Type 2 diabetes mellitus (T2DM) is a global pandemic, as evident from the global cartographic picture of diabetes by the International Diabetes Federation (). Diabetes mellitus is a chronic, progressive, incompletely understood metabolic condition chiefly characterized by hyperglycemia. Impaired insulin secretion, resistance to tissue actions of insulin, or a combination of both are thought to be the commonest reasons contributing to the pathophysiology of T2DM, a spectrum of disease originally arising from tissue insulin resistance and gradually progressing to a state characterized by complete loss of secretory activity of the beta cells of the pancreas. T2DM is a major contributor to the very large rise in the rate of non-communicable diseases affecting developed as well as developing nations. In this mini review, we endeavor to outline the current management principles, including the spectrum of medications that are currently used for pharmacologic management, for lowering the elevated blood glucose in T2DM.
The provision of quality health care is of utmost importance for a physician. Over the years, there has been much debate regarding work-life imbalance and physician burnout, which may, in turn, have adverse effects on the quality of care. Medical school students, residents, interview candidates for residency, and internal medicine faculty are all under a varying degree of stress, which may impact their personal and professional lives. We distributed questionnaires to investigate our hypothesis: Progression in training years leads to a decline in well-being. The main objective of our assessment was to help devise interventions to improve the quality of training and the productivity of internal medicine physicians. Understanding the emotional functioning of physicians will help us improve the learning environment and, in turn, have a positive impact in the future for medical professionals. Medical students are burdened with excessive loans for undergraduate and graduate studies, which contributes to higher rates of burnout, depression, and suicide among medical professionals, which can lead to a direct and negative impact on quality of care. Our study showed that well-being scores declined with increasing financial stress; they were also affected by the visa status and training background of our subjects as medical students.
Diabetes mellitus (DM) continues to be a major health concern in the Western hemisphere, and the management of type 2 DM (T2DM) is an ongoing challenge for the American healthcare system despite major advances in DM research. T2DM imparts a massive economic burden, and a major challenge in managing T2DM continues to be timely screening. Adults are more likely to visit a dentist than a primary care physician. This study was designed to compare current screening standards recommended by the American Diabetes Association with the use of gingival-crevicular blood and its compatibility with traditional methods using a fingerstick. Patients routinely presenting to the dental clinic were offered participation in the trial and, after informed consent, checked for blood glucose levels using the fingerstick method as a control. The control values were compared to the results of the gingival-crevicular blood glucose test obtained during the dental procedure from the same patient (i.e., patients were their own controls). A total of 226 study participants were included. Of these, 127 (56.1%) participants were women, whereas 99 (43.9%) participants were men. The sample size was derived using the Slovin’s equation (Power = 80%) statistical test. We used the Pearson coefficient test to measure the statistical difference between the two tests. We found no significant difference in glucose readings between the fingerstick method and the gingival methods of collection (t = -1.134, P = 0.258). A small sample was also tested for glycosylated hemoglobin (HbA1c) using the same sample collecting methods. However, due to the cost restraints involved in using HbA1c kits, a statistically significant cohort could not be collected. By incorporating this interdisciplinary approach, testing for DM during routine dental visits can be a vital resource for the early diagnosis of DM, potentially leading to significant savings in future healthcare costs.
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