“diabetes problems”

In patients with metformin contraindications or intolerance, consider an initial drug from another class depicted in Fig. 8.1 under “Dual Therapy” and proceed accordingly. When A1C is ≥9% (75 mmol/mol), consider initiating dual combination therapy (Fig. 8.1) to more expeditiously achieve the target A1C level. Insulin has the advantage of being effective where other agents may not be and should be considered as part of any combination regimen when hyperglycemia is severe, especially if catabolic features (weight loss, ketosis) are present. Consider initiating combination insulin injectable therapy (Fig. 8.2) when blood glucose is ≥300 mg/dL (16.7 mmol/L) or A1C is ≥10% (86 mmol/mol) or if the patient has symptoms of hyperglycemia (i.e., polyuria or polydipsia). As the patient’s glucose toxicity resolves, the regimen may, potentially, be simplified.

Medications to treat diabetes include insulin and glucose-lowering pills, called oral hypoglycemic agents. People with type 1 diabetes cannot make their own insulin, so daily insulin injections or inhalations are required. People with type 2 diabetes make insulin but cannot use it effectively.

Dining out with diabetes is possible! Refer to a restaurant’s menu or website, or carry a reference guide to help you determine nutrition information for a dish before you go. For lunch or dinner, opt for the following and you’ll gain a nutritional bargain:

There are a few types of diabetes, though the main two types are type 1 and type 2 diabetes. They differ due to the cause. You may have sudden symptoms of diabetes, or a diagnosis may surprise you because the symptoms have been gradual over many months or years.




This book is a very good book for people wanting to cure or control their diabetes. It gives you step by step instructions on what you should do. The book tells how through detoxing your body you start to heal and take control of your sugar level. This is a very good and rewarding book if you follow it.

Jump up ^ The Diabetes Control; Complications Trial Research Group (April 1995). “The effect of intensive diabetes therapy on the development and progression of neuropathy”. Annals of Internal Medicine. 122 (8): 561–68. doi:10.7326/0003-4819-122-8-199504150-00001. PMID 7887548.

200 mg/dL or higher Diabetes mellitus (type 2 diabetes) Type 2 diabetes develops when your body doesn’t make enough insulin or develops “insulin resistance” and can’t make efficient use of the insulin it makes. It greatly increases your risk of heart disease and stroke.

Glucose is a simple sugar found in food. Glucose is an essential nutrient that provides energy for the proper functioning of the body cells. Carbohydrates are broken down in the small intestine and the glucose in digested food is then absorbed by the intestinal cells into the bloodstream, and is carried by the bloodstream to all the cells in the body where it is utilized. However, glucose cannot enter the cells alone and needs insulin to aid in its transport into the cells. Without insulin, the cells become starved of glucose energy despite the presence of abundant glucose in the bloodstream. In certain types of diabetes, the cells’ inability to utilize glucose gives rise to the ironic situation of “starvation in the midst of plenty”. The abundant, unutilized glucose is wastefully excreted in the urine.






Age-Adjusted Percentage of Adults Aged 18 Years or Older with Diagnosed Diabetes Performing Daily Self-Monitoring of Blood Glucose, United States, 1994-2010 (Centers for Disease Control and Prevention)

Metformin monotherapy should be started at diagnosis of type 2 diabetes unless there are contraindications. Metformin is effective and safe, is inexpensive, and may reduce risk of cardiovascular events and death (32). Compared with sulfonylureas, metformin as first-line therapy has beneficial effects on A1C, weight, and cardiovascular mortality (33). Metformin may be safely used in patients with estimated glomerular filtration rate (eGFR) as low as 30 mL/min/1.73 m2, and the FDA recently revised the label for metformin to reflect its safety in patients with eGFR ≥30 mL/min/1.73 m2 (34). Patients should be advised to stop the medication in cases of nausea, vomiting, or dehydration. Metformin is associated with vitamin B12 deficiency, with a recent report from the Diabetes Prevention Program Outcomes Study (DPPOS) suggesting that periodic testing of vitamin B12 levels should be considered in metformin-treated patients, especially in those with anemia or peripheral neuropathy (35).

Insulin therapy. Some people who have type 2 diabetes need insulin therapy as well. In the past, insulin therapy was used as a last resort, but today it’s often prescribed sooner because of its benefits.

Levels which are significantly above or below this range are problematic and can in some cases be dangerous. A level of <3.8 mmol/L (<70 mg/dL) is usually described as a hypoglycemic attack (low blood sugar). Most diabetics know when they are going to "go hypo" and usually are able to eat some food or drink something sweet to raise levels. A patient who is hyperglycemic (high glucose) can also become temporarily hypoglycemic, under certain conditions (e.g. not eating regularly, or after strenuous exercise, followed by fatigue). Intensive efforts to achieve blood sugar levels close to normal have been shown to triple the risk of the most severe form of hypoglycemia, in which the patient requires assistance from by-standers in order to treat the episode.[21] In the United States, there were annually 48,500 hospitalizations for diabetic hypoglycemia and 13,100 for diabetic hypoglycemia resulting in coma in the period 1989 to 1991, before intensive blood sugar control was as widely recommended as today.[22] One study found that hospital admissions for diabetic hypoglycemia increased by 50% from 1990–1993 to 1997–2000, as strict blood sugar control efforts became more common.[23] Among intensively controlled type 1 diabetics, 55% of episodes of severe hypoglycemia occur during sleep, and 6% of all deaths in diabetics under the age of 40 are from nocturnal hypoglycemia in the so-called 'dead-in-bed syndrome,' while National Institute of Health statistics show that 2% to 4% of all deaths in diabetics are from hypoglycemia.[24] In children and adolescents following intensive blood sugar control, 21% of hypoglycemic episodes occurred without explanation.[25] In addition to the deaths caused by diabetic hypoglycemia, periods of severe low blood sugar can also cause permanent brain damage.[26] Interestingly, although diabetic nerve disease is usually associated with hyperglycemia, hypoglycemia as well can initiate or worsen neuropathy in diabetics intensively struggling to reduce their hyperglycemia.[27] [redirect url='https://curediabetesforever.com/bump' sec='7']

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