Pharmacologic Management of Type 2 Diabetes

Harper, William; Clement, Maureen; Goldenberg, Ronald; Hanna, Amir; Main, Andrea; Retnakaran, Ravi; Sherifali, Diana; Woo, Vincent; Yale, Jean‐François

doi:10.1016/j.jcjd.2013.01.021

Cited by 122 publications

(60 citation statements)

References 109 publications

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“…Additionally, treatment regimens should include medications that involve less risk of hypoglycemia when food access is unpredictable [57]. For example, Metformin and DPP-4 inhibitors involve a very low risk of hypoglycemia when used alone [68]. For patients requiring insulin, regimens that allow for as much flexibility (such as multiple daily injections with basal and bolus insulin) can allow patients to omit doses if meals are missed, reducing the risk of hypoglycemia [69].…”

Section: Medications and Reducing Hypoglycemic Episodesmentioning

confidence: 99%

The Intersection between Food Insecurity and Diabetes: A Review

et al. 2014

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Access to sufficient, safe, and nutritious food not only affects the health of people who experience food insecurity, but also their ability to manage health conditions, such as diabetes. When people find it difficult to access sufficient food, tailoring their food selection to a diabetes regimen is even more difficult. Food insecurity in North America is consistently more prevalent among households with a person living with diabetes, and similarly, diabetes is also more prevalent in food-insecure households. Diabetes management can be stressful due to the many required responsibilities; when compounded with food insecurity, it becomes an even greater challenge. As a result, many food-insecure diabetics find themselves caught between competing priorities such as procuring food, prescribed medications and supplies for diabetes, and managing other living expenses, potentially worsening their condition and overall health. Healthcare providers should be aware and informed about the significant role that food security can play in the prevention and management of diabetes.

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Section: Medications and Reducing Hypoglycemic Episodesmentioning

confidence: 99%

The Intersection between Food Insecurity and Diabetes: A Review

et al. 2014

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“…1) (24). Presentation of diabetes with ketonuria, with or without marked symptoms, should raise the suspicion of type 1 diabetes, although the possibility of accelerated lipolysis and ketogenesis due to starvation also deserves consideration.…”

Section: When Should Insulin Therapy Be Started?mentioning

confidence: 99%

“…1). Some guidelines suggest insulin is indicated for HbA 1c >69 mmol/mol (>8.5%) at diagnosis (24). This approach is not well substantiated by evidence, but it clearly can help by reducing glucose toxicity.…”

Section: When Should Insulin Therapy Be Started?mentioning

confidence: 99%

Insulin Therapy in People With Type 2 Diabetes: Opportunities and Challenges?

et al. 2014

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Given the continued interest in defining the optimal management of individuals with type 2 diabetes, the Editor of Diabetes Care convened a working party of diabetes specialists to examine this topic in the context of insulin therapy. This was prompted by recent new evidence on the use of insulin in such people. The group was aware of evidence that the benefits of insulin therapy are still usually offered late, and thus the aim of the discussion was how to define the optimal timing and basis for decisions regarding insulin and to apply these concepts in practice. It was noted that recent evidence had built upon that of the previous decades, together confirming the benefits and safety of insulin therapy, albeit with concerns about the potential for hypoglycemia and gain in body weight. Insulin offers a unique ability to control hyperglycemia, being used from the time of diagnosis in some circumstances, when metabolic control is disturbed by medical illness, procedures, or therapy, as well as in the longer term in ambulatory care. For those previously starting insulin, various other forms of therapy can be added later, which offer complementary effects appropriate to individual needs. Here we review current evidence and circumstances in which insulin can be used, consider individualized choices of alternatives and combination regimens, and offer some guidance on personalized targets and tactics for glycemic control in type 2 diabetes.

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“…Pharmacists who have active diabetes practices lead these sessions and the content is consistent with current guideline recommendations and training material provided to patients who are starting insulin. 3,14,15 The session runs for 50 minutes with a ratio of 8 students to 1 pharmacist in each session. Students are encouraged to attempt at least one blood glucose check and mock insulin injection while they are directly supervised by the pharmacists.…”

Section: Methodsmentioning

confidence: 99%

Effect of an Experiential Exercise in Diabetes Management on Pharmacy Students’ Fear and Perceived Pain of Injection and Fingertip Lancing

Sahnan

Simpson

2015

American Journal of Pharmaceutical Education

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Objective. To determine if a diabetes management exercise would change pharmacy students' fear and perceived pain associated with injection and fingertip lancing. Methods. Before and after a 1-week experiential exercise of living with diabetes, students completed questionnaires measuring fear of injection and self-testing and recorded the level of perceived pain associated with injection and fingertip lancing. Anticipated (baseline) and experienced (follow-up) scores were compared. Results. Forty students returned both baseline and follow-up survey instruments. Reported levels of fear decreased significantly for self-injection ( p,0.0001) and self-testing ( p50.0089) after the exercise. Experienced pain was also significantly lower than anticipated pain for both injection ( p,0.0001) and fingertip lancing ( p50.013). Experienced pain of injection was significantly lower than fingertip lancing ( p50.017). Conclusion. Participation in the exercise significantly reduced pharmacy students' fear and perceived pain associated with injection and fingertip lancing. Students can use information gained from their experiences when helping patients manage diabetes.

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Pharmacologic Management of Type 2 Diabetes

Cited by 122 publications

References 109 publications

The Intersection between Food Insecurity and Diabetes: A Review

The Intersection between Food Insecurity and Diabetes: A Review

Insulin Therapy in People With Type 2 Diabetes: Opportunities and Challenges?

Effect of an Experiential Exercise in Diabetes Management on Pharmacy Students’ Fear and Perceived Pain of Injection and Fingertip Lancing

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