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Metformin to Prevent Diabetes in Patients at Increased Risk - Cochrane for Clinicians -... Restricted content. Login required.

Nov 1, 2020 - In patients at increased risk of developing type 2 diabetes, metformin reduces the risk (number needed to treat [NNT] = 7; 95% CI, 6 to 10) compared with counseling on standard diet and exercise.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/1101/p531.html

Linagliptin and Glimepiride Equally Effective for Adults with Type 2 Diabetes Mellitus ... Restricted content. Login required.

Mar 1, 2020 - This study found that linagliptin is noninferior to glimepiride for reducing the risk of cardiovascular death, myocardial infarction, and stroke in adults with type 2 diabetes at an increased risk of cardiovascular disease.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0301/p309a.html

Should Adults with Prediabetes Be Prescribed Metformin to Prevent Diabetes Mellitus? ...

Aug 1, 2019 - Discussing with patients the pros and cons of medications for borderline glucose values could distract us from more important topics such as lifestyle changes, smoking cessation, and blood pressure control. Time is the most valuable resource in a physician-patient partnership, and there...

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2019/0801/p136.html

Should Adults with Prediabetes Be Prescribed Metformin to Prevent Diabetes Mellitus? ...

Aug 1, 2019 - High-quality evidence supports metformin use for diabetes prevention among younger or more obese individuals or for women with a history of gestational diabetes. Clinicians should consider prescribing metformin, in addition to intensive lifestyle interventions, in accordance with ...

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2019/0801/p134.html

Dapagliflozin in High-Risk Type 2 Diabetes Reduces Hospitalization for Heart Failure ...

Aug 1, 2019 - The only cardiovascular benefit to treatment with dapagliflozin was a reduction in the likelihood of hospitalization; 125 patients would need to be treated for 10 years to prevent one hospitalization.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0801/p184.html

Semaglutide (Ozempic) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Jul 15, 2019 - Semaglutide can be added to existing treatment to improve glycemic control and induce weight loss. It may also protect against cardiovascular outcomes in patients with type 2 diabetes and established cardiovascular disease.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0715/p116.html

Understanding the High Cost of Insulin: What Family Physicians Can Do to Help Our ...

Apr 1, 2019 - Through clinical and system-level interventions, family physicians can push back against the high cost of insulin and help patients with type 2 diabetes afford these essential medications.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0401/p416.html

Statins Ineffective for Primary Prevention of Cardiovascular Disease in Patients 75 ...

Apr 1, 2019 - In this retrospective study, statin treatment in patients 75 years or older without preexisting CVD did not change the likelihood of developing CVD or reduce any-cause mortality. However, patients 75 to 84 years of age with diabetes mellitus benefitted from treatment. These results ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p461.html

Type 2 Diabetes Therapies: A STEPS Approach - American Family Physician

Feb 15, 2019 - A concise way to evaluate pharmacotherapy options for type 2 diabetes mellitus is to use the five patient-oriented STEPS criteria: safety, tolerability, efficacy, price, and simplicity. The first-line treatment option, metformin, is safe and fairly well-tolerated, has excellent ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0215/p237.html

Type 1 Diabetes: Management Strategies - American Family Physician

Aug 1, 2018 - There is considerable benefit of tight glucose control in patients with type 1 diabetes mellitus. Tight blood glucose control dramatically decreases the incidence of microvascular and macrovascular complications. Although glycemic goals should be individualized, most nonpregnant adults ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0801/p154.html

Type 2 Diabetes Mellitus: Outpatient Insulin Management - American Family Physician

Jan 1, 2018 - In patients with type 2 diabetes mellitus, insulin may be used to augment therapy with oral glycemic medications or as insulin replacement therapy. The American Diabetes Association suggests the use of long-acting (basal) insulin to augment therapy with one or two oral agents or one ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0101/p29.html

Glucose Management in Hospitalized Patients - American Family Physician

Nov 15, 2017 - Glucose management in hospitalized patients poses challenges to physicians, including identifying blood glucose targets, judicious use of oral diabetes mellitus medications, and implementing appropriate insulin regimens. Uncontrolled blood glucose levels can lead to deleterious effects ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1115/p648.html

Newer Oral Hypoglycemics Do Not Increase or Decrease Mortality - POEMs - American ...

Oct 15, 2017 - 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 ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1015/od2.html

Treating Painful Diabetic Peripheral Neuropathy: An Update - American Family Physician

Aug 1, 2016 - Painful diabetic peripheral neuropathy occurs in approximately 25% of patients with diabetes mellitus who are treated in the office setting and significantly affects quality of life. It typically causes burning pain, paresthesias, and numbness in a stocking-glove pattern that progresses...

American Family Physician : Article

https://www.aafp.org/afp/2016/0801/p227.html

Management of Blood Glucose with Noninsulin Therapies in Type 2 Diabetes - American ...

Jul 1, 2015 - A comprehensive, collaborative approach is necessary for optimal treatment of patients with type 2 diabetes mellitus. Treatment guidelines focus on nutrition, exercise, and pharmacologic therapies to prevent and manage complications. Patients with prediabetes or new-onset diabetes ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0701/p27.html

Dapagliflozin (Farxiga) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Jun 15, 2015 - Dapagliflozin will lower A1C levels by an average of 0.7 percentage points when used alone or by an average of 0.5 percentage points when added to metformin therapy. Its effect on diabetes-associated morbidity and mortality has not been studied, and although it is well tolerated, there ...

American Family Physician : STEPS

https://www.aafp.org/afp/2015/0615/p828.html

Tight Glycemic Control for Type 2 Diabetes Mellitus (Over Five Years) - Medicine by the...

Jun 1, 2015 - Studies show that none were helped and 1 in 6 patients were harmed. See why.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/0601/od2.html

Metformin Associated with Less Need for a Second Medicine - POEMs - American Family ...

Feb 15, 2015 - n this retrospective analysis, which benefits from large numbers of patients but suffers from possible biases, patients who initially took an oral hypoglycemic other than metformin (Glucophage) were significantly more likely to require a second oral agent.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0215/p261.html

Lending a Hand to Patients with Type 2 Diabetes: A Simple Way to Communicate Treatment ...

Feb 15, 2014 - A new approach to the care of adults with type 2 diabetes emphasizes proven interventions that improve duration and quality of life.

American Family Physician : Editorials

https://www.aafp.org/afp/2014/0215/p256.html

Pioglitazone Exposure Increases Bladder Cancer Risk - POEMs - American Family Physician

Jan 15, 2014 - This review of all available data found a significantly increased risk of bladder cancer among adults with type 2 diabetes treated with pioglitazone. Pioglitazone also significantly increases the risk of heart failure, and there is minimal, if any, patient-oriented evidence of benefit ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0115/p136.html

Metformin Use in Adolescents - FPIN's Clinical Inquiries - American Family Physician

Apr 15, 2013 - There are no studies evaluating whether metformin prevents or delays the onset of diabetes in adolescents who are obese. In adults, metformin is as effective as lifestyle interventions in preventing increases in A1C and fasting glucose levels, but it is less effective in preventing or ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2013/0415/od4.html

Insulin for Glycemic Control in Acute Ischemic Stroke - Cochrane for Clinicians - ...

Dec 1, 2012 - Administering insulin to maintain glycemic control does not improve the rates of mortality or dependency, or the final neurologic outcome after an acute ischemic stroke. Additionally, in randomized controlled trials, patients in the intervention groups (those under tight glycemic ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2012/1201/p1008.html

Does Metformin Increase the Risk of Fatal or Nonfatal Lactic Acidosis? - Cochrane for ...

Nov 1, 2010 - In patients without standard contraindications to metformin therapy, metformin does not increase the risk of lactic acidosis.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2010/1101/p1068.html

Treating Diabetic Peripheral Neuropathic Pain - American Family Physician

Jul 15, 2010 - Diabetic peripheral neuropathic pain affects the functionality, mood, and sleep patterns of approximately 10 to 20 percent of patients with diabetes mellitus. Treatment goals include restoring function and improving pain control. Patients can realistically expect a 30 to 50 percent ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0715/p151.html

Glucose Control in Hospitalized Patients - American Family Physician

May 1, 2010 - Evidence indicates that hospitalized patients with hyperglycemia do not benefit from tight blood glucose control. Maintaining a blood glucose level of less than 180 mg per dL (9.99 mmol per L) will minimize symptoms of hyperglycemia and hypoglycemia without adversely affecting ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0501/p1121.html

Type 2 Diabetes: Separating Proven from Unproven Interventions - Editorials - American ...

Sep 1, 2009 - ...COLIN KOPES-KERR, MD, Santa Rosa Family Medicine Residency, Santa Rosa, California Am Fam Physician. 2009 Sep 1;80(5):450-452. Type 2 diabetes is common and is becoming alarmingly more so, yet it is often misunderstood. Physicians and patients tend to think of it as a problem with...

American Family Physician : Editorials

https://www.aafp.org/afp/2009/0901/p450.html

Diagnosis and Management of Gestational Diabetes Mellitus - American Family Physician

Jul 1, 2009 - Gestational diabetes occurs in 5 to 9 percent of pregnancies in the United States and is growing in prevalence. It is a controversial entity, with conflicting guidelines and treatment protocols. Recent studies show that diagnosis and management of this disorder have beneficial effects ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0701/p57.html

Management of Blood Glucose in Type 2 Diabetes Mellitus - American Family Physician

Jan 1, 2009 - Evidence-based guidelines for the treatment of type 2 diabetes mellitus focus on three areas: intensive lifestyle intervention that includes at least 150 minutes per week of physical activity, weight loss with an initial goal of 7 percent of baseline weight, and a low-fat, ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0101/p29.html

Pharmacologic Management of Hypertension in Patients with Diabetes - American Family ...

Dec 1, 2008 - Hypertension is a common comorbidity in patients with diabetes, and adequate control of blood pressure significantly reduces the risk of macrovascular and microvascular complications. Patients with diabetes should achieve a target blood pressure of less than 130/80 mm Hg. The use of ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1201/p1277.html

Becaplermin (Regranex) for Diabetic Foot Ulcers - STEPS - American Family Physician

Jul 15, 2008 - Although patients treated with becaplermin are more likely to experience complete and faster ulcer healing than patients continuing good wound care alone, the increased risk of cancer mortality and significant cost outweigh the possible benefits in most patients.

American Family Physician : STEPS

https://www.aafp.org/afp/2008/0715/p255.html

Choosing First-Line Therapy for Management of Type 2 Diabetes - AFP Journal Club - ...

Jan 1, 2008 - 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.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0101/p16.html

Does Pioglitazone Benefit Patients With Type 2 Diabetes? - Cochrane for Clinicians - ...

Oct 1, 2007 - 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 ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2007/1001/p969.html

Angiotensin Blockade in Patients with Diabetic Nephropathy - FPIN's Clinical Inquiries ...

Aug 1, 2007 - When used to delay the progression of early nephropathy in patients with type 2 diabetes mellitus, angiotensin receptor blockers (ARBs) are not superior to angiotensin-converting enzyme (ACE) inhibitors.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2007/0801/p423.html

Home Monitoring of Glucose and Blood Pressure - American Family Physician

Jul 15, 2007 - 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 ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0715/p255.html

ACE Inhibitors vs. ARBs for Patients with Diabetic Kidney Disease - Cochrane for ...

Jul 1, 2007 - Studies comparing ACE inhibitors or ARBs with placebo found no mortality benefit in patients with diabetic kidney disease. A subgroup analysis of five studies (2,034 total patients) found that, when given at full or maximally tolerated doses, ACE inhibitors reduce all-cause mortality ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2007/0701/p68.html

Glycemic Control in Patients with Type 2 Diabetes - FPIN's Clinical Inquiries - ...

Apr 1, 2007 - There is no clearly superior oral agent for glycemic control in patients with type 2 diabetes.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2007/0401/p1051.html

The Role of Exercise in Patients with Type 2 Diabetes - Cochrane for Clinicians - ...

Feb 1, 2007 - Regular exercise reduces A1C levels, adiposity, and triglyceride levels. However, no research has definitively proved a benefit of exercise on patient-oriented outcomes such as diabetes-related morbidity and mortality.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2007/0201/p335.html

Tight Control of Type 1 Diabetes: Recommendations for Patients - American Family Physician

Sep 15, 2006 - Tight control of blood glucose levels and risk factors for cardiovascular disease (e.g., hypertension, hypercholesterolemia) can substantially reduce the incidence of microvascular and macrovascular complications from type 1 diabetes. Physicians play an important role in helping ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0915/p971.html

Insulin Detemir (Levmir) for Diabetes Mellitus - STEPS - American Family Physician

Jul 15, 2006 - Insulin detemir is suitable as basal insulin in a basal-bolus regimen. In limited research, it has been shown to cause slightly fewer episodes of minor hypoglycemia and no weight gain in patients with type 1 and 2 diabetes, which is a benefit that must be balanced against its higher ...

American Family Physician : STEPS

https://www.aafp.org/afp/2006/0715/p323.html

Exenatide Injection (Byetta): Adjunctive Therapy for Glycemic Control - STEPS - ...

Jun 15, 2006 - Exenatide is an injectable treatment for type 2 diabetes. Its use requires patient education and strict monitoring of glucose levels because of the difficulty of its administration; therefore, it may not be a safe or practical option for patients who are not willing or able to ...

American Family Physician : STEPS

https://www.aafp.org/afp/2006/0615/p2213.html

Short-Acting Insulin Analogues vs. Human Insulin for Diabetes - Cochrane for Clinicians...

Sep 1, 2005 - For patients with type 2 diabetes, regular insulin and short-acting insulin analogues are equally effective in the treatment of diabetes and in lowering A1C levels. For patients with type 1 diabetes, short-acting analogues produce a slightly greater reduction of A1C levels than regular ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2005/0901/p805.html

Statin Therapy in Patients with Type 2 Diabetes - FPIN's Clinical Inquiries - American ...

Sep 1, 2005 - Based on current evidence, statin therapy should be offered to all patients with type 2 diabetes who are known to have coronary artery disease.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2005/0901/p866.html

Hyperglycemic Crises: Improving Prevention and Management - Editorials - American ...

May 1, 2005 - ...it also has been shown that quarterly visits for children with type 1 diabetes to endocrine clinics can significantly reduce the number of emergency admissions for DKA.12 A prospective study of 1,243 patients with type 1 diabetes from infancy to 19 years of age showed that elevated...

American Family Physician : Editorials

https://www.aafp.org/afp/2005/0501/p1659.html

ACP Releases Guideline on Lipid Control in Patients with Type 2 Diabetes Mellitus - ...

Aug 15, 2004 - A guideline on the management of dyslipidemia, particularly hypercholesterolemia, in patients with type 2 diabetes mellitus has been published by the Clinical Efficacy Assessment Subcommittee of the American College of Physicians (ACP).

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2004/0815/p775.html

Insulin Therapy for Type 2 Diabetes: Rescue, Augmentation, and Replacement of Beta-Cell...

Aug 1, 2004 - Type 2 diabetes is characterized by progressive beta-cell failure. Indications for exogenous insulin therapy in patients with this condition include acute illness or surgery, pregnancy, glucose toxicity, contraindications to or failure to achieve goals with oral antidiabetic ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0801/p489.html

Facilitating Treatment Adherence With Lifestyle Changes in Diabetes - American Family ...

Jan 15, 2004 - Healthy eating and increased physical activity can prevent or delay diabetes and its complications. Techniques that facilitate adherence to these lifestyle changes can be adapted to primary care. Often, the patient's readiness to work toward change must be developed gradually. To ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0115/p309.html

Preventive Therapy for Diabetes: Lifestyle Changes and the Primary Care Physician - ...

Jan 15, 2004 - ...MARTIN S. LIPSKY, M.D., and LISA K. SHARP, PH.D., Northwestern University, Feinberg School of Medicine, Chicago, Illinois Am Fam Physician. 2004 Jan 15;69(2):269-273. During the past decade, the United States has been part of the worldwide epidemic of obesity and diabetes. From 1990...

American Family Physician : Editorials

https://www.aafp.org/afp/2004/0115/p269.html

Perioperative Management of Diabetes - American Family Physician

Jan 1, 2003 - Maintaining glycemic and metabolic control is difficult in diabetic patients who are undergoing surgery. The preoperative evaluation of all patients with diabetes should include careful screening for asymptomatic cardiac or renal disease. Frequent self-monitoring of glucose levels is ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0101/p93.html

Combination Therapy for Type 2 Diabetes - Editorials - American Family Physician

Dec 1, 2001 - ...University of Alabama at Birmingham School of Medicine, Birmingham, Alabama Am Fam Physician. 2001 Dec 1;64(11):1812-1815. Until just over six years ago, patients with type 2 diabetes were started on treatment with a sulfonylurea. When this treatment failed, insulin was added to or...

American Family Physician : Editorials

https://www.aafp.org/afp/2001/1201/p1812.html

Treatment of Type 2 Diabetes Mellitus: A Rational Approach Based on Its Pathophysiology...

May 1, 2001 - ...*–The number of arrows indicates the magnitude of the change in insulin secretion (i.e.,↑= increased;↓= decreased). TABLE 3 Progression of Type 2 Diabetes Mellitus FactorsStage 1 (NGT)Stage II (IGT/IFG)Stage III (type 2 diabetes mellitus)Stage IV (type 2 diabetes mellitus)Stage V...

American Family Physician : Editorials

https://www.aafp.org/afp/2001/0501/p1687.html

Alternative Therapies: Part 1. Depresssion, Diabetes, Obesity - American Family Physician

Sep 1, 2000 - Natural supplements are widely used in the United States and, while claims of their therapeutic effects abound, medical research does not always support their effectiveness. St. John's wort acts as a weak selective serotonin reuptake inhibitor with fewer side effects. ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0901/p1051.html

Educational Guidelines for Achieving Tight Control and Minimizing Complications of Type...

Nov 1, 1999 - Tight glucose control with intensive therapy in patients with type 1 diabetes (formerly known as juvenile-onset or insulin-dependent diabetes) can delay the onset and slow the progression of retinopathy, nephropathy and neuropathy. Optimal blood glucose control is defined by a target ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1101/p1985.html

The Costs of Helping Patients with Type 1 Diabetes Achieve Tight Control - Editorials -...

Nov 1, 1999 - ...JIM NUOVO, M.D., University of California, Davis, School of Medicine, Davis, California JENNIFER NUOVO, M.D., MedClinic, Sacramento, California Am Fam Physician. 1999 Nov 1;60(7):1914-1921. Related Article The management of patients with type 1 diabetes mellitus (formerly known as...

American Family Physician : Editorials

https://www.aafp.org/afp/1999/1101/p1914.html

Management of the Hyperosmolar Hyperglycemic Syndrome - American Family Physician

Oct 1, 1999 - Hyperglycemic hyperosmolarity is part of a clinical spectrum of severe hyperglycemic disorders ranging from pure hyperglycemic hyperosmolarity without ketosis to diabetic ketoacidosis, with significant overlap in the middle. From 50 to 75 percent of hospitalizable patients who have ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1001/p1468.html

Treatment of Type 2 Diabetes Mellitus - American Family Physician

May 15, 1999 - Type 2 diabetes mellitus (formerly called non-insulin-dependent diabetes) causes abnormal carbohydrate, lipid and protein metabolism associated with insulin resistance and impaired insulin secretion. Insulin resistance is a major contributor to progression of the disease and to ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0515/p2835.html

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