Mellitus Case Studies

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1.8.1. Primary prevention (Lifestyle improvement)
According to the results of the Diabetes Prevention Program (DPP) trial, even modest change in lifestyle such as reduction of weight was associated with substantial reduction in the risk of diabetes mellitus.(37) Furthermore, a study found that even later in life, combined lifestyle factors are associated with a markedly lower incidence of new-onset diabetes mellitus. (38)

1.8.2. Secondary prevention (screening in asymptomatic adults)
Screening for diabetes mellitus is indicated as a means of secondary prevention in the following situations: (39,40)
- Sustained blood pressure >135/80 mm Hg
- Overweight and 1 or more other risk factors for diabetes such as positive family history among first degree relatives, BP >140/90 mm Hg, and HDL < 35 mg/dL and/or triglyceride level >250 mg/dL)
- Persons aged
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The recommendations include the following : (41)
– Patients on intensive insulin regimens – Perform SMBG at least before meals and snacks, as well as occasionally after meals; at bedtime; before exercise and before critical tasks (e.g., driving); when hypoglycemia is suspected; and after treating hypoglycemia until normoglycemia is achieved.
– Patients using less frequent insulin injections or noninsulin therapies – Use SMBG results to adjust to food intake, activity, or medications to reach specific treatment goals. The ongoing need for and frequency of SMBG should be reevaluated at each routine visit by their clinicians.

1.9. Importance of knowledge about diabetes

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