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PDF Editor FAQ

Is there a direct link between improvement in medication adherence and improvement in glycemic control in type 2 diabetes?

Adherence to insulin treatment, glycaemic control, and ketoacidosis in insulin-dependent diabetes mellitus. The DARTS/MEMO Collaboration. Diabetes ... - PubMed - NCBIThe deterioration in glycaemic control observed in patients aged 10-20 years was associated with a significant reduction (p = 0.01) in the adherence index.Adherence to insulin and its association with glycaemic control in patients with type 2 diabetesAdherence to insulin appears poor in these type 2 diabetes patients, and there was a significant relationship between adherence and long-term metabolic control.As a doc I would have thought this to be obvious, how could we otherwise control a disease if not taking the measures and meds needed to control it?Other links:Executive Functioning, Treatment Adherence, and Glycemic Control in Children With Type 1 DiabetesImproving Patient AdherenceTreatment Adjustment and Medication Adherence for Complex Patients With Diabetes, Heart Disease, and Depression: A Randomized Controlled Trial

How long are military records kept?

Personnel military Service records are kept in perpetuity in the US.After a period of maintenance by the Service headquarters, they are transferred for permanent storage by the National Archives in St. Louis.As for the many other types of US military records, such as budgets, plans, notes, awards, memos, classified documents, studies and reports, maintenance logs, ship’s logs, aircraft logs, unit logs, message traffic, regulations, etc., there are “retention standards” that are fairly standard across the Services.Some common themes:1 - memos and simple, daily work products = 6 months to a year, then destroyed,2 - many common records of all types = 1 year to 2 years, then destroyed,3 - certain more important records = up to 5 years, then destroyed.4 - very important records like Service budgets, historically relevant documents, ship and aircraft logs, etc., are often maintained locally by the military unit that generated the records for periods of 2–5 years (depending on the type of records), and then transferred to the Archives for “permanent retention.”The shift to records that are either partially or completely electronic, I.e., never necessarily printed onto paper, has on the one hand allowed the retention rate of vast quantities of various records, even if not organized properly or even needed at all, while simultaneously making the organization and actual retention of the right records at the right place for the right retention period thus allowing for the right recall as needed VERY DIFFICULT.

What happens to my blood sugar if I don't eat for a long time? Why are diabetics advised to eat something at regular intervals?

TID here. ( this is not to be taken as medical advice or opinion)If you are not a diabetic and you fast ( but drink water or other sugar/fat/protein-free fluids) your body has a system to maintain your blood sugar level within strict limits.Imagine your digestive system is a fuel refinery to render foods down into less complex sugars, fats and protein, vitamins etc.Glucose leaves the refinery at the small intestine stage and goes to the liver via the blood stream. Along the way a glucose detector signals the pancreas gland to release insulin. At the liver a portion of the glucose is syphoned off into the liver cells and put into storage as glycogen, no insulin needed.The remainder of the glucose and all the insulin flows out via the blood to all other body cells. Most cells require insulin to allow glucose to enter these cells - like a gate pass.The brain is dependent on glucose as its fuel. No insulin is required for the glucose to get across into the brain cells. Hence one could say the brain is pretty keen to ensure its fuel supply.To keep the blood sugar between comfortable limits for the brain and secondarily all other cells there is a loop system. Blood sugar rises after a meal, insulin is released in a timely fashion and assists lowering of the blood sugar to help keep levels in range.Between meals the blood sugar drifts down and again the body’s blood glucose sensors, very mindful of the bossy brain’s memo to them, triggers release of another hormone called glucagon, again from the pancreas gland, and this glucagon causes the liver to release some of its stored glucose ( glycogen). Thus the blood sugar is kept within normal limits and adjustments are made second by second.When the non-diabetic person fasts it is my understanding that insulin stays at a low basal level, and glucagon encourages glucose release from the liver. If fasting continues long enough the liver’s glycogen storage is exhausted. Then fat and protein has to be changed into glucose by the body to keep bossy boots brain happy.In summary your pancreas gland releases hormones that help regulate your blood sugar levels during feast and fasting.In diabetes type 1, there is no insulin available or present in the pancreas gland so insulin has to be injected and then absorbed into the blood stream.Type 1 diabetics will be injecting one or more types of insulin in order to keep some amount of insulin present in the blood stream and to allow for blood sugar rises after meals.If there is too much insulin for the blood sugar level and its rises and falls, or insufficient glucose is absorbed from the gut to match the amount of insulin in the blood stream or the insulin’s action is assisted by exercise - the blood sugar falls too far. Bossy boot brain suffers from lack of fuel - with the risk that the brain may suffer damage.Once a diabetic injects insulin he or she cannot take it back.(There is a joke about someone tying to suck insulin out like an old remedy for snake bite where people used to try to suck the poison out !!).Once the diabetic has insulin on board he or she is committed to keep sugar levels from getting too low ( and with less immediacy, too high). So regular input of food helps to even out the blood sugar levels to match the action of the one or more insulin types injected.

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