sample speech presentation on diabetes

Speech on Diabetes

Diabetes is a serious health condition where your body can’t control sugar levels in your blood properly. It’s like a car running with too much or too little fuel.

If untreated, diabetes can lead to other health problems. It’s like a domino effect, knocking down one health aspect after another.

1-minute Speech on Diabetes

Ladies and Gentlemen,

Let’s talk about a health issue called diabetes. It’s like a naughty kid living in our body. It plays with our sugar levels, making them too high. This happens when our body can’t make or use a hormone called insulin properly.

Now, there are two types of diabetes. Type 1 is when our body can’t make insulin at all. Type 2 is when our body can’t use the insulin it makes. Type 2 is more common. It’s like a naughty kid who doesn’t listen, while Type 1 is like a kid who’s not there at all.

But here’s the thing. We can control this naughty kid. Eating healthy food, exercising regularly, and taking our prescribed medicines can help us keep our sugar levels in check. It’s like giving the naughty kid a set of rules to follow.

But if we don’t control it, it can cause problems. It can hurt our eyes, kidneys, and heart. It’s like letting the naughty kid run wild and damage the house.

So, remember, it’s important to get checked for diabetes, especially if it runs in your family. If you have it, work with your doctor to control it. It’s like finding out if the naughty kid lives in your house, and if he does, making sure he behaves.

In conclusion, diabetes is a serious health issue, but it’s not unbeatable. With the right lifestyle and treatment, we can keep it under control. So let’s pledge to stay healthy and keep diabetes at bay.

Also check:

• Essay on Diabetes

2-minute Speech on Diabetes

Ladies and gentlemen, boys and girls, today we are going to talk about a health condition that affects millions of people worldwide. It’s called diabetes. It’s a condition where the level of sugar in your blood is too high. Now, let’s break down this topic into simple parts.

First, let’s understand what diabetes is. Your body needs sugar for energy. But, too much sugar is not good. It’s like having too much of your favorite candy, it can make you sick. Diabetes happens when your body can’t control the amount of sugar in your blood. It’s like a car with broken brakes, it can’t stop when it needs to.

There are two main types of diabetes. Type 1 diabetes is when your body can’t make insulin, a hormone that helps to control your blood sugar. It’s like a key that opens the door of your body’s cells to let the sugar in. If you don’t have this key, the sugar can’t get into the cells and stays in your blood, which is not good.

Type 2 diabetes is when your body doesn’t use insulin properly. It’s like having a rusty key that doesn’t work well. The sugar can’t get into the cells easily and again, stays in your blood.

Now, let’s talk about why we should care about diabetes. It can cause a lot of health problems. It’s like a small leak in a boat. At first, it may not seem like a big deal. But over time, the boat can fill with water and sink. Diabetes can lead to heart disease, kidney problems, and even blindness if not treated properly.

So, how can we prevent diabetes? Eating healthy food, staying active, and maintaining a healthy weight are very important. It’s like keeping your car in good shape. If you take care of it, it will run smoothly. If you don’t, it can break down.

If you have diabetes, it’s not the end of the world. Many people live healthy lives with diabetes. It’s all about managing it. It’s like driving a car. You need to keep your eyes on the road, steer the wheel, and adjust your speed. With the right care and treatment, you can keep your blood sugar in check.

In conclusion, diabetes is a serious condition, but it can be managed. We all need to understand it, prevent it if we can, and manage it if we have it. Remember, your health is in your hands. Take care of your body, and it will take care of you. Thank you.

• Speech on Dhoni Inspirational
• Speech on Deworming Day
• Speech on Development Of India

We also have speeches on more interesting topics that you may want to explore.

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Save my name, email, and website in this browser for the next time I comment.

Talk to us about diabetes

0345 123 2399

customer support

Presenting with impact

Use the following resources to design and deliver a compelling presentation that will have a real and lasting impact on your audience..

Giving a talk at a conference or event can be a powerful way of sharing your ideas and inspiring others to take action to improve diabetes prevention and care.

Publications

How to: present with impact, Diabetes UK (August 2017) (PDF, 98KB)

This guide contains everything you need to know to design and deliver a presentation that will be remembered long after, including how to create key messages, build engaging content and improve your stage presence.

Essential reading

The 20 habits of truly brilliant presenters (may 2016), 7 powerful public speaking tips from one of the most-watched ted talks speakers, entrepreneur website (november 2014), how to give a killer presentation, harvard business review website (june 2013), share this page.

© The British Diabetic Association operating as Diabetes UK, a   charity registered in England and Wales (no. 215199) and in Scotland (no. SC039136). A company limited by guarantee registered in England and Wales with (no.00339181) and registered office at Wells Lawrence House, 126 Back Church Lane London E1 1FH

Essay on Diabetes for Students and Children

500+ words essay on diabetes.

Diabetes is a very common disease in the world. But people may never realize, how did they get diabetes and what will happen to them and what will they go through. It may not be your problem but you have to show respect and care for the one who has diabetes. It can help them and also benefited you to know more about it and have a better understanding of it. Diabetes is a metabolic disorder which is identified by the high blood sugar level. Increased blood glucose level damages the vital organs as well as other organs of the human’s body causing other potential health ailments.

Types of Diabetes

Diabetes  Mellitus can be described in two types:

Description of two types of Diabetes Mellitus are as follows

1) Type 1 Diabetes Mellitus is classified by a deficiency of insulin in the blood. The deficiency is caused by the loss of insulin-producing beta cells in the pancreas. This type of diabetes is found more commonly in children. An abnormally high or low blood sugar level is a characteristic of this type of Diabetes.

Most patients of type 1 diabetes require regular administration of insulin. Type 1 diabetes is also hereditary from your parents. You are most likely to have type 1 diabetes if any of your parents had it. Frequent urination, thirst, weight loss, and constant hunger are common symptoms of this.

2) Type 2 Diabetes Mellitus is characterized by the inefficiency of body tissues to effectively respond to insulin because of this it may be combined by insulin deficiency. Type 2 diabetes mellitus is the most common type of diabetes in people.

People with type 2 diabetes mellitus take medicines to improve the body’s responsiveness to insulin or to reduce the glucose produced by the liver. This type of diabetes mellitus is generally attributed to lifestyle factors like – obesity, low physical activity, irregular and unhealthy diet, excess consumption of sugar in the form of sweets, drinks, etc.

Get the huge list of more than 500 Essay Topics and Ideas

Causes of Diabetes

By the process of digestion, food that we eat is broken down into useful compounds. One of these compounds is glucose, usually referred to as blood sugar. The blood performs the job of carrying glucose to the cells of the body. But mere carrying the glucose to the cells by blood isn’t enough for the cells to absorb glucose.

This is the job of the Insulin hormone. Pancreas supply insulin in the human body. Insulin acts as a bridge for glucose to transit from blood to the body cells. The problem arises when the pancreas fails to produce enough insulin or the body cells for some reason do not receive the glucose. Both the cases result in the excess of glucose in the blood, which is referred to as Diabetes or Diabetes Mellitus.

Symptoms of Diabetes

Most common symptoms of diabetes are fatigue, irritation, stress, tiredness, frequent urination and headache including loss of strength and stamina, weight loss, increase in appetite, etc.

Levels of Diabetes

There are two types of blood sugar levels – fasting blood sugar level and postprandial blood sugar level. The fasting sugar level is the sugar level that we measure after fasting for at least eight hours generally after an overnight fast. Blood sugar level below 100 mg/dL before eating food is considered normal. Postprandial glucose level or PP level is the sugar level which we measure after two hours of eating.

The PP blood sugar level should be below 140 mg/dL, two hours after the meals. Though the maximum limit in both the cases is defined, the permissible levels may vary among individuals. The range of the sugar level varies with people. Different people have different sugar level such as some people may have normal fasting sugar level of 60 mg/dL while some may have a normal value of 90 mg/dL.

Effects of Diabetes

Diabetes causes severe health consequences and it also affects vital body organs. Excessive glucose in blood damages kidneys, blood vessels, skin resulting in various cardiovascular and skin diseases and other ailments. Diabetes damages the kidneys, resulting in the accumulation of impurities in the body.

It also damages the heart’s blood vessels increasing the possibility of a heart attack. Apart from damaging vital organs, diabetes may also cause various skin infections and the infection in other parts of the body. The prime cause of all type of infections is the decreased immunity of body cells due to their inability to absorb glucose.

Diabetes is a serious life-threatening disease and must be constantly monitored and effectively subdued with proper medication and by adapting to a healthy lifestyle. By following a healthy lifestyle, regular checkups, and proper medication we can observe a healthy and long life.

Customize your course in 30 seconds

Which class are you in.

• Travelling Essay
• Picnic Essay
• Our Country Essay
• My Parents Essay
• Essay on Favourite Personality
• Essay on Memorable Day of My Life
• Essay on Knowledge is Power
• Essay on Gurpurab
• Essay on My Favourite Season
• Essay on Types of Sports

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Download the App

Speech: World Diabetes Day

Mrs PHILLIPS ( Gilmore) ( 11:11):  I thank the member for Werriwa for the opportunity to speak on this motion. I commend the motion for bringing attention to the new technologies acting to address diabetes. Diabetes is a common disease and one that most people know about, but perhaps not everyone knows how difficult it can be to manage. We do, of course, all know how important access to treatment is for people living with chronic diseases like diabetes. We know the valuable and essential work that carers—be they family, friends or healthcare workers—do to help support those living with diabetes. This is absolutely invaluable work, and I thank all those carers for everything they do.

This motion points out the significant social, human and financial burden of this disease on government and health systems. I want to talk about that today, and also, most importantly, I want to talk about the burden this disease has on the people with diabetes and on their families. After all, that is what we really are talking about—people. This is about people's lives, people's health and people's families. In regional areas, like my electorate, the cost to the health system can be huge. And there are other costs too. There is time away from families, from work or school; that's a huge cost. There are expensive medical interventions and daily medications; those are both financial and emotional costs.

But technology is changing, and now there are amazing devices that can literally change lives. Continuous glucose monitoring and insulin pumps can mean the difference between hospitalisation and good health outcomes, something Amy in my electorate is all too familiar with. Amy suffers from type 1 diabetes. In the last two years, she has been hospitalised four times. Last year, her hyperglycaemia caused potentially fatal brain swelling that led to an extended stay in hospital. It was awful, and so difficult for her and her family to cope with. Amy's doctor has told her that access to a continuous glucose monitoring device could potentially save her life. But this device costs around $5,000 a year—a steep price. There is some subsidised access to this technology, and Amy does satisfy most of the criteria for this. She is the right age, she has a low-income healthcare card and she has demonstrated a high clinical need, because she has been hospitalised so many times. But there is a hitch: Amy suffers predominantly from hyperglycaemia—high blood sugar—and the program only provides access for those suffering hypoglycaemia or low blood sugar. This technology could save Amy's life. It could save our health system thousands of dollars by keeping Amy out of it, at home and well, but she can't access it because she can't afford it. This is simply not right.

And she is not alone. Kristi is a young mum who suffers from diabetic gastroparesis, a terrible disease that causes paralysis of the stomach. Kristi has suffered with this disease for decades and she has been hospitalised 27 times this year alone.

Her longest stint in hospital was four weeks. The government does not provide any funding for treatment or to find a cure. There are no new miracle medications and no proper targeted treatments. One thing that can help to manage symptoms, though, is an insulin pump. Kristi says her insulin pump keeps her alive. Kristi's insulin pump is due to expire. I understand they only last for four years, but they cost $8,000. As a young mum, this is a huge expense on top of all the other costs associated with managing her disease. But Kristi has been told there are no subsidies she is able to access. They are only for children.

This is life-saving medical treatment for these two young women. Technology has come a long way in a short period of time. Technology that, as this motion rightly states, has shown significant improvement in overall control for people with diabetes who—and this is the crux—can access it. But Amy and Kristi can't access it because it is too expensive. This is an absolute tragedy, so I support the member for Werriwa's call in this motion. This government must ensure that all people with diabetes—regardless of their age and whether they have high or low blood sugar—need to have earlier access to new technology under the National Diabetes Services Scheme. I will continue to advocate on behalf of people like Amy and Kristi to make sure that they are not missing out on life-saving technology because they can't afford it.

Authorised by Fiona Phillips, Australian Labor Party, 3/59 Junction Street Nowra NSW

• News in brief
• Diabetes views
• Advocating for diabetes
• Caring for diabetes
• Living with diabetes
• Diabetes profiles

Search your topic

• Submit an article
• Middle East and North Africa
• North America and Caribbean
• South and Central America
• South-East Asia
• Western Pacific

Global perspectives on diabetes

• Visual storytelling

The impact of language in diabetes

Experts say words matter when speaking directly to people with diabetes. diabetes voice reached out to two individuals to express their views on the subject., share this:.

• Click to share on Facebook (Opens in new window)
• Click to share on Twitter (Opens in new window)
• Click to share on LinkedIn (Opens in new window)

Experts say words matter when speaking directly to people with diabetes. New guidance from two sources, Language Matters: Language and Diabetes (NHS, June 11, 2018) and the American Association of Diabetes Educators (AADE) and the American Diabetes Association (ADA) in The Use of Language in Diabetes Care and Education (October 17, 2017) recommend that healthcare providers should be attentive and respectful of words when discussing diabetes treatment and test results with patients in a way that encourages and motivates. The objective of each guidance is an effort to reduce any negativity in the language used by clinicians that might lead to unintentional bias or express negativity which can adversely affect the psychosocial well-being of the individual. According to an important paper from 2017, “For people with diabetes, language has an impact on motivation, behaviours, and outcomes” .

The language of diabetes and the stigma associated with words like control, non-compliant and diabetic (used as both a noun and an adjective) don’t only apply to the healthcare setting; they are often heard or seen in the home, office and more traditional or social media platforms. In light of this global discussion, Diabetes Voice reached out to two individuals to express their views on the subject. Betsy Rodríguez , who lives with diabetes, is a nurse, diabetes educator, national and international speaker on diabetes-related topics, bicultural specialist in health communication strategies, and author. She presently serves as a Senior Public Health Advisor in the Translation Health Education and Evaluation Branch in the Division of Diabetes Translation (DDT) at the Centers for Disease Control and Prevention (CDC). Paul Sandells was diagnosed with type 1 diabetes in 1984. He is a vlogger and lives in the United Kingdom. Each of our contributors represent perspectives that illuminate the impact of language in diabetes.

Why does language matter when we talk about diabetes?

Betsy Rodríguez

Have you ever been on the wrong side of a conversation at a clinic or a hospital, where the language used to describe your condition sounded critical and made you feel judged and even, depersonalized?  I live with diabetes and I have been called a diabetic patient many times! At some point, you start asking yourself, since when did my full identity become diabetic patient instead of a person who has diabetes or a person living with diabetes.

There are many examples of this conundrum. Perhaps while searching online, you come across a website, talking about diabetic feet so now I am realizing that my feet are diabetic too! On the Internet, you are more likely to skip to the next website in your search results.  However, in a clinic setting, you would likely: a) seek out another healthcare team or doctor or b) decide to stick with them and work to increase their awareness, helping them understand that when it comes to diabetes, language matters!

Words are powerful weapons that healthcare teams can utilize to empower people living with diabetes or demotivate them.

As a person with diabetes, I am not defined by my diagnosis. Language used in the community and in the healthcare system has been a battle that many people have been fighting for years. This is not only happening in the diabetes community; one example is the work of parents of children with Down syndrome and the Global Down Syndrome Foundation and their campaign Words Can Hurt. For people with Down syndrome and their families, the history of labels is not a pleasant one. People with Down syndrome were associated with words like idiot, moron, and imbecile by society and the medical profession. Today, these labels are considered politically incorrect, hurtful and dehumanizing.

In the diabetes community, the topic of why language matters for healthcare advisors, professionals and people with diabetes is connected to the nature of language in diabetes care, in the media, and the stigma associated with language when diabetes is the topic.  In 2016, Diabetes Australia launched a position statement : A new language for diabetes: Improving communications with and about people with diabetes . ( Position Statement: A new language for diabetes , 2011) The aim of Australia’s position statement is to encourage greater awareness of the language surrounding diabetes, and to identify potential improvements. Diabetes Australia believes that optimal communication increases motivation, health and the well-being of people with diabetes.  Furthermore, careless or negative language can be demotivating, is often inaccurate, and can be harmful. In 2017, The Use of Language in Diabetes Care and Educatio n was published. (Jane K. Dickinson, 2017) This publication opened many opportunities for the American Association of Diabetes Educators (AADE) to increase awareness about the way healthcare professionals talk to and about people with diabetes; how language plays an important role in engagement, conceptualization of diabetes and its management, treatment outcomes, and psychosocial wellbeing. A taskforce consisting of representatives from AADE and the American Diabetes Association convened to develop these guidelines using four guiding principles:

• Diabetes is a complex and challenging disease involving many factors and variables.
• Every member of the healthcare team can serve people with diabetes more effectively through a respectful, inclusive, and person-centered approach.
• Stigma that has historically been attached to a diagnosis of diabetes can contribute to stress and feeling of shame and judgement.
• Person-first, strengths-based, empowering language can improve communication and enhance motivation, health and well-being of people with diabetes.

As a person living with diabetes for more than 30 years, I can say that living with diabetes can be overwhelming at times. Like all chronic diseases, it affects every aspect of our daily routine. Diabetes management is not as simple as just taking a pill. It requires timing of meals, checking blood sugar and being vigilant about exercise, all in accordance with a personalized management plan developed in consultation with healthcare professionals.

The time has come to reflect on the language of diabetes and share insights with others. Messages of strength and hope will signify progress toward the goals of eradicating stigma and considering people first (Jane K. Dickinson, 2017).

Betsy Rodríguez, RN, MSN, DE is a nurse, diabetes educator, national and international speaker on diabetes-related topics, bicultural specialist in health communication strategies, and author, presently serves as a Senior Public Health Advisor in the Translation Health Education and Evaluation Branch in the Division of Diabetes Translation (DDT) at the Centers for Disease Control and Prevention (CDC). At CDC, Mrs. Rodriguez provides technical assistance and support to state grantees, national diabetes-related professional organizations, such as the American Diabetes Association (ADA) and the American Association of Diabetes Educators (AADE), as well as community-based organizations. At the international level, Mrs. Rodriguez provides technical assistance and support to the International Diabetes Federation, IDF SACA Region and is a member of the IDF Blue Circle Voices of Diabetes.

I am not offended by the word diabetic

Paul Sandells

While I support Language Matters and recognise that it is a force for the good, on the whole, it doesn’t really matter to somebody like me, a seasoned diabetic. How I choose to refer to my condition and my management of it is my own business. I’ve had type 1 diabetes (T1D) for almost 34 years. I’ve always considered myself to be a diabetic. It says so on my social media profiles and on the tattoo on my arm. I’m not offended by the word “diabetic”. I understand it doesn’t define me but it is a significant part of my life.

I believe the language used in a clinic environment is more significant but not to a very strict level. I want to know my HbA 1c isn’t good enough and if my healthcare professional (HCP) describes it as “poor” or “too high” then that is fine with me. I can take that information away and work on it, rather than sulk because I got a bad mark in class. I want my clinic team to be pro-active in helping me and others with diabetes, rather than walking on egg shells because of the terminology they might use.

Language matters to a point but my health matters far more than the words you use.

There is a fine line between offering constructive encouragement, even criticism and being downright offensive, though. I never want to be told that I’m a “bad diabetic” or even a “bad person with diabetes”. The latter actually sounds worse than the former to me! Neither do I want to be referred to as “non-compliant”. Those terms, amongst others, are very offensive when used by a HCP. In fact, unless used jokingly between friends, they are offensive if used by anybody. I realise that we are all different. We all have our line in the sand when it comes to what offends us and what doesn’t. Being offended and possibly extremely upset, following a clinic appointment, can never be a good thing when it comes to long term management of our diabetes.

We all respond differently to how a HCP approaches us, their body language, how they engage and how interested they are in our condition. If language does matter, then so do all those things. I am much more likely to be upset or offended if my HCP doesn’t look at me when I’m talking, isn’t open to my questions and doesn’t show a genuine interest in my care. I believe the vast majority do those things. I don’t want to be judged on my condition negatively because I live with T1D, my T1D, every single day. I’m not the same as the patient you saw earlier, with an HbA 1c of 6%. Don’t compare me to that person or any other diabetic. Comparison to “perfect” diabetics is what offends me far more than being labelled a diabetic and, to me, that’s what HCPs should be focusing on during appointments rather than worrying about how to tell me that my HbA 1c for the last 90 days is terrible. Work with me to manage my diabetes in the best possible way, based upon how I live and I’ll be a happy patient. Language matters to a point but my health matters far more than the words you use.

Paul Sandells is a type 1 diabetes vlogger from the United Kingdom. Diagnosed in 1984, he is a husband and father of two. @DiabeticDadUK

Elizabeth Snouffer is Editor of Diabetes Voice

You may also find these interesting

No related posts.

Do you have something to say?

Your thoughts and opinions matter to us., be the first to comment.

Got any suggestions?

We want to hear from you! Send us a message and help improve Slidesgo

Top searches

Trending searches

11 templates

21 templates

holy spirit

35 templates

memorial day

12 templates

17 templates

art portfolio

81 templates

World Diabetes Day

It seems that you like this template, world diabetes day presentation, free google slides theme, powerpoint template, and canva presentation template.

Diabetes is a serious illness that affects millions of people all around the world, and making proper treatment, care and information accessible to everyone who needs it is an unresolved issue that needs more awareness. For reasons like these, the United Nations decided to establish November 14th as the World Diabetes Day. The symbol of this day is a blue circle, and this template is inspired by it. Use it to speak about what events will be hold or what problems are still to be solved by adding your information and editing the resources we have included. Every little speech counts when it comes to spreading information about dangerous illnesses like this one.

Features of this template

• 100% editable and easy to modify
• 35 different slides to impress your audience
• Contains easy-to-edit graphics such as graphs, maps, tables, timelines and mockups
• Includes 500+ icons and Flaticon’s extension for customizing your slides
• Designed to be used in Google Slides, Canva, and Microsoft PowerPoint
• 16:9 widescreen format suitable for all types of screens
• Includes information about fonts, colors, and credits of the free resources used

How can I use the template?

Am I free to use the templates?

How to attribute?

Combines with:

This template can be combined with this other one to create the perfect presentation:

Attribution required If you are a free user, you must attribute Slidesgo by keeping the slide where the credits appear. How to attribute?

Related posts on our blog.

How to Add, Duplicate, Move, Delete or Hide Slides in Google Slides

How to Change Layouts in PowerPoint

How to Change the Slide Size in Google Slides

Related presentations.

Premium template

Unlock this template and gain unlimited access

This comprehensive  slide deck of ADA's 2023 Standards of Care contains content created, reviewed, and approved by the American Diabetes Association.  You are free to use the slides in presentations without further permission as long as the slide content is not altered in any way and appropriate attribution is made to the American Diabetes Association (the Association name and logo on the slides constitutes appropriate attribution).

Permission is required from the Association for any commercial use or for reproduction in any print materials (contact [email protected] ).

Using the links to the slide deck will download the deck. You may need to check the folder for downloaded documents on your device to see/open the file. 

• Diabetes & Primary Care
• Vol:11 | No:06

Clinical presentations, diagnosis and prevention of diabetes

• 14 Dec 2009

Researchers, public health physicians and frontline clinicians, including GPs, are increasingly convinced that we are entering an epidemic (if not a pandemic) of diabetes mellitus. Rates of diabetes prevalence are increasing across the world, particularly in developing countries, and an increasing number of people are being diagnosed in primary care. This article explores the classification and diagnosis of diabetes, focusing on risk factors, pre-diabetes, and management and prevention strategies for type 2 diabetes in primary care.

Share this article + Add to reading list – Remove from reading list ↓ Download pdf

In 2007 it was estimated that 4.82% of the UK population have diabetes (2.45 million people) (Yorkshire and Humber Public Health Observatory, 2007). Data from the author’s own practice alone show a trebling in the prevalence of type 2 diabetes in the past 20 years, with a relentless year on year increase (Evans et al, 2008). With the diagnosis of diabetes comes an increased risk of cardiovascular disease (CVD) and three-quarters of people with diabetes will die from cardiovascular causes (Garber, 2003). 

Along with this rise in the prevalence of diabetes there is also a growing number of people in the UK with intermediate or borderline hyperglycaemia (often known as “pre-diabetes”). The challenge to primary care is therefore to encourage early diagnosis, intervention and, if possible, prevention of both of these disorders.

The questions, therefore, are: how do we define diabetes and pre-diabetes, and how can we prevent people developing these potentially life-threatening conditions?

Type 1 and type 2 diabetes Raised blood glucose (hyperglycaemia) has numerous health implications. Diabetes mellitus is “a group of metabolic diseases characterised by hyperglycaemia resulting from defects in insulin secretion, action or both”. This definition by the American Diabetes Association (ADA, 2009) illustrates the fact that diabetes is a syndrome with multiple causes. 

The vast majority of people with diabetes fall into two main groups: type 1 and type 2 (ADA, 2009). As described in an earlier module in the series, type 1 diabetes is caused by an absolute deficiency of insulin thought to be due to autoimmune destruction of pancreatic islet cells. Type 1 accounts for between 5% and 10% of all cases and is often seen in younger people, usually before the age of 40 (Diabetes UK, 2009). Type 2 diabetes, however, is far more common (90% of all cases) and is usually diagnosed in people over 45 years of age who are often obese or physically inactive (Diabetes UK, 2009). It is rapidly increasing in prevalence and is the driver for the current diabetes epidemic.

Type 2 diabetes is strongly dependent on ethnicity and is more common in south Asian or Afro-Caribbean populations. In these populations in the UK, people may develop type 2 diabetes at a younger age and at lower BMI levels than their Caucasian counterparts. Unlike type 1 diabetes, type 2 is characterised by a relative insulin deficiency and is often associated with insulin resistance and features of the so-called metabolic syndrome – an increase in waist circumference and raised blood pressure, low HDL-cholesterol, raised plasma triglycerides or a raised blood glucose (Alberti et al, 2005).

Type 2 diabetes usually develops after a long prodromal period of several years of gradually increasing blood glucose levels (Harris et al, 1992), and most people pass through a period of pre-diabetes before their hyperglycaemia reaches the diabetes threshold. Recent data from the Whitehall II study (Tabák et al, 2009) showed that before diagnosis with type 2 diabetes, study participants had a slow increase in their blood glucose levels over the 13 years of the study, but that blood glucose levels then rose rapidly in the 2–3 years preceding diagnosis. 

People with type 2 diabetes often do not need insulin for a period of time after diagnosis (hence the previous term “non-insulin dependent”). In addition, type 2 diabetes is often asymptomatic until blood glucose levels rise (Evans et al, 2003). 

Whatever the cause of the hyperglycaemia, however, be it type 1 or 2 diabetes, the symptoms include polyuria, polydipsia, weight loss, tiredness, blurred vision and susceptibility to infections. Long-term complications can be disabling, even fatal, and include neuropathy, retinopathy, CVD, sexual dysfunction and a significant impact on the individual’s quality of life and social functioning. However, even at diagnosis of type 2 diabetes, around 25% of people may already have complications (UK Prospective Diabetes Study Group, 1998). 

Rarer causes of diabetes Type 2 diabetes is generally considered to be a polygenic disorder. Monogenic causes of diabetes are seen less frequently (1–2% of all cases) (Murphy et al, 2008), but nevertheless can present to GPs. For example, it is thought that each GP practice has at least one person whose diabetes is due to maturity-onset diabetes of the young (MODY), although this is unlikely to have been recognised as such. 

MODY is a monogenic autosomal dominant condition often causing hyperglycaemia in people under the age of 20, and hence is likely to be diagnosed as either type 1 or early type 2 diabetes. The chromosomal defects and functional deficiencies have now been determined, and the most common form involves a mutation in one of the liver transcription factors known as hepatocyte nuclear factor (HNF-1 α ). People with MODY usually present with early-onset diabetes aged 15–30 years, are not insulin-dependent and usually not obese. There is usually a strong family history of diabetes, often with family members developing the condition before the age of 25.

MODY is important to the primary care team for several reasons, including the need to screen other family members and offer genetic counselling, the need to define the precise sub-type of MODY by genetic testing, and the need for specialist referral to ensure the right diagnosis is made. Treatment options are often dependent on the individual’s genetic sub-type (e.g. the use of low-dose sulphonylureas in people with the HNF-1 α subtype) (Murphy et al, 2008).

Another monogenic cause of diabetes in middle-aged adults is maternally inherited diabetes and deafness (MIDD). People with the condition have hyperglycaemia and a maternal history of diabetes as well as young-onset bilateral sensori-neural hearing loss. A mitochondrial mutation has been identified (m.3243A>G) (Fischel-Ghodsian, 2001).

When a more unusual form of diabetes is suspected, e.g. younger onset, a strong family history or a lack of the usual insulin resistance features, then discussion with your local specialist about the possibility of monogenic diabetes, the need for genetic testing and possible referral may be helpful. A very practical and educational website is www.diabetesgenes.org.

Diagnosing diabetes Diabetes can and should be diagnosed in primary care without specialist referral unless the individual’s condition is potentially life-threatening, such as diabetic ketoacidosis, or hyperglycaemia is severe and requiring immediate insulin treatment.

Currently, both the World Health Organization and International Diabetes Federation (WHO and IDF, 2006) and the ADA (2009) recommend that the diagnosis of diabetes (and pre-diabetes states) is based on a blood glucose measurement ( Table 1 ). Unless people have hyperglycaemic symptoms then this blood glucose estimation should be repeated; either repeated fasting plasma measures (after at least an 8-hour fast) or an oral glucose tolerance test (OGTT) (75 g of anhydrous glucose which equates to 410 ml of Lucozade Energy Original) are commonly used in primary care.

Traditionally, the OGTT has been promoted as the gold standard for the diagnosis of diabetes and has been used extensively in epidemiological studies. However, the recommended use of repeated fasting plasma glucose (FPG) estimations, which are cheap and more convenient for both doctor and patient, may well have moved UK primary care teams away from the OGTT. The use of OGTT is therefore debatable as it is intensive in terms of patient time, nurse time, and has surprisingly poor repeatability. A proportion of general practices do not therefore use it as a diagnostic tool. However, OGTT should be considered in people with impaired fasting glucose (IFG), 30% of whom will have diabetes if challenged with a glucose load (WHO and IDF, 2006).

Currently, there is also debate regarding the introduction of HbA 1c as the diagnostic test for diabetes. HbA 1c is the predominant form of glycated haemoglobin, present in red blood cells, which reflects the average plasma glucose concentration over the preceding 2–3 months, and is expressed as a percentage of HbA (International Expert Committee [IEC], 2009), and hence would give a better overall glycaemic picture. The new NHS Health Check Programme (2009) advocates the use of HbA 1c with a cut-off of >6.5% (>48 mmol/mol) as diagnostic of diabetes. The use of HbA 1c may therefore rapidly gain in popularity. It is more convenient (as it does not require a fasting specimen), is reliable and correlates well with long-term complications, hence its use in people once they are diagnosed with diabetes. International recommendations promoting the use of HbA 1c in diagnosis were recently published (IEC, 2009), and national bodies across the world are currently considering whether to implement HbA 1c as the diagnostic test for diabetes. 

It should be noted that the diagnostic cut-offs for the development of diabetes specified in Table 1 are derived from plasma glucose levels associated with increased risk of retinopathy, as well as the population distribution of plasma glucose (WHO and IDF, 2006).

Risk factors for diabetes  The most important risk factor for type 2 diabetes is obesity. There are, however, other modifiable and non-modifiable risk factors ( Table 2 ). These are used as risk indicators to identify those at higher risk of type 2 diabetes in several clinical settings, for example in risk-screening questionnaires such as FINDRISC (Finnish Type 2 Diabetes Risk Score; Lindström and Tuomilehto, 2003); in opportunistic screening in GP surgeries (Evans et al, 2008); in risk calculations using routinely collected data held in GP databases such as the QDScore (Hippisley-Cox et al, 2009); and in the new NHS Health Check Programme (2009) to identify those who should have a glucose test.

Pre-diabetes Another area of debate is the diagnosis of the intermediate hyperglycaemic states collectively known as pre-diabetes. All these conditions have in common the fact that blood glucose levels are raised yet are not above the threshold that is diagnostic of type 2 diabetes. The two most important features of pre-diabetes in primary care are the increased risk of CVD, which is two to three times that of normoglycaemic individuals (Coutinho et al, 1999), and the increased risk of progression to type 2 diabetes. Hence the potential for prevention of both diabetes and CVD in this high-risk group.

The term “pre-diabetes” has been considered by some as being potentially misleading, as a large proportion of people with pre-diabetes do not progress to diabetes. Other terms such as non-diabetic hyperglycaemia, intermediate hyperglycaemia and impaired glucose regulation are therefore gaining popularity. Risk factors for pre-diabetes are generally considered to be the same as those for type 2 diabetes as both conditions share the common pathology of insulin resistance. 

The terminology is complicated, but currently two states are recognised: IFG diagnosed on repeated fasting blood glucose (FBG) measurements and impaired glucose tolerance (IGT) diagnosed on an OGTT ( Table 1 ). There is some debate, however, about the level of FPG in IFG. The ADA (2009) recommend that IFG includes an FPG of 5.6–6.9 mmol/L rather than the stricter criterion of 6.1–6.9 mmol/L in the WHO and IDF (2006) recommendations. A person may have either IFG or IGT (in isolation) or both (i.e. an FPG of 6.1–6.9 mmol/L and a 2-hour glucose ≥7.8 mmol/L and

People with pre-diabetes are asymptomatic. Nevertheless, some features of the metabolic syndrome may often be present. Also, a number of associated conditions, such as peripheral neuropathy (Singleton et al, 2005) and carpal tunnel syndrome (Gulliford et al, 2006), are increasingly being recognised. Despite these associations, people with pre-diabetes are usually diagnosed by screening.

Both IFG and IGT are increasingly prevalent. For example, it is estimated that 5.1% of the UK population aged 20–79 may have IGT (IDF, 2003). Pre-diabetes carries an increased risk of progression to type 2 diabetes, although this can vary dependent on ethnicity and other factors such as initial level of glycaemia (Unwin et al, 2002). On average, around 5% of people with IGT progress to type 2 diabetes annually (Santaguida et al, 2005). It is widely accepted that people with these conditions are at greater risk of both type 2 diabetes and CVD (Coutinho et al, 1999), and interventions designed to prevent diabetes have, in the main, been targeted at this population.  

Education of people with pre-diabetes  Previous work in developing a pragmatic screening programme using the GP database identified a large proportion of people with pre-diabetes (Greaves et al, 2004). 

Studies had previously shown that individuals and healthcare professionals alike were confused about the implications of the diagnosis of pre-diabetes (Wylie et al, 2002; Whitford et al, 2003; Williams et al, 2004). The author and colleagues therefore developed an educational package for people with pre-diabetes and their healthcare professionals. This package, known as WAKEUP (Ways of Addressing Knowledge Education and Understanding in Prediabetes), was found to be acceptable both to people with pre-diabetes and healthcare professionals (Evans et al, 2006). 

Managing pre-diabetes Although generic guidance was given to GPs and practice nurses, the qualitative data from healthcare professionals in the WAKEUP study revealed a need for robust practice systems to facilitate effective management and follow-up of individuals with pre-diabetes (Evans et al, 2006). Key messages in the WAKEUP study that should be conveyed to people with pre-diabetes were identified ( Table 3 ). Similar qualitative work undertaken by Troughton et al (2008) has also shown that this population expected structured follow-up after their diagnosis.

It should not be forgotten that people with pre-diabetes need appropriate lifestyle advice regarding smoking, alcohol, and possible prescription of lipid-lowering drugs, such as statins, and also blood pressure medication if appropriate. For these reasons an annual review in primary care would seem reasonable with these cardiovascular risk factors being addressed, and also an FBG test (or even OGTT) undertaken to assess any progression towards diabetes.

Primary prevention of type 2 diabetes  As the transition from normoglycaemia through impaired glucose regulation to type 2 diabetes takes several years, it is logical to intervene and aim to prevent or delay the onset of diabetes. This can be at individual or population level. The best evidence regarding prevention exists in high-risk individuals, although several countries such as Finland have a national population programme to prevent diabetes that involves all stakeholders.

There is now substantial evidence from large-scale randomised trials in various populations across the world that progression to diabetes can be prevented or delayed in high-risk groups both by behavioural (Tuomilehto et al, 2001; Knowler et al, 2002; Ramachandran et al, 2006) and pharmacological interventions (Chiasson et al, 2002; Knowler et al, 2002; Lindström and Tuomilehto, 2003; Torgerson et al, 2004; Gerstein et al, 2006).

Lifestyle A meta-analysis has shown that lifestyle interventions can produce a 50% relative risk reduction in the incidence of type 2 diabetes at 1 year (Yamaoka and Tango, 2005). Typically these interventions are in high-risk individuals, such as those with pre-diabetes (usually IGT), and interventions are targeted at halting or slowing beta-cell dysfunction. 

The majority of behavioural interventions are relatively intensive and designed to increase an individual’s physical activity levels and encourage weight loss and dietary change. Relatively modest changes in lifestyle, such as a 5% reduction in weight or an increase in moderate physical activity to 4 hours a week, can have important benefits in reducing the risk of diabetes. 

In the Finnish Diabetes Prevention Study (DPS; Tuomilehto et al, 2001) a clear “dose–response” curve was observed, such that the greater the number of behavioural changes (the success score), the lower the risk of diabetes in an individual ( Figure 1 ). It was also noted that the beneficial effects observed in the Finnish DPS persisted when the participants were followed-up a median of 3 years after the intervention had finished (Lindström et al, 2006). 

Lifestyle interventions of course have other general benefits for the individual. However, the majority of these interventions are not feasible or affordable in a resource-limited NHS, and there is therefore a need to develop, pilot and evaluate a pragmatic intervention that could be delivered in primary care or in the community. It is possible that this could be based on motivational interviewing (MI), and early results with MI in promoting weight loss in obese people through lay facilitators are encouraging (Greaves et al, 2008). 

The need for a pragmatic intervention is now more urgent as the NHS Health Check Programme begins. A large number of people with pre-diabetes will undoubtedly be identified and will need intervention. These interventions will also need to be culturally sensitive in the light of the large number of people from ethnic communities in the UK with pre-diabetes. 

Pharmacological interventions As well as lifestyle interventions, drugs have also been shown to reduce progression to type 2 diabetes, including metformin (Knowler et al, 2002; Ramachandran et al, 2006), acarbose (Chiasson et al, 2002), orlistat (Torgerson et al, 2004) as well as troglitazone – although later withdrawn (Azen et al, 1998) – and rosiglitazone (Gerstein et al, 2006). 

A meta-analysis by Gillies et al (2008) showed that drug interventions were both less effective and less cost-effective than lifestyle. The IDF (Alberti et al, 2007) recommends drug therapy as second-line after lifestyle intervention for diabetes prevention, yet, unfortunately, no pharmaceutical agent is licensed for diabetes prevention in the UK. 

There is also debate about whether these drugs simply mask progression to diabetes by lowering blood glucose, which then rises in the subsequent wash-out period once treatment has finished. On balance, however, it is generally thought that diabetes prevention through lifestyle or drugs is cost-effective and should be actively promoted in clinical practice (Gillies et al, 2008).  

Practitioner behaviour  In UK primary care there is a considerable gap between the theory of diabetes prevention and its active implementation. Several qualitative and questionnaire studies have shown that GPs and primary care staff are confused by the whole area of pre-diabetes and its diagnosis and wanted more information and guidance (Wylie et al, 2002; Whitford et al, 2003; Williams et al, 2004). GPs also expressed a variety of attitudes towards pre-diabetes, ranging from enthusiastically embracing its management to diagnostic nihilism (Fearn-Smith et al, 2007). 

In the biggest database study to date (Holt et al, 2008), it was demonstrated that GPs were missing opportunities to diagnose both pre-diabetes and diabetes in their registered patients. For example, borderline blood glucose results were not being followed-up with either a repeat test or OGTT. Better education of healthcare professionals is therefore needed. Box 1 gives a case study highlighting some common problems encountered in primary care.

Screening for diabetes and pre-diabetes  Although population screening is not thought to be appropriate (Wareham and Griffin, 2001), targeted or selective screening for both diabetes and pre-diabetes is now considered to be both effective and cost-effective (Waugh et al, 2008). Most authorities advise two-stage screening. First, individuals at higher risk of diabetes are identified using GP data or a questionnaire, such as FINDRISC (Lindström and Tuomilehto, 2003), and then a blood glucose test such as an FBG, an OGTT or an HbA 1c test is used.

NICE guidance on preventing type 2 diabetes will not be available until June 2011, although European guidance from the IMAGE (Development and Implementation of a European Guideline and Training Standards for Diabetes Prevention) project will be available in early 2010 ( http://www.image-project.eu/ ). 

In the new NHS Health Check Programme, all people aged 40–74 years who are not on a disease register will be called in for a face-to-face check and assessment of their vascular risk. Those who are overweight or obese or have a raised blood pressure will also be screened for diabetes. Managing this exercise and its implications will be a major challenge to all practitioners in primary care who wish to prevent type 2 diabetes and its complications.

Conclusion The prevalence of type 2 diabetes is rapidly increasing in the UK, although primary care teams should be aware of the rarer types of diabetes (e.g. MODY or MIDD) as well as type 1 diabetes. 

The risk factors for type 2 diabetes and pre-diabetes are well recognised and primary care teams are in an ideal position to screen for both conditions (either opportunistically or systematically). Finally, it is now clear that type 2 diabetes can be prevented or delayed by lifestyle or pharmacological interventions in those at highest risk.

To complete the CPD module, click here.

Alberti KG, Zimmet P, Shaw J; IDF Epidemiology Task Force Consensus Group (2005) The metabolic syndrome – a new worldwide definition.  Lancet   366 : 1059–62 Alberti KG, Zimmet P, Shaw J (2007) International Diabetes Federation: a consensus on Type 2 diabetes prevention. Diabet Med   24 : 451–63 American Diabetes Association (2009) Diagnosis and classification of diabetes mellitus.  Diabetes Care   32 : S62–7 Azen SP, Peters RK, Berkowitz K et al (1998) TRIPOD (TRoglitazone In the Prevention Of Diabetes): a randomized, placebo-controlled trial of troglitazone in women with prior gestational diabetes mellitus.  Control Clin Trials  19 : 217–31 Chiasson JL, Josse RG, Gomis R et al (2002) Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial.  Lancet   359 : 2072–7 Coutinho M, Gerstein HC, Wang Y, Yusuf S (1999) The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years.  Diabetes Care 22 : 233–40 Diabetes UK (2009) Diabetes in the UK 2009: Key Statistics on Diabetes. Diabetes UK, London Evans PH, Luthra M, Powell R et al (2003) Diagnosis of type 2 diabetes in primary care.  British Journal of Diabetes and Vascular Disease   3 : 342–4  Evans PH, Winder R, Greaves C et al (2006) Ways of addressing knowledge, education and understanding in pre-diabetes: the WAKEUP study. Abstract.  Diabet Med   23 (Suppl2): 132–3 Evans P, Langley P, Gray DP (2008) Diagnosing type 2 diabetes before patients complain of diabetic symptoms – clinical opportunistic screening in a single general practice.  Fam Pract   25 : 376–81 Fearn-Smith JDG, Evans PH, Harding G, Campbell JL (2007) Attitudes of GPs to the diagnosis and management of impaired glucose tolerance: The practitioners’ attitudes to hyperglycaemia (PAtH) questionnaire.  Primary Care Diabetes   1 : 35–41 Fischel-Ghodsian N (2001) Mitochondrial DNA mutations and diabetes: another step toward individualized medicine.  Ann Intern Med   134 : 777–9 Garber AJ (2003) Cardiovascular complications of diabetes: prevention and management.  Clin Cornerstone   5 : 22–37 Gerstein HC, Yusuf S, Bosch J et al (2006) Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trial.  Lancet   368 : 1096–105 Gillies CL, Lambert PC, Abrams KR et al (2008) Different strategies for screening and prevention of type 2 diabetes in adults: cost effectiveness analysis.  Br Med J   336 : 1180–5 Greaves CJ, Stead JW, Hattersley A et al (2004) A simple pragmatic system for detecting new cases of type 2 diabetes and impaired fasting glycaemia in primary care.  Fam Pract   21 : 57–62 Greaves CJ, Middlebrooke A, O’Loughlin L et al (2008) Motivational interviewing for modifying diabetes risk: a randomised controlled trial.  Br J Gen Pract   58 : 535–40 Gulliford MC, Latinovic R, Charlton J, Hughes RA (2006) Increased incidence of carpal tunnel syndrome up to 10 years before diagnosis of diabetes.  Diabetes Care   29 : 1929–30 Harris MI, Klein R, Wellborn TA, Knuiman MW (1992) Onset of NIDDM occurs at least 4–7 years before clinical diagnosis. Diabetes Care   15 : 815–19 Hippisley-Cox J, Coupland C, Robson J et al (2009) Predicting risk of type 2 diabetes in England and Wales: prospective derivation and validation of QDScore.  Br Med J   338 : b880 Holt TA, Stables D, Hippisley-Cox J et al (2008) Identifying undiagnosed diabetes: cross-sectional survey of 3.6 million patients’ electronic records.  Br J Gen Pract   58 : 192–6 International Diabetes Federation (2003)  Diabetes Atlas.  2nd ed. IDF, Brussels International Expert Committee (2009) Report on the role of the A1C assay in the diagnosis of diabetes.  Diabetes Care   32 : 1327–34 Knowler WC, Barrett-Connor E, Fowler SE et al (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.  N Engl J Med  346 : 393–403 Lindström J, Tuomilehto J (2003) The diabetes risk score: a practical tool to predict type 2 diabetes risk.  Diabetes Care  26 : 725–31 Lindström J, Ilanne-Parikka P, Peltonen M et al (2006) Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study.  Lancet   368 : 1673–9 Murphy R, Ellard S, Hattersley AT (2008) Clinical implications of a molecular genetic classification of monogenic beta-cell diabetes.  Nat Clin Pract Endocrinol Metab   4 : 200–13 NHS Health Check Programme (2009)  NHS Health Check: Vascular Risk Assessment and Management Best Practice Guidance.  Department of Health, London Ramachandran A, Snehalatha C, Mary S et al (2006) The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia   49 : 289–97 Santaguida PL, Balion C, Hunt D et al (2005) Diagnosis, prognosis, and treatment of impaired glucose tolerance and impaired fasting glucose.  Evid Rep Technol Assess (Summ)  Aug: 1–11 Singleton JR, Smith AG, Russell J, Feldman EL (2005) Polyneuropathy with impaired glucose tolerance: implications for diagnosis and therapy.  Curr Treat Options Neurol   7 : 33–42 Tabák AG, Jokela M, Akbaraly TN et al (2009) Trajectories of glycaemia, insulin sensitivity, and insulin secretion before diagnosis of type 2 diabetes: an analysis from the Whitehall II study.  Lancet   373 : 2215–21 Torgerson JS, Hauptman J, Boldrin MN, Sjöström L (2004) XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients.  Diabetes Care   27 : 155–61 Troughton J, Jarvis J, Skinner C et al (2008) Waiting for diabetes: perceptions of people with pre-diabetes: a qualitative study.  Patient Educ Couns   72 : 88–93 Tuomilehto J, Lindström J, Eriksson JG et al (2001) Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance.  N Engl J Med   344 : 1343–50 UK Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33).  Lancet   352 : 837–53 Unwin N, Shaw J, Zimmet P, Alberti KG (2002) Impaired glucose tolerance and impaired fasting glycaemia: the current status on definition and intervention.  Diabet Med   19 : 708–23 Wareham NJ, Griffin SJ (2001) Should we screen for type 2 diabetes? Evaluation against National Screening Committee criteria.  BMJ   322 : 986–8 Waugh N, Scotland G, McNamee P et al (2008) Screening for type 2 diabetes: literature review and economic modelling. Health Technol Assess   11 : iii–iv, ix–xi, 1–125 Whitford DL, Lamont SS, Crosland A (2003) Screening for type 2 diabetes: is it worthwhile? Views of general practitioners and practice nurses.  Diabet Med   20 : 155–8 Williams R, Rapport F, Elwyn G et al (2004) The prevention of type 2 diabetes: general practitioner and practice nurse opinions.  Br J Gen Pract  54 : 531–5 World Health Organization, International Diabetes Federation (2006)  Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycaemia. Report of a WHO/IDF Consultation.  WHO, Geneva Wylie G, Hungin AP, Neely J (2002) Impaired glucose tolerance: qualitative and quantitative study of general practitioners’ knowledge and perceptions.  BMJ   324 : 1190 Yamaoka K, Tango T (2005) Efficacy of lifestyle education to prevent type 2 diabetes: a meta-analysis of randomized controlled trials.  Diabetes Care  28 : 2780–6 Yorkshire and Humber Public Health Observatory (2007)  Diabetes Key Facts Supplement 2007.  YHPHO, York

Editorial: Updated guidance on prescribing incretin-based therapy, cardiovascular risk reduction and the wider uptake of CGM

How to diagnose and treat hypertension in adults with type 2 diabetes, diabetes distilled: statin heart benefits outweigh diabetes risks, interactive case study: non-diabetic hyperglycaemia – prediabetes, diabetes distilled: smoking cessation cuts excess mortality rates after as little as 3 years, impact of freestyle libre 2 on diabetes distress and glycaemic control in people on twice-daily pre-mixed insulin, updated guidance from the pcds and abcd: managing the national glp-1 ra shortage.

Jane Diggle highlights advice on preventing eye damage when initiating new incretin-based therapies.

Diagnosing and treating hypertension in accordance with updated NICE guidelines.

24 Apr 2024

Quantifying the risk of worsening glycaemia, and how should healthcare professionals respond?

22 Apr 2024

Diagnosing and managing non-diabetic hyperglycaemia.

17 Apr 2024

Sign up to all DiabetesontheNet journals

• CPD Learning
• Journal of Diabetes Nursing
• Diabetes Care for Children & Young People
• The Diabetic Foot Journal
• Diabetes Digest

Useful information

• Terms and conditions
• Privacy policy
• Editorial policies and ethics

By clicking ‘Subscribe’, you are agreeing that DiabetesontheNet.com are able to email you periodic newsletters. You may unsubscribe from these at any time. Your info is safe with us and we will never sell or trade your details. For information please review our Privacy Policy .

Are you a healthcare professional?  This website is for healthcare professionals only. To continue, please confirm that you are a healthcare professional below.

We use cookies  responsibly to ensure that we give you the best experience on our website. If you continue without changing your browser settings, we’ll assume that you are happy to receive all cookies on this website.  Read about how we use cookies .

My Speech Class

Public Speaking Tips & Speech Topics

89 Medical Speech Topic Ideas [Persuasive, Informative, Nursing]

Jim Peterson has over 20 years experience on speech writing. He wrote over 300 free speech topic ideas and how-to guides for any kind of public speaking and speech writing assignments at My Speech Class.

Medical speech topic list with public speaking ideas for an informative or persuasive medical text such as speech recognition software, Staphylococcus aureus or self-esteem problems. I have these informative ideas for a public speaking speech in mind for you:

In this article:

Informative

• Safety and legal issues on acupuncture.
• Frustrations for color blind people.
• The benefits of ozone therapy.
• What is Reiki stress reduction and relaxation?
• Tip for making up a first aid kit for wilderness expeditions.
• What is autism?
• Epidemiological studies on the bird flu.
• Which home tests are safe and reliable?
• Facts and myths about Cellulitis.
• Short-sightedness and long-sightedness explained.
• Medical speech recognition software developments.
• Heart attack signs.
• What health problems with diabetes, how to deal with them?
• Diagnosing a food allergy, symptoms, diagnosis, and treatment.
• How to prevent Lyme disease, spread to humans by infected ticks.
• A day with the crew of an air ambulance helicopter.
• Arguments for embryonic stem cell research.
• How to patent medicine.
• Philosophies about genetic engineering.
• Stages of pregnancy month by month.
• The importance of organ donation.
• The principles of medical ethics.
• What do our kidneys do?

Here are some concrete persuasive medical speech topic samples. Keep going back and forth in your mind to sort out the way you like to talk about it.

• Isolation is the best way to prevent the spread of Methicillin-resistant Staphylococcus aureus MRSA infections.
• Medical marijuana must be allowed for ill people – or not.
• Migraine often is misunderstood in the workplace.
• Most infertile couples use alternative medicine .
• Mental health issues affect us all in some way.
• Food allergy can manifest in behavior issues.
• Stuttering causes self-acceptance and self-esteem problems.
• The food industry should be blamed for obesity.
• Tourette’s syndrome patients can’t help it, let’s help them.
• Alzheimer’s disease should be involved in the care he or she will get.
• Atkins isn’t a quick fix for weight loss.
• Solve asthma by improving air quality.
• Effective medicines aren’t always expensive.
• Medical speech recognition and pathology experiences.
• Stopping smoking speeds recovery after operations.
• How a donation help your local Alzheimer’s charity.
• Everyone should donate blood.
• A woman can be too old to give birth.
• Air ambulance helicopters are the most efficient way to help victims of road accidents.
• Back pain is caused by a spinal disk problem.
• Beauty is not a valid reason to pursue cosmetic plastic surgery.
• Brushing your teeth twice a day will not keep the dentist away.
• Cell phones have a dangerous amount of radiation.
• Children should be first on organ transplant lists.
• Computer use is the reason for those repetitive strain injuries.
• Do not be afraid of biotechnology developments.
• Everyone needs dentistry insurance.
• Everybody should be an organ donor.
• Food allergy is a disease.
• Human fetal tissue research will help patients suffering from Alzheimer disease.
• Medication for general use should not be protected for 20 years.
• Needle exchange programs help to prevent the widespread of blood-borne viruses.
• Newborns without brains should not be used as organ donors.
• Nutrition patterns will change the human DNA genome structure.
• Patients should never accept money from the pharmaceutical industry.
• Pharmaceuticals are not transparent.
• Techniques and methods for transgenderation need to be assessed better.
• Terminally ill patients should freely rely on a hospital hospice program.
• The birth control pill is not safe.
• The E Coli bacteria is not explained properly enough.
• The morning-after pill must be freely prescribed in drugstores and pharmacies.
• The Morning-After Pill must be made available without a prescription.
• Using a known sperm donor is too risky.
• War veterans suffering from post-traumatic stress are not treated in time.

Of course these statements for a medical speech are not my opinion, but examples to trigger your mind for finding your own medical speech topic. Let these ideas form a rough outline in your head.

In other articles and entirely new threads I have written detailed tips to convert them into a real public speaking presentation.

Tip: A good topic title is short and sharp, conveys and channels a clear message, is easy to remember for the listeners, has no like or equal, is descriptive, and contains your own personal speaking signature.

Can We Write Your Speech?

Get your audience blown away with help from a professional speechwriter. Free proofreading and copy-editing included.

6 Additional Medical Persuasive Speech Topic Ideas

Medical persuasive speech topic ideas based on official position statements of organizations in the field, they are perfect for building speech topics in public speaking education. I scraped the net and found mission and vision claims that could be transformed into an issue for speechwriting purposes:

Sun Damage – ‘In most situations, sun protection to prevent skin cancer and sun damage to the skin is required during times when the ultraviolet index (UVI)A is raised’. According to the dermatology resource DermNet NZ. Offer pros and cons, and offer tips for listeners.

Dentistry – ‘The ADA Council on Scientific Affairs continues to believe that amalgam is a valuable, viable and safe choice for dental patients.’ Do you agree with the ADA Council on Scientific Affairs? Or not? Try to find persuasive arguments to adstruct the opposite, or weaken this firm medical persuasive speech topic ideas a little bit.

Nutrition – ‘In overweight and obese insulin-resistant individuals, modest weight loss has been shown to improve insulin resistance. Thus, weight loss is recommended for all such individuals who have or are at risk for diabetes.’ The American Diabetes Association writes on its site. Examine and prove direct relations between overweight and diabetes in a persuasion way of talking. Weight loss and diabetes in itself are great medical persuasive speech topic ideas.

Revalidation – ‘In the United Kingdom doctors will need to be revalidated every five years in order to retain their licence to practise.’ A citation of the Royal College of Surgeons of England. Good idea? Take a stand and convince your audience.

Equity – ‘A greater equity in health should be a progress indicator of populations within and between countries.’ That’s a formal statement of WHO World Health Organization. Do yo agree? Construct the arguments of this thesis.

Surgery – ‘Pregnant women should be given the right to choose major abdominal surgery (cesarean section) or a normal birth.’ That is the opinion of the American College of Obstetricians and Gynecologists. Judge pros and cons, convince your public as speaker in all ways. Good idea for an essay too!

Speech topics related to nursing, mental and travel health careh, and dietary counseling on primary care fostering for high school.

Many, especially female students, like to choose to prepare informative public speaking on an assistant to doctors related issue.

Here are twenty sample speech ideas, divided in specific central ideas and more general writing topics.

• How to help patients with self-care products.
• Medical treatment is not available to most people in the world.
• Involve a nurse in developing mental health policies.
• What community nurses can do for the health of the neigbourhood.
• Nursing is also an important provider of mental treatment in complex situations.
• Care in humanitarian disaster areas.
• Alzheimers and family relations.
• Travel health care services.
• The rights of mentally ill persons.
• Adolescents with disorders of development.
• Disabled children and their special needs.
• Neonatal care for premature babies.
• Benefits of nursery to the health system.
• Pediatric oncology for children with cancer.
• Dietary counseling for babies and their mothers.
• The altering role of male nurses in the past decades.
• What does the American Academy of Nurse Practitioners do
• The romantic history of Florence Nightingale.
• What education is needed to work in the healthcare business
• Medical ethics explained.
• The road to becoming a nurse.
• Please move your patients the right way!

66 Military Speech Topics [Persuasive, Informative]

259 Interesting Speech Topics [Examples + Outlines]

1 thought on “89 Medical Speech Topic Ideas [Persuasive, Informative, Nursing]”

You could include a topic on Fibromyalgia chronic disease.

Leave a Comment

I accept the Privacy Policy

Reach out to us for sponsorship opportunities

Vivamus integer non suscipit taciti mus etiam at primis tempor sagittis euismod libero facilisi.

© 2024 My Speech Class

357 Diabetes Essay Topics & Examples

When you write about the science behind nutrition, heart diseases, and alternative medicine, checking titles for diabetes research papers can be quite beneficial. Below, our experts have gathered original ideas and examples for the task.

🏆 Best Diabetes Essay Examples & Topics

⭐ most interesting diabetes research paper topics, ✅ simple & easy diabetes essay topics, 🎓 good research topics about diabetes, 💡 interesting topics to write about diabetes, 👍 good essay topics on diabetes, ❓ diabetes research question examples.

• Type 2 Diabetes The two major types of diabetes are type 1 diabetes and type 2 diabetes. Doctor: The first step in the treatment of type 2 diabetes is consumption of healthy diet.
• Adult-Onset Type 2 Diabetes: Patient’s Profile Any immediate care as well as post-discharge treatment should be explained in the best manner possible that is accessible and understandable to the patient.
• Living With a Chronic Disease: Diabetes and Asthma This paper will look at the main effects of chronic diseases in the lifestyle of the individuals and analyze the causes and the preventive measures of diabetes as a chronic disease.
• Leadership in Diabetes Management Nurses can collaborate and apply evidence-based strategies to empower their diabetic patients. The involvement of all key stakeholders is also necessary.
• Diabetes in Adults in Oxfordshire On a national level, Diabetes Research and Wellness Foundation aims to prevent the spread of the decease through research of the causes and effective treatment of diabetes 2 type.
• Case Study of Patient with DKA and Diabetes Mellitus It is manifested by a sharp increase in glucose levels and the concentration of ketone bodies in the blood, their appearance in the urine, regardless of the degree of violation of the patient’s consciousness.
• Intervention Methods for Type 2 Diabetes Mellitus An individual should maintain a regulated glycemic control using the tenets of self-management to reduce the possibility of complications related to diabetes.
• Relation Between Diabetes And Nutrition Any efforts to lessen and eliminate the risk of developing diabetes must involve the dietary habit of limiting the consumption of carbohydrates, sugar, and fats. According to Belfort-DeAguiar and Dongju, the three factors of obesity, […]
• Diabetes Mellitus: Symptoms, Types, Effects Insulin is the hormone that controls the levels of glucose in the blood, and when the pancreas releases it, immediately the high levels are controlled, like after a meal.
• Health Promotion: Diabetes Mellitus and Comorbidities This offers a unique challenge in the management of diabetes and other chronic diseases; the fragmented healthcare system that is geared towards management of short-term medical emergencies often is not well prepared for the patient […]
• Type 2 Diabetes as a Public Health Issue In recent years, a steady increase in the incidence and prevalence of diabetes is observed in almost all countries of the world.
• Diabetes Management: Case Study Type 1 and Type 2 diabetes contrast based on their definitions, the causes, and the management of the conditions. Since the CDC promotes the avoidance of saturated fat and the increase of fiber intake for […]
• Diabetes Mellitus Management in the Elderly Diabetes mellitus is a health complication involving an increase in the concentration in the concentration of blood sugar either due to a failure by cells to effectively respond to the production of insulin in the […]
• A Study of Juvenile Type 1 Diabetes in the Northwest of England The total number of children under seventeen years living with type 1 diabetes in North West England by 2009 was 2,630.
• Diabetes Prevention: The Sanofi-Aventis Leaflet Review Using the Flesh formula, it can be concluded that the leaflet has a good level of readability, but it can be improved in case it is shorter because a few sections of it are better […]
• Gestational Diabetes in a 38-Year-Old Woman The concept map, created to meet B.’s needs, considers her educational requirements and cultural and racial hurdles to recognize her risk factors and interventions to increase her adherence to the recommended course of treatment.B.said in […]
• Type 2 Diabetes Mellitus and Its Implications You call an ambulance and she is taken in to the ED. Background: Jean is still very active and works on the farm 3 days a week.
• Development of Comprehensive Inpatient and Outpatient Programs for Diabetes Overcoming the fiscal and resource utilization issues in the development of a comprehensive diabetes program is essential for the improvement of health and the reduction of treatment costs.
• Healthcare Cost Depending on Chronic Disease Management of Diabetes and Hypertension A sufficient level of process optimization and the presence of a professional treating staff in the necessary number will be able to help improve the indicators.
• Improving Glycemic Control in Black Patients with Type 2 Diabetes Information in them is critical for answering the question and supporting them with the data that might help to acquire an enhanced understanding of the issue under research. Finally, answering the PICOT question, it is […]
• Shared Decision-Making That Affects the Management of Diabetes The article by Peek et al.is a qualitative study investigating the phenomenon of shared decision-making that affects the management of diabetes. The researchers demonstrate the racial disparity that can arise in the choice of approaches […]
• Managing Obesity as a Strategy for Addressing Type 2 Diabetes When a patient, as in the case of Amanda, requires a quick solution to the existing problem, it is necessary to effectively evaluate all options in the shortest possible time.
• Tests and Screenings: Diabetes and Chronic Kidney Disease The test is offered to patients regardless of gender, while the age category is usually above 45 years. CDC1 recommends doing the test regardless of gender and is conducted once or twice to check the […]
• Obesity Management for the Treatment of Type 2 Diabetes American Diabetes Association states that for overweight and obese individuals with type 2 diabetes who are ready to lose weight, a 5% weight reduction diet, physical exercise, and behavioral counseling should be provided.
• COVID-19 and Diabetes Mellitus Lim et al, in their article, “COVID-19 and diabetes mellitus: from pathophysiology to clinical management”, explored how COVID-19 can worsen the symptoms of diabetes mellitus.
• The Importance of Physical Exercise in Diabetes II Patients The various activities help to improve blood sugar levels, reduce cardiovascular cases and promote the overall immunity of the patient. Subsequently, the aerobic part will help to promote muscle development and strengthen the bones.
• Diabetes Education Workflow Process Mapping DSN also introduces the patient to the roles of specialists involved in managing the condition, describes the patient’s actions, and offers the necessary educational materials.
• Diabetes: Treatment Complications and Adjustments One of the doctor’s main priorities is to check the compatibility of a patient’s medications. The prescriptions of other doctors need to be thoroughly checked and, if necessary, replaced with more appropriate medication.
• The Type 2 Diabetes Mellitus PICOT (Evidence-Based) Project Blood glucose levels, A1C, weight, and stress management are the parameters to indicate the adequacy of physical exercise in managing T2DM.
• Chronic Disease Cost Calculator (Diabetes) This paper aims at a thorough, detailed, and exhaustive explanation of such a chronic disease as diabetes in terms of the prevalence and cost of treatment in the United States and Maryland.
• Diabetes Mellitus Epidemiology Statistics This study entails a standard established observation order from the established starting time to an endpoint, in this case, the onset of disease, death, or the study’s end. It is crucial to state this value […]
• Epidemiology: Type II Diabetes in Hispanic Americans The prevalence of type II diabetes in Hispanic Americans is well-established, and the search for inexpensive prevention methods is in the limelight.
• Diabetes: Risk Factors and Effects Trends in improved medical care and the development of technology and medicine are certainly contributing to the reduction of the problem. All of the above indicates the seriousness of the problem of diabetes and insufficient […]
• Barriers to Engagement in Collaborative Care Treatment of Uncontrolled Diabetes The primary role of physicians, nurses, and other healthcare team members is to provide patients with medical treatment and coordinate that care while also working to keep costs down and expand access.
• Hereditary Diabetes Prevention With Lifestyle Modification Yeast infections between the fingers and toes, beneath the breast, and in or around the genital organs are the common symptoms of type 2 diabetes.
• Health Equity Regarding Type 2 Diabetes According to Tajkarimi, the number of research reports focusing on T2D’s prevalence and characteristics in underserved minorities in the U. Adapting the program’s toolkits to rural Americans’ eating and self-management habits could also be instrumental […]
• Diabetes Mellitus: Treatment Methods Moreover, according to the multiple findings conducted by Park et al, Billeter et al, and Tsilingiris et al, bariatric surgeries have a positive rate of sending diabetes into remission.
• Diagnosing Patient with Insulin-Dependent Diabetes The possible outcomes of the issues that can be achieved are discussing the violations with the patient’s family and convincing them to follow the medical regulations; convincing the girl’s family to leave her at the […]
• Human Service for Diabetes in Late Adulthood The mission of the Georgia Diabetic Foot Care Program is to make a positive difference in the health of persons living with diabetes.
• Diabetes: Symptoms and Risk Factors In terms of the problem, according to estimates, 415 million individuals worldwide had diabetes mellitus in 2015, and it is expected to rise to 642 million by the year 2040.
• Diabetes: Types and Management Diabetes is one of the most prevalent diseases in the United States caused when the body fails to optimally metabolize food into energy.
• Type 2 Diabetes’ Impact on Australian Society Consequently, the most significant impact of the disease is the increased number of deaths among the population which puts their lives in jeopardy. Further, other opportunistic diseases are on the rise lowering the quality of […]
• Epidemiology of Diabetes and Forecasted Trends The authors note that urbanization and the rapid development of economies of different countries are the main causes of diabetes. The authors warn that current diabetes strategies are not effective since the rate of the […]
• The Aboriginal Diabetes Initiative in Canada The ADI’s goal in the CDS was to raise type 2 diabetes awareness and lower the incidence of associated consequences among Aboriginal people.
• Communicating the Issue of Diabetes The example with a CGM sensor is meant to show that doctors should focus on educating people with diabetes on how to manage their condition and what to do in extreme situations.
• Obesity and Diabetes Mellitus Type 2 The goal is to define the features of patient information to provide data on the general course of the illness and its manifestations following the criteria of age, sex, BMI, and experimental data.
• The Prevention of Diabetes and Its Consequences on the Population At the same time, these findings can also be included in educational programs for people living with diabetes to warn them of the risks of fractures and prevent them.
• Uncontrolled Type 2 Diabetes and Depression Treatment The data synthesis demonstrates that carefully chosen depression and anxiety treatment is likely to result in better A1C outcomes for the patient on the condition that the treatment is regular and convenient for the patients.
• Type 2 Diabetes: Prevention and Education Schillinger et al.came to the same conclusion; thus, their findings on the study of the Bigger Picture campaign effectiveness among youth of color are necessary to explore diabetes prevention.
• A Diabetes Quantitative Article Analysis The article “Correlates of accelerometer-assessed physical activity and sedentary time among adults with type 2 diabetes” by Mathe et al.refers to the global issue of the prevention of diabetes and its complications.
• A Type 2 Diabetes Quantitative Article Critique Therefore, the main issue is the prevention of type 2 diabetes and its consequences, and this paper will examine one of the scientific studies that will be used for its exploration.
• The Diabetes Prevention Articles by Ford and Mathe The main goal of the researchers was to measure the baseline MVPA of participants and increase their activity to the recommended 150 minutes per week through their participation in the Diabetes Community Lifestyle Improvement Program.
• Type 2 Diabetes in Hispanic Americans The HP2020 objectives and the “who, where, and when” of the problem highlight the significance of developing new, focused, culturally sensitive T2D prevention programs for Hispanic Americans.
• Diabetes Mellitus as Problem in US Healthcare Simultaneously, insurance companies are interested in decreasing the incidence of diabetes to reduce the costs of testing, treatment, and provision of medicines.
• Diabetes Prevention as a Change Project All of these queries are relevant and demonstrate the importance of including people at high risk of acquiring diabetes in the intervention.
• Evidence Synthesis Assignment: Prevention of Diabetes and Its Complications The purpose of this research is to analyze and synthesize evidence of good quality from three quantitative research and three non-research sources to present the problem of diabetes and justify the intervention to address it.
• Diabetes Mellitus: Causes and Health Challenges Second, the nature of this problem is a clear indication of other medical concerns in this country, such as poor health objectives and strategies and absence of resources.
• Diabetes Mellitus (DM) Disorder Case Study Analysis Thus, informing the patient about the importance of regular medication intake, physical activity, and adherence to diet in maintaining diabetes can solve the problem.
• Diabetes Mellitus in Young Adults Thus, programs for young adults should predominantly focus on the features of the transition from adolescence to adulthood. As a consequence, educational programs on diabetes improve the physical and psychological health of young adults.
• A Healthcare Issue of Diabetes Mellitus Diabetes mellitus is seen as a primary healthcare issue that affects populations across the globe and necessitates the combination of a healthy lifestyle and medication to improve the quality of life of people who suffer […]
• Control of LDL Cholesterol Levels in Patients, Gestational Diabetes Mellitus In addition, some patients with hypercholesterolemia may have statin intolerance, which reduces adherence to therapy, limits treatment efficacy, and increases the risk of CVD.
• Exploring Glucose Tolerance and Gestational Diabetes Mellitus In the case of a glucose tolerance test for the purpose of diagnosing GDM type, the interpretation of the test results is carried out according to the norms for the overall population.
• Type 2 Diabetes Health Issue and Exercise This approach will motivate the patient to engage in exercise and achieve better results while reducing the risk of diabetes-related complications.
• Diabetes Interventions in Children The study aims to answer the PICOT Question: In children with obesity, how does the use of m-Health applications for controlling their dieting choices compare to the supervision of their parents affect children’s understanding of […]
• Diabetes Tracker Device and Its Advantages The proposed diabetes tracker is a device that combines the functionality of an electronic BGL tester and a personal assistant to help patients stick to their diet plan.
• Disease Management for Diabetes Mellitus The selection of the appropriate philosophical and theoretical basis for the lesson is essential as it allows for the use of an evidence-based method for learning about a particular disease.
• Latino People and Type 2 Diabetes The primary aim of the study is to determine the facilitators and barriers to investigating the decision-making process in the Latin population and their values associated with type 2 diabetes.
• Diabetes Self-Management Education and Support Program The choice of this topic and question is based on the fact that despite the high prevalence of diabetes among adolescents in the United States, the use of DSMES among DM patients is relatively low, […]
• Diabetes Mellitus Care Coordination The aim is to establish what medical technologies, care coordination and community resources, and standards of nursing practice contribute to the quality of care and safety of patients with diabetes.
• Healthy Lifestyle Interventions in Comorbid Asthma and Diabetes In most research, the weight loss in cases of comorbid asthma and obesity is reached through a combination of dietary interventions and physical exercise programs.
• PDSA in Diabetes Prevention The second step in the “Do” phase would be to isolate a few members of the community who are affected by diabetes voluntarily.
• Diabetes: Statistics, Disparities, Therapies The inability to produce adequate insulin or the body’s resistance to the hormone is the primary cause of diabetes. Diabetes is a serious health condition in the U.S.and the world.
• Type 2 Diabetes Prescriptions and Interventions The disadvantage is the difficulty of obtaining a universal model due to the complexity of many factors that can affect the implementation of recommendations: from the variety of demographic data to the patient’s medical history.
• Health Education for Female African Americans With Diabetes In order to address and inform the public about the challenges, nurses are required to intervene by educating the population on the issues to enhance their understanding of the risks associated with the conditions they […]
• Diabetes Risk Assessment and Prevention It is one of the factors predisposing patients suffering from diabetes to various cardiovascular diseases. With diabetes, it is important to learn how to determine the presence of carbohydrates in foods.
• Diabetes Mellitus: Preventive Measures In addition to addressing the medical specialists who will be of service in disease prevention, it will emphasize the intervention programs required to help control the spread of the illness.
• “The Diabetes Online Community” by Litchman et al. The researchers applied the method of telephone interviews to determine the results and effectiveness of the program. The study described the value of DOC in providing support and knowledge to older diabetes patients.
• Mobile App for Improved Self-Management of Type 2 Diabetes The central focus of the study was to assess the effectiveness of the BlueStar app in controlling glucose levels among the participants.
• Type 2 Diabetes in Minorities from Cultural Perspective The purpose of this paper is to examine the ethical and cultural perspectives on the issue of T2DM in minorities. Level 2: What are the ethical obstacles to treating T2DM in ethnic and cultural minorities?
• Ethics of Type 2 Diabetes Prevalence in Minorities The purpose of this article analysis is to dwell on scholarly evidence that raises the question of ethical and cultural aspects of T2DM prevalence in minorities.
• Type 2 Diabetes in Minorities: Research Questions The Level 2 research questions are: What are the pathophysiological implications of T2DM in minorities? What are the statistical implications of T2DM in minorities?
• Improving Adherence to Diabetes Treatment in Primary Care Settings Additionally, the patients from the intervention group will receive a detailed explanation of the negative consequences of low adherence to diabetes treatment.
• An Advocacy Tool for Diabetes Care in the US To ensure the implementation and consideration of my plea, I sent a copy of the letter to the government officials so it could reach the president.
• Diabetes and Allergies: A Statistical Check The current dataset allowed us to test the OR for the relationship between family history of diabetes and the presence of diabetes in a particular patient: all variables were dichotomous and discrete and could take […]
• Type 2 Diabetes in Adolescents According to a National Diabetes Statistics Report released by the Centers for Disease Control and Prevention, the estimated prevalence of the disease was 25 cases per 10,000 adolescents in 2017. A proper understanding of T2D […]
• Analysis of Diabetes and Its Huge Effects In the US, diabetes is costly to treat and has caused much physical, emotional and mental harm to the people and the families of those who have been affected by the disease.
• Nursing: Self-Management of Type II Diabetes Sandra Fernandes and Shobha Naidu’s journal illustrates the authors’ understanding of a significant topic in the nursing profession.”Promoting Participation in self-care management among patients with diabetes mellitus” article exposes readers to Peplau’s theory to understand […]
• The Impact of Vegan and Vegetarian Diets on Diabetes Vegetarian diets are popular for a variety of reasons; according to the National Health Interview Survey in the United States, about 2% of the population reported following a vegetarian dietary pattern for health reasons in […]
• “Diabetes Prevention in U.S. Hispanic Adults” by McCurley et al. This information allows for supposing that face-to-face interventions can be suitable to my practicum project that considers measures to improve access to care among African Americans with heart failure diseases. Finally, it is possible to […]
• Diabetes Disease of the First and Second Types It is a decrease in the biological response of cells to one or more effects of insulin at its average concentration in the blood. During the first type of diabetes, insulin Degludec is required together […]
• The Trend of the Higher Prevalence of Diabetes According to the CDC, while new cases of diabetes have steadily decreased over the decades, the prevalence of the disease among people aged below twenty has not.
• Person-Centered Strategy of Diabetes and Dementia Care The population of focus for this study will be Afro-American women aged between sixty and ninety who have diabetes of the second type and dementia or are likely to develop dementia in the future.
• Video Consultations Between Patients and Clinicians in Diabetes, Cancer, and Heart Failure Services For example, during one of my interactions with the patient, I was asked whether the hospital had the policy to avoid face-to-face interaction during the pandemic with the help of video examinations.
• Diets to Prevent Heart Disease, Cancer, and Diabetes In order to prevent heart disease, cancer, and diabetes, people are required to adhere to strict routines, including in terms of diet. Additionally, people wanting to prevent heart disease, cancer, and diabetes also need to […]
• The Centers for Diabetes’ Risks Assessment In general, the business case for the Centers for Diabetes appears to be positive since the project is closely aligned with the needs of the community and the targets set by the Affordable Care Act.
• Diabetes Mellitus as Leading Cause of Disability The researchers used data from the Centers for Disease Control and Prevention, where more than 12% of older people in the US live with the condition.
• Depression in Diabetes Patients The presence of depression concomitant to diabetes mellitus prevents the adaptation of the patient and negatively affects the course of the underlying disease.
• The Relationship Between Diabetes and COVID-19 After completing the research and analyzing the articles, it is possible to suggest a best practice that may be helpful and effective in defining the relationship between diabetes and COVID-19 and providing a way to […]
• Pre-diabetes and Urinary Incontinence Most recent reports indicate that a physiotherapy procedure gives a positive result in up to 80% of patients with stage I or SUI and mixed form and 50% of patients with stage II SUI.
• Type 1 Diabetes: Recommendations for Alternative Drug Treatments Then, they have to assess the existing levels of literacy and numeracy a patient has. Tailoring educational initiatives to a person’s unique ethnic and cultural background is the basis of cultural competence in patient education.
• Type 2 Diabetes: A Pharmacologic Update Diabetes presents one of the most common diagnoses in causes of ED visits among adults and one of the leading causes of death in the United States.
• Type 2 Diabetes and Its Treatment The main difference in type 2 diabetes is the insensitivity of the body’s cells to the action of the hormone insulin and their insulin resistance.
• Diabetes: Vulnerability, Resilience, and Care In nursing care, resilience is a critical concept that shows the possibility of a person to continue functioning and meeting objectives despite the existing challenges.
• Diabetes Prevention in the United States The analysis of these policies and the other strategies provides the opportunity to understand what role they might play in the improvement of human health. NDPP policy, on the other hand, emphasizes the role of […]
• Teaching Experience: Diabetes Prevention The primary objective of the seminar is to reduce the annual number of diabetes cases and familiarize the audience with the very first signs of this disease.
• Summary of Type 2 Diabetes: A Pharmacologic Update The authors first emphasize that T2D is one of the most widespread diseases in the United States and the seventh leading cause of death.
• Insulin Effects in a Diabetes Person I will use this source to support my research because the perception of diabetes patients on insulin therapy is essential for understanding the impact they cause on the person.
• Diabetes and Medical Intervention In the research conducted by Moin et al, the authors attempted to define the scope of efficiency of such a tool as an online diabetes prevention program in the prevention of diabetes among obese/overweight population […]
• Diabetes Mellitus Type 2 and a Healthy Lifestyle Relationship The advantage of this study over the first is that the method uses a medical approach to determining the level of fasting glucose, while the dependences in the study of Ugandans were found using a […]
• Diabetes and Its Economic Effect on Healthcare For many years, there has been an active increase in the number of cases of diabetes of all types among the global population, which further aggravates the situation.
• Diabetes: Epidemiological Analysis I would like to pose the following question: how can epidemiology principles be applied to these statistics for further improvements of policies that aim to reduce the impact of diabetes on the U.S.population? The limited […]
• Pathogenesis and Prevention of Diabetes Mellitus and Hypertension The hormone is produced by the cells of the islets of Langerhans found in the pancreas. It is attributed to the variation in the lifestyle of these individuals in these two geographical zones.
• Parental Intervention on Self-Management of an Adolescent With Diabetes Diabetes development and exposure are strongly tied to lifestyle, and the increasing incidents rate emphasizes the severity of the population’s health problem.
• Addressing the Needs of Hispanic Patients With Diabetes Similarly, in the program at hand, the needs of Hispanic patients with diabetes will be considered through the prism of the key specifics of the community, as well as the cultural background of the patients.
• Diabetes Issues: Insulin Price and Unaffordability According to the forecast of researchers from Stanford University, the number of people with type 2 diabetes who need insulin-containing drugs in the world will increase by about 79 million people by 2030, which will […]
• Diabetes: Epidemiologic Study Design For instance, the range of their parents’ involvement in the self-management practices can be a crucial factor in treatment and control.
• What to Know About Diabetes? Type 1 diabetes is caused by autoimmune reaction that prevent realization of insulin in a body. Estimated 5-10% of people who have diabetes have type 1.
• Diabetes in Saudi Arabia It is expected that should this underlying factor be discovered, whether it is cultural, societal, or genetic in nature, this should help policymakers within Saudi Arabia create new governmental initiatives to address the problem of […]
• “Medical Nutrition Therapy: A Key to Diabetes Management and Prevention” Article Analysis In the process of MNT application, the dietitian keeps a record of the changes in the main components of food and other components of the blood such as blood sugars to determine the trend to […]
• Nutrition and Physical Activity for Children With a Diabetes When a child understands that the family supports him or her, this is a great way to bring enthusiasm in dealing with the disease.
• Global and Societal Implications of the Diabetes Epidemic The main aim of the authors of this article seems to be alerting the reader on the consequences of diabetes to the society and to the whole world.
• Diabetes and Hypertension Avoiding Recommendations Thus, the promotion of a healthy lifestyle should entail the encouragement of the population to cease smoking and monitor for cholesterol levels.
• Pregnant Women With Type I Diabetes: COVID-19 Disease Management The grounded theory was selected for the given topic, and there are benefits and drawbacks of utilizing it to study the experiences of pregnant women with type I diabetes and COVID-19.
• Current Recommendations for the Glycemic Control in Diabetes Management of blood glucose is one of the critical issues in the care of people with diabetes. Therefore, the interval of the A1C testing should also depend on the condition of the patient, the physician’s […]
• Diabetes Mellitus: Types, Causes, Presentation, Treatment, and Examination Diabetes mellitus is a chronic endocrinologic disease, which is characterized by increased blood glucose concentration.
• Diabetes Problem at Country Walk Community: Intervention and Evaluation This presentation develops a community health nursing intervention and evaluation tool for the diabetes problem affecting Country Walk community.
• The Minority Diabetes Initiative Act’s Analysis The bill provides the right to the Department of Health and Human Services to generate grants to public and nonprofit private health care institutions with the aim of providing treatment for diabetes in minority communities.
• Communication Challenges Between Nurses and Patients With Type 2 Diabetes According to Pung and Goh, one of the limitations of communication in a multicultural environment is the language barrier that manifests itself in the direct interaction of nurses with patients and in the engagement work […]
• Diabetes Type 2 from Management Viewpoint Demonstrate the effects of type 2 diabetes and provide background information on the disease; Discuss the management plans of diabetes centers and critically analyze the frameworks implemented in the hospitals; Examine the existing methodology models […]
• Nursing Plan for the Patient with Diabetes Type 2, HTN, and CAD The health of the population is the most valuable achievement of society, so the preservation and strengthening of it is an essential task in which everyone should participate without exception.
• Diagnosis and Classification of Diabetes Mellitus Diabetes is a serious public health concern that introduces a group of metabolic disorders caused by changes in the sugar blood level.
• Diabetes Mellitus Type II: A Case of a Female Adult Patient In this presentation, we are going to develop a care plan for a 47-year-old woman with a 3-year-old history of Diabetes Mellitus Type 2 (also known as Type II DM).
• Diabetes Insipidus: Disease Process With Implications for Healthcare Professionals This presentation will consider the topic of Diabetes Insipidus (DI) with a focus on its etiology and progress.
• The Nature of Type 1 Diabetes Mellitus Type 1 diabetes mellitus is a chronic autoimmune disease that has an active genetic component, which is identified by increased blood glucose levels, also known as hyperglycemia.
• Imperial Diabetes Center Field Study The purpose is to examine the leadership’s practices used to maintain and improve the quality and safety standards of the facility and, using the observations and scholarly research, offer recommendations for improvement.
• Diabetes Risk Assessment After completing the questionnaire, I learned that my risk for the development of diabetes is above average. Modern risk assessment tools allow identifying the current state of health and possibilities of developing the disease.
• The Role of Telenursing in the Management of Diabetes Type 1 Telemedicine is the solution that could potentially increase the coverage and improve the situation for many t1DM patients in the world.
• Health Issues of Heart Failure and Pediatric Diabetes As for the population, which is intended to participate in the research, I am convinced that there is the need to specify the patients who should be examined and monitored.
• Juvenile Diabetes: Demographics, Statistics and Risk Factors Juvenile diabetes, also referred to as Type 2 diabetes or insulin-dependent diabetes, describes a health condition associated with the pancreas’s limited insulin production. The condition is characterized by the destruction of the cells that make […]
• Diabetes Mellitus: Pathophysiologic Processes The main function of insulin produced by cells within the pancreas in response to food intake is to lower blood sugar levels by the facilitation of glucose uptake in the cells of the liver, fat, […]
• Type 2 Diabetes Management in Gulf Countries One such study is the systematic review on the quality of type 2 diabetes management in the countries of the cooperation council for the Arab states of the Gulf, prepared by Alhyas, McKay, Balasanthiran, and […]
• Patient with Ataxia and Diabetes Mellitus Therefore, the therapist prioritizes using the cushion to the client and persuades the patient to accept the product by discussing the merits of the infinity cushion with a low profile in enabling the customer to […]
• Diabetes Evidence-Based Project: Disseminating Results In this presentation, the involvement of mentors and collaboration with administration and other stakeholders are the preferred steps, and the idea to use social networking and web pages has to be removed.
• The Problem of Diabetes Among African Americans Taking into consideration the results of the research and the information found in the articles, the problem of diabetes among African Americans has to be identified and discussed at different levels.
• Childhood Obesity, Diabetes and Heart Problems Based on the data given in the introduction it can be seen that childhood obesity is a real problem within the country and as such it is believed that through proper education children will be […]
• Hypertension and Antihypertensive Therapy and Type 2 Diabetes Mellitus In particular, Acebutolol impairs the functions of epinephrine and norepinephrine, which are neurotransmitters that mediate the functioning of the heart and the sympathetic nervous system.
• Diabetes: Diagnosis and Treatment The disease is characterized by the pancreas almost not producing its own insulin, which leads to an increase in glucose levels in the blood.
• How to Manage Type 2 Diabetes The article is significant to the current research problem as the researchers concluded that the assessment of metabolic processes in diabetic patients was imperative for adjusting in the management of the condition.
• Type 2 Diabetes Analysis Thus, type 2 diabetes has medical costs, or the difficulties of coping up with the illness, economic ones, which are the financial costs of managing it, and the organizational ones for the healthcare systems.
• Clinical Trial of Diabetes Mellitus On the other hand, type II diabetes mellitus is caused by the failure of the liver and muscle cells to recognize the insulin produced by the pancreatic cells.
• Diabetes: Diagnosis and Related Prevention & Treatment Measures The information presented on the articles offers an insight in the diagnosis of diabetes among various groups of persons and the related preventive and treatment measures. The study identified 3666 cases of initial stages of […]
• Reinforcing Nutrition in Schools to Reduce Diabetes and Childhood Obesity For example, the 2010 report says that the rates of childhood obesity have peaked greatly compared to the previous decades: “Obesity has doubled in Maryland over the past 20 years, and nearly one-third of youth […]
• The Connection Between Diabetes and Consuming Red Meat In light of reporting the findings of this research, the Times Healthland gave a detailed report on the various aspects of this research.
• Synthesizing the Data From Relative Risk Factors of Type 2 Diabetes Speaking of such demographic factors as race, the white population suffers from it in the majority of cases, unlike the rest of the races, the remaining 0.
• Using Exenatide as Treatment of Type 2 Diabetes Mellitus in Adults Kendal et al.analyzed the effects of exenatide as an adjunct to a combination of metformin and sulfonylurea against the combination of the same drugs without the adjunct.
• Enhancing Health Literacy for People With Type 2 Diabetes Two professionals, Andrew Long, a professor in the school of heath care in the University of Leeds, and Tina Gambling, senior lecturer in the school of health care studies from the University of Cardiff, conducted […]
• The Scientific Method of Understanding if Coffee Can Impact Diabetes The hypothesis of the experiment ought to be straightforward and understandable. The control group and the experiment group for the test are then identified.
• Gestational Diabetes Mellitus: Review This is because of the current patterns that show an increase in the prevalence of diabetes in offspring born to mothers with GDM.
• Health Service Management of Diabetes During the task, Fay makes a countless number of short calls and often takes water irrespective of the time of the day or the prevailing weather conditions.
• Necrotizing Fasciitis: Pathophysiology, Role of Diabetes In the event of such an infection, the body becomes desperate to get rid of the intruders. For WBC, zero is given if the count is below 15cells/mm3, one is given if the count lies […]
• The Benefits of Sharing Knowledge About Diabetes With Physicians
• Gestational Diabetes Mellitus – NSW, Australia
• Health and Wellness: Stress, Diabetes and Tobacco Related Problems
• 52-Year-Old Female Patient With Type II Diabetes
• Healthy People Project: Personal Review About Diabetes
• Nursing Diagnosis: Type 1 Diabetes & Hypertension
• Nursing Care For the Patient With Diabetes
• Nursing Care Development Plan for Diabetes and Hypertension
• Coronary Heart Disease Aggravated by Type 2 Diabetes and Age
• Diabetes as the Scourge of the 21st Century: Locating the Solution
• Psychosocial Implications of Diabetes Management
• Gestational Diabetes in a Pregnant Woman
• Diabetes Mellitus: Prominent Metabolic Disorder
• Holistic Approach to Man’s Health: Diabetes Prevention
• Holistic Image in Prevention of Diabetes
• Educational Strategies for Diabetes to Patients
• Diabetes and Obesity in the United Arab Emirates
• Epidemiological Problem: Diabetes in Illinois
• Diabetes as a Chronic Condition
• Managing Diabetes Through Genetic Engineering
• Diabetes, Functions of Insulin, and Preventive Practices
• Treating of Diabetes in Adults
• Counseling and Education Session in Type II Diabetes
• Diabetes II: Reduction in the Incidence
• Community Health Advocacy Project: Diabetes Among Hispanics
• Community Health Advocacy Project: Hispanics With Diabetes
• Hispanics Are More Susceptible to Diabetes That Non-Hispanics
• Rates Diabetes Between Hispanics Males and Females
• Diabetes Mellitus and HFSON Conceptual Framework
• Prince Georges County Community Health Concern: Diabetes
• Fats and Proteins in Relation to Type 2 Diabetes
• Alcohol Interaction With Medication: Type 2 Diabetes
• Diabetes Management and Evidence-Based Practice
• Critical Analysis of Policy for Type 2 Diabetes Mellitus in Australia
• The Treatment and Management of Diabetes
• Obesity and Diabetes: The Enemies Within
• Impact of Diabetes on the United Arab Emirates’ Economy
• Childhood Obesity and Type 2 Diabetes
• Health Nursing and Managing Diabetes
• Diabetes Management: How Lifestyle, Daily Routine Affect Blood Sugar
• Diabetes Management: Diagnostics and Treatment
• Diabetes Mellitus Type 2: The Family Genetic History
• Diabetes Type II: Hormonal Mechanism and Intracellular Effects of Insulin
• Social, Behavioral, and Psychosocial Causes of Diseases: Type 2 Diabetes
• Supportive Intervention in the Control of Diabetes Mellitus
• Enhancing Foot Care Practices in Patients With Diabetes
• Community Health Promotion: The Fight Against Diabetes in a Community Setting
• Diabetes in Australia and Saudi Arabia
• Diabetes: The Advantages and Disadvantages of Point of Care Testing
• Diabetes Mellitus Type 2 or Non-Insulin-Dependent Diabetes Mellitus
• Qualitative Research in Diabetes Management in Elderly Patient
• Diabetes Prevention Measures in the Republic of the Marshall Islands
• Impact of Diabetes on Healthcare
• Gestational Diabetes: American Diabetes Association Publishers
• Gestational Diabetes: Child Bearing Experience
• Diabetes Mellitus Effects on Periodontal Disease
• Diabetes Type II Disease in the Community
• The Relationship of Type 2 Diabetes and Depression
• Glycemic Control in Individuals With Type 2 Diabetes
• The Diagnosis of Diabetes in Older Adults and Adolescents
• Physical Activity in Managing Type-2 Diabetes
• High Risk of Developing Type 1 and Type 2 Diabetes Mellitus
• Children With Type 1 Diabetes in Clinical Practice
• Type 2 Diabetes Treatment Analysis
• Type 2 Diabetes Mellitus: Revealing the Diagnosis
• The Type 2 Diabetes Prevention: Lifestyle Choices
• Indigenous and Torres Strait Population and Diabetes
• Interpretation of the Diabetes Interview Transcript
• Type 1 Diabetes: Using Glucose Monitoring in Treatment
• Managing Type 2 Diabetes Patients’ Blood Sugar Prior to and After Surgical Procedures
• Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes: Medical Terminology Definition
• Modern Diabetes Treatment Tools
• Diabetes: Encapsulation to Treat a Disease
• Current Dietary for the Treatment of Diabetes
• Diabetes: Discussion of the Disease
• Stranahan on Diabetes Impairs Hippocampal Function
• A Clinical-Based Study of Young Adults Who Have Diabetes
• Panax Ginseng for Diabetes Treatment
• Depression and Diabetes Association in Adults
• Is There Anu Cure For Diabetes?
• Diabetes Self-Management: Evidence-Based Nursing
• Diabetes Type 2 in Children: Causes and Effects
• Type 1 Diabetes Mellitus Case
• Health, Culture, and Identity as Diabetes Treatment Factors
• Diabetes Prevention in Chinese Elderly in Hunan
• “Experiences of Patients With Type 2 Diabetes Starting Insulin Therapy” by Phillips
• Type 2 Diabetes: Nursing Change Project
• Diabetes and Health Promotion Concepts
• Type 2 Diabetes Project Results Dissemination
• Type 2 Diabetes in Geriatric Patients
• Type 2 Diabetes and Geriatric Evidence-Based Care
• Cultural Empowerment. Diabetes in Afro-Americans
• Diabetes Self-Management: Relationships & Expectations
• Diagnosis and Classification of Diabetes Mellitus
• Improving Comprehensive Care for Patients With Diabetes
• Diabetes Impact on Cardiovascular and Nervous Systems
• Side Effects of Metformin in Diabetes Treatment
• Type 2 Diabetes and Drug Treatments
• Diabetes Mellitus and Health Determinants
• Nursing Leadership in Diabetes Management
• Diabetes Education for African American Women
• Latent Autoimmune Adult Diabetes
• Obesity: Epidemiology and Health Consequences
• Diabetes in Urban Cities of United States
• Diabetes in Australia: Analysis
• Type 2 Diabetes in the Afro-American Bronx Community
• Type 2 Diabetes From Cultural and Genetic Aspects
• Type 2 Diabetes in Bronx: Evidence-Based Practice
• Type 2 Diabetes in Bronx Project for Social Change
• Cardiovascular Care in Type 2 Diabetes Patients
• Ambition Diabetes and Diet on Macbeths’ Example
• Diabetes as Community Health Issue in the Bronx
• Diabetes Management Plan: Diagnosis and Development
• Diabetes Treatment and Care
• Transition from Pediatric to Adult Diabetes Care
• Diabetes Awareness Program and Strategic Planning
• Diabetes: Disease Control and Investigation
• Diabetes Pain Questionnaire and Patient Feedback
• Perception of Diabetes in the Hispanic Population
• Clinical Studies of Diabetes Mellitus
• Diabetes Mellitus and Problems at Work
• Diabetes in the US: Cost Effectiveness Analysis
• Diabetes Investigation in Space Flight Research
• Diabetes Care Advice by Food and Drug Administration
• Artificial Intelligence for Diabetes: Project Experiences
• Diabetes Patients’ Long-Term Care and Life Quality
• Chronic Care Model for Diabetes Patients in the UAE
• Diabetes Among British Adults and Children
• Endocrine Disorders: Diabetes and Fibromyalgia
• Future Technologies: Diabetes Treatment and Care
• Epidemiology of Type 1 Diabetes
• Diabetes: Treatment Technology and Billing
• Pathophysiology of Mellitus and Insipidus Diabetes
• Cure for Diabetes: The Impossible Takes a Little Longer
• Stem Cell Therapy as a Potential Cure for Diabetes
• Stem Cell Therapy and Diabetes Medical Research
• Type II Diabetes Susceptibility and Socioeconomic Status
• Diabetes Mellitus Type 2: Pathophysiology and Treatment
• Obesity and Hypertension in Type 2 Diabetes Patients
• Strongyloides Stercoralis Infection and Type 2 Diabetes
• Socioeconomic Status and Susceptibility to Type II Diabetes
• Diabetes Mellitus: Differential Diagnosis
• Diabetes Disease in the USA Adults
• Education for African Americans With Type 2 Diabetes
• Diabetes Treatment and Funding in Fulton County
• Diabetes Care: Leadership and Strategy Plan
• Diabetes Mellitus’ New Treatment: Principles and Process
• Diet and Nutrition: European Diabetes
• Preventing the Proliferation Diabetes
• Diabetes: Symptoms, Treatment, and Prevention
• Diabetes and Cardiovascular Diseases in Medicine
• Ecological Models to Deal with Diabetes in Medicine
• Different Types of Diabetes Found in Different Countries
• Analysis of Program “Prevent Diabetes Live Life Well”
• The Effect of Physical, Social, and Health Variables on Diabetes
• Micro and Macro-Cosmos in Medicine and Care Models for Prevention of Diabetes
• Why Qualitative Method Was Chosen for Diabetes Program Evaluation
• Humanistic Image of Managing Diabetes
• Diabetes mellitus Education and hemoglobin A1C level
• Obesity, Diabetes and Heart Disease
• Illuminate Diabetes Event Design
• Cause and Diagnosis of Type 2 diabetes
• Patient Voices: Type 2 Diabetes. Podcast Review
• Type I Diabetes: Pathogenesis and Treatment
• Human Body Organ Systems Disorders: Diabetes
• Age Influence on Physical Activity: Exercise and Diabetes
• Hemoglobin A1C Test for Diabetes
• Why Injury and Diabetes Have Been Identified as National Health Priority?
• What Factors Are Involved in the Increasing Prevalence of Type II Diabetes in Adolescents?
• Does the Socioeconomic Position Determine the Incidence of Diabetes?
• What Are the Four Types of Diabetes?
• How Fat and Obesity Cause Diabetes?
• How Exercise Affects Type 2 Diabetes?
• How Does the Treatment With Insulin Affect Type 2 Diabetes?
• How Diabetes Does Cause Depression?
• Does Diabetes Prevention Pay For Itself?
• How Does Snap Participation Affect Rates of Diabetes?
• Does Overeating Sugar Cause Diabetes, Cavities, Acne, Hyperactivity and Make You Fat?
• Why Diabetes Mellitus and How It Affects the United States?
• Does Alcohol Decrease the Risk of Diabetes?
• How Does a Person With Diabetes Feel?
• Does Periodontal Inflammation Affect Type 1 Diabetes in Childhood and Adolescence?
• How Can the Paleolithic Diet Control Type 2 Diabetes?
• How Does Insulin Help Diabetes Be Controlled?
• Does Economic Status Matter for the Regional Variation of Malnutrition-Related Diabetes?
• How Can Artificial Intelligence Technology Be Used to Treat Diabetes?
• What Are the Main Causes and Treatments of Diabetes?
• What Evidence Exists for Treatments Depression With Comorbid Diabetes Using Traditional Chinese Medicine and Natural Products?
• Why Was Qualitative Method Chosen for Diabetes Program Evaluation?
• What Are the Three Types of Diabetes?
• How Does Poverty Affect Diabetes?
• What Is the Leading Cause of Diabetes?
• How Is Diabetes Diagnosed?
• What Are the Main Symptoms of Diabetes?
• How Diabetes Adversely Affects Your Body?
• What Are the Most Common Symptoms of Undiagnosed Diabetes?
• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2024, February 25). 357 Diabetes Essay Topics & Examples. https://ivypanda.com/essays/topic/diabetes-essay-examples/

"357 Diabetes Essay Topics & Examples." IvyPanda , 25 Feb. 2024, ivypanda.com/essays/topic/diabetes-essay-examples/.

IvyPanda . (2024) '357 Diabetes Essay Topics & Examples'. 25 February.

IvyPanda . 2024. "357 Diabetes Essay Topics & Examples." February 25, 2024. https://ivypanda.com/essays/topic/diabetes-essay-examples/.

1. IvyPanda . "357 Diabetes Essay Topics & Examples." February 25, 2024. https://ivypanda.com/essays/topic/diabetes-essay-examples/.

Bibliography

IvyPanda . "357 Diabetes Essay Topics & Examples." February 25, 2024. https://ivypanda.com/essays/topic/diabetes-essay-examples/.

• Epigenetics Essay Titles
• Alcohol Abuse Paper Topics
• Pathogenesis Research Ideas
• Therapeutics Research Ideas
• Hypertension Topics
• Osteoarthritis Ideas
• Cardiomyopathy Titles
• Malnutrition Titles

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• HHS Author Manuscripts

Case 6–2020: A 34-Year-Old Woman with Hyperglycemia

Presentation of case.

Dr. Max C. Petersen (Medicine): A 34-year-old woman was evaluated in the diabetes clinic of this hospital for hyperglycemia.

Eleven years before this presentation, the blood glucose level was 126 mg per deciliter (7.0 mmol per liter) on routine laboratory evaluation, which was performed as part of an annual well visit. The patient could not recall whether she had been fasting at the time the test had been performed. One year later, the fasting blood glucose level was 112 mg per deciliter (6.2 mmol per liter; reference range, <100 mg per deciliter [<5.6 mmol per liter]).

Nine years before this presentation, a randomly obtained blood glucose level was 217 mg per deciliter (12.0 mmol per liter), and the patient reported polyuria. At that time, the glycated hemoglobin level was 5.8% (reference range, 4.3 to 5.6); the hemoglobin level was normal. One year later, the glycated hemoglobin level was 5.9%. The height was 165.1 cm, the weight 72.6 kg, and the body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) 26.6. The patient received a diagnosis of prediabetes and was referred to a nutritionist. She made changes to her diet and lost 4.5 kg of body weight over a 6-month period; the glycated hemoglobin level was 5.5%.

Six years before this presentation, the patient became pregnant with her first child. Her prepregnancy BMI was 24.5. At 26 weeks of gestation, the result of a 1-hour oral glucose challenge test (i.e., the blood glucose level obtained 1 hour after the oral administration of a 50-g glucose load in the nonfasting state) was 186 mg per deciliter (10.3 mmol per liter; reference range, <140 mg per deciliter [<7.8 mmol per liter]). She declined a 3-hour oral glucose tolerance test; a presumptive diagnosis of gestational diabetes was made. She was asked to follow a meal plan for gestational diabetes and was treated with insulin during the pregnancy. Serial ultrasound examinations for fetal growth and monitoring were performed. At 34 weeks of gestation, the fetal abdominal circumference was in the 76th percentile for gestational age. Polyhydramnios developed at 37 weeks of gestation. The child was born at 39 weeks 3 days of gestation, weighed 3.9 kg at birth, and had hypoglycemia after birth, which subsequently resolved. Six weeks post partum, the patient’s fasting blood glucose level was 120 mg per deciliter (6.7 mmol per liter), and the result of a 2-hour oral glucose tolerance test (i.e., the blood glucose level obtained 2 hours after the oral administration of a 75-g glucose load in the fasting state) was 131 mg per deciliter (7.3 mmol per liter; reference range, <140 mg per deciliter). Three months post partum, the glycated hemoglobin level was 6.1%. Lifestyle modification for diabetes prevention was recommended.

Four and a half years before this presentation, the patient became pregnant with her second child. Her prepregnancy BMI was 25.1. At 5 weeks of gestation, she had an elevated blood glucose level. Insulin therapy was started at 6 weeks of gestation, and episodes of hypoglycemia occurred during the pregnancy. Serial ultrasound examinations for fetal growth and monitoring were performed. At 28 weeks of gestation, the fetal abdominal circumference was in the 35th percentile for gestational age, and the amniotic fluid level was normal. Labor was induced at 38 weeks of gestation; the child weighed 2.6 kg at birth. Neonatal blood glucose levels were reported as stable after birth. Six weeks post partum, the patient’s fasting blood glucose level was 133 mg per deciliter (7.4 mmol per liter), and the result of a 2-hour oral glucose tolerance test was 236 mg per deciliter (13.1 mmol per liter). The patient received a diagnosis of type 2 diabetes mellitus; lifestyle modification was recommended. Three months post partum, the glycated hemoglobin level was 5.9% and the BMI was 30.0. Over the next 2 years, she followed a low-carbohydrate diet and regular exercise plan and self-monitored the blood glucose level.

Two years before this presentation, the patient became pregnant with her third child. Blood glucose levels were again elevated, and insulin therapy was started early in gestation. She had episodes of hypoglycemia that led to adjustment of her insulin regimen. The child was born at 38 weeks 5 days of gestation, weighed 3.0 kg at birth, and had hypoglycemia that resolved 48 hours after birth. After the birth of her third child, the patient started to receive metformin, which had no effect on the glycated hemoglobin level, despite adjustment of the therapy to the maximal dose.

One year before this presentation, the patient became pregnant with her fourth child. Insulin therapy was again started early in gestation. The patient reported that episodes of hypoglycemia occurred. Polyhydramnios developed. The child was born at 38 weeks 6 days of gestation and weighed 3.5 kg. The patient sought care at the diabetes clinic of this hospital for clarification of her diagnosis.

The patient reported following a low-carbohydrate diet and exercising 5 days per week. There was no fatigue, change in appetite, change in vision, chest pain, shortness of breath, polydipsia, or polyuria. There was no history of anemia, pancreatitis, hirsutism, proximal muscle weakness, easy bruising, headache, sweating, tachycardia, gallstones, or diarrhea. Her menstrual periods were normal. She had not noticed any changes in her facial features or the size of her hands or feet.

The patient had a history of acne and low-back pain. Her only medication was metformin. She had no known medication allergies. She lived with her husband and four children in a suburban community in New England and worked as an administrator. She did not smoke tobacco or use illicit drugs, and she rarely drank alcohol. She identified as non-Hispanic white. Both of her grandmothers had type 2 diabetes mellitus. Her father had hypertension, was overweight, and had received a diagnosis of type 2 diabetes at 50 years of age. Her mother was not overweight and had received a diagnosis of type 2 diabetes at 48 years of age. The patient had two sisters, neither of whom had a history of diabetes or gestational diabetes. There was no family history of hemochromatosis.

On examination, the patient appeared well. The blood pressure was 126/76 mm Hg, and the heart rate 76 beats per minute. The BMI was 25.4. The physical examination was normal. The glycated hemoglobin level was 6.2%.

A diagnostic test was performed.

DIFFERENTIAL DIAGNOSIS

Dr. Miriam S. Udler: I am aware of the diagnosis in this case and participated in the care of this patient. This healthy 34-year-old woman, who had a BMI just above the upper limit of the normal range, presented with a history of hyperglycemia of varying degrees since 24 years of age. When she was not pregnant, she was treated with lifestyle measures as well as metformin therapy for a short period, and she maintained a well-controlled blood glucose level. In thinking about this case, it is helpful to characterize the extent of the hyperglycemia and then to consider its possible causes.

CHARACTERIZING HYPERGLYCEMIA

This patient’s hyperglycemia reached a threshold that was diagnostic of diabetes 1 on two occasions: when she was 25 years of age, she had a randomly obtained blood glucose level of 217 mg per deciliter with polyuria (with diabetes defined as a level of ≥200 mg per deciliter [≥11.1 mmol per liter] with symptoms), and when she was 30 years of age, she had on the same encounter a fasting blood glucose level of 133 mg per deciliter (with diabetes defined as a level of ≥126 mg per deciliter) and a result on a 2-hour oral glucose tolerance test of 236 mg per deciliter (with diabetes defined as a level of ≥200 mg per deciliter). On both of these occasions, her glycated hemoglobin level was in the prediabetes range (defined as 5.7 to 6.4%). In establishing the diagnosis of diabetes, the various blood glucose studies and glycated hemoglobin testing may provide discordant information because the tests have different sensitivities for this diagnosis, with glycated hemoglobin testing being the least sensitive. 2 Also, there are situations in which the glycated hemoglobin level can be inaccurate; for example, the patient may have recently received a blood transfusion or may have a condition that alters the life span of red cells, such as anemia, hemoglobinopathy, or pregnancy. 3 These conditions were not present in this patient at the time that the glycated hemoglobin measurements were obtained. In addition, since the glycated hemoglobin level reflects the average glucose level typically over a 3-month period, discordance with timed blood glucose measurements can occur if there has been a recent change in glycemic control. This patient had long-standing mild hyperglycemia but met criteria for diabetes on the basis of the blood glucose levels noted.

Type 1 and Type 2 Diabetes

Now that we have characterized the patient’s hyperglycemia as meeting criteria for diabetes, it is important to consider the possible types. More than 90% of adults with diabetes have type 2 diabetes, which is due to progressive loss of insulin secretion by beta cells that frequently occurs in the context of insulin resistance. This patient had received a diagnosis of type 2 diabetes; however, some patients with diabetes may be given a diagnosis of type 2 diabetes on the basis of not having features of type 1 diabetes, which is characterized by autoimmune destruction of the pancreatic beta cells that leads to rapid development of insulin dependence, with ketoacidosis often present at diagnosis.

Type 1 diabetes accounts for approximately 6% of all cases of diabetes in adults (≥18 years of age) in the United States, 4 and 80% of these cases are diagnosed before the patient is 20 years of age. 5 Since this patient’s diabetes was essentially nonprogressive over a period of at least 9 years, she most likely does not have type 1 diabetes. It is therefore not surprising that she had received a diagnosis of type 2 diabetes, but there are several other types of diabetes to consider, particularly since some features of her case do not fit with a typical case of type 2 diabetes, such as her age at diagnosis, the presence of hyperglycemia despite a nearly normal BMI, and the mild and nonprogressive nature of her disease over the course of many years.

Less Common Types of Diabetes

Latent autoimmune diabetes in adults (LADA) is a mild form of autoimmune diabetes that should be considered in this patient. However, there is controversy as to whether LADA truly represents an entity that is distinct from type 1 diabetes. 6 Both patients with type 1 diabetes and patients with LADA commonly have elevated levels of diabetes-associated autoantibodies; however, LADA has been defined by an older age at onset (typically >25 years) and slower progression to insulin dependence (over a period of >6 months). 7 This patient had not been tested for diabetes-associated autoantibodies. I ordered these tests to help evaluate for LADA, but this was not my leading diagnosis because of her young age at diagnosis and nonprogressive clinical course over a period of at least 9 years.

If the patient’s diabetes had been confined to pregnancy, we might consider gestational diabetes, but she had hyperglycemia outside of pregnancy. Several medications can cause hyperglycemia, including glucocorticoids, atypical antipsychotic agents, cancer immunotherapies, and some antiretroviral therapies and immunosuppressive agents used in transplantation. 8 However, this patient was not receiving any of these medications. Another cause of diabetes to consider is destruction of the pancreas due to, for example, cystic fibrosis, a tumor, or pancreatitis, but none of these were present. Secondary endocrine disorders — including excess cortisol production, excess growth hormone production, and pheochromocytoma — were considered to be unlikely in this patient on the basis of the history, review of symptoms, and physical examination.

Monogenic Diabetes

A final category to consider is monogenic diabetes, which is caused by alteration of a single gene. Types of monogenic diabetes include maturity-onset diabetes of the young (MODY), neonatal diabetes, and syndromic forms of diabetes. Monogenic diabetes accounts for 1 to 6% of cases of diabetes in children 9 and approximately 0.4% of cases in adults. 10 Neonatal diabetes is diagnosed typically within the first 6 months of life; syndromic forms of monogenic diabetes have other abnormal features, including particular organ dysfunction. Neither condition is applicable to this patient.

MODY is an autosomal dominant condition characterized by primary pancreatic beta-cell dysfunction that causes mild diabetes that is diagnosed during adolescence or early adulthood. As early as 1964, the nomenclature “maturity-onset diabetes of the young” was used to describe cases that resembled adult-onset type 2 diabetes in terms of the slow progression to insulin use (as compared with the rapid progression in type 1 diabetes) but occurred in relatively young patients. 11 Several genes cause distinct forms of MODY that have specific disease features that inform treatment, and thus MODY is a clinically important diagnosis. Most forms of MODY cause isolated abnormal glucose levels (in contrast to syndromic monogenic diabetes), a manifestation that has contributed to its frequent misdiagnosis as type 1 or type 2 diabetes. 12

Genetic Basis of MODY

Although at least 13 genes have been associated with MODY, 3 genes — GCK , which encodes glucokinase, and HNF1A and HNF4A , which encode hepatocyte nuclear factors 1A and 4A, respectively — account for most cases. MODY associated with GCK (known as GCK-MODY) is characterized by mild, nonprogressive hyperglycemia that is present since birth, whereas the forms of MODY associated with HNF1A and HNF4A (known as HNF1A-MODY and HNF4A-MODY, respectively) are characterized by the development of diabetes, typically in the early teen years or young adulthood, that is initially mild and then progresses such that affected patients may receive insulin before diagnosis.

In patients with GCK-MODY, genetic variants reduce the function of glucokinase, the enzyme in pancreatic beta cells that functions as a glucose sensor and controls the rate of entry of glucose into the glycolytic pathway. As a result, reduced sensitivity to glucose-induced insulin secretion causes asymptomatic mild fasting hyperglycemia, with an upward shift in the normal range of the fasting blood glucose level to 100 to 145 mg per deciliter (5.6 to 8.0 mmol per liter), and also causes an upward shift in postprandial blood glucose levels, but with tight regulation maintained ( Fig. 1 ). 13 This mild hyperglycemia is not thought to confer a predisposition to complications of diabetes, 14 is largely unaltered by treatment, 15 and does not necessitate treatment outside of pregnancy.

Key features suggesting maturity-onset diabetes of the young (MODY) in this patient were an age of less than 35 years at the diagnosis of diabetes, a strong family history of diabetes with an autosomal dominant pattern of inheritance, and hyperglycemia despite a close-to-normal body-mass index. None of these features is an absolute criterion. MODY is caused by single gene–mediated disruption of pancreatic beta-cell function. In MODY associated with the GCK gene (known as GCK-MODY), disrupted glucokinase function causes a mild upward shift in glucose levels through-out the day and does not necessitate treatment. 13 In the pedigree, circles represent female family members, squares male family members, blue family members affected by diabetes, and green unaffected family members. The arrow indicates the patient.

In contrast to GCK-MODY, the disorders HNF1A-MODY and HNF4A-MODY result in progressive hyperglycemia that eventually leads to treatment. 16 Initially, there may be a normal fasting glucose level and large spikes in postprandial glucose levels (to >80 mg per deciliter [>4.4 mmol per liter]). 17 Patients can often be treated with oral agents and discontinue insulin therapy started before the diagnosis of MODY. 18 Of note, patients with HNF1A-MODY or HNF4A-MODY are typically sensitive to treatment with sulfonylureas 19 but may also respond to glucagon-like peptide-1 receptor agonists. 20

This patient had received a diagnosis of diabetes before 35 years of age, had a family history of diabetes involving multiple generations, and was not obese. These features are suggestive of MODY but do not represent absolute criteria for the condition ( Fig. 1 ). 1 Negative testing for diabetes-associated autoantibodies would further increase the likelihood of MODY. There are methods to calculate a patient’s risk of having MODY associated with GCK , HNF1A , or HNF4A . 21 , 22 Using an online calculator ( www.diabetesgenes.org/mody-probability-calculator ), we estimate that the probability of this patient having MODY is at least 75.5%. Genetic testing would be needed to confirm this diagnosis, and in patients at an increased risk for MODY, multigene panel testing has been shown to be cost-effective. 23 , 24

DR. MIRIAM S. UDLER’S DIAGNOSIS

Maturity-onset diabetes of the young, most likely due to a GCK variant.

DIAGNOSTIC TESTING

Dr. Christina A. Austin-Tse: A diagnostic sequencing test of five genes associated with MODY was performed. One clinically significant variant was identified in the GCK gene ( {"type":"entrez-nucleotide","attrs":{"text":"NM_000162.3","term_id":"167621407","term_text":"NM_000162.3"}} NM_000162.3 ): a c.787T→C transition resulting in the p.Ser263Pro missense change. Review of the literature and variant databases revealed that this variant had been previously identified in at least three patients with early-onset diabetes and had segregated with disease in at least three affected members of two families (GeneDx: personal communication). 25 , 26 Furthermore, the variant was rare in large population databases (occurring in 1 out of 128,844 European chromosomes in gnomAD 27 ), a feature consistent with a disease-causing role. Although the serine residue at position 263 was not highly conserved, multiple in vitro functional studies have shown that the p.Ser263Pro variant negatively affects the stability of the glucokinase enzyme. 26 , 28 – 30 As a result, this variant met criteria to be classified as “likely pathogenic.” 31 As mentioned previously, a diagnosis of GCK-MODY is consistent with this patient’s clinical features. On subsequent testing of additional family members, the same “likely pathogenic” variant was identified in the patient’s father and second child, both of whom had documented hyperglycemia.

DISCUSSION OF MANAGEMENT

Dr. Udler: In this patient, the diagnosis of GCK-MODY means that it is normal for her blood glucose level to be mildly elevated. She can stop taking metformin because discontinuation is not expected to substantially alter her glycated hemoglobin level 15 , 32 and because she is not at risk for complications of diabetes. 14 However, she should continue to maintain a healthy lifestyle. Although patients with GCK-MODY are not typically treated for hyperglycemia outside of pregnancy, they may need to be treated during pregnancy.

It is possible for a patient to have type 1 or type 2 diabetes in addition to MODY, so this patient should be screened for diabetes according to recommendations for the general population (e.g., in the event that she has a risk factor for diabetes, such as obesity). 1 Since the mild hyperglycemia associated with GCK-MODY is asymptomatic (and probably unrelated to the polyuria that this patient had described in the past), the development of symptoms of hyperglycemia, such as polyuria, polydipsia, or blurry vision, should prompt additional evaluation. In patients with GCK-MODY, the glycated hemoglobin level is typically below 7.5%, 33 so a value rising above that threshold or a sudden large increase in the glycated hemoglobin level could indicate concomitant diabetes from another cause, which would need to be evaluated and treated.

This patient’s family members are at risk for having the same GCK variant, with a 50% chance of offspring inheriting a variant from an affected parent. Since the hyperglycemia associated with GCK-MODY is present from birth, it is necessary to perform genetic testing only in family members with demonstrated hyperglycemia. I offered site-specific genetic testing to the patient’s parents and second child.

Dr. Meridale V. Baggett (Medicine): Dr. Powe, would you tell us how you would treat this patient during pregnancy?

Dr. Camille E. Powe: During the patient’s first pregnancy, routine screening led to a presumptive diagnosis of gestational diabetes, the most common cause of hyperglycemia in pregnancy. Hyperglycemia in pregnancy is associated with adverse pregnancy outcomes, 34 and treatment lowers the risk of such outcomes. 35 , 36 Two of the most common complications — fetal overgrowth (which can lead to birth injuries, shoulder dystocia, and an increased risk of cesarean delivery) and neonatal hypoglycemia — are thought to be the result of fetal hyperinsulinemia. 37 Maternal glucose is freely transported across the placenta, and excess glucose augments insulin secretion from the fetal pancreas. In fetal life, insulin is a potent growth factor, and neonates who have hyperinsulinemia in utero often continue to secrete excess insulin in the first few days of life. In the treatment of pregnant women with diabetes, we strive for strict blood sugar control (fasting blood glucose level, <95 mg per deciliter [<5.3 mmol per liter]; 2-hour postprandial blood glucose level, <120 mg per deciliter) to decrease the risk of these and other hyperglycemia-associated adverse pregnancy outcomes. 38 – 40

In the third trimester of the patient’s first pregnancy, obstetrical ultrasound examination revealed a fetal abdominal circumference in the 76th percentile for gestational age and polyhydramnios, signs of fetal exposure to maternal hyperglycemia. 40 – 42 Case series involving families with GCK-MODY have shown that the effect of maternal hyperglycemia on the fetus depends on whether the fetus inherits the pathogenic GCK variant. 43 – 48 Fetuses that do not inherit the maternal variant have overgrowth, presumably due to fetal hyperinsulinemia ( Fig. 2A ). In contrast, fetuses that inherit the variant do not have overgrowth and are born at a weight that is near the average for gestational age, despite maternal hyperglycemia, presumably because the variant results in decreased insulin secretion ( Fig. 2B ). Fetuses that inherit GCK-MODY from their fathers and have euglycemic mothers appear to be undergrown, most likely because their insulin secretion is lower than normal when they and their mothers are euglycemic ( Fig. 2D ). Because fetal overgrowth and polyhydramnios occurred during this patient’s first pregnancy and neonatal hypoglycemia developed after the birth, the patient’s first child is probably not affected by GCK-MODY.

Pathogenic variants that lead to GCK-MODY, when carried by a fetus, change the usual relationship of maternal hyperglycemia to fetal hyperinsulinemia and fetal overgrowth. GCK-MODY–affected fetuses have lower insulin secretion than unaffected fetuses in response to the same maternal blood glucose level. In a hyperglycemic mother carrying a fetus who is unaffected by GCK-MODY, excessive fetal growth is usually apparent (Panel A). Studies involving GCK-MODY–affected hyperglycemic mothers have shown that fetal growth is normal despite maternal hyperglycemia when a fetus has the maternal GCK variant (Panel B). The goal of treatment of maternal hyperglycemia when a fetus is unaffected by GCK-MODY is to establish euglycemia to normalize fetal insulin levels and growth (Panel C); whether this can be accomplished in the case of maternal GCK-MODY is controversial, given the genetically determined elevated maternal glycemic set point. In the context of maternal euglycemia, GCK-MODY–affected fetuses may be at risk for fetal growth restriction (Panel D).

In accordance with standard care for pregnant women with diabetes who do not meet glycemic targets after dietary modification, 38 , 39 the patient was treated with insulin during her pregnancies. In her second pregnancy, treatment was begun early, after hyperglycemia was detected in the first trimester. Because she had not yet received the diagnosis of GCK-MODY during any of her pregnancies, no consideration of this condition was given during her obstetrical treatment. Whether treatment affects the risk of hyperglycemia-associated adverse pregnancy outcomes in pregnant women with known GCK-MODY is controversial, with several case series showing that the birth weight percentile in unaffected neonates remains consistent regardless of whether the mother is treated with insulin. 44 , 45 Evidence suggests that it may be difficult to overcome a genetically determined glycemic set point in patients with GCK-MODY with the use of pharmacotherapy, 15 , 32 and affected patients may have symptoms of hypoglycemia when the blood glucose level is normal because of an enhanced counterregulatory response. 49 , 50 Still, to the extent that it is possible, it would be desirable to safely lower the blood glucose level in a woman with GCK-MODY who is pregnant with an unaffected fetus in order to decrease the risk of fetal overgrowth and other consequences of mildly elevated glucose levels ( Fig. 2C ). 46 , 47 , 51 In contrast, there is evidence that lowering the blood glucose level in a pregnant woman with GCK-MODY could lead to fetal growth restriction if the fetus is affected ( Fig. 2D ). 45 , 52 During this patient’s second pregnancy, she was treated with insulin beginning in the first trimester, and her daughter’s birth weight was near the 16th percentile for gestational age; this outcome is consistent with the daughter’s ultimate diagnosis of GCK-MODY.

Expert opinion suggests that, in pregnant women with GCK-MODY, insulin therapy should be deferred until fetal growth is assessed by means of ultrasound examination beginning in the late second trimester. If there is evidence of fetal overgrowth, the fetus is presumed to be unaffected by GCK-MODY and insulin therapy is initiated. 53 After I have counseled women with GCK-MODY on the potential risks and benefits of insulin treatment during pregnancy, I have sometimes used a strategy of treating hyperglycemia from early in pregnancy using modified glycemic targets that are less stringent than the targets typically used during pregnancy. This strategy attempts to balance the risk of growth restriction in an affected fetus (as well as maternal hypoglycemia) with the potential benefit of glucose-lowering therapy for an unaffected fetus.

Dr. Udler: The patient stopped taking metformin, and subsequent glycated hemoglobin levels remained unchanged, at 6.2%. Her father and 5-year-old daughter (second child) both tested positive for the same GCK variant. Her father had a BMI of 36 and a glycated hemoglobin level of 7.8%, so I counseled him that he most likely had type 2 diabetes in addition to GCK-MODY. He is currently being treated with metformin and lifestyle measures. The patient’s daughter now has a clear diagnosis to explain her hyperglycemia, which will help in preventing misdiagnosis of type 1 diabetes, given her young age, and will be important for the management of any future pregnancies. She will not need any medical follow-up for GCK-MODY until she is considering pregnancy.

FINAL DIAGNOSIS

Maturity-onset diabetes of the young due to a GCK variant.

Acknowledgments

We thank Dr. Andrew Hattersley and Dr. Sarah Bernstein for helpful comments on an earlier draft of the manuscript.

This case was presented at the Medical Case Conference.

No potential conflict of interest relevant to this article was reported.

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org .

AI + Machine Learning , Announcements , Azure AI Content Safety , Azure AI Studio , Azure OpenAI Service , Partners

Introducing GPT-4o: OpenAI’s new flagship multimodal model now in preview on Azure

By Eric Boyd Corporate Vice President, Azure AI Platform, Microsoft

Posted on May 13, 2024 2 min read

• Tag: Copilot
• Tag: Generative AI

Microsoft is thrilled to announce the launch of GPT-4o, OpenAI’s new flagship model on Azure AI. This groundbreaking multimodal model integrates text, vision, and audio capabilities, setting a new standard for generative and conversational AI experiences. GPT-4o is available now in Azure OpenAI Service, to try in preview , with support for text and image.

Azure OpenAI Service

A step forward in generative AI for Azure OpenAI Service

GPT-4o offers a shift in how AI models interact with multimodal inputs. By seamlessly combining text, images, and audio, GPT-4o provides a richer, more engaging user experience.

Launch highlights: Immediate access and what you can expect

Azure OpenAI Service customers can explore GPT-4o’s extensive capabilities through a preview playground in Azure OpenAI Studio starting today in two regions in the US. This initial release focuses on text and vision inputs to provide a glimpse into the model’s potential, paving the way for further capabilities like audio and video.

Efficiency and cost-effectiveness

GPT-4o is engineered for speed and efficiency. Its advanced ability to handle complex queries with minimal resources can translate into cost savings and performance.

Potential use cases to explore with GPT-4o

The introduction of GPT-4o opens numerous possibilities for businesses in various sectors: 

• Enhanced customer service : By integrating diverse data inputs, GPT-4o enables more dynamic and comprehensive customer support interactions.
• Advanced analytics : Leverage GPT-4o’s capability to process and analyze different types of data to enhance decision-making and uncover deeper insights.
• Content innovation : Use GPT-4o’s generative capabilities to create engaging and diverse content formats, catering to a broad range of consumer preferences.

Exciting future developments: GPT-4o at Microsoft Build 2024 

We are eager to share more about GPT-4o and other Azure AI updates at Microsoft Build 2024 , to help developers further unlock the power of generative AI.

Get started with Azure OpenAI Service

Begin your journey with GPT-4o and Azure OpenAI Service by taking the following steps:

• Try out GPT-4o in Azure OpenAI Service Chat Playground (in preview).
• If you are not a current Azure OpenAI Service customer, apply for access by completing this form .
• Learn more about  Azure OpenAI Service  and the  latest enhancements.  
• Understand responsible AI tooling available in Azure with Azure AI Content Safety .
• Review the OpenAI blog on GPT-4o.

Let us know what you think of Azure and what you would like to see in the future.

Provide feedback

Build your cloud computing and Azure skills with free courses by Microsoft Learn.

Explore Azure learning

Related posts

AI + Machine Learning , Azure AI Studio , Customer stories

3 ways Microsoft Azure AI Studio helps accelerate the AI development journey     chevron_right

AI + Machine Learning , Analyst Reports , Azure AI , Azure AI Content Safety , Azure AI Search , Azure AI Services , Azure AI Studio , Azure OpenAI Service , Partners

Microsoft is a Leader in the 2024 Gartner® Magic Quadrant™ for Cloud AI Developer Services   chevron_right

AI + Machine Learning , Azure AI , Azure AI Content Safety , Azure Cognitive Search , Azure Kubernetes Service (AKS) , Azure OpenAI Service , Customer stories

AI-powered dialogues: Global telecommunications with Azure OpenAI Service   chevron_right

AI + Machine Learning , Azure AI , Azure AI Content Safety , Azure OpenAI Service , Customer stories

Generative AI and the path to personalized medicine with Microsoft Azure   chevron_right

Join the conversation, leave a reply cancel reply.

Your email address will not be published. Required fields are marked *

I understand by submitting this form Microsoft is collecting my name, email and comment as a means to track comments on this website. This information will also be processed by an outside service for Spam protection. For more information, please review our Privacy Policy and Terms of Use .

I agree to the above