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Surgery

Surgery Options and Outcomes for Diabetes Patients: Diabetes in Control answers key questions about the use of surgery in diabetes management and treatment, including:
– Surgical options for weight loss
– How/when a healthcare professional might recommend surgery for a diabetes patient
– What a healthcare professional needs to know about the spectrum of diabetes related surgeries

Practical Diabetes Care, 3rd Ed., Excerpt #9: Infections in Diabetes Part 1 of 3

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David Levy, MD, FRCP Introduction Infections in patients with diabetes are a persistent trap for both the inexperienced and world-wise physician. Whenever someone with diabetes presents unwell, always consider the possibility of infection. High blood glucose levels predispose to some acute infections, especially postoperatively, but other mechanisms are involved, for example …

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Practical Diabetes Care, 3rd Ed., Excerpt #9: Pharmacological Treatment of Hyperglycemia Part 2 of 2

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David Levy, MD, FRCP Drugs acting on the incretin system (entero-insular axis) (Fig. 6.2) The incretin effect Bayliss and Starling inferred the existence of gut-derived substances affecting carbohydrate metabolism more than a century ago, but the incretin effect was not described until 1969: the observation that for a given achieved level …

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GLP-1 Not As Effective after Roux-en-Y Gastric Bypass

Researchers compared glucose and hormonal responses to a liquid meal test in 20 obese participants with T2 who underwent RYGB or nonsurgical intensive lifestyle modification… Rapid glycemic improvements following Roux-en-Y gastric bypass (RYGB) are frequently attributed to the enhanced GLP-1 response, but causality remains unclear. To determine the role of …

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Practical Diabetes Care, 3rd Ed., Excerpt #6: Type 2 Diabetes: General Introduction

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David Levy, MD, FRCP Introduction: Type 2 Diabetes as a Progressive Condition Glycemia in type 2 diabetes progressively deteriorates with time, usually thought to be related to progressive beta-cell failure. This was demonstrated dramatically in the United Kingdom Prospective Diabetes Study (UKPDS 1998), but the glycemic trends have been less marked …

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Diabetes Screening at the Dentist

Dental visits may allow for diabetes screening and monitoring glucose control in at-risk patients… A new study suggests that using gingival crevicular blood, collected during dental visits, for HbA1c testing produced values that were nearly identical to those obtained using finger stick blood. Correlation was 0.991 between the HbA1c values …

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Practical Diabetes Care, 3rd Ed., Excerpt #3: Management of Inpatient Diabetes Part 2 of 2

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David Levy, MD, FRCP Patients in the Intensive Care Unit Hyperglycemia, whether associated with known diabetes or not, carries a poor prognosis in critically ill patients through multiple mechanisms, including vascular disease, polyneuropathy, an increased tendency to infection, dyslipidemia, and abnormal anti-inflammatory and coagulation responses. Consistent near-normoglycemia has therefore been a …

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