Jul 1, 2008 Issue
Diabetic Foot Infection [Article]

Foot infections are common in patients with diabetes and are associated with high morbidity and risk of lower extremity amputation. Diabetic foot infections are classified as mild, moderate, or severe. Gram-positive bacteria, such as Staphylococcus aureus and beta-hemolytic streptococci, are the mos...

Jun 15, 2008 Issue
Gastrointestinal Complications of Diabetes [Article]

Gastrointestinal complications of diabetes include gastroparesis, intestinal enteropathy (which can cause diarrhea, constipation, and fecal incontinence), and nonalcoholic fatty liver disease. Patients with gastroparesis may present with early satiety, nausea, vomiting, bloating, postprandial fullne...

Feb 15, 2008 Issue
Are Long-acting Insulin Analogues Better Than Isophane Insulin? [Cochrane for Clinicians]

Based on poor quality evidence, this review suggests that insulin glargine and insulin detemir have no advantage over isophane insulin in reducing A1C levels. In one study, isophane insulin reduced A1C levels slightly more than insulin detemir. However, patients on insulin glargine and detemir repor...

Jan 1, 2008 Issue
Choosing First-Line Therapy for Management of Type 2 Diabetes [AFP Journal Club]

Which controls type 2 diabetes best at five years: rosiglitazone, metformin, or glyburide? Metformin should be the first-line drug for managing type 2 diabetes. Insulin and sulfonylureas should be second line, and glitazones should be reserved for third line.

Oct 1, 2007 Issue
Does Pioglitazone Benefit Patients With Type 2 Diabetes? [Cochrane for Clinicians]

Pioglitazone produces a reduction in A1C levels similar to that produced by other drugs. One trial found that although pioglitazone, used as an adjunct to other antihyperglycemic medications, may lead to a statistically significant reduction in morbidity and mortality in patients with established ma...

Sep 15, 2007 Issue
Sitagliptin (Januvia) for the Treatment of Patients with Type 2 Diabetes [STEPS]

Sitagliptin may be useful as second-line or third-line therapy in patients with a mildly elevated A1C level (less than 9 percent) who do not reach their A1C goal with first-line therapy (metformin). Sitagliptin will decrease postprandial blood glucose and mildly lower fasting blood glucose for a total A1C reduction around 0.8 percent.

Sep 1, 2007 Issue
Management of Type 2 Diabetes in Youth: An Update [Article]

Although type 1 diabetes historically has been more common in patients eight to 19 years of age, type 2 diabetes is emerging as an important disease in this group. Type 2 diabetes accounts for 8 to 45 percent of new childhood diabetes. This article is an update from the National Diabetes Education P...

Aug 1, 2007 Issue
Alpha-glucosidase Inhibitors May Reduce the Risk of Type 2 Diabetes [Cochrane for Clinicians]

The literature shows that acarbose can reduce the risk of type 2 diabetes in patients with impaired glucose tolerance or impaired fasting glucose. However, it is unclear whether the drug stops or delays the development of the disease or masks the diagnosis. There is no evidence that acarbose use red...

Jul 15, 2007 Issue
Home Monitoring of Glucose and Blood Pressure [Article]

Home monitoring of blood glucose and blood pressure levels can provide patients and physicians with valuable information in the management of diabetes mellitus and hypertension. Home monitoring allows patients to play an active role in their care and may improve treatment adherence and clinical outc...

Jun 15, 2007 Issue
Therapies for Diabetes: Pramlintide and Exenatide [Article]

The American Diabetes Association currently recommends an A1C goal of less than 7 percent. However, many patients are unable to achieve this goal by using oral drug combinations or diet and exercise, leaving insulin as the only treatment option. In most cases, insulin is initiated later in therapy b...

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