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Diabetes Mellitus, Obesity, Lipoprotein Disorders and other Metabolic Diseases
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
There are multiple oral therapies for treating type 2 diabetes (Table 11.8). Metformin is the first-line drug for type 2 diabetes and lowers mortality in overweight diabetic patients. Many patients with type 2 DM require more than one oral hypoglycaemic drug to achieve good glucose control. Current US/European guidelines recommend assessing cardiovascular and renal disease when choosing a second-line oral hypoglycaemic drug.
Preventing, Treating, and Reversing Chronic Disease With Nutritional Interventions
Published in Gia Merlo, Kathy Berra, Lifestyle Nursing, 2023
Alexandra Lessem, Caroline Trapp
Nutrition can be helpful in treating established diabetes as well. A systematic review looking at 11 studies completed between 1999 and 2017, including a total of 433 participants with mean duration of 23.2 weeks, showed that plant-based diets were associated with improvements in HbA1C levels as well as many quality-of-life measures, cholesterol levels, and general health as compared to various comparison diets (Toumpanakis et al., 2018). Overall, HbA1C levels declined by 0.55% in intervention group participants and 0.19% in control group participants. More participants in the intervention groups were able to reduce or discontinue diabetes medication and lost more weight than those in the control groups (Toumpanakis et al., 2018). Dietary adherence was generally greater among intervention group participants.
Risk factors – Treatable traits
Published in Vibeke Backer, Peter G. Gibson, Ian D. Pavord, The Asthmas, 2023
Vibeke Backer, Peter G. Gibson, Ian D. Pavord
Treatment involves treating the associated asthma and specific anti-infective therapy where available. If the infection causes a lung attack, then this is treated with bronchodilators and corticosteroids (Global Initiative for Asthma [GINA])
Systematic Review of Hypnotherapy for Sleep and Sleep Disturbance
Published in International Journal of Clinical and Experimental Hypnosis, 2023
Nathan Wofford, Morgan Snyder, Chris E. Corlett, Gary R. Elkins
Two of the most widely used approaches for treating sleep disturbance are pharmacotherapy, such as benzodiazepines, z-drugs, and serotonin receptor antagonists and reuptake inhibitors (SARIs), and cognitive behavioral therapy for insomnia (CBT-I; Buscemi et al., 2007; Matheson & Hainer, 2017; Morin et al., 2006). However, both these interventions have limitations in clinical practice. Specifically, pharmacotherapy has risk of abuse and substance dependency, can suppress rapid eye movement (REM) sleep, and can have sedating effects during the day (Buscemi et al., 2007; Matheson & Hainer, 2017; Qureshi & Lee-Chiong, 2004). CBT-I is time intensive, may involve behavioral instructions that are difficult for patients to complete or find burdensome, may initially worsen sleep, and appears to have attrition rates between 14% and 40% (Manber et al., 2015; Ong et al., 2008). Therefore, safe and effective alternatives are needed.
Effects of testicular sperm aspiration upon first cycle ICSI-ET for type 2 diabetic male patients
Published in Systems Biology in Reproductive Medicine, 2020
Xiang Liu, Ming Gao, Jianhua Sun, Zheng Sun, Juan Song, Xia Xue, Zhou Zhang, Juanzi Shi, Junping Xing
Drugs are a common method of treating diabetes. Metformin is a biguanide compound isolated from Galega officinalis. It promotes the uptake of glucose by peripheral tissues and delays the absorption of glucose in the intestine, thereby reducing blood sugar. However, there is no consensus on whether metformin can improve or reduce male reproductive function. Some researchers found that sperm density and vitality could be improved after a 6-month study of metformin in the treatment of metabolic syndrome in patients with oligo-terato-male azoospermia (Morgante et al. 2011). In addition, it has also been reported that the normal sperm morphology of men with hyperinsulinemia can be improved after 3 months of metformin treatment (Bosman et al. 2014). However, other research provides an opposite conclusion that metformin not only does not improve sperm quality but also reduces sperm motility and even interferes with the normal testicular physiological process, resulting in spermatogenesis failure and obvious histological changes (Adaramoye et al. 2012; Tartarin et al. 2012; Calle-Guisado et al. 2018). Calle-Guisado et al. (2018) consider that the reason for drawing the opposite conclusion is due to the differences in the research methods and testing instruments. Obviously, the safety of diabetic drugs on male reproductive capacity needs further research. Standardizing the research population, refining the dosage of drugs, unifying the medication methods and evaluation methods can help draw more reliable conclusions.
The current state of acute treatment for migraine in adults in the United States
Published in Postgraduate Medicine, 2020
Wade Cooper, Erin Gautier Doty, Helen Hochstetler, Ann Hake, Vincent Martin
Migraine is a common and disabling disorder with a substantial personal, social, and economic burden. Effective acute treatment requires the clinician to assess the patient, make a positive diagnosis, and then offer individualized therapy based on the patient’s medical history, comorbidities, and preferences as well as published clinical evidence. The mainstays for acute treatment of migraine include NSAIDs and analgesics, triptans, ergotamines, and combination therapies. There still exists an unmet need for acute treatment options because current therapies are not always effective, may have unwanted side effects, or are contraindicated for people with cerebro- or cardiovascular disease. Recently approved therapies including oral CGRP receptor antagonists, a 5-HT1F receptor agonist, and neuromodulation devices may help address this unmet need because they do not induce vasoconstriction. It is also important to counsel patients on lifestyle modifications and behavioral strategies that can aid with the management of migraine. For primary care clinicians, treating migraine requires keeping abreast of current guidance and keeping an open mind to the variety of treatment options.