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KISS Keep Insulin Safe and Simple is a very practical and simple way to initiate insulin and achieve optimal glycaemic control in type 2 diabetic.
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This patient has type 2 diabetes, obesity, hypertension, and a family history of cardiovascular disease. She is currently taking metformin, glipizide, lisinopril, and simvastatin but is not achieving optimal blood sugar control. The doctor is considering adding pioglitazone, NPH insulin before bed, or exenatide twice daily.
Alternative to insulin for gestational diabetes
Gestational diabetes develops due to increased insulin resistance during pregnancy. It can cause complications for both mother and fetus if uncontrolled. The standard treatment is insulin therapy, but oral hypoglycemic drugs like glyburide may be used. Glyburide does not cross the placenta and has not been shown to cause fetal anomalies. It can be started at a low dose of 2.5 mg once daily before meals and increased slowly as needed to control blood sugar levels while minimizing risks for the mother and fetus. Lifestyle changes like diet and exercise are also important for managing gestational diabetes.
Sick day managment in diabetic children and adolescent
This document outlines rules for managing sick days in children with diabetes to prevent diabetic ketoacidosis. It discusses increasing insulin needs during illness due to stress hormones and insulin resistance. Key rules include continuing oral intake, frequent blood sugar and ketone monitoring, giving scheduled insulin and extra rapid-acting insulin for high blood sugar or ketones as needed, treating nausea, preventing dehydration, resting, and knowing when to call the doctor for uncontrolled symptoms. Following these sick day rules can help keep diabetic children out of the hospital during illness.
Insulin mgt
This document provides information on different types of insulin, including their onset, peak times and durations of action. It discusses using rapid-acting insulin to mimic the first phase insulin response and long-acting insulin to mimic the second phase. Formulas for calculating total daily insulin doses for patients with type 2 diabetes are presented. The importance of titrating insulin doses daily based on blood glucose results is emphasized to maintain good glucose control without hypoglycemia for hospitalized patients.
Insulin Therapy in Pregnant Women
The goal in managing diabetes during pregnancy is to maintain near-normal glucose levels to decrease risks for the baby. This can be achieved through medical nutrition therapy and insulin as needed. Only certain insulins like NPH, regular human insulin, lispro and aspart are approved for use in pregnancy. Lispro and aspart are preferred over regular insulin as they provide better post-meal control with fewer side effects. Insulin dosing is adjusted throughout pregnancy based on weight and stage of pregnancy. Near-normal glucose levels are also important during delivery to prevent neonatal hypoglycemia.
Anaesthetic Management of Diabetes Mellitus in Pediatrics
This document discusses the anesthetic management of pediatric diabetes mellitus. The key goals are providing balanced glycemic control to avoid hypoglycemia and hyperglycemia. Various insulin regimens and preparations are outlined. Preoperative assessment focuses on blood glucose, metabolic control, and electrolyte balance. Intraoperatively, blood glucose is closely monitored and IV insulin may be used. Postoperatively, the child's usual insulin or oral medication regimen is restarted once oral intake resumes. Hypoglycemia is avoided through careful glucose monitoring during all phases of care.
Starting Insulin by M Daoud
This document discusses two case studies of patients with type 2 diabetes mellitus. For the first case, a 50-year old female patient with HbA1c of 8.5-9% on oral medications, the summary recommends starting basal insulin such as glargine or detemir 15-20 units at bedtime. For the second case, a 68-year old obese male patient with HbA1c of 10.5% on maximum oral medications, the summary recommends starting a total daily dose of insulin of 0.3-0.5 units/kg, starting with premixed insulin such as Mixtard 18/10 units. Both cases emphasize individualizing treatment targets and adjusting insulin doses based on self-
INSULIN MANAGEMENT OF TYPE 1 DIABETES
This document discusses insulin management for type 1 diabetes mellitus. It provides information on diabetic ketoacidosis, goals of treatment, criteria for diabetes diagnosis, the treatment team, intensive insulin therapy including different insulin preparations and regimens, goals for blood sugar and HbA1c levels, and home blood glucose monitoring. The standard treatment involves multiple daily insulin injections or insulin pump therapy to closely mimic normal insulin secretion and intensive education to allow patients to lead normal lives.
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This patient has type 2 diabetes, obesity, hypertension, and a family history of cardiovascular disease. She is currently taking metformin, glipizide, lisinopril, and simvastatin but is not achieving optimal blood sugar control. The doctor is considering adding pioglitazone, NPH insulin before bed, or exenatide twice daily.
Alternative to insulin for gestational diabetes
Gestational diabetes develops due to increased insulin resistance during pregnancy. It can cause complications for both mother and fetus if uncontrolled. The standard treatment is insulin therapy, but oral hypoglycemic drugs like glyburide may be used. Glyburide does not cross the placenta and has not been shown to cause fetal anomalies. It can be started at a low dose of 2.5 mg once daily before meals and increased slowly as needed to control blood sugar levels while minimizing risks for the mother and fetus. Lifestyle changes like diet and exercise are also important for managing gestational diabetes.
Sick day managment in diabetic children and adolescent
This document outlines rules for managing sick days in children with diabetes to prevent diabetic ketoacidosis. It discusses increasing insulin needs during illness due to stress hormones and insulin resistance. Key rules include continuing oral intake, frequent blood sugar and ketone monitoring, giving scheduled insulin and extra rapid-acting insulin for high blood sugar or ketones as needed, treating nausea, preventing dehydration, resting, and knowing when to call the doctor for uncontrolled symptoms. Following these sick day rules can help keep diabetic children out of the hospital during illness.
Insulin mgt
This document provides information on different types of insulin, including their onset, peak times and durations of action. It discusses using rapid-acting insulin to mimic the first phase insulin response and long-acting insulin to mimic the second phase. Formulas for calculating total daily insulin doses for patients with type 2 diabetes are presented. The importance of titrating insulin doses daily based on blood glucose results is emphasized to maintain good glucose control without hypoglycemia for hospitalized patients.
Insulin Therapy in Pregnant Women
The goal in managing diabetes during pregnancy is to maintain near-normal glucose levels to decrease risks for the baby. This can be achieved through medical nutrition therapy and insulin as needed. Only certain insulins like NPH, regular human insulin, lispro and aspart are approved for use in pregnancy. Lispro and aspart are preferred over regular insulin as they provide better post-meal control with fewer side effects. Insulin dosing is adjusted throughout pregnancy based on weight and stage of pregnancy. Near-normal glucose levels are also important during delivery to prevent neonatal hypoglycemia.
Anaesthetic Management of Diabetes Mellitus in Pediatrics
This document discusses the anesthetic management of pediatric diabetes mellitus. The key goals are providing balanced glycemic control to avoid hypoglycemia and hyperglycemia. Various insulin regimens and preparations are outlined. Preoperative assessment focuses on blood glucose, metabolic control, and electrolyte balance. Intraoperatively, blood glucose is closely monitored and IV insulin may be used. Postoperatively, the child's usual insulin or oral medication regimen is restarted once oral intake resumes. Hypoglycemia is avoided through careful glucose monitoring during all phases of care.
Starting Insulin by M Daoud
This document discusses two case studies of patients with type 2 diabetes mellitus. For the first case, a 50-year old female patient with HbA1c of 8.5-9% on oral medications, the summary recommends starting basal insulin such as glargine or detemir 15-20 units at bedtime. For the second case, a 68-year old obese male patient with HbA1c of 10.5% on maximum oral medications, the summary recommends starting a total daily dose of insulin of 0.3-0.5 units/kg, starting with premixed insulin such as Mixtard 18/10 units. Both cases emphasize individualizing treatment targets and adjusting insulin doses based on self-
INSULIN MANAGEMENT OF TYPE 1 DIABETES
This document discusses insulin management for type 1 diabetes mellitus. It provides information on diabetic ketoacidosis, goals of treatment, criteria for diabetes diagnosis, the treatment team, intensive insulin therapy including different insulin preparations and regimens, goals for blood sugar and HbA1c levels, and home blood glucose monitoring. The standard treatment involves multiple daily insulin injections or insulin pump therapy to closely mimic normal insulin secretion and intensive education to allow patients to lead normal lives.
Diabetes Mellitus management in OPD
This document discusses the management of type 1 diabetes mellitus (T1DM) in an outpatient setting. It covers the history and pathogenesis of T1DM, classification, epidemiology, complications, monitoring strategies, treatment including insulin regimens and pumps, and management of sick days and hypoglycemia. Continuous glucose monitoring has shown that the majority of hypoglycemic episodes in children with T1DM are asymptomatic and occur overnight. New insulin formulations and pump therapy aim to better mimic normal pancreatic insulin secretion and reduce risks of hypoglycemia and ketoacidosis.
Geeta
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Developed by University of Virginia. No published data.
Glucommander
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Glycemic
Management
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PID
Developed by University of Padua. No published data.
GlucoDose
PID
Developed by University of Virginia. No published data.
28
References:
1. Klonoff DC. Automated insulin delivery: the perspective of the artificial pancreas project. J Diabetes Sci
Technol. 2011;5(5):10
Review studies of new insulin products
The document reviews studies of new insulin products including Degludec (Tresiba), Degludec/Aspart (Ryzodeg), and Glargine (Basaglar). It finds that Degludec has a longer duration of action of over 42 hours and lower day-to-day variability compared to other long-acting insulins. Degludec/Aspart is found to reduce post-dinner blood glucose excursions and provide more stable nocturnal glycemia than Glargine. Basaglar is approved as the first follow-on biologic insulin and demonstrated comparable efficacy and safety to Glargine in clinical trials.
Gestational diabetes mellitus
The document discusses gestational diabetes mellitus (GDM). It begins with physiological changes in pregnancy that increase insulin resistance and glucose intolerance. It then defines GDM, discusses prevalence, screening methods, diagnosis, medical and obstetric management, and controversies around screening. Key points include that GDM is associated with adverse maternal and neonatal outcomes. Screening methods include fasting blood glucose and glucose challenge tests. Treatment involves diet, exercise, and potentially insulin or oral hypoglycemic drugs. The goal of management is to maintain euglycemia and prevent macrosomia and other complications.
GDM analogs
This document summarizes the use of various insulin analogs and medications for managing diabetes in pregnancy. It finds that short-acting insulin analogs like lispro and aspart are considered category B and are safe alternatives to regular human insulin for managing gestational and pregestational diabetes. Long-acting analogs like glargine and detemir are category C due to limited safety data, though retrospective studies found no increases in adverse outcomes. Metformin and glyburide may be options for some gestational diabetes cases but require additional insulin in many cases and have some risks. Tight glycemic control is important for reducing fetal complications.
sick day managment CAN SAFE LIFE FOR DM1
This document discusses the importance of sick day management for diabetic patients and provides guidance on managing common illness scenarios. It emphasizes that failure to properly manage illness can lead to dangerous complications like DKA, cerebral edema, and death. The document outlines criteria for diagnosing DKA and provides a 5-step approach to prevent DKA during illness. It also discusses guidelines for different scenarios involving hypoglycemia, ketosis, and hyperglycemia during sickness. Overall, the document stresses that educating patients and caregivers on sick day management is critical for safely managing illness and avoiding life-threatening outcomes.
Insulin Therapy (Indian Pediatrics)
This review article discusses optimal insulin therapy for children with type 1 diabetes mellitus. It covers the following key points in 3 sentences:
Intensive insulin therapy involving multiple daily injections or continuous pump therapy is recommended to achieve optimal glycemic control and reduce long-term complications. Various types of insulin are available including short-acting analogs like lispro and aspart, intermediate-acting insulins like NPH, and long-acting insulins like glargine and detemir. While insulin analogs provide some benefits like faster absorption, studies show they provide similar or only minor improvements in glycemic control compared to regular human insulin.
Diabetes Asia
Our aim is to alleviate human suffering related to diabetes and its complications among those least able to withstand the burden of the disease. From 2002 to March 2017, the World Diabetes Foundation provided USD 130 million in funding to 511 projects in 115 countries.
For every dollar spent, the Foundation raises approximately 2 dollars in cash or as in-kind donations from other sources.
The total value of the WDF project portfolio reached USD 377 million, excluding WDF’s own advocacy and strategic platforms.
Diabetes Asia
Our aim is to reduce morbidity and mortality related to Non communicable diseases such as hypertension, diabetes, cardiovascular disease, stroke, Obesity, Cancer and lifestyle diseases among those least able to withstand the burden of the disease.
Gdm and-nutrition
This document discusses nutrition and gestational diabetes mellitus. It provides recommendations for weight gain during pregnancy based on pre-pregnancy BMI. It outlines the criteria for diagnosing gestational diabetes. The document then discusses recommended calorie and macronutrient intake during pregnancy and lactation based on clinical practice guidelines. It presents a sample meal plan providing the recommended calories and macronutrient breakdown for a pregnant patient diagnosed with gestational diabetes.
SMBG by Dr Shahjada Selim
Dr. Shahjada Selim, an assistant professor at Bangabandhu Sheikh Mujib Medical University, discusses self-monitoring of blood glucose (SMBG) and recommends that patients on multiple-dose insulin or insulin pump therapy should perform SMBG before meals and snacks, at bedtime, before exercise, when suspecting low blood glucose, after treating low blood glucose until normoglycemic, before critical tasks like driving, and possibly after meals. The recommendations are based on standards from the American Diabetes Association.
Periop management of diabetes
Insulin is a protein hormone that regulates blood glucose levels. It is produced by beta cells in the pancreas and released into the bloodstream. Insulin binds to receptors on cells and stimulates the uptake of glucose from the bloodstream into cells, where it is used for energy or stored as glycogen. There are several types of insulin preparations that vary in their onset and duration of action, including rapid-acting, short-acting, intermediate-acting, and long-acting insulins. Insulin is essential for treatment of type 1 diabetes and is often used in combination with oral medications to treat type 2 diabetes.
Gestational diabetes
screening, diagnosis & management of gestational diabetes, different modalities of treatment, complication of GD, macrosomia
Cgm case studies
This case discusses a 62-year-old woman with type 1 diabetes and hypoglycemia unawareness who underwent professional continuous glucose monitoring on two occasions. The initial monitoring revealed no overnight hypoglycemia but significant hyperglycemia throughout the day. Therapy was adjusted based on these results. Follow-up monitoring showed fewer post-meal excursions but continued hyperglycemia after high-fat dinners. Examination of the patient's diary revealed she had been inaccurately recording her blood glucose levels. Professional CGM was useful in identifying patterns of hyperglycemia and informing changes to the patient's insulin regimen and dietary advice.
Gestational Diabetes by Dr Shahjada Selim
Gestational diabetes mellitus (GDM) is a type of diabetes that develops during pregnancy and usually resolves after giving birth. However, women with GDM have an increased risk of developing type 2 diabetes later in life. The document discusses the pathophysiology, risk factors, screening and diagnostic criteria, management, and long term risks of GDM. Key points include that GDM results from insufficient insulin production in the face of insulin resistance during pregnancy, and is diagnosed through an oral glucose tolerance test between 24-28 weeks of gestation. Treatment involves medical nutrition therapy, exercise, blood glucose monitoring, and possibly insulin to control blood sugar levels and minimize risks.
Hypoglycemia Hyperglycemia In The Pregnant Patient
This document discusses hypoglycemia and hyperglycemia in pregnancy. It defines normal blood glucose levels during pregnancy and classifications of diabetes in pregnant women. It covers screening, signs and symptoms, and management of hypoglycemia and hyperglycemia in pregnancy. Potential complications of uncontrolled blood sugar levels during pregnancy are also outlined. A case study example is provided to demonstrate discussion and management of gestational diabetes.
Management of diabetes
Gestational diabetes (GDM) and preexisting diabetes during pregnancy carry risks for both mother and baby. GDM is diagnosed through a two-step screening and testing process involving glucose challenges. Left untreated, GDM can lead to complications like fetal overgrowth and hypoglycemia. Treatment involves lifestyle changes like medical nutrition therapy, exercise and glucose monitoring. If needed, oral medications or insulin may be used to control blood sugar. Close monitoring and control of blood sugar levels during pregnancy and delivery can help reduce risks. After pregnancy, women with GDM have an elevated risk of developing diabetes and require follow up testing.
Gestational Diabetes Screening case studies by diabetesasia.org
Gestational Diabetes Screening case studies by diabetesasia.orgJain hospital,Mahavir Sikshan Sansthan
Our aim is to alleviate human suffering related to diabetes and its complications among those least able to withstand the burden of the disease. From 2002 to March 2017, the World Diabetes Foundation provided USD 130 million in funding to 511 projects in 115 countries. For every dollar spent, the Foundation raises approximately 2 dollars in cash or as in-kind donations from other sources. The total value of the WDF project portfolio reached USD 377 million, excluding WDF’s own advocacy and strategic platforms.Diabetes in pregnancy
This document describes the case of a 41-year-old woman, Iman, who is 13 weeks pregnant with her tenth pregnancy. She has a history of gestational diabetes in previous pregnancies and is currently being treated for diabetes with insulin. She presented with high fasting blood glucose and symptoms of polydipsia, polyphagia, and mood lability. Her pregnancy is considered high risk due to her history of gestational diabetes and previous complications. She is being monitored closely and managed according to guidelines for gestational diabetes.
RECENT ADVANCES IN THE MANAGEMENT OF GESTATIONAL DIABETES AND PRE-ECLAMPSIA
Gestational Diabetes is a highly prevalent condition, which has a great impact on maternal and fetal Health. It a condition triggered by metabolic adaption, which occurs during the second half of pregnancy. The aim of this review to discuss the advances in management of GDM, as well as their implications in the field, the issue of hyperglycemia in early pregnancy. Pre-eclampsia is a multisystemic disease characterized by the development of hypertension after 20 weeks of gestation, with the presence of proteinuria or, in its absence, of signs or symptoms indicative of target organ injury.
Simposio ALAD Avances en la prevención y el tratamiento de la diabetes tipo 2...
This document summarizes research on diabetes treatment and outcomes from several long-term clinical trials. It finds that intensive glucose control early in type 2 diabetes can significantly reduce cardiovascular and renal complications long-term. However, rapidly lowering glucose in those with existing cardiovascular disease may increase mortality risk. Multifactorial treatment including blood pressure and glucose control provides substantial benefits and is recommended for all type 2 diabetes patients.
Rotarians and Diabetes Prevention Developing Healthy Communities: Part 1 rag ...
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This document summarizes information presented at the 2014 Rotary International Convention on diabetes. It provides statistics on the prevalence of type 1 and type 2 diabetes globally. It discusses the major complications of diabetes including retinopathy, neuropathy, nephropathy, and atherosclerosis. The document reviews landmark diabetes studies like the DCCT that demonstrated the benefits of intensive glucose control in reducing complications. It outlines strategies for primary, secondary, and tertiary prevention of diabetes and improving life expectancy for those with diabetes through glucose monitoring, lifestyle changes, and access to care. Finally, it discusses ways Rotary clubs can support, advocate for, and promote diabetes prevention and management.More Related Content
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This document discusses the management of type 1 diabetes mellitus (T1DM) in an outpatient setting. It covers the history and pathogenesis of T1DM, classification, epidemiology, complications, monitoring strategies, treatment including insulin regimens and pumps, and management of sick days and hypoglycemia. Continuous glucose monitoring has shown that the majority of hypoglycemic episodes in children with T1DM are asymptomatic and occur overnight. New insulin formulations and pump therapy aim to better mimic normal pancreatic insulin secretion and reduce risks of hypoglycemia and ketoacidosis.
Geeta
PID
Developed by University of Virginia. No published data.
Glucommander
PID
Developed by University of Colorado. No published data.
Glycemic
Management
System
PID
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GlucoStabilizer
PID
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PID
Developed by University of Virginia. No published data.
28
References:
1. Klonoff DC. Automated insulin delivery: the perspective of the artificial pancreas project. J Diabetes Sci
Technol. 2011;5(5):10
Review studies of new insulin products
The document reviews studies of new insulin products including Degludec (Tresiba), Degludec/Aspart (Ryzodeg), and Glargine (Basaglar). It finds that Degludec has a longer duration of action of over 42 hours and lower day-to-day variability compared to other long-acting insulins. Degludec/Aspart is found to reduce post-dinner blood glucose excursions and provide more stable nocturnal glycemia than Glargine. Basaglar is approved as the first follow-on biologic insulin and demonstrated comparable efficacy and safety to Glargine in clinical trials.
Gestational diabetes mellitus
The document discusses gestational diabetes mellitus (GDM). It begins with physiological changes in pregnancy that increase insulin resistance and glucose intolerance. It then defines GDM, discusses prevalence, screening methods, diagnosis, medical and obstetric management, and controversies around screening. Key points include that GDM is associated with adverse maternal and neonatal outcomes. Screening methods include fasting blood glucose and glucose challenge tests. Treatment involves diet, exercise, and potentially insulin or oral hypoglycemic drugs. The goal of management is to maintain euglycemia and prevent macrosomia and other complications.
GDM analogs
This document summarizes the use of various insulin analogs and medications for managing diabetes in pregnancy. It finds that short-acting insulin analogs like lispro and aspart are considered category B and are safe alternatives to regular human insulin for managing gestational and pregestational diabetes. Long-acting analogs like glargine and detemir are category C due to limited safety data, though retrospective studies found no increases in adverse outcomes. Metformin and glyburide may be options for some gestational diabetes cases but require additional insulin in many cases and have some risks. Tight glycemic control is important for reducing fetal complications.
sick day managment CAN SAFE LIFE FOR DM1
This document discusses the importance of sick day management for diabetic patients and provides guidance on managing common illness scenarios. It emphasizes that failure to properly manage illness can lead to dangerous complications like DKA, cerebral edema, and death. The document outlines criteria for diagnosing DKA and provides a 5-step approach to prevent DKA during illness. It also discusses guidelines for different scenarios involving hypoglycemia, ketosis, and hyperglycemia during sickness. Overall, the document stresses that educating patients and caregivers on sick day management is critical for safely managing illness and avoiding life-threatening outcomes.
Insulin Therapy (Indian Pediatrics)
This review article discusses optimal insulin therapy for children with type 1 diabetes mellitus. It covers the following key points in 3 sentences:
Intensive insulin therapy involving multiple daily injections or continuous pump therapy is recommended to achieve optimal glycemic control and reduce long-term complications. Various types of insulin are available including short-acting analogs like lispro and aspart, intermediate-acting insulins like NPH, and long-acting insulins like glargine and detemir. While insulin analogs provide some benefits like faster absorption, studies show they provide similar or only minor improvements in glycemic control compared to regular human insulin.
Diabetes Asia
Our aim is to alleviate human suffering related to diabetes and its complications among those least able to withstand the burden of the disease. From 2002 to March 2017, the World Diabetes Foundation provided USD 130 million in funding to 511 projects in 115 countries.
For every dollar spent, the Foundation raises approximately 2 dollars in cash or as in-kind donations from other sources.
The total value of the WDF project portfolio reached USD 377 million, excluding WDF’s own advocacy and strategic platforms.
Diabetes Asia
Our aim is to reduce morbidity and mortality related to Non communicable diseases such as hypertension, diabetes, cardiovascular disease, stroke, Obesity, Cancer and lifestyle diseases among those least able to withstand the burden of the disease.
Gdm and-nutrition
This document discusses nutrition and gestational diabetes mellitus. It provides recommendations for weight gain during pregnancy based on pre-pregnancy BMI. It outlines the criteria for diagnosing gestational diabetes. The document then discusses recommended calorie and macronutrient intake during pregnancy and lactation based on clinical practice guidelines. It presents a sample meal plan providing the recommended calories and macronutrient breakdown for a pregnant patient diagnosed with gestational diabetes.
SMBG by Dr Shahjada Selim
Dr. Shahjada Selim, an assistant professor at Bangabandhu Sheikh Mujib Medical University, discusses self-monitoring of blood glucose (SMBG) and recommends that patients on multiple-dose insulin or insulin pump therapy should perform SMBG before meals and snacks, at bedtime, before exercise, when suspecting low blood glucose, after treating low blood glucose until normoglycemic, before critical tasks like driving, and possibly after meals. The recommendations are based on standards from the American Diabetes Association.
Periop management of diabetes
Insulin is a protein hormone that regulates blood glucose levels. It is produced by beta cells in the pancreas and released into the bloodstream. Insulin binds to receptors on cells and stimulates the uptake of glucose from the bloodstream into cells, where it is used for energy or stored as glycogen. There are several types of insulin preparations that vary in their onset and duration of action, including rapid-acting, short-acting, intermediate-acting, and long-acting insulins. Insulin is essential for treatment of type 1 diabetes and is often used in combination with oral medications to treat type 2 diabetes.
Gestational diabetes
screening, diagnosis & management of gestational diabetes, different modalities of treatment, complication of GD, macrosomia
Cgm case studies
This case discusses a 62-year-old woman with type 1 diabetes and hypoglycemia unawareness who underwent professional continuous glucose monitoring on two occasions. The initial monitoring revealed no overnight hypoglycemia but significant hyperglycemia throughout the day. Therapy was adjusted based on these results. Follow-up monitoring showed fewer post-meal excursions but continued hyperglycemia after high-fat dinners. Examination of the patient's diary revealed she had been inaccurately recording her blood glucose levels. Professional CGM was useful in identifying patterns of hyperglycemia and informing changes to the patient's insulin regimen and dietary advice.
Gestational Diabetes by Dr Shahjada Selim
Gestational diabetes mellitus (GDM) is a type of diabetes that develops during pregnancy and usually resolves after giving birth. However, women with GDM have an increased risk of developing type 2 diabetes later in life. The document discusses the pathophysiology, risk factors, screening and diagnostic criteria, management, and long term risks of GDM. Key points include that GDM results from insufficient insulin production in the face of insulin resistance during pregnancy, and is diagnosed through an oral glucose tolerance test between 24-28 weeks of gestation. Treatment involves medical nutrition therapy, exercise, blood glucose monitoring, and possibly insulin to control blood sugar levels and minimize risks.
Hypoglycemia Hyperglycemia In The Pregnant Patient
This document discusses hypoglycemia and hyperglycemia in pregnancy. It defines normal blood glucose levels during pregnancy and classifications of diabetes in pregnant women. It covers screening, signs and symptoms, and management of hypoglycemia and hyperglycemia in pregnancy. Potential complications of uncontrolled blood sugar levels during pregnancy are also outlined. A case study example is provided to demonstrate discussion and management of gestational diabetes.
Management of diabetes
Gestational diabetes (GDM) and preexisting diabetes during pregnancy carry risks for both mother and baby. GDM is diagnosed through a two-step screening and testing process involving glucose challenges. Left untreated, GDM can lead to complications like fetal overgrowth and hypoglycemia. Treatment involves lifestyle changes like medical nutrition therapy, exercise and glucose monitoring. If needed, oral medications or insulin may be used to control blood sugar. Close monitoring and control of blood sugar levels during pregnancy and delivery can help reduce risks. After pregnancy, women with GDM have an elevated risk of developing diabetes and require follow up testing.
Gestational Diabetes Screening case studies by diabetesasia.org
Gestational Diabetes Screening case studies by diabetesasia.orgJain hospital,Mahavir Sikshan Sansthan
Our aim is to alleviate human suffering related to diabetes and its complications among those least able to withstand the burden of the disease. From 2002 to March 2017, the World Diabetes Foundation provided USD 130 million in funding to 511 projects in 115 countries. For every dollar spent, the Foundation raises approximately 2 dollars in cash or as in-kind donations from other sources. The total value of the WDF project portfolio reached USD 377 million, excluding WDF’s own advocacy and strategic platforms.Diabetes in pregnancy
This document describes the case of a 41-year-old woman, Iman, who is 13 weeks pregnant with her tenth pregnancy. She has a history of gestational diabetes in previous pregnancies and is currently being treated for diabetes with insulin. She presented with high fasting blood glucose and symptoms of polydipsia, polyphagia, and mood lability. Her pregnancy is considered high risk due to her history of gestational diabetes and previous complications. She is being monitored closely and managed according to guidelines for gestational diabetes.
RECENT ADVANCES IN THE MANAGEMENT OF GESTATIONAL DIABETES AND PRE-ECLAMPSIA
Gestational Diabetes is a highly prevalent condition, which has a great impact on maternal and fetal Health. It a condition triggered by metabolic adaption, which occurs during the second half of pregnancy. The aim of this review to discuss the advances in management of GDM, as well as their implications in the field, the issue of hyperglycemia in early pregnancy. Pre-eclampsia is a multisystemic disease characterized by the development of hypertension after 20 weeks of gestation, with the presence of proteinuria or, in its absence, of signs or symptoms indicative of target organ injury.
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Hypoglycemia Hyperglycemia In The Pregnant Patient
Hypoglycemia Hyperglycemia In The Pregnant Patient
Gestational Diabetes Screening case studies by diabetesasia.org
Gestational Diabetes Screening case studies by diabetesasia.org
RECENT ADVANCES IN THE MANAGEMENT OF GESTATIONAL DIABETES AND PRE-ECLAMPSIA
RECENT ADVANCES IN THE MANAGEMENT OF GESTATIONAL DIABETES AND PRE-ECLAMPSIA
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This document summarizes research on diabetes treatment and outcomes from several long-term clinical trials. It finds that intensive glucose control early in type 2 diabetes can significantly reduce cardiovascular and renal complications long-term. However, rapidly lowering glucose in those with existing cardiovascular disease may increase mortality risk. Multifactorial treatment including blood pressure and glucose control provides substantial benefits and is recommended for all type 2 diabetes patients.
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This document summarizes information presented at the 2014 Rotary International Convention on diabetes. It provides statistics on the prevalence of type 1 and type 2 diabetes globally. It discusses the major complications of diabetes including retinopathy, neuropathy, nephropathy, and atherosclerosis. The document reviews landmark diabetes studies like the DCCT that demonstrated the benefits of intensive glucose control in reducing complications. It outlines strategies for primary, secondary, and tertiary prevention of diabetes and improving life expectancy for those with diabetes through glucose monitoring, lifestyle changes, and access to care. Finally, it discusses ways Rotary clubs can support, advocate for, and promote diabetes prevention and management.19 Insulin Types
1. Insulin therapy is needed for all patients with type 1 diabetes and many with type 2 diabetes as their beta cell function declines.
2. Insulin can be initiated if diet and exercise fail to control blood sugar, and oral medications are not achieving target goals.
3. There are different types of insulin preparations that provide either basal insulin levels or rapid-acting insulin to cover meals. Intensive regimens separate these types of insulin to better mimic natural patterns.
Different Types of Insulin, Presented by Homeland HealthCare
There are different types of insulin that serve different purposes for managing blood sugar levels. Rapid-acting insulin works within 15 minutes and is well-suited for pre- or post-meal use, while short-acting insulin takes 30-60 minutes and controls blood sugar during meals. Intermediate-acting insulin lasts 12 hours and can be taken before bed, and long-lasting insulin takes effect within an hour but works for up to 26 hours. People should consult their physician to determine the best insulin type for their needs.
Insulins And Insulin Delivery
The document discusses various types of insulin and insulin delivery methods for managing diabetes. It describes a 37-year-old man with type 1 diabetes of 18 years whose HbA1c is consistently high at 9.0-10.5% despite different insulin regimens. It then discusses options like Glargine insulin and education programs that can help improve blood sugar control and reduce hypoglycemia for patients.
Insulin preparations
Insulin is a hormone that regulates blood glucose levels. There are different types of insulin preparations categorized by their onset and duration of action: rapid-acting insulin has an onset of 15 minutes; short-acting insulin has an onset of 30-60 minutes; intermediate-acting insulin has an onset of 1-2 hours; and long-acting insulin has an onset of 2-8 hours. Insulin can also be administered as a combination of short-acting and intermediate/long-acting insulins to better control blood glucose throughout the day. Insulin is usually administered via subcutaneous injection in the arm, thigh, or abdomen using a syringe or portable pen device.
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Type 1 Diabetes Mellitus
Type 1 diabetes is characterized by an absolute deficiency of insulin due to the autoimmune destruction of pancreatic beta cells. It typically presents in childhood or early adulthood with symptoms of polyuria, polydipsia, and unexplained weight loss. Treatment involves lifelong insulin replacement therapy via injections to control blood glucose levels and minimize the risk of complications. Rapid-, short-, intermediate-, and long-acting insulin formulations have different onset and duration profiles suited to individual treatment regimens. Strict glycemic control is important to reduce microvascular and macrovascular risks.
Diabetes Management by Insulin.pptx
This document discusses the management of diabetes through insulin therapy. It defines diabetes mellitus and describes the different types. It outlines the criteria for diagnosing diabetes and discusses gestational diabetes. The major components of diabetes treatment are described as medical nutrition therapy, oral medications, and insulin. The different types of insulin are explained along with common insulin regimens. Recommendations are provided for starting insulin therapy and calculating insulin doses for treatment of diabetes and gestational diabetes.
Diebetes mellitus type 1
Type 1 diabetes is characterized by low or absent insulin production. It is an autoimmune disease where the body's immune system attacks the beta cells in the pancreas that produce insulin. The main treatment is lifelong insulin therapy via injections or insulin pump to control blood glucose levels. Strict glucose monitoring and management of diet and activity is needed to prevent complications like diabetic ketoacidosis and maintain overall health. Sick day management may require increased insulin dosing and monitoring of blood glucose and ketone levels.
H:\Diabetes In Pregnancy 1[1]
This document discusses gestational diabetes, its causes, effects, and treatment options. It defines gestational diabetes as a form of diabetes that arises during pregnancy due to placental hormones interfering with insulin production. Left untreated, gestational diabetes can increase risks for both mother and baby during pregnancy and delivery. The document recommends treating gestational diabetes through medical nutrition therapy, glucose monitoring, and insulin when needed to control blood sugar levels and minimize risks.
Diabetes Medications
Grand Rounds presentation I gave at Saratoga Hospital on Diabetes Meds and the effect glucose control has on outcomes
Diabetic ketoacidosis: a case study
A review of the investigation and management of diabetic ketoacidosis in newly diagnosed type I diabetes. Patient details have been changed and anonymised to protect the identity of the individual.
Obesidad: nutrientes moduladores de neuropeptidos y neurotransmisores
This document discusses ketogenic enteral nutrition (KEN) as a treatment for obesity. It describes a study of over 19,000 obese patients who underwent 10-day cycles of receiving 50-65 grams of protein per day via continuous nasogastric tube infusion, without any carbohydrates. This protocol resulted in an average weight loss of 10.2 kg over 2.5 cycles, with 57% of the loss being fat mass. No significant adverse effects occurred. KEN is concluded to be a safe, fast, and inexpensive treatment that provides good long-term weight maintenance results.
Obesity: nutrients modulators of neuropeptides and neurotransmmitters
Expositor: Efrain Olszewer
Obesity: nutrients modulators of neuropeptides and neurotransmmitters.
Arequipa 2015
DIABETES MELLITUS TYPE 1 & MANAGEMENT OF DIABETIC KETOACIDOSIS
1) Type 1 diabetes is characterized by low or absent insulin production and is caused by autoimmune destruction of pancreatic beta cells.
2) It requires lifelong insulin replacement therapy via injections or pumps to control blood glucose levels and prevent complications.
3) Intensive insulin regimens aim to mimic normal physiology using rapid, short, intermediate and long-acting insulin preparations in combination with diet, exercise and glucose monitoring.
Insulin: what is new ?
Insulin types update ; Diabetes Mellitus
Update ; Endocrinology and Diabetes
Degludec ; Ryzodeg ;Basal Insulin ;PEG-Lispro
Prescribing insulin safely
Presentation1.pptx
- The patient has type 2 diabetes and stage 3 chronic kidney disease, so metformin was discontinued.
- Liraglutide treatment has been shown to decrease the risk of cardiovascular death but not cause significant weight loss or increase cancer risk.
- Glyburide should be avoided given the patient's low GFR, while linagliptin can be used.
- Most insulins can be used but doses may need adjusting to avoid hypoglycemia risk from prolonged half-lives in kidney disease. Glucagon-like peptide-1 receptor agonists are also options but can increase hypoglycemia risk if used with insulin.
STARTING INSULIN IN DMII INDIVIDUALIZED APPROACH & INSULINE PREPARATIONS
Seminar presentation on how to start insulin preparations in type 2 Diabetes mellitus (DM) and discussion of new insulin preparations
Perioperative Diabetes mellitus management
The document discusses the perioperative management of diabetes mellitus. It provides criteria for diagnosing diabetes, discusses how surgery and diabetes affect metabolism, and outlines recommendations for preoperative evaluation and glycemic control in the perioperative period. The goals are to maintain good glycemic control, prevent complications, and shift patients back to their usual diabetes medications and diet as quickly as possible after surgery.
Managing Diabetes With Insulin by Dr Shahjada Selim
- Mrs. Is has type 2 diabetes for 12 years and is on lifestyle management and 3 oral antidiabetic drugs. Her recent HbA1c is 9.6%. She needs intensification of her treatment as her blood glucose levels are not controlled. Given her reluctance to follow lifestyle changes and high HbA1c, starting basal insulin is recommended.
- Mr. Lp has type 2 diabetes for 8 years and is on glimepiride and metformin but is irregular with treatment. His HbA1c is 8.8% and he cannot make lifestyle changes. Given his poor control and non-adherence, switching him to basal insulin will provide better glucose control.
- Mr. Rk has
Diabetes Information Power Point
This document provides information on diabetes in children and adolescents for nurses. It discusses the types of diabetes, signs and symptoms, treatment including insulin types and dosing, management goals, and guidelines for hyperglycemia, hypoglycemia, diet, exercise, and sick days. The importance of frequent monitoring, education, and documentation for optimal diabetes management in pediatric patients is emphasized.
Pregestational Diabetes in pregnancy
Presentation at Monthly Seminar of Obstetrics and Gynaecology Eden Hospital< Medical College, Kolkata- July, 2012
Pharmacotherapy of diabetes mellitus (DM)
This document summarizes the pharmacotherapy of diabetes mellitus. It describes the types of diabetes, diagnostic criteria, goals of treatment, and various classes of medications used to treat diabetes. The main drug classes discussed include insulin, sulfonylureas, meglitinides, incretin mimetics, DPP-4 inhibitors, metformin, thiazolidinediones, and SGLT-2 inhibitors. For each class, the mechanisms of action, pharmacokinetics, indications, and side effects are summarized. The document provides an overview of current best practices for treatment and medication management of both type 1 and type 2 diabetes.
DIABETES MELLITUS TIPE 2 PIT PDUI 2019.pptx
This document discusses diabetes mellitus and its classification, signs, symptoms, and treatment. It defines diabetes as a disease marked by high blood sugar levels. There are four main types of diabetes: type 1, type 2, gestational diabetes, and other specific types. Type 2 diabetes accounts for 85-95% of cases and is usually diagnosed in people over age 40. The document outlines criteria for diagnosing diabetes based on hemoglobin A1c levels, fasting plasma glucose, and oral glucose tolerance tests. It also discusses potential acute complications like hypoglycemia and hyperglycemic crises, as well as treatments for managing blood sugar levels in such situations.
Insulin therapy in Diabetes Mellitus Pts
Insulin therapy in type 1 and type 2 Diabetes Mellitus patients.
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Hybrid closed loop insulin delivery system-Artificial Pancreas.
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Obesidad: nutrientes moduladores de neuropeptidos y neurotransmisores
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DIABETES MELLITUS TYPE 1 & MANAGEMENT OF DIABETIC KETOACIDOSIS
DIABETES MELLITUS TYPE 1 & MANAGEMENT OF DIABETIC KETOACIDOSIS
STARTING INSULIN IN DMII INDIVIDUALIZED APPROACH & INSULINE PREPARATIONS
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Kiss
- 37. BANTING-1891-1941 & BEST-1899-1978 Orthopod who became a physiologist and died in air crash in Newfoundland while on wartime mission Together they isolated insulin and Banting won the Nobel Prize in 1923 knighted in 1934
- 54. Lower A1C level Reduces the Risk of Complications DCCT * KUMAMOTO * UKPDS Each 1% fall in A1C results in 20-30% RRR in microvascular compln
- 67. HbA 1c and Microvascular Complications Relative Risk 15 13 11 9 7 5 3 1 HbA 1c , % 7 8 9 10 11 12 Neuropathy Nephropathy Retinopathy
- 68. Every 1% HbA 1c Increase Above Goal Elevates the Risk of Diabetic Complications Increase in Any Diabetes-Related Endpoint Increase in Risk of Myocardial Infarction (MI) Increase in Risk of Stroke Increase in Risk of Microvascular Complications Incidence of Diabetes- Related Complications (%) +21% +37% +12% +14% Adapted from Stratton et al. BMJ . 2000;321:405-412.
- 69. Lower A1C level Reduces the Risk of Complications DCCT * KUMAMOTO * UKPDS Each 1% fall in A1C results in 20-30% RRR in microvascular compln
- 70. Good Glycemic Control (Lower HbA 1c ) Reduces Incidence of Complications DCCT Research Group. N Engl J Med . 1993;329:977-986. Ohkubo Y et al. Diabetes Res Clin Pract . 1995;28:103-117. UKPDS 33: Lancet . 1998;352:837-853. HbA 1c Retinopathy Nephropathy Neuropathy Macrovascular disease DCCT 9 7% 63% 54% 60% 41%* Kumamoto 9 7% 69% 70% – – UKPDS 8 7% 17-21% 24-33% – 16%* * not statistically significant
- 76. Chris Rhodes Ph.D. PNRI, Seattle, WA. TYPE 2 DIABETES – A QUESTION OF BALANCE PERIPHERAL INSULIN RESISTANCE BETA CELL MASS AND FUNCTION NON DIABETIC STATE BETA CELL MASS AND FUNCTION PERIPHERAL INSULIN RESISTANCE DIABETIC STATE
- 85. Lifestyle
- 86. The long term goal might be 30- 40 minutes or 10000 steps per day WALK MORE ,WALK EACH DAY AND WALK MORE EACH WEEK
- 88. Lifestyle
- 107. FIRST PHASE INSULIN SECRETION
- 109. BETA CELL FUNCTION
- 124. Insulin Glargine : Structure Insulin Glargine : 21 A -Gly 30 B a-L-Arg-30 B b-L-Arg-insulin Metabolites : M1-21 A -Gly-insulin M2-21 A -Gly-des-30 B -Thr-insulin Substitution Extension A-chain B-chain 1 5 10 15 20 Asn 1 5 10 15 20 25 30 Arg Arg Gly
- 139. INITIATION&TITRATION
- 156. Sweet food
- 157. Sweet food
- 158. Fat food
- 159. Meat
- 162. Cereals
- 163. Vegetables
- 164. Vegetables
- 165. Raw vegetables
- 166. Vegetables
- 167. Vegetables
- 168. Fish
- 181. INSULIN Rx PROGRAM
- 197. INSULIN IS NOT……
- 203. THANK YOU THANK YOU VERY MUCH