Diabetes

Patients with type 2 diabetes should be receiving statin therapy, but many patients who would benefit from these agents are not taking them-and not reaching target lipid levels. A recent study shows that timing of statin initiation can make a difference. Here to put the issue into perspective are Drs Christopher Cannon and Payal Kohli.

Do you consider an LDL of 100 and a non-HDL of 150 significant? What is your diagnosis? Would you consider medication in addition to recommending lifestyle changes? Answers to these quiz questions here.

A 47-year-old man sees you for a check-up. He complains only of low energy and attributes it to recent weight gain. But, there is much more.

The American College of Physicians (ACP) has recently published its updated guidelines for type 2 diabetes mellitus (T2DM) management. While touted as "new," these guidelines offer no real breakthroughs in understanding. Our blogger offers a perspective; we’d like to hear yours.

Spots on the shins may indicate diabetes.

In his second podcast, Dr Louis Kuritzky discusses the classes of incretin-based therapies now available for patients with type 2 diabetes mellitus.

Louis Kuritzky, MD, talks about this relatively new treatment option.

A 50-year-old African American woman with type 2 diabetes mellitus and hypertension was admitted with constant bilateral knee and thigh pain and swelling of both knees, all of 1 week’s duration. The pain was not relieved with hydrocodone/acetaminophen and had caused weakness and subsequent falls.

How does the chronic care model of diabetes care differ from the acute care model-and how might this approach work for you and your patients?

Dr Robert Gabbay discusses strategies to improve patient compliance with insulin therapy.

However, persistent, unexplained hypoglycemia can indicate a potentially grave, often treatable, underlying disorder, such as insulinoma, or adrenal or pituitary insufficiency.

How can you determine whether your patient with newly diagnosed diabetes has type I or type II disease?

Adding aliskiren to antihypertension regimens that already include losartan reduced blood protein levels from 19% to 22% in hypertensive type 2 diabetic patients with nephropathy.

A review of 140 trials and 26 observational studies supports metformin as the best first-line treatment for type 2 diabetes in adults, both stand-alone and in combination with other medications. But second-line treatments are still a judgment call.

A variety of effective treatments are available for diabetic peripheral neuropathic pain (DPNP), including topical agents, oral medications, and nondrug approaches. The lidocaine patch 5% is recommended for relatively localized pain.

Are persons with asthma at risk for other proinflammatory disorders? Yes, say researchers from the Mayo Clinic and Olmsted Medical Center in Rochester, Minn, who found that asthma is associated with the development of diabetes mellitus and coronary artery disease. However, there was no association between asthma and rheumatoid arthritis or inflammatory bowel disease.

Since it came onto the market in 1983, glyburide has been one of the most popular sulfonylureas. The American Diabetes Association (ADA) recommends the use of these agents as part of a stepwise approach to treating type 2 diabetes mellitus.

I advise patients with diabetic neuropathy to break in new shoes gradually.

Type 2 diabetes mellitus is an epidemic with serious and fatal complications. Some predictions estimate that 440 million persons will have this disease by 2030.

Diabetes is a demanding and difficult chronic disease. Life changes dramatically for a patient and his or her family once the diagnosis is made. Nutritional food choices, increased physical activity, multiple medications, visits to a physician, and blood tests are no longer optional. They now are a means of changing the length and quality of life. The patient has to rapidly become knowledgeable about nutritional content of any food he eats, different ways to be active, blood glucose testing, medication doses and side effects, and new words and abbreviations, such as A1c, LDL, HDL, and triglycerides.

Your patient is a middle-aged man with type 2 diabetes who wants to start a weight-training program. What recommendations would you offer him? Another patient with diabetes has peripheral neuropathy; which types of exercise are safest for her? Answers to these and other questions about physical activity by patients who have diabetes mellitus can be found in guidelines from the American Diabetes Association.1 Highlights of those recommendations are presented here.

From 1996 to 2007, the rate of end-stage renal disease (ESRD) in persons with diabetes decreased 35% nationwide, according to the CDC.

Increased dietary intake of selenium is associated with a heightened risk of type 2 diabetes, reported Italian researchers recently. Included in their prospective study were 7182 women from Northern Italy.