Small fiber neuropathy (SFN), a subtype of peripheral neuropathy characterized by painful distal neuropathic pain and autonomic symptoms, is increasing in incidence. SFN associated with diabetes and other causes is more likely to progress to large-fiber polyneuropathy and have faster deterioration and higher disability compared to slow progression with idiopathic SFN. Glucose impairment, obesity, and elevated triglycerides are modifiable risk factors of idiopathic SFN. Although major disability and neurologic impairment are uncommon in this slowly progressive condition, higher mortality and cardiovascular events are noted in patients with SFN.
Incorporating all the encompassing data to support decision-making and treatment plan adjustments can be a daunting task for healthcare professionals. A real clinical case illustrating a patient with full insulin replacement therapy is described here.
Diabetes-specific support and guidance from healthcare professionals can be amplified and strengthened through incorporating diabetes technology into delivering care to those for whom an educational and motivational boost is warranted. The various technological advances explored in this article include smart insulin pens and accessories, continuous glucose monitoring systems, insulin pumps, diabetes mobile applications, and remote glycemic monitoring platforms.
In this retrospective cohort study of 243 pregnant women who had combined hemoglobin A1c (HbA1c) and a two-step oral glucose tolerance testing at less than 21 weeks of gestation, median values of HbA1c were higher in women with gestational diabetes compared to nondiabetics (5.8% compared to 5.3%; P < 0.001). The predictive probability of using HbA1c in diagnosing diabetes in early pregnancy was high compared to two-step testing (area under the curve, 0.8), with an optimal diagnostic threshold of 5.6%. Although a HbA1c level of > 6.5% is diagnostic of early gestational diabetes, a lower diagnostic threshold might be justified during pregnancy.
Obesity and diabetes are important risk factors for severity of COVID-19, according to the results of a new study. The research also revealed that patients with diabetes and coronavirus infections need continuous glucose monitoring and insulin to better manage both their chronic illness and their infection.
In this study, the authors demonstrated significantly improved postprandial glucose levels in patients that consumed high glycemic index meals with extra-virgin olive oil compared to meals with butter or low fat meals.