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Diabetes for dummies
Take control of your health-- manage and treat your diabetes so you can live a full life. Rubin gives you reassuring guidance on putting together a state-of-the-art treatment program, advice on the latest medications, and tips on developing a diet and exercise plan to stay healthy.
Book
Treatment of Diabetes in Older Adults: An Endocrine Society Clinical Practice Guideline
Abstract
Objective
The objective is to formulate clinical practice guidelines for the treatment of diabetes in older adults.
Conclusions
Diabetes, particularly type 2, is becoming more prevalent in the general population, especially in individuals over the age of 65 years. The underlying pathophysiology of the disease in these patients is exacerbated by the direct effects of aging on metabolic regulation. Similarly, aging effects interact with diabetes to accelerate the progression of many common diabetes complications. Each section in this guideline covers all aspects of the etiology and available evidence, primarily from controlled trials, on therapeutic options and outcomes in this population. The goal is to give guidance to practicing health care providers that will benefit patients with diabetes (both type 1 and type 2), paying particular attention to avoiding unnecessary and/or harmful adverse effects.
Screening, treatment, and management of diabetes mellitus and complications in older patients.
Journal Article
Type 2 Diabetes Mellitus: New Pathogenetic Mechanisms, Treatment and the Most Important Complications
Type 2 diabetes mellitus (T2DM), a prevalent chronic disease affecting over 400 million people globally, is driven by genetic and environmental factors. The pathogenesis involves insulin resistance and β-cell dysfunction, mediated by mechanisms such as the dedifferentiation of β-cells, mitochondrial dysfunction, and oxidative stress. Treatment should be based on non-pharmacological therapy. Strategies such as increased physical activity, dietary modifications, cognitive-behavioral therapy are important in maintaining normal glycemia. Advanced therapies, including SGLT2 inhibitors and GLP-1 receptor agonists, complement these treatments and offer solid glycemic control, weight control, and reduced cardiovascular risk. Complications of T2DM, such as diabetic kidney disease, retinopathy, and neuropathy, underscore the need for early diagnosis and comprehensive management to improve patient outcomes and quality of life.
Journal Article
Quick diabetic recipes
\"Plan delicious, diabetes-friendly meals--easily! When you have diabetes, meal planning and preparation are important parts of caring for your health. Quick Diabetic Recipes for Dummies gives you everything you need to create healthy, diabetes-friendly meals in a snap. Find recipes for delicious soups and stews, appetizers, salads, veggies even the kids will eat, hearty breakfasts, satisfying entrâees, and even desserts! Tips on shopping, cooking, keeping a healthy kitchen, and more will make your healthy eating journey even easier! Inside... basics of diabetes nutrition and meal planning; nutritious foods to keep in stock; healthy cooking techniques; dishes your guests will love; portion control tips and tricks, diabetes choices/exchanges\"-- Page 4 of cover.
Book
Clinical efficacy of therapeutic footwear with a rigid rocker sole in the prevention of recurrence in patients with diabetes mellitus and diabetic polineuropathy: A randomized clinical trial
Therapeutic footwear becomes the first treatment line in the prevention of diabetic foot ulcer and future complications of diabetes. Previous studies and the International Working Group on the Diabetic Foot have described therapeutic footwear as a protective factor to reduce the risk of re-ulceration. In this study, we aimed to analyze the efficacy of a rigid rocker sole to reduce the recurrence rate of plantar ulcers in patients with diabetic foot.
Between June 2016 and December 2017, we conducted a randomized controlled trial in a specialized diabetic foot unit.
Fifty-one patients with diabetic neuropathy who had a recently healed plantar ulcer were randomized consecutively into the following two groups: therapeutic footwear with semi-rigid sole (control) or therapeutic footwear with a rigid rocker sole (experimental). All patients included in the study were followed up for 6 months (one visit each 30 ± 2 days) or until the development of a recurrence event.
Primary outcome measure was recurrence of ulcers in the plantar aspect of the foot.
A total of 51 patients were randomized to the control and experimental groups. The median follow-up time was 26 [IQR-4.4-26.1] weeks for both groups. On an intention-to-treat basis, 16 (64%) and 6 (23%) patients in the control and experimental groups had ulcer recurrence, respectively. Among the group with >60% adherence to therapeutic footwear, multivariate analysis showed that the rigid rocker sole improved ulcer recurrence-free survival time in diabetes patients with polyneuropathy and DFU history (P = 0.019; 95% confidence interval, 0.086-0.807; hazard ratio, 0.263).
We recommend the use of therapeutic footwear with a rigid rocker sole in patients with diabetes with polyneuropathy and history of diabetic foot ulcer to reduce the risk of plantar ulcer recurrence.
ClinicalTrials.gov NCT02995863.
Journal Article
Dapagliflozin Monotherapy in Type 2 Diabetic Patients With Inadequate Glycemic Control by Diet and Exercise: A randomized, double-blind, placebo-controlled, phase 3 trial
Dapagliflozin, a highly selective inhibitor of the renal sodium-glucose cotransporter-2, increases urinary excretion of glucose and lowers plasma glucose levels in an insulin-independent manner. We evaluated the efficacy and safety of dapagliflozin in treatment-naive patients with type 2 diabetes.
This was a 24-week parallel-group, double-blind, placebo-controlled phase 3 trial. Patients with A1C 7.0-10% (n = 485) were randomly assigned to one of seven arms to receive once-daily placebo or 2.5, 5, or 10 mg dapagliflozin once daily in the morning (main cohort) or evening (exploratory cohort). Patients with A1C 10.1-12% (high-A1C exploratory cohort; n = 73) were randomly assigned 1:1 to receive blinded treatment with a morning dose of 5 or 10 mg/day dapagliflozin. The primary end point was change from baseline in A1C in the main cohort, statistically tested using an ANCOVA.
In the main cohort, mean A1C changes from baseline at week 24 were -0.23% with placebo and -0.58, -0.77 (P = 0.0005 vs. placebo), and -0.89% (P < 0.0001 vs. placebo) with 2.5, 5, and 10 mg dapagliflozin, respectively. Signs, symptoms, and other reports suggestive of urinary tract infections and genital infection were more frequently noted in the dapagliflozin arms. There were no major episodes of hypoglycemia. Data from exploratory cohorts were consistent with these results.
Dapagliflozin lowered hyperglycemia in treatment-naive patients with newly diagnosed type 2 diabetes. The near absence of hypoglycemia and an insulin-independent mechanism of action make dapagliflozin a unique addition to existing treatment options for type 2 diabetes.
Journal Article
The complete diabetes cookbook : the healthy way to eat the foods you love
\"Diabetes is a health crisis. America's Test Kitchen's urgent mission is to provide a path to healthier eating for anyone cooking for diabetes and encourage home cooks to get into the kitchen with a complete collection of great-tasting recipes. Vetted by a dietician and a doctor, all of the more than 400 inspired recipes maximize healthy ingredients and flavor while adhering to specific nutritional guidelines. Enjoy every meal with fresh and creative recipes for breakfast, lunch, and dinner, including options for entertaining, snacks, and occasional sweet treats\"-- Provided by publisher.
Book
Standards of Medical Care in Diabetes—2012
Strategies such as explicit goal setting with patients (453); identifying and addressing language, numeracy, or cultural barriers to care (454-456); integrating evidence-based guidelines and clinical information tools into the process of care (457-459); and incorporating care management teams including nurses, pharmacists, and other providers (460-463) have each been shown to optimize provider and team behavior and thereby catalyze reduction in AlC, blood pressure, and LDL cholesterol. Support patient behavior change Successful diabetes care requires a systematic approach to supporting patients' behavior change efforts, including (a) healthy lifestyle changes (physical activity, healthy eating, nonuse of tobacco, weight management, effective coping), (b) disease self-management (medication taking and management, self-monitoring of glucose and blood pressure when clinically appropriate); and (c) prevention of diabetes complications (self-monitoring of foot health, active participation in screening for eye, foot, and renal complications, and immunizations).
Journal Article