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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 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...

Dipeptidyl Peptidase 4 Inhibitors

Dipeptidyl Peptidase 4 Inhibitors

Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a significant...

Hyperglycemia

Hyperglycemia

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Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis

Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis

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Glucagon-like Receptor Agonists

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Updated: Jul 7, 2026

Improving IV Insulin Administration in a Community Hospital

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Can we predict future improvement in glycaemic control?

R Singh¹, M Press

¹Department of Diabetes, The Royal Free Hospital, London, UK. rajiv.singh@lpct.scot.nhs.uk

Diabetic Medicine : a Journal of the British Diabetic Association

|February 23, 2008

Summary

This summary is machine-generated.

Identifying factors linked to poor diabetes control can predict improvement. About half of patients with high HbA1c levels showed better glycaemic control within a year based on specific clinic indicators.

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Last Updated: Jul 7, 2026

Improving IV Insulin Administration in a Community Hospital

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Area of Science:

Endocrinology
Metabolic Diseases
Clinical Medicine

Background:

Poor glycaemic control in diabetes mellitus (DM) is a significant public health concern.
Identifying predictors of glycaemic control is crucial for effective diabetes management.
Understanding factors influencing glycaemic control can optimize patient outcomes.

Purpose of the Study:

To identify factors contributing to poor glycaemic control in diabetic patients.
To determine if these factors predict subsequent improvement in glycaemic control.

Main Methods:

Prospective cohort study of 130 diabetic patients with poor glycaemic control (HbA1c ≥ 10.0%).
1-year follow-up in a teaching hospital Diabetes Clinic.
Measurement of changes in HbA1c after 1 year.

Main Results:

Factors associated with significant HbA1c improvement included recent diabetes diagnosis, inadequate diet/medication, co-morbidities, stressful life events, and missed appointments.
Factors associated with persistent poor control included low mood, alcohol excess, inadequate glucose monitoring, sedentary lifestyle, and medication non-adherence.
Patients were almost equally divided between those likely to improve and those likely to have sustained poor control.

Conclusions:

Simple clinical features can predict which patients with poor glycaemic control are likely to improve.
Approximately half of patients with poor control may improve within current diabetes clinic practices.
Targeted strategies are needed for patients unlikely to respond to standard care.