Diabetes Basics
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2015 Prediabetes Data Summary
The Georgia Department of Public Health Prediabetes Data Summary Diabetes is the 6th leading cause of death among adults and over 800,000 people live with diabetes in Georgia.1 Individuals with prediabetes have an increased risk of developing Type 2 diabetes, heart disease and stroke. Moreover, individuals with prediabetes often possess cardiovascular risk factors such as hypertension, obesity and high cholesterol. Prediabetes almost always occurs among individuals who eventually develop Type 2 diabetes.2 In Type 2 diabetes, the body does not use insulin properly which causes blood glucose (sugar) levels to be higher than normal. Approximately 450,000 adults in Georgia have prediabetes. Prediabetes (also known as borderline diabetes) is a medical condition that occurs when blood glucose levels are higher than normal, but are not high enough to be diagnosed as diabetes.3 Test results among individuals diagnosed with prediabetes include: A1C test value: 5.7% - 6.4% Impaired fasting blood glucose (IFG) levels: 100-125 mg/dl OR Two- hour Oral Glucose Tolerance Test (OGTT) value: 140 mg/dl – 199 mg/dl Making healt hy lifestyle choices, such as eating healthy foods, being physically active and maintaining a healthy weight, may help to bring blood glucose (sugar) levels down to normal and decrease the risk of developing Type 2 diabetes Table 1. Demographic Characteristics among Prediabetics, Georgia, 2013 Demographic Characteristics Percent (%) 95% CI State Total 7.9 (7.2, 8.9) Sex Male 7.8 (6.8, 9.5) Female 7.9 (6.9, 9.1) Race/Ethnicity -
Comparative Evaluation of Fructosamine and Hba1c As a Marker of Glycemic Control in Type 2 Diabetes: a Hospital Based Study
International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Original Research Article Comparative Evaluation of Fructosamine and HbA1c as a Marker of Glycemic Control in Type 2 Diabetes: A Hospital Based Study Dr. Jyoti Goyal1, Dr. Nibhriti Das2, Dr. Navin Kumar3, Ms. Seema Raghav4, Dr. Paramjeet Singh Bhatia5, Dr. Karunesh Prasad Singh6, Dr. Sabari Das7 1DNB, Department of Internal Medicine, Nayati Healthcare and Research Centre, Mathura, India- 281003, 2Ex-Director of Laboratory services and Additional Dean Research and Academics, Nayati Healthcare and Research Centre, Mathura, India- 281003, 3Ph.D, Biostatistitian, Department of Biostatistics, Nayati Healthcare and Research Centre, Mathura, India-281003. 4M.Sc., Certified Diabetes Educator, Department of Internal Medicine, Nayati Healthcare and Research Centre, Mathura, India-281003. 5MD, Department of Internal Medicine, Nayati Healthcare and Research Centre, Mathura, India-281003. 6MD Physician, Department of Internal Medicine, Nayati Healthcare and Research Centre, Mathura, India-281003. 7Department of Laboratory Medicine, Nayati Healthcare and Research Centre, Mathura, India- 281003, Corresponding Author: Dr. Jyoti Goyal ABSTRACT Introduction: Management of type 2 diabetes revolves around achievement of target glycemic control with the help of antidiabetic drugs or insulin. There are various markers for measurement of glyceamic control like HbA1c, Mean Blood Glucose and fructosamine levels. Though HbA1c is a well validated standard method for assessment of glycemic control but it has also got certain limitations. Fructosamine, a less explored method may be used as an alternative marker for an assessment of glycemic control in cases where HbA1c is unreliable or unavailable. The objective of this study is to compare the fructosamine levels with HbA1c in assessment of glycemic control in type 2 diabetics so as to assess the utility of fructosamine as an alternative marker for evaluation of glucose control. -
Glucose Regulation in Diabetes
Glucose Regulation in Diabetes Samantha Lozada Advised by Charles S. Peskin and Thomas Fai Glucose 1 Abstract Complicated and extensive models of glucose regulation, involving several variables, have been developed over the years. Our research specifically focuses on the feedback loop between insulin and glucagon. Although our model is simpler than a model including state variables such as non-esterified fatty acids concentration in the blood plasma, β-cell mass, TAG content of lipocytes, and/or leptin concentrations in the blood plasma, we are still able to simulate most of the key effects of diabetes and other health problems on glucose regulation; such as, hyperglycemia, hyperinsulinism, and insulin shock (hypoglycemia). We are even able to simulate eating a bowl of vanilla ice cream! 2 Introduction For most of our qualitative and quantitative experimentations we worked with MATLAB, a computer programming language and data visualization software, which offers a rich set of tools for solving problems in engineering, scientific, computing, and mathematical disciplines, such as a graphical user interface. Our model is a refinement of a realistic model developed by Cobelli et al. (1982). Despite the fact that the paper is nearly 28 years old, the experimental data of diagnostic tests used by medical professionals, such as the Intravenous Glucose Tolerance Test (IVGTT), correlates with our simulated graphs. From a Biological Perspective Regulation in a Healthy System In order for us to model any biological system, we need to first understand exactly what is happening within a human body. We need to ask what causes this effect and why. To answer these questions we need to identify the key organs and hormones, and then see how they interact within our bodies. -
Metformin for Prediabetes
FACT SHEET FOR PATIENTS AND FAMILIES Metformin for Prediabetes What is metformin? Metformin [met-FORE-min] is a medication that is often prescribed for prediabetes in order to help prevent type 2 diabetes. It is taken by mouth (orally) as a pill. Like other prediabetes medications, it works best when you follow the rest of your treatment plan, like improving your nutrition by eating more fruits and vegetables, being physically active every day, and in most cases, losing weight. What does it do? Metformin helps lower your blood glucose (blood sugar). It does this by: Does metformin cause hypoglycemia • Decreasing the amount of glucose released by your (low blood glucose)? liver. Less glucose enters into your bloodstream. No. Metformin doesn’t cause hypoglycemia by itself. • Increasing the ability of your muscles to use glucose But combined with other medications, vigorous for energy. As more glucose is used, more glucose exercise, or too little food, it can make your blood leaves your bloodstream. glucose drop too low. Why is metformin important Since low blood glucose can be dangerous, make sure for my health? that you and your family know the symptoms. These include feeling shaky, sweaty, hungry, and irritable. Metformin can’t cure your prediabetes. But, by If you have these symptoms, take some quick-acting helping control your blood glucose, it can help sugar. Good sources are 3 or 4 glucose tablets, a half- prevent type 2 diabetes, especially among those at cup of fruit juice or regular soda, or a tablespoon of highest risk for developing type 2 diabetes. -
Prediabetes: What Is It and What Can I Do?
Prediabetes: What Is It and What Can I Do? What is prediabetes? Weight loss can delay or prevent diabetes. Prediabetes is a condition that comes before Reaching a healthy weight can help you a lot. diabetes. It means your blood glucose levels are If you’re overweight, any weight loss, even higher than normal but aren’t high enough to be 7 percent of your weight (for example, losing called diabetes. about 15 pounds if you weigh 200), may lower your risk for diabetes. There are no clear symptoms of prediabetes. You can have it and not know it. If I have prediabetes, what does it mean? It means you might get type 2 diabetes soon or down the road. You are also more likely to get heart disease or have a stroke. The good news is that you can take steps to delay or prevent type 2 diabetes. How can I delay or prevent type 2 diabetes? You may be able to delay or prevent type 2 diabetes with: Daily physical activity, such as walking. Weight loss, if needed. Losing even a few pounds will help. Medication, if your doctor prescribes it. If you have prediabetes, these steps may bring your blood glucose to a normal range. But you are still at a higher risk for type 2 diabetes. Regular physical activity can delay or prevent diabetes. Being active is one of the best ways to delay or prevent type 2 diabetes. It can also lower your weight and blood pressure, and improve cholesterol levels. Ask your health care team about activities that are safe for you. -
Religious Fasting, Ramadan and Hypoglycemia in People with Diabetes
VOLUME 7 > ISSUE 01 > JUNE 30 2014 SPOTLIGHT ARTICLE Diabetic Hypoglycemia June 2014, Volume 7, Issue 1: page 15-19 Religious fasting, Ramadan and hypoglycemia in people with diabetes Alia Gilani1, Melanie Davies2, Kamlesh Khunti2 1 NHS Glasgow, United Kingdom 2 Leicester Diabetes Centre, Leicester General Hospital, Leicester, United Kingdom Abstract Most Muslims with diabetes will take part in Ramadan even though they may be exempt from doing so. In some countries a religious fast can last between 10 and 21 hours. The main risk of fasting to people with diabetes is hypoglycemia. People with diabetes who fast may have to alter the dose of their medications or modify their therapeutic regimen to avoid hypoglycemia, which can have adverse effects on glycemic control. Therapies which pose a high risk of hypoglycemia when used during fasting are sulfonylureas and insulin therapy. Metformin, incretin therapies and the newer sodium glucose co-transporter 2 inhibitor class have a low risk of hypoglycemia. The practice of fasting during Ramadan is advocated for all healthy individuals. If deemed detrimental to health then a person can be considered exempt from fasting; this includes frail and elderly people, pregnant and breast feeding women, children and people with multi-morbidities. Keywords: diabetes, hypoglycemia, Ramadan, religious fasting Introduction the Islamic calendar, the risks associated with prolonged fasting and how it should be managed. Living in a diverse society, it is important that healthcare professionals are kept informed about cultural and religious Fasting during Ramadan practices, which can affect the control of diabetes. The practice of fasting by Muslims has implications for Muslim What does fasting entail? people with diabetes, in particular an increased risk of Ramadan in Arabic is translated as “sawm”, literally hypoglycemia during the period of Ramadan and at other meaning “abstention from”. -
Study Protocol
CLINICAL TRIAL REPORT ZP4207-16136 (ZEA-DNK-01711) 16.1 TRIAL INFORMATION 16.1.1 PROTOCOL AND PROTOCOL AMENDMENTS This appendix includes Document Date, Version Clinical Trial Protocol 18 January 2017, Version 1 Amendment 01 08 May 2017 Clinical Trial Protocol 08 May 2017, Version 2 Amendment 02 21 August 2017 Clinical Trial Protocol 21 August 2017, Version 3 Section 16.1.1: Protocol and Protocol Amendments Clinical Trial Protocol, final version 1 ZP4207-16136 (ZEA-DNK-01711) Clinical Trial Protocol A phase 3, Randomized, Double-Blind, Parallel Group Safety Trial to Evaluate the Immunogenicity of Dasiglucagon Compared to GlucaGen® Administered Subcutaneously in Patients with Type 1 Diabetes Mellitus (T1DM) Sponsor code: ZP4207-16136 SynteractHCR: ZEA-DNK-01711 EudraCT number: 2017-000062-30 Coordinating investigator: Linda Morrow, MD Prosciento 855 Third Avenue 91911 Chula Vista CA, USA Sponsor: Zealand Pharma A/S Smedeland 36 2600 Glostrup, Copenhagen Denmark Version: final version 1 Date: 18 January 2017 GCP statement This trial will be performed in compliance with Good Clinical Practice (GCP), the Declaration of Helsinki (with amendments) and local legal and regulatory requirements. 18 Jan 2017 CONFIDENTIAL Page 1/48 Clinical Trial Protocol, final version 1 ZP4207-16136 (ZEA-DNK-01711) Title: A phase 3, randomized, double-blind, parallel group safety trial to evaluate the immunogenicity of dasiglucagon compared to GlucaGen® administered subcutaneously in patients with type 1 diabetes mellitus (T1DM) I agree to conduct this trial according to the Trial Protocol. I agree that the trial will be carried out in accordance with Good Clinical Practice (GCP), with the Declaration of Helsinki (with amendments) and with the laws and regulations of the countries in which the trial takes place. -
Korelasi Kadar Asam Urat Dalam Darah Terhadap Luaran Klinis Stroke
Artikel Penelitian KORELASI KADAR ASAM URAT DALAM DARAH TERHADAP LUARAN KLINIS STROKE ISKEMIK AKUT THE CORRELATION BETWEEN URIC ACID SERUM LEVELS AND ACUTE STROKE ISCHEMIC OUTCOME Daniel Mahendrakrisna,* Aria Chandra Gunawan Triwibowo Soedomo** ABSTRACT Background: Uric acid is an end metabolism product of purine. It has been known as an important antioxidant in the serum. Correlation between uric acid serum with stroke has been reported controversial finding. However, Uric acid has been proposed to be a stroke risk factor. Aim: To determine the correlation between uric acid serum levels and acute stroke ischemic outcome. Method: This was a cross-sectional study at Surakarta Hospital. All of first experience stroke ischemic patients proven by CT-Scan were included as subjects. Demographic data (age, sex, blood pressure, etc) and laboratory results such as uric acid 24 hours, blood glucose test (random glucose test and fasting glucose test), lipid profile (cholesterol, triglyceride) were obtained from medical records. Data was analysed by software and p<0.05 was statistically accepted. Results: Of 49 acute stroke ischemic patients were include to this study. The mean of uric acid level serum as 5.71±2.64 mg/dL. 30,6% subjects had hyperuricemia and 8,2% subjects had hypouricemia. There were no correlation between uric acids levels with stroke clinical outcome (r= 0.08, p>0.05). Discussion: There was no correlation between uric acid serum levels and acute stroke ischemic outcome.. Keywords: Ischemic, Modified Rankin Scale, outcome, stroke, uric acid ABSTRAK Latar Belakang: Asam urat dalam darah merupakan produk akhir dari metabolism purin pada manusia dan merupakan diduga menjadi salah satu antioksidan yang penting didalam plasma. -
What Everyone Needs to Know About Prediabetes
diaTribe.org provides free cutting-edge diabetes insights and actionable tips for people with diabetes. Our mission is to help individuals better understand their diabetes and to make our readers happier & healthier. What Everyone Needs to Know about Prediabetes: Symptoms, Diagnosis, Prevention, and more! What is prediabetes? Prediabetes is a condition where blood sugar levels are higher than normal, but not high enough to be diagnosed as type 2 diabetes. This occurs when the body has problems in processing glucose properly, and sugar starts to build up in the bloodstream instead of fueling cells in muscles and tissues. Insulin is the hormone that tells cells to take up glucose, and in prediabetes, people typically initially develop insulin resistance (where the body’s cells can’t respond to insulin as well), and over time the ability to produce sufficient insulin is reduced (if no actions are taken to reverse the situation). People with prediabetes also commonly have high blood pressure as well as abnormal blood lipids (e.g. cholesterol.) These often occur prior to the rise of blood glucose levels. What are the symptoms of prediabetes? People typically do not have symptoms of prediabetes, which is partially why up to 90% of people don’t know they have it. The ADA reports that some people with prediabetes may develop symptoms of type 2 diabetes, though even many people diagnosed with type 2 diabetes show little or no symptoms initially at diagnosis. These symptoms include: Urinating often Blurry vision Feeling very thirsty Feeling very hungry, even Cuts/bruises that Tingling, pain, or though you are eating are slow to heal numbness in the hands/ feet Extreme fatigue /diaTribeNews @diaTribeNews diaTribe.org “ People typically do not have symptoms of prediabetes, which is partially why up to 90% of people don’t know they have it.” Who is at risk of developing prediabetes? Overweight and obese adults (a BMI >25 kg/m2) are at significantly greater risk for developing prediabetes, as well as people with a family history of type 2 diabetes. -
Outpatient Education Referral Form
Outpatient Education Referral Form 805 Dixie Street – Carrollton, GA 30117 Telephone: 770.812.5954 Fax: 770.812.5776 We are pleased to provide same-day walk-in appointments at our location above. Please send your patient to our office to be seen today! Patient Name: _______________________________ Date of Birth: ____/____/_____ Patient Phone: ___________________________ Insurance: ______________________________ Diagnosis (including ICD-10 code) ________________________________________________________________________ *Special needs due to impairment of: □ vision □ hearing □ language □ reading □ other__________ Patients with special needs are eligible for 10 hours of individual 1 on 1 training (please check appropriate boxes for service) □ Pre-Diabetes/Metabolic Syndrome □ Diabetes Self-Management Education Current Diabetes Medication: □ Insulin regimen □ Oral agents □ Other injectables □ Gestational Diabetes: # weeks gestation: ____________ Estimated Delivery Date: _______________ □ Medical Nutrition Therapy (MNT) – with Registered Dietitian □ Living Well with Chronic Disease □ Tobacco Cessation □ Get Healthy Kids The following are MEDICARE criteria for DIABETES only services -must have occurred within the last 12 months; must have documentation of the labs before accepting the referral. Fasting blood sugar greater than or equal to 126 mg/dl on two different occasions (or) Two hour post-glucose challenge greater than or equal to 200 mg/dl on two different occasions (or) Random glucose test over 200 mg/dl for a person with symptoms of uncontrolled diabetes Change in Medical Condition, diagnosis or treatment i.e., chronic renal insufficiency and diabetes Please fax this referral, along with relevant labs (blood glucose, A1c, lipids, creatinine, basic metabolic panel, or relevant physician notes) to 770.812.5776. The American Diabetes Association Recognized Diabetes Patient Education Program / Medical Nutrition Therapy is integral to the care of my patient. -
Am I at Risk for Gestational Diabetes?
Am I at risk for gestational diabetes? U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES NATIONAL INSTITUTES OF HEALTH Eunice Kennedy Shriver National Institute of Child Health and Human Development What is gestational diabetes? Gestational diabetes (pronounced jess-TAY-shun-ul die-uh-BEET-eez) is a type of high blood sugar that only pregnant women get. In fact, the word “gestational” means pregnant. If a woman gets high blood sugar when she’s pregnant, but she never had high blood sugar before, she has gestational diabetes. Between 2 percent and 10 percent of U.S. pregnancies are affected by the condition every year,1 making it one of the top health concerns related to pregnancy. If not treated, gestational diabetes can cause problems for mothers and babies, some of them serious. But there is good news. Most of the time, gestational diabetes goes away after the baby is born. The changes in your body that cause gestational diabetes normally occur only when you are pregnant. After the baby is born, your body goes back to normal and the condition goes away. Gestational diabetes is treatable, and the best outcomes result from careful management and control of blood sugar levels. The best way to control gestational diabetes is to find out you have it early and start treatment quickly. Treating gestational diabetes—even if you don’t have any symptoms or your symptoms are mild— greatly reduces health problems for mother and baby. Why do some women get gestational diabetes? Usually, the body breaks down much of the food you eat into a type of sugar, called glucose (pronounced GLOO-kos). -
1 Jasvinder Chawla, MD, MBA Chief Neurology, Hines Veterans Affairs
Jasvinder Chawla, MD, MBA Chief Neurology, Hines Veterans Affairs Hospital, Professor of Neurology, Loyola University Medical Medical Center Jasvinder Chawla, MD, MBA is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, American Clinical Neurophysiology Society, American Medical Association. Specialty Editor Board Francisco Talavera, PharmD, PhD Adjuct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Editor-in-Chief, Medscape Drug Reference Howard S Kirshner, MD Professor of Neurology, Psychiatry and Hearing and Speech Sciences, Vice Chairman, Department of Neurology, Vanderbilt University School of Medicine, Director, Vanderbilt Stroke Center, Program Director, Stroke Service, Vanderbilt Stallworth Rehabilitation Hospital, Consulting Staff, Department of Neurology, Nashville Veterans Affairs Medical Center. Chief Editor Helmi L Letsep, MD Professor and Vice Chair, Department of Neurology, Oregon Health and Science University School of Medicine, Associate Director, OHSU Stoke Center Additional Contributors Pitchaiah Mandava, MD, PhD Assistant Professor, Department of Neurology, Baylor College of Medicine, Consulting Staff, Department of Neurology, Michael E DeBakey Veterans Affairs Medical Center. Richard M Zweifler, MD Chief of Neurosciences, Sentara Healthcare, Professor and Chair of Neurology, Eastern Virginia Medical School. 1 Thomas A Kent, MD Professor and Director of Stroke Research and Education, Department