By Amer Diabetes Assn
This magazine offers learn advances with medical relevance. Articles on scientific perform, commentaries, digests of contemporary study experiences, scientific information, medical studies, and guidelines of the yankee Diabetes organization of keep an eye on, analysis, nutrition and remedy.
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73 m2, evaluate and manage potential complications of CKD. (E) Consider referral to a physician experienced in the care of kidney disease when there is uncertainty about the etiology of kidney disease (heavy proteinuria, active urine sediment, absence of retinopathy, rapid decline in GFR), difficult management issues, or advanced kidney disease. (B) Diabetic nephropathy occurs in 20 – 40% of patients with diabetes and is the single leading cause of end-stage renal disease (ESRD). Persistent albuminuria in the range of 30 –299 mg/24 h (microalbuminuria) has been shown to be the earliest stage of diabetic nephropathy in type 1 diabetes and a marker for development of nephropathy in type 2 diabetes.
D. Neuropathy screening and treatment (301) Recommendations All patients should be screened for distal symmetric polyneuropathy (DPN) at diagnosis and at least annually thereafter, using simple clinical tests. (B) ● Electrophysiological testing is rarely needed, except in situations where the clinical features are atypical. (E) ● Screening for signs and symptoms of autonomic neuropathy should be instituted at diagnosis of type 2 diabetes and 5 years after the diagnosis of type 1 diabetes. Special testing is rarely needed and may not affect management or outcomes.
In those with clinical CVD or over age 40 years with other CVD risk factors, pharmacological treatment should be added to lifestyle therapy regardless of baseline lipid levels. Statins are the drugs of choice for LDL cholesterol lowering. , multiple cardiovascular risk factors or long duration of diabetes). Very little clinical trial evidence exists for type 2 diabetic patients under age 40 years or for type 1 patients of any age. In the Heart Protection Study (lower age limit 40 years), the subgroup of 600 patients with type 1 diabetes had a proportionately similar reduction in risk as patients with type 2 diabetes, although not statistically significant (216).
Diabetes Care-Supplement1-2011 by Amer Diabetes Assn