Diabetes: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
Line 1: | Line 1: | ||
{{DevelopmentPhase}} | {{DevelopmentPhase}} | ||
__TOC__ | __TOC__ | ||
==Preamble== | ==Preamble== | ||
Diabetes (diabetes mellitus) is one of the metabolic diseases with higher blood sugar level, either due to the pancreatic beta cells do not produce enough insulin, or the cells do not respond to the insulin that is produced.<cite>1</cite> Its clinical symptoms include three polies: polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger). | Diabetes (diabetes mellitus) is one of the metabolic diseases with higher blood sugar level, either due to the pancreatic beta cells do not produce enough insulin, or the cells do not respond to the insulin that is produced.<cite>1</cite> Its clinical symptoms include three polies: polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger). | ||
Line 687: | Line 214: | ||
===Treatments and outcomes=== | ===Treatments and outcomes=== | ||
According to the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD) Guidelines,<cite>31</cite> there are very few clinical trials on heart failure treatment specifically for diabetic patients. Information on treatment efficacy of various drugs is therefore based on diabetic subgroups included in various heart failure trials. A disadvantage of this is that the subgroups are not always well defined as regards the diabetic state and treatment. Most data favor a proportionately similar efficacy in patients with and without diabetes. Traditional treatment of heart failure in diabetic patients is based on diuretics, ACE-inhibitors, and Beta-blockades, as outlined in other guidelines.<cite>44</cite> Moreover, it is assumed that meticulous metabolic control should be beneficial in heart failure patients with diabetes. | According to the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD) Guidelines,<cite>31</cite> there are very few clinical trials on heart failure treatment specifically for diabetic patients. Information on treatment efficacy of various drugs is therefore based on diabetic subgroups included in various heart failure trials. A disadvantage of this is that the subgroups are not always well defined as regards the diabetic state and treatment. Most data favor a proportionately similar efficacy in patients with and without diabetes. Traditional treatment of heart failure in diabetic patients is based on diuretics, ACE-inhibitors, and Beta-blockades, as outlined in other guidelines.<cite>44</cite> Moreover, it is assumed that meticulous metabolic control should be beneficial in heart failure patients with diabetes. | ||
Line 700: | Line 225: | ||
===Treatments and outcomes=== | ===Treatments and outcomes=== | ||
Aspirin and anticoagulant use as recommended for patients with atrial fibrillation should be rigorously applied in diabetic patients with atrial fibrillation to prevent heart stroke. Oral anticoagulation is most beneficial for patients at higher risk for stroke, whereas the risks outweigh the benefit in patients at low risk.<cite>50</cite> Thus, quantifying the risk of stroke is crucial for determining which atrial fibrillation patients would benefit most from anticoagulant therapy. | Aspirin and anticoagulant use as recommended for patients with atrial fibrillation should be rigorously applied in diabetic patients with atrial fibrillation to prevent heart stroke. Oral anticoagulation is most beneficial for patients at higher risk for stroke, whereas the risks outweigh the benefit in patients at low risk.<cite>50</cite> Thus, quantifying the risk of stroke is crucial for determining which atrial fibrillation patients would benefit most from anticoagulant therapy. | ||
Line 742: | Line 265: | ||
===Treatments and outcomes=== | ===Treatments and outcomes=== | ||
Peripheral vascular diseases: Preventions are most important strategies, such as regular exercises, the optimization of glycemic control, management of hypertension, smoking cessation, antiplatelet and anti-cholesterol medications like aspirin, clopidogrel and statins. | Peripheral vascular diseases: Preventions are most important strategies, such as regular exercises, the optimization of glycemic control, management of hypertension, smoking cessation, antiplatelet and anti-cholesterol medications like aspirin, clopidogrel and statins. | ||
Line 813: | Line 332: | ||
#50 pmid=10507957 | #50 pmid=10507957 | ||
#51 pmid=22922413 | #51 pmid=22922413 | ||
#52 pmid= | #52 pmid=7867189 | ||
#53 pmid= | #53 pmid=9484982 | ||
#54 | #54 [http://www.merckmanuals.com/professional/cardiovascular_disorders/peripheral_arterial_disorders/peripheral_arterial_disease.html?qt=&sc=&alt= Peripheral Arterial Disease at Merck Manual of Diagnosis and Therapy, retrieved on January 5, 2013.] | ||
#55 pmid=18468545 | |||
#56 pmid=12574553 | |||
#57 pmid=8918275 | |||
#58 pmid=11372014 | |||
#59 pmid=12941721 | |||
#60 pmid=10666287 | |||
# | #61 pmid=7525794 | ||
# | #62 pmid=9243111 | ||
# | #63 pmid=8981292 | ||
# | #64 pmid=14526040 | ||
# | #65 pmid=16476626 | ||
# | #66 pmid=22182267 | ||
# | #67 pmid=21190097 | ||
# | #68 pmid=19531590 | ||
# | #69 pmid=21871056 | ||
# | #70 pmid=19327317 | ||
# | #71 [http://www.who.int/mediacentre/factsheets/fs312/en/index.html World Health Organization (''WHO''), an estimated 347 million people world-wide have diabetes in 2012] | ||
# | #72 pmid=16399854 | ||
# | |||
# | |||
# | |||
# | |||
# | |||
# | |||
</biblio> | </biblio> |