Female, 24 years of age, type 2 diabetes and obesity, wants better glucose management and to lose weight. Most of her meals consist of high carb, fast food take out, she skips breakfast and overeats during the evening hours. She has a sedentary lifestyle. She reports being an “all or …

David Levy, MD, FRCP      Preferred treatment: angiotensin blockade It is universally accepted that angiotensin blockade should be preferentially used in hypertensive diabetic patients. Although the evidence for greater cardiovascular risk reduction compared with other drug groups is not overwhelming, the renoprotective benefits in type 2 diabetes, and reduction in renal end …

David Levy, MD, FRCP      Pharmacological treatment: general features The value of ranking antihypertensive agents The near-universal adoption of treatment algorithms using strong recommendations for first-, second-and third-line treatments, habitual for the past 30 years or more, has been challenged by the European Society of Hypertension (ESH, 2007, 2009). The logic of …

David Levy, MD, FRCP      Thresholds and targets for treatment Type 2 diabetes Thresholds and targets for treatment are shown in Table 11.1. There is general agreement that treatment should start once blood pressure is persistently greater than 140/90 mmHg. Targets for treatment have in some cases run ahead of the evidence; …

David Levy, MD, FRCP      Introduction Despite more clinical trials than any other aspect of diabetes, many questions still remain about hypertension. Treatment targets continued to fall after UKPDS (1998), but even in contemporary trials with the most stringent treat-to-target protocols they are rarely achieved (see Chapter 8). Because antihypertensive agents, like …

Insulin use for more than three years associated with increased risk of disease… People with diabetes may be at a greater risk of cancer such as liver, pancreas, endometrium, colorectum, bladder, and breasts. Certain diabetes medications can increase the odds of cancer even more. A previous study has suggested that …

Low glucose events requiring emergency services differs according to diabetes type… Hypoglycemic episodes are a common event among patients with diabetes. Most hypoglycemic events are treated without ambulance services or admission to a hospital. However, severe hypoglycemic events are treated differently. Severe hypoglycemia is defined as “an episode requiring external …

Indication given for heterozygous HF and secondary prevention…

Blood glucose showed significant decrease months after procedure… Type 2 diabetes has become more common in today’s society. Currently, modified gastric bypass surgery is used to treat type 2 diabetes. This intervention has been utilized since the 1990s. The procedure reached 83% efficiency and currently the therapeutic mechanism is still …

Impact of long-term use of medication on cardiovascular events studied… There are several studies that state that diabetes decreases life expectancy due to an increase of cardiovascular events and there is inclusive evidence about utilizing tight glycemic control to decrease the risk of these events. Many diabetics utilize insulin glargine …