Physicians' Corner: Is Diabetes Mellitus Ready for the "Do It Yourself" Approach?
Charles F. Shaefer, Jr., MD, FACP, FCCP
Exercising, watching one's weight, monitoring diet, and even self-monitoring of blood glucose are mainstays of self-care. But can the DIY concept go even further than this in DM care?
Hypoglycemia in Childhood Type 1 Diabetes Mellitus: Understanding and Managing the Dark Side of Intensive Insulin Therapy
William V. Tamborlane, MD, Karena Swan, MD, Stuart A. Weinzimer, MD
Despite the availability of advanced insulin delivery systems, blood glucose-monitoring equipment, and insulin analogue formulations, hypoglycemia remains a significant concern in the treatment of children and adolescents with type 1 diabetes mellitus. These observations underscore the need for a closed-loop insulin delivery system in which the rate of insulin infusion is regulated by real-time changes in glucose concentrations.
Pramlintide as an Adjunct to Basal Insulin: Effects on Glycemic Control and Weight in Patients with Type 2 Diabetes Mellitus
Cameron W. Lush, PhD, Tamara Darsow, PhD, Bei Zhang, MD, Gayle Lorenzi, RN, Juan P. Frias, MD
The current post hoc analyses examined the efficacy and tolerability of pramlintide as an adjunct to basal insulin in a subset of patients with type 2 DM in 2 clinical trials. The improvements in glycemic control and weight warrant further clinical investigation into the use of pramlintide as a potential next therapeutic step.
An Update on Insulin Injection Devices
Michael A. Magnotti, MD, Elliot J. Rayfield, MD
This article provides an overview of the various pen devices available in the United States for subcutaneous insulin delivery and discusses the benefits these devices can provide to patients; their disadvantages are also discussed. Third-party reimbursement for these devices is highlighted.
Insulin for Type 2 Diabetes Mellitus: Separating the Myths from the Facts
Timothy S. Reid, MD
Reluctance to use insulin is a well-established problem among patients with type 2 diabetes mellitus. Many of the concerns that prompt patients to resist insulin are rooted in myths that arose because of the medical profession's difficult history with this medication. By investigating the new, simpler, more straightforward algorithms for initiating insulin and using them in patient care, it will be possible to help patients make an informed decision when the time comes to start insulin therapy.
Response to Previous Case Study
Derek LeRoith, MD, PhD
A 25-year-old white woman with a history of polycystic ovary syndrome (PCOS) came to the diabetes mellitus (DM) clinic for a follow-up appointment after gestational DM (GDM) was diagnosed during a recent pregnancy. She was overweight with a body mass index of 29 kg/m squared (height 61 in, weight 154 lb). Blood pressure was 130/80 mm Hg. Her skin examination revealed mild hirsutism and acanthosis nigricans on the back of the neck.
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