Long-Term Complications and Treatments: Dyslipidemia Steve V. Edelman, MD Robert R. Henry, MD Dyslipidemia Lipid abnormalities that accelerate atherosclerosis and increase the risk of CV disease are significantly more common in patients with type 2 diabetes than in nondiabetic individuals. In addition, central obesity associated with type 2 diabetes is …

Long-Term Complications: Macrovascular Steve V. Edelman, MD Robert R. Henry, MD The long-term, chronic complications of diabetes have the greatest impact on the health of individuals with diabetes as well as on the health care system. Diabetes and its associated vascular complications are the fourth leading cause of death in …

Metabolic: Hyperosmolar Hyperglycemic Nonketotic Syndrome Steve V. Edelman, MD Robert R. Henry, MD This acute metabolic complication is a life-threatening crisis with a high mortality rate that usually is seen in: Elderly patients with Type 2 diabetes (particularly those in nursing homes without access to free water) People with undiagnosed …

Assessment of the Treatment Regimen, Part 4 Steve V. Edelman, MD Robert R. Henry, MD Applying SMBG Results to Adjust Insulin Doses Patients can be taught how to analyze and use SMBG data to effectively make adjustments in their insulin doses so that they can maintain and improve glycemic control…. …

Combination Therapy, Chapter 9 – Part 4 Steve V. Edelman, MD Robert R. Henry, MD Combination therapy usually refers to the use of oral antidiabetic agents (daytime) together with a single injection of intermediate-acting or long-acting insulin at bedtime. The rationale for using an evening-insulin strategy is based on the …

Acute Complications: Metabolic – DKA Steve V. Edelman, MD Robert R. Henry, MD The most common acute complications of diabetes are metabolic problems (DKA, HHNS, hypoglycemia) and infection. In addition, the quality of life of patients with chronic and severe hypoglycemia is adversely affected. Characteristic symptoms of tiredness and lethargy …

Multiple-Injection Regimens, Chapter 9 – Part 5 Steve V. Edelman, MD Robert R. Henry, MD One of the more common insulin regimens utilized in Type 2 diabetes mellitus is a split-mixed regimen consisting of a prebreakfast and predinner dose of an intermediate- and a fast-acting insulin. This split-mixed regimen of …

Insulin-Pump Therapy + New Types of Insulin Preparations + Complications of Insulin Therapy, Chapter 9 – Part 6 Steve V. Edelman, MD Robert R. Henry, MD Insulin-Pump Therapy Insulin-pump therapy has been traditionally used for people with Type 1 diabetes. People with Type 1 diabetes usually do not have insulin …

Pramlintide Therapy, Chapter 11 – Part 1 Steve V. Edelman, MD Robert R. Henry, MD The discovery of insulin over 80 years ago is one of the great success stories in the history of modern medicine.  Although insulin remains the mainstay of therapy for many patients with diabetes, the greatest …

Pramlintide Therapy Steve V. Edelman, MD Robert R. Henry, MD Mechanisms of Action: Gastric Emptying In healthy individuals, amylin modulates the rate of gastric emptying, most likely via the vagus nerve, to regulate the inflow of nutrients into the small intestine and thereby reduce the postprandial rise in glucose.