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Related Concept Videos

Hyperglycemia01:29

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 II: Pathophysiology01:24

Type II Diabetes II: Pathophysiology

PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.
Diabetes Mellitus: Type 2 and Gestational01:22

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...
Hypoglycemia01:26

Hypoglycemia

Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
Type I Diabetes III: Clinical Manifestations01:19

Type I Diabetes III: Clinical Manifestations

Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...
Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood glucose levels...

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A Zebrafish Model of Diabetes Mellitus and Metabolic Memory
10:03

A Zebrafish Model of Diabetes Mellitus and Metabolic Memory

Published on: February 28, 2013

[Hyperglycemia and cardiovascular risk: lessons from randomized trials].

André Grimaldi1

  • 1Service de diabétologie, métabolisme, groupe hospitalier La Pitié-Salpêtrière, AP-HP, 75651 Paris Cedex 13. andre.grimaldi@psl.aphp.fr

La Revue Du Praticien
|May 15, 2010
PubMed
Summary

Achieving optimal blood sugar control in diabetes can reduce cardiovascular disease risk. However, intensive glucose lowering may increase mortality in patients with prior heart attacks, necessitating a balanced approach to glycemic targets.

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Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

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Last Updated: Jun 13, 2026

A Zebrafish Model of Diabetes Mellitus and Metabolic Memory
10:03

A Zebrafish Model of Diabetes Mellitus and Metabolic Memory

Published on: February 28, 2013

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Area of Science:

  • Endocrinology
  • Cardiology
  • Metabolic Diseases

Context:

  • Diabetes mellitus is a significant risk factor for cardiovascular disease (CVD).
  • Hyperglycemia is strongly linked to microvascular complications but less so to macrovascular events.
  • Epidemiological data suggest a 15% rise in myocardial infarction risk for every 1% increase in HbA1c.

Purpose:

  • To evaluate the relationship between glycemic control and cardiovascular outcomes in diabetic patients.
  • To determine the optimal HbA1c targets considering the risk of hypoglycemia, especially in patients with established CVD.

Summary:

  • While good initial glycemic control offers long-term cardiovascular benefits, intensive glucose lowering (e.g., HbA1c < 6%) has not shown clear advantages and may increase mortality, particularly in patients with previous myocardial infarction (MI).
  • Studies like ACCORD and VADT indicate increased cardiovascular mortality associated with severe hypoglycemia.
  • Glycemic goals should be individualized, balancing the benefits of blood sugar reduction against the risks of hypoglycemia, especially in high-risk populations.

Impact:

  • Individualized glycemic targets are crucial for diabetic patients with prior MI, modulating goals based on hypoglycemia risk.
  • For patients on sulfonylureas or insulin with hypoglycemia risk, an HbA1c goal of 7.5% may be appropriate.
  • A general HbA1c target of < 7% remains suitable, while < 6.5% is appropriate for those on insulin sensitizers without hypoglycemia risk.