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Your search term(s) "newly diagnosed" returned 53 results.

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Beating the Lows: What You Need to Know About Hypoglycemia. Diabetes Forecast. 61(2): 29-30. February 2008.

This article helps readers newly diagnosed with diabetes to understand hypoglycemia, the condition of low blood glucose levels. The author reviews the causes, symptoms, treatment, and prevention of hypoglycemia, focusing on practical approaches to everyday activities and diabetes care. Blood glucose levels can drop too low when a person with diabetes exercises longer or harder than usual, eats too little, delays a meal, eats too few carbohydrates, mistakenly takes too much insulin, or drinks alcohol on an empty stomach. Combinations of insulin, sulfonylureas, or meglitinides with other diabetes pills and injectable drugs carry a risk of hypoglycemia. Symptoms of hypoglycemia can include nervousness, shakiness, hunger, lightheadedness, sweating, irritability, impatience, chills, sleepiness, nausea, and confusion or other unusual behavior. The author briefly describes hypoglycemia unawareness, which can happen in a person who experiences repeated episodes of hypoglycemia. This occurs more often in people who practice tight diabetes control. Readers are encouraged to test their blood glucose levels as soon as they feel the symptoms of a potential episode of hypoglycemia. To counter mild-to-moderate hypoglycemia, patients should eat or drink something containing 15 grams of carbohydrate, wait 15 minutes, and test their blood glucose again. This pattern can be repeated if needed. The article concludes with a list of suggestions that can help prevent hypoglycemia. 1 figure.

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Glycemic Control and Hemoglobinopathy: When A1C May Not Be Reliable. Diabetes Spectrum. 21(1):46-49. Winter 2008.

This article, from a series that presents patient cases using an evidence-based practice framework, describes a situation in which glycosylated hemoglobin (A1C) measures may not be a reliable marker for glycemic control and hemoglobinopathy. The case patient was an 11-year-old African-American girl newly diagnosed with type 1 diabetes and Hashimoto’s thyroiditis, who was being followed up after her initial hospitalization for diabetic ketoacidosis 2 weeks previously. The author describes her medication compliance, symptoms, concerns about preprandial hypoglycemia, and vital signs. The review of the patient’s laboratory records show that A1C was not measured by the laboratory because of an abnormal hemoglobin peak. The author considers whether hemoglobinopathies affect the clinical reliability of A1C measurement and, if so, what alternate method of assessment should be used for monitoring these patients. The author reports the results of a literature review, discussing hemoglobinopathy in patients with diabetes, variation by laboratory method, assessment of glycemic control using fructosamine, and an evidence grading system for clinical practice recommendations. The author concludes with an overview of the case patient’s present situation and recommendations for improvement of care and ongoing measurement of the child’s blood glucose levels. 33 references.

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Latent Autoimmune Diabetes in Adults and Pregnancy: Foretelling the Future. Clinical Diabetes. 26(1): 44-46. Winter 2008.

This case report presents the case of a 25-year-old woman referred for newly diagnosed gestational diabetes mellitus (GDM). Before the pregnancy, her baseline weight was 205 pounds, and her BMI was 33. Overall, she was feeling well and tolerating her pregnancy well. A previous pregnancy, uncomplicated by GDM, had resulted in a healthy, full-term girl who was subsequently diagnosed with type 1 diabetes at age 4. The authors describe the woman’s care, which included the use of bedtime human insulin NPH and close monitoring of blood glucose levels. Insulin lispro was added for mealtime coverage, and her blood glucose control improved on intensive insulin therapy. At term, she delivered a healthy boy by uncomplicated, spontaneous vaginal delivery. Follow-up therapy noted ongoing impaired glucose tolerance, and 4 weeks later the patient experienced symptoms of polyuria, polydipsia, and blurry vision. Her blood glucose values had been between 200 and 350 mg/dl for 3 days. Because of the family history of type 1 diabetes in her daughter and the acute exacerbation of hyperglycemia, an autoantibody test was ordered and she was diagnosed with latent autoimmune diabetes in adults (LADA). Intensive insulin therapy was started with insulin lispro for prandial coverage and insulin glargine for basal coverage. She used an insulin pump and had excellent glycemic control, including through her third pregnancy. The authors use this case to review LADA, how it is diagnosed, and how treatment for LADA varies from that for type 1 or type 2 diabetes. 2 figures. 8 references.

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Staying Healthy with Diabetes: Nutrition and Meal Planning. Boston, MA: Joslin Diabetes Center. 2008. 134 p.

This book is designed to help readers newly diagnosed with diabetes understand how to adapt their food habits to help keep blood glucose levels as close to target ranges as possible. The authors encourage readers to learn more about how to make healthy choices to help manage their diabetes. The book offers 16 chapters covering meal planning, how different types of foods affect blood glucose levels, three types of meal plans, exchange lists, carbohydrate counting, a starter meal plan, the role of the dietitian, meal planning tools and recordkeeping, nutrition labels, caloric and noncaloric sweeteners, dietary fiber, glycemic index and glycemic load, hearty-healthy eating, blood fats, dietary fats, sodium, tips for cooking and baking, shopping tips, eating at restaurants, alcohol, holidays and special occasions, meal replacements, coping with sick days, vitamins and minerals, and herbal and other dietary supplements. A final chapter encourages readers to keep their meal planning approach simple and enjoyable. The book concludes with eight lists of food items, serving sizes, and their carbohydrate and calorie content: carbohydrates, protein, fat, free foods, combination foods, fast foods, and vegetarian items. The book includes numerous charts and tables that summarize the data in the text. The inside back cover presents a brief description of the Joslin Diabetes Center in Boston, MA.

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Case Study 2: New Insights: Clinical Pearls for Using Incretin Mimetics in Type 2 Diabetes. Diabetes Educator. 33(Suppl 1): 14S-19S. January-February 2007.

Type 2 diabetes is a progressive disease that requires early diagnosis and close monitoring for adequate disease management. This case study is from a journal supplement that presents information about oral and injectable diabetes medications as well as other management techniques that may ultimately improve patient outcomes. This case study illustrates a situation in which an injectable incretin mimetic (exenatide) is used as an adjunct to treatment for a patient whose diabetes is inadequately controlled by oral diabetes agents. The patient is a 54-year-old Caucasian man with newly diagnosed, poorly controlled type 2 diabetes. His medical history included hypertension, disk problems, and dyslipidemia. The authors review the mechanism of action, benefits, and adverse event profile of incretin mimetics; they also discuss the potential for incretin mimetics to promote glycemic control and weight loss. The authors stress that education of and communication with patients are both important components of care, particularly when introducing an injectable therapy into their treatment regimen. Patients must be instructed in the proper injection technique, as well as storage of the medication and needle disposal, timing of the doses, and oral drugs that can and cannot be taken concomitantly with exenatide. 2 figures. 3 tables. 15 references.

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Dealing Day-to-Day With Diabetes: A Whole Family Experience. Today’s Dietitian. 9(11): 44-48. November 2007.

This article reminds dietitians of the importance of considering the whole family when working with a child who has been diagnosed with diabetes. The author begins with a description of what families of children with diabetes go through as they cope with the diagnosis and their “new normal.” Parents of children newly diagnosed with diabetes are given all the facts about managing diabetes from a clinical standpoint but are left with many questions about the social and emotional aspects of diabetes. The author uses the story of one family’s journey through diagnosis and adjustment to their son’s diabetes as a case example of the positive role that a dietitian can play on the patient’s care team. The mother of the family under discussion is a dietitian herself, and she speaks clearly to her readers. She shares her feelings of being overwhelmed by how much she had to learn about her young son’s disease and about diabetes management. Two sidebars outline a typical day in the family’s busy life and list readings recommended by the dietitian mother, some of which focus on coping with diabetes in the school setting. Another sidebar lists strategies that parents can use to help educate school personnel. 2 references.

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Diabetes and You: Your Guide to Living with Diabetes. Princeton, NJ: Novo Nordisk, 2006. 32 p.

This booklet answers common questions about living with diabetes. Designed primarily for people who are newly diagnosed with type 2 diabetes, the booklet reviews the different types of diabetes, the signs and symptoms of diabetes, the components of a diabetes treatment plan, medications used for diabetes, insulin, the need to manage blood glucose levels, blood glucose goals, meal planning, the role of exercise and activity, diabetes complications and how to avoid them, the types of monitoring tests and check-ups that should be undertaken, the psychosocial factors of diabetes, workplace considerations, and traveling with diabetes. Readers are encouraged to eat healthy, well-balanced meals at the right times, to be physically active, to manage their self-care (taking diabetes medicine, checking blood glucose, getting health check-ups), and to work closely with their diabetes health care team. The booklet includes many drawings and photographs that colorfully illustrate the textual information. The inside back cover describes the free program, Changing Life with Diabetes, available through the Novo Nordisk company (ChangingDiabetes-us.com). 59 figures. 6 tables.

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Metformin: Now or Later?. Harvard Health Letter. 32(1): 4. November 2006.

This newsletter article considers the use of metformin (Glucophage) and when it should be started in people newly diagnosed with type 2 diabetes. Metformin lowers blood sugar levels by decreasing the liver’s production of sugar and by increasing the effectiveness of insulin, the hormone that escorts sugar into the cells where it can be used. Insulin resistance is one of the main features of type 2 diabetes. Metformin is a first-line medication for several reasons: It is effective, lowering blood sugar levels by about 20 percent; people do not tend to gain weight when they take it, in contrast to insulin and the sulfonylurea drugs; and it is relatively inexpensive. Proponents of this type of drug therapy say that these medications tame conditions that are too serious to allow to progress. Critics counter that not nearly enough has been invested in devising ways to make diet and exercise programs work; approaches that do not carry the side effects that medications cause. The author concludes that the most important thing for people with newly diagnosed type 2 diabetes is to get their blood glucose levels under control. If this can be achieved without the drug therapy, that is fine, but if metformin is required to reach appropriate glycosylated hemoglobin levels, patients should not hesitate to include the drug in their diabetes management plan.

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Sweet Dreams. Today's Dietitian. 7(7): 18-21. February 2006.

This article encourages dietitians who work with patients newly-diagnosed with diabetes to help their clients liberalize strict food habits in a healthy way. Focusing primarily on the glycemic index (GI), the author re-considers the often-emphasized requirement that people with diabetes completely give up all added sugars. The author notes that many studies indicate that postmeal glucose levels and insulin responses to dietary starches and sucrose are similar in people with diabetes when mixed meals containing the same amount of total carbohydrate are compared. The author reviews the positions of the American Diabetes Association and the Canadian Diabetes Association. Although health care providers, including dietitians, may be concerned that giving patients more freedom to incorporate sugars and sweets into their diet may result in worsened metabolic control and weight loss, studies have shown that additional dietary freedoms did not result in any metabolic deterioration. In fact, patients following liberalized guidelines actually ate less total carbohydrate during the day than did those patients told to strictly avoid sweets. The author concludes that dietitians can teach individuals to choose foods that are both satisfying and nutritious. Using fruits, yogurts, and even whole grains in desserts can add a host of nutrients to the person's diet. The article concludes with 2 recipes that utilize fresh and dried fruit and dark chocolate. 5 references.

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Decreased Lung Function in Female but not Male Subjects With Established Cystic Fibrosis-Related Diabetes. Diabetes Care. 28(7): 1581-1587. July 2005.

Although cystic-fibrosis-related diabetes (CFRD) is associated with decreased lung function, sex is not known to influence CFRD. This article reports on a study that examined the association between female subjects with CFRD and poor lung function relative to male subjects using the percent predicted forced expiratory volume in 1 second (FEV1) as a surrogate measure of morbidity. The authors compared 323 patients with established CFRD with 489 cystic fibrosis control subjects with normal glucose tolerance (NGT) from the United Kingdom Cystic Fibrosis Database. CFRD in female subjects (but not male subjects) without chronic Pseudomonas aeruginosa infection had a 20 percent lower percent predicted FEV1 compared with control subjects with NGT. Genotype, age, treatment center, age at diagnosis of cystic fibrosis, pregnancy, liver function, or dose of pancreatic enzyme replacement therapy did not confound this female disadvantage. Comparison of female subjects with newly diagnosed CFRD free of chronic P. aeruginosa infection with matched control subjects with NGT showed no FEV1 disadvantage in the first year after CFRD diagnosis. The authors conclude that only female subjects with CFRD have significantly decreased lung function compared with sex-matched NGT control subjects. The absence of poor lung function in the first 12 months after diagnosis of diabetes suggests that an opportunity may exist to intervene and possibly prevent a decline in lung function (which can be as much as 20 percent in female subjects with CFRD). 2 figures. 2 tables. 32 references.

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