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Intensive insulin therapy or flexible insulin therapy is a therapeutic regimen for diabetes mellitus treatment. This newer approach contrasts with conventional insulin therapy. Rather than minimize the number of insulin injections per day, the intensive approach favors flexible meal times with variable carbohydrate as well as flexible physical activities. The trade-off is the increase from 2 or 3 injections per day to 4 or more injections per day, which was considered "intensive" relative to the older approach. In North America in 2004, many endocrinologists prefer the term "flexible insulin therapy" (FIT) to "intensive therapy" and use it to refer to any method of replacing insulin that attempts to mimic the pattern of small continuous basal insulin secretion of a working pancreas combined with larger insulin secretions at mealtimes. The semantic distinction reflects changing treatment.
The following is a glossary of diabetes which explains terms connected with diabetes.
Hyperglycemia is a condition in which an excessive amount of glucose circulates in the blood plasma. This is generally a blood sugar level higher than 11.1 mmol/L (200 mg/dL), but symptoms may not start to become noticeable until even higher values such as 13.9–16.7 mmol/L (~250–300 mg/dL). A subject with a consistent range between ~5.6 and ~7 mmol/L is considered slightly hyperglycemic, and above 7 mmol/L is generally held to have diabetes. For diabetics, glucose levels that are considered to be too hyperglycemic can vary from person to person, mainly due to the person's renal threshold of glucose and overall glucose tolerance. On average, however, chronic levels above 10–12 mmol/L (180–216 mg/dL) can produce noticeable organ damage over time.
Type 2 diabetes, formerly known as adult-onset diabetes, is a form of diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. Common symptoms include increased thirst, frequent urination, and unexplained weight loss. Symptoms may also include increased hunger, feeling tired, and sores that do not heal. Often symptoms come on slowly. Long-term complications from high blood sugar include heart disease, strokes, diabetic retinopathy which can result in blindness, kidney failure, and poor blood flow in the limbs which may lead to amputations. The sudden onset of hyperosmolar hyperglycemic state may occur; however, ketoacidosis is uncommon.
Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy. Gestational diabetes generally results in few symptoms; however, it does increase the risk of pre-eclampsia, depression, and requiring a Caesarean section. Babies born to mothers with poorly treated gestational diabetes are at increased risk of being too large, having low blood sugar after birth, and jaundice. If untreated, it can also result in a stillbirth. Long term, children are at higher risk of being overweight and developing type 2 diabetes.
Glycated hemoglobin is a form of hemoglobin (Hb) that is chemically linked to a sugar. Most monosaccharides, including glucose, galactose and fructose, spontaneously bond with hemoglobin, when present in the bloodstream of humans. However, glucose is less likely to do so than galactose and fructose, which may explain why glucose is used as the primary metabolic fuel in humans.
Joslin Diabetes Center is the world's largest diabetes research center, diabetes clinic, and provider of diabetes education. It is located in the Longwood Medical and Academic Area in Boston, Massachusetts, United States. Among the Harvard Medical School affiliated institutions, Joslin is unique in its sole focus on diabetes. Joslin has the world's largest team of board-certified physicians treating diabetes and its complications, as well as the largest staff of Certified Diabetes Educators anywhere in the world. Joslin also supports the world's largest diabetes research team with more than 40 faculty investigators and more than 300 researchers.
Type 1 diabetes (T1D), formerly known as juvenile diabetes, is an autoimmune disease that originates when cells that make insulin are destroyed by the immune system. Insulin is a hormone required for the cells to use blood sugar for energy and it helps regulate glucose levels in the bloodstream. Before treatment this results in high blood sugar levels in the body. The common symptoms of this elevated blood sugar are frequent urination, increased thirst, increased hunger, weight loss, and other serious complications. Additional symptoms may include blurry vision, tiredness, and slow wound healing. Symptoms typically develop over a short period of time, often a matter of weeks.
The term diabetes includes several different metabolic disorders that all, if left untreated, result in abnormally high concentration of a sugar called glucose in the blood. Diabetes mellitus type 1 results when the pancreas no longer produces significant amounts of the hormone insulin, usually owing to the autoimmune destruction of the insulin-producing beta cells of the pancreas. Diabetes mellitus type 2, in contrast, is now thought to result from autoimmune attacks on the pancreas and/or insulin resistance. The pancreas of a person with type 2 diabetes may be producing normal or even abnormally large amounts of insulin. Other forms of diabetes mellitus, such as the various forms of maturity onset diabetes of the young, may represent some combination of insufficient insulin production and insulin resistance. Some degree of insulin resistance may also be present in a person with type 1 diabetes.
Impaired fasting glucose is a type of prediabetes, in which a person's blood sugar levels during fasting are consistently above the normal range, but below the diagnostic cut-off for a formal diagnosis of diabetes mellitus. Together with impaired glucose tolerance, it is a sign of insulin resistance. In this manner, it is also one of the conditions associated with metabolic syndrome.
Automated insulin delivery systems are automated systems designed to assist people with diabetes, primarily type 1, by automatically adjusting insulin delivery to help them control their blood glucose levels. Currently available systems can only deliver a single hormone—insulin. Other systems currently in development aim to improve on current systems by adding one or more additional hormones that can be delivered as needed, providing something closer to the endocrine functionality of a healthy pancreas.
Islet transplantation is the transplantation of isolated islets from a donor pancreas into another person. It is an experimental treatment for type 1 diabetes mellitus. Once transplanted, the islets begin to produce insulin, actively regulating the level of glucose in the blood.
Prediabetes is a component of the metabolic syndrome and is characterized by elevated blood sugar levels that fall below the threshold to diagnose diabetes mellitus. It usually does not cause symptoms but people with prediabetes often have obesity, dyslipidemia with high triglycerides and/or low HDL cholesterol, and hypertension. It is also associated with increased risk for cardiovascular disease (CVD). Prediabetes is more accurately considered an early stage of diabetes as health complications associated with type 2 diabetes often occur before the diagnosis of diabetes.
MiniMed Paradigm is a series of insulin pumps manufactured by Medtronic for patients with diabetes mellitus. The pump operates with a single AA battery and uses a piston-plunger pump to infuse a programmed amount of insulin into the patient through a length of tubing. The Paradigm uses a one-way wireless radio frequency link to receive blood sugar measurements from select glucose meters. The Paradigm RT series adds the ability to receive data from a mated continuous blood-glucose monitor. Although the pump can use these measurements to assist in calculating a dose of insulin, no actual change in insulin delivery occurs without manual user-intervention.
Complications of diabetes mellitus include problems that develop rapidly (acute) or over time (chronic) and may affect many organ systems. The complications of diabetes can dramatically impair quality of life and cause long-lasting disability. Overall, complications are far less common and less severe in people with well-controlled blood sugar levels. Some non-modifiable risk factors such as age at diabetes onset, type of diabetes, gender and genetics may influence risk. Other health problems compound the chronic complications of diabetes such as smoking, obesity, high blood pressure, elevated cholesterol levels, and lack of regular exercise. Complications of diabetes are a strong risk factor for severe COVID-19 illness.
Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level (hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased appetite. If left untreated, diabetes can cause many health complications. Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death. Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, damage to the nerves, damage to the eyes, and cognitive impairment.
Ambulatory glucose profile (AGP) is a single page, standardized report for interpreting a patient's daily glucose and insulin patterns. AGP provides both graphic and quantitative characterizations of daily glucose patterns. First developed by Drs. Roger Mazze and David Rodbard, with colleagues at the Albert Einstein College of Medicine in 1987, AGP was initially used for representation of episodic self-monitored blood glucose (SMBG). The first version included a glucose median and inter-quartile ranges graphed as a 24-hour day. Dr. Mazze brought the original AGP to the International Diabetes Center (IDC) in the late 1980s. Since then, IDC has built the AGP into the internationally recognized standard for glucose pattern reporting.
Bernard Zinman is a Canadian clinical and research endocrinologist, whose research at the University of Toronto focuses on type 1 and type 2 diabetes. He directed the Mount Sinai Hospital Leadership Sinai Centre for Diabetes and the Banting and Best Diabetes Centre. In 2019, he was appointed as an Officer to the Order of Canada in recognition of his scientific contributions, including the development of preventative therapies for diabetes.
William V. Tamborlane has been Professor and Chief of Pediatric Endocrinology at Yale School of Medicine since 1986.
Anne Peters is a endocrinologist, diabetes expert, and professor of clinical medicine at the Keck School of Medicine of USC. She runs diabetes centers in well-served Beverly Hills and under-resourced East Los Angeles. She teaches physicians and people with diabetes around the world how to better treat the condition, through lifestyle, medications and technology.
References
- ↑ Hare, Jr., JR. (1996). Managing Change, Changing Medicine. Park Nicollet Press. ISBN 0-9655104-0-9.
- ↑ Franz, MJ. (2003). "A Tribute to Donnell D. Etzwiler, MD: Innovator, leader, and educator". The Diabetes Educator. 29 (6): 969–975. doi:10.1177/014572170302900607. PMID 14692371. S2CID 26623112.
- 1 2 "Diabetes Control and Complications Trial (DCCT)". Archived from the original on 2007-10-18. Retrieved 2010-06-10.
- ↑ "WHOCC - WHO Collaborating Centres". Apps.who.int. Retrieved 16 May 2018.
- ↑ Mazze, RS, Strock, ES, Bergenstal, RM, Criego, A, Cuddihy, R, Langer, O, Simonson, GD, Powers, MA. (2012). Staged Diabetes Management, Third Edition. Wiley-Blackwell. ISBN 978-0-470-65466-8.
- ↑ Franz MJ, Splett PL, Monk A, Barry B, McLain K, Weaver T, Upham P, Bergenstal R, Mazze RS. (1995). Cost effectiveness of medical nutrition therapy provided by dietitians for persons with non-insulin dependent diabetes mellitus. Journal of the American Dietetic Association. 95:1018–1024.
- ↑ Bergenstal, RM, Reader, D, and Doran, M. (2003). Betty Crocker’s Diabetes Cookbook. Wiley Publishing, Inc. ISBN 0-7645-6704-7.
- ↑ Powers, MA, Cuddihy, RM, Bergenstal, RM, Tompos, P, Pearson, J, Morgan, B. (2011). "Improving blood pressure control in individuals with diabetes: A quality improvement collaborative". Joint Commission Journal on Quality and Patient Safety. 37 (3): 110–119. doi:10.1016/S1553-7250(11)37013-4. PMID 21500753.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ↑ "The T1D Exchange Explained" (PDF). Publicfiles.jaeb.org. Retrieved 16 May 2018.
- ↑ "Park Nicollet takes fight against diabetes to China | StarTribune.com". Star Tribune . Archived from the original on 2011-12-28. Retrieved 2012-03-27.
- ↑ "A Comparative Effectiveness Study of Major Glycemia-lowering Medications for Treatment of Type 2 Diabetes - Full Text View". ClinicalTrials.gov. Retrieved 16 May 2018.
- ↑ "Margaret Powers, PHD, RD, CDE: American Diabetes Association®". Archived from the original on 2016-04-27. Retrieved 2016-04-18.
- ↑ "'Game changer' device for Type 1 diabetes patients mimics pancreas". Fox9.com. Retrieved 16 May 2018.
- ↑ "Medtronic gets FDA approval for automated insulin delivery device". Startribune.com. Retrieved 16 May 2018.
- ↑ "Four pivotal NIH-funded artificial pancreas research efforts begin". Nih.gov. 7 February 2017. Retrieved 16 May 2018.