Drug Topics - March 3, 2008 - (Page 5)

5 Of Interest to Pharmacists that low-carbohydrate diets should be a viable option for such patients. It has been known that overweight and obese patients with prediabetes or diabetes are at a much greater risk for developing complications.” Maltz went on to caution patients considering switching to a low-carb diet. “Patients who choose to go on a low-carbohydrate diet for weight loss should be counseled to undergo proper nutritional counseling and will require additional monitoring of their lipid profile and renal function. Additionally, they will need to be more diligent with blood glucose monitoring since adjustments may need to be made to their diabetes regimen.” There are a few other notable changes from the 2007 standards. For one thing, the ADA provided explicit testing recommendations for obese patients. Now any overweight or obese patients, defined as having a body mass index greater than 25 kg/m2, and who have one or more additional risk factors, should be screened for prediabetes. The recommended A1C levels are unchanged for 2008; however, now an A1C of <7% has been clearly shown to reduce microvascular and neuropathic complications of diabetes and possibly macrovascular disease. For individual patients an A1C of as close to normal (<6%) as possible without hypoglycemia is recommended. Although an A1C of less than 6 is associated with lower risk of complications, it is not for everyone, due to the increased risk of hypoglycemia and the relatively small risk reduction. The treatment options for hypertension and dyslipidemia have been simplified to place emphasis on a preferred regimen. Pharmacological therapies for patients with diabetes and hypertension are either angiotensin converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs). The number of treatment recommendations for dyslipidemia has been reduced to emphasize use of statins for most patients. “The Standards of Medical Care in Diabetes— 2008” was published as a supplement to Diabetes Care [2008, 31; suppl 1] and is currently available at care. diabetesjournals.org. is a writer and a pharmacist in a family-owned pharmacy in Brooklyn, N.Y. THE AUTHOR http://care.diabetesjournals.org http://care.diabetesjournals.org

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Drug Topics - March 3, 2008 Drug Errors: A Nonpunitive Approach ADA Issues New Diet Options for Diabetics Medco Using Clinical Pharmacists as Specialists in Direct Patient Care Latest News Roundup

Drug Topics - March 3, 2008

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