Diabetes Features Archive
A 63-year-old man with type 2 diabetes was admitted to the hospital to undergo right robotic partial nephrectomy.
The document addresses important new issues in diabetes management, including metabolic surgery and a more specific definition of hypoglycemia.
Often underreported and undertreated, outcomes can be improved in this condition with appropriate screening and diagnosis.
A patient with type 2 diabetes is undergoing dialysis and needs to control his HbA1c levels while fasting during Ramadan.
Developing personalized nutrition goals with a registered dietitian can be effective in managing non-insulin-dependent diabetes.
A patient with type 2 diabetes presents with elevated microalbumin levels and a recent history of elevated glucose due to bedtime snacking.
While undergoing physical therapy after a stroke, a patient with type 1 diabetes has a hypoglycemia-related stroke.
Patients with type 2 diabetes and severe insulin resistance may require large doses of insulin to achieve glycemic control.
Patients who forget to take Metformin SR twice daily can be switched to Metformin XR with once daily dosing.
Patients aged 20 to 44 years who have diabetes have unique health concerns compared with older and younger patients with diabetes.
SGLT2 receptor blockers are only approved for type 2 diabetes.
An older patient with type 2 diabetes expresses concern about potential peripheral neuropathy.
A patient with diabetes questions the necessity of starting a statin.
The patient, aged 69 years, had a 43-year history of type 1 diabetes and was scheduled to undergo a chest wall resection.
A patient presented to the office with a 45-year history of maturity onset diabetes of the young after renal failure.
Metabolic syndrome can be managed using changes in diet and exercise.
Adequate fiber intake is critical for maintaining good health, but only 5% of Americans consume the recommended daily amount.
NPs and PAs must work in collaboration with oral health clinicians to effectively educate patients in the prevention of periodontal disease.
An older male patient started antidepressants for neuropathy pain but developed hyponatremia as a result.
A patient, aged 57 years, was admitted to the hospital to undergo gastric bypass surgery. He had a history of type 2 diabetes for ten years.
When diagnosing the cause of chronic abdominal pain, a more specific history and a broad consideration of causes can help with diagnosis.
A patient, Ms. B., was diagnosed with type 1 diabetes three years ago.
Encouraging a patient to get an overdue Pap exam resulted in an early discovery of uterine cancer that could have gone undetected.
A type 1 diabetes patient presents to an outpatient facility agitated and slurring his words. Emergency medical help was called to assist the patient.
Compared with patients who had not taken statins, those who had were less likely to develop diabetic neuropathy by 34%, diabetic retinopathy by 40%, and gangrene by 12%.
After a patient's elective surgery was postponed due to glucose readings, an assessment of his medical profile and history were evaluated to manage his type 2 diabetes mellitus complications.
The Grain Foods Foundation explores popular carbohydrate-related myths and assumptions patients with diabetes have likely encountered.
Each patient loses 0.8% kidney function/year after the age of 30. If you round this to a loss of 1% per year (for simplicity), you can calculate if a GFR is normal for a patient's age.
In specific situations, clinicians should monitor a patient's metformin use in order to prevent dialysis and higher risk of kidney failure.
Airflow disturbances during sleep need to be recognized and evaluated before harm comes to the patients themselves or those around them.
Patients who ate nuts regularly had reduced diabetes, fatal and nonfatal ischemic heart disease.
A patient recently diagnosed with diabetes complains of worsening malaise and fatigue as well as bilateral extremity cramps.
Multiple studies show that just about any low-meat or no-meat diet reduces almost all controllable risk factors for cardiovascular disease.
Our patient had an extensive medical history, but were her new-onset symptoms the result of poor compliance?
Only about one-third of the coronary plaque detected showed calcification.
Heavy metal exposure from a patient's well water accelerated multisystem damage associated with diabetes.
A "bruise" from a minor injury continues to linger for weeks.
Are hormonal changes to blame, or something else?
Are more aggressive approaches to cardiac work up warranted in patients with diabetes?
In which disease states or at what stages of chronic kidney disease is the HbA1c test no longer reliable?
Dietary supervision may have driven the patient out of his facility.
Despite adhering to lifestyle modifications, a woman's glycemic control remains inadequate.
Why are individuals with diabetes especially prone to developing frozen shoulder?
An off-label treatment gives a patient in pain a second chance.
Many patients with diabetes develop poor blood-glucose monitoring habits over time. Reviewing technique helps assure the process is painless.
Does fruit juice carry the same diabetes risk as other sugar-sweetened beverages?
Bariatric surgery may induce type 2 diabetes remission in obese patients, but more direct evidence is needed.
Omega-3 fatty acid supplementation does not reduce mortality or cardiovascular events in patients with or at high risk for diabetes.
Two clinicians disagree on a diagnosis after reviewing two-hour oral glucose tolerance test results. Who is correct?
A patient with newly diagnosed diabetes has a hemoglobin (Hb) A1c of 12.2% and glucose 350 mg/dL, despite increasing insulin (glargine [Lantus]) to 25 units. What else can be done to lower blood sugar?
Two patients present with asymptomatic red lesions -- a 60-year-old man, whose lesion was present for five years before beginning to bleed, and a 27-year-old man whose lesion doubled in size during a two year period. Can you differentiate between the two?
Advancements in diabetes care abound, but busy practice schedules make staying current difficult.
A 69-year-old man with multiple health conditions develops gynecomastia after hemodialysis. Are the two related?
Treating patients before they develop a disease is tempting, but the old adage still applies: First, do no harm.
With obesity on the rise, more patients are at risk for metabolic syndrome, a diagnosis given to a set of simultaneous disorders.
How can a clinician determine whether it's appropriate to raise or lower bedtime insulin in a patient experiencing difficulty controlling morning glucose levels?
Statins are widely used for treating elevated cholesterol for both primary and secondary prevention of coronary artery disease. One concern about their use has been the possibility of increasing the risk of diabetes.
When is it appropriate to refer diabetic and hypertensive patients to a renal specialist?
What is maturity onset diabetes of the young (MODY)? How does it differ from types 1 and 2 diabetes?
Insulin is the only agent recommended to lower glucose levels in pregnant women, but a second-generation sulfonylurea may provide another option.
Type 2 diabetes in this population is increasing, but type1 diabetes is more prevalent. The ability to differentiate between these conditions is crucial.
What is the treatment goal for B12 in a patient with diabetic neuropathy, given the wide range of normal (200-950 pg/mL)?
Obese adults are at risk for many serious health conditions, including diabetes, coronary heart disease, hypertension, stroke, obstructive sleep apnea (OSA), depression and liver disease.
A quick review of polycystic ovary syndrome, a heterogeneous androgen excess syndrome that can cause hirsutism, secondary amenorrhea, obesity, hyperinsulinemia and infertility, providing the latest global evidence for diagnosis and treatment.
The risk for experiencing a serious GI event rises exponentially with increasing numbers of risk factors.
Following gastric bypass surgery, many patients will still need metformin or glipizide (Glucotrol). Is there any evidence that one class of hypoglycemic agents is better absorbed than another?
Tight glycemic, BP and cholesterol control, as well as weight reduction, exercise and smoking cessation can help prevent renal nephropathy.
What are the effects of using insulin detemir as first-line treatment for type 2 diabetes?
How much B12 supplement is adequate for patients on metformin?
The latest evidence-based dietary recommendations from the American Diabetes Association focus on disease prevention and treatment.
Diabetic retinopathy is the most common eye disorder in people with diabetes and is a primary cause of blindness in adults.
Latent autoimmune diabetes in adults is often mistakenly diagnosed and treated as type 2 diabetes.
Is there any role for C-peptide in the management of type 2 diabetes mellitus?
Is it prudent to discontinue insulin in an incarcerated man with diabetes who was started on insulin while in jail, but who wishes to stop treatment?
Unlike other chronic life-threatening diseases type 2 diabetes can be managed and even reversed. Exercising can help patients reduce the risk of complications, including stroke and heart disease.
Early identification and treatment is essential to the prevention of chronic kidney disease, a common diabetes complication.
Consider psychosocial factors, heart disease and other unique risk factors when treating women with diabetes.
Neuropathy is one of the most common diabetic comorbidities — affecting about 60% to 70% of patients. Managing glucose levels is the most direct way to prevent nerve damage and alleviate pain.
Health care practitioners may need to navigate language barriers, cultural differences and health-literacy challenges to effectively educate patients with diabetes.
A black woman aged 52 years developed large (1.5-2.0 cm wide), fluid-filled blisters on her swollen ankles. There were no other symptoms, and the patient's health history was unremarkable except for anemia. What could be the cause?
Did a patient die because her clinicians waited too long before referring her to a wound-care clinic?
Does research support the addition of coenzyme Q10 for those on lipid-lowering medication?
What is the best way to tactfully discuss a child's excess weight with his or her parent?
Because the HbA1c test doesn't require fasting, clinicians hope it will reduce the number of people going undiagnosed with type 2 diabetes
What are the most recent screening and diagnostic criteria for maturity-onset diabetes of the young?
A 54-year-old man from India with a history of type 2 diabetes, hypertension, and dyslipidemia, has cold hands and feet despite wearing sufficient clothing. A specialist has ruled out Raynaud's disease.
Husband and wife in an arranged marriage share story of life-long bond forged during a crisis.
Nurse's curiosity leads to a cure for a debilitating skin condition.
Selenium is a stable trace-metal element that is found in such cruciferous foods as broccoli, garlic, and onions, as well as in meats, seafood, and nuts. In the human body, selenium is essential for protein synthesis and multiple enzymatic functions.
A 72-year-old man with a diabetic foot ulcer shares one of his past times before surgery.
Successful treatment can cost tens of thousands of dollars. With limited access to care, these patients often present with advanced disease.
In rural health-care settings, many patients are reluctant to use insulin.
Designed to record blood sugar levels throughout the day, these devices spot trends that may go unnoticed with standard tests and measurements.
How can I ensure that patients receiving dialysis maintain therapeutic anticoagulation while on warfarin?
When it is OK to say, "I have done as much as I can for this patient."
How does screening for microalbuminuria change the management of these patients?
Prescribe at least 150 minutes of moderate-intensity or 90 minutes of vigorous-intensity aerobic exercises per week, plus some weight training.
After five years of treatment without side effects, his glucose level took off.
Lymphedema often turns into cellulitis in patients with diabetes.
Should a noncompliant patient bear the full responsibility for not following instructions?