The choices for insulin therapy are ever increasing with the development of new products that provide greater flexibility, greater range of effectiveness, lower risk of hypoglycemia, and lower pharmacokinetic and pharmacodynamic variability. These allow for individualization of treatment to match a patient’s daily life but typically at greater cost. This article will review the psychological, social, and clinical factors pertaining to the various insulin products, as well as strategies to initiate and intensify insulin therapy, to help clinicians supplement and enhance their clinical practices in diabetes management.
Despite billions of dollars in research and nearly 200 medications tested for dementia, pharmacologic treatment for Alzheimer’s disease is severely limited in effectiveness and safety. With the disappointing benefits of drug treatment, the promise of lifestyle changes to prevent and delay cognitive decline appears hopeful.
In this prospective, double-blind, randomized trial, the probiotic strain Lactobacillus reuteri SD5865 at a dosage of 1010 colony-forming units or placebo was provided to non-diabetic individuals twice daily for a period of four weeks to investigate the effect on various parameters associated with blood sugar handling, including secretion of insulin, C-peptide, and glucagon-like peptides-1 and -2.