This document provides information about Prof. M. Hesham El Hefnawy, the head of the National Institute of Diabetes & Endocrinology in Egypt. It gives details about his credentials and experience in diabetes research and management. It then discusses guidelines for managing type 1 diabetes, including using insulin therapy, nutritional education, exercise, and treating complications. It provides guidance on initial insulin dosing, separating doses into basal and bolus components. It also offers tips on titrating insulin doses based on glucose monitoring and factors affecting insulin needs. The document aims to help optimize type 1 diabetes management through individualized care plans.
It is a group of metabolic disorders of fat, carbohydrate and protein metabolism that results from defects in insulin secretion, insulin action (sensitivity) or both
Definition of diabetes - introduction - classification of diabetes - etiology of diabetes type 1 and type 2- risk factors for diabetes - diagnosis of diabetes - clinical manifestations of diabetes type 1 and type 2- investigations for diabetes - treatment of diabetes - non-pharmacological treatment and pharmacological treatment - pharmacotherapy of type 1 and type 2 - acute complications of diabetes and treatment
Diabetes Mellitus- Case Presentaion by Jayesh Anil MahirraoJayesh Mahirrao
This presentation is made especially for B. Pharm. level. It is based on the study of diabetic patient. It mainly focuses on medications and their mechanisms.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
This Journal publishes original research work that contributes significantly to further the scientific knowledge in pharmacy.
It is a group of metabolic disorders of fat, carbohydrate and protein metabolism that results from defects in insulin secretion, insulin action (sensitivity) or both
Definition of diabetes - introduction - classification of diabetes - etiology of diabetes type 1 and type 2- risk factors for diabetes - diagnosis of diabetes - clinical manifestations of diabetes type 1 and type 2- investigations for diabetes - treatment of diabetes - non-pharmacological treatment and pharmacological treatment - pharmacotherapy of type 1 and type 2 - acute complications of diabetes and treatment
Diabetes Mellitus- Case Presentaion by Jayesh Anil MahirraoJayesh Mahirrao
This presentation is made especially for B. Pharm. level. It is based on the study of diabetic patient. It mainly focuses on medications and their mechanisms.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
This Journal publishes original research work that contributes significantly to further the scientific knowledge in pharmacy.
Diagnosis of diabetes using classification mining techniques [IJDKP
Diabetes has affected over 246 million people worldwide with a majority of them being women. According to the WHO report, by 2025 this number is expected to rise to over 380 million. The disease has been named the fifth deadliest disease in the United States with no imminent cure in sight. With the rise of information technology and its continued advent into the medical and healthcare sector, the cases of diabetes as well as their symptoms are well documented. This paper aims at finding solutions to diagnose the disease by analyzing the patterns found in the data through classification analysis by employing
Decision Tree and Naïve Bayes algorithms. The research hopes to propose a quicker and more efficient technique of diagnosing the disease, leading to timely treatment of the patients.
Diabetes is a chronic health condition that affects how the body converts food into energy. There are two main types of diabetes: type 1 and type 2. In type 1 diabetes, the body doesn't produce enough insulin, a hormone that regulates blood sugar levels. In type 2 diabetes, the body becomes resistant to insulin or doesn't produce enough insulin.
High blood sugar levels associated with diabetes can cause a range of health problems, including nerve damage, kidney disease, and heart disease. Managing diabetes involves monitoring blood sugar levels, taking medications, and making lifestyle changes such as eating a healthy diet and exercising regularly.
If you have diabetes, it's important to work closely with your healthcare provider to develop a treatment plan that meets your individual needs. This may include regular blood sugar testing, taking medications as prescribed, and making lifestyle changes to help manage your condition.
Diabetes refers to a group of diseases that affect how the body consumes blood sugar (glucose). Glucose is an important source of energy for the cells that make up muscles and tissues. It is also the main source of energy for the brain.
Diabetes is a rapidly and serious health problem in Pakistan. This chronic condition is associated with serious long-term complications, including higher risk of heart disease and stroke. Aggressive treatment of hypertension and hyperlipideamia can result in a substantial reduction in cardiovascular events in patients with diabetes 1. Consequently pharmacist-led diabetes cardiovascular risk (DCVR) clinics have been established in both primary and secondary care sites in NHS Lothian during the past five years. An audit of the pharmaceutical care delivery at the clinics was conducted in order to evaluate practice and to standardize the pharmacists’ documentation of outcomes. Pharmaceutical care issues (PCI) and patient details were collected both prospectively and retrospectively from three DCVR clinics. The PCI`s were categorized according to a triangularised system consisting of multiple categories. These were ‘checks’, ‘changes’ (‘change in drug therapy process’ and ‘change in drug therapy’), ‘drug therapy problems’ and ‘quality assurance descriptors’ (‘timer perspective’ and ‘degree of change’). A verified medication assessment tool (MAT) for patients with chronic cardiovascular disease was applied to the patients from one of the clinics. The tool was used to quantify PCI`s and pharmacist actions that were centered on implementing or enforcing clinical guideline standards. A database was developed to be used as an assessment tool and to standardize the documentation of achievement of outcomes. Feedback on the audit of the pharmaceutical care delivery and the database was received from the DCVR clinic pharmacist at a focus group meeting.
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
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Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Ueda2016 type 1 diabetes guidelines - hesham el hefnawy
1. Type 1 Diabetes Guidelines ?
Prof. M. Hesham El Hefnawy
Head of National Institute of Diabetes & Endocrinology
E mail: drhefnawy@yahoo.com
2. Prof. Dr. Mohamed Hesham El-
Hefnawy
| Confidential2
Preferred language: English
Who is Prof. El-Hefnawy?
-Dean of Egypt National Institute for Diabetes & Endocrinology
-Certified Medical Diabetes Education Instructor (ADA, Verginia)
-Professor degree of Diabetes & Endocrinology in National Institute of Diabetes &
Endocrinology (NIDE), Cairo, Egypt.
-Head of research unit in National Institute of diabetes & Endocrinology (NIDE).
-Member of Research Ethics Committee of General Organization of Teaching
Hospitals & Institutes, (GOTHI).
-Reviewer in the African Research Academy for evaluation of the researches to be
published in the International Journals of the Academy.
-Member of ISPAD, (International Society of Pediatric & Adolescence Diabetes).
-Sharing in writing a chapter of international Text-Book of Diabetes in Croatia in
2011.
-International published researches in field of Diabetes management, epidemiology,
educational programs,….etc.
-Contact details: drhefnawy@yahoo.com
3. Diabetes Cases in Middle Eastern and African Countries 1*
1. IDF. Diabetes Atlas. 5th edition. 2012 Update. http://www.idf.org/sites/default/files/IDFAtlas5E_Detailed_Estimates_0.xls. Accessed on April 18, 2013.
*All cases of diabetes, including type 1 and type 2 diabetes in patients aged 20-79 years
In 2012, Egypt had the highest number of people with diabetes
Egypt is one of the 20 countries of the IDF MENA region; 382 million people have diabetes in the world and more than 34.6 million
people in the MENA Region, by 2035 this will rise to 67.9 million in MENA region, There were 7.5 million cases of diabetes in Egypt in 2013.
4. Diabetes In Egypt .. 2013
IDF Diabetes Atlas sixth edition.
Source; IDF Diabetes Atlas 2013.
http://www.idf.org/membership/mena/egypt
NumberofPeoplewithdiabetes(20-69years)2013
To become the 7th. By 2035
5. 1 Fong DS, et al. Diabetes Care. 2003; 26 [Suppl. 1]:S99–S102.
2 Molitch ME, et al. Diabetes Care. 2003; 26 [Suppl.1]:S94–S98.
3 Kannel WB, et al. Am Heart J. 1990; 120:672–676.
4 Gray RP & Yudkin JS. In Textbook of Diabetes. 1997.
5 Mayfield JA, et al. Diabetes Care. 2003;26 [Suppl. 1]:S78–S79.
Diabetic
retinopathy
Leading cause
of blindness in working-age adults1
Diabetic
nephropathy
Leading cause of
end-stage renal disease2
Cardiovascular
disease
Stroke
2- to 4-fold increase
in cardiovascular
mortality and stroke3
Diabetic
neuropathy
Leading cause of non-
traumatic lower extremity
amputations5
8/10 diabetic patients
die from CV events4
Diabetes is a Serious Chronic Disease
6. Legacy effect: Early glycaemic control is key to
long-term reduction in complications
Bad legacy effect
Achieving glycaemic control late in the disease, after a prolonged period
of poor control, does not improve long-term risk of macrovascular
complications2
Long-standing, preceding hyperglycaemia accounted for
the high rate of complications at baseline in VADT3
UKPDS=UK Prospective Diabetes Study; VADT=Veterans Affairs Diabetes Trial.
1Holman RR, et al. N Engl J Med. 2008; 359: 1577–1589.
2Duckworth W, et al. N Engl J Med. 2009; 360: 129–139;
3Del Prato S. Diabetologia. 2009; 52: 1219–1226.
Good legacy effect
Early, strict glycaemic control brings benefits,
reducing the long-term risk of microvascular and macrovascular complications
(UKPDS1)
10. Management Of Type 1 DM
•(1) Insulin.
•(2) Nutritional & Educational therapy.
•(3) Monitored Exercises.
•(4) Psycho-socio-economic Care.
•(5) Treatment of Complications :
•acute & chronic.
•(6) New Approaches for Treatment
•(7) Prevention trials of Type 1 D.M.
•(8) Prevention of complications.
*Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus.
Diabetes Care. 1999; 26:5–20.
33. INSULIN
•* Insulin is essential for life in type 1 D.M.
•* We have to reach to a strict control of
D.M.(Glycated HbA1c < 7.5%).
•* Strict control is not to give multiple
injections, but it is better to achieve excellent
control ,to avoid most of the diabetic
complications, by the least number of injections
to avoid the lipodystrophy and for psychological
reasons also.
34. Initial insulin dose:
• 0.4 - 0.8 U/kg/Day
• Q: Why this wide range of the initial insulin
dose?
– Family history of type 2 diabetes.
– Lifestyle (sedentary vs. active).
– Adiposity.
– Gender (males usually require more than females).
– Any remaining endogenous insulin secretion.
– Concomitant illness.
•
35. Q: How to classify the initial insulin dose?
Basal: 40-50% of total dose.
•Bolus: 50-60% of total dose
36. Basal Insulin:
–NPH or Detimir twice daily.
–Galargin can be administered once daily. If it is
decided to start with once daily basal insulin, it is
usually administered at bedtime.
– Titration of basal insulin
• By observing glucose trends during periods of fasting.
• The median glucose level before breakfast
• Any information on glucose levels during the night
when glycemia is not contaminated by food or
prandial insulin.
•
37. Bolus (Prandial) Insulin
– Typical doses: 1 unit per 10 to 15 grams of carbohydrate.
– But in obese patients: 1 unit per 5 grams of carbohydrate.
– While thin patients: 1 unit per 20 grams of carbohydrate
– Titration of bolus insulin dose
• Insulin Sensitivity Factor: The drop in blood glucose level (mg/dl),
caused by each unit of insulin taken.
• For patients who use Regular (short-acting) insulin: Use
1500 rule. Divide 1500 by the total daily dose of Regular
insulin, in units.
• For patients who use the Rapidly-acting Insulin Analogues:
Use 1800 rule. Divide 1800 by the total daily dose of rapidly
acting insulin analogues, in units.
38. Q: When higher doses (basal and
bolus) of insulin may be needed?
– If your patient have an infection.
– If your patient reduce his level of activity.
– If you are prescribed a medicine that changes
insulin sensitivity (such as Prednisone).
– If your patient are under emotional stress.
– During adolescence.
– During pregnancy.
39. Q: When lower doses (basal and
bolus) of insulin may be needed?
–If your patient become more active.
–If your patient have problems with kidney
function.
40. Methods of insulin
injection
• Insulin syringes;
– Insulin syringes must have a measuring scale
consistent with the insulin concentration (e.g. U 100
syringes for insulin concentration 100 U/ml).
– Injections by syringe are usually given into the deep
SC tissue through a two-finger pinch of skin at a 45
angle. A 90 angle can be used if the SC fat is thick
enough.
• Pen injector devices:
– Requires careful wait of 15 seconds after pushing in
the plunger helps to ensure complete expulsion of
insulin through the needle.