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diabetes guidelines

Michèle M Kislan, Adam T Bernstein, Loretta R Fearrington, Timothy J Ives
BACKGROUND: Clinical Pharmacist Practitioners are advanced practicing pharmacists in North Carolina that provide disease-specific management. The purpose of this retrospective cohort study was to compare the efficacy and charges from referrals to a Clinical Pharmacist Practitioner by the primary care provider, to those managed by a primary care provider alone. METHODS: Patients were separated into cohorts depending if they had at least two appointments with a Clinical Pharmacist Practitioner from November 2008 to November 2011...
October 21, 2016: BMC Health Services Research
Z Y Dai, D Liu, R Li, Y Wang, J Zhang, J Liu, R Zhou, G Zeng
Objective: To understand the association between gestational weight gain (GWG) per trimester/total (GWG) and gestational diabetes mellitus (GDM). Methods: A prospective cohort study was conducted among 829 healthy pregnant women from Chengdu who delivered a singleton during March-September 2013. Basic information about pre-pregnancy was collected at the first time, exercise information per trimester, dietary intake information per trimester and gestational age at delivery were obtained by questionnaire. Weight at the (12 ± 1)(th), (28 ± 1)(th), (36 ± 1)(th) and last week before delivery were measured...
October 10, 2016: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
Sarita Parihar, Richik Tripathi, Ajit Vikram Parihar, Fahad M Samadi, Akhilesh Chandra, Neeta Bhavsar
AIM: This study was designed to assess the reliability of blood glucose level estimation in gingival crevicular blood(GCB) for screening diabetes mellitus. MATERIALS AND METHOD: 70 patients were included in study. A randomized, double-blind clinical trial was performed. Among these, 39 patients were diabetic (including 4 patients who were diagnosed during the study) and rest 31 patients were non-diabetic. GCB obtained during routine periodontal examination was analyzed by glucometer to know blood glucose level...
September 2016: Journal of Oral Biology and Craniofacial Research
Irma Elizabeth Huayanay-Espinoza, Felix Guerra-Castañon, María Lazo-Porras, Ana Castaneda-Guarderas, Nimmy Josephine Thomas, Ana-Lucia Garcia-Guarniz, Augusto A Valdivia-Bustamante, Germán Málaga
OBJECTIVE: The objective of this study was to assess patients' achievement of ADA (American Diabetes Association) guideline recommendations for glycosylated hemoglobin, lipid profile, and blood pressure in a type 2 diabetes mellitus (T2DM) outpatient clinic in a low-middle income country (LMIC) setting. METHODS: This is a descriptive cross-sectional study with 123 ambulatory T2DM patients who are being treated at a public hospital in Lima, Peru. Data was gathered via standardized interviews, clinical surveys, and anthropomorphic measurements for each patient...
2016: PeerJ
Sedighe Moradi, Mohammad Javad Haji Ghanbari, Hedyeh Ebrahimi
BACKGROUND: Diabetes is a leading cause of cardiovascular disease (CVD). Moreover, CVD accounts for primary cause of death among diabetic patients. Physicians, especially in the primary care setting, have effective role in the management of cardiovascular risk factors. Therefore, we aimed to compare the prevalence of modifiable cardiovascular risk factors in Type 2 diabetic patients attending to an urban health center as a primary care center with Institute of Endocrinology and Metabolism Diabetes Clinic (IEMDC) as a tertiary center...
2016: International Journal of Preventive Medicine
Bishal Gyawali, Alessandra Ferrario, Edwin van Teijlingen, Per Kallestrup
BACKGROUND AND OBJECTIVES: Diabetes has become an increasingly prevalent and severe public health problem in Nepal. The Nepalese health system is struggling to deliver comprehensive, quality treatment and services for diabetes at all levels of health care. This study aims to review evidence on the prevalence, cost and treatment of diabetes mellitus type 2 and its complications in Nepal and to critically assess the challenges to be addressed to contain the epidemic and its negative economic impact...
2016: Global Health Action
Peter Kruzliak, Alexander Berezin, Alexander Kremzer, Tatyana Samura, Roman Benacka, Ioana Mozos, Emmanuel Egom, Luis Rodrigo
BACKGROUND: Biomechanical stress and inflammatory biomarkers relate to global contractility dysfunction; however, adding these biomarkers into a risk model constructed on clinical data does not improve its prediction value in chronic heart failure (CHF). AIM: The aim of this study was to evaluate whether biomarkers predict declining of left ventricular global contractility function in diabetic patients with ischemia-induced CHF. PATIENTS AND METHODS: The study retrospectively evolved 54 diabetic patients who had systolic or diastolic ischemia-induced CHF that was defined as left-ventricular ejection fraction (LVEF) ≤45% or 46-55% respectively assessed by quantitative echocardiography and other conventional criteria according to current clinical guidelines...
September 1, 2016: Folia Medica
Rajkumar Bharatia, Manoj Chitale, Ganesh Narain Saxena, Raman Ganesh Kumar, Chikkalingaiah, Abhijit Trailokya, Kalpesh Dalvi, Suhas Talele
INTRODUCTION: Hypertension (HTN), being a major risk factor for cardiovascular diseases (CVDs), is an important issue of medical and public health. High blood pressure (BP) is ranked as the third most important risk factor for attributable burden of disease in south Asia (2010). Hypertension (HTN) exerts a substantial public health burden on cardiovascular health status and healthcare systems in India. Uncontrolled hypertension among adults with hypertension is associated with increased mortality...
July 2016: Journal of the Association of Physicians of India
Martin C S Wong, Harry H X Wang, Mandy W M Kwan, Wai Man Chan, Carmen K M Fan, Miaoyin Liang, Shannon Ts Li, Franklin D H Fung, Ming Sze Yeung, David K L Chan, Sian M Griffiths
The prevalence of diabetes mellitus has been increasing both globally and locally. Primary care physicians (PCPs) are in a privileged position to provide first contact and continuing care for diabetic patients. A territory-wide Reference Framework for Diabetes Care for Adults has been released by the Hong Kong Primary Care Office in 2010, with the aim to further enhance evidence-based and high quality care for diabetes in the primary care setting through wide adoption of the Reference Framework.A valid questionnaire survey was conducted among PCPs to evaluate the levels of, and the factors associated with, their adoption of the Reference Framework...
August 2016: Medicine (Baltimore)
John J B Anderson, David C Nieman
The Mediterranean diet is upheld in the 2015-2020 Dietary Guidelines as an example of an eating pattern that promotes good health, a healthy body weight, and disease prevention throughout the lifespan. The Mediterranean eating pattern is based on a variety of unprocessed plant foods including fruits, vegetables, whole grains, legumes, nuts, and seeds that are high in polyphenols. The majority of polyphenols arrive in the colon where bacteria degrade them into smaller phenolics that can be translocated via the portal vein to the liver...
October 14, 2016: Nutrients
Kesavan Balakumaran, Mosesbabu Janagili, Nagaraju Rajana, Sureshbabu Papureddy, Jayashree Anireddy
Alpha glucoside inhibitors used to treat type-2 diabetes mellitus (DM) are likely to be safe and effective. These agents are most effective for postprandial hyperglycemia. Miglitol is a type of drug used to treat type-2 DM. A simple, selective, linear, precise and accurate reversed-phase high-performance liquid chromatography (RP-HPLC) method was developed and validated for a related substance of miglitol and its identification, and characterization was done by different mass spectrometry techniques. The gradient method at a flow rate of 1...
October 14, 2016: Scientia Pharmaceutica
Jongha Park
Cardiovascular (CV) risk assessment is not easy in chronic kidney disease (CKD) patients. Age, male sex, race, family history of CV disease, smoking status and diabetes should be considered as CV risk factors as the general population. It is also accepted that hypertension (HTN) is associated with the greater risk of CV complications in this population. However, there are some concerns in this issue.First, supporting evidence for specific blood pressure (BP) targets in CKD is scarce. Many observational studies reported a J-shaped association between BP level and CV mortality unlike a linear association in the general population...
September 2016: Journal of Hypertension
Zhiming Zhu
Management of hypertension in diabetes is critical for reducing cardiovascular mortality and morbidity. Dietary approaches for controlling high blood pressure have historically focused on sodium. Thus, many guidelines recommend that patients with type 2 diabetes reduce high sodium intake. Nonetheless, the potential benefits of sodium reduction are debatable. The kidney has a crucial role in glucose filtration and reabsorption in addition to its regulation of fluid and electrolyte homeostasis. A key factor linking sodium uptake and glucose transport is the sodium-glucose cotransporter 2 (SGLT2) in renal proximal tubular cells...
September 2016: Journal of Hypertension
Ganiyu Amusa, Babatunde Awokola, Godsent Isiguzo, James Onuh, Samuel Uguru, David Oke, Solomon Danbauchi, Basil Okeahialam
OBJECTIVE: To evaluate the prevalence of Hypertension and associated risk factors in HIV+ adults and assessment of these risks using the Framingham risk score 'FRS'. DESIGN AND METHOD: A cross-sectional analytical study. One hundred and fifty consecutive HIV+ adults presenting at the HIV clinic of Jos University Teaching Hospital (90 on HAART) with 50 HIV- as controls were recruited. Relevant history, physical examination (including blood pressure measured according to standard guidelines), laboratory specimen (fasting plasma sugar and lipids, CD4 count and viral load) and electrocardiogram were obtained from the participants...
September 2016: Journal of Hypertension
Clive Rosendorff
Many guidelines for the management of hypertension have recommended that the goal of antihypertensive treatment in the elderly (usually specified as 80 years or above) should be less than 150/90 mmHg. SPRINT included subjects 50 years or above, and a substantial proportion of subjects 75 years and older. These are individuals at high risk for adverse cardiovascular events because of high prevalence of hypertension and atherosclerotic disease. The less stringent BP goals have been based on a percieved danger of lowering BP to levels that threaten vital organ pefusion (myocardium, brain, kidney)...
September 2016: Journal of Hypertension
Paul Whelton
BACKGROUND: Choice of the optimal target for blood pressure (BP) reduction during treatment of patients with hypertension, including those with underlying co-morbid conditions, is an important challenge in clinical practice. The Systolic Blood Pressure Intervention Trial (SPRINT) was designed to provide guidance in selection of a Systolic BP target during treatment of hypertension. METHODS: Adults ≥50 years old with hypertension and at least one additional risk factor for cardiovascular disease (CVD), but excluding persons with diabetes mellitus, prior stroke, or advanced chronic kidney disease (CKD) were randomly assigned to intensive therapy (intensive), targeting a systolic BP (SBP) <120 mmHg, or standard therapy (standard), targeting a SBP <140 mmHg...
September 2016: Journal of Hypertension
Jiadela Teliewubai, Yu-Yan Lv, Shi-Kai Yu, Bin Bai, Chen Chi, Kai Wang, Yi-Wu Zhou, Jing Xiong, Yi Zhang, Ya-Wei Xu
OBJECTIVE: The Eighth Joint National Committee Panel recommended novel blood pressure (BP) goals for individuals with hypertension, which is still under debate. We therefore assessed patients' target organ damages in controlled hypertensives defined by the Seventh or Eighth Joint National Committee thresholds (JNC7 and JNC8) in a community-based elderly Chinese population, in order to find the optimal BP goal for the elderly Chinese. DESIGN AND METHOD: 1599 community-based elderly participants (age > 65 years old) were recruited in the northern Shanghai...
September 2016: Journal of Hypertension
Jürgen Bohlender, Jürg Nussberger, Beate Bohlender
OBJECTIVE: In elderly hypertensive patients, systolic blood pressure (sBP) goals recommended by US and European guidelines (ESH) for the initiation of treatment are more liberal than in younger patients because of an increased risk of treatment-associated side-effects and hypotension. Carotid stenosis increases with age and poses a risk of brain ischemia if hypotension occurs. Its relevance for the routine care of elderly hypertensives, however, remains unclear. We analyzed data on precerebral artery morphology and BP evolution from a survey of aged hospitalized patients...
September 2016: Journal of Hypertension
Hiroshi Itoh
Many hypertension guidelines have been published mainly from Western countries to standardize the management of hypertension all over the world, however, the significance of hypertension, along with other cardio-metabolic risks, such as obesity, diabetes or dyslipidemia should differ among different races. This paper compares the relevance of hypertension, one of the most important cardio-metabolic risk factors, in Asian and Western societies.1) Low target level of blood pressure control for diabetic hypertensives in JapanIn the Japanese Society of Hypertension Guidelines for the management of Hypertension (JSH2014), the target of blood pressure (BP) control in hypertensive patients with diabetes was set as < 130/80 mmHg...
September 2016: Journal of Hypertension
David John Webb
Treatment-resistant hypertension (TRH) is defined as the failure to achieve an office BP target of <140/90 mmHg (<130/80 mmHg in patients with chronic kidney disease (CKD) or diabetes) in patients with hypertension (HT), despite adherence to at least 3 antihypertensive medications at optimal tolerated doses, ideally including a diuretic (Calhoun et al., Circulation 2008). TRH identifies patients with hard-to-treat HT, who might benefit from specialist investigation and treatment. Although some studies put the prevalence of TRH as >10%, these levels may be inflated by white-coat hypertension and poor adherence...
September 2016: Journal of Hypertension
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