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Diabetes: Management and Pharmacotherapy

Diabetes: Management and Pharmacotherapy

The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...

Diabetes: Symptoms, Diagnosis, and Complications

Diabetes: Symptoms, Diagnosis, and Complications

For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is based on...

Diabetes Mellitus: Type 2 and Gestational

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...

Hyperglycemia

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...

Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis

Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis

Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...

Oral Hypoglycemic Agents: α-Glucosidase Inhibitors

Oral Hypoglycemic Agents: α-Glucosidase Inhibitors

α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are typically...

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Updated: Jul 10, 2026

Improving IV Insulin Administration in a Community Hospital

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Is glycemic control improving in U.S. adults?

Thomas J Hoerger¹, Joel E Segel, Edward W Gregg

¹RTI-UNC Center of Excellence in Health Promotion Economics, RTI International, 3040 Cornwallis Rd., P.O. Box 12194, Research Triangle Park, NC 27709, USA. tjh@rti.org

|October 16, 2007

Summary

Glycemic control in adults with diagnosed diabetes has improved significantly between 1999 and 2004. This trend in hemoglobin A1C (A1C) levels indicates better diabetes care and may reduce future complications.

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Area of Science:

* Endocrinology and Metabolism
* Public Health and Epidemiology
* Diabetes Care Research

Background:

* Assessing trends in glycemic control is crucial for evaluating the effectiveness of diabetes management strategies.
* Hemoglobin A1C (A1C) is a key biomarker for long-term blood glucose levels in individuals with diabetes.

Purpose of the Study:

* To investigate recent trends in glycemic control among adults diagnosed with diabetes.
* To determine if improvements in A1C levels have occurred in the early 2000s.

Main Methods:

* Analysis of three consecutive National Health and Nutrition Examination Survey (NHANES) waves (1999-2004).
* Examination of A1C levels, including mean values and proportions below specific targets (<7.0%, <8.0%, <9.0%).
* Application of multivariate regression and logistic regression to identify trends and control for confounding factors.

Main Results:

* Mean A1C levels decreased from 7.82% (1999-2000) to 7.18% (2003-2004).
* The proportion of individuals achieving A1C <7.0% increased substantially, rising from 37.0% to 55.7% over the study period.
* Statistically significant improvements in glycemic control were observed in later survey waves after adjusting for covariates.

Conclusions:

* Glycemic control among individuals with diagnosed diabetes showed a significant positive trend between 1999 and 2004.
* The observed improvement suggests advancements in diabetes care practices.
* These findings offer encouragement for reducing the long-term complications associated with diabetes.