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Biology behind how to prevent type 2 diabetes
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Clinical Case: Management of Pre-diabetes with Metformin
A 46-year-old Hispanic man presented to the clinic for a routine physical and a review of his recent laboratory studies. His medical history was significant for high cholesterol. His daily medication regimen included a multivitamin, aspirin 81 mg, and simvastatin (Zocor) 40 mg for high cholesterol. His family history was remarkable for type 2 diabetes, hypertension, and hyperlipidemia in his mother, maternal grandmother, maternal aunt, and maternal uncle. Physical examination revealed a height of 69 inches, weight of 199 pounds, body mass index (BMI) of 29.4 kg/m2, waist circumference of 36 inches and blood pressure of 125/72 mm Hg. Initial laboratory results were: total cholesterol 195 mg/dL; triglycerides 136 mg/dL; low-density lipoprotein cholesterol (LDL), 124 mg/dL; high-density lipoprotein cholesterol (HDL), 44 mg/dL; and fasting plasma glucose (FPG), 119 mg/dL. Complete blood count, renal function and liver function tests were all normal. Additional studies included an oral glucose tolerance test (OGTT) of 157 mg/dL and hemoglobin A1c (HbA1c) of 5.9%. The patient’s physical exam was unremarkable with no abnormalities noted.
This patient has been seen every 6 months for a focused physical examination with a total cholesterol, liver function panel and a FPG to evaluate his diabetes status and cholesterol management program. He has attended nutrition counseling in the past and has complied with lifestyle modifications including diet and exercise resulting in a weight loss of eight pounds over the past year. Over the pasts twelve months, this patient’s total cholesterol levels have significantly improved from 280 mg/dL to 190 mg/dL. This is the second time h...
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...spectives; Journal of the Council on Nutrition of the American Chiropractic Association. April 2011;34(2):11-12.
Rhee MK., Herrick K., Ziemer DC, et al. Many Americans have pre-diabetes and should be considered for metformin therapy. Diabetes Care. January 2010;33(1):49-54
Moutzouri E, Tsimihodimos V, Rizos E, Elisaf M. Prediabetes: To treat or not to treat. European Journal of Pharmacology. 2011;672:9-19.
Ngatena IJ, Kapustin JF. Preventing type 2 diabetes: What really works. The Journal for Nurse Practitioners. July/August 2011;7(7):550-558.
Olson DE, Rhee MK, Herrick K, Ziemer DC. Screening for diabetes and prediabetes with Proposed A1c-based diagnostic criteria. Diabetes Care. July 2010;33(10):2184-2189.
Scheen AJ. Antidiabetic agents in subjects with mild dysglycaemia: Prevention or early treatment of type 2 diabetes. Diabetes and Metabolism. 2007;33:3-12.
My case study was based on a women name Margie. Margie is a 50 year-old women that frequently exercises and maintains a healthy eating habit. Even though Margie is a fit 50 year-old her cholesterol was well above average 222. Her trainer then recommended her to sign up for extra kickboxing class and maintain a vegetarian low fat diet, therefore her cholesterol would decease. About a month later she tested her cholesterol again and after the extra exercise, low fat diet her cholesterol was higher than the previous time at 230. Therefore, Margie attended the doctor where she was diagnosed with hypothyroidism.
Journal of Continuing Education in Nursing, 44(9), 406. doi:10.3928/00220124-20130617-38. Torpy, J. M. (2011). The 'Standard' Diabetes. Jama, 305(24), 2592 pp.
Mr Smith is a former truck driver who is a 63 year old male, for the last 20 years he has been taking medication for both hypertension and diabetes however his administration has not been consistent.
Diabetes is a disease that is very common in the world. Early detection of diabetes can significantly decrease the risk of it getting worse throughout a person’s life. There are symptom...
Jost, Kenneth. “Diabetes Epidemic: why is this serious disease on the increase?” The CQ Researcher (March 9, 2001): 185-200
Diabetes and uncontrolled sugar levels is now the seventh leading cause of death in the United States, and the number one cause of adult onset blindness, lower limb amputations and kidney failure (healthy people citation). Additionally, those diagnosed diabetes have an amplified risk of having a heart attack and an overall increased mortality rate, both of which are proportional to 1.8 times greater than those not afflicted with diabetes (Healthy people). Obviously, without proper glycemic control, these number can be a much higher ratio; consequently, it is imperative proper health promotion measures are
According to the CDC, diabetes is becoming more common and has more than tripled from 1980 through 2011, from 5.6 million to 20.9 million (Diabetes public health resource, 2013). Type two diabetes can be managed through diet and exercise. Type two diabetes is a condition formerly called ‘adult-onset’ or ‘non insulin-dependent’ where the body doesn’t
Long range BMI target/goal is less than 25. If lifestyle changes are not enough, than drugs that help lower cholesterol levels, high blood pressure and blood sugar can be used such as statins, fibrates or nicotinic acid. 4Other things that can be done include trying to fight the insulin resistance by starting thiazolidinedione. Also, treating the different risk factors like elevated blood pressure, prothrombotic and proinflammatory state independently. Our patient has 4 of the 5 risk factors: low HDL, high triglycerides, high fasting blood glucose, and central obesity.
Schulze, M. B., & Hu, F. B. (2005). PRIMARY PREVENTION OF DIABETES: What Can Be Done and How Much Can Be Prevented?. Annual Review of Public Health, 26(1), 445-467.
The tendency to build up high cholesterol may run in families, but extremely high levels are usually the result of a poor diet high in saturated fats and calories, along with little or no exercise. In some cases, high levels of cholesterol may be associated with undiagnosed medical symptoms such as diabetes or low thyroid function. According to the American Heart Association, there would eventually be a 50 percent lower rate of heart disease if Americans would lower their blood cholesterol levels by 25 percent. These statements find confirmation in a 1984 report done by the National Heart, Lung and Blood Institution on the results of a 10 year study. It showed that for every 1 percent of lowered cholesterol, the chances of a heart attack are lowered by 2 percent.
...ome of the patients were on anti-diabetic medications, close to 50 percent were on anti-hypertensive medications along with 20 percent are on cholesterol medications (3).
Diabetes affects 18.2 million people in the United States. It is often referred to by doctors as diabetes mellitus and described as, “… a metabolic disease in which the person has high blood sugar …” (Collazo- Clavell et all. 2009), either because the insulin is inadequate or the body’s cells don’t respond well to the insulin. The health and economic consequences of diabetes are considerable. The majority of people that have diabetes live in low and middle income countries, where the prevalence of the disease is high. There are three types of diabetes that are called type 1, type 2, and gestational diabetes. Although diabetes is a disorder, it can lead to other diseases such as heart attack, kidney failure or death. A person that has diabetes has to maintain a healthy lifestyle, by eating the right diet, controlling their blood sugar level, and be optimistic.
Nationally, Type II Diabetes has increased to epidemic proportions. In 2010, it was the seventh leading cause of death in the United States. According to the National Diabetes Statistics Report of 2014, “29.1 million people or 9.3% of the US population have diabetes, with 8.1 million of them being undiagnosed.”1 In addition, the comorbidity conditions associated with diabetes include: high blood pressure, high LDL cholesterol, heart disease/stroke, blindness/eye problems, kidney disease, amputations and other related problems such as: hearing loss, nerve disease, and pregnancy complications. The national financial burden of this disease is impressive. In 2012, the CDCs’ estimated costs of diabetes in the United States were broken down as follows: Direct – medical costs of $176 billion; and Indirect costs: (work
Among diabetic patients a high prevalence of coronary heart disease is observed at a relatively young age. Thus, risk factors for atherosclerosis must be defined and avoided in patients with diabetes mellitus. Abnormality of lipids such as high triglyceride levels and low HDL cholesterol levels emerged as residual cardiovascular risks for diabetic patients (Ehara et al., 2012).
Nazarko, L. (2009). Causes and consequences of diabetes. British Journal of Healthcare Assistants, 3(11), 534-538. Retrieved from EBSCOhost.