ITEMS IN AFP WITH KEYWORD:
This study found that compared with expensive long-acting insulin analogs costing two to 10 times as much, NPH insulin results in a similar number of episodes of severe hypoglycemia (if not fewer) that result in emergency department visits and hospitalizations.
Dec 1, 2018 Issue
Preventing or Delaying Type 2 Diabetes Mellitus with Diet and Exercise [Cochrane for Clinicians]
There is moderate-quality evidence that in patients with impaired glucose tolerance (IGT) defined by an abnormal 75-g two-hour glucose tolerance test, implementing changes in diet and adding physical activity together can prevent or delay the development of type 2 diabetes.
The prevalence of type 2 diabetes mellitus in children and adolescents has increased worldwide with the obesity epidemic, and minorities are disproportionately affected. Find out who should be screened, when to begin screening, and recommended management strategies for younger patients.
This guidance statement from the American College of Physicians (ACP) aims to help physicians achieve appropriate A1C targets via medication for nonpregnant patients with type 2 diabetes based on a review of six health care organization guidelines.
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.
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.
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.