Blood sugar control

Insulin is the one agent that can be used in all forms of DM for blood sugar control. Insulin is the essential treatment for patients with type 1 DM and can overcome insulin resistance in patients with type 2 DM. Insulin is available commercially in various formulations that vary markedly in terms of onset and duration of action and the source from which a product is obtained. Insulins can be divided into four separate classes based on their length of action. Most formulations are available as U-100, indicating a concentration of 100 units/mL. Insulin is typically refrigerated, and most vials are good for 28 days at room temperature. Specific details of insulin products are listed in Table 40-9. 

Hamano, K, et al (2002). Blood sugar control reverses the increase in urinary... 

Wright AD, Barber SG, Kendall MJ, Poole PH. Beta-adrenoceptor-blocking drugs and blood sugar control in diabetes mellitus. BMJ 1979 1(6157) 159-61. 

Glucophage is an antidiabetic drug prescribed to treat Type II diabetes. Type II diabetes is also called non-insulin-dependent diabetes mellitus. Individuals who have Type II diabetes are usually unable to produce enough insulin naturally (in response to the food they ingest) or suffer cell insulin receptor-site insensitivity. However, Glucophage can be prescribed by a doctor for Type I diabetics as a means of additional glucose (blood sugar) control in unison with insulin injections. 

Good blood glucose control can prevent the development and slow the progression of diabetic nephropathy, as well as preventing the other complications of diabetes, even if kidney failure has developed. This cannot be achieved by insulin alone, but requires a good diet too. Ideally HbAlc levels (a measure of average blood sugar control over three months) should be less than 7%. 

Q15 How can we measure the overall success of a patient s blood sugar control ... 

Chlorothiazide, the first of the thiazide diuretics, was found within a year of its introduction in 1958 to have hyperglycaemic effects. Since then a very large number of reports have described hyperglycaemia, the precipitation of diabetes in prediabetics, and the disturbance of blood sugar control in diabetics taking thiazides. One example from many ... 

Fiber supplements vary in the types of fiber that they contain. Psyllium, a naturally occurring soluble fiber, has been studied extensively, and research suggests a benefit in terms of constipation prevention, cholesterol reduction, blood sugar control, and weight loss, particularly when combined with a healthy diet. It also seems to help those suffering from irritable bowel syndrome (IBS), a common condition associated with bowel irregularity, bloating, and abdominal pain. 

Management of type 2 diabetes long-awaited evidence of benefits after blood sugar control. Prescrire Int 1999 8 147-152. 

Endocrine A 43-year-old patient with type 1 diabetes attained very good blood sugar control with minimal insulin requirement over a period of 5 years while taking topiramate 8-13 mg/kg/day in addition to other AEDs (initially VPA, then lamotrigine and subsequently primidone) [169 ]. Topiramate, which has previously been noted to have antidiabetic properties in patients with type 2 diabetes, was thought to play a role in protecting p-cell function in this patient. 

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