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Related Concept Videos

Diabetes: Management and Pharmacotherapy01:15

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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.
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Diabetes Mellitus: Type 2 and Gestational01:22

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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...
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Type II Diabetes I: Introduction01:26

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Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance, in which target tissues such as the liver, muscle, and adipose tissue respond poorly to insulin. It is also associated with inadequate compensatory insulin secretion, where pancreatic β-cells fail to produce sufficient insulin. Together, these abnormalities lead to persistent hyperglycemia.EtiologyT2DM develops through a complex interaction of genetic predisposition and environmental or...
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Type II Diabetes II: Pathophysiology01:24

Type II Diabetes II: Pathophysiology

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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.
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Hyperglycemia01:29

Hyperglycemia

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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...
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Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

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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...
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Updated: May 3, 2026

Improving IV Insulin Administration in a Community Hospital
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Improving Glycemic Control Through Population-Based Strategies: A Case-Control Study Within a Large Health System.

Taynara Formagini1,2, Minyong Kim3, Xing Wei4

  • 1Department of Research & Evaluation, Division of Health Services Research and Implementation Science, Kaiser Permanente Southern California, Pasadena, CA, USA. taynara.x.formagini@kp.org.

Journal of General Internal Medicine
|May 1, 2026
PubMed
Summary
This summary is machine-generated.

Diabetes Self-Management Education and Support (DSMES) improved A1c control in type 2 diabetes patients. Population care management was less effective than primary care physician-led care, with optimal encounter frequency showing diminishing returns.

Keywords:
Type 2 diabetesdiabetes self-management education and supportglycemic controlpopulation health managementreal-world data

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Area of Science:

  • Endocrinology
  • Public Health
  • Health Services Research

Background:

  • Nearly half of US adults with type 2 diabetes (T2D) do not achieve glycemic control (A1c < 7%).
  • This increases the risk of diabetes-related complications.
  • System-level strategies are recommended, but real-world impact on A1c control is unclear.

Purpose of the Study:

  • To examine the association between T2D management program components and A1c target attainment.
  • To investigate the relationship between encounter frequency and A1c control.

Main Methods:

  • Retrospective nested case-control study (2017-2022) of T2D patients with baseline A1c ≥ 7%.
  • Cases achieved two consecutive A1c < 7% within 2 years.
  • Predominant encounter types (PCP, PCM, DSMES) and encounter frequency were analyzed using conditional logistic regression.

Main Results:

  • Patients with Diabetes Self-Management Education and Support (DSMES) had higher odds of achieving A1c target (OR 1.39).
  • Population Care Management (PCM) encounters were associated with lower odds of A1c target attainment (OR 0.78) compared to Primary Care Physician (PCP) care.
  • A1c control improved with encounter frequency up to 9-14 visits, then diminished.

Conclusions:

  • DSMES is associated with improved glycemic control in T2D.
  • Enhancing DSMES reach and effectiveness may help patients achieve sustained glycemic control.
  • Further research into optimal care delivery models for T2D is warranted.