Most Popular posts from other blogs...
As a result of a landmark study, the Diabetes Control and Complications Trial (DCCT), there has been a revolution in care for people with type 1 diabetes. It was conclusively demonstrated that progression of microvascular complications, particularly retinopathy, can be delayed or prevented by intensive control of blood glucose. This has now been made possible by major advances in monitoring glucose excursions, estimating total glycemic exposure by measuring HbA1 c, and in treatment using newly designed human insulins, either by insulin pump or by injections. It was clear in the DCCT and confirmed as its findings were translated into practice that a team approach with a physician, a nurse specially trained in diabetic management, and a nutritionist is the way to accomplish this degree of diabetic control.
Future therapeutic developments include perfection of techniques for transplantation of islet cells and development of a closed loop system which would measure glucose concentrations and deliver the proper insulin dosage by an automated pump. New methods of giving insulin without requiring an injection, such as inhaled insulin, show promise.
Finally, major headway has been made in preventing the vascular complications which have traditionally affected type 1 diabetics. In particular, monitoring of small amounts of albumin in the urine (microalbuminuria) will identify people who may progress to renal insufficiency. It is clear that this progression may be delayed or stopped by therapy with angiotensin-converting enzyme inhibitors (ACE-I) or receptor blockers (ARB). In an analogous fashion, aggressive treatment of elevated blood pressure, with a new guideline of B.P.< or="130/80" mm/hg,="" will="" delay="" or="" prevent="" progression="" not="" only="" of="" renal="" insufficiency,="" but="" also="" of="" retinopathy.="" this="" can="" be="" accomplished="" in="" most="" patients,="" often="" with="" combinations="" of="" newly="" developed="" agents:="" ace-i="" (or="" arb),="" calcium="" channel="" blockers,="" cardiospecific="" beta="" blockers,="" and="">
*3\357\8*
|
0 comments:
Post a Comment