Category: Fundamentals
Metabolic acidosis is a concern with biguanides. Ideally, metformin should be withheld for 48 hours prior to the administration of iodinated contrast media. The serum creatinine should be monitored to asses the risk for renal failure.
Category: Fundamentals
The ADA has recommended lifestyle changes at the time of type 2 diabetes diagnosis. Metformin is the initial drug of choice because it does not induce weight gain, has low cost, good tolerability and tends not to induce hypoglycemia.
Category: Fundamentals
Medications that decrease insulin resistance include biguanides and thiazolidinediones. Drugs that reduce glucose absorption include α-glucosidase inhibitors. Oral hypoglycemic agents generally lower HbA1C levels by 0.5 to 1.5%.
Category: Fundamentals
The HbA1c measurement provides insight into the quality of glycemic control over time. Given the long half-life of red blood cells, the percentage of HbA1c is an index of glucose concentration of the preceding 6 to 8 weeks.
Category: Fundamentals
Patients with type 2 diabetes demonstrate impaired insulin function related to poor insulin production, failure of insulin to reach the site of action or failure of an end-organ response to insulin.
Category: Fundamentals
The patient with type 1 diabetes is usually lean, younger than 40 years and prone to ketosis. Plasma insulin levels are absent to low. Plasma glucagon levels are high and patients require insulin therapy to treat their symptoms.
Category: Fundamentals
Impaired glucose tolerance (IGT) has been replaced by the term prediabetes to identify individuals at high risk for the development of diabetes. The pathogenesis of prediabetes is thought to be related to insulin resistance.
Category: Fundamentals
Myriad causes of diabetes have been identified, including chronic pancreatitis, cystic fibrosis, genetic defects in the beta cell or in insulin receptors and chemical-induced (eg, chemotherapeutic, antipsychotic, or antiretroviral medications).
Category: Fundamentals
The American Diabetes Association (ADA) defines four major types of diabetes mellitus - type 1 diabetes mellitus, type 2 diabetes mellitus, gestational diabetes and diabetes due to secondary disease processes or drugs.
Category: Fundamentals
The most striking feature of type 1 diabetes is the nearly total lack of insulin-secreting beta cells and insulin, with the preservation of glucagon-secreting alpha cells, somatostatin-secreting delta cells, and pancreatic polypeptide–secreting cells.
Category: Fundamentals
Glucagon is released in response to hypoglycemia as well as to stress, trauma, infection, exercise and starvation. It increases hepatic glucose production within minutes, although transiently.
Category: Fundamentals
When glucose is not transported into the cells because of a lack of food intake or lack of insulin, the body perceives a fasting state and releases glucagon, attempting to provide the glucose necessary for brain function.
Category: Fundamentals
Insulin suppresses endogenous glucose production and stimulates glucose use. Insulin is secreted from the beta cells of the pancreatic islets into the hepatic portal circulation and has important actions on the liver and peripheral tissues.
