ITEMS IN AFP WITH KEYWORD:
Patients with type 1 diabetes should maintain tight glycemic control to prevent complications. Frequent self-monitoring of blood glucose levels leads to improved A1C levels. Insulin administration via multiple daily injections or an insulin pump is effective. Physicians should educate patients about lifestyle management, recognition of hypoglycemia, and proper care during sick days.
Because the evidence regarding medical care for persons with diabetes mellitus continues to evolve, the American Diabetes Association (ADA) annually updates its standards. In addition, starting in 2018, the ADA will also periodically update its guidance online if warranted.
The latest installment of the top 20 research studies for primary care physicians includes studies on cardiovascular disease and hypertension, infections, diabetes mellitus, musculoskeletal problems, and cancer screening, among other topics. The five highest-rated practice guidelines are also summarized.
There is only limited-quality evidence that at-risk patients taking GLP-1 receptor agonists are less likely to progress to diabetes (number needed to treat [NNT] = 23). Serious adverse events were more likely in patients taking GLP-1 receptor agonists than in patients taking placebo (number needed to harm [NNH] = 42).
Counseling by a diabetes educator or a team of educators delivered in a variety of formats may reduce A1C levels by 0.2% to 0.8% compared with usual care alone. Diabetes educators should be considered for patients who have higher baseline A1C levels (8% to 9%) because this group had greater improvem...
In patients with type 2 diabetes mellitus, insulin may be used to augment therapy with oral glycemic medications or as insulin replacement therapy. Insulin regimens should be adjusted every three or four days until self-monitoring of blood glucose targets are reached. Goals should be individualized.
Home glucose monitoring of patients in primary care does not improve A1C scores or quality of life over one year in patients who are not taking insulin.
Although this life-threatening emergency commonly affects adults with type 2 diabetes mellitus, its incidence is increasing in children. Read the latest evidence on causes, risk factors, and complications, and get a treatment algorithm from the American Diabetes Association.
Challenges to glucose control in hospitalized patients with type 2 diabetes mellitus include determining blood glucose targets, judicious use of oral diabetes medications, and implementing appropriate insulin regimens. Home oral diabetes medications should be continued in the absence of contraindications. Insulin dosing is based on patient factors, such as current oral intake, comorbidities, baseline diabetic control, and experience with prior insulin therapy. Sliding scale insulin regimens are not recommended.
This seems like a strange question considering that the goal is to decrease mortality with drug therapy. Nevertheless, this study showed that the new kids on the diabetes block—exenatide (Byetta), dulaglutide (Trulicity), sitagliptin (Januvia), saxagliptin (Onglyza), and others—do not increase mortality, even in patients with cardiovascular risk.