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Production Assistant, Diabetes In Control

Screening for Type 2 Part 2

Mrs. O’Doole is a 34 year-old of Irish descent. She works as a florist who and is married with three children. She arrives at your clinic for her annual wellness exam. Her blood pressure is 130/84 mmHg, pulse 65, BMI 24 kg/m2 and her physical exam is notable for acne and mild hirsutism. Her only current medication is oral birth control pills. She recalls starting OCP, 15 years prior, due to irregular menses. Based upon her medical history and physical, you believe it would be prudent to screen Mrs. O’Doole for type 2 diabetes. You discuss your recommendations with her and she agrees to be tested. The lab returns a fasting plasma glucose (FBG) of 112 mg/dL. You share these results with your patient and inform her, that while only mildly elevated, she has impaired fasting glucose. What is the best choice for initial management of Mrs. O’Doole’s prediabetes? A. Metformin B. Metformin+ Pioglitazone C. Lifestyle modifications + Pioglitazone D. Lifestyle modifications (dietary modifications, weight loss and exercise) Follow the link for the answer.

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CGMS for Type 2

Using a CGMS for type 2 diabetes can be very beneficial for type 2 patients not using insulin. Do you agree or disagree? Follow the link to share your opinion.

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Gut Reactions

This is not one patient’s disaster averted but what I have experienced working in the field of diabetes and obesity for years. Many times patients who are taking glucose lowering and/or anti obesity medications will report different GI complaints-such as bloating, diarrhea, constipation, nausea, vomiting, and GERD. They tell me they are going to see a gastroenterologist for an evaluation.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #117: Diabetes and Sleep Apnea Part 7

OSA and diabetes-related complications: Recently, there has been increasing interest in the association between OSA and diabetes-related complications. There is one cross-sectional published study regarding the association between OSA and macrovascular complications in T2DM, but several studies have examined the association between microvascular complications and OSA in T2DM. Most of these studies are cross-sectional in nature but more recently prospective studies proving causality have been published. Many of these studies fail to adjust for many of the possible confounders.

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