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Flexible eating and schedule.
Match insulin doses precisely to need.
Correct the Dawn Phenomenon.
Less hypoglycemia and hypoglycemia unawareness.
Reduces insulin quickly for exercise.
Provide better health through better control (http://www.diabetesnet.com/diabetes_technology/insulin-pumps-advanced.html)."
Problems ith Pumps
hile the insulin pump has many advantages, it is not immune to problems. One of its basic problems "is the potential alteration of the administered insulin by motion, contact with pump surfaces and changes in temperature. Insulin forms aggregated macromolecules that have reduced insulin activity and tend to precipitate in the catheter, causing obstruction. Insulin must be buffered and treated with additives to increase viscosity, thereby improving it physical stability (http://medind.nic.in/ibi/t02/i6/ibit02i6p379.pdf).
The pump has another problem, especially prevalent in the initial models, which is "encapsulation by the dense fibrous tissue of the implant. Early versions were plagued by problems with fluid leakage into the system, short battery life, insulin blockage of the pump…
Bode, Bruce W., MD. William V. Tamborlane, MD and Paul C. Davidson, MD. "Insulin pump therapy in the 21st century. Postgraduate Medicine, Vol. 111. No. 5. May 2002 (accessed 20 January, 2005). http://www.postgradmed.com/issues/2002/05_02/bode3.htm ).
Blake, Donna. The Evolution of Insulin Pumps. (accessed 20 January, 2005). http://www.nfb.org/vod/vsum0001.htm ).
Diabetes and Endocrinology Ask the Expert. The Insulin Pump in Infants and Young
Children. Medscape Diabetes and Endocrinology. 16 October, 2003. (accessed (20 January, 2005). http://www.insulin-pumpers.org/faq/askexpert01.shtml ).
Efficacy and Safety of Oral Insulin Analogs
Oral Insulin Analogs and Gestational Diabetes
Efficacy and Safety of Oral Insulin Analogs during Pregnancy
The promise of better glycemic control and patient treatment compliance is offered by oral insulin analogs (Lee-Parritz, 2012). In the United States and Europe, the most common insulin analogs used to treat pregnant women are the sulphonylureas glyburide and glibenclamide, and the biguanide metformin (Nicholson and Baptiste-oberts, 2011). Most studies examining the efficacy and safety of insulin analogs have relied on gestational diabetes patients, therefore there has been little data generated using type II pregestational diabetes patients. However, Lee-Parritz (2012) assumes the successful use of these drugs in patients with gestational diabetes should not deter physicians from turning to these drugs when treating pregestational diabetes.
A recent meta-analysis of six randomized, controlled studies, having a combined subject pool of 1388 patients, compared insulin to oral insulin analogs (glyburide…
Dhulkotia, Jaya Saxena, Ola, Bolarinde, Fraser, Robert, and Farrell, Tom. (2010). Oral hypoglycemic agents vs. insulin in the management of gestational diabetes: A systematic review and meta-analysis. American Journal of Obstetrics & Gynecology, 203, 457.e1-457.e9.
Lee-Parritz, Aviva. (2012). New technologies for the management of pregestational diabetes mellitus. Obstetrical and Gynecological Survey, 67(3), 167-175.
Nicholson, Wanda and Baptiste-Roberts, Kesha. (2011). Oral hypoglycaemic agents during pregnancy: The evidence for effectiveness and safety. Best Practice & Research Clinical obstetrics and Gynaecology, 25, 51-63.
Diabetes is a major global health concern. Besides the commonly understood lifestyle implications, it is important to understand certain populations' propensity or vulnerability to these diseases in order to more effectively combat them. Obesity, which often starts at childhood and can be dictated genetically through triggers, often leads to insulin rejection, which if left unchecked can lead to full-blown diabetes. Once diabetes becomes visible in an individual, the care and maintenance of that person's health becomes much more difficult. If the genetic, environmental, and behavioral warning signs are heeded, these conditions are much less likely to affect the populations who may be most vulnerable. Certain triggers, both genetic and environmental have been identified in mice that suggest every human has an equal lot in understanding their risk factors for these conditions and mitigating these risks as best as possible. If these triggers and environmental factors are caught and reversed early,…
Bacquer, Olivier; Emmanuel Petroulakis, Sabina Paglialunga, Francis Poulin, Denis Richard,
Katherine Cianflone, and Nahum Sonenberg. "Elevated sensitivity to diet-induced obesity and insulin resistance in mice lacking 4E-BP1 and 4E-BP2." Journal of Clinical Investigation, Vol. 111, No. 2, February, 2007. pp. 387-396.
Lewis a. Barness, Lewis a.; John M. Opitz, and Enid Gilbert-Barness. "Obesity: Genetic, molecular, and environmental aspects." American Journal of Medical Genetics Part a. Vol. 143A, No. 24, December, 2007. pp. 3016 -- 3034.
Jhingan, Ashok. Diet and Diabetes. New Dheli: Concept Publishing, 2005.
Counterbalance of Sugar and Fat Content between Insulin and Glucagon
Physical survival depends on the sustained availability and use of energy in the form of adenosine triphosphate or ATP from sufficient levels of a substance, called glucose (owen, 2001). The use of energy depends on the varying levels of activity. Hence, the amount of glucose needed for activity likewise varies each day. Too much or too little glucose is damaging to the body, hence the need for some system to regulate the availability of glucose. It must be present at the precise time and amount that it is needed in order to maintain what is called glucose homeostasis. Homeostasis is the tendency of the body to maintain internal stability and balance through the coordinated responses of body parts to stimuli or conditions (owen).
Insulin and Glucagon
The regulation of glucose availability begins with the pancreas, primarily by…
Biomed (2002). Insulin/glucagons. Brown University. Retrieved on November 25, 2013
Bowen, R.A. (2001). Hormones, receptors and control systems. University of Colorado.
Retrieved on November 25, 2013 from http://arbl.cvmbs.colostate.edu/hbooks/pathphys/endocrine/basics/index.html
It is generally assumed that iron stores increase during menopausal transition (Kim et al. 2012). However, no longitudinal studies have been conducted to ascertain this. Some women undergoing menopause experience increased insulin resistance and other cardiovascular conditions, which are not attributable to changes in adiposity or sex hormones. Iron is known to be a strong pro-oxidant, which catalyzes reactions tending to raise oxidative stress. This, in turn, is a risk factor for insulin resistance. Increased measures of iron during menopause may then contribute to insulin resistance at this period (Kim et al.).
In response, the Study of Women's Health across the Nation or SWAN was designed and conducted to determine and investigate biologic and sociologic changes during and after menopause (Kim et al. 2012). The researchers measured several iron markers at pre-menopause and post-menopause to find out if 1) iron measures increase from pre-menopause to post-menopause longitudinally; 2) there…
Kim, Catherine, et al. 2012. Changes in iron measures over menopause and associations with insulin resistance. Vol 21 # 8 Journal of Women's Health: 872-877
Diabetes and Thyroid
What is the mechanism of action of insulin and what are the differences in insulin therapy for Type I and Type II diabetes mellitus?
The pancreas secretes insulin, and it is used for the regulation of glucose from the blood into the cells. Insulin assists in lowering blood glucose by causing peripheral glucose uptake by skeletal muscle cells. The breakdown of fat, proteins, and manufacture of glucose is inhibited by insulin. Insulin will also increase protein synthesis and the conversion of excess glucose to fat. Patients suffering from diabetes are not able to produce enough insulin, and this leads to hyperglycemia. Insulin therapy for type I diabetes mellitus is aimed at increasing or providing insulin in the patient's body (Trauner, ichert, & Luddeke, 2013). For type II diabetes, insulin therapy is aimed at controlling blood sugar, increasing insulin levels, and lowering the patient's resistance to insulin.…
Kahn, S.E. (2013). Incretin therapy and islet pathology: a time for caution. Diabetes, 62(7), 2178-2180.
Reinehr, T. (2010). Obesity and thyroid function. Molecular and cellular endocrinology, 316(2), 165-171.
Stohl, H.E., Ouzounian, J., Rick, A.-M., Hueppchen, N.A., & Bienstock, J.L. (2013). Thyroid disease and gestational diabetes mellitus (GDM): is there a connection? The Journal of Maternal-Fetal & Neonatal Medicine, 26(11), 1139-1142.
Trauner, A., Richert, K., & Luddeke, H.-J. (2013). Start of an insulin therapy in type 1 diabetes patients. Diabetes aktuell fur die Hausarztpraxis, 11(06), 248-252.
Type 1 Diabetes
Diabetes has been among the illnesses that need rigid and proper attention to maintain the normal condition of the patient's body. Among the stages and types of diabetes, type 1 diabetes is the illness type that usually hits both the young and adults. This disease is preventable though. However, if the health condition of the patient with type 1 diabetes is not properly managed, the risk to serious complications such as heart ailments, damage in kidney and nerve, blindness, and many others, is high.
In any kind of illnesses, it is essential that one acquire enough information to prevent from getting or developing a disease. In view of this, in relation to type 1 diabetes, this paper finds it important to discuss the pathogenesis of Type 1 Diabetes. This paper aims to provide useful information on the following.
History of Type 1 Diabetes
Symptoms of Type 1…
2002). Clinical practice recommendations: 2002. Diabetes Care.
American Diabetes Association. 25, 21.
Ackinson, M.A., Wilson, S.B. (2002). Fatal Attraction: Chemokines and Type 1 Diabetes.
The Journal of Clinical Investigation, (110)11, 1611.
Discussion #1 Diabetes (either type 1 or type 2) can cause many problems for the patient when the disease is uncontrolled. Please choose one of the problems associated with diabetes and describe what happens to the body to cause the problem. Examine what causes the problem in the patient with diabetes and create a teaching strategy for a patient who is at risk for the problem. Include the types of Insulin in your post, Lantis, Lispro, egular and Intermediate acting and illustrate how evidence-based practice can improve outcomes. Justify your answers and cite your references.
Type 1 diabetes is an autoimmune disease that destroys the insulin-producing beta cells in the pancreas such that it produces only a little or no insulin. Accounting for 5 to 10% of diabetes in the U.S., the disease occurs primarily in children and young adults. Prior to the discovery of insulin in 1921, everyone…
Drugs & Medications - Singulair Oral. WebMed. Retrieved http://www.webmd.com/drugs/mono-8277-MONTELUKAST+-+ORAL.aspx?drugid=6485&drugname=Singulair+Oral
Why Is This Medicine Prescribed? Med Line Plus. Retrieved http://www.nlm.nih.gov/medlineplus/druginfo/meds/a600014.html#side-effects [Type text]
Type 2 Diabetes (T2D) in the U.S.
The development of Type 2 Diabetes (T2D) in the U.S. And developing countries
Type 2 diabetes was known previously as non-insulin-dependent diabetes. Unlike an individual with type 1 diabetes, a person with type 2 diabetic issues continues to produce insulin, but the individual's body fails to respond to it in a normal manner. Glucose cannot penetrate the cells and supply the required energy (it has been commonly referred to as insulin resistance). Eventually, the blood sugar levels rise and make the pancreas produce additional blood vessels insulin. In the end, the pancreas wears out because of overworking to generate surplus insulin and eventually becomes unable to generate adequate insulin to keep blood vessels sugar levels normal. Individuals with insulin resistance may or may not develop type 2 diabetic issues (Atta-ur-ahman, eitz & Choudhary, 2010). This is independent of the pancreas' ability to generate…
Atta-ur-Rahman, Reitz, A.B., & Choudhary, M.I. (2010). Frontiers in Medicinal Chemistry Volume 1. Sharjah: Bentham Science Publishers.
Ginsburg, G.S., & Willard, H.F. (2013). Genomic and personalized medicine. London: Academic.
Kalhan, S.C., Prentice, A. & Yajnik, C.S. (2009). Emerging societies: Coexistence of childhood malnutrition and obesity. Basel, Switzerland: Karger.
Kumar, D. (2012). Genomics and health in the developing world. Oxford: Oxford University Press.
However, advancements in pharmacogenetics promises new and better ways of managing diabetes. Studies have shown that Lisofylline, an anti-inflammatory compound is very effective in suppressing the autoimmune activity and in improving the islet secretion of insulin. Mice studies showed significant difference (25% vs. 91.6%) in the onset of diabetes among Lisofylline treated mice compared to placebo mice. Reduction of inflammatory cytokines IFN-? And TNF-? levels correlated with reduction in ss cell apoptosis. [Yang et.al, 2003] Recent study by Lipsett et.al (2007) has shown that Islet Neogenesis-Associated Protein (INGAP) is useful as a pancreatic regeneration agent. Successful tests in mice and regeneration of cultured human pancreatic cells have encouraged the researchers to seriously consider INGAP as an effective agent for improving insulin synthesis. [Lipsett et.al, (2007)]
A recent Cornell University study focused on an entirely different approach to diabetes management. The researchers examined the possibility of recombinant Commensal bacteria engineered to…
1) George S. Eisenbarth, (2007) 'Update in Type 1 Diabetes', The Journal of Clinical Endocrinology & Metabolism Vol. 92, No.7. http://jcem.endojournals.org/cgi/content/full/92/7/2403
2) McGill University, 'Deficient Regulators in the Immune System Responsible for Type 1 Diabetes', Updated 25 Jan 2008, Available at, http://www.sciencecentric.com/news/article.php?q=08012539
3) Kent SC, Chen Y, & Bregoli L. et.al (2005) 'Expanded T cells from pancreatic lymph nodes of type 1 diabetic subjects recognize an insulin epitope'. Nature 435:224 -- 228
4) Mathieu C, Gysemans C. et.al (Jul 2005), 'Vitamin D and Diabetes', Diabetologia. 48(7):1247-57
Metabolic syndrome is significant for our patient for several reasons. As we have noted, the syndrome is associated with a higher risk of cardiovascular disease. Those patients who have metabolic syndrome tend to develop coronary atherosclerosis at a higher rate than those who have coronary risk factors alone. Obesity increases the risk of metabolic syndrome but so does pre-obesity, or BMI ranging from 25-30. Women who have been diagnosed with polycystic ovarian syndrome are noted to be at increased risk of hypertension, dylipidemia, insulin resistance, impaired glucose tolerance and Type II diabetes. Because of all these comorbidities, women with PCOS also tend to be at greater risk for patients with subclinical carotid atherosclerosis, especially in the premenopausal population (Talbot, et al., 2000). For these same reasons, women diagnosed with PCOS have a 5 fold increased risk for the development of complications of coronary and cerebrovascular atherosclerosis.
Mrs. Stiller has many…
Reaven G. (2002) Metabolic syndrome. Pathophysiology and implications for management of cardiovascular disease. Circulation.106:286-288
Manson JE, Willet WC, Stampfer MJ, Colditz GA, Hunter DJ, Hankinson SE, et al. (2005) Body weight and mortality among women. N Eng J. Med 333:677-85
Juahan-Vague I, Alessi MC. (1997) PAI-1, obesity, insulin resistance and risk of cardiovascular events. Thromb Haemost 78:656-60
Wilson PW. (2004) Estimating cardiovascular disease risk and the metabolic syndrome: a Framingham view. Endocrinol Metab Clin N. Am. 33:467-81
Diabetes in Australia
The Australian government and the relevant Health agencies have for many years strived to put the diabetes menace under close observation and management. There have been massive researches and huge sums directed towards good management and possible elimination of diabetes at the national levels. This commitment is exhibited by the specialized funds and efforts like the Juvenile Diabetes esearch Fund (JDF) that has been committed to striving to mitigate the effects of diabetes from the render age of the Australians.
Since diabetes is such a big challenge to Australia as a whole, diabetes mellitus was declared a National Health Priority Area in 1996 during the Australian Health Minister's Conference and this was as recognition to the high levels of diabetes prevalence within Australia, the mortality rates that were due to it, the impact it had on morbidity and the possibility of the health improvements that can be…
American Diabetes Association, (2013). Kidney Disease (Nephropathy). Retrieved May 13, 2013 from http://www.diabetes.org /living-with-diabetes/complications/kidney-disease-nephropathy.html' target='_blank' REL='NOFOLLOW'>
Lee is only the first step in the process of building a team that is able to cover all aspects of Mrs. Lee's care. The team approach involving a social worker, nurse, physician, pharmacist, and physical therapist affords Mrs. Lee a full range of professionals attending to her various needs.
Although Mrs. Lee has a number of problems that need to be addressed the one problem that must be addressed immediately is her elevated blood pressure. Hypertension is an important risk factor for the development and worsening of many complications of diabetes and an elevated blood pressure is like walking around with a detonated bomb. Within moments, and with little warning, a diabetic patient can suffer a stroke or heart attack as a result of an elevated blood pressure. Well over fifty percent of diabetics suffer from hypertension and proper treatment of hypertension can minimize most of the tangential problems…
Calle-Pascual, A.L. (2002). A preventive foot care programme for people with diabetes with different stages of neuropathy. Diabetes Research and Clinical Practice, 111-117.
Caminal, J. And Barbara Starfield, et. al.(2004). The role of primary care in preventing ambulatory care sensitive conditions. European Journal of Public Health, 246-251.
Deichmann, R.E. (1999). Improvements in Diabetic Care as Measured by HbA1c After a Physician Education Project. Diabetes Care, 1612-1616.
Epstein, M. (1997). Diabetes and hypertension: the bad companions. Journal of Hypertension, 55-62.
How to deal with hypoglycemia:
What is hypoglycemia?
Hypoglycemia is a condition that occurs when a patient's blood sugar (glucose) is too low. Quite often, the patient will be aware of this condition through symptoms such as feeling faint, agitation or anxiety, sweating, weakness, or headache. Confusion and double vision may also manifest themselves. Technically, any blood sugar below 70 mg/dL is considered low (Topiwala 2012). Common causes of hypoglycemia include too much insulin is released into the bloodstream when the patient is an insulin-dependent diabetic.
People with diabetes often suffer hypoglycemia when their condition is not being treated properly, such as when they inject themselves with too much insulin. "Hypoglycemia may also result if, after taking your diabetes medication, you don't eat as much as usual (ingesting less glucose) or you exercise more (using up more glucose) than you normally would" (Hypoglycemia, 2012, Mayo Clinic). Other causes include…
Consent to treatment: Capacity. 2012. NHS. Accessed:
http://www.nhs.uk/Conditions/Consent-to-treatment/Pages/Capacity.aspx [24 Nov 2012]
Diabetes. 2012. Ambulance Technician Study. Accessed:
elationship of high cholesterol levels to the development of cardiovascular disease
Diabetes, heart disease, and high cholesterol are all strongly correlated. Even when diabetes is being well-managed, the patient's risks factors increase for comorbidity with these disorders. "High blood pressure has long been recognized as a major risk factor for cardiovascular disease. Studies report a positive association between hypertension and insulin resistance. When patients have both hypertension and diabetes, which is a common combination, their risk for cardiovascular disease doubles" (Cardiovascular disease and diabetes, 2014, AHA). Also, in the case of Ms. X, because of her uncontrolled diabetes, her risk for high cholesterol is higher than average even in the absence of obesity and inactivity. "This triad of poor lipid counts often occurs in patients with premature coronary heart disease. It is also characteristic of a lipid disorder associated with insulin resistance called atherogenic dyslipidemia, or diabetic dyslipidemia…
Burden, M. (2003). Diabetes: Treatment and complications. Nursing Times, 99(2) 30/
Cardiovascular disease and diabetes. (2012). American Heart Association. Retrieved from:
.....nurse assigned to care for this patient, I would strongly advocate on behalf of the patient's autonomy. The clash between patient autonomy and the healthcare system and its representatives like nurses can only be resolved by being honest in this situation. The patient is under a high degree of stress, not only because of his health condition and the fear that brings out in him, but due to other stressful life events including his financial situation. He was also supposed to get married immediately before the bypass surgery was scheduled, and this is bound to add to his level of stress. The primary issue here is providing what the patient needs to keep him safe during the procedure, and if he insists on using his own pump, which he has successfully used for the thirty years he has lived with the disease of diabetes, then he should use his own…
Type I diabetes is usually diagnosed in children and young adults and results from the body's failure to produce insulin. Type 1 account for 5% to 10% of all diagnosed cases of diabetes (Centers for Disease Control, National Diabetes Fact Sheet, www.cdc.gov/diabetes/pubs/pdf/ndfs_2003.pdf). The most common form of diabetes is Type II, which accounts for about 90 to 95% of all diagnosed cases of diabetes (Centers for Disease Control, National Diabetes Fact Sheet, www.cdc.gov/diabetes/pubs/pdf/ndfs_2003.pdf). Pre- diabetes is a condition often present prior to the development of Type II diabetes. In pre-diabetes, blood glucose levels are higher than normal, but not high enough to be considered diabetic.
Pre-diabetes does not have to lead to the development of diabetes if a person diagnosed with this condition: Patients who work to control their weight and increase their physical activity can often prevent or delay the onset of diabetes. There are 41 million Americans…
American Diabetics Association. Retrieved 22 March 2010 from http://www.diabetes.org /diabetes-basics/diabetes-statistics/
Centers for Disease Control, National Diabetes Fact Sheet.Retrieved 18 March 2010 from www.cdc.gov/diabetes/pubs/pdf/ndfs_2003.pdf
Biological Mechanisms of Hunger
What Causes Hunger: The Biological Mechanisms of Hunger
The biological mechanisms that trigger hunger are rather complex. In that regard, several theories have been proposed in an attempt to explain hunger and the biological mechanisms that control it. It is therefore important to note that the feeling of hunger has no single source. Indeed, as Pastorino and Doyle-Portillo (2012) point out; although the stomach plays a role in the initiation of hunger, it is not the only source of the same.
The liver according to Pastorino and Doyle-Portillo (2012) plays an important part in the regulation of hunger. This it accomplishes by closely monitoring not on the levels of glucose but also the levels of glycogen in the body. In basic terms, glucose (a form of sugar) is burnt by our bodies for energy. On the other hand, glycogen according to Pastorino and Doyle-Portillo (2012) "is…
McGuire, M. & Beerman, K.A. (2009). Nutritional Sciences: From Fundamentals to Food (2nd ed.). Belmont, CA: Cengage Learning.
Pastorino, E.E. & Doyle-Portillo, S.M. (2012). What is Psychology? Essentials (2nd ed.). Belmont, CA: Cengage Learning.
Wagner, H. (2004). Physiological Psychology. New York, NY: Garland Science.
Health Letter to Friend
Hormone problems. Who can't relate to those these days? People talk a lot about symptoms like high blood pressure, emotional ups and down, obesity, all of which might well be related to serious medical concerns that come with our age, or that might be caused by stress or junk food!
Which means you are right to have questions and a bit of anxiety. Some hormone conditions (minor or severe) need attention because they tell us how well the endocrine system is in balance -- and it's the endocrine system that influences how the body works and how different parts of our system function together. So the balance is important.
But hormone imbalances can vary a lot, and it takes information to figure out what's wrong. Diabetes (or being overweight), reproduction problems, infertility, thyroid conditions, high blood pressure, poor cholesterol levels and even lipids (not putting on…
Kemp, S., Chausmer, A.B., and Talavera, F., (2011) emedicineHealth, Anatomy of the Endocrine System. Retrieved on October 15, 2011 from http://www.emedicinehealth.com/anatomy_of_the_endocrine_system/article_em.htm .
Diabetes and Vitamin D Studies
Clearly Focused Issue
Appropriate Method to Answer the Research Question
Acceptable Recruitment Methods
Acceptable Method of Selection of Controls
Minimization of Bias
Were the Confounders Accounted for in the Study Design
Are the Results Believable
Are They Applicable to Other Populations (Generalizable)
Do the Results Fit with Available Evidence
Witham et al., 2010
This is a follow-up study. The issue is whether patients with a vitamin D level of higher than 250 HD will gain a benefit from vitamin D supplementation.
A positive result is defined by reaching a level of 75 nmol or above. This is considered the level for optimum health.
Patients for the study were selected from general practice and diabetes specialty offices based on a positive type 2 diabetes mellitus diagnosis in accordance with the requirement set forth by the World Health Organization.
The group was divided into three…
However, what was once a slow journey has recently gathered momentum with the introduction of "more flexible immunosuppression protocols, the ability to individualize surgical options to patient needs, and the dramatic improvement of isolated islet transplantation results." (Allen, p. 3485) esearchers use pancreas transplant options and advanced surgical techniques, but the donor pancreas and surgical complications, as well as the type of immunosuppression affect the outcome of islet transplantation.
The immunosuppressive drugs have significant side effects and long-term effects are still not known. Known side effects of immunosuppressive drugs include mouth sores and gastrointestinal problems, such as stomach upset or diarrhea. Patients also have experienced increased blood cholesterol levels, decreased white blood cell counts, decreased kidney function, and increased susceptibility to bacterial and viral infections. Taking immunosuppressive drugs increases the risk of tumors and cancer as well.
Progress on whole pancreas and beta cell transplantation has been hampered by the…
Allen, R.D.M., et al. (January-February 2000). Pancreas and islet transplantation: an unfinished journey. Transplantation Proceedings. Vol. 33. Nov-Dec 2001.
Clark, W.L. (January-February 2000). Beta cell replacement and islet transplantation. Diabetes Self-Management. Vol. 17(1): pp. 52, 54, 56.
Collazo-Clavel, M., ed.. (2001). Mayo Clinic on Managing Diabetes. Rochester, MN: Mayo Clinic.
Faustman, D. (December 2004). Towards a cure for type 1 diabetes (and other autoimmune diseases?). Infocus. 12(4): 1.
Glycogen Storage and Use
Exercise and diabetes: Beneficial effects
Diabetes is increasing in the United States and throughout the world due to the ever-growing adoption of an unhealthy lifestyle, including poor diet and lack of physical activity. Obesity is a characteristic often present in individuals with diabetes, and in order for the occurrences of diabetes to be reduced and the effects of diabetes to be minimized, efforts must be put in place to encourage weight loss and the maintenance of a healthy weight. It is expected that obesity and diabetes will reach epidemic proportions unless prompt action is taken to counteract these conditions (Albu & aja-Khan, 2003).
Lifestyle factors have been identified that are associated with glycemic control and body mass in individuals with diabetes. Grylls et al. (2003) found that reducing dietary saturated fat and excess body weight may be useful for improving glycemic control in older adults with…
Albu, J. & Raja-Khan, N. (2003). The management of the obese diabetic patient. Primary Care, 30(2), 465-91.
Borghouts, L. & Keizer, H. (2000). Exercise and insulin sensitivity: A review. International Journal of Sports Medicine, 21(1), 1-12.
Casteneda, C., Layne, J., Munoz-Orians, L., Gordon, P., Walsmith, J., Foldvari, M., Roubenoff, R., Tucker, K., Nelson, M. (2002). A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes. Diabetes Care, 25(12), 2335-41.
Cradock, S. (1997). The role of exercise in diabetes management. Community Nurse, 3(3), 23-4.
According to Waryasz & McDermott (2009), the global prevalence of diabetes among people aged between 20 and 79 rose to 6.4% affecting 285 million people in 2010 and the rate will rise to 7.7% affecting 439 million people by 2030. Amid 2010 and 2030, the rate of individuals with diabetes will increase by 69% in developing nations, and a twenty percent rate in developed nations. In 2011, the number rose to 366 and it is expected to rise to 552 by 2030. The pervasiveness of diabetes is advanced in males compared to females, yet the number of women with diabetes is more compared to that of men.
Diabetes affects any part of the human body and people with diabetes are likely to die of heart-related problems or stroke. Seventy-percent of individuals with diabetes show signs of high blood pressure which a risk factor for heart-related diseases. The majority of…
Boussageon R, Supper I, Bejan-Angoulvant T, Kellou N, Cucherat M, et al. (2012).Reappraisal of metformin efficacy in the treatment of type 2 diabetes: A meta-analysis of randomized controlled trials. PLoS Med, 9(4): e1001204. doi:10.1371/journal.pmed.1001204.
Karin et al.(2002). Diet and exercise among adults with type 2 diabetes: Findings from the Third National Health and Nutrition Examination Survey (NHANES III) . Diabetes Care, 25 (10), 1722-1728
Wang, H., & Yeh, M.(2012). Systematic to insulin therapy in adults with type 2 diabetes. Mixed- method systematic review. Journal of Advanced Nursing, 68(4), 743 -- 757. doi: 10.1111/j.1365-2648.2011.05853.x.
Waryasz, G., & McDermott, A. (2009). Exercise prescription and the patient with type 2 diabetes: A clinical approach to optimizing patient outcomes. Journal of the American Academy of Nurse Practitioners, 22, 217-227.
Beneficial effects of the Mediterranean Diet on Type 2 Diabetic Patients in the United Kingdom.
The beneficial effects of the Mediterranean Diet on Type 2 Diabetic Patients in the UK
Science of the problem
Type II diabetes progresses through two stages. The initial stage is referred to as insulin resistance. During this stage, the pancreas produces enough insulin, but the body's cell are unable to respond to insulin. The pancreas increases the production of insulin in the body to compensate for the resistance. The body cells absorb more and more insulin resulting in the pancreas continuously increasing its insulin production. Eventually, the pancreas will shut down the production of insulin because it is unable to keep up with the demand, which results in type II diabetes. The lack of sugar for conversion to energy results in the starvation of cells and there is a buildup of glucose levels in the…
Carter, P, et al. "A Mediterranean Diet Improves Hba1c but Not Fasting Blood Glucose Compared to Alternative Dietary Strategies: A Network Meta-Analysis." Journal of Human Nutrition and Dietetics 27.3 (2014): 280-97. Print.
Ceriello, Antonio, et al. "The Protective Effect of the Mediterranean Diet on Endothelial Resistance to Glp-1 in Type 2 Diabetes: A Preliminary Report." Cardiovascular diabetology 13.1 (2014): 140. Print.
Huo, R, et al. "Effects of Mediterranean-Style Diet on Glycemic Control, Weight Loss and Cardiovascular Risk Factors among Type 2 Diabetes Individuals: A Meta-Analysis." European journal of clinical nutrition (2014). Print.
InterAct Consortium. "Mediterranean Diet and Type 2 Diabetes Risk in the European Prospective Investigation into Cancer and Nutrition (Epic) Study the Interact Project." Diabetes Care 34.9 (2011): 1913-18. Print.
Obesity cause Diabetes Type 2?
From the time people came into existence; they have witnessed changes in virtually every aspect of life including the global environment, food production, health concerns, demographic growth, and so forth. Nevertheless, the capacity to adapt to the changes has facilitated the inhabitants to survive and have an improved lifestyle. However, as the globe penetrated into the twenty-first century, the standard of living of numerous people has altered to a great extent due to the technological advancements and innovations. People are now in a race where everyone wants to win success, prosperity, and affluence because of which they have neglected or overlooked the aspect of their health (Stern & Kazaks, 2009). Therefore, health has become an escalating and emerging concern in this epoch across the world.
However, when taking health issues under consideration, obesity has been observed as one of the epidemics that have been witnessed…
Barnett, A. (2012). Type 2 Diabetes. New York, NY: Oxford University Press.
Bouatia-Naji, N., Bonnefond, A., Cavalcanti-Proenca, C., Sparso, T., Holmkvis, J., Marchand, M., Delplanque, J., Lobbens, S., Rocheleau, G., Durand, E., Franck De Graeve, Chevre, J., Borch-Johnsen, K., Hartikainen, A., Ruokonen, A., Tichet, J., Marre, M., Weill, J., Heude, B., Tauber, M., Lemaire, K., Schuit, F., Elliott, P., Jorgensen, T., Charpentier, G., Hadjadj, S., Cauchi, S., Vaxillaire, M., Sladek, R., Visvikis-Siest, S., Balkau, B., Levy-Marchal, C., Pattou, F., Meyre, D., Blakemore, A.I., Jarvelin, M., Walley, A.J., Hansen, T., Dina, C., Pedersen, O. & Froguel, P. (2009). A variant near MTNR1B is associated with increased fasting plasma glucose levels and type 2 diabetes risk. PubMed, 41(1): 89-94.
Gastaldelli, A., Ferrannini, E., Miyazaki, Y., Matsuda, M. & DeFronzo, R.A. (2004). Beta-cell dysfunction and glucose intolerance: results from the San Antonio metabolism (SAM) study. PubMed, 47(1): 31-39.
Lim, S., Ahn, S.Y., Song, I.C., Chung, M.H., Jang, H.C., Park, K.S., Lee, K., Pak, Y.K. & Lee, H.K. (2009). Chronic Exposure to the Herbicide, Atrazine, Causes Mitochondrial Dysfunction and Insulin Resistance. PubMed, 4(4). doi: 10.1371/journal.pone.0005186
Diabetic Vascular Disease state caused by the deficiency of a chemical in the body called insulin which is a hormone is called Diabetes. There are two forms of diabetes. In the type-one diabetes no insulin is formed and people require insulin injections for existence. This was once thought it would affect only children, but now it can occur at any age. The type2 diabetes is due to the resistance of the body towards the effects of insulin. This also includes insulin which is insufficient. ut in this type there is some amount of insulin produced. In both the types the blood glucose levels is increased. When compared to people without diabetes, people with diabetes are prone to certain problems. These problems occur in the nerves (neuropathy), kidney (nephropathy) and eye (retinopathy). These people are prone to early heart attacks and stroked due to the hardening of the arteries (arteriosclerosis). With…
Diabetes Basics-About Diabetics," Retrieved from www.orthop.washington.edu/faculty/Hirsch/diabetesAccessed on March 3, 2004
Diabetes & Vascular Disease Research" retrieved from www.medstv.unimelb.edu.au/Research/DCVDR/. Accessed on March 3, 2004
Haptoglobin: A major susceptibility gene for diabetic vascular complications," retrieved from www.pulsus.com/europe/07_02/szaf_ed.htm. Accessed on March 3, 2004
Pathophysiology of Diabetes" retrieved at http://www.dhss.state.mo.us/diabetes/manual/DMOverview.pdf. Accessed on March 3, 2004
Diabetes and Drug Treatments
TYPE II DIABETES AND DUG TEATMENTS
Type I Diabetes
Diabetes mellitus type 1 result from autoimmune destruction of insulin-producing beta cells within the pancreas. Subsequent shortage of insulin translates to increased urine and blood glucose. The developed world is associated with increasingly variant type I diabetes with a large cause of kidney failure and non-traumatic blindness. The link is based on an increased dementia and cognitive dysfunction risk through disease processes of vascular dementia and Alzheimer's disease. The complications are inclusive of sexual dysfunction, acanthosis nigricans, and frequent infections (Jones, et al., 2012).
Type II Diabetes
The classic diabetes symptoms include polyuria (frequent urination), increased thirst, increased hunger (polyphagia), and weight loss. Alternative symptoms commonly presented in the diagnosis include histories of blurred vision, fatigue, recurrent vaginal infections, peripheral neuropathy, and itchiness (Barnett, 2012). However, many people lack symptoms in the initial years and while…
Barnett, A. (2012). Type II Diabetes. New York: OUP Oxford.
Ezrin, C. & Kowalski, R. (2011). The Type 2 Diabetes Diet Book, Fourth Edition. McGraw Hill Professional
Jones, R. M. et al., (2012). New Therapeutic Strategies for Type 2 Diabetes: Small Molecule Approaches. New York: Royal Society of Chemistry
Pereira, M. A. (2013). Nutrition and Type II Diabetes: Etiology and Prevention. New York: CRC Press.
The structure of yetta is similar to that of GLP-1 and performs the same functions. oth promote decreased appetite (Wilson).
Dr. Wysham was an observer at a study conducted on 20 Rockwood diabetic patients who were taking conventional diabetic medication for their uncontrolled blood sugar (Wilson 2005). She was not informed about their glucose levels for several months after the tests began. About two-thirds of the respondents were given different injectible doses of yetta to incorporate into their medication plan, while the rest were given placebos. All of them were instructed and trained to do the injections at certain times twice daily for a month. Then they were subjected to a physical exam. Dr. Wysham closely monitored their liver, kidney, blood counts, and other functions. She observed that the patients consistently lose weight while taking yetta. The average respondent-patient lost 15 pounds in the duration of the study, 5 lost…
Business Editors (2005). Understand the impact of regulatory reform and raised drug
Safety awareness on off-label drug use. 2 pages. Business Wire: Gale Group
2007). Januvia approved in the European Union for the treatment of type-2 diabetes. 4 pages.
2007). Late breaking data released at ADA showed that the investigational use of Januvia and Metformin as initial combination therapy provided significant glucose lowering efficacy over 54 weeks in patients with type 2 diabetes. 8
patient is a 35-year-old (male?), he was diagnosed with diabetes twenty five years ago at the age of ten years old, he claims that this is hereditary in his family. He has one sister who has Type 2 diabetes and a brother who has type 1 diabetes. He manages his diabetes and other illnesses from home and through a medical clinic; for most of his life he has known he has diabetes and manages to regulate it through insulin shots, glucose tablets as well as through the right nutrition, however he claims that this is difficult and there are most days where he experiences draw backs. Many complications have arisen from his diabetes. This patient was selected because of the certain case he has in regards to his diabetes and other complications which had developed from it. His treatment and management also includes an extensive study. At the young age…
role of hormones in the control of body fuel/energy mechanism has been appreciated for close to a century (Dzamko & Steinberg,2009). This concept was identified by the groundbreaking findings by the scientists, Banting et al. (1922) that the hormone, insulin could effectively restore euglycaemia. This paper seeks to give an in depth understanding of metabolism by definition and gives the various component of metabolism and finally the hormonal influence of metabolism. This paper looks into the various substrates that are influence the hormonal actions in fuel metabolism, circumstances under which they occur and the various pathways followed during these metabolisms (Becker, 2001). The intermediary compounds are also considered to the effect. In conclusion, the paper discuses the medical conditions that would arise once these hormones fail to act.
Metabolism is a biological process that takes place in living organisms throughout their lives, once metabolism stops the individuals automatically dies. A…
Banting, F., Best, C., Collip, J., Macleod, J. & Noble, E. (1922). The effects of insulin on experimental hyperglycemia in rabbits. Am J. Physiol 62, 559 -- 580.
Campfield, L.A., Smith, F.J., Guisez, Y., Devos, R. & Burn, P. (1995). Recombinant mouse OB protein: evidence for a peripheral signal linking adiposity and central neural networks. Science 269, 546 -- 549.
Cusin, I., Sainsbury, A., Doyle, P., Rohmer-Jeanreneaud, F. & Jeanrenaud, B. (1995). The ob gene and insulin: a relationship leading to clues to the understanding of obesity. Diabetes 44,
1467 -- 1470.
Teaching Proposal on Diabetes
In recent years, an increase in demand for expansion of education programs for diabetes patients has been observed and for Federal Government or third party payers to support these programs. A survey by Veterans Administration Hospital evaluating the capability of patient for diabetes management, reported lack of formal training in over 35% of patients interviewed (Miller, Goldstein & Nicolaisen, 1978, p. 275). Similarly, accomplishing proper management of self-administration of insulin also continues to be a critical concern. Therefore, an educator needs to set appropriate and reasonable, specific, mutually agreed goals; and should remain sensitive to individual fears and anxieties while setting these goals.
Diabetes education is a lifetime learning process, which is developed and modified as per the requirements of people afflicted with diabetes. However, assessment of these requirements is time-taking, still vital for customizing diabetes education. Thus, to determine one's educational requirements…
Diehl, L. (2002-2016). Teaching Plan for Diabetes Mellitus. Nursesaregreat.com. Retrieved 13 August 2016 from http://www.nursesaregreat.com/teaching-plan-for-diabetes.php
Miller, L. V., Goldstein, J. & Nicolaisen, G. (Sep-Oct. 1978). Patients' Knowledge of Diabetes Self-Care. Diabetes Care, 1(5), 275-280. Retrieved 11 August 2016 from http://care.diabetesjournals.org/content/1/5/275
Ozcan, S. & Erol, O. (Nov 2007). Teaching and Learning in Diabetes: Techniques and Methods. Diabetes Voice, 52(special issue), 23-25. Retrieved 13 August 2016 from https://www.idf.org/sites/default/files/attachments/article_554_en.pdf
Powers, M. A., Bardsley, J., Cypress, M., Duker, P., Funnell, M. M., Fischl, A. H., Maryniuk, M. D., Siminerio, L. & Vivian, Eva. (Jul 2015). Diabetes Self-Management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. Diabetes care, 38(7), 1372-1382. http://dx.doi.org/10.2337/dc15-0730 . Retrieved 11 August 2016 from http://care.diabetesjournals.org/content/38/7/1372
Homeostasis, according to Nirmalan and Nirmalan (2017), is the propensity for living organisms to maintain relative stability in the internal environment. Homeostasis is made possible through the cooperation of several regulatory mechanisms and separate sub-systems which make up the normal physiology of a living organism (Nirmalan & Nirmalan, 2017). During critical illnesses internal or external stress can make an attempt at interfering with the self-regulation systems beyond what is considered as normal range in physiology. According to Palaparthi and Med (2017), the word homeostasis is derived from two Greek words i.e. ‘homeo’ (stands for similar) and ‘stasis’ (standing for stable). Homeostasis is the balance, equilibrium and the stability of the body or of the cell (Palaparthi & Med, 2017). Living organisms exhibit this character. The process of maintaining stability in the internal environment necessitates occasional internal adjustments as the environmental conditions continue to change outside and inside the…
Psychological Influence of Diabetes
The National Diabetes Educational Program is under the sponsorship of the Disease control and prevention and the National institutes of health. The purpose of this joint interaction is to reduce the effects of diabetes and delay the onset of diabetes. The target audience for this program is children, Adults, families, caregivers, healthcare professionals, promoters and peers.
Diabetes as a health related issue has diverse effects on the psychological aspects of people infected. Diabetes as a disease falls into two categories: Type 1 and Type 2. Type 1 Diabetes mellitus also known as juvenile diabetes or insulin dependent diabetes is as a result of destruction of insulin producing cells of the pancreas. The lack of insulin results to an increased urine or blood glucose (Penckofer et. al., 2007). If left untreated the disease may turn out being fatal. The illness may, however, be treated by administration…
Penckofer, S., Ferrans, C.E., Velsor-Friedrich, B., & Savoy, S. (2007). The psychological impact of living with diabetes women's day-to-day experiences. The Diabetes
Educator, 33(4), 680-690.
Sepa, A., Frodi, A., Vaarala, O., & Ludvigsson, J. (2005). Diabetes-related autoimmunity in infancy Psychological stress . Diabetes care, 28(2), 290-295.
Funnell, M.M., Brown, T.L., Childs, B.P., Haas, L.B., Hosey, G.M., Jensen, B., ... & Weiss, M.A. (2009). Self-management education and National standards for diabetes. Diabetes care, 32 (1), 87-94.
Burden of disease: disability/morbidity
The word 'pre-diabetes' applies to persons highly susceptible to contracting diabetes mellitus (type 2). Those diagnosed as pre-diabetic have sustained, higher-than-normal blood glucose levels; however, these levels are not sufficiently high to be characterized as diabetes. Pre-diabetics suffer from either IGT (impaired glucose tolerance), or IFG (impaired fasting glucose), or both. The former denotes a condition wherein glucose tolerance levels of individuals after two hours of glucose consumption lie between 140 and 199 milligrams/deciliter whereas the latter refers to a condition wherein fasting blood glucose levels lie between 100 and 125 milligrams/deciliter (when nothing has been consumed throughout the night) (Thomaskutty & Dwivedi, 2011).
After pre-diabetes sets in, beta cells lose their function progressively, resulting in the onset of diabetes. Type 2 diabetics characteristically have by high blood sugar levels, a condition that, with time, damages blood vessels and nerves, thereby giving rise to…
Diabetes is regarded as one of the most problematic and major health concerns that has become prevalent across the globe. According to Kam et al. (2016), in 2012, diabetes resulted in the deaths of 1.5 million people throughout the world. Given its prevalence and devastating impacts, effective prevention and management of diabetes has become a major issue, especially among high-risk individuals/populations. Based on existing findings in the public health sector, dietary and lifestyle changes have been identified as the most suitable prevention and management techniques of diabetes. This study focuses on examining whether an intervention consisting of a traditional, organic, and all-natural diet of locally grown/produced foods plus exercise is more effective in addressing the body's issues in creating or absorbing insulin than insulin injections. In this regard, the researcher has identified relevant studies that will be synthesized based on their relevance, rigor, and level of evidence in…
Aguiar et al. (2014, January 15). Efficacy of Interventions that include Diet, Aerobic and Resistance Training Components for Type 2 Diabetes Prevention: A Systematic Review with Meta-Analysis. International Journal of Behavioral Nutrition and Physical Activity, 11(2), 1-10.
Ajala O., English, P., & Pinkney, J. (2013). Systemic Review and Meta-analysis of Different Dietary Approaches to the Management of Type 2 Diabetes. American Journal of Clinical Nutrition, 97(3), 505-516.
Cunningham-Myrie, C., Theall, K., Yonger, N., et al. (2015). Associations Between Neighborhood Effects and Physical Activity, Obesity, and Diabetes. The Jamaica Health and Lifestyle Survey, 2008. Journal of Clinical Epidemiology, 68(9), 970-978.
Kam et al. (2016, September 27). Dietary Interventions of Type 2 Diabetes: How Millet Comes to Help. Frontiers in Plant Science, 7(1454), 1-14.
esearch activities, whether clinical trial based, experimentally designed, or product oriented, must exhibit and command interest, enthusiasm, and passionate commitment. To this end the researcher must catch the essential quality of the excitement of discovery that comes from research well done. The first step in the attainment of the desired research goal is to develop a scientific approach toward that which is being investigated. A requirement within the scientific approach best-fit format that is oftentimes misunderstood, and consequently wrongly applied, is that of sampling.
In a rather philosophical approach to sampling Ohlson (1998) states that sampling is " ... But part of the whole. Check to make sure I fairly represent my larger connection " (p. 27). With these words Ohlson is informing the research enthusiast that sampling alone can skew testing results, infuse uncontrollable error into statistical processes, and violate the empirical premise under which the research investigation…
Ferguson, Geroge A. 1966. Statistical Analysis in Psychology and Education. New York:
McGraw-Hill Book Company
Ohlson, E.L 1998. Best-Fit Statistical Procedures, ACTS Testing Labs. Chicago Thompson, David M., Kozak, Sharon E. And Sheps, Sam (1999). Insulin adjustment by a diabetes nurse educator improves glucose control in insulin-requiring diabetic patients: A randomized trial. CMAJ, 161(8):959-62
Van Dalen, Debold B. (1966). Understanding educational research. New York: McGraw-Hill
"A step backward -- or is it forward?" Diabetes Care, 31, 1093-1096.
Huan-Cheng C., Yue-Cune C., Su-Mei, L., Mei-Fang, C., Mei-Ching, H., & Chin-Lin, P. et al. (2007). The effectiveness of hospital-based diabetes case management: an example from a northern Taiwan regional hospital. Journal of Nursing esearch, 15, 296-309.
Khamaisi, M., az, I. (2006). Endothelial dysfunction in diabetes: the role of proteik kinase c. Vascular Disease Prevention, 3, 305-312.
Loganathan, ., Searls, Y.M., Smirnova, I.V., & Stehno-Bittel, L. (2006). Exercise-induced benefits in individuals with type 1 diabetes. Physical Therapy eviews, (11), 77-89.
Ohman-Strickland, P.A., Orzano, a.J., Hudson, S.V., Solberg, L.I., DiCiccio-Bloom, B., & O'Malley, D. et al. (2008). Quality of diabetes care in family medicine practices: influence of nurse-practitioners and physician's assistants. Annals of Family Medicine, 6, 14-22.
Ohshiro, Y., Takasu, N. (2007). ole of protein kinase c-? activation in diabetic nephropathy. Diabetes, 24(3), 61-64.
Sharma, S., Kulkarni, S.K., &…
Balagopal, P., Kamalamma, N., Patel, T.G., & Misra, R. (2008). "A community-based diabetes prevention and management education program in a rural village in india." Diabetes Care, 31, 1097-1104.
Bloomgarden, Z.T. (2007). Screening for and managing diabetic retinopathy: current approaches. American Journal of Health-System Pharmacy, 64(S), S8-S14.
Chang, K., Davis, R., Birt, J., Castelluccio, P., Woodbridge, P., & Marrero, D. (2007). Nurse practioner-based diabetes care management. Disease Management & Health Outcomes, 15, 377-385.
Davis, S., Asch-Goodkin, J. (2007). Heart failure risk climbs with use of glitazones. Geriatrics, 62(9), 11-11.
The high levels of blood glucose lead to the production of insulin therefore patients have excessive production of insulin. There is insulin resistance and hence body cells do not respond in an appropriate way in the presence of insulin (Mealey, 2010).
The main difference between diabetes insipidus, and diabetes mellitus, is that in diabetes mellitus insulin resistance is referred to being "post-receptor." This implies that the problem lies with the cells which respond to insulin as opposed to there being a problem in the production of insulin. The onset of diabetes mellitus is slow and the disorder might go undiagnosed for a very long period of time. Diabetes insipidus has an abrupt onset and it might be diagnosed at any age.
Factors affecting diagnosis and treatment prescription of diabetes
There are various factors that might affect the diagnosis and treatment of these two types of diabetes.one of these factors is…
Mealey, B.L. (2010).Diabetes Pathophysiology. Retrieved July 29, 2013 from http://www.health.am/db/diabetes-pathophysiology/
MediLexicon International Ltd.(2013). All about Diabetes. Retrieved July 29, 2013 from http://www.medicalnewstoday.com/info/diabetes/
The following is the assessment of AB case, a first time visitor to the writer. The assessment will include checking the pharmacologic treatment, reactions to the drugs in the medicines consumed, advisory healthcare practices and exercises, and non-pharmacologic treatment. More information to be provided if need be.
AB, an overweight, 52--?year -- ?old, Hispanic, male comes for the first visit to your office for assessment of complaints about tiredness, nocturia x 2 -- ?3, and finding it difficult to do the required paperwork in the office (Masters, 2014). He informs that he is reportedly having diabetes type 2 for about six years when he first experienced same feelings of fatigue and nocturia x 2 -- ?3. The patient informs he has attended infrequent classes on diabetes that emphasized on importance of physical activity and weight loss (Masters, 2014). His was accompanied by his wife to these…
http://www.webmd.com/sleep-disorders/sleep-apnea/sleep-apnea-treatmentsBeckerman , J., MD, FACC. (2014). Sleep Apnea Treatments. from Food and Drug Administration. (2013). Drug Interactions: What You Should Know. from http://www.fda.gov/Drugs/ResourcesForYou/ucm163354
James Beckerman, M., FACC. (2013). An Overview of High Blood Pressure Treatment. from http://www.webmd.com/hypertension-high-blood-pressure/guide/hypertension-treatment-overview
Joel C. Marrs. (2010). Pharmacy Perspectives in Dyslipidemia Management. from http://www.uspharmacist.com/USPExams/107084/PHS1005.pdf
Lozanda, C., J, MD. (2014). Osteoarthritis Treatment & Management. from http://emedicine.medscape.com/article/330487-treatment#aw2aab6b6b2
Nursing and Diabetics elationship
Assess the past and present impact nurses, including advanced professional/advanced practice nurses, have made in addressing this health issue. The growing number of diabetics as well as the condition's characteristic lasting effects and associated high cost of treatment have given many health personnel sleepless nights. Due to its frightening numbers, the importance of nurses in assisting patients so as to reduce illnesses and deaths among diabetics is on the rise. Some of the roles the concerned nurses can play include patient examination for signs of the disease, placing the patient on effective treatment patterns, assisting the patient to create and work towards health objectives and provide quality care for problems related to the disease when they occur. By carrying out these roles effectively, nurses can be on the frontlines of diabetics training about the complicated nature of the disease and how crucial early treatment could be…
Levich, B. R. (2011). Diabetes management: optimizing roles for nurses in insulin initiation. J MultidiscipHealthc, 4, 15-24.
Arabi, A., Rafii, F., Cheraghi, M. A., & Ghiyasvandian, S. (2014). Nurses' policy influence: A concept analysis. Iranian journal of nursing and midwifery research, 19(3), 315-22.
Doctors use a fasting plasma glucose test to confirm a diagnosis of type-two diabetes. A patient must fast for 8 hours prior to giving a blood sample (http://diabetes.webmd.com/guide/diagnosing-type-2-diabetes). If it is determine that the patient has diabetes, the doctor will prescribe diet management and exercise. In some cases, insulin shots or pills may also be prescribed.
Unlike type-one diabetes, type-two develops because of lifestyle choices. If you are overweight and get little or no exercise, you have a greater chance of developing type-two diabetes. Other un-controllable factors known to contribute to type-two diabetes include: family history, age, race, ethnicity and a low body weight at birth (https://members.kaiserpermanente.org/kpweb/healthency.do?hwid=hw135189§ionId=ur1000&contextId=hw135189).
COMPLICATIONS AND EFFECTS OF DIABETES
There are many long-term health issues are associated with diabetes. If a patient fails to be diagnosis or a patient does not maintain their insulin schedule, complications may occur. Diabetics have a higher likelihood of developing eye problems…
www.webmd.com www.diabetes.org www.kaiserpermanente.org
Bakalar, N. "Diabetes: A state-by-State Breakdown," New York Times, October 12, 2009.
Clinical Learning Outcomes
Interaction of Variables.
Evaluating clinical learning outcomes
Describe the skill and the learner you intend to teach and evaluate
Because of cutbacks in the number of days new patients are allotted to spend in the hospital, patients and their families are increasingly responsible for more of the patient's care, even immediately following a diagnosis of a serious illness such as type I, or juvenile, insulin-dependent diabetes. Teaching patients to correctly monitor their blood sugar and self-administer insulin is essential, but it requires a high level of patient compliance and willingness to learn. It is essential that young patients and their parents have a thorough understanding of the process.
Briefly describe how you would design the learning experience
Learning is a step-by-step process. It is important not to bombard patients with knowledge right away, when they are still frightened and confused. Also, although there are real risks with…
Hahn, K.K. (1990). Teaching patients to administer insulin. Nursing, 20(4), 70-70.
Silvestrone, J.M. (2004). Performance-based assessment: Improving the value of laboratory and skills examinations. New Directions for Teaching & Learning, 100, 65 -- 71.
Quality Improvement Project
Diabetes -- Chronic Condition Background
Type 1 and Type 2 Diabetes
isk factors for type 1 diabetes
isk factors for prediabetes and type 2 diabetes
isk factors for gestational diabetes
The ationale for Selection
The Target Population
It has been estimated that in New York there is roughly two million people, or over twelve percent of the population, that have diabetes; furthermore, of this population, over half a million people have the condition but are not aware that they have it (American Diabetes Association, N.d.). It is further estimated that nearly five and a half million people, or over a third of the population, have prediabetes. Diabetes and diabetes-associated cardiovascular diseases have become the leading cause of death in the region accounting for roughly two-thirds of the deaths and the rates of diabetes has lead this trend to be referred to as the…
American Diabetes Association. (N.d.). Health Disparities. Retrieved from American Diabetes Association: http://www.diabetes.org /advocacy/advocacy-priorities/health-disparities.html
American Diabetes Association. (N.d.). New York, New York. Retrieved from American Diabetes Association:
ewards and Benefits From Exercise
Specific Purpose: The purpose of this essay is to find out the rewards and benefits individuals rewards and benefits from exercise.
Consistent exercise gets rid of tension, enhances appearance, keeps person healthy, and raises stamina plus keeps you younger.
In recent years, numerous individuals have turn out to be more and more aware of the need for physical fitness. Nearly everywhere individuals turn, whether it is to a kiosk, television or commercial, information for protecting and refining health overwhelms them. Even though much of this information is commercially inspired by those enthusiastic to sell natural foods, vitamins, and decreasing tricks, some of it, particularly that encouraging a consistent exercise program, merits thoughtful consideration. This kind of a program, if it entails of as a minimum an hour or just thirty minutes a week and if an individual's physician supports it, offers numerous benefits. Consistent exercise…
Bijnen FC, F. E. (2012). Baseline and previous physical activity in relation to mortality in elderly men: the Zutphen Elderly Study. American Journal of Epidemiol, 150(34), 1289-96.
Helmrich SP, R. D. (2014). Prevention of non-insulin-dependent diabetes mellitus with physical activity. Medical Science Sports Exercercise, 87(4), 824-30.
Mayo Clinic Staff. (2014, March 8). Exercise: 7 benefits of regular physical activity. Retrieved from Mayo Clinic: http://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise/art-20048389
Richardson, V. (2014, March 8). A Fit Body Means a Fit Mind. Retrieved from Edutopia: http://www.edutopia.org/exercise-fitness-brain-benefits-learning
Untreated diabetes can result in serious deterioration of the circulatory system as a consequence of long-term exposure to elevated blood glucose levels (NIDDKD, 2006). By monitoring blood glucose levels and administering insulin to reduce glucose concentration in the blood, many patients can carry on with their lives without significant effects of the disease (ADA, 2009).
However, undiagnosed or untreated diabetes can have very serious effects on the body and consequences for the patient. Among those effects and consequences are kidney damage, cardiac and circulatory system damage, as well as vision problems leading to increasing blindness (ADA, 2007; ADA, 2009). Because untreated or insufficiently managed diabetes often results in decreased circulation to the extremities, diabetes is also associated with the significant risk of losing fingers, toes, and even arms or legs. Once circulation is reduced below the minimum level required to oxygenate tissues enough to sustain them, the patient is at…
American Diabetes Association. (2007). "Diabetes and women's sexual health"
Retrieved July 31, 2009, from: http://www.diabetes.org /type-1-diabetes/women-sexual-health.jsp.
American Diabetes Association. (2009). "Standards of medical care in diabetes"
Retrieved July 31, 2009, from:
Medical Conditions -- There are a number of factors that can increase the likelyhood of type-2 diabetes: hypertension, eleveted cholesterol, and a condition called Symdrome X, or metabolic syndrome (combination of obesity, high cholesterol, sedentary lifestyle, stress, and poor diet). Cushing's syndrome, cortisol excess and testosterone deficiency are also associated with the disease. Often, it is a number of co-dependent conditions that seem to give rise to diabetes (Jack & Boseman, 2004).
Genetics -- There is ample evidence that there is a strong inheritable genetic condition in type-2 diabetes. In addition, there is a genetic mutation to the Islet Amyloid Polypeptide gene that results in early onset diabetes (Lee & Hasim, 2001). There is a stronger inheritance pattern for type-2 diabetes with a significant association between family members. Typically, this is excacerbated by cultural and lifestyle factors that, while not inherited, are culturally shared. Gene expression promoted by a diet…
Diabetes mellitus (DM) is a multisystem disease with both biochemical and anatomical consequences. It is a chronic disease of carbohydrate, fat, and protein metabolism caused by the lack of insulin. In type 1 diabetes, insulin is functionally absent because of the destruction of the beta cells of the pancreas. Type 1 DM occurs most commonly in juveniles but can occur in adults, especially in those in their late 30s and early 40s. Unlike people with type 2 DM, those with type 1 DM generally are not obese and may present initially with diabetic ketoacidosis (DKA).
In this particular case, Yusuf, a 12-year-old boy was diagnosed with type 1 diabetes after exhibiting some of the following symptoms: weight loss, excessive urinating, and an unquenchable thirst. More recently, Yusuf was again admitted to the hospital after complaining of nausea, vomiting and intense thirst. The doctor observed that he appeared confused and was…
Diabetic Intervention Planning
The intervention plan that I would create and attempt to implement to address the health promotion issue of Type 2 diabetes is one that is fairly standard for treating this malady. Quite simply, it would involve patients monitoring their blood sugar levels multiple times a day. Additionally, it would also require their self-administration of insulin (Ehrlich, 2013) in order to maintain patient-specific targets for their blood glucose values. This intervention plan would occur for a finite period of time -- for a one month period -- in order to properly evaluate its efficacy in helping patients achieve target objectives for maintaining acceptable and healthy blood sugar levels. Individuals would have a variety of options that they could select for injecting insulin. They could either choose to utilize an insulin pen, insulin pump, or the "long-acting basal insulin glargine" (Trask, 2014). Patients would be expected to measure their…
Ehrlich, S.D. (2013). Diabetes. University of Maryland Medical Center. Retrieved from http://umm.edu/health/medical/altmed/condition/diabetes
Trast, J.M. (2014). CE: diabetes and puberty: a glycemic challenge. American Journal of Nursing. Retrieved from http://journals.lww.com/ajnonline/Fulltext/2014/07000/CE___Diabetes_and_Puberty___A_Glycemic_Challenge.23
There are various types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. Type 1 diabetes occurs when the body fails to produce adequate amounts of insulin. It most often is found in children and young adults which is why it is now referred to as juvenile diabetes. Type 2 diabetes occurs when cells fail to respond to insulin. This subtle distinction makes a great deal of difference in terms of treating the two types of diabetes (Arcangelo & Peterson, 2006). It is also worth noting that type 2 diabetes tends to set in later in life, typically around middle age, though it can occur earlier. Moreover, 90% of all diabetes cases are type 2 diabetes. Gestational diabetes occurs in pregnant women who have never had diabetes but who have high blood sugar levels during pregnancy. Nearly one in ten women is at risk of developing gestational diabetes.…
Exercise and Pregnancy
"How much, and how intensively, nurse, should I exercise over the course of my pregnancy?' A seemingly simple question -- and one a gynecological or obstetrical nurse must be prepared to answer, given that many newly pregnant women may feel more comfortable directing such queries to a nursing staff health care provider, rather than a physician. This may be particularly the case if the attending physician is male, and the woman has concerns germane to the 'female' experience of pregnancy and exercise, such as weight control or temporary pregnancy-specific problems related to exercise such as bladder or back pain or incontinence. ut as nursing strives to teach and treat the whole individual undergoing a pregnancy, all nurses must be prepared to answer such crucial questions as to how much, when, and how a pregnant woman should exercise.
Article 1: 1998 Overview from the American Family Physician
Note: All articles from the peer-reviewed journal available on the EBSCO list of ejournals at http://ejournals.ebsco.com/info/EJSTitles.asp?PageNo=1
Miller, Karl E. (1 Sept 2004) "Exercise in patients with gestational diabetes."American Family Physician. Retrived 1 Jul 2005 at http://www.findarticles.com/p/articles/mi_m3225/is_5_70/ai_n6182511
Walling, Anne D. (15 May 2005) "Exercise During Pregnancy Is Associated with Thinner Babies." American Family Physician. Retrived 1 Jul 2005 at http://www.findarticles.com/p/articles/mi_m3225/is_10_65/ai_85615776
Wang, Thomas W. & Barbara S. Apagar. (15 Apr 1998)"Exercise during pregnancy." American Family Physician. Retrived 1 Jul 2005 at http://www.findarticles.com/p/articles/mi_m3225/is_n8_v57/ai_20570146/pg_2
The pathophysiology of Type 2 diabetes is found in the way the body's relationship with insulin. Either the body produces too little of it to meet the body's own needs or else there is a resistance to the insulin that the body has developed (which makes the insulin unable to do what it should -- thus there could be enough insulin in the body, it is just that cells in the body do not respond to it). The cause is due to "a combination of genetic factors related to impaired insulin secretion and insulin resistance" and impacts from external factors "such as obesity," inadequate exercise, aging, etc. (Kaku, 2010, p. 41).
Wilmot and Idris (2014) show that there is an age continuum risk associated with separating Type 2 diabetes diagnosis onsets into two separate categories -- pediatric (under 20 years of age) and adult (over 20). They assert that…
Billings, L., Florez, J. (2010). The genetics of type 2 diabetes: what have we learned from GWAS? Annals of the New York Academy of Sciences, 1212: 59-77
Cunningham-Myrie, C., Theall, K., Yonger, N., et al. (2015). Associations between neighborhood effects and physical activity, obesity, and diabetes: The Jamaica Health and Lifestyle Survey, 2008. Journal of Clinical Epidemiology, 68(9): 970-978.
Davis, B. (2012). Defeating Diabetes: Lessons from the Marshall Islands. Today's
Dietitian, 10(8): 24.
A group of authors note, "In the United States, an increase from fewer than four percent to more than 50% of new cases of type 2 diabetes in the pediatric population was reported between the years of 1982 and 1998" (Leung, Kamla, Lee, and Mak). This means that children in our family could come down with the disease earlier in life, and they would have to manage their disease throughout their lives.
After diagnosis, without treatment, the disease can progress. One of the problems with the disease is that people often do not know they have the disease, and so it progresses before they gain treatment. Therefore, it is important to know the symptoms of diabetes. They can include fatigue and weakness, dehydration (often due to increased urination), increased thirst, weight loss, blurred vision, and confusion. There can also be some severe, long-term complications from type 2 diabetes. It can…
Draznin, Boris. "T2D: The Longest Mile Type 2 Diabetes." USA Today (Society for the Advancement of Education) Sept. 2007: 74+.
Leung, Raymond W., Jim Kamla, Man-Cheong Lee, and Jennifer Y. Mak. "Preventing and Treating Type 2 Diabetes through a Physically Active Lifestyle." JOPERD -- The Journal of Physical Education, Recreation & Dance 78.4 (2007): 38+.
Masharani, Umesh. Diabetes Demystified. New York: McGraw-Hill, 2008.
Type II iabetes
Achieving Optimum Well-Being with Type-II iabetes
iabetes is a serious illness, and it is becoming more and more common in the United States. Obesity statistics are startling, and they are rising yearly; with increased overweight individuals, the risk of Type II diabetes especially, also increases, and few things are undertaken to curb these harmful side effects of the unhealthiness that is taking over this country. While diabetes includes both Type I and Type II, and while both are very common and must be understood, this paper will undertake to understanding Type II diabetes, and will aim to find out exactly what causes this type of diabetes and how society can begin to curb its effect in the populations most affected. Furthermore, the paper will argue that there are two fundamental things that can help a person with diabetes live a better life, and these are…
Diabetes and Exercise, 2012.
9 Foods you should be eating for Type 2 Diabetes. (2012). Joy Bauer Food Cures. Retrieved, .
Diabetes Diet: Foods to Avoid. (2012). Everyday Health. Retrieved, .
acial and Ethnic Approaches to Community Health (EACH 2010 Program)
The health objectives for the United States for the 21st century have been described in The Federal Initiative to Eliminate acial and Ethnic Health Disparities and Healthy People 2010. The national interest in the areas of racial and ethnic disparities has been renewed with the public health initiatives with the leadership for the discussion being taken by the Center for Disease Control and Prevention. The overall health of the nation has improved a lot, but the members of the minority groups in the ethnic and racial areas have not been benefited. This includes the African-Americans, Alaska Natives, American Indians, Asian-Americans, Hispanic-Americans and Pacific Islanders.
This segment of our population is more likely to have poor health and premature deaths than the white Americans. During 1992 to 1998, the deaths from breast cancer have come down noticeably, but there are more…
Author Unknown) (n.d) Chronic Diseases, Risk Factors, and Preventive Services, Alabama. Retrieved at http://www.4woman.gov/owh/reg/4/overview.htm. Accessed on 15/10/2003
Author Unknown) (n.d) Health Disparities and Non-insulin Type 2 Diabetes. Retrieved at http://www.medicalnewsservice.com . Accessed on 15/10/2003
Author Unknown) (n.d) HHS Awards more than 65 Million to eliminate health disparities. Retrieved at http://apps.nccd.cdc.gov/BurdenBook/DeathCause.asp?state=alAccessed on 15/10/2003
Author Unknown) (n.d) Overview of Region lV. Retrieved at http://www.cdc.gov /nccdphp/exemplary/racial.htm. Accessed on 15/10/2003
Diagnostic Treatment and Interventions for Diabetes in Children
"Diabetes can affect many parts of the body with serious complications ... heart disease, stroke, blindness, kidney failure, and lower-limb amputations ... " (CDC).
According to the American Diabetes Association (ADA) approximately 1.25 million American children and adults have diabetes type 1. As for children, the Centers for Disease Control and Prevention (CDC) reported in 2014 that 22 out of every 100,000 children under the age of 10 in the U.S. have type 1 diabetes. And a 2014 report in USA Today quotes a study in the Journal of the American Medical Association that shows that "... nearly 167,000 children and teens younger than 20 have type 1 diabetes" (Szabo, 2014). That data conflicts with the ADA data that reports 208,000 Americans under 20 have type 1 diabetes. No matter the conflicting data, it is clear that the rate of diabetes in…
American Diabetes Association. (2014). Statistics About Diabetes. Retrieved July 21, 2016, from http://www.diabetes.org .
Bukara-Radujkovic, G, Zdravkovic, D., and Lakic, S. (2011). Short-term use of continuous
Glucose monitoring system adds to glycaemic control in young type 1 diabetes mellitus
Patients in the long run: A clinical trial. Vojnosanitetski Pregled (VSP), 68(8), 650-660.
The circulatory or cardiovascular system is responsible for moving nutrients, wastes and gases between body cells, transporting blood across the whole body and battling disease (Circulatory System). Its principal elements are the heart, numerous blood vessels, and blood.
The heart forms the circulatory system's core. This 2-sided, 4-chambered pump which distributes blood to various arteries comprises of the right and left ventricles, and right and left atria. The ventricles, situated within the heart's lower half, are responsible for pumping blood to the whole body (away from our heart), whilst the atria, situated within the heart's upper half are in charge of receiving blood from different parts of the human body. The right and left ventricles pump de-oxygenated and oxygenated blood, respectively; de-oxygenated blood is pumped to lungs while oxygenated blood is pumped to the remainder of the human body (smith, 2013). These 4 chambers are connected to one another by…
Five thousand flyers will be distributed to local synagogues and churches. Another major distribution channel is through the public education system, Brooklyn College is located within the Midwood community, it has now become a strong community meeting point for both students and adults. Pamphlets distributed through the school will be able to attract large audiences. ADA provides a series of seminar and workshops called the "Diabetes Awareness Program." Using the DAP as the basis for creating local interest; this series will be launched through the community as a public forum for understanding diabetes. Such a forum will be targeted to two distinct audiences. The first will be public speaking engagements for local health care professionals to increase their awareness of diabetes within their community and prepare for the flood of questions to come. Information sessions for the general public will take the form of public rallies or seminars staged through…
On the afternoon of February 8, 2007, I received a dispatch call on a potential homicide at 1100 SE Lynn Boulevard, Prineville, Oregon. This location is the local high school, named Crook County High School. The information given to me prior to my arrival at the scene is as follows:
Upon arrival to the scene, school security guard William Parkins and responding Officer Edward ichardson of Crook County Police department provided some information to me. Parkins provided to me the name of the victim, Marc Hollingsworth. Officer ichardson informed me that Hollingsworth's mother, Karen Lynn Griesel Hollingsworth, was already notified and currently en route to our location. Parkins then told me that student and girlfriend of the victim, Amber Johnson, had been the one to find Hollingsworth's body after seeing his red 2000 Ford F150 in the back row of the school parking lot. Soon before seeing him,…
Bend Bulletin. (2007, February 14). Marc Adam Hollingsworth. Retrieved January 19, 2011
Fisher, B. (2004). Techniques of crime scene investigation. Boca Raton, FL: CRC Press.
Saferstein, R. (2004). Criminalistics: An introduction to forensic science. Upper Saddle River,
A disease is classified as 'chronic' when it cannot be cured and will last throughout the duration of the patient's life. Type II diabetes is an example of a chronic disease which is on the rise and which can be managed but cannot be entirely 'cured.' Unlike type I diabetes, which typically manifests itself in early childhood as an autoimmune disorder, type II diabetes is caused by a combination of environmental and genetic factors. "The majority of people (80%) who develop type 2 diabetes are overweight" (Burden 2003).
What two nursing preventions can nurses do for this chronic illness?
Because type II diabetes is classified as a lifestyle-related disorder, treating it requires a change of diet and altering other habitual factors. "The basis of initial treatment is to pay attention to dietary intake and to encourage exercise so as to induce weight loss, the rationale being to improve…
Burden, M. (2003). Diabetes: treatment and complications - the nurse's role. Nursing Times,
99 (2): 30. Retrieved from http://www.nursingtimes.net/nursing-practice/clinical-zones/diabetes/diabetes-treatment-and-complications-the-nurses-role/205780.article
ole of Autoimmunity in Three Endocrine Disorders
A number of endocrine illnesses are immune mediated and can now be reliably predicted. Autoimmune disorders can occur in a person and people related to them. Families with history of autoimmunity, and has had antibody screening done, becomes aware of those that carry such risk. Knowing the prevalence of such disorders and the diseases associated with them can help in early diagnosis and prevent them from becoming more serious. Autoimmunity affects several glands in the body. Studies reveal that alleles are very important in the determination of tissue-specific targeting (Aaron W. Michels & George S. Eisenbarth, 2010).
The Process of Autoimmunity
Autoimmunity is necessary for the body to maintain its health by countering effects of external virulent and organic attacks. It involves regulatory networks that provide the body with immunity against infection. It has not yet been determined why instances arise where autoimmunity…
Aaron W. Michels, & George S. Eisenbarth. (2010). Immunologic Endocrine Disorders. Journal of Allergy, Clinical Immunology, 225-237.
Aleksandra Krzewska, & Iwona Ben-Skowronek. (2016). Effect of Associated Autoimmune Diseases on Type 1 Diabetes Mellitus Incidence and Metabolic Control in Children and Adolescents. Biomed Research International.
Heves Kirmizibekmez, Rahime Gul Yesiltepe Mutlu, Nafiye Demirkiran Urganci, & Ayse Oner. (2015). Autoimmune Polyglandular Syndrome Type 2: A Rare Condition in Childhood. Kirmizibekmez H, Yesiltepe Mutlu RG, Demirkiran Urganci N, Oner A. Autoimmune Polyglandular Syndrome Type 2: A Rare Condition in Childhood. Journal of Clinical Research in Pediatric Endocrinology. 2015;7(1):80-82. doi:10.4274/jcrpe.1394., 80-82.
Kohei KAKU. (2010). Pathophysiology of Type 2 Diabetes and its Treatment Policy. Japan Medical Association Journal, 41-46.