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Diabetes Mellitus: Screening and Diagnosis - American Family Physician

Jan 15, 2016 - Diabetes mellitus is one of the most common diagnoses made by family physicians. Uncontrolled diabetes can lead to blindness, limb amputation, kidney failure, and vascular and heart disease. Screening patients before signs and symptoms develop leads to earlier diagnosis and treatment, ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0115/p103.html

Diabetes: Type 2 - American Family Physician

Nov 1, 2020 - This collection features AFP content on type 2 diabetes and related issues, including blood glucose levels, diabetic complications (such as ketoacidosis and neuropathy), glycemic control, insulin management, and gestational diabetes. This collection features AFP content on type 2 ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=7

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

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

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

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

Diabetic Kidney Disease: Diagnosis, Treatment, and Prevention - American Family Physician

Jun 15, 2019 - Globally, approximately 20% of the 400 million individuals with diabetes mellitus have diabetic kidney disease (DKD). DKD is associated with higher cardiovascular and all-cause morbidity and mortality, so timely diagnosis and treatment are critical. Screening for early DKD is best done ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0615/p751.html

Screening, Diagnosis, and Management of Gestational Diabetes Mellitus - American Family...

Apr 1, 2015 - Gestational diabetes mellitus (GDM) affects approximately 6% of pregnancies in the United States, and it is increasing in prevalence. Pregnant women without known diabetes mellitus should be screened for GDM after 24 weeks of gestation. Treatment of GDM results in a statistically ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0401/p460.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

Charcot Foot: Clinical Clues, Diagnostic Strategies, and Treatment Principles - ...

May 1, 2018 - Acute Charcot neuroarthropathy of the foot and ankle is often difficult to diagnose because of limited findings in the patient history, physical examination, imaging, and laboratory studies. Delay in treatment results in the development of rigid foot and ankle deformities, increasing ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0501/p594.html

Diabetic Nephropathy--The Family Physician's Role - American Family Physician

May 1, 2012 - Nearly one-half of persons with chronic kidney disease have diabetes mellitus. Diabetes accounted for 44 percent of new cases of kidney failure in 2008. Diabetic nephropathy, also called diabetic kidney disease, is associated with significant macrovascular risk, and is the leading cause...

American Family Physician : Article

https://www.aafp.org/afp/2012/0501/p883.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

Diabetes Mellitus: Diagnosis and Screening - American Family Physician

Apr 1, 2010 - Based on etiology, diabetes is classified as type 1 diabetes mellitus, type 2 diabetes mellitus, latent autoimmune diabetes, maturity-onset diabetes of youth, and miscellaneous causes. The diagnosis is based on measurement of A1C level, fasting or random blood glucose level, or oral ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0401/p863.html

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

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

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

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

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

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

Preventing or Delaying Type 2 Diabetes Mellitus with Diet and Exercise - Cochrane for ...

Dec 1, 2018 - 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.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/1201/p643.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

Impaired Glucose Tolerance and Impaired Fasting Glucose - American Family Physician

Apr 15, 2004 - Impaired glucose tolerance and impaired fasting glucose form an intermediate stage in the natural history of diabetes mellitus. From 10 to 15 percent of adults in the United States have one of these conditions. Impaired glucose tolerance is defined as two-hour glucose levels of 140 to ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0415/p1961.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

Metabolic Syndrome: Time for Action - American Family Physician

Jun 15, 2004 - The constellation of dyslipidemia (hypertriglyceridemia and low levels of high-density lipoprotein cholesterol), elevated blood pressure, impaired glucose tolerance, and central obesity is identified now as metabolic syndrome, also called syndrome X. Soon, metabolic syndrome will ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0615/p2875.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

Diabetic Nephropathy: Common Questions - American Family Physician

Jul 1, 2005 - Diabetic nephropathy, or diabetic kidney disease, affects 20 to 30 percent of patients with diabetes. It is a common cause of kidney failure. Diabetic nephropathy presents in its earliest stage with low levels of albumin (microalbuminuria) in the urine. The most practical method of ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0701/p96.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

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

Benefits and Harms for Low-Dose Aspirin in Patients with Diabetes Mellitus - POEMs - ...

Jun 1, 2019 - The 7,740 patients who took low-dose aspirin experienced 51 fewer vascular deaths, nonfatal myocardial infarctions, or nonfatal ischemic strokes; 29 fewer transient ischemic attacks; and 44 fewer revascularizations than patients who took placebo over a mean of 7.4 years.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p718.html

Diabetic Foot Ulcers: Pathogenesis and Management - American Family Physician

Nov 1, 2002 - Foot ulcers are a significant complication of diabetes mellitus and often precede lower-extremity amputation. The most frequent underlying etiologies are neuropathy, trauma, deformity, high plantar pressures, and peripheral arterial disease. Thorough and systematic evaluation and ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1101/p1655.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

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

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

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

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

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

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

Recognition and Management of Hereditary Hemochromatosis - American Family Physician

Mar 1, 2002 - Hereditary hemochromatosis is the most common inherited single-gene disorder in people of northern European descent. It is characterized by increased intestinal absorption of iron, with deposition of the iron in multiple organs. Previously, the classic description was combined diabetes ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0301/p853.html

Omega-3 Oil Does Not Reduce Serious Cardiovascular Events for Patients with Diabetes ...

Jul 15, 2019 - In this study, there was no significant difference in the likelihood of a composite vascular outcome or all-cause mortality in patients given an omega-3 fatty acid supplement compared with those given an olive oil placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p120.html

AAN, AANEM, and AAPMR Publish Guideline for Treatment of Painful Diabetic Neuropathy - ...

Sep 1, 2012 - Painful diabetic neuropathy is a chronic disease that affects approximately 16 percent of patients who have diabetes mellitus. The American Academy of Neurology (AAN), the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM), and the American Academy of Physical ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2012/0901/p469.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

Diagnosis and Classification of Diabetes Mellitus: New Criteria - American Family ...

Oct 15, 1998 - New recommendations for the classification and diagnosis of diabetes mellitus include the preferred use of the terms

American Family Physician : Article

https://www.aafp.org/afp/1998/1015/p1355.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

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

Attenuating Cardiovascular Risk Factors in Patients with Type 2 Diabetes - American ...

Dec 15, 2000 - Patients with type 2 diabetes (formerly known as non-insulin-resistant diabetes) have a significantly increased risk of developing cardiovascular disease. Once clinical cardiovascular disease develops, these patients have a poorer prognosis than normoglycemic patients. By inducing ...

American Family Physician : Article

https://www.aafp.org/afp/2000/1215/p2633.html

Screening for Gestational Diabetes Mellitus: Recommendation Statement - U.S. Preventive...

Dec 1, 2014 - The U.S. Preventive Services Task Force (USPSTF) recommends screening for gestational diabetes mellitus (GDM) in asymptomatic pregnant women after 24 weeks of gestation.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2014/1201/od1.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

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

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