Prediabetes

ABSTRACT   The global epidemic of type 2 diabetes remains one of the greatest health challenges of our time.  The collective human and economic costs are staggering and rising.  Widespread initiatives now exist to prevent diabetes wherever possible.  These initiatives are singularly focused on preventing diabetes in the very highest risk group: people with prediabetes. […]

Diagnostic Testing for Diabetes Insipidus

ABSTRACT   Diabetes insipidus (DI) is a disorder characterized by excretion of large volumes of hypotonic urine. The underlying cause is either a deficiency of the hormone arginine vasopressin (AVP) in the pituitary gland/hypothalamus (central DI), or resistance to the actions of AVP in the kidneys (nephrogenic DI). In most circumstances, DI is also characterized […]

Inpatient Diabetes Management

CLINICAL RECOGNITION Background   Appropriate inpatient glycemic management limits the risks of severe hypo- and hyperglycemia.  Preventing and treating hyperglycemia reduces infections and minimizes fluid and electrolyte abnormalities. Specific glucose goals remain fluid.  Hyperglycemia and hypoglycemia are associated with poor outcomes but the few prospective randomized studies have failed to demonstrate consistent improvements.  For example, […]

Role Of Glucose And Lipids In The Cardiovascular Disease Of Patients With Diabetes

ABSTRACT Cardiovascular disease is a major cause of morbidity and mortality in both men and women with Type 1 and Type 2 diabetes. In patients with Type 1 diabetes, intensive glycemic control results in a reduction in cardiovascular disease. However, intensive glycemic control does not have a major impact in reducing cardiovascular disease in patients […]

Diabetes and Dyslipidemia

ABSTRACT Cardiovascular disease is a major cause of morbidity and mortality in both men and women with Type 1 and Type 2 diabetes. In patients with Type 1 diabetes, intensive glycemic control results in a reduction in cardiovascular disease. However, intensive glycemic control does not have a major impact in reducing cardiovascular disease in patients […]

Non-Pharmaceutical Intervention Options For Type 2 Diabetes: Diets And Dietary Supplements (Botanicals, Antioxidants, and Minerals)

ABSTRACT   Complementary health approaches, otherwise known as non-mainstream practices, are commonly used by patients with diabetes. Natural products, including dietary supplements, are the most frequently used complementary approach by patients with diabetes. While popular, there are regulatory, safety, and efficacy concerns regarding natural products. Commonly used dietary supplements for diabetes can be categorized as […]

Initial Management of Severe Hyperglycemia in Type 2 Diabetes

CLINICAL RECOGNITION   Type 2 diabetes mellitus (DM) is a common disease affecting 30.3 million people, 9.4% of the US population.  Of these, an estimated 7 million people are undiagnosed.   Type 2 DM typically has two pathophysiologic defects: an insulin secretory defect and insulin resistance.  Symptoms of uncontrolled hyperglycemia include polyuria, polydipsia, blurry vision […]

Changing the Course of Disease in Type 1 Diabetes

ABSTRACT   In the U.S. alone, more than one million people are living with type 1 diabetes (TID) and approximately 80 people per day, or 30,000 individuals per year, are newly diagnosed [1, 2]. Recent epidemiological studies demonstrate that the global T1D incidence is increasing at a rate of approximately 3-4% per year, notably among […]

Diabetes Insipidus

CLINICAL RECOGNITION   Diabetes Insipidus (DI) is the excess production of dilute urine. Diagnosis requires a targeted history, examination and confirmation through appropriate laboratory and radiological investigations. DI presents with polyuria and polydipsia. Urine output is more than 40 ml/kg /24 hours in adults and more than 100 ml/kg/24 hours in children. DI reflects either […]

Hypoglycemia During Therapy of Diabetes

ABSTRACT   Hypoglycemia, caused by treatment with a sulfonylurea, a glinide, or insulin coupled with compromised defenses against the resulting falling plasma glucose concentrations, is the limiting factor in the glycemic management of diabetes. It causes recurrent morbidity in most people with type 1 diabetes mellitus (T1DM) and many with advanced type 2 diabetes mellitus […]