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Your search term(s) "hypoglycemia" returned 234 results.

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Educating Patients With Type 2 Diabetes on a New Class of Drug, Dipeptidyl Peptidase 4 Inhibitors. Diabetes Educator. 33(Suppl 5):111S-113S. May - June 2007.

New and innovative antihyperglycemic therapies for people with type 2 diabetes have recently become available. This article is from a special supplement about an American Association of Diabetes Educators’ continuing education program called a Multidisciplinary Approach in Addressing Novel Mechanisms in the Management of Type 2 Diabetes, held in Los Angeles in August 2006. In this article, the author considers patient education approaches for people with type 2 diabetes who are being treated with dipeptidyl peptidase 4 (DPP-4) inhibitors. DPP-4 inhibitors, including sitagliptin and vildagliptin, can be given orally once a day and are not associated with an increased risk for hypoglycemia or weight gain. Patient adherence to any drug regimen remains a problem; reports show that adherence to oral medications ranges from 65 to 85 percent. The author briefly reviews some of the reasons for patient nonadherence and offers suggestions about how diabetes educators can be an active part of the diabetes patient care team. The patient with a good health care team, appropriate support, and adequate diabetes self-management education (DSME) is more likely to comply with drug regimens and prevent complications. 1 figure. 1 table. 8 references.

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Frequency, Causes and Risk Factors for Hypoglycaemia in Type 1 Diabetes. IN: Frier, B. and Fisher, M., eds. Hypoglycaemia in Clinical Diabetes. 2nd ed. Somerset, NJ: John Wiley & Sons. 2007. pp 48-82.

This chapter on the frequency, causes, and risk factors for hypoglycemia in type 1 diabetes is from a textbook that provides in-depth information for the understanding and management of hypoglycemia in clinical diabetes care. The author provides various definitions of hypoglycemia, including biochemical definitions as well as clinical definitions. The author discusses the frequency of hypoglycemia, the severity of hypoglycemia, the occurrence of asymptomatic, biochemical hypoglycemia, the causes of hypoglycemia, the role of patient error, the impact of alcohol and exercise on hypoglycemia, intensive insulin therapy as a risk factor for hypoglycemia, acquired hypoglycemia syndromes, the genetic predisposition to hypoglycemia, patients with absent endogenous insulin secretion, nocturnal hypoglycemia, microvascular complications, and social and psychological factors associated with hypoglycemia. The author notes that episodes of hypoglycemia can be classified as mild or severe depending on whether the individual is able to self-treat. Although hypoglycemia is common, most episodes can be handled by the patient or family and only rarely require emergency services intervention. 7 figures. 5 tables. 94 references.

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Getting a Grip on Diabetes: Quick Tips and Techniques for Kids And Teens. 2nd ed. Alexandria, VA: American Diabetes Association. 2007. 191 p.

Authors and brothers Spike and Bo Loy know what it is like to grow up with diabetes because both have lived with it for more than 10 years. This book explains how to control blood sugar levels in a way teenagers can identify with and understand. The book includes 23 chapters that discuss blood glucose, hyperglycemia, hypoglycemia, managing growth spurts, getting organized for diabetes care, elementary school issues, outdoor school and camp, sports, pursuing academics, eating out at restaurants, traveling with one’s family, driving, partying, starting college, traveling alone, insulin, insulin pumps, dealing with doctors, coping with sick days, accidents, surgery, meals and snacks, nutrition, schedules, siblings, practical tips for everyday diabetes management, and diabetes research. The book includes special “What the Doc Says” comments in each section from Marc Weigensberg, MD. The book concludes with a list of the authors’ favorite products and supplies, and a list of recommended books. A subject index is provided. The book is illustrated with black-and-white photographs of the boys and their activities growing up.

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Goals of Metabolic Management of Gestational Diabetes: Is At All About the Sugar?. Diabetes Care. 30(Suppl 2): S180-S187. July 2007.

Gestational diabetes mellitus (GDM), defined as glucose intolerance first recognized in pregnancy, has been traditionally considered a disorder primarily of carbohydrate metabolism. Thus, blood glucose levels have become the main focus of monitoring and directing treatment during pregnancy for these women. This article reviews the goals of metabolic management of GDM. The authors note that the traditional focus on glycemic metabolism ignores the role of other potential fetal fuels such as proteins and lipids in the pathophysiology of GDM. Topics discussed include the glycemic profile in normal and diabetic pregnancy, the diurnal glycemic profile in nondiabetic pregnancies, postprandial glycemic profile and its use in management approaches, glycemic profile in relation to maternal weight, the problem of undiagnosed hyperglycemia and hypoglycemia, the role of the HbA1c test in the management of GDM, the use of anthropometric measurements and ultrasound for assessment of fetal growth in GDM, the interrelationship between level of glycemia and perinatal fetal mortality, the impact of obesity not complicated by GDM, amino acids and protein metabolism in GDM, and lipid metabolism and GDM. The authors conclude that GDM is characterized by many metabolic changes diverting physiology to pathophysiology in pregnancy. 3 tables. 79 references.

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Guide to Insulin And Type 2 Diabetes. Alexandria, VA: American Diabetes Association. 2007. 234 p.

This handbook helps people with type 2 diabetes understand the role of insulin in a comprehensive program of care to manage their disease. The author first reminds readers that type 2 diabetes is a progressive disease, so even patients who are doing all the recommended strategies of diet, exercise, and medications may still find the need to incorporate insulin to maintain appropriate blood glucose levels. The book includes chapters that cover the basics of blood glucose physiology and the normal progression of type 2 diabetes, the psychological aspects of adding insulin into a care regimen, the myths surrounding insulin, the different types of insulin, the usual insulin regimen, using insulin to cover meals, carbohydrate counting, sliding scales and pattern management, preventing and treating hypoglycemia, sick-day guidelines, and special circumstances such as traveling, pregnancy, and religious fasting. A final section walks readers through the practical aspects of buying, storing, and injecting insulin. Throughout the book are lengthy quotes from people who have experienced the shift to insulin therapy and who share their thoughts and perspectives about the topics under consideration. The book concludes with a subject index, a description of some of the other titles available from the American Diabetes Association (ADA), and a summary of the activities and contact information for various components of the ADA.

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Handling Diabetes Emergencies: Your Guide to Recognizing And Treating Problems Fast. South Deerfield, MA: Channing Bete Company. 2007. 4 p.

This pocket-sized guide to diabetes emergencies helps patients recognize and treat problems quickly. The guide focuses on problems with blood glucose levels, offering a chart of the common warning signs and recommended treatments for hypoglycemia, hyperglycemia, and ketoacidosis. Basic information about each condition is provided, and readers are encouraged to follow a healthy routine to help avoid problems with blood glucose levels. The guide provides space for patients to record the contact information for their health care providers. The guide is illustrated with full-color photographs and graphics.

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High Expectations for Sitagliptin. Today's Dietitian. 9(2): 22-24. February 2007.

This article reviews the use of sitagliptin, a dipeptidyl peptidase IV (DPP–IV) inhibitor that prolongs the physiologic action of the incretin hormones, which are involved in blood glucose regulation. Incretin hormones are produced in cells lining the gut; concentrations of these hormones rise rapidly after food is ingested. GLP-1 stimulates first-phase, glucose-dependent (meal-induced) insulin secretion from the pancreas. GLP–1 inhibits gastric emptying and inhibits glucagon secretion from the alpha cells of the pancreas. GIP, in contrast, stimulates insulin secretion from the pancreas and regulates the proliferation and survival of beta cells. DPP-IV is a membrane-associated enzyme found in cells throughout the body; it neutralizes the incretin hormones and plays a role in immune function by stimulating T-cell activation and proliferation. Sitagliptin blocks the production of DPP–IV temporarily, so impaired incretin hormones have a longer life span and thus have more time to lower blood glucose levels. It is glucose-dependent, so it works only when food is ingested; thus, hypoglycemia associated with this drug is rare. Sitagliptin has been approved for use as a monotherapy, or in combination with metformin or pioglitazone. The article concludes with a summary of the dosing recommendations for sitagliptin. 6 references.

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Hypoglycaemia in Children With Diabetes. IN: Frier, B. and Fisher, M., eds. Hypoglycaemia in Clinical Diabetes. 2nd ed. Somerset, NJ: John Wiley & Sons. 2007. pp 190-216.

This chapter on hypoglycemia in children with diabetes is from a textbook that provides in-depth information for the understanding and management of hypoglycemia in clinical diabetes care. The author stresses that children are very susceptible to repeated and severe episodes of hypoglycemia, with long-term consequences. This chapter examines the etiology, physiology, consequences, and management of episodes of hypoglycemia during childhood. Specific topics include a definition of hypoglycemia in childhood diabetes; nocturnal hypoglycemia; risk factors for hypoglycemia; glycemic control; the varying insulin requirements at different ages; intensive insulin regimens; diet and nutrition; physical activity and exercise; genetics; counterregulation in childhood, glucagon; epinephrine response; the effect of sleep stage on counterregulation; and the consequences of hypoglycemia, including cognitive impairment, hypoglycemic hemiplegia, and fear of hypoglycemia. A final section of the chapter focuses on the management of hypoglycemia, including prevention, patient education, insulin use, diet therapy, and exercise. 3 figures. 3 tables. 109 references.

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Hypoglycaemia in Clinical Diabetes. 2nd ed. Somerset, NJ: John Wiley & Sons. 2007. 346 p.

This textbook provides in-depth information for the understanding and management of hypoglycemia in clinical diabetes care. The editors note that hypoglycemia may be becoming even more prevalent as patients with diabetes are trying to achieve stricter metabolic targets to control their blood glucose levels. The book includes 14 chapters: normal glucose metabolism and responses to hypoglycemia; the symptoms of hypoglycemia and its effects on mental performance and emotions; the frequency, causes, and risk factors for hypoglycemia in type 1 diabetes; nocturnal hypoglycemia; moderators, monitoring, and management of hypoglycemia; counterregulatory deficiencies in diabetes; impaired awareness of hypoglycemia; risks of strict glycemic control; hypoglycemia in children with diabetes; hypoglycemia in pregnancy; hypoglycemia in type 2 diabetes and in elderly people; mortality, cardiovascular morbidity, and the possible effects of hypoglycemia on diabetes complications; the long-term effects of hypoglycemia on cognitive function and the brain in people with diabetes; and living with hypoglycemia. Each chapter includes figures and tables, and concludes with a list of references. A subject index concludes the text.

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Hypoglycaemia in Pregnancy. IN: Frier, B. and Fisher, M., eds. Hypoglycaemia in Clinical Diabetes. 2nd ed. Somerset, NJ: John Wiley & Sons. 2007. pp 216-238.

This chapter on hypoglycemia in pregnancy is from a textbook that provides in-depth information for the understanding and management of hypoglycemia in clinical diabetes care. The authors describe why hypoglycemia is a recognized problem during pregnancy and how this influences the management of diabetic pregnancies. They stress that meticulous control of blood glucose before conception and throughout the pregnancy is the cornerstone of management to reduce congenital anomalies, neonatal morbidity, and mortality. However, this tight control may lead the woman to experience more frequent episodes of hypoglycemia. Topics covered include metabolic changes during pregnancy, the frequency of hypoglycemia in diabetic pregnancy, preconception care, organization of clinical care, optimizing insulin regimens, dietary and lifestyle management, management and timing of delivery, management of diabetes during labor, the risks of maternal hypoglycemia to the mother, microvascular complications of pregnancy, and complications in the infant of the diabetic mother. The authors conclude there is no evidence to suggest that hypoglycemia has an adverse effect on the human fetus or the infant of a diabetic mother, although significant maternal morbidity may occur. 3 figures. 6 tables. 56 references.

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