Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Changing shape of Type 2

Discussion in 'Diabetic Foot & Wound Management' started by Cameron, Jun 20, 2008.

  1. Cameron

    Cameron Well-Known Member

    Members do not see these Ads. Sign Up.

    From The Medscape Journal of Medicine

    Clinical Reviews
    The Changing Shape of Type 2 Diabetes CME
    Posted 06/18/2008

    Stephen A. Brunton, MD

    Context: Type 2 diabetes is primarily a disease that affects late-middle-aged and elderly individuals. Due to increasing affluence, lifestyle changes, and obesity, however, it is also affecting younger age groups. Therefore, treatment recommendations may need to be revised to reflect these changes. Fortunately, various new treatment options, including insulin analogs with more physiologic time-action profiles and drugs that target the incretin system, are now available.
    Evidence acquisition: This review was based on a PubMed literature search done in August 2007, using relevant search terms.

    Evidence synthesis: Improving diet and increasing physical activity are important therapeutic interventions in diabetes and associated conditions. However, many people find it difficult to maintain lifestyle changes, which is why the American Diabetes Association recommends lifestyle intervention plus metformin following initial diagnosis. Current guidelines recommend a stepwise approach, with additional oral antidiabetic drugs (OADs) being added as the disease progresses. Insulin therapy should be initiated once OADs fail to control hyperglycemia, as there is good evidence that intensive therapy, with strict glycemic targets, can reduce the long-term microvascular complications that are associated with poorly controlled diabetes. In addition, while the evidence is less conclusive, intensive therapy may also improve long-term macrovascular comorbidities.

    Conclusions: It is important that patients with diabetes receive the most effective therapy for maintaining glycemic control and that treatment is modified or augmented in those who are not achieving appropriate glycemic goals. Only by maintaining long-term, effective glycemic control can the microvascular and macrovascular comorbidities associated with diabetes be minimized.
  2. Adrian Misseri

    Adrian Misseri Active Member

    Good one!

    Choice of drugs and delivery mechanisms may assist in this. SIGN 55 suugests that long acting vs. short acting insulin, and inhaled insulin vs. short actibng insulin demonstrate no additional efficacy, but certainly may make a difference ot a patient's lifestyle and improve compliance. Food for thought....

    SIGN Giudelines for Managent of Diabetes

    SIGN 55 update

Share This Page