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Type 1 Diabetes: Management Strategies - American Family Physician

Aug 1, 2018 - There is considerable benefit of tight glucose control in patients with type 1 diabetes mellitus. Tight blood glucose control dramatically decreases the incidence of microvascular and macrovascular complications. Although glycemic goals should be individualized, most nonpregnant adults ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0801/p154.html

Type 2 Diabetes Mellitus: Outpatient Insulin Management - American Family Physician

Jan 1, 2018 - In patients with type 2 diabetes mellitus, insulin may be used to augment therapy with oral glycemic medications or as insulin replacement therapy. The American Diabetes Association suggests the use of long-acting (basal) insulin to augment therapy with one or two oral agents or one ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0101/p29.html

Testosterone Therapy: Review of Clinical Applications - American Family Physician

Oct 1, 2017 - Testosterone therapy is increasingly common in the United States, and many of these prescriptions are written by primary care physicians. There is conflicting evidence on the benefit of male testosterone therapy for age-related declines in testosterone. Physicians should not measure ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1001/p441.html

Semaglutide Reduces CV Events in High-Risk Patients with Type 2 Diabetes Mellitus - ...

Mar 15, 2017 - Semaglutide significantly reduced the composite outcome of CV death, nonfatal myocardial infarction, and nonfatal stroke (number needed to treat [NNT] = 43 over 2.1 years). It was generally well tolerated, and it reduced body weight by approximately 6.4 to 9.5 lb (2.9 to 4.3 kg).

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/p396.html

Diabetes Mellitus: Management of Gastrointestinal Complications - American Family ...

Dec 15, 2016 - Gastrointestinal disorders are common complications of diabetes mellitus and include gastroparesis, nonalcoholic fatty liver disease, gastroesophageal reflux disease, and chronic diarrhea. Symptoms of gastroparesis include early satiety, postprandial fullness, nausea, vomiting of ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1215/p980.html

Update on Office-Based Strategies for the Management of Obesity - American Family ...

Sep 1, 2016 - Obesity is a common condition that is associated with numerous medical problems such as cardiovascular disease, pulmonary disease, and diabetes mellitus. Primary care physicians have an important role in helping patients develop a successful weight loss plan to improve their overall ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0901/p361.html

Treating Painful Diabetic Peripheral Neuropathy: An Update - American Family Physician

Aug 1, 2016 - Painful diabetic peripheral neuropathy occurs in approximately 25% of patients with diabetes mellitus who are treated in the office setting and significantly affects quality of life. It typically causes burning pain, paresthesias, and numbness in a stocking-glove pattern that progresses...

American Family Physician : Article

https://www.aafp.org/afp/2016/0801/p227.html

Blood Pressure Goal of 140 to 150 mm Hg Is Best for Patients with Diabetes - POEMs - ...

Jul 1, 2016 - Although most recent practice guidelines have relaxed the blood pressure goals for patients with diabetes, there are still a few holdouts that suggest aggressive treatment. This analysis shows that the ideal range for hypertension control in patients with diabetes is between 140 and 150...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0701/p59a.html

Adding Sitagliptin Does Not Reduce or Increase the Risk of Cardiovascular Outcomes - ...

Dec 1, 2015 - The glass half full is that sitagliptin does not increase the risk of cardiovascular events in patients with type 2 diabetes. The glass half empty is that it does not reduce the risk, either. And that is the important message: In patients with a mean glycated hemoglobin level of 7.2%, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1201/p1020a.html

Management of Blood Glucose with Noninsulin Therapies in Type 2 Diabetes - American ...

Jul 1, 2015 - A comprehensive, collaborative approach is necessary for optimal treatment of patients with type 2 diabetes mellitus. Treatment guidelines focus on nutrition, exercise, and pharmacologic therapies to prevent and manage complications. Patients with prediabetes or new-onset diabetes ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0701/p27.html

Type 2 Diabetes: Updated Evidence Requires Updated Decision Making - Editorials - ...

Jul 1, 2015 - Clinicians need to consider the best available research findings, their own experience, and their patients' needs and values.

American Family Physician : Editorials

https://www.aafp.org/afp/2015/0701/p22.html

Glycemic Control in Type 2 Diabetes (Drug Treatments) - Clinical Evidence Handbook - ...

May 15, 2014 - What are the effects of blood glucose–lowering medications in adults with type 2 diabetes?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2014/0515/p820.html

AAP Releases Guideline on Managing Type 2 Diabetes Mellitus in Patients 10 to 18 Years ...

Nov 15, 2013 - Childhood type 2 diabetes poses a challenge to many physicians who are not used to treating this disease in such young patients. The American Academy of Pediatrics (AAP) has released a guideline of evidence-based recommendations for treating type 2 diabetes in patients 10 to 18 years of...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2013/1115/p710.html

Endocrine Society Releases Guidelines on Diagnosis and Management of ...

Jul 15, 2013 - The Endocrine Society recently published evidence-based recommendations on the diagnosis and management of hypertriglyceridemia in adults. Contributing factors include overweight and obesity, physical inactivity, excessive alcohol intake, metabolic syndrome, type 2 diabetes mellitus, ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2013/0715/p142.html

Diabetes: Treating Hypertension - Clinical Evidence Handbook - American Family Physician

Apr 15, 2013 - What are the effects of antihypertensives and different blood pressure targets in persons with diabetes and hypertension?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2013/0415/p574.html

Diabetic Ketoacidosis: Evaluation and Treatment - American Family Physician

Mar 1, 2013 - Diabetic ketoacidosis is characterized by a serum glucose level greater than 250 mg per dL, a pH less than 7.3, a serum bicarbonate level less than 18 mEq per L, an elevated serum ketone level, and dehydration. Insulin deficiency is the main precipitating factor. Diabetic ketoacidosis ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0301/p337.html

Diabetic Nephropathy: Preventing Progression - Clinical Evidence Handbook - American ...

Mar 15, 2011 - What are the effects of treatments to prevent progression of nephropathy in persons with type 1 and type 2 diabetes and early and late nephropathy?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2011/0315/p732.html

ADA Releases Updated Recommendations on Standards of Medical Care in Diabetes - ...

Jul 15, 2010 - The 2010 American Diabetes Association's (ADA) Standards of Medical Care in Diabetes includes revisions based on new evidence. Several sections have undergone major changes.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2010/0715/p206.html

Joint Guideline on Intensive Glycemic Control and the Prevention of Cardiovascular ...

Nov 15, 2009 - Recommendations from the American Diabetes Association (ADA), American College of Cardiology Foundation (ACC), and American Heart Association (AHA) for glycemic control and prevention of cardiovascular events in patients with diabetes.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2009/1115/p1167.html

Diagnosis and Management of Gestational Diabetes Mellitus - American Family Physician

Jul 1, 2009 - Gestational diabetes occurs in 5 to 9 percent of pregnancies in the United States and is growing in prevalence. It is a controversial entity, with conflicting guidelines and treatment protocols. Recent studies show that diagnosis and management of this disorder have beneficial effects ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0701/p57.html

Management of Blood Glucose in Type 2 Diabetes Mellitus - American Family Physician

Jan 1, 2009 - Evidence-based guidelines for the treatment of type 2 diabetes mellitus focus on three areas: intensive lifestyle intervention that includes at least 150 minutes per week of physical activity, weight loss with an initial goal of 7 percent of baseline weight, and a low-fat, ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0101/p29.html

Pharmacologic Management of Hypertension in Patients with Diabetes - American Family ...

Dec 1, 2008 - Hypertension is a common comorbidity in patients with diabetes, and adequate control of blood pressure significantly reduces the risk of macrovascular and microvascular complications. Patients with diabetes should achieve a target blood pressure of less than 130/80 mm Hg. The use of ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1201/p1277.html

Subclinical Hypothyroidism - Cochrane for Clinicians - American Family Physician

Apr 1, 2008 - Although there is evidence that thyroid hormone therapy in patients with subclinical hypothyroidism may improve lipid profiles, cognitive function, and echographic left ventricular function, there is no evidence that this will decrease morbidity or mortality.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2008/0401/p953.html

Effectiveness of Insulin Sensitizing Drugs for Polycystic Ovary Syndrome - Cochrane for...

Nov 1, 2007 - Insulin sensitizing drugs are more effective than oral contraceptives alone at improving fasting insulin levels in patients with PCOS. Compared with metformin (Glucophage) alone, oral contraceptives alone better control irregular menstrual cycles and reduce androgen levels. There is ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2007/1101/p1308.html

Management of Type 2 Diabetes in Youth: An Update - American Family Physician

Sep 1, 2007 - Although type 1 diabetes historically has been more common in patients eight to 19 years of age, type 2 diabetes is emerging as an important disease in this group. Type 2 diabetes accounts for 8 to 45 percent of new childhood diabetes. This article is an update from the National ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0901/p658.html

Angiotensin Blockade in Patients with Diabetic Nephropathy - FPIN's Clinical Inquiries ...

Aug 1, 2007 - When used to delay the progression of early nephropathy in patients with type 2 diabetes mellitus, angiotensin receptor blockers (ARBs) are not superior to angiotensin-converting enzyme (ACE) inhibitors.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2007/0801/p423.html

Home Monitoring of Glucose and Blood Pressure - American Family Physician

Jul 15, 2007 - Home monitoring of blood glucose and blood pressure levels can provide patients and physicians with valuable information in the management of diabetes mellitus and hypertension. Home monitoring allows patients to play an active role in their care and may improve treatment adherence and ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0715/p255.html

ACE Inhibitors vs. ARBs for Patients with Diabetic Kidney Disease - Cochrane for ...

Jul 1, 2007 - Studies comparing ACE inhibitors or ARBs with placebo found no mortality benefit in patients with diabetic kidney disease. A subgroup analysis of five studies (2,034 total patients) found that, when given at full or maximally tolerated doses, ACE inhibitors reduce all-cause mortality ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2007/0701/p68.html

Tight Control of Type 1 Diabetes: Recommendations for Patients - American Family Physician

Sep 15, 2006 - Tight control of blood glucose levels and risk factors for cardiovascular disease (e.g., hypertension, hypercholesterolemia) can substantially reduce the incidence of microvascular and macrovascular complications from type 1 diabetes. Physicians play an important role in helping ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0915/p971.html

ADA Releases Standards of Medical Care for Patients with Diabetes - Practice Guidelines...

Sep 1, 2006 - The American Diabetes Association (ADA) has published a position statement containing evidence-based recommendations for diabetes care, treatment goals, and tools to evaluate the quality of care.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2006/0901/p871.html

Diabetic Nephropathy - Clinical Evidence Handbook - American Family Physician

Dec 1, 2005 - What are the effects of treatments in persons with type 1 diabetes and early or late nephropathy? What are the effects of treatments in persons with type 2 diabetes and early or late nephropathy?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2005/1201/p2299.html

Statin Therapy in Patients with Type 2 Diabetes - FPIN's Clinical Inquiries - American ...

Sep 1, 2005 - Based on current evidence, statin therapy should be offered to all patients with type 2 diabetes who are known to have coronary artery disease.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2005/0901/p866.html

Diabetic Ketoacidosis - American Family Physician

May 1, 2005 - A diagnosis of diabetic ketoacidosis requires the patient's plasma glucose concentration to be above 250 mg per dL (although it usually is much higher), the pH level to be less than 7.30, and the bicarbonate level to be 18 mEq per L or less. Beta-hydroxybutyrate is a better measurement ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0501/p1705.html

Practice Guidelines - Apr 15, 2005 - American Family Physician

Apr 15, 2005 - ...of disease control (e.g., serum A1C levels, blood pressure) and physician adherence (e.g., serial monitoring of A1C levels, control of hypertension, management of cardiovascular risk factors). The researchers found 58 articles reporting a total of 66 trials that met the established...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2005/0415/p1612.html

Cochrane for Clinicians - Mar 1, 2005 - American Family Physician

Mar 1, 2005 - NPH insulin and metformin taken at bedtime appears to be the most favorable combination studied, but this conclusion is based on poor-quality, inconsistent studies that measure disease-oriented outcomes. There are no data on the effect of these drug combinations on patient-oriented ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2005/0301/p899.html

ACP Releases Guideline on Lipid Control in Patients with Type 2 Diabetes Mellitus - ...

Aug 15, 2004 - A guideline on the management of dyslipidemia, particularly hypercholesterolemia, in patients with type 2 diabetes mellitus has been published by the Clinical Efficacy Assessment Subcommittee of the American College of Physicians (ACP).

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2004/0815/p775.html

Preventive Therapy for Diabetes: Lifestyle Changes and the Primary Care Physician - ...

Jan 15, 2004 - ...Regular exercise has the potential to reduce morbidity and mortality from diabetes and many other conditions such as vascular disease, hypertension, and osteoporosis. Although the data are mixed about the positive impact of counseling, the potential benefits of exercise combined...

American Family Physician : Editorials

https://www.aafp.org/afp/2004/0115/p269.html

Controlling Hypertension in Patients with Diabetes - American Family Physician

Oct 1, 2002 - Hypertension and diabetes mellitus are common diseases in the United States. Patients with diabetes have a much higher rate of hypertension than would be expected in the general population. Regardless of the antihypertensive agent used, a reduction in blood pressure helps to prevent ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1001/p1209.html

Hypertension and Diabetes: Family Physicians' Pivotal Role - Editorials - American ...

Oct 1, 2002 - ...Hypertension and Diabetes: Family Physicians' Pivotal Role GEORGE L. BAKRIS, M.D. Rush Presbyterian/St. Luke's Medical Center Chicago, Illinois Am Fam Physician. 2002 Oct 1;66(7):1151-1153. Related Article In the United States, diabetes is the most common cause of both blindness and...

American Family Physician : Editorials

https://www.aafp.org/afp/2002/1001/p1151.html

Combination Therapy for Type 2 Diabetes - Editorials - American Family Physician

Dec 1, 2001 - ...rather than the exception. Just as different agents are added for a cumulative lowering of blood pressure in patients with essential hypertension, effective treatment of diabetes often requires combination therapy. In patients with type 2 diabetes, each of the agents used in a...

American Family Physician : Editorials

https://www.aafp.org/afp/2001/1201/p1812.html

Treatment of Type 2 Diabetes Mellitus: A Rational Approach Based on Its Pathophysiology...

May 1, 2001 - ...insulin resistance.1,2 The insulin resistance is associated with a cluster of metabolic abnormalities, including central obesity, hypertension, dyslipidemia (elevated plasma triglycerides, low high-density lipoprotein [HDL] cholesterol levels and postprandial hyperlipidemia),...

American Family Physician : Editorials

https://www.aafp.org/afp/2001/0501/p1687.html

Why Can't This Patient Take Insulin? - Curbside Consultation - American Family Physician

Jan 1, 2000 - One of the prevailing challenges for physicians is dealing with noncompliant patients—those patients who seem unable or unwilling to comply with their treatment plan. When faced with such a patient, the physician's first impulse is frequently one of anger and frustration. The reasons ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2000/0101/p226.html

Oral Pharmacologic Management of Type 2 Diabetes - American Family Physician

Dec 1, 1999 - Epidemiologic and interventional studies have led to lower treatment targets for type 2 diabetes (formerly known as non-insulin-dependent diabetes), including a glycosylated hemoglobin level of 7 percent or less and a before-meal blood glucose level of 80 to 120 mg per dL (4.4 to 6.7 ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1201/p2613.html

Educational Guidelines for Achieving Tight Control and Minimizing Complications of Type...

Nov 1, 1999 - Tight glucose control with intensive therapy in patients with type 1 diabetes (formerly known as juvenile-onset or insulin-dependent diabetes) can delay the onset and slow the progression of retinopathy, nephropathy and neuropathy. Optimal blood glucose control is defined by a target ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1101/p1985.html

The Costs of Helping Patients with Type 1 Diabetes Achieve Tight Control - Editorials -...

Nov 1, 1999 - ...and secondary interventions to prevent or ameliorate these complications, and screening for and managing comorbid conditions (e.g., hypertension and hyperlipidemia). Reasonable targets for tight control have been defined as a mean blood glucose level of 155 mg per dL (8.6 mmol per...

American Family Physician : Editorials

https://www.aafp.org/afp/1999/1101/p1914.html

Management of the Hyperosmolar Hyperglycemic Syndrome - American Family Physician

Oct 1, 1999 - Hyperglycemic hyperosmolarity is part of a clinical spectrum of severe hyperglycemic disorders ranging from pure hyperglycemic hyperosmolarity without ketosis to diabetic ketoacidosis, with significant overlap in the middle. From 50 to 75 percent of hospitalizable patients who have ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1001/p1468.html

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