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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

Obesity - American Family Physician

Nov 1, 2020 - This collection features AFP content on obesity and related issues, including bariatric surgery, childhood obesity, diet, exercise, lifestyle counseling, and weight loss maintenance. This collection features AFP content on obesity and related issues, including bariatric surgery, ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=19

Cycled Hyperbaric Oxygen Improves the Healing of Diabetic Foot Ulcers - POEMs - ... Restricted content. Login required.

Oct 15, 2020 - Hyperbaric oxygen provided with a device that cycles oxygen from high pressure to low pressure increased the likelihood of complete healing of diabetic foot ulcers when combined with standard dressing and an offloading boot.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/1015/od3.html

Management of Hypertriglyceridemia: Common Questions and Answers - American Family ... Restricted content. Login required.

Sep 15, 2020 - Hypertriglyceridemia, defined as fasting serum triglyceride levels of 150 mg per dL or higher, is associated with increased risk of cardiovascular disease. Severely elevated triglyceride levels (500 mg per dL or higher) increase the risk of pancreatitis. Common risk factors for ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0915/p347.html

Similar Long-Term Morbidity and Mortality with Human Insulin and Analogue Insulin - ... Restricted content. Login required.

Sep 15, 2020 - This study found no difference in long-term patient-oriented outcomes between human and analogue insulins in adults with type 2 diabetes.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0915/p375.html

Thyroid Nodules: Advances in Evaluation and Management - American Family Physician Restricted content. Login required.

Sep 1, 2020 - Thyroid nodules can be detected by ultrasonography in up to 68% of the general population. They are typically benign and are often discovered incidentally. The primary goal of thyroid nodule evaluation is to determine whether it is malignant. After thyroid ultrasonography has been ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0901/p298.html

Thyroid and Parathyroid Disorders - American Family Physician

Sep 1, 2020 - This collection features AFP content on thyroid and parathyroid disorders and related issues, including hyperthyroidism, hypothyroidism, and thyroiditis. This collection features AFP content on thyroid and parathyroid disorders and related issues, including hyperthyroidism, ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=67

Treatment of Subclinical Hypothyroidism: BMJ Rapid Recommendation - Practice Guidelines... Restricted content. Login required.

Sep 1, 2020 - Previous guidelines suggested that levothyroxine treatment may be appropriate with hypothyroid symptoms or a TSH level exceeding 10 mIU per L based on limited evidence. A recent large trial in older adults suggests that treatment shows no benefit in many areas and possible harm.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0901/p316.html

Paget Disease of Bone for Primary Care - American Family Physician Restricted content. Login required.

Aug 15, 2020 - Paget disease of bone is a benign disorder characterized by focal areas of increased bone turnover in one or more skeletal sites. It usually affects older adults, and men are at a higher risk than women. Any bone may be affected, but the disease has a high preference for the pelvis, ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0815/p224.html

Continuous Glucose Monitoring in Type 2 Diabetes Is Not Ready for Widespread Adoption -...

Jun 1, 2020 - Although continuous glucose monitoring may benefit patients with type 1 diabetes mellitus, there is limited evidence that it offers similar benefits in patients with type 2 diabetes, regardless of whether they are taking insulin.

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0601/p646.html

Fracture Prevention in Older Adults - Lown Right Care: Reducing Overuse and Underuse - ... Restricted content. Login required.

Mar 15, 2020 - A collaboration between AFP and the Lown Institute promotes a vision of delivering health care that is based on the evidence, balanced in its approach, and focused on the patient.

American Family Physician : Lown Right Care: Reducing Overuse and Underuse

https://www.aafp.org/afp/2020/0315/p370.html

IDx-DR for Diabetic Retinopathy Screening - Diagnostic Tests: What Physicians Need to ... Restricted content. Login required.

Mar 1, 2020 - IDx-DR is a reliable screening tool used to diagnose diabetic retinopathy in the primary care office and may reduce barriers to screening and improve gaps in eye care for those with diabetes.

American Family Physician : Diagnostic Tests: What Physicians Need to Know

https://www.aafp.org/afp/2020/0301/p307.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

Hirsutism in Women - American Family Physician

Aug 1, 2019 - Hirsutism is the excessive growth of terminal hair in a typical male pattern in a female. It is often a sign of excessive androgen levels. Although many conditions can lead to hirsutism, polycystic ovary syndrome and idiopathic hyperandrogenism account for more than 85% of cases. Less ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0801/p168.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

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

Amenorrhea: A Systematic Approach to Diagnosis and Management - American Family Physician

Jul 1, 2019 - Menstrual patterns can be an indicator of overall health and self-perception of well-being. Primary amenorrhea, defined as the lifelong absence of menses, requires evaluation if menarche has not occurred by 15 years of age or three years post-thelarche. Secondary amenorrhea is ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0701/p39.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

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

Aromatase Inhibitors Such as Letrozole (Femara) vs. Clomiphene (Clomid) for Subfertile ...

May 1, 2019 - When treated with letrozole, subfertile women with PCOS who are trying to conceive have increased chances of pregnancy (number needed to treat [NNT] = 11) and live birth (NNT = 10) compared with those treated with clomiphene.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0501/p545.html

Denosumab for Reducing Risk of Fractures in Postmenopausal Women - Medicine by the ...

May 1, 2019 - Denosumab appears to be effective in reducing the risk of vertebral and nonvertebral fractures in postmenopausal women with osteoporosis. Treatment with denosumab does not increase the risk of cancer or death but might increase the risk of infection. However, more studies are required.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0501/od1.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

Metformin for Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis - ...

Feb 15, 2019 - Metformin does not seem to be an effective treatment for nonalcoholic steatohepatitis. There are no studies evaluating whether metformin improves long-term patient-oriented outcomes such as progression from NAFLD to nonalcoholic steatohepatitis, cirrhosis, hepatocellular carcinoma, or ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0215/p262.html

Abaloparatide (Tymlos) for Osteoporosis - STEPS - American Family Physician

Feb 15, 2019 - Abaloparatide is a safe and effective medication used to reduce the likelihood of vertebral and nonvertebral fractures in women at high risk. However, it is expensive and requires daily injections. It has not been evaluated for its effect on decreasing hip fractures.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0215/p260.html

Oral Contraceptives and Antiandrogens Most Effective for Hirsutism Pharmacotherapy - ...

Jan 1, 2019 - Combination oral contraceptive pills (OCPs) are an excellent treatment option for women desiring medical therapy for hirsutism. Based on this meta-analysis, an accompanying practice guideline recommends adding an antiandrogen, such as finasteride (Propecia), if there is an inadequate ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p55.html

NPH Insulin: Fewer Episodes of Severe Hypoglycemia Than Analogs and Less Than One-Half ...

Jan 1, 2019 - 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.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p53a.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

Type 2 Diabetes Mellitus in Children - American Family Physician

Nov 1, 2018 - The prevalence of type 2 diabetes mellitus in children and adolescents has increased worldwide over the past three decades. This increase has coincided with the obesity epidemic, and minority groups are disproportionately affected. The American Diabetes Association recommends screening ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1101/p590.html

Type 2 Diabetes Mellitus: ACP Releases Updated Guidance Statement on A1C Targets for ...

Nov 1, 2018 - 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.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/1101/p613.html

Morning vs. Evening Administration of Levothyroxine - FPIN's Clinical Inquiries - ...

Oct 15, 2018 - The effectiveness of levothyroxine for reducing TSH levels is most dependent on the timing of meals in relation to drug administration. There is conflicting evidence. In two studies, levothyroxine taken at least two hours after eating in the evening maintained or improved TSH levels ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2018/1015/p532.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

Diabetes: ADA Releases Revised Position Statement on Standards of Medical Care - ...

Aug 1, 2018 - 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.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0801/p187.html

Hyperhidrosis: Management Options - American Family Physician

Jun 1, 2018 - Hyperhidrosis is excessive sweating that affects patients’ quality of life, resulting in social and work impairment and emotional distress. Primary hyperhidrosis is bilaterally symmetric, focal, excessive sweating of the axillae, palms, soles, or craniofacial region not caused by other ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0601/p729.html

High-Dose vs. Standard-Dose Heparin for VTE Prophylaxis in Obese Patients - FPIN's Help...

Jun 1, 2018 - In most patients weighing more than 220 lb (100 kg), high-dose heparin prophylaxis (7,500 units subcutaneously three times per day) does not further reduce the risk of VTE compared with standard-dose heparin (5,000 units subcutaneously two or three times per day).

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0601/od2.html

Maternal Obesity and Labor Induction - FPIN's Help Desk Answers - American Family ...

May 15, 2018 - Pregnant women who are obese have nearly double the rate of cesarean delivery, and obesity increases the median duration of active labor by up to four hours when labor is induced. The difference in cesarean delivery rate is larger in obese primigravida patients presenting with cervical ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0515/p671.html

Obesity in Pregnancy: Risks and Management - Editorials - American Family Physician

May 1, 2018 - As obesity becomes more common, it is important for all maternity care clinicians to understand the risks and associated management of obesity in pregnancy. Elevated prepregnancy weight increases the absolute risk of many adverse fetal and maternal outcomes.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0501/p559.html

Gender-Dysphoric/Gender-Incongruent Persons: Treatment Recommendations from the ...

May 1, 2018 - Gender-dysphoric/gender-incongruent persons require a safe and effective hormone regimen. These recommendations are an update to the clinical practice guideline on endocrine treatment of transsexual persons published in 2009 by the Endocrine Society.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0501/p608.html

Duration of Bisphosphonate Therapy - FPIN's Help Desk Answers - American Family Physician

Apr 1, 2018 - Oral bisphosphonates significantly reduce clinical fracture risk at four years in women with postmenopausal osteoporosis (T-score less than −2.5). Treatment beyond five years is associated with further reductions in fractures in women with persistent femoral neck T-scores less than −2.5.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0401/od1.html

DPP-4 Inhibitors and GLP-1 Receptor Agonists for Prevention or Delay of Type 2 Diabetes...

Apr 1, 2018 - 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 ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0401/p437.html

Screening for Thyroid Cancer: Recommendation Statement - U.S. Preventive Services Task ...

Mar 15, 2018 - The USPSTF recommends against screening for thyroid cancer in asymptomatic adults.

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

https://www.aafp.org/afp/2018/0315/od1.html

Screening for Thyroid Cancer - Putting Prevention into Practice - American Family ...

Mar 15, 2018 - A 45-year-old Korean American woman comes to your office for a wellness visit. She has a history of allergic rhinitis, and her family history is significant for diabetes mellitus in her father. She describes her health as good and has no concerns.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2018/0315/p406.html

Vitamin D Screening and Supplementation in Community-Dwelling Adults: Common Questions ...

Feb 15, 2018 - Measurement of vitamin D levels and supplementation with oral vitamin D have become commonplace, although clinical trials have not demonstrated health benefits. The usefulness of serum 25-hydroxyvitamin D levels to assess adequate exposure to vitamin D is hampered by variations in ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0215/p254.html

Vitamin D Screening and Supplementation in Primary Care: Time to Curb Our Enthusiasm - ...

Feb 15, 2018 - Evidence for vitamin D screening and supplementation in adults shows that these commonplace practices have virtually no established health benefits.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0215/p226.html

Diabetes Education and Glycemic Control - FPIN's Clinical Inquiries - American Family ...

Feb 15, 2018 - 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 ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2018/0215/p269.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

Long-Term Use of Bisphosphonates Increases the Risk of Fractures in Older Women - POEMs...

Jan 1, 2018 - In this cohort study, older women at a high risk of fractures who used oral bisphosphonates for 10 to 13 years had a higher risk of fractures than women who used bisphosphonates for only two years.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0101/p53a.html

Home Glucose Monitoring Offers No Benefit to Patients Not Using Insulin - POEMs - ...

Dec 15, 2017 - 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.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1215/od4.html

Hyperosmolar Hyperglycemic State - American Family Physician

Dec 1, 2017 - Hyperosmolar hyperglycemic state is a life-threatening emergency manifested by marked elevation of blood glucose and hyperosmolarity with little or no ketosis. Although there are multiple precipitating causes, underlying infections are the most common. Other causes include certain ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1201/p729.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

Disorders of Puberty: An Approach to Diagnosis and Management - American Family Physician

Nov 1, 2017 - Disorders of puberty can profoundly impact physical and psychosocial well-being. Precocious puberty is pubertal onset before eight years of age in girls and before nine years of age in boys. Patients with early isolated pubertal changes, prepubertal linear growth, and no worrisome ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1101/p590.html

Dulaglutide (Trulicity) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Oct 15, 2017 - Dulaglutide is an easy-to-use, once-weekly injectable therapy for the treatment of type 2 diabetes in adults. It produces a modest decrease in A1C levels with only a small risk of severe hypoglycemia. The small average weight loss it induces may be an advantage for some patients.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/1015/p540.html

Treatment of Subclinical Hypothyroidism Ineffective in Older Adults - POEMs - American ...

Oct 15, 2017 - Treatment of patients with a minimally elevated thyrotropin (thyroid-stimulating hormone) level did not result in any improvement in symptoms. If patients present with a thyrotropin level between 4.6 and 10 mIU per L, repeat the test because the levels often normalize (this occurred in ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1015/od3.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

Testosterone Therapy: Review of Clinical Applications - American Family Physician

Oct 1, 2017 - Testosterone therapy is increasingly common in the United States, and many of these prescriptions are written by primary care physicians. There is conflicting evidence on the benefit of male testosterone therapy for age-related declines in testosterone. Physicians should not measure ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1001/p441.html

Type 2 Diabetes Mellitus: ACP Releases Updated Recommendations for Oral Pharmacologic ...

Oct 1, 2017 - The American College of Physicians (ACP) previously released guidelines in 2012 regarding the effectiveness and safety of oral pharmacologic treatment for type 2 diabetes; however, new evidence has emerged and new drugs have been approved by the U.S. Food and Drug Administration. For ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/1001/p472.html

Treating Aging with Testosterone - Editorials - American Family Physician

Oct 1, 2017 - Most patients on testosterone are being treated for normal symptoms of aging. Given that the diagnostics are questionable and the benefits are unconvincing, the risks of testosterone, some of which may be life-threatening, are not worth taking.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/1001/p428.html

Hair Loss: Common Causes and Treatment - American Family Physician

Sep 15, 2017 - Hair loss is often distressing and can have a significant effect on the patient’s quality of life. Patients may present to their family physician first with diffuse or patchy hair loss. Scarring alopecia is best evaluated by a dermatologist. Nonscarring alopecias can be readily ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0915/p371.html

Diabetes Self-Management: Facilitating Lifestyle Change - American Family Physician

Sep 15, 2017 - Healthy eating and increased physical activity can prevent or delay the onset of diabetes mellitus and facilitate diabetes management. Current guidelines recommend long-term weight loss of 5% to 7% of body weight and 150 minutes of at least moderate-intensity physical activity per week ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0915/p362.html

Lixisenatide (Adlyxin) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Aug 15, 2017 - ixisenatide is an easy-to-use, once-daily injectable therapy for the treatment of type 2 diabetes in adults. It is at least as effective as exenatide at reducing A1C and body weight, with similar rates of gastrointestinal adverse effects.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0815/p257.html

Bariatric Surgery Improves Quality of Life and Results in More Weight Loss Than ...

Jun 15, 2017 - Bariatric surgery using Roux-en-Y gastric bypass or sleeve gastrectomy was more effective than intensive medical therapy at improving quality of life and helping patients lose weight and reduce the need for medications. Anemia was more common with sleeve gastrectomy, and approximately ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0615/p805.html

Subclinical Hyperthyroidism: When to Consider Treatment - American Family Physician

Jun 1, 2017 - Subclinical hyperthyroidism is defined by a low or undetectable serum thyroid-stimulating hormone level, with normal free thyroxine and total or free triiodothyronine levels. It can be caused by increased endogenous production of thyroid hormone (e.g., in Graves disease, toxic nodular ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0601/p710.html

Testosterone Does Not Improve Cognition in Memory-Impaired Older Men with Low ...

Jun 1, 2017 - Testosterone supplementation for men 65 years or older with age-associated memory impairment and a low baseline testosterone level was not associated with significant improvements in memory or other cognitive functions.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0601/p733a.html

Albiglutide (Tanzeum) for Diabetes Mellitus - STEPS - American Family Physician

Apr 15, 2017 - Reductions in A1C are less with albiglutide than with the first-line therapy metformin, and albiglutide costs significantly more than metformin and sulfonylureas. Albiglutide's ability to reduce diabetes-related morbidity and major cardiovascular events is unknown.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0415/p521.html

Detrimental Effect of Tight Glucose Control on CV Mortality Persists Over Nine Years - ...

Mar 15, 2017 - The initial Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, which compared standard treatment with intensive control, found that despite good intentions, cardiovascular (CV) and overall mortality are significantly higher when blood glucose levels are lower.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/od2.html

Semaglutide Reduces CV Events in High-Risk Patients with Type 2 Diabetes Mellitus - ...

Mar 15, 2017 - Semaglutide significantly reduced the composite outcome of CV death, nonfatal myocardial infarction, and nonfatal stroke (number needed to treat [NNT] = 43 over 2.1 years). It was generally well tolerated, and it reduced body weight by approximately 6.4 to 9.5 lb (2.9 to 4.3 kg).

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/p396.html

Radioactive Iodine Therapy vs. Antithyroid Medications for Graves Disease - Cochrane ...

Mar 1, 2017 - Radioactive iodine therapy and antithyroid medications produce similar health-related quality-of-life outcomes in patients with Graves disease. Radioactive iodine therapy is an appropriate choice for patients who prefer definitive treatment.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0301/p292.html

Brief Interventions for Weight Management in Kids Are Not Effective - POEMs - American ...

Feb 1, 2017 - Calculating the BMI of children and adolescents in primary care practices and counseling those who are overweight is ineffective to reduce BMI in children over several years of follow-up.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0201/p194a.html

ADA Updates Standards of Medical Care for Patients with Diabetes Mellitus - Practice ...

Jan 1, 2017 - The American Diabetes Association (ADA) recently updated its standards of care to provide the components of diabetes care, general treatment goals, and tools to evaluate the quality of care. Key changes in the 2016 update include new screening recommendations, clarification of ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0101/p40.html

Diabetes Mellitus: Management of Gastrointestinal Complications - American Family ...

Dec 15, 2016 - Gastrointestinal disorders are common complications of diabetes mellitus and include gastroparesis, nonalcoholic fatty liver disease, gastroesophageal reflux disease, and chronic diarrhea. Symptoms of gastroparesis include early satiety, postprandial fullness, nausea, vomiting of ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1215/p980.html

Empagliflozin (Jardiance) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Dec 15, 2016 - Empagliflozin can be added to existing type 2 diabetes treatment to lower A1C levels, although there are less expensive options. In older patients with preexisting cardiovascular disease, empagliflozin can decrease all-cause mortality, cardiovascular mortality, and hospitalization for ...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/1215/p1014.html

Society for Vascular Surgery Releases Guideline on Managing the Diabetic Foot - ...

Nov 15, 2016 - The Society for Vascular Surgery collaborated with the American Podiatric Medical Association and the Society for Vascular Medicine to create evidence-based guidelines to improve the care of patients with a diabetic foot.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/1115/p834.html

Update on Office-Based Strategies for the Management of Obesity - American Family ...

Sep 1, 2016 - Obesity is a common condition that is associated with numerous medical problems such as cardiovascular disease, pulmonary disease, and diabetes mellitus. Primary care physicians have an important role in helping patients develop a successful weight loss plan to improve their overall ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0901/p361.html

Alternatives to Metformin for Patients with PCOS - FPIN's Help Desk Answers - American ...

Sep 1, 2016 - Compared with placebo, thiazolidinediones (TZDs) decrease systolic blood pressure and fasting blood glucose and insulin levels while improving menstrual irregularities in women with PCOS. Metformin and TZDs have similar effects on pregnancy rates, ovulation, and menstrual frequency, but...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0901/p378.html

Newer Sulfonylureas Not Associated with Increased Mortality, MIs, or Strokes - POEMs - ...

Sep 1, 2016 - In multiple randomized trials, the long-term use of second- or third-generation sulfonylureas in patients with type 2 diabetes is not associated with more deaths, myocardial infarctions (MIs), or strokes. The included trials tended not to report other safety data.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p386.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

Blood Pressure Goal of 140 to 150 mm Hg Is Best for Patients with Diabetes - POEMs - ...

Jul 1, 2016 - Although most recent practice guidelines have relaxed the blood pressure goals for patients with diabetes, there are still a few holdouts that suggest aggressive treatment. This analysis shows that the ideal range for hypertension control in patients with diabetes is between 140 and 150...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0701/p59a.html

Screening for Abnormal Blood Glucose and Type 2 Diabetes Mellitus - Putting Prevention ...

Jun 15, 2016 - M.A. is a 43-year-old woman with a seven pack-year smoking history. She has no health concerns and has not visited a physician in four years. Her blood pressure and pulse are normal, and her body mass index (BMI) is 27 kg per m2. She does not have a family history of diabetes mellitus ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2016/0615/p1025.html

Hyperthyroidism: Diagnosis and Treatment - American Family Physician

Mar 1, 2016 - Hyperthyroidism is an excessive concentration of thyroid hormones in tissues caused by increased synthesis of thyroid hormones, excessive release of preformed thyroid hormones, or an endogenous or exogenous extrathyroidal source. The most common causes of an excessive production of ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0301/p363.html

Treating Low Vitamin D Levels Is Ineffective in Postmenopausal Women - POEMs - American...

Feb 15, 2016 - You do not have to treat a low vitamin D level if your patient is a typical community-dwelling postmenopausal woman younger than 75 years. The usual dosage of vitamin D, 800 IU (20 mcg) daily, will not increase levels even after a year of therapy and has little effect on calcium ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0215/p315.html

Preventing CVD in Adults with Type 2 Diabetes Mellitus: An Update from the AHA and ADA ...

Feb 1, 2016 - The American Heart Association (AHA) and American Diabetes Association (ADA) joined together to release statements on preventing CVD in persons with diabetes.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/0201/p232.html

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

Screening for Abnormal Blood Glucose and Type 2 Diabetes Mellitus: Recommendation ...

Jan 15, 2016 - The USPSTF recommends screening for abnormal blood glucose as part of cardiovascular risk assessment in adults aged 40 to 70 years who are overweight or obese. Clinicians should offer or refer patients with abnormal blood glucose to intensive behavioral counseling interventions to ...

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

https://www.aafp.org/afp/2016/0115/od1.html

Adding Sitagliptin Does Not Reduce or Increase the Risk of Cardiovascular Outcomes - ...

Dec 1, 2015 - The glass half full is that sitagliptin does not increase the risk of cardiovascular events in patients with type 2 diabetes. The glass half empty is that it does not reduce the risk, either. And that is the important message: In patients with a mean glycated hemoglobin level of 7.2%, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1201/p1020a.html

Screening for Thyroid Dysfunction - Putting Prevention into Practice - American Family ...

Oct 15, 2015 - A 40-year-old woman presents for a routine well-woman examination. She is not pregnant, is in good health, reports no symptoms, and her physical examination is unremarkable. After seeing a health news segment on television, she asks if she should have her thyroid function checked.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2015/1015/p717.html

Insulin Sensitizers for Treatment of Menstrual Irregularities Associated with PCOS - ...

Sep 1, 2015 - Metformin, pioglitazone (Actos), and rosiglitazone (Avandia) can be used to improve menstrual cycling in women with PCOS.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2015/0901/p390.html

Diagnosis and Management of Osteoporosis - American Family Physician

Aug 15, 2015 - Osteoporosis-related fractures affect approximately one in two white women and one in five white men in their lifetime. The impact of fractures includes loss of function, significant costs, and increased mortality. The U.S. Preventive Services Task Force recommends using dual energy ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0815/p261.html

Evaluation of Short and Tall Stature in Children - American Family Physician

Jul 1, 2015 - Short stature is defined as a height more than two standard deviations below the mean for age (less than the 3rd percentile). Tall stature is defined as a height more than two standard deviations above the mean for age (greater than the 97th percentile). The initial evaluation of short ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0701/p43.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

Type 2 Diabetes: Updated Evidence Requires Updated Decision Making - Editorials - ...

Jul 1, 2015 - Clinicians need to consider the best available research findings, their own experience, and their patients' needs and values.

American Family Physician : Editorials

https://www.aafp.org/afp/2015/0701/p22.html

Growth Hormone for Treatment of Idiopathic Short Stature in Children - FPIN's Help Desk...

Jul 1, 2015 - Advertisement << Previous article Next article >> Jul 1, 2015 Issue FPIN's Help Desk Answers Growth Hormone for Treatment of Idiopathic Short Stature in Children SUFIAN ZAYED, MD, and DIANE J. MADLON-KAY, MD, MS, University of Minnesota Medical Center, Smiley's Family Medicine...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2015/0701/p64.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

Screening for Thyroid Dysfunction: Recommendation Statement - U.S. Preventive Services ...

Jun 1, 2015 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for thyroid dysfunction in nonpregnant, asymptomatic adults.

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

https://www.aafp.org/afp/2015/0601/od1.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

Individualizing Target Goals and Treatment in Patients with Type 2 Diabetes - POEMs - ...

Jun 1, 2015 - This statement from American and European diabetes societies suggests that tighter control of hyperglycemia be attempted only in patients with a recent diagnosis and a low risk of hypoglycemia; who have a long life expectancy with few or no comorbidities, including cardiovascular ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0601/p788.html

No Benefit to Screening with CTA for Asymptomatic CAD in Adults with Diabetes - POEMs -...

Apr 15, 2015 - Using coronary CTA to screen for CAD in adults with type 1 or type 2 diabetes and no indication of existing CAD does not improve outcomes more than standard care.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0415/p566.html

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