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Diabetes in Older Adults: A Growing Population With Special Challenges. In the United States, 57.9% of patients with diabetes have 1 or more diabetes-related complications and 14.3% have 3 or more. Gestational Diabetes Mellitus (GDM) is defined as Impaired Glucose Tolerance (IGT) with onset or first recognition during pregnancy2. Diabetes mellitus is a chronic disease that poses a significant burden to patients. Management ofDiabetes mellitus Dr. Kartik Doshi 25.1.2012. •Engagement with psychosocial concerns –Addressing barriers to medication taking Improving Care and Promoting Health in Population: Standards of Medical Care in Diabetes - 2018. Clipping is a handy way to collect important slides you want to go back to later. The doctor should work closely with the nurse and other members of the diabetes health care team, whenever available, and with the person with diabetes. The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the prior position statements, published in 2012 and 2015, on the management of type 2 diabetes in adults. National guideline for diagnosis and management of Gestational Diabetes endorses the single step test recommended by WHO for diagnosis of GDM using a 75gm The hospital management of Hypoglycaemia in adults with Diabetes Mellitus (Revised April 2018) Hypoglycaemia is the commonest side effect of insulin and sulfonylureas in the treatment of all types of diabetes and presents a major barrier to satisfactory long term glycaemic control. Abnormal glucose counterregulation in insulin-dependent diabetes mellitus. Management of these conditions requires an in-depth knowledge of blood glucose monitoring. Residue prolong the action…. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. 1st generation – no more used so we will discuss about only 1 stgen,bcoz hypoglycemia are more widthem.hypoglycemia – ore common in elderly and hepatic and renal fun. Detemir fatty acid side chain - prolong the action, GLP1 analogue greater effectiveness of reducing glucose excursions and also ass. Diabetes mellitus type 1 results when the pancreas no longer produces significant amounts of the hormone insulin, usually owing to the autoimmune destruction of the insulin-producing beta cells of the pancreas. Diabetes. A systematic evaluation of the literature since 2014 informed new recommendations. –High-quality diabetes self-management education and support (DSMES) •Clinical content & skills •Behavioral strategies (goal setting, problem solving, etc.) The estimated number of Americans with diabetes increased from 12.1 million in 2002 to 29.1 million in 2017. With time, the monomers slowly dissociate. The multihexamers form a depot at the site of injection and represents the primary mechanism of protraction. CDC1 The CDC projects that by 2050, as many as 33 % of U.S. adults could have diabetes. A systematic evaluation of the literature since 2014 informed new recommendat … The unique properties of the side chain (glutamic acid and fatty acid) facilitates the formation of multihexamers in the presence of zinc ions (contained in the formulation). 1 unit rabbit decrease the glucose 45mg/dl after 30 min…. 8. Gestational diabetes mellitus (GDM), or diabetes first recognised during pregnancy, is being diagnosed with increasing frequency. Interaction of anti-insulin antibodies and impaired glucagon and epinephrine secretion. OUTPATIENT MANAGEMENT OF ADULT DIABETES MELLITUS AUGUST 2018 Why Focus ON DIABETES? Weight loss, Exenetide – reduce hypoglucemia episodes, asso. Chapter 4: The Diagnosis and management of monogenic diabetes in children and adolescents CDC2 Course Hero is not sponsored or endorsed by any college or university. View Notes - DIABETES MELLITUS.ppt from PHARM 300 at McGill University. This represents the secondary mechanism of protraction and provides a form for “buffering” of insulin degludec blood levels. ICMR Guidelines for Management of Type 2 Diabetes 2018 1 SECTION 1 INTRODUCTION 1.1 Defi nition Diabetes mellitus is a syndrome of multiple etiologies characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action or both. Management ofDiabetes mellitus Dr. Kartik Doshi 25.1.2012 2. The monomers are able to diffuse into the capillary where they bind to albumin (due to the fatty acid side chain). Continuous Subcutaneous Insulin Infusions, Mimic endogenous insulin secretion; basal and. Necessary lifestyle changes, the complexities and possible side effects of therapy make patient education and self-management important aspects of diabetes care. We evaluated telemedicine’s effectiveness in delivering endocrinology care from Atlanta-based endocrinologists. 2018 2018 AAHA Diabetes Management Guidelines for Dogs and Cats. Special tests – C peptide level ( diagnsis and also suggest insulin requirement), insulin antibodies. Bolli G, de Feo P, Compagnucci P, Cartechini MG, Angeletti G, Santeusanio F, Brunetti P, Gerich JE. 1 In addition, new diagnostic criteria, now widely adopted in Australia, 2–4 have greatly increased diagnosis of GDM. You can change your ad preferences anytime. Glucose transporter Insulin dependent and independent glucoseutiliztion, regulation of insulin by chemical. Overview• Learning Objectives • Management of type 1 DM• Introduction • Management of type 2• Disease burden DM• Physiology • Recent advances• Pathogenesis • Summary • References The term “Diabetes Mellitus” describes a metabolic disorder of multiple etiology characterized by chronic hyperglycemia with disturbances […] Women are entering pregnancy at an older age, are more likely to be obese or overweight and are often from a high‑risk ethnic background. Nursing Management Diabetes Mellitus Covenant School of Nursing N201 Fall, 2009 Gloria Rodriguez, MSN.RN,CDE ... – A free PowerPoint PPT presentation (displayed as a Flash slide show) on PowerShow.com - id: 3bffba-ZDMzM Diet is the cornerstone of therapy for diabetes mellitus. Neuronal and hormonal, Already established patients – look for diabetes knowledge, HbA1c level, no. This disorder is often 3.4 Management of hyperglycemia r Pharmacological intervention 3.5 General approach to management of diabetes 3.6 Special situations in the management of diabetes 4 4 5 5 8 13 15 4 Treatment of associated metabolic conditions 4.1 Hypertension 4.2 Hyperlipidemia 4.3 Anti rplatelet therapy 17 17 17 17 5 Management of acute complications of diabetes DIABETIC MELLITUS DEFINITION:- Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. See our Privacy Policy and User Agreement for details. 3 principles in management of DM – eliminate symptoms, microvascular and macrovascular complication should be avoided, and achieve normal lifestyle as possible…. Multiple vascular risk factors and wide-ranging complications make diabetes care complex and time-consuming, and many areas of healthcare services must be involved for optimal management. Dental Management of Diabetes Mellitus: Review of Literature Aggarwal A 1* Gupta A 2 Sharma P 3 Rajeev Pandey 4 Garg B 5 Kumar S 6 1 Reader, Department of Prosthodontics , … See our User Agreement and Privacy Policy. At the target organs, the insulin degludec monomers are able to activate the insulin receptors as the affinity for the IR is much higher than for the albumin (which is also present in the interstitial fluid, but at a lower concentration than in blood). If you continue browsing the site, you agree to the use of cookies on this website. • Management of non-insulin-dependent diabetes mellitus (NIDDM) requires teamwork. 1983 Feb; 32 (2):134–141. Significant evidence exists that supports a range of interventions to improve diabetes outcomes. II. Looks like you’ve clipped this slide to already. Inhaled insulin – not yet commercially available. The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the prior position statements, published in 2012 and 2015, on the management of type 2 diabetes in adults. most amputations in diabetes are preceded by foot ulceration, a thorough understanding of the causes and management of ulceration is essential. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. 1. Diabetes is a complex, chronic illness requiring continuous medical care with multifactorial risk-reduction strategies beyond glycemic control. Background Veterans with type 1 diabetes who live in rural Alabama and Georgia face barriers to receiving specialty diabetes care because of a lack of endocrinologists in the Central Alabama Veterans Health Care System. Education of the person with diabetes and his/her In patients diagnosed with diabetes mellitus (DM), the therapeutic focus is on preventing complications caused by hyperglycemia. CGMS – interstial fluid measurement of glucose ….. Hemoglobinopathie s – Hba1cis not reliable ………, Most insulin are formulated as u-100 (100units/ml0 regular insulin U-500 (500units/ml) insulin by bioassay units …. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) Melanie J. Davies1,2 & David A. D’Alessio3 & Judith Fradkin4 & Walter N. Kernan5 & Chantal Mathieu6 & With weight loss, actions on glucagon nd other b cellprotective effect, Glimipiride – 6-8mg/day, pioglitazone 45mg/day, rosiglitazone – 8 mg/day). Classification (4 clinical classes classification criteria, 2018 American Diabetes Association) Type 1 diabetes (autoimmune B-cell destruction, usually leading to absolute insulin deficiency) Type 2 diabetes (results from a progressive insulin secretory defect on a background of insulin resistance) Other specific types of diabetes (due to other causes, e.g. Telemedicine is a promising solution to help increase access to needed health care. Education – SMBG, ketone bodies, insulin administration, signs and treatment of hypoglycemia Nutrition – MNT, type 1 timing, type 2 less calori intake ….Exercise-decrease glucose level and also increase insulin sensitivity.aerobic exercise. These include additional focus on lifestyle management and diabetes self-management … Diabetes. • Self-care is an essential strategy. An individual with diabetes can often manage his condition by diet and exercise alone. Compromise and taking long acting agents…… other s/e agranulocytosis, rash. J Am Anim Hosp Assoc 54:1–21 Callegari C., Mercuriali E., Hafner M. et al 2013 Survival times and prpgnostic factors in cats with newly diagnosed diabetes mellitus: 114 cases (2000-2009). *DO NOT EDIT* Note: this slide is animatedInsulin degludec tends to exist as dihexamers in the formulation (in pen). Exercising regularly. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Diabetes Mellitus: Management of Diabetes Authored by: Virginia G. Miller, PhD, RN, CS, FNP Contact Hours: Valid for 7.0 (ANCC) and 8.4 (ABN) contact hours valid July 21, 2016 through July 21, 2018 Target Audience: Registered Nurses and Licensed Practical Nurses Purpose/Goal: The purpose of this activity is to provide a comprehensive review of Diabetes Mellitus If you continue browsing the site, you agree to the use of cookies on this website. • Diabetes is a growing problem . At the injection site, as phenol is rapidly diffuses away, insulin degludec quickly forms multihexamers. Ongoing patient self-management education and support are critical to preventing acute complications and reducing the risk of long-term complications. Also quantified by hypoglycemic convulsion in mice …… now purified form… chemcal assay…. According to the CDC, an estimated 30.3 million people in the United States received a diagnosis of diabetes in 2015. 28 units/1mg…..glargine 2 arg. 1 Although the majority of patients affected by diabetes receive a proper diagnosis, 23.8% of affected adults remain undiagnosed. Pharmacotherapy Management of Diabetes Mellitus, Diabetes Therapeutics with special populations 2013 outline, Medical University of South Carolina • PHARM 101. Diabetes mellitus is a group of metabolic diseases in which the person has high blood glucose (blood sugar) level either due to inadequate insulin production or because the body’s cells do not respond properly to insulin or both. Chapter 3: Type 2 Diabetes mellitus in youth Phil Zeitler, Silva Arslanian, Junfen Fu, Orit Pinhas-Hamiel, Thomas Reinehr, Nikhil Tandon, Tatsuhiko Urakami, Jencia Wong and David M Maahs. Ueda2016 wark shop - insulin therapy - mohamed mashahit, 2013 6-19 DM, Pre-DM & MetS PSEM Weekend course bulacan insulin 101, Insulin therapy: art of initiation and titration, Experimental evaluation of antifertility agents, No public clipboards found for this slide. It is essential that nurses are aware of normal blood glucose levels, so that they can respond to complications caused by elevated and reduced blood glucose levels. You hold the keys to managing your diabetes by: Planning what you eat and following a balanced meal plan. Taking medication, if prescribed, and closely following the … When a person with diabetes neglects this important aspect of diabetes management, then his/her blood sugars become uncontrolled. Global Diabetes Drug Market will be US$ 78.10 Billion by 2026 - According to the latest report by Renub Research, titled "Diabetes Drug Market Global & Forecast By Disease, Oral Therapy, Injection, Insulin, Regions, Company" Diabetes drugs are used to treat pre-diabetes and diabetes mellitus type 2 by controlling the blood glucose level of the body. Chapter Highlights. Download Chapter. 200 mg/dl target. Diabetes management 1. Diabetes Mellitus Greek word "diabainein" meaning "to siphon or pass through" Latin word "mellitus" meaning "sweetened with honey" "To pass through sweetened with Honey" 5. The last 90 years have seen considerable advances in the management of type 1 and type 2 diabetes. Now customize the name of a clipboard to store your clips. Methods We condu… The term diabetes includes several different metabolic disorders that all, if left untreated, result in abnormally high concentration of a sugar called glucose in the blood. of hypoglycemia episodes, any chronic complications, chronic glucose level SMBG, exercise and nutrtion. J Am Vet Med Assoc 243: 91-5. 1982 Jun; 31 (6 Pt 1):479–483. Management of hyperglycaemia in type 2 diabetes, 2018. The annual incidence of foot ulcers in diabetes is approximately 2% in most Western countries, although higher rates have been reported Prof MacLean of Guy's Hospital wrote in the Postgraduate Medical Journal in 1926 about the numerous challenges that faced patients and their healthcare professionals in delivering safe and effective diabetes care at that time. 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