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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #99: Pathogenesis of nonalcoholic fatty liver disease (NAFLD) Part 1

NAFLD is defined as steatosis (greater than 5–10% of hepatocytes are fatty), which is not due to excess use of alcohol (defined in European and American guidelines as greater than 20 g of alcohol daily for women and greater than 30 g for men), or other conditions as determined by careful family and medical history, and laboratory tests to exclude at least steatosis due to viral and autoimmune causes and iron overload.

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Health Benefits

Which do you feel plays a more important role in the health of your patients with diabetes? 1) Nutrition 2) Exercise 3) Both

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Achieving A1C Target

Test Your Knowledge

Your patient has been taking metformin, glipizide, and a daily basal insulin dose (.85 U/kg/day). While his fasting glucose levels are on target, he has not yet been able to reach his individualized glycemic target of A1C<7%. In your discussion with him about the addition of a prandial insulin dose to his regimen, you compare and contrast his options. Compared to basal insulin alone, premixed insulins: A. tend to lower A1c to a larger degree. B. are associated with less weight gain. C. cause less hypoglycemia. D. are a good option for people with irregular meal schedules. Follow the link to see the right answer.

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