Treating Patients with PRE-DIABETES David Doriguzzi, PA-C First Valley Medical Group. Learning Objectives. Background. CAPA 2015 Annual Conference
|
|
- Sydney Byrd
- 8 years ago
- Views:
Transcription
1 Treating Patients with PRE-DIABETES David Doriguzzi, PA-C First Valley Medical Group Learning Objectives To accurately make the diagnosis of pre-diabetes/metabolic syndrome To understand the prevalence of this disorder To understand the risk that pre-diabetes poses to the patient To know the treatment options available to manage pre-diabetes To understand the benefits and efficacy of lifestyle modification vs medication in management To motivate patients to actively participate in the treatment plan Background Type 2 Diabetes diagnostic criteria (ADA) 1 Fasting blood glucose greater than or equal to 126 mg/dl on more than one occasion 2-hour glucose tolerance test greater than or equal to 200 mg/dl Hemoglobin A1c measurement greater than or equal to 6.5% 1
2 Background Pre-Diabetes diagnostic criteria (ADA) 1 Fasting blood glucose between 100 and 125 mg/dl on more than one occasion 2-hour glucose tolerance test between 140 and 199 mg/dl Hemoglobin A1c measurement between 5.7 and 6.4% Importance of Recognition Pre-Diabetes is a direct risk factor for Type 2 Diabetes 1/3 of pre-diabetics will progress into full diabetes Pre-diabetes (whether the patient progresses to DM2 or not) carries an increased risk of cardiovascular complications and cancer Pre-diabetes appears to be closely associated with Metabolic Syndrome (abdominal obesity, elevated BP, impaired fasting blood glucose, elevated triglycerides, and low HDL) Epidemiology Diabetes incidence is increasing at alarming rates M US persons with diabetes in 1980 has increased to 20.9 M in 2011 Incidence of Type 2 Diabetes has increased by 40% between 2007 and 2012 Incidence of Pre-Diabetes has increased by 70% between 2007 and
3 Epidemiology Diabetes prevalence is expected to rise to 1/3 of the general population by the year % OF GENERAL POPULATION Pre-diabetes Prevalence Approximately 1/3 of all US adults have Pre- Diabetes (86 Million) 5 About 56% of US adults over 65 are Pre-diabetic 16% of adolescents age have either impaired fasting glucose or impaired glucose tolerance 6 Only 11% of people with pre-diabetes are aware of the condition The Goal Intervention of prediabetes aims to influence the inertia of the disease state, to prevent progression into Type 2 Diabetes and, ideally, revert to a normal metabolic state 3
4 The Key Early identification of pre-diabetes is key ADA recommends screening all adults with BMI >25 if there are additional risk factors for diabetes 7 If no other risk factors, consider screening adults with BMI > 25 starting at age 45. Repeat in 3 years if normal. Test A1c [at least] yearly if a patient is confirmed to have pre-diabetes Diabetes Risk Factors Family history of DM (first degree) Previous A1c > 5.7% Physical inactivity High-risk race/ethnicity Hypertension History of cardiovascular disease Dyslipidemia History of gestational diabetes or delivery of a baby weighing more than 9 lbs. Severe obesity Other conditions related to insulin resistance (eg. PCOS or acanthuses nigrans) So we have a diagnosis. Now What? Appropriate approach to patients with prediabetes isn t as clearly laid out as recommendations for Type 2 diabetes 4
5 AGGRESSIVE management of pre-diabetes can have a significant impact on preventing progression into Type 2 Diabetes Developing an appropriately aggressive management is an individualized process that requires understanding your patients on an individual level, a solid understanding of the diabetes disease process, and a fair amount of dedication from the both the patient and the provider Diabetes Prevention Program Research Group is one of the best known studies evaluating treatment strategies in pre-diabetes. 8 3,234 pre-diabetics were randomized to Placebo, Metformin (850 mg BID), or intensive lifestyle modification. Patients on placebo and metformin were provided with information about diet and exercise, but did not get intensive guidance 5
6 Lifestyle modification group had very clear and intense guidelines Patients were to exercise 150 minutes per week at moderate-to-vigorous intensity Goal was at least 7% weight loss, compared to baseline Patients had regular interactions with dieticians and personal trainers Lifestyle Recommendations Exercise at least 150 minutes per week, spread over at least 3 days per week Don t go more than 2 consecutive days without exercise Incorporate resistance/weight training at least twice per week Avoid prolonged (>90 minutes) of sedentary time Be sure to individualize the plan for a patient s age, physical limitations (eg. OA), and previous level of activity Working one s way up gradually is acceptable Counsel patients in detail regarding dietary changes The Da Qing study 9 and the Finnish DPS 10 studies have also shown significant improvement of outcomes with rigorous lifestyle modification Metformin, Alpha-glucosidase inhibitors (acarbose), orlistat, and Thiazolidinediones have all been studied in pre-diabetes and have been shown to be 20-80% effective in preventing progression to DM2, depending on the medication and the study ADA position is that metformin has the strongest evidence base and is recommended first line 6
7 Medically-Assisted Weight Loss Lorcaserin (Belviq), Phentermine/Topiramate (Qsymia), Naltrexone/Bubroprion (Contrave), and Liraglutide (Saxenda) are FDA approved medications for treatment of obesity in combination with lifestyle modification. Bariatric surgery can also be considered in patients with BMI>40 kg/m 2 without risk factors or BMI>35 kg/m 2 with at least one obesity-related comorbidity Choosing the Right Approach Developing a treatment plan requires truly understanding the patient Recommending a lifestyle modification plan requires truly understanding the exercise Choosing a medication plan involves truly understanding the diabetes process Pre-diabetes is the earliest stages of the diabetes process Diabetes Disease Process 7
8 Summary Early identification and early intervention of pre-diabetes is key in managing the condition Medication therapy offers a valid improvement of the disease state Intensive lifestyle modification offers a greater impact on interrupting the disease inertia The health care provider s approach and level of dedication in guiding the patient through effective lifestyle modification can greatly impact the patient s adherence and ultimate outcome Citations 1. American Diabetes Association (2012) Diagnosis and classification of diabetes mellitus. Diabetes Care, 35(Suppl 1): S64-S71 2. Center for Disease Control and Prevention; 3. Boyle, JP, et al. Popul Health Metr 2010; 8: Diabetes Care 2014; 37: CDC. MMWR Morb Mortal Weekly Report 2013; 62: Li C, et al. Diabetes Care. 2009; 32: ADA. Diabetes Care. 2015: 38 (suppl 1): S8-S16 8. Knowler, et al. N Eng J Med 2002; 346: Diabetes Care 1997;20: N Eng J Med;2001;
TYPE 2 DIABETES IN CHILDREN DIAGNOSIS AND THERAPY. Ines Guttmann- Bauman MD Clinical Associate Professor, Division of Pediatric Endocrinology, OHSU
TYPE 2 DIABETES IN CHILDREN DIAGNOSIS AND THERAPY Ines Guttmann- Bauman MD Clinical Associate Professor, Division of Pediatric Endocrinology, OHSU Objectives: 1. To discuss epidemiology and presentation
More informationTYPE 2 DIABETES MELLITUS: NEW HOPE FOR PREVENTION. Robert Dobbins, M.D. Ph.D.
TYPE 2 DIABETES MELLITUS: NEW HOPE FOR PREVENTION Robert Dobbins, M.D. Ph.D. Learning Objectives Recognize current trends in the prevalence of type 2 diabetes. Learn differences between type 1 and type
More informationType 2 Diabetes Mellitus and Insulin resistance syndrome in Children
Type 2 Diabetes Mellitus and Insulin resistance syndrome in Children Anil R Kumar MD Pediatric Endocrinology MCV/VCU, Richmond VA Introduction Type 2 diabetes mellitus (T2 DM) has increased in children
More informationInsulin Resistance and PCOS: A not uncommon reproductive disorder
Insulin Resistance and PCOS: A not uncommon reproductive disorder Joyce L. Ross, MSN, CRNP, CS, FNLA, FPCNA Diplomate Accrediation Council for Clinical Lipidology President Preventive Cardiovascular Nurses
More informationESC/EASD Pocket Guidelines Diabetes, pre-diabetes and cardiovascular disease
Diabetes, prediabetes and cardiovascular disease Classes of recommendations Levels of evidence Recommended treatment targets for patients with diabetes and CAD Definition, classification and screening
More informationDiagnosis, classification and prevention of diabetes
Diagnosis, classification and prevention of diabetes Section 1 1 of 4 Curriculum Module II 1 Diagnosis, classification and presentation of diabetes Slide 2 of 48 Polyurea Definition of diabetes Slide 3
More informationDiabetes and Obesity in Children. Janie Berquist, RN, BSN, MPH, CDE Children s Mercy Hospitals and Clinics Kansas City, MO
Diabetes and Obesity in Children Janie Berquist, RN, BSN, MPH, CDE Children s Mercy Hospitals and Clinics Kansas City, MO Diabetes and Obesity in Children What is Diabetes? How are Diabetes and Obesity
More informationThe National Diabetes Prevention Program: An Update on Efforts in Michigan
The National Diabetes Prevention Program: An Update on Efforts in Michigan Gretchen A. Piatt, PhD, MPH Assistant Professor Department of Medical Education University of Michigan 10/11/12 WHY PREVENT DIABETES?
More informationDiabetes mellitus is a chronic condition that occurs as a result of problems with the production and/or action of insulin in the body.
International Diabetes Federation Diabetes Background Information Diabetes mellitus is a chronic condition that occurs as a result of problems with the production and/or action of insulin in the body.
More informationDrug Treatment for Weight Loss: New Advances
Drug Treatment for Weight Loss: New Advances William G. Haynes FRCP MD Professor of Internal Medicine Divisions of Endocrinology and Cardiovascular Medicine University of Iowa Outline Why should we use
More informationStatistics of Type 2 Diabetes
Statistics of Type 2 Diabetes Of the 17 million Americans with diabetes, 90 percent to 95 percent have type 2 diabetes. Of these, half are unaware they have the disease. People with type 2 diabetes often
More informationDiabetes is a. A case for prevention of type 2 diabetes mellitus
A case for prevention of type 2 diabetes mellitus Joseph Cook, DO Diabetes is a disease that has reached epidemic proportions in the United States and around the world. This is troubling because, as bad
More informationDouble Diabetes: Definition, Diagnosis, Treatment, Prediction and Prevention.
Double Diabetes: Definition, Diagnosis, Treatment, Prediction and Prevention. Professor Paolo Pozzilli University Campus Bio-Medico, Rome Institute of Cell & Molecular Science, Queen Mary, University of
More informationDiabetes Mellitus 1. Chapter 43. Diabetes Mellitus, Self-Assessment Questions
Diabetes Mellitus 1 Chapter 43. Diabetes Mellitus, Self-Assessment Questions 1. A 46-year-old man presents for his annual physical. He states that he has been going to the bathroom more frequently than
More informationIs Insulin Effecting Your Weight Loss and Your Health?
Is Insulin Effecting Your Weight Loss and Your Health? Teressa Alexander, M.D., FACOG Women s Healthcare Associates www.rushcopley.com/whca 630-978-6886 Obesity is Epidemic in the US 2/3rds of U.S. adults
More informationNutrition. Type 2 Diabetes: A Growing Challenge in the Healthcare Setting NAME OF STUDENT
1 Nutrition Type 2 Diabetes: A Growing Challenge in the Healthcare Setting NAME OF STUDENT 2 Type 2 Diabetes: A Growing Challenge in the Healthcare Setting Introduction and background of type 2 diabetes:
More information嘉 義 長 庚 醫 院 藥 劑 科 Speaker : 翁 玟 雯
The Clinical Efficacy and Safety of Sodium Glucose Cotransporter-2 (SGLT2) Inhibitors in Adults with Type 2 Diabetes Mellitus 嘉 義 長 庚 醫 院 藥 劑 科 Speaker : 翁 玟 雯 Diabetes Mellitus : A group of diseases characterized
More informationTreatment of diabetes In order to survive, people with type 1 diabetes must have insulin delivered by a pump or injections.
National Diabetes Statistics What is diabetes? Diabetes mellitus is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both.
More informationNancy S. Swayze. 2 ND YEAR RESEARCH ELECTIVE RESIDENT S JOURNAL Volume V, 2000-2001. A. Background
Efficacy Of Insulin Sensitizing Agents In Subjects With Metabolic Syndrome X And Impaired Glucose Tolerance After 6 Months Of Diet And Exercise Therapy Nancy S. Swayze A. Background Impaired glucose tolerance
More informationMetabolic Syndrome Overview: Easy Living, Bitter Harvest. Sabrina Gill MD MPH FRCPC Caroline Stigant MD FRCPC BC Nephrology Days, October 2007
Metabolic Syndrome Overview: Easy Living, Bitter Harvest Sabrina Gill MD MPH FRCPC Caroline Stigant MD FRCPC BC Nephrology Days, October 2007 Evolution of Metabolic Syndrome 1923: Kylin describes clustering
More informationFamily History and Diabetes. Practical Genomics for the Public Health Professional
Family History and Diabetes Practical Genomics for the Public Health Professional Outline Overview of Type 2 Diabetes/Gestational Diabetes Familial/Genetic Nature of Diabetes Interaction of Genes and Environment
More informationWHAT DOES DYSMETABOLIC SYNDROME MEAN?
! WHAT DOES DYSMETABOLIC SYNDROME MEAN? Dysmetabolic syndrome (also referred to as syndrome X, insulin resistance syndrome, and metabolic syndrome ) is a condition in which a group of risk factors for
More informationClinical Research on Lifestyle Interventions to Treat Obesity and Asthma in Primary Care Jun Ma, M.D., Ph.D.
Clinical Research on Lifestyle Interventions to Treat Obesity and Asthma in Primary Care Jun Ma, M.D., Ph.D. Associate Investigator Palo Alto Medical Foundation Research Institute Consulting Assistant
More informationPreservation and Incorporation of Valuable Endoscopic Innovations (PIVI)
Preservation and Incorporation of Valuable Endoscopic Innovations (PIVI) The American Society for Gastrointestinal Endoscopy PIVI on Endoscopic Bariatric Procedures (short form) Please see related White
More informationMetabolic Syndrome with Prediabetic Factors Clinical Study Summary Concerning the Efficacy of the GC Control Natural Blood Sugar Support Supplement
CLINICALLY T E S T E D Natural Blood Sugar Metabolic Syndrome with Prediabetic Factors Clinical Study Summary Concerning the Efficacy of the GC Control Natural Blood Sugar Metabolic Syndrome with Prediabetic
More informationConnecticut Diabetes Statistics
Connecticut Diabetes Statistics What is Diabetes? State Public Health Actions (1305, SHAPE) Grant March 2015 Page 1 of 16 Diabetes is a disease in which blood glucose levels are above normal. Blood glucose
More informationDR. Trinh Thi Kim Hue
TYPE 2 DIABETES IN THE CHILD AND ADOLESCENT DR. Trinh Thi Kim Hue CONTENTS Definition Diagnosis Treatment Comorbidities and Complications Comorbidities and Complications Screening for T2D References DEFINITION
More informationDiabetes Complications
Managing Diabetes: It s s Not Easy But It s s Worth It Presenter Disclosures W. Lee Ball, Jr., OD, FAAO (1) The following personal financial relationships with commercial interests relevant to this presentation
More informationNew Medicare Preventive
New Medicare Preventive Services Screening Tests You Can Perform in the Office Charles B. Root, PhD Medicare is finally getting serious about preventive services. Until now, the limited preventive testing
More informationPrevention of and the Screening for Diabetes Part I Insulin Resistance By James L. Holly, MD Your Life Your Health The Examiner January 19, 2012
Prevention of and the Screening for Diabetes Part I Insulin Resistance By James L. Holly, MD Your Life Your Health The Examiner January 19, 2012 In 2002, SETMA began a relationship with Joslin Diabetes
More informationDIABETES MELLITUS. By Tracey Steenkamp Biokineticist at the Institute for Sport Research, University of Pretoria
DIABETES MELLITUS By Tracey Steenkamp Biokineticist at the Institute for Sport Research, University of Pretoria What is Diabetes Diabetes Mellitus (commonly referred to as diabetes ) is a chronic medical
More informationTake a moment Confer with your neighbour And try to solve the following word picture puzzle slides.
Take a moment Confer with your neighbour And try to solve the following word picture puzzle slides. Example: = Head Over Heels Take a moment Confer with your neighbour And try to solve the following word
More informationCauses, incidence, and risk factors
Causes, incidence, and risk factors Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. To understand diabetes,
More informationDISCLOSURES RISK ASSESSMENT. Stroke and Heart Disease -Is there a Link Beyond Risk Factors? Daniel Lackland, MD
STROKE AND HEART DISEASE IS THERE A LINK BEYOND RISK FACTORS? D AN IE L T. L AC K L AN D DISCLOSURES Member of NHLBI Risk Assessment Workgroup RISK ASSESSMENT Count major risk factors For patients with
More informationAntipsychotic Medications and the Risk of Diabetes and Cardiovascular Disease
Antipsychotic Medications and the Risk of Diabetes and Cardiovascular Disease Professional Tool #1: Screening and Monitoring in a High-Risk Population: Questions and Answers Overview of Cardiometabolic
More informationPowerPoint Lecture Outlines prepared by Dr. Lana Zinger, QCC CUNY. 12a. FOCUS ON Your Risk for Diabetes. Copyright 2011 Pearson Education, Inc.
PowerPoint Lecture Outlines prepared by Dr. Lana Zinger, QCC CUNY 12a FOCUS ON Your Risk for Diabetes Your Risk for Diabetes! Since 1980,Diabetes has increased by 50 %. Diabetes has increased by 70 percent
More informationBaskets of Care Diabetes Subcommittee
Baskets of Care Diabetes Subcommittee Disclaimer: This background information is not intended to be a comprehensive scientific discussion of the topic, but rather an attempt to provide a baseline level
More informationSecond- and Third-Line Approaches for Type 2 Diabetes Workgroup: Topic Brief
Second- and Third-Line Approaches for Type 2 Diabetes Workgroup: Topic Brief March 7, 2016 Session Objective: The objective of this workshop is to assess the value of undertaking comparative effectiveness
More informationAdult Weight Management Training Summary
Adult Weight Management Training Summary The Commission on Dietetic Registration, the credentialing agency for the Academy of Nutrition and Dietetics Marilyn Holmes, MS, RDN, LDN About This Presentation
More informationPATHWAYS TO TYPE 2 DIABETES. Vera Tsenkova, PhD Assistant Scientist Institute on Aging University of Wisconsin-Madison
PATHWAYS TO TYPE 2 DIABETES Vera Tsenkova, PhD Assistant Scientist Institute on Aging University of Wisconsin-Madison Overview Diabetes 101 How does diabetes work Types of diabetes Diabetes in numbers
More informationChallenges in Glycemic Control in Adult and Geriatric Patients. Denyse Gallagher, APRN-BC, CDE Endocrinology Nurse Practitioner
Challenges in Glycemic Control in Adult and Geriatric Patients Denyse Gallagher, APRN-BC, CDE Endocrinology Nurse Practitioner Provide an overview of diabetes prevalence; discuss challenges and barriers
More informationDiabetes and Obesity. The diabesity epidemic
Diabetes and Obesity Frank B. Diamond, Jr. M.D. Professor of Pediatrics University of South Florida College of Medicine The diabesity epidemic Prevalence of diabetes worldwide was over 135 million people
More informationPlus increased risk -malignancies -osteoarthritis -depression
Pharmacotherapy for Obesity: To Use or not to Use Joslin Diabetes Center Cardiometabolic Congress April 23, 2013 Jody Dushay, MD, MMSc Beth Israel Deaconess Medical Center Division of Endocrinology The
More informationStatins and Risk for Diabetes Mellitus. Background
Statins and Risk for Diabetes Mellitus Kevin C. Maki, PhD, FNLA Midwest Center for Metabolic & Cardiovascular Research and DePaul University, Chicago, IL 1 Background In 2012 the US Food and Drug Administration
More informationGetting Off the Chronic Disease Merry-Go-Round: What s the Weight of the Research?
Getting Off the Chronic Disease Merry-Go-Round: What s the Weight of the Research? Jody Dushay, MD MMSc Beth Israel Deaconess Medical Center Boston, MA Session 445 No disclosures Disclosure Jody Dushay,
More informationType 2 Diabetes and Prediabetes: A New Understanding of Cause and Treatment. Bruce Latham, M.D. Endocrine Specialists Greenville Health System
Type 2 Diabetes and Prediabetes: A New Understanding of Cause and Treatment Bruce Latham, M.D. Endocrine Specialists Greenville Health System Objectives for this presentation - Understand the thrifty genotype
More informationDeakin Research Online
Deakin Research Online This is the published version: Cameron, Adrian J., Shaw, J.E. and Zimmet, P.Z. 2003, Diabetes, in Diabetes and kidney disease : time to act, nternational Diabetes Federation, Brussels,
More informationINSULIN TREATMENT FOR TYPE 2 DIABETES MANAGEMENT
INSULIN TREATMENT FOR TYPE 2 DIABETES MANAGEMENT APIRADEE SRIWIJITKAMOL DIVISION OF ENDOCRINOLOGY AND METABOLISM DEPARTMENT OF MEDICINE FACULTY OF MEDICINE SIRIRAJ HOSPITOL QUESTION 1 1. ท านเคยเป นแพทย
More informationOverview of Diabetes Management. By Cindy Daversa, M.S.,R.D.,C.D.E. UCI Health
Overview of Diabetes Management By Cindy Daversa, M.S.,R.D.,C.D.E. UCI Health Objectives: Describe the pathophysiology of diabetes. From a multiorgan systems viewpoint. Identify the types of diabetes.
More informationDiabetes and Heart Disease
Diabetes and Heart Disease Diabetes and Heart Disease According to the American Heart Association, diabetes is one of the six major risk factors of cardiovascular disease. Affecting more than 7% of the
More informationBariatric Surgery 101
Bariatric Surgery 101 Dr. Brent Bell, MD Bariatric / General Surgeon Medical Conditions Caused By Morbid Obesity Type 2 DM Hypertension Cholesterol Sleep Apnea Fatty Liver Asthma Osteoarthritis Reduced
More informationRole of Body Weight Reduction in Obesity-Associated Co-Morbidities
Obesity Role of Body Weight Reduction in JMAJ 48(1): 47 1, 2 Hideaki BUJO Professor, Department of Genome Research and Clinical Application (M6) Graduate School of Medicine, Chiba University Abstract:
More informationGuidelines for the management of hypertension in patients with diabetes mellitus
Guidelines for the management of hypertension in patients with diabetes mellitus Quick reference guide In the Eastern Mediterranean Region, there has been a rapid increase in the incidence of diabetes
More informationPractice Guidelines for the
1 Treatment goals: Practice Guidelines for the The goal of treatment is to keep blood sugar at normal or near-normal levels. This reduces the risk of complications associated with diabetes. A normal fasting
More informationObesity Affects Quality of Life
Obesity Obesity is a serious health epidemic. Obesity is a condition characterized by excessive body fat, genetic and environmental factors. Obesity increases the likelihood of certain diseases and other
More informationType II diabetes: How to use the new oral medications
Type II diabetes: How to use the new oral medications A TWO-PART INTERVIEW WITH NANCY J.V. BOHANNON, MD, BY DAVID B. JACK, MD Several new oral drugs have been approved for the management of type II diabetes.
More informationtrends in the treatment of Diabetes type 2 - New classes of antidiabetic drugs. IAIM, 2015; 2(4): 223-
Review Article Pharmacological trends in the treatment of Diabetes type 2 - New classes of antidiabetic Silvia Mihailova 1*, Antoaneta Tsvetkova 1, Anna Todorova 2 1 Assistant Pharmacist, Education and
More informationCHAPTER V DISCUSSION. normal life provided they keep their diabetes under control. Life style modifications
CHAPTER V DISCUSSION Background Diabetes mellitus is a chronic condition but people with diabetes can lead a normal life provided they keep their diabetes under control. Life style modifications (LSM)
More informationDiabetes Prevention in Latinos
Diabetes Prevention in Latinos Matthew O Brien, MD, MSc Assistant Professor of Medicine and Public Health Northwestern Feinberg School of Medicine Institute for Public Health and Medicine October 17, 2013
More informationImproving cardiometabolic health in Major Mental Illness
Improving cardiometabolic health in Major Mental Illness Dr. Adrian Heald Consultant in Endocrinology and Diabetes Leighton Hospital, Crewe and Macclesfield Research Fellow, Manchester University Metabolic
More informationCME Test for AMDA Clinical Practice Guideline. Diabetes Mellitus
CME Test for AMDA Clinical Practice Guideline Diabetes Mellitus Part I: 1. Which one of the following statements about type 2 diabetes is not accurate? a. Diabetics are at increased risk of experiencing
More informationCHEM 1406 BSA/BMI Measurement Laboratory (revised 01/03//06) BSA, Body Surface Area
CHEM 1406 BSA/BMI (revised 01/03//06) BSA, Body Surface Area See pages 105-110 of dosage text for equations, calculations and adult nomogram See pages 270-273 of dosage calculation text for pediatric nomogram
More informationHow To Prevent Type 2 Diabetes
Introduction The Primary Prevention of Type 2 Diabetes AADE Practice Synopsis Issued December 1, 2014 The prevalence of type 2 diabetes is reaching epidemic proportions with more than 9.3% of adults in
More informationDiabetes Mellitus. Melissa Meredith M.D. Diabetes Mellitus
Melissa Meredith M.D. Diabetes mellitus is a group of metabolic diseases characterized by high blood glucose resulting from defects in insulin secretion, insulin action, or both Diabetes is a chronic,
More informationFaculty. Program Objectives. Introducing the Problem. Diabetes is a Silent Killer. Minorities at Greater Risk of Having Type 2 Diabetes
Diabetes: The Basics Understanding and Managing Diabetes (Part 1 of 3) Satellite Conference Tuesday, October 18, 2005 2:00-4:00 p.m. (Central Time) Produced by the Alabama Department of Public Health Video
More informationLong term Weight Management in Obese Diabetic Patients Osama Hamdy, MD, PhD, FACE
Long term Weight Management in Obese Diabetic Patients Osama Hamdy, MD, PhD, FACE Medical Director, Obesity Clinical Program, Director of Inpatient Diabetes Management, Joslin Diabetes Center Assistant
More informationVascular Risk Reduction: Addressing Vascular Risk
Vascular Risk Reduction: Addressing Vascular Risk Vascular Risk Reduction (VRR) Welcome! Presentation & Activities Focus: Managing known risk factors for vascular disease. Engage, collaborate and have
More informationBariatric Surgery in Class I Obesity
OBES SURG (2014) 24:487 519 DOI 10.1007/s11695-014-1214-1 OTHER Bariatric Surgery in Class I Obesity A Position Statement from the International Federation for the Surgery of Obesity and Metabolic Disorders
More informationCASE B1. Newly Diagnosed T2DM in Patient with Prior MI
Newly Diagnosed T2DM in Patient with Prior MI 1 Our case involves a gentleman with acute myocardial infarction who is newly discovered to have type 2 diabetes. 2 One question is whether anti-hyperglycemic
More informationStarting Insulin Sooner Than Later
Starting Insulin Sooner Than Later Rotorua GP Insulin Seminar 13 June 2014 Kingsley Nirmalaraj MBBS, FRACP, FACE Consultant Endocrinologist and Physician Tauranga Hospital/ Bay Endocrinology Ltd Declaration
More informationSubject Index. Bariatric surgery, obesity management 134
Subject Index Acromegaly, PCOS differential diagnosis 149, 150, 154, 155 Adipokines, see specific adipokines Adiponectin, metabolic syndrome role 41 43 Adolescents, PCOS diagnosis 16, 17 Adrenal hyperplasia,
More informationKaren Kovach M.S, R.D Chief Scientific Officer Weight Watchers International Inc.
Waking up to real solutions to Chronic Disease: Tackling obesity can reduce the burden of chronic disease and deliver substantial cost savings to struggling European healthcare systems Karen Kovach M.S,
More informationThe Arguments: T2DM - tremendous economic burden globally Lifestyle / Pharm Rx:
James Cromie The Arguments: T2DM - tremendous economic burden globally Lifestyle / Pharm Rx: INEFFECTIVE and UNSUSTAINED Bariatric surgery is an Effective and Durable treatment option Well established
More informationStrengthening the Pharmacist Skills in Managing Diabetes Practice Based Program 27 Contact Hours
Strengthening the Pharmacist Skills in Managing Diabetes Practice Based Program 27 Contact Hours Presented by New York State Council of Health system Pharmacists October 18 19, 2013 St. John s University,
More informationDiabetes Dispatch. Children with Type 2 Diabetes: How do we treat them? A L A S K A N A T I V E D I A B E T E S T E A M. Inside this issue:
A L A S K A N A T I V E D I A B E T E S T E A M Diabetes Dispatch Volume 8, Issue 1 Spring 2013 Compiled by Justin Park, Pharm.D. Candidate Type 2 diabetes is a relatively new disease in children and adolescents.
More informationThe Obesity Explosion: How Did We Get Here and Where Are We At?
The Obesity Explosion: How Did We Get Here and Where Are We At? Donald D. Hensrud, M.D., M.P.H. Chair, Division of Preventive, Occupational, and Aerospace Medicine Associate Professor of Preventive Medicine
More informationWelchol (colesevelam HCl) Receives FDA Approval to Reduce Blood Glucose in Adults with Type 2 Diabetes
For Immediate Release Company name: DAIICHI SANKYO COMPANY, LIMITED Representative: Takashi Shoda, President and Representative Director (Code no.: 4568, First Section, Tokyo, Osaka and Nagoya Stock Exchanges)
More informationOverweight, Obesity, and Diabetes in North Carolina
Overweight, Obesity, and Diabetes in North Carolina Overweight, obesity, and diabetes are among the most costly and harmful health problems in North Carolina. Moreover, the rates of overweight, obesity,
More informationBariatric Surgery. OHTAC Recommendation. Bariatric Surgery
OHTAC Recommendation Bariatric Surgery January 21, 2005 1 The Ontario Health Technology Advisory Committee (OHTAC) met on January 21, 2005 and reviewed bariatric surgery for morbid obesity. Obesity is
More informationUpstate New York adults with diagnosed type 1 and type 2 diabetes and estimated treatment costs
T H E F A C T S A B O U T Upstate New York adults with diagnosed type 1 and type 2 diabetes and estimated treatment costs Upstate New York Adults with diagnosed diabetes: 2003: 295,399 2008: 377,280 diagnosed
More informationKansas Behavioral Health Risk Bulletin
Kansas Behavioral Health Risk Bulletin Kansas Department of Health and Environment November 7, 1995 Bureau of Chronic Disease and Health Promotion Vol. 1 No. 12 Diabetes Mellitus in Kansas Diabetes mellitus
More informationType 2 diabetes Definition
Type 2 diabetes Definition Type 2 diabetes is a lifelong (chronic) disease in which there are high levels of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes. Causes Diabetes
More informationTreating Obesity in Primary Care Medical Practice
Treating Obesity in Primary Care Medical Practice Adam Gilden Tsai, MD, MSCE, FACP Internal Medicine & Metabolic-Surgical Weight Management, Kaiser Permanente Colorado Associate Professor, University of
More information4/4/2013. Mike Rizo, Pharm D, MBA, ABAAHP THE PHARMACIST OF THE FUTURE? METABOLIC SYNDROME AN INTEGRATIVE APPROACH
METABOLIC SYNDROME AN INTEGRATIVE APPROACH AN OPPORTUNITY FOR PHARMACISTS TO MAKE A DIFFERENCE Mike Rizo, Pharm D, MBA, ABAAHP THE EVOLUTION OF THE PHARMACIST 1920s 1960s 2000s THE PHARMACIST OF THE FUTURE?
More informationPrimary Care Guidance Program: Non-Alcohol related Fatty Liver Disease (NAFLD) Guidance on Management in Primary Care
Primary Care Guidance Program: Non-Alcohol related Fatty Liver Disease (NAFLD) Guidance on Management in Primary Care This advice has been developed to help GPs with shared care of patients with Non- Alcohol
More informationpublished online 8-25-10, http://healthpolicyandreform.nejm.org/?p=12171&query=home.
Comments to Interim Final Rules for group health plans and health insurance issuers relating to coverage of preventive services under the Patient Protection and Affordable Care Act (PPACA) File Code: OCIIO-9992-IFC
More informationImproving drug prescription in elderly diabetic patients. FRANCESC FORMIGA Hospital Universitari de Bellvitge
Improving drug prescription in elderly diabetic patients FRANCESC FORMIGA Hospital Universitari de Bellvitge High prevalence, but also increases the incidence. The older the patients, the higher the percentages
More informationDIABETES YOUR GUIDE TO
YOUR GUIDE TO DIABETES b What is diabetes? b Type 2 diabetes prevention b Prevention checklist b Living with diabetes b Complications b Terms to know b Resources To promote and protect the health of Canadians
More informationDiabetes mellitus. Lecture Outline
Diabetes mellitus Lecture Outline I. Diagnosis II. Epidemiology III. Causes of diabetes IV. Health Problems and Diabetes V. Treating Diabetes VI. Physical activity and diabetes 1 Diabetes Disorder characterized
More informationAccountable Care Project EMR Reporting Guide January 6, 2014
Accountable Care Project EMR Reporting Guide January 6, 2014 Web Reporting System The system can be accessed at http://www.nhaccountablecare.org. You will need the ID and password assigned to you by NHIHPP
More informationPosition Statement Weight Loss Surgery (Bariatric Surgery) and its Use in Treating Obesity or Treating and Preventing Diabetes
Position Statement Weight Loss Surgery (Bariatric Surgery) and its Use in Treating Obesity or Treating and Preventing Diabetes People with diabetes Losing excess weight will assist in the management of
More informationRoux-en-Y Gastric Bypass
Roux-en-Y Gastric Bypass Restrictive and malabsorptive procedure Most frequently performed bariatric procedure in the US First done in 1967 Laparoscopic since 1993 75% EWL in 18-24 months 50% EWL is still
More informationJune Fowler Brill, RN, CDE UC San Diego Diabetes and Pregnancy Program
June Fowler Brill, RN, CDE UC San Diego Diabetes and Pregnancy Program 1 Objectives Describe the different types of diabetes in pregnancy Review the incidence and screening for diagnosis of Gestational
More informationNova Scotia Guidelines for Acute Coronary Syndromes (Updating the 2008 Diabetes sections of the Guidelines)
Cardiovascular Health Nova Scotia Guideline Update Nova Scotia Guidelines for Acute Coronary Syndromes (Updating the 2008 Diabetes sections of the Guidelines) Authors: Dr. M. Love, Kathy Harrigan Reviewers:
More informationDiabetes 101: A Brief Overview of Diabetes and the American Diabetes Association What Happens When We Eat?
Diabetes 101: A Brief Overview of Diabetes and the American Diabetes Association What Happens When We Eat? After eating, most food is turned into glucose, the body s main source of energy. 1 Normal Blood
More informationType 2 Diabetes in Children
Type 2 Diabetes in Children February 19, 2005 Brandon Nathan, MD Endocrinology Department of Pediatrics University of Minnesota Medical School University of Minnesota Masonic Children s Hospital Agenda
More informationMortality Associated with Diabetes
Mortality Associated with Diabetes A review paper prepared for the 7th Global Conference of Actuaries, New Delhi, 15-16 February, 2005 Dr. David Muiry, MB;BS, FIA, FASI David_Muiry@swissre.com Introduction
More informationTechnology Assessment
Technology Assessment Lifestyle Interventions for Four Conditions: Type 2 Diabetes, Metabolic Syndrome, Breast Cancer, and Prostate Cancer Technology Assessment Program Prepared for: Agency for Healthcare
More informationThe Challenge of Preventing and Treating Diabesity Los Angeles University of Best Practices
The Challenge of Preventing and Treating Diabesity Los Angeles University of Best Practices The Right Care Initiative Long Beach Memorial Hospital July 26, 2013 Francine Ratner Kaufman, MD Distinguished
More information6.4 Diabetes. 6 Priority diseases and reasons for inclusion. Background. Developments since 2004. See Background Paper 6.4 (BP6_4DM.
6 Priority diseases and reasons for inclusion 6.4 Diabetes See Background Paper 6.4 (BP6_4DM.pdf) Background Diabetes and diabetes-related illnesses place an enormous burden on the health care systems
More information