March 27th 2025
Mean reduction in HbA1c was nearly 1% after transition from MDI plus CGM to Omnipod 5 in the first randomized trial to evaluate the shift in mode of insulin delivery.
The Diabetes Epidemic:Keys to Prevention, Guide to Therapy
May 1st 2006Diabetes is epidemic! The numbersare truly alarming. In 1997, official datashowed that 16 million people in theUnited States had diabetes. Approximately1 million had type 1 disease,and 10.4 million had type 2 disease; theremainder had undiagnosed diabetes.1If these numbers are projected outagainst an annual increase in diseaseprevalence of about 3.5%, it means thatby the year 2028, 50 million people willhave diabetes. However, the actual rateis closer to 7% each year. As such, approximately100 million Americans-roughly 1 of every 4-will have diabetesby 2028.
Antihypertensives and Diabetes: Is There a Connection?
January 1st 2006The prevalence of type 2 diabetes is expected to continue to increase rapidly, and it is not surprising that the issue of the potential effects of different classes of antihypertensive drugs on glucose metabolism and glycemic control has sparked debate.
Type 2 Diabetes, the Metabolic Syndrome, Inflammation, and Arteriosclerosis:
December 1st 2005Up to 10% of Americans older than 20 years have type 2 diabetes, and more than 20% have the metabolic syndrome. The prevalence of both diseases has risen by 33% over the past decade as a result of an increasingly sedentary lifestyle, the obesity epidemic, the growth of ethnic groups at risk for the disease, and the aging of the population.
Clinical Citations: Increased risk of common infections in patients with diabetes mellitus?
November 1st 2005Researchers in the Netherlands investigating the relative risks of common infections in patients with type 1 or type 2 diabetes mellitus (DM1 or DM2, respectively) determined that both groups are at increased risk for lower respiratory tract infection, urinary tract infection, and skin and mucous membrane infection.
Diabetes: How Early--and Aggressively--to Intervene
November 1st 2005The growing epidemic of type 2 diabetes makes it imperative to identify persons at risk, screen for impaired glucose tolerance (IGT), and treat to prevent progression. Calculation of body mass index (BMI) is an appropriate starting point for identification of patients with possible IGT.
How to Manage Insulin Resistance in Children
May 1st 2005As recommended by the authors, I commonly order a fasting lipid profile and measurements of glucose and insulin levels in children at risk for type 2 diabetes. One area of management that remains confusing is the approach to take with children who have an elevated fasting insulin level but otherwise normal laboratory results.
Consultations & Comments: How to Prevent Diabetes?
March 1st 2005In their article, “Diabetes: How Early-and Aggressively-to Intervene?”(CONSULTANT, November 2005, page 1416), Drs Thomas Clark and John R.Holman discussed the results of the lifestyle intervention and metformin armsof the Diabetes Prevention Program (DPP) study. However, the authors neglectedto include data from the troglitazone arm of the DPP study.
Complications of Diabetes Mellitus: Lisfranc Fracture and Dislocation
November 2nd 2004A 53-year-old man with a 20-year history of type 2 diabetes mellitus (for which he required insulin) sought evaluation of a hot, swollen right foot that seemed to have become “flat.” He had no pain, fever, or chills. The patient’s metatarsal bones were readily movable, consistent with Charcot joint. Further workup ruled out osteomyelitis. Plain films demonstrated extensive deformity of the tarsal and metatarsal bones with Lisfranc fracture/dislocation through the base aspects of all 5 metatarsals.
Complications of Diabetes Mellitus: Right-Sided Endocarditis in a Diabetic Patient
November 2nd 2004High-grade fever, chills, fatigue, malaise, and anorexia developed in a 35-year-old man following subclavian catheterization because of chronic renal failure of unknown cause. The patient, who had long-standing diabetes mellitus, was admitted to the ICU with the diagnosis of possible sepsis. The next day, he was found to have a grade 2/6 systolic murmur compatible with tricuspid regurgitation. This was confirmed when a 4-chamber echocardiogram (A) revealed a large single piece of vegetation (2 arrows) lying on the tricuspid valve, flapping in and out of the right ventricle. In a 2-dimensional echocardiogram of the right atrium and right ventricle (B), 3 arrows point to the vegetation. (RV, right ventricle; LV, left ventricle; RA, right atrium; LA, left atrium; TV, tricuspid valve.)
Diabetic Neuropathy: Early Clues, Effective Management
October 1st 2004ABSTRACT: The early signs of diabetic neuropathy can be detected during a routine clinical examination. Inspect patients' feet for deformities and sensory loss, which indicate risk of ulceration. Prolonged poor glycemic control, alcohol abuse, and obesity increase the risk of amputation. Autonomic dysfunction, which can lead to sexual dysfunction and gastropathy, can be detected by measurement of heart rate and blood pressure. A resting heart rate of about 100 beats per minute and a decrease of about 30 mm Hg in systolic blood pressure within 2 minutes of standing are abnormal findings. Electromyography and nerve conduction studies confirm the diagnosis. Improved metabolic control is the main goal of treatment. Analgesics, neuromodulators, and tricyclic antidepressants are effective for managing pain. In patients with autonomic neuropathy, treat the associated symptoms.