Asian Indians who live in the U.S. have a 20% higher prevalence of having prediabetes than those residing in India, but Indian residents have a 50% higher prevalence of type 2 diabetes compared with those in the U.S. The cross-sectional analyses, involved Asian Indians enrolled in the Centre for Cardiometabolic …

After 10 years of follow-up, type 2 diabetes screening is not associated with improved mortality rates. The investigators conducted a systematic literature review using data from Cochrane databases and MEDLINE, and relevant studies from previous task force reviews. Screening for diabetes correlated with no 10-year mortality benefit versus no screening …

  Google gets the patent on a system that would likely contain a couple of parts: the contact lens, which would sense glucose levels; a "reader" device, which would communicate and power the contact lens; and a user display, where the reader and user display could be on the same …

David Levy, MD, FRCP Renal replacement therapy The decision to start dialysis is often difficult. The clinical decision is based on many factors, including the presence of uremic symptoms and weight loss, and biochemical measurements including serum creatinine (e.g. serum creatinine 700–800 μmol/L(small mu), eGFR < 12–14 mL/min, falling albumin, hyperkalemia). …

David Levy, MD, FRCP Other management problems in diabetic nephropathy Glycemic control Once nephropathy is established, good control of blood pressure and lipids is probably more important than glycemic control. Observational studies abound and show that, for example, patients with advanced renal failure entering renal replacement programmes survive longer with a …

David Levy, MD, FRCP Management of diabetic nephropathy Investigations Mid-stream urine if leucocytes on routine urinalysis. Renal tract ultrasound scan: a. Normal renal length is about 11 cm, correlating weakly with height and BMI; it is about 10 cm in South Asian and oriental subjects. Kidneys are large in the poorly …

David Levy, MD, FRCP Quantification of Urinary Albumin Excretion The following methods are in current use: Spot early-morning urine specimen expressed as ACR (mg/mmol or mg/g): albumin excretion corrected for urine output; 24-hour urinary albumin excretion (mg per 24 hours); Timed (usually overnight) AER (µg/min); Urinary albumin concentration uncorrected for creatinine …

David Levy, MD, FRCP Overview of Diabetic Kidney Disease End-stage renal disease (ESRD) is a common and terrible outcome of diabetes. However, recent data in both type 1 and type 2 diabetes are encouraging. In type 1 diabetes, where not long ago diabetic nephropathy was almost inevitable after 20–30 years, fewer …

In the state of Florida there is a law in the statehouse to give drug prescribing privileges to Nurse Practitioners and Physician Assistants. Supporters of the bill say there is an acute shortage of prescribers in many areas which prevents patients from getting care. This could be attributed to the …

Over the past few weeks Dr. Stanley Schwartz has been looking at the causes and reasons that insulin resistance and hyperinsulinemia go crazy when a patient develops diabetes. This week, in the last part of the series, he brings to light the use of a couple of older medications and …