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

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Preconception Counseling and Type 2 Diabetes. Diabetes Spectrum. 20(2): 117-123. Spring 2007.

This article reviews the idea of preconception counseling for women who have type 2 diabetes. The author first reviews the recommendations of professional groups, including the American Diabetes Association and the American College of Obstetricians and Gynecologists, both of which recommend preconception counseling (PC) for all women with diabetes who have child-bearing potential. The author then reviews characteristics of women seeking PC and presents a case study of a 33-year-old African American woman, diagnosed with type 2 diabetes after the birth of her second child, who wants to know about additional pregnancies. The author conducted a literature study that would address some of the questions raised by this patient’s concerns. The author discusses the information found in 15 relevant studies, including metabolic control, rates of spontaneous abortion, perinatal mortality, congenital anomalies, pregnancy and delivery complications, macrosomia, and neonatal hypoglycemia. A final section considers the implications of these findings for clinical practice care of women with diabetes who are seeking preconception counseling. 3 tables. 34 references.

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Products for Treating Low Blood Glucose. Diabetes Forecast. 60(1): RG52-RG54. January 2007.

This article, from the annual resource guide that is published as a supplement to Diabetes Forecast, brings readers up-to-date on products for treating low blood glucose levels. The author first reviews the causes of hypoglycemia—low blood glucose—and its symptoms, and then considers approaches to treating the condition. The author reviews three things to remember when considering purchasing a commercial product to treat hypoglycemia: how fast it works, the form it comes in, and cost. One section briefly considers products that contain ingredients that are designed to either aid in the prevention of hypoglycemia or lessen the rise in blood glucose after meals or snacks. One chart summarizes the features of the products discussed. 1 table.

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Psychological Insulin Resistance: The Patient Perspective. Diabetes Educator. 33(Suppl 7): 241S-244S. July - August 2007.

This article is from a special supplement about an American Association of Diabetes Educators’ continuing education program called The Tipping Point: Overcoming Psychological Insulin Resistance, held in Los Angeles, in August 2006. In this article, the author offers the type 2 diabetes patient’s perspectives on psychological insulin resistance (PIR). The author reminds readers that because type 2 diabetes is a progressive disease, most patients will likely require insulin therapy at some point. However, studies of compliance rates with oral antidiabetes drugs and insulin show that compliance rates range from 36 to 93 percent, with the average compliance rate for insulin being about 63 percent. Thus, PIR poses a significant barrier to what is already a difficult situation. The author reviews the attitudes toward insulin therapy, beliefs underlying PIR, the belief on most patients’ part that insulin is ineffective, strategies for overcoming PIR, the problem of clinicians who harbor negative beliefs about insulin therapy, and anxiety about insulin therapy and potential episodes of hypoglycemia. The author concludes by encouraging diabetes educators to play an important role in educating physicians, patients, and the community about the role of insulin in type 2 diabetes and to share the good news about the safety and effectiveness of contemporary insulin preparations. Insulin therapy can be an appropriate, effective, and flexible treatment option during all stages of type 2 diabetes. 2 figures. 1 table. 19 references.

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Removing Barriers to Insulin Therapy. Diabetes Educator. 33(Supl 3): S60-S65. March-April 2007.

This section on removing barriers to insulin therapy is from a special supplement of the Diabetes Educator that presents a continuing education program on early intervention with insulin analogs, from the American Association of Diabetes Educators (AADE) 2006 Annual Meeting in Los Angeles. The author stresses that understanding patient-oriented concerns is critical to helping patients overcome the psychological resistance to initiating insulin therapy. The article identifies 10 reasons that patients resist starting insulin and presents strategies for supporting patients through the decision-making process. The ten reasons are: lack of knowledge, cultural taboos and family beliefs, fear of needles or injection pain, fear of hypoglycemia, fear of weight gain, inconvenience associated with insulin therapy, viewing insulin as a sign that one's diabetes is worse or more serious, personal failure, insulin causes complications, and fear that insulin therapy will require constant demands and decision making. The author concludes by describing strategies that diabetes educators can employ to help create a culture that is more receptive to insulin. By inviting patients to voice their concerns, engaging in active listening, and providing both accurate information and emotional support, educators facilitate the transition to insulin and also contribute to a culture that encourages and supports the most effective diabetes management. 2 tables. 14 references.

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Risks of Strict Glycaemic Control. IN: Frier, B. and Fisher, M., eds. Hypoglycaemia in Clinical Diabetes. 2nd ed. Somerset, NJ: John Wiley & Sons. 2007. pp 171-190.

This chapter on the risks of strict glycemic control is from a textbook that provides in-depth information for the understanding and management of hypoglycemia in clinical diabetes care. The author notes that, in general, the main risk of intensified diabetes therapy remains hypoglycemia. Topics include a definition of hypoglycemia; factors predisposing patients to severe hypoglycemia in intensified insulin therapy regimens; the link between intensified insulin therapy and risk of severe hypoglycemia; cerebral adaptation and cognitive function; other risks of intensified insulin therapy, notably diabetic ketoacidosis and hyperinsulinemia; strategies to avoid hypoglycemia; and patients who are unsuitable for intensive diabetes management and tight control of blood glucose. 4 figures. 2 tables. 77 references.

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Self-Monitoring of Blood Glucose. Chevy Chase, MD: Hormone Foundation. 2007. 1 p.

This brief fact sheet reviews the use of self-monitoring of blood glucose (SMBG) as part of a comprehensive program of treating diabetes, a disease characterized by blood glucose levels that are higher than normal. The fact sheet first outlines the three main types of diabetes: type 1, type 2, and gestational diabetes. The fact sheet then answers common questions about the importance of controlling blood glucose levels, complications associated with hyperglycemia and hypoglycemia, how blood glucose levels can be checked with a small battery-operated meter, and how often blood glucose levels should be checked. The fact sheet concludes with a section of practical strategies for incorporating this information into one’s daily diabetes care. Readers are referred to the Hormone Foundation’s website at www.hormone.org and other resources for more information. One figure lists recommended target blood glucose values and how to know when to call a health care provider for a value that is out of the range noted. The fact sheet is also available in Spanish. 4 references.

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Standards of Medical Care in Diabetes-2007. Diabetes Care. 30 (Suppl 1): S4-S41. January 2007.

This supplement to the Diabetes Care journal contains the American Diabetes Association’s (ADA) Standards of Medical Care in Diabetes, the major position statement of the organization. This section of the supplement presents the Standards of Medical Care in Diabetes (2007) in the areas of Classification and Diagnosis; Screening for Diabetes; Detection and Diagnosis of Gestational Diabetes Mellitus; the Prevention or Delay of Type 2 Diabetes; Diabetes Care; the Prevention and Management of Diabetes Complications; Diabetes Care in Specific Populations, including children and adolescents, preconception care, and older individuals; Diabetes Care in Specific Settings, including the hospital, school and day care settings, diabetes camps, correctional institutions, and emergency and disaster preparedness; Hypoglycemia and Employment or Licensure; Third-Party Reimbursement for Diabetes Care; and Strategies for Improving Diabetes Care. Each standard includes a statement of the problem, and then lists recommendations; relevant references are also included. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided with the standards. The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. 1 figure. 11 tables. 234 references.

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Symptoms of Hypoglycaemia and Effects on Mental Performance and Emotions. IN: Frier, B. and Fisher, M., eds. Hypoglycaemia in Clinical Diabetes. 2nd ed. Somerset, NJ: John Wiley & Sons. 2007. pp 25-48.

This chapter on the symptoms of hypoglycemia and its effects on mental performance and emotions is from a textbook that provides in-depth information for the understanding and management of hypoglycemia in clinical diabetes care. The author stresses that the most obvious benefit of knowing about the symptoms of hypoglycemia is the ability to recognize the onset of a hypoglycemic episode as early as possible. Topics include identifying the symptoms of hypoglycemia, which commonly include sweating, trembling, difficulty concentrating, dizziness, and hunger; the individuality of hypoglycemic symptom clusters; classifying the symptoms as autonomic, neuroglycopenic, or general malaise; typical symptoms in children and in older people; symptom interpretation and intervention strategies; acute hypoglycemia and cognitive functioning; and acute hypoglycemia and emotions. The author concludes by reiterating the importance of accurate patient knowledge about the symptoms of hypoglycemia in order to avoid the dangers of hypoglycemia. 3 figures. 2 tables. 72 references.

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Treatment With Insulin and Its Analogs in Pregnancies Complicated by Diabetes. Diabetes Care. 30(Suppl 2): S220-S224. July 2007.

This article presents a literature review about the safety and effectiveness of insulin analogs in pregnancy, with the goal of enabling clinicians to choose the optimal insulin treatment protocol to achieve and maintain normoglycemia throughout pregnancies complicated by diabetes. Topics include the rationale for the use of nonimmunogenic insulins during pregnancy, long-acting insulin analogs such as insulin glargine and insulin detemir, and the potential risks associated with insulin analogs. The authors note that, if postprandial glucose is the target of treatment, the rapid-acting insulin lispro and insulin aspart appear to be as safe and effective as regular human insulin in women with GDM and they achieve better postprandial glucose concentrations with less late prandial hypoglycemia. If the patient has elevated fasting and postprandial blood glucose levels and requires multiple daily injections to achieve good glycemic control, a basal-bolus regimen should be considered. 1 table. 44 references.

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Use of Insulin Pump Therapy in the Pediatric Age-Group: Consensus Statement from the European Society for Pediatric Endocrinology, the Lawson Wilkins Pediatric Endocrine Society and the International Society for Pediatric and Adolescent Diabetes, Endorsed by the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 30(6): 1653-1662. June 2007.

This article presents a consensus statement on the use of insulin pump therapy in the pediatric age group, implemented primarily to avoid recurrent episodes of hypoglycemia in patients seeking to achieve near-normal blood glucose ranges. Continuous subcutaneous insulin infusion (CSII) is used to closely simulate the normal pattern of insulin secretion and offers more flexibility and more precise insulin delivery than multiple daily injections (MDI). The consensus panel was convened to clear up controversy as to whether CSII has advantages over MDI in terms of reduction in blood glucose levels, occurrence of severe hypoglycemic events, episodes of diabetic ketoacidosis (DKA), and frequency of hospitalizations in young patients. In addition, physicians need guidelines for choosing patients for whom CSII therapy might be appropriate. Recommendations are provided in the areas of glycosylated hemoglobin (A1C) levels, severe hypoglycemia, blood glucose variability, physical activity and exercise, weight gain, metabolic deterioration, infusion site reactions, psychosocial issues, pump features, selecting an insulin pump, catheter features, calculating and timing the prandial (bolus) insulin requirement, monitoring patients on CSII, cost-effectiveness, and terminating CSII. The authors conclude that CSII use in children and adolescents may be associated with improved glycemic control and improved quality of life and poses no greater, and possibly less, risk than MDI. Minimizing the risks of CSII entails the same interventions that promote safety in all patients with type 1 diabetes, including proper education, frequent blood glucose monitoring, attention to diet and exercise, and the ongoing of communication with a diabetes team. 1 table. 95 references.

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