Active Life with Type 2 Diabetes – Find Out … the Latest Treatments (Everything Series)

A Type 2 diabetes diagnosis can be daunting, but with good information and helpful guidance, it’s a manageable condition. The first step is to understand the disease and learn how it affects daily routines. With this all-in-one guide, readers will get expert advice on establishing a healthier lifestyle and getting control of their diabetes. “The Everything Guide to Managing Type 2 Diabetes” provides easy-to-follow advice on all aspects of living with diabetes, including: recognizing symptoms of pre-diabetes and diabetes; monitoring blood glucose levels; learning about the types of insulin and insulin-delivery systems; understanding the importance of nutrition and exercise; and reducing the short- and long-term effects of diabetes. Filled with valuable advice and the latest information on medication and therapies, this invaluable guide will show readers how to take control of their diabetes and live a normal, healthy life.

 

Managing Preexisting Diabetes and Pregnancy: Technical Reviews and Consensus Recommendations for Care

Offers a single resource for American Diabetes Association standards of care for pregnant women with preexisting diabetes – type 1 (DM1) or type 2 (DM2). It providers up-to-date recommendations and treatment protocols for the management of diabetes and pregnancy to researchers, academic physicians, and clinicians who deal with the broad spectrum of problems.

 

The Everything Guide to Managing and Reversing Pre-Diabetes: Your complete plan for preventing the onset of Diabetes (Everything (Health))

A pre-diabetes diagnosis diagnosis is a wake-up call. And with this book, you can make the lifestyle changes you need to ensure your good health. Certified Diabetes Educator and Registered Dietitian Gretchen Scalpi provides helpful tips not only on what to eat and when, but how to prepare delicious healthy foods such as:

  • Honey Oat Bran Bread
  • Layered Veggie Casserole
  • Cold Roasted Red Pepper Soup
  • Roasted Garlic Mashed Potatoes
  • Strawberry-Banana Sorbet

Reversing a diagnosis can be daunting, but with this guide, you learn to take the process one step–and one meal–at a time.

 

Everything Parent’s Guide to Children with Juvenile Diabetes: Reassuring Advice for Managing Symptoms and Raising a Healthy, Happy Child   [EVERYTHING PARENTS GT CHILDREN] [Paperback]

 

The Everything Parent’s Guide To Children With Juvenile Diabetes: Reassuring Advice for Managing Symptoms and Raising a Happy, Healthy Child (Everything: Parenting and Family)

 

The Best Life Guide to Managing Diabetes and Pre-Diabetes

LET BOB GREENE HELP YOU TAKE CONTROL OF YOUR HEALTH AND CLAIM THE LIFE YOU DESERVE!BOB GREENE has helped millions of Americans become fit and healthy with his life-changing Best Life plan. Now, for the first time, Oprah’s trusted expert on diet and fitness teams up with a leading endocrinologist and an expert dietitian to offer a Best Life program tailored to the needs of people with diabetes and pre-diabetes. Coping with the unique challenges of living with these conditions can feel like a full-time job, but The Best Life Guide to Managing Diabetes and Pre-Diabetes gives you a gradual, three-phase plan designed to improve your blood sugar and stave off heart disease, neuropathy, and other diabetes- and pre-diabetes-related conditions. Whether you are controlling your disease simply with diet and exercise, taking drugs orally, or need injected insulin, this comprehensive volume gives you all the information you need to stay healthy and motivated. Detailed but flexible meal plans take the guesswork out of eating, and recipes for budget- and family-friendly dishes come with complete nutritional analyses. Extensive reference sections, including a complete guide to diabetes drugs and a chart of the carbohydrate value of foods, give you quick answers you can trust, while a log for tracking your blood sugar readings, exercise, diet, and medication helps you stay organized without hassle or added expense.

With The Best Life Guide to Managing Diabetes and Pre-Diabetes, you won’t have to let your life be defined by your diagnosis.

 

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