MAJOR RISK FACTORS TOR TYPE 2 DIABETES AND SCREENING FOR TYPE 2 DIABETES

admin — Wed, 01 Jun 2011 10:25:35 +0000

_Family history of diabetes (i.e., parents or siblings with diabetes) Overweight (BMI >= 25 kg/m2) Habitual physical inactivityRace/ethnicity (e.g., African-Americans, Hispanic-Americans, Native Americans, Asian-Americans, and Pacific Islanders) Previously identified IFG or IGT Hypertension (a 140/90 mmHg in adults) HDL cholesterol ? 35 mg/dl and/or a triglyceride level a 250 mg/dl History of GDM or delivery of a baby weighing > 9 lb Polycystic ovary syndromeThe best screening test is a fasting plasma glucose value, determined in a certified laboratory, after an overnight fast of at least 8 hours. It is important to recognize that fingerstick capillary glucose values are not accurate enough for screening purposes. An FPG > =126 mg/dl should be repeated; if still elevated, the test indicates that diabetes is present. If FPG is <= 126 mg/dl and suspicion of diabetes is high, an oral glucose tolerance should be performed. In view of the results of the Diabetes Prevention Program (DPP), an intervention trial done in overweight subjects with IGT, an increased use of oral glucose tolerance testing in people at high risk for type 2 diabetes should be done in the future. Intervention may then be indicated if IGT is found because studies have shown that onset of diabetes can be delayed by intensive diet and exercise or metformin therapy.An interpretation of the screening test should be provided to the patient, and follow-up evaluation and treatment should be recommended. Although community screening programs may increase public awareness of diabetes, they are not recommended as a cost-effective approach to reduce the morbidity and mortality associated with diabetes in presumably healthy people.*19\357\8*

HYPOGLYCAEMIA—THE EXCEPTION TO THE LOW G.I. RULE

admin — Fri, 08 May 2009 14:00:00 +0000

In people with diabetes who are treated with insulin or tablets the blood sugar may sometimes fall below 4 millimoles per litre which is the lower end of the normal range. When this happens you might feel hungry, shaky, sweaty and be unable to think clearly. This is called a hypo (short for ‘hypoglycaemia’).

A hypo is a potentially dangerous situation and must be treated straight away by eating some carbohydrate food. In this case you should pick a carbohydrate with a high G.I. factor because you need to increase your blood sugar quickly. Jelly beans (with a G.I. factor of 80) are a good choice. If you are not due for your next meal or snack you should also have some low G.I. carbohdyrate, like an apple, to keep your blood sugar from falling again until you next eat.

Hypos in the night were a particularly worrying problem for Jane. Her evening insulin doses had been adjusted in an effort to stop her blood sugar going too low at night, but she believed experimenting with her supper carbohydrate could also help. After trying all sorts of different foods and many 3 am blood tests, she struck the answer that the G.I. factor predicted would work—milk! Jane found that a large glass of milk before going to bed, rather than her usual plain biscuits was easy to have, and maintained her blood sugar at a good level through the night.

Sometimes, despite your best efforts with diet, tablets will still be needed to obtain good blood sugar control. This is eventually the case for most people with type 2 diabetes.

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Pharmasweblog. Medical Weblog » Diabetes

MAJOR RISK FACTORS TOR TYPE 2 DIABETES AND SCREENING FOR TYPE 2 DIABETES

HYPOGLYCAEMIA—THE EXCEPTION TO THE LOW G.I. RULE