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RESOURCES

What’s the Best Teacher?

Over the years I’ve found the best teacher for people who have diabetes is their numbers. Without teaching the patient targets, they don’t learn much. This patient is just one example of many. A man, 57 years of age, visits a community diabetes education course. He tells me he has type 2 diabetes, hypertension hyperlipidemia. He said his doctor told him his numbers were fine about 9 months ago. When he came to the course, he was losing weight, was thirsty and was very tired.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #82: Insulin Actions In Vivo: Glucose Metabolism Part 9 of 9

Oral glucose: At any point in time, the glycemic response to exogenous glucose is the balance between the rate at which glucose appears in the systemic circulation (from oral as well as endogenous sources) and the rate at which glucose is disposed of. Oral glucose appearance in the peripheral circulation depends on: (a) the rate at which the gastric contents are passed on to the small intestine; (b) the rate of intestinal glucose absorption; (c) the extent of gut glucose utilization; (d) the degree of hepatic glucose trapping; and (e) the dynamics of glucose transfer through gut, liver, and posthepatic circulation on to the right heart.

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