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pancreaticoduodenectomy\t(Whipple\tprocedure)\n,\nin\twhich\tdistal\tsegment\t(antrum)\tof\tthe\tstomach,\tthe\tfirst\tand\tsecond\tportions\tof\tthe\tduodenum,\tthe\thead\tof\tthe\npancreas,\tthe\tcommon\tbile\tduct,\tand\tthe\tgallbladder\tare\tremoved.\tThe\tbasic\tconcept\tbehind\tthe | [
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pancreaticoduodenectomy\tis\tthat\tthe\thead\tof\tthe\tpancreas\tand\tthe\tduodenum\tshare\tthe\tsame\tarterial\tblood\tsupply\n(the\tgastroduodenal\tartery).\tThese\tarteries\trun\tthrough\tthe\thead\tof\tthe\tpancreas,\n\tso\tboth\torgans\tmust\tbe\tremoved\tif\nthe\tsingle\tblood\tsupply\tis\tsevered.\tIf\tonly\tthe... | [
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the\tduodenum,\tresulting\tin\ttissue\tnecrosis.\tA\tcholecystectomy,\tvagotomy,\tor\ta\tpartial\tgastrectomy\talso\tmay\tbe\nperformed\tduring\tthe\tsurgery.\tThe\tpancreatic\tduct\tis\treanastomosed\t(reattached)\tto\tthe\tjejunum.\tPartial\tor\tcomplete\npancreatic\tinsufficiency\n\tcan\tresult,\tdepending\ton\tthe\... | [
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undergone\tpancreatic\tresection\tare\tat\trisk\tfor\tvitamin\tand\tmineral\tdeficiencies\tand\twill\tbenefit\tfrom\tvitamin\tand\nmineral\tsupplementation.\tNutrition\tcare\tis\tsimilar\tto\tthat\tfor\tCP.\nPancreatic\tand\tislet\tcell\ttransplantation\nThere\thave\tbeen\tsignificant\timprovements\tin\tthe\toutcomes\t... | [
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transplants\tor\npancreatic\ttransplants\tcombined\twith\ta\tkidney\ttransplant\t(\nDean\tet\tal,\t2017\n;\t\nLaftavi\tet\tal,\t2017\n).\tIn\tpatients\twith\nunstable\t(brittle)\tdiabetes\tmellitus\twho\tsuffer\tfrom\tbouts\tof\thyper-\tand\thypoglycemia,\ttransplantation\tcan\trestore | [
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normal\tglucose\thomeostasis\tand\tprevent,\thalt,\tor\treverse\tthe\tprogression\tof\tsecondary\tcomplications\t(\nDunn,\t2014\n;\nGruessner\tand\tGruessner,\t2013\n).\nPancreatic\n\tislet\tallotransplantation\tis\ta\tprocedure\tin\twhich\tislets\tfrom\tthe\tpancreas\tof\ta\tdeceased\torgan\tdonor\tare | [
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purified,\tprocessed,\tand\ttransferred\tinto\ta\trecipient.\tIt\tis\tperformed\tin\tcertain\tpatients\twith\ttype\t1\tdiabetes\tmellitus\nwhose\tblood\tglucose\tlevels\tare\textremely\tlabile\tand\tdifficult\tto\tcontrol.\t\nPancreatic\tislet\tautotransplantation\n\tis\nperformed\tafter\ttotal\tpancreatectomy\tin\tpat... | [
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is\nperformed\tafter\ttotal\tpancreatectomy\tin\tpatients\twith\tsevere\n\tand\tchronic,\tor\tlong-lasting,\tpancreatitis\tthat\tcannot\tbe\nmanaged\tby\tother\ttreatments.\tAfter\tpancreatectomy,\tislets\tare\textracted\tand\tpurified\tfrom\tthe\tpancreas.\tThe\tislets | [
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then\tare\tinfused\tthrough\ta\tcatheter\tinto\tthe\tliver.\tThe\tgoal\tis\tto\tgive\tthe\tbody\tenough\thealthy\tislets\tto\tmake\tinsulin.\nA\tperson\twho\treceives\ta\tpancreatic\tislet\tcell\ttransplant\tshould\tfollow\ta\tmeal\tplan\tdesigned\tfor\ta\tperson\n\twith\ndiabetes\tmellitus\tif\thyperglycemia\tis\tpres... | [
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without\texogenous\tinsulin\t(see\t\nChapter\t29\n).\tImmunosuppressive\tmedications\tare\trequired\tfor\tallo-\tbut\tnot\nautotransplantation;\tthese\tmedications\tcan\tcontribute\tto\tweight\tgain,\thypertension,\tdyslipidemia,\tand\tlabile\tblood\nglucose\tlevels\t(\nChhabra\tand\tBrayman,\t2014\n).\nAlthough\tpancr... | [
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glucose\tlevels\t(\nChhabra\tand\tBrayman,\t2014\n).\nAlthough\tpancreas\n\ttransplantation\thas\tbeen\tfavored\tfor\tβ-cell\treplacement,\twith\timproved\toutcomes\tfollowing\tislet\ntransplantation,\tthe\tuse\tof\tthis\tminimally\tinvasive\ttherapy\tin\tcarefully\tselected\tpatients\tshould\tbe\tconsidered\t(\nWisel\... | [
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Wisel\net\tal,\t2016\n;\t\nHatipoglu,\t2016\n;\t\nMarkmann\tet\tal,\t2016\n).\tPancreas\ttransplant\tremains\tthe\tprocedure\tof\tchoice\tfor\tβ-cell\nreplacement\tin\turemic\tpatients.\tIslet\ttransplantation\tshould\tbe\tconsidered\n\tin\tnonuremic\tpatients\twith\tlow\tbody\tmass | [
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in\tnonuremic\tpatients\twith\tlow\tbody\tmass\nindex\t(BMI)\tand\tlow\tinsulin\trequirements,\tpatients\tlacking\tthe\tcardiovascular\treserve\tto\tundergo\topen\tabdominal\nsurgery,\tor\tpatients\twho\telect\tto\tforego\tthe\trisks\tof\ta\tmajor\toperation\tin\texchange\tfor\tan\tincreased\trisk\tof\tislet\tgraft\nfa... | [
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failure.\nClinical\tCASE\tSTUDY\t1\nA\t62-year-old\twhite\tman\tis\tadmitted\tto\tthe\thospital\tfrom\tthe\tdoctor’s\toffice\twith\taltered\n\tmental\tstatus.\tPast\nmedical\thistory\treveals\tcirrhosis\tresulting\tfrom\thepatitis\tC,\tesophageal\tvarices,\thepatic\tencephalopathy,\tand | [
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ascites.\tThe\tpatient\treports\tmissing\this\tdoses\tof\tlactulose\tthe\ttwo\tprevious\tdays.\tMuscle\twasting\tis\tnoted\tin\tthe\nform\tof\tsquared\tshoulders,\tprominent\tclavicle,\ttemporal\twasting,\tand\tthin\textremities.\tHe\thas\t3+\tpitting\tedema\nin\this\tlower\textremities\tand\ta\tprotuberant\n\tabdomen\... | [
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abdomen\tfrom\tascites.\tHis\tabnormal\tlaboratory\tvalues\ton\tadmission\nincluded\televated\tliver\tfunction\tenzymes\tand\ttotal\tbilirubin,\tsodium\t127\tmEq/L,\tglucose\t68\tmg/dL.\tNutritional\ndata\tinclude\theight,\t177.8\tcm;\tweight,\t71.8\tkg;\tdry\tweight,\t75\tkg;\trecent\tbody\tweight\trange\tdue\tto\tflu... | [
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fluctuations,\t63.6\tkg\tto\t90.9\tkg.\nNutrition\tdiagnostic\tstatements\n•\t\nInvoluntary\tweight\tloss\trelated\tto\tcirrhosis\n\tas\tevidenced\tby\t4.5%\tweight\tloss\t(based\ton\tdry\tweight)\tand\nphysical\tsigns\tof\tmalnutrition.\n•\t\nAltered\tlaboratory\tvalues\trelated\tto\tcirrhosis\tas\tevidenced\tby\thypo... | [
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Interventions\n•\t\nInitiate\t2\tg\tsodium\tdiet\twith\tsmall,\tfrequent\tmeals.\n•\t\nEnsure\tadequate\tkcals\tand\tprotein.\n•\t\nFluid\trestriction\t(coordinate\tcare\twith\tmedical\tteam).\n•\t\nInitiate\tcommercial\tbeverage\ttwice\n\tdaily.\nMonitoring\tand\tevaluation\n•\t\nMonitor\tfood\tand\tbeverage\tintake.\... | [
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0.047218434... |
•\t\nAssess\tfood\tand\tnutrition\tknowledge.\n•\t\nAssess\tadherence\tto\tprescribed\tdiet.\nCLINICAL\tCASE\tSTUDY\t2\nA\t42-year-old\tHispanic\tfemale\tpresents\twith\ta\thistory\tof\tchronic\tpancreatitis\tresulting\tfrom\tpancreatic\tdivisum\t(a\ncongenital\tabnormality\tin\twhich\tthere\tare\ttwo\tpancreatic\tduct... | [
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0.03597... |
has\thad\tmultiple\nhospitalizations\tfor\tacute\tpancreatitis.\tDespite\tplacement\tof\tpancreatic\tstents,\tshe\thas\tdeveloped\tchronic\npancreatitis\t(confirmed\tby\tabnormal\tendoscopic\tultrasound\tand\tlow\tfecal\telastase)\tand\tdepends\ton\tchronic\tpain\nmedications.\tShe\tpresents\tfor\tevaluation\tof\ttotal... | [
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0.055987... |
29\nMedical\tnutrition\ttherapy\tfor\ndiabetes\tmellitus\tand\nhypoglycemia\tof\tnondiabetic\norigin\nJessica\tJones,\tMS,\tRDN,\tCDE\nKEY\tTERMS\nacanthosis\tnigricans\namylin\nautonomic\tsymptoms\nbasal\tor\tbackground\tinsulin\tdose\nC-peptide\ncarbohydrate\tcounting\ncontinuous\tglucose\tmonitoring\t(CGM)\ncorrecti... | [
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0.0345... |
counterregulatory\t(stress)\thormones\ndawn\tphenomenon\ndiabetic\tketoacidosis\n\t(DKA)\nfasting\thypoglycemia\nfasting\tplasma\tglucose\t(FPG)\ngastroparesis\ngestational\tdiabetes\tmellitus\t(GDM)\nglucagon\nglucotoxicity\nglycemic\tindex\t(GI)\nglycemic\tload\t(GL)\nglycosylated\themoglobin\t(A1C)\nhoneymoon\tphase... | [
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honeymoon\tphase\nhyperglycemia\nhyperglycemic\thyperosmolar\tstate\t(HHS)\nhypoglycemia\t(or\tinsulin\treaction)\nhypoglycemia\tof\tnondiabetic\torigin\nimmune-mediated\tdiabetes\tmellitus\nimpaired\n\tfasting\tglucose\t(IFG)\nimpaired\tglucose\ttolerance\t(IGT)\nincretins\ninsulin\ninsulin\tdeficiency\ninsulin\tresis... | [
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0.0354665... |
insulin\tsecretagogues\ninsulin\tto\tcarbohydrate\tratio\nlag\ttime\nlatent\tautoimmune\tdiabetes\tof\tthe\tadult\t(LADA) | [
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lipotoxicity\nmacrosomia\nmacrovascular\tdiseases\nmaturity\tonset\tdiabetes\tof\tyouth\t(MODY)\nmetabolic\tsyndrome\nmicrovascular\tdiseases\nneuroglycopenic\tsymptoms\nnormoglycemia\npolydipsia\npolyphagia\npolyuria\npostprandial\t(after\ta\tmeal)\tblood\tglucose\npostprandial\t(reactive)\thypoglycemia\nprediabetes\n... | [
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prediabetes\npreprandial\t(fasting/premeal)\tblood\tglucose\nself-monitoring\tof\tblood\tglucose\t(SMBG)\nSomogyi\teffect\ntype\t1\tdiabetes\tmellitus\t(T1DM)\ntype\t2\tdiabetes\tmellitus\t(T2DM)\nWhipple’s\ttriad\nFor\tmost\tpeople,\teating\tcarbohydrate\tfoods\twill\tcause\tblood\tsugar\tlevels\tto\trise.\n\tHowever,... | [
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However,\tthe\ndifference\tbetween\tpeople\twith\tdiabetes\tand\tthose\twithout\tthe\tdisease\tis\thow\thigh\tthe\tblood\tsugar\nrises,\tand\tfor\thow\tlong.\nDiabetes\tmellitus\tis\ta\tgroup\tof\tdiseases\tcharacterized\tby\tprolonged\thigh\tblood\tglucose\nconcentrations.\tThe\tcause\tof\thigh\tblood\tglucose—also\tk... | [
0.0630543902516365,
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0.05266399309039116,
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0.09535221010446548,
0.0560511089861393,
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0.026061102747917175,
0.0180... |
hyperglycemia\n—is\tthe\tresult\tof\ndefects\tin\tinsulin\tsecretion,\tinsulin\taction,\tor\tboth.\t\nInsulin\n,\ta\thormone\tproduced\n\tby\tthe\tbeta-cells\tof\nthe\tpancreas,\tis\tnecessary\tfor\tthe\tuse\tor\tstorage\tof\tmacronutrients\t(think\tcarbohydrate,\tprotein,\tand\nfat).\tSince\tpeople\twith\tdiabetes\tdo... | [
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0.04841802641749382,
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0.006369295064359903,
0.0142676... |
insulin\tresistance—hyperglycemia\toccurs.\nDiabetes\tmellitus\tcontributes\tto\ta\tconsiderable\tincrease\tin\tmorbidity\tand\tmortality,\twhich\tcan\tbe\nreduced\tby\tearly\tdiagnosis\tand\ttreatment.\n\tDirect\tmedical\texpenditures\tsuch\tas\tinpatient\tcare,\noutpatient\tservices,\tand\tnursing\thome\tcare\tare\ta... | [
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0.011032459326088428,
0.012592683546245098,
0.017415329... |
work\tloss,\tand\tpremature\tmortality\tare\tequally\thigh.\tResearch\testimates\tthat\tthe\ttotal\tcosts\tof\ndiagnosed\tdiabetes\thave\trisen\tto\t$327\tbillion\tin\t2017\tfrom\t$245\tbillion\tin\t2012\t(\nYang\tet\tal,\t2018\n).\nThus\tproviding\tmedical\tnutrition\ttherapy\t(MNT)\tfor\n\tprevention\tand\ttreatment\... | [
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0.0436876155436039,
0.0358133390545845,
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0.009171419776976109,
0.1103847548365593,
0.03414329141378403,
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0.026882652193307877,
0.01364159770309925,
0.006825107149779797,
0.005056144203990698,
0.03418949991... |
prevention\tand\ttreatment\tof\tdiabetes\thas\ntremendous\tpotential\tto\treduce\tthese\tcosts.\tFortunately,\tpeople\twith\tdiabetes\tcan\ttake\tsteps\tto\ncontrol\tthe\tdisease\tand\tlower\tthe\trisk\tof\tcomplications\tor\tpremature\tdeath.\nIncidence\tand\tprevalence\nIt\tis\testimated\tthat\t9.4%\tof\tthe\tU.S.\tp... | [
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0.042366743087768555,
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0.09104792028665543,
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0.0361828... |
diabetes\tin\tthe\tUnited\tStates\tin\tall\tages\twas\t30.3\tmillion\n\tpeople\t(15.3\tmillion\tadult\tmen\tand\t14.9\nadult\twomen),\tor\t9.4%\tof\tthe\tpopulation.\tOf\tthese,\t23.1\tmillion\tare\tdiagnosed\tand\t7.2\tmillion\tare\nundiagnosed.\tIn\t2015\tan\testimated\t1.5\tmillion\tnew\tcases\tof\tdiabetes\twere\td... | [
-0.0003367469762451947,
0.017245139926671982,
0.027160849422216415,
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0.11571229249238968,
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0.07550086081027985,
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0.010802109725773335,
-0.004... |
18\tyears\tor\tolder\t(\nCenters\tfor\tDisease\tControl\tand\tPrevention\t[CDC],\t2017a\n).\tDiabetes\tprevalence\nalso\tincreases\twith\tage,\taffecting\t12\tmillion\tpeople\tage\t65\tyears\n\tand\tolder,\tor\t39.7%\tof\tall\tpeople\tin\nthis\tage\tgroup.\nMuch\tof\tthe\tincrease\tin\tprevalence\tis\tbecause\tthe\tpre... | [
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0.0221910011023283,
0.05351554974913597,
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0.0010767593048512936,
0.10331279039382935,
0.013797569088637829,
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0.06288240849971771,
0.12083590775728226,
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0.02275017276406288,
0.0148858... |
dramatically\tin\tyounger\tage\tgroups\tin\tthe\tlast\tdecade,\tespecially\tin\tminority\tpopulations.\tAmong\nyouth\twith\tnewly\tdiagnosed\tdiabetes,\tapproximately\t23%\thave\ttype\t2\tdiabetes\t(\nMayer-Davis\tet\tal,\n2017\n).\tThe\tprevalence\tof\ttype\t2\tdiabetes\tis\thighest\tin\n\tethnic\tgroups\tin\tthe\tUni... | [
0.022350985556840897,
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0.04172318056225777,
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0.05520239472389221,
0.041769664734601974,
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0.018954500555992126,
0.0... |
ethnic\tgroups\tin\tthe\tUnited\tStates.\tData\nindicate\tin\tpeople\taged\t20\tyears\tor\tolder,\t15.1%\tof\tAmerican\tIndians\tand\tAlaska\tNatives,\t12.7%\tof\nnon-Hispanic\tblacks,\t12.1%\tof\tHispanics,\tand\t8.0%\tof\tAsian\tAmericans\thad\tdiagnosed\tdiabetes.\nAmong\tHispanics,\trates\twere\t13.8%\tfor\tMexican... | [
0.05426297336816788,
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0.023265693336725235,
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0.0544852688908577,
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0.06508586555719376,
0.1632891744375229,
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-0.02711872197687626,
-0.003282352... |
great\tconcern\tare\tthe\t84.1\tmillion\tpeople\t(34%\tof\tadults\t18\tyears\tor\tolder\n\tand\t48.3%\tof\tadults\t65\nyears\tor\tolder)\twith\tprediabetes,\twhich\tincludes\timpaired\tglucose\ttolerance\t(IGT)\tand\timpaired\nfasting\tglucose\t(IFG)\t(\nCDC,\t2017a\n).\tAll\tare\ta\thigh\trisk\tfor\tconversion\tto\tty... | [
-0.030035918578505516,
0.0036689434200525284,
0.09912039339542389,
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0.1294110119342804,
0.036985017359256744,
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0.05415600165724754,
0.04280291125178337,
-0.0078301215544343,
-0.011306974105536938,
0.02439... |
).\tAll\tare\ta\thigh\trisk\tfor\tconversion\tto\ttype\t2\tdiabetes\tand\ncardiovascular\tdisease\t(CVD)\tif\tlifestyle\tprevention\tstrategies\tare\tnot\timplemented.\nCategories\tof\tglucose\tintolerance\nAssigning\ta\ttype\tof\tdiabetes\tto\tan\tindividual\toften\tdepends\ton\n\tthe\tcircumstances\tpresent\tat\tthe\... | [
0.013015282340347767,
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0.0444490946829319,
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0.08063221722841263,
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0.059647392481565475,
0.07684827595949173,
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0.008099917322397232,
0.0342... |
the\tcircumstances\tpresent\tat\tthe\ttime\nof\tdiagnosis,\tand\tmany\tindividuals\tdo\tnot\teasily\tfit\tinto\ta\tsingle\tcategory.\tWhat\tis\tessential\tis\tthe\nneed\tto\tintercede\tearly\twith\tlifestyle\tinterventions,\tbeginning\twith\tprediabetes\tand\tcontinuing\nthrough\tthe\tdisease\tprocess.\nPrediabetes | [
0.017624130472540855,
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0.07748410105705261,
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0.0696772113442421,
0.06579295545816422,
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0.013538963161408901,
0.016... |
Individuals\twith\ta\tstage\tof\timpaired\tglucose\thomeostasis\tthat\tincludes\t\nimpaired\tfasting\tglucose\n(IFG)\n\tand\t\nimpaired\tglucose\ttolerance\t(IGT)\n\tare\treferred\tto\tas\thaving\tprediabetes,\tindicating\ntheir\trelatively\thigh\trisk\tfor\tthe\tdevelopment\tof\tdiabetes\tand\tCVD.\t\nPrediabetes\n\ti... | [
0.030473217368125916,
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0.09541232883930206,
0.10218781232833862,
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0.0... |
Prediabetes\n\tis\tdiagnosed\twith\tat\nleast\tone\tof\tthe\tfollowing:\tIFG\t(fasting\tplasma\tglucose\t100\tto\t125\tmg/dL),\tIGT\t(2-hour\tpostchallenge\nglucose\tof\t140\tto\t199\tmg/dL),\tboth,\tor\ta\themoglobin\tA1C\tof\t5.7%\tto\t6.4%.\tIndividuals\tdiagnosed\nwith\tprediabetes\tand\tshould\tbe\tcounseled\tabou... | [
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0.010307441465556622,
0.02847175858914852,
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0.10430805385112762,
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0.005221290048211813,
0.02131623961031437,
0.00451316824182868,
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-0.01... |
diabetes\tprevention\tstrategies,\tsuch\tas\neating\ta\tbalanced\tdiet\tand\tincreasing\tphysical\tactivity,\tto\tlower\ttheir\trisks\t(\nAmerican\tDiabetes\nAssociation\t[ADA],\t2018\n).\nType\t1\tdiabetes\nThe\tADA\testimates\tthat\tabout\t1.25\tmillion\tAmericans\thave\ttype\t1\tdiabetes\t(\nADA,\t2018\n).\tAt\ndiag... | [
-0.01776237040758133,
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0.029092494398355484,
0.024036822840571404,
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0.14078979194164276,
0.011340862140059471,
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0.04357625171542168,
0.05276427045464516,
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-0.008... |
).\tAt\ndiagnosis,\tpeople\twith\t\ntype\t1\tdiabetes\tmellitus\t(T1DM)\n\toften\texperience\texcessive\tthirst,\nfrequent\turination,\tand\tsignificant\n\tweight\tloss.\tThe\tprimary\tdefect\tis\tpancreatic\tbeta-cell\ndestruction,\tusually\tleading\tto\tabsolute\t\ninsulin\tdeficiency\n\tand\tresulting\tin\thyperglyc... | [
0.005137031897902489,
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0.05847178027033806,
0.008908637799322605,
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0.055352117866277695,
0.0968199297785759,
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0.0321119986474514,
0.0157664... |
polyuria\n\t(excessive\turination),\t\npolydipsia\n\t(excessive\tthirst),\t\npolyphagia\n\t(excessive\thunger),\nunexpected\tweight\tloss,\tdehydration,\telectrolyte\tdisturbance,\tand\t\ndiabetic\tketoacidosis\t(DKA)\n—a\nserious\tcomplication\tof\tdiabetes\tcharacterized\tby\textreme\n\thyperglycemia\tand\ta\tbuildup... | [
0.002473267028108239,
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0.012504944577813148,
0.025652587413787842,
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0.03457436338067055,
0.033757179975509644,
0.0064505934715271,
0.01049147080630064,
0.04208942... |
hyperglycemia\tand\ta\tbuildup\tof\tketones\tin\nthe\tblood\tand\turine.\tThe\trate\tof\tbeta-cell\tdestruction\tis\tvariable,\tproceeding\trapidly\tin\tinfants\tand\nchildren\tand\tslowly\tin\tothers\t(mainly\tadults.)\tThe\tcapacity\tof\ta\thealthy\tpancreas\tto\tsecrete\tinsulin\tis | [
-0.009565002284944057,
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-0.0... |
far\tin\texcess\tof\twhat\tis\tneeded\tnormally.\tTherefore\tthe\tclinical\tonset\tof\tdiabetes\tmay\tbe\tpreceded\tby\nan\textensive\tasymptomatic\tperiod\tof\tmonths\tto\tyears,\n\tduring\twhich\tbeta-cells\tare\tundergoing\ngradual\tdestruction.\nT1DM\taccounts\tfor\t5%\tof\tall\tdiagnosed\tcases\tof\tdiabetes\t(\nC... | [
0.04444039985537529,
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0.05530175939202309,
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0.08596709370613098,
0.1014239639043808,
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0.03569895774126053,
-0.007... |
CDC,\t2017a\n).\tPeople\twith\tT1DM\tare\ndependent\ton\texogenous\tinsulin—meaning\tinsulin\tproduced\toutside\tof\tthe\tbody—to\tprevent\nketoacidosis\tand\tdeath.\tT1DM\tcan\tdevelop\tat\tany\tage.\tAlthough\tmore\tcases\tare\tdiagnosed\tin\tpeople\nbefore\tthe\tage\tof\t30\tyears,\tit\talso\toccurs\tin\tolder\tindi... | [
0.0016482730861753225,
0.0010483275400474668,
0.06025773286819458,
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0.0854005292057991,
0.03604813292622566,
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0.0913509875535965,
0.11472877860069275,
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0.05065256357192993,
0.0250390... |
Most\tindividuals\tare\tlean\tbut\tsome\tare\ndiagnosed\twithout\tany\t(or\twith\tmore\tsubtle)\tsymptoms\tand\tmay\tbe\tat\ta\thigher\tweight.\nT1DM\thas\ttwo\tforms:\timmune-mediated\tand\tidiopathic\t(\nADA,\t2018\n).\t\nImmune-mediated\tdiabetes\nmellitus\n\tresults\tfrom\tan\tautoimmune\tdestruction\tof\tthe\tbeta... | [
0.01688220724463463,
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0.04996640980243683,
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0.0010956365149468184,
0.09505520761013031,
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0.08776222169399261,
0.05121311545372009,
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0.00753176910802722,
0.0687665... |
the\tbody\tthat\tmake\tthe\thormone\tinsulin.\tIdiopathic\tT1DM\trefers\tto\tforms\tof\tthe\tdisease\n\tthat\thave\tno\nknown\tetiology.\tAlthough\tonly\ta\tminority\tof\tindividuals\twith\tT1DM\tfall\tinto\tthis\tcategory,\tof\tthose\nwho\tdo,\tmost\tare\tof\tAfrican\tor\tAsian\tancestry\t(\nADA,\t2018\n).\tAt\tthis\t... | [
0.01769568957388401,
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0.03832756727933884,
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0.09729959070682526,
0.08249756693840027,
-0.03686250373721123,
0.04313232749700546,
0.035793... |
ADA,\t2018\n).\tAt\tthis\ttime\tthere\tis\tno\tknown\tcure\tfor\nT1DM.\nSince\tautoimmune\tthyroid\tdisease\tand\tceliac\tdisease\toccur\twith\tincreased\tfrequency\tin\tpeople\nwith\tT1DM,\tthe\tADA\tsuggests\tscreening\tfor\tthyroid\tdisease\tin\tpeople\tdiagnosed\twith\tT1DM.\n\tOther\nautoimmune\tconditions,\tsuch\... | [
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0.026573942974209785,
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0.002052095951512456,
0.11684863269329071,
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0.06611093133687973,
0.08955686539411545,
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0.006552419159561396,
0.043679... |
autoimmune\tgastritis,\tdermatomyositis,\tand\tmyasthenia\tgravis,\talso\toccur\tmore\tcommonly\tin\tpeople\nwith\tT1DM\tcompared\twith\tthe\tgeneral\tpediatric\tpopulation.\tIndividuals\twith\tceliac\tdisease\tthat\thas\nbeen\tconfirmed\tby\ta\tbiopsy\tshould\tbe\tplaced\ton\ta\tgluten-free\tdiet\tby\ta\tregistered\td... | [
-0.002185636665672064,
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0.059423577040433884,
0.013309192843735218,
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0.0002632151881698519,
0.1245623528957367,
0.029249871149659157,
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0.048305537551641464,
0.07112690061330795,
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0.010212031193077564,
0.... |
nutritionist\n\t(RDN)\texperienced\tin\tmanaging\tdiabetes\tand\tceliac\tdisease\t(\nADA,\t2018\n).\nPathophysiology\nAs\tmentioned\tpreviously,\tpeople\twith\tT1DM\texperience\tdestruction\tof\tthe\tpancreatic\tbeta\tcells,\nwhich\tresults\tin\tdecreased\tinsulin\tproduction\tand\tprolonged\televation\tof\tblood\tgluc... | [
-0.02348274365067482,
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0.05480656400322914,
0.012450779788196087,
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0.11973077803850174,
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0.04314415156841278,
0.08141402900218964,
-0.05570802465081215,
-0.04102243483066559,
0.024... |
Markers\tof\tthe\timmune\tdestruction\tof\tthe\tbeta-cells\tinclude\tislet\tcells\tautoantibodies;\tautoantibodies\nto\tinsulin;\tautoantibodies\n\tto\tglutamic\tacid\tdecarboxylase\t(GAD65)\t(a\tprotein\ton\tthe\tsurface\tof\tthe\nbeta-cells);\tand\tautoantibodies\tto\tthe\ttyrosine\tphosphatases\tIA-2,\tIA-2beta,\tan... | [
-0.022884508594870567,
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0.05992969870567322,
0.04892665520310402,
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0.08533333986997604,
0.07124768197536469,
-0.026675380766391754,
-0.018546942621469498,
0.03604007... |
defined\tby\tthe\tpresence\tof\tone\tor\tmore\tof\tthese\tautoimmune\tmarkers.\tIt\tis\timportant\tto\tnote\tthat\nT1DM\talso\thas\tstrong\tgenetic\tfactors,\twhich\tinvolve\tthe\tassociation\tbetween\tT1DM\tand\nhistocompatibility\tlocus\tantigen\t(HLA)\n\twith\tlinkage\tto\tthe\tDQA\tand\tDQB\tand\tthe\tDRB\tgenes.\t... | [
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0.013091832399368286,
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0.07161473482847214,
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0.05694551393389702,
0.08968459069728851,
-0.006419115699827671,
0.05681176111102104,
0.053158... |
ADA,\t2018\n).\tIn\tT1DM,\tthe\trate\tof\nclinical\tbeta-cell\tdestruction\tis\tvariable,\tbeing\trapid\tin\tsome\tindividuals\t(mainly\tinfants\tand\tchildren)\nand\tslow\tin\tothers\t(mainly\tadults).\tChildren\tand\tadolescents,\tfor\texample,\tmay\tpresent\twith\tDKA\tas\nthe\tfirst\tmanifestation\tof\tthe\tdisease... | [
-0.029850827530026436,
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0.04888133332133293,
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0.0619465671479702,
0.08051106333732605,
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-0.003137955442070961,
0.03... |
can\toften\tretain\tsufficient\tb-cell\tfunction\tto\tprevent\nDKA\tfor\tmany\tyears.\tNote\tthat\talthough\tT1DM\tcommonly\toccurs\tin\tchildhood\tand\tadolescence,\tit\ncan\toccur\tat\tany\tage\t(\nADA,\t2018\n).\nFrequently\tafter\tdiagnosis\tand\tthe\tcorrection\tof\thyperglycemia,\tmetabolic\tacidosis,\tand | [
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0.053096... |
ketoacidosis,\tendogenous\tinsulin\tsecretion—or\tinsulin\tsecreted\tinside\tthe\tbody—recovers.\tDuring\nthis\t\nhoneymoon\tphase\n,\texogenous\n\t(outside\tthe\tbody)\tinsulin\trequirements\tdecrease\tdramatically\nfor\tup\tto\t1\tyear\tor\tlonger,\tand\tgood\tmetabolic\tcontrol\tmay\tbe\teasily\tachieved\t(\nFonolle... | [
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0.04807648807764053,
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0.08110133558511734,
0.006269396282732487,
-0.011960223317146301,
0.... |
Fonolleda\tet\tal,\t2017\n).\nHowever,\tthe\tneed\tfor\tincreasing\texogenous\tinsulin\treplacement\tis\tinevitable\tand\talways\tshould\tbe\nanticipated.\tIntensive\tinsulin\ttherapy\talong\twith\tattention\tto\tMNT\tand\tself-monitoring\tof\tglucose\nfrom\tearly\tdiagnosis\thas\tbeen\tshown\n\tto\tprolong\tinsulin\ts... | [
0.018521150574088097,
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0.07662639766931534,
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0.007792091928422451,
0.10539520531892776,
-0.02691352367401123,
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0.0678577721118927,
0.10727620124816895,
-0.025635594502091408,
0.01019336562603712,
0.02401... |
to\tprolong\tinsulin\tsecretion.\tOne\tstudy\tfound\tthat\tchildren\twho\nwere\tdiagnosed\twith\tT1DM\tearly\tin\tlife—specifically\tbefore\tthe\tage\tof\t7\tyears—had\ta\tmuch\tgreater\nloss\tof\tβ-cells\tcompared\twith\tthose\twho\tare\tdiagnosed\twith\tthe\tillness\tin\ttheir\tteenage\tyears\tor\nbeyond\t(\nLeete\te... | [
-0.012736780568957329,
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0.014250453561544418,
-0.07575198262929916,
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0.024438878521323204,
0.017289161682128906,
0.0009654212626628578,
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0.08420906960964203,
0.08033449947834015,
0.005226501729339361,
0.04871036484837532,
-0.... |
Leete\tet\tal,\t2016\n).\nLatent\tautoimmune\tdiabetes\tof\tthe\tadult\t(LADA)\n—also\tknown\tas\ttype\t1.5\tdiabetes—is\tan\nautoimmune\tdiabetes\tthat\n\toccurs\tin\tadulthood.\tIt\tis\tdefined\tby\tadult-onset,\tpresence\tof\tdiabetes\nassociated\tautoantibodies,\tand\tno\tinsulin\ttreatment\trequirement\tfor\ta\tpe... | [
-0.007233351469039917,
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0.04357684403657913,
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0.04002213850617409,
0.07350906729698181,
-0.025065720081329346,
0.003903327975422144,
0.0004... |
genetic\tfeatures\tof\tboth\ttype\t1\tand\ttype\t2\tdiabetes,\tLADA\tis\tthe\tmost\tprevalent\tform\tof\tadult-onset\nautoimmune\tdiabetes\t(and\tpossibly\tthe\tmost\tcommon\tform\tof\tautoimmune\tdiabetes\tin\tgeneral).\nLADA\tmay\tbe\tcontrolled\tinitially\twith\n\tnutrition\ttherapy,\tbut\twithin\ta\trelatively\tsho... | [
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0.03185411915183067,
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0.05702229216694832,
0.0016839555464684963,
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0.07095014303922653,
0.09831880778074265,
-0.043604958802461624,
0.009304109960794449,
0.0124... |
nutrition\ttherapy,\tbut\twithin\ta\trelatively\tshort\tperiod\tof\ttime\nglucose-lowering\tmedication\tand\tprogression\tto\tinsulin\ttreatment\tare\trequired\t(\nLaugesen\tet\tal,\n2015\n). | [
-0.016895735636353493,
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0.027225997298955917,
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0.03048553690314293,
0.06493750214576721,
0.08779532462358475,
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0.10046487301588058,
-0.01835954748094082,
-0.034906093031167984,
0.... |
Type\t2\tdiabetes\nType\t2\tdiabetes\tmellitus\t(T2DM)\n\taccounts\tfor\t90%\tto\t95%\tof\tall\tdiagnosed\tcases\tof\tdiabetes\tand\nis\ta\tprogressive\tdisease\tthat,\tin\tmany\tcases,\tis\tpresent\tlong\tbefore\tit\tis\tdiagnosed\t(\nADA,\t2018\n).\nHyperglycemia\tdevelops\n\tgradually\tand\tis\toften\tnot\tsevere\te... | [
-0.000048675236030248925,
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0.07665415853261948,
0.0011469677556306124,
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0.032677244395017624,
0.0728912502527237,
0.028906939551234245,
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0.050369590520858765,
0.0585801936686039,
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0.0025884448550641537,
0.... |
to\tnotice\tany\tof\tthe\tclassic\tsymptoms\tof\tdiabetes.\tAlthough\tundiagnosed,\tthese\tindividuals\tare\tat\nincreased\trisk\tof\tdeveloping\tmacrovascular\tand\tmicrovascular\tcomplications\t(\nCDC,\t2017a\n).\nMost\tpeople\twith\tT2DM\tare\tobese\t(defined\tas\tbody\tmass\tindex\t[BMI]\t>30\tkg/m\n2\n),\tyet\tmos... | [
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0.0002311556600034237,
0.0163939967751503,
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0.09032779932022095,
0.09720880538225174,
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0.04220738634467125,
0.07640725374221802,
-0.0715356171131134,
0.01642199605703354,
0.04585341... |
2\n),\tyet\tmost\tobese\nindividuals\tdo\tnot\tdevelop\tT2DM.\tBeing\tat\ta\thigher\tweight\tmay\tincrease\tinsulin\tresistance\tand\tcan\ncontribute\tto\tthe\tdestruction\tof\tthe\tpancreatic\tbeta-cells;\thowever\tthe\texact\tmechanism\tof\taction\nremains\tunclear.\tTherefore\tobesity\tcombined\twith\ta\tgenetic\tpr... | [
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0.04145276919007301,
-0.04194355010986328,
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0.07780851423740387,
0.03000064194202423,
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0.10461244732141495,
0.1066688522696495,
-0.01729969121515751,
0.025790449231863022,
0.0239... |
T2DM\tto\n\toccur.\tOther\trisk\tfactors\tinclude\tgenetic\tand\tenvironmental\tfactors,\tincluding\ta\tfamily\nhistory\tof\tdiabetes,\tolder\tage,\tphysical\tinactivity,\ta\tprior\thistory\tof\tgestational\tdiabetes,\tprediabetes,\nhypertension\tor\tdyslipidemia,\tand\trace\tor\tethnicity\t(\nEckel\tet\tal,\t2011\n).\... | [
0.00002869070704036858,
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0.041757483035326004,
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0.1000116840004921,
0.045702748000621796,
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0.08017832785844803,
0.07260391861200333,
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0.0029125462751835585,
0.... |
).\nPathophysiology\nT2DM\tis\tcharacterized\tby\ta\tcombination\tof\t\ninsulin\tresistance\n\t(decreased\ttissue\tsensitivity\tor\nresponsiveness\n\tto\tinsulin)\tand\tbeta-cell\tfailure.\tEndogenous\tinsulin\tlevels\tmay\tbe\tnormal,\tdepressed,\nor\televated,\tbut\tthey\tare\tinadequate\tto\tovercome\tconcomitant\ti... | [
0.018213769420981407,
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0.046255435794591904,
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0.07394421845674515,
0.09156720340251923,
0.0012650645803660154,
0.021733371540904045,
0.060... |
hyperglycemia\tensues.\tAt\tthe\ttime\tT2DM\tis\tdiagnosed,\tthere\tis\tan\testimated\t24%\tto\t65%\treduction\nin\tbeta-cell\tfunction\t(\nChen\tet\tal,\t2017\n).\nInsulin\tresistance\tis\tdemonstrated\tfirst\tin\ttarget\ttissues,\tmainly\tmuscle,\tliver,\n\tand\tadipose\tcells.\nInitially\tthere\tis\ta\tcompensatory\... | [
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0.06010150909423828,
0.0736585259437561,
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0.02... |
glucose\tconcentrations\tin\tthe\tnormal\tor\tprediabetic\trange.\tHowever,\tin\tmany\tpeople,\tthe\tpancreas\tis\nunable\tto\tcontinue\tto\tproduce\tadequate\tinsulin,\twhich\tresults\tin\tchronic\thyperglycemia\tfollowed\tby\na\tdiabetes\tdiagnosis.\nHyperglycemia\tis\tfirst\texhibited\tas\tan\televation\tof\t\npostp... | [
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0.01661788858473301,
0.021743983030319214,
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0.07185328751802444,
0.0567052885890007,
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0.0036019... |
postprandial\t(after\ta\tmeal)\tblood\tglucose\ncaused\tby\tinsulin\tresistance\tat\tthe\tcellular\tlevel\tand\tis\tfollowed\tby\tan\televation\tin\tfasting\tglucose\nconcentrations.\tAs\tinsulin\tsecretion\tdecreases,\thepatic\tglucose\tproduction\tincreases,\tcausing\tthe\nincrease\tin\t\npreprandial\t(fasting/premea... | [
0.011854931712150574,
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0.07634148001670837,
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0.07508684694766998,
0.004844909068197012,
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0.06107852980494499,
0.15097375214099884,
0.002686853054910898,
-0.008234932087361813,
0.01041... |
.\tThe\tinsulin\tresponse\tis\talso\ninadequate\tin\tsuppressing\talpha-cell\t\nglucagon\n\tsecretion,\tresulting\tin\tglucagon\thypersecretion\tand\nincreased\n\thepatic\tglucose\tproduction.\tCompounding\tthe\tproblem\tis\t\nglucotoxicity\n,\tthe\tdeleterious\neffect\tof\thyperglycemia\ton\tinsulin\tsensitivity\tand\... | [
0.0048117320984601974,
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0.06396087259054184,
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0.038289446383714676,
0.0704130083322525,
0.02950088307261467,
0.006688910536468029,
0.09648611396551132,
0.09116789698600769,
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-0.004694771021604538,
0.026761... |
achieving\tnear-euglycemia\tin\tpeople\twith\tT2DM\t(\nHædersdal\tet\tal,\t2018\n).\nInsulin\tresistance\talso\tis\tdemonstrated\tat\tthe\tadipocyte\tlevel,\tleading\tto\tlipolysis\tand\tan\televation\nin\tcirculating\tfree\tfatty\tacids.\tIn\tparticular,\n\texcess\tintraabdominal\tobesity,\tcharacterized\tby\tan | [
-0.01617736928164959,
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0.08724839240312576,
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0.14780691266059875,
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0.05130680650472641,
0.1180456280708313,
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0.03839... |
excess\tintraabdominal\tobesity,\tcharacterized\tby\tan\nexcess\taccumulation\tof\tvisceral\tfat\taround\tand\tinside\tabdominal\torgans,\tresults\tin\tan\tincreased\tflux\nof\tfree\tfatty\tacids\tto\tthe\tliver,\tleading\tto\tan\tincrease\tin\tinsulin\tresistance.\tIncreased\tfatty\tacid\tlevels | [
0.04546067863702774,
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0.08957692235708237,
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0.0393533781170845,
0.09738796949386597,
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0.024907009676098824,
0.0476609691... |
(\nlipotoxicity\n)\talso\tcause\ta\tfurther\tdecrease\tin\tinsulin\tsensitivity\tat\tthe\tcellular\tlevel,\timpair\npancreatic\tinsulin\tsecretion,\tand\tdisrupt\n\thepatic\tglucose\tproduction.\tThe\tabove\tdefects\tcontribute\tto\nthe\tdevelopment\tand\tprogression\tof\tT2DM\tand\tare\talso\tprimary\ttargets\tfor\tph... | [
0.022733813151717186,
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0.06714001297950745,
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0.006589183583855629,
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0.07612673938274384,
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0.021873801946640015,
0.067390... |
People\twith\tT2DM\tmay\tor\tmay\tnot\texperience\tthe\tclassic\tsymptoms\tof\tuncontrolled\tdiabetes\n(polydipsia,\tpolyuria,\tpolyphagia,\tweight\tloss)\tand\tthey\tare\tnot\tprone\tto\tdevelop\tketoacidosis\texcept\nduring\ttimes\tof\tsevere\tstress.\tThe\tprogressive\tloss\n\tof\tbeta-cell\tsecretory\tfunction\tmea... | [
0.01588631048798561,
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0.01683392934501171,
0.027935028076171875,
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0.017278609797358513,
0.10522002726793289,
0.020613696426153183,
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0.05028172582387924,
0.12857817113399506,
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0.002834899118170142,
0.001176... |
of\tbeta-cell\tsecretory\tfunction\tmeans\tthat\tpeople\nwith\tT2DM\trequire\tmore\tmedication(s)\tover\ttime\tto\tmaintain\tthe\tsame\tlevel\tof\tglycemic\tcontrol;\neventually\texogenous\tinsulin\twill\tbe\trequired.\tInsulin\tis\talso\trequired\tsooner\tfor\tcontrol\tduring\nperiods\tof\tstress-induced\thyperglycemi... | [
-0.0066628167405724525,
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0.030600016936659813,
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0.04929647967219353,
0.09824636578559875,
0.08265253156423569,
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0.07463568449020386,
0.08953931927680969,
-0.014121484011411667,
0.02713960036635399,
0.026... |
If\tat\tdiagnosis\tit\tis\tnot\tclear\twhether\tT1DM\tor\tT2DM\tis\tpresent,\t\nC-peptide\n\tmay\n\tbe\tmeasured.\nWhen\tthe\tpancreas\tproduces\tinsulin,\tit\tbegins\tas\ta\tlarge\tmolecule—proinsulin.\tThis\tmolecule\tsplits\ninto\ttwo\tequal-sized\tpieces:\tinsulin\tand\tC-peptide.\tA\tperson\twith\tT1DM\thas\ta\tlo... | [
-0.016745062544941902,
-0.08811935782432556,
-0.0374266542494297,
-0.07687736302614212,
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0.005391052458435297,
0.06081424281001091,
0.1438744217157364,
0.02577171102166176,
0.04890380799770355,
0.06982308626174927,
0.005137976258993149,
-0.02055857516825199,
0.12100315... |
whereas\tas\ta\tperson\twith\tT2DM\tcan\thave\ta\tnormal\tor\thigh\tlevel\tof\tC-peptide.\tAs\tT2DM\tprogresses,\nC-peptide\talso\tmay\tbe\tmeasured\tto\tsee\tif\tendogenous\tinsulin\tis\tstill\tbeing\tproduced\tby\tthe\n\tpancreas.\nIf\tit\tis\tnot,\texogenous\tinsulin\tis\tneeded\t(\nLeighton\tet\tal,\t2017\n).\nGest... | [
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0.009519288316369057,
0.09661898016929626,
0.050075508654117584,
0.07587069272994995,
0.09173968434333801,
0.031608302146196365,
-0.00906375516206026,
0.091719... |
).\nGestational\tdiabetes\tmellitus\nGestational\tdiabetes\tmellitus\t(GDM)\n\tis\ta\ttype\tof\tdiabetes\tthat\toccurs\tduring\tpregnancy.\tAbout\n2%\tto\t10%\tof\tall\tpregnancies\tin\tthe\tUnited\tStates\tare\taffected\tby\tthis\tcondition\t(\nCDC,\t2017b\n).\nGestational\tdiabetes\tincreases\ta\tmother’s\trisk\tof\t... | [
-0.013453985564410686,
-0.02159961126744747,
0.008939382620155811,
0.02833714708685875,
-0.04960108920931816,
0.02948322705924511,
0.09136644750833511,
0.050436194986104965,
-0.024330709129571915,
0.05579553544521332,
0.11330833286046982,
-0.02711435966193676,
-0.015559994615614414,
-0.044... |
a\nlarge\tbaby\trequiring\ta\tcesarean\tsection\t(C-section).\tGestational\tdiabetes\talso\tincreases\tthe\tbaby’s\nrisk\tof\tpremature\tlabor\t(causing\tbreathing\tand\tother\tproblems),\thaving\tlow\tblood\tsugar,\tand\ndeveloping\tdiabetes\tlater\tin\tlife.\tWomen\tof\tlow\tsocioeconomic\tstatus\tand\tthose\tof\tHis... | [
0.019868329167366028,
-0.024771343916654587,
0.06237693503499031,
-0.017199765890836716,
-0.0668085440993309,
-0.0015567175578325987,
0.05268614739179611,
-0.019170274958014488,
0.0062316544353961945,
0.10315593332052231,
0.1252671778202057,
-0.03479388356208801,
0.01747603714466095,
0.042... |
American,\tAsian,\tand\tAfrican\tAmerican\tdescent\tare\tmore\tlikely\tto\texperience\tGDM\t(\nPhelan,\t2016\n).\nFor\tmany\n\twomen,\tblood\tsugar\tlevels\twill\trevert\tback\tto\tnormal\tafter\tpregnancy.\tOthers\twill\tend\tup\ndeveloping\tdiabetes.\tIt\tis\testimated\tthat\t15%\tto\t25%\tof\twomen\twith\tprior\tGDM... | [
0.02997315116226673,
-0.04721558466553688,
0.056316640228033066,
-0.05331738665699959,
-0.08741709589958191,
-0.046315331012010574,
0.048881322145462036,
-0.006011167541146278,
-0.01312276627868414,
0.06953595578670502,
0.12490412592887878,
-0.021623453125357628,
0.02492508478462696,
0.011... |
within\t1\tto\t2\tyears\tafter\tpregnancy,\tand\tthat\t35%\tto\t70%\twill\tdevelop\tT2DM\t10\tto\t15\tyears\tafter\npregnancy\t(\nPhelan,\t2016\n).\nTreatment\tfor\tGDM\tincludes\tchecking\tblood\tsugar\tregularly\t(and\tmaking\tsure\tthe\tnumbers\tare\nwithin\ta\thealthy\trange),\teating\ta\tbalanced\tdiet,\tbeing\tac... | [
-0.028526192530989647,
-0.043000586330890656,
0.06569404155015945,
-0.020669590681791306,
-0.08477547019720078,
-0.013876748271286488,
0.09786833077669144,
0.04641496762633324,
0.01039261557161808,
0.04452374950051308,
0.1210215836763382,
-0.036693088710308075,
0.03181302547454834,
0.04242... |
recommended),\tand\tmonitoring\tthe\tbaby’s\tgrowth\tand\tdevelopment.\tMost\twomen\twill\tbe\table\tto\nmanage\tGDM\twith\tlifestyle\tchanges,\tbut\tsome\twill\trequire\tmedications\tto\tachieve\toptimal\tblood\nglucose\tranges\t(\nKelley\tet\tal,\t2015\n).\tInsulin\tis\tthe\tpreferred\tagent\tfor\tmanagement\tof\tbot... | [
0.010016866959631443,
-0.0140751414000988,
0.04839678108692169,
-0.029780231416225433,
-0.09418315440416336,
-0.009742483496665955,
0.1074291244149208,
0.0651588961482048,
0.028858015313744545,
0.05236753821372986,
0.1250443160533905,
-0.0010597812943160534,
0.0007481170468963683,
0.024862... |
T2DM\tin\tpregnancy\n\tbecause\tit\tdoes\tnot\tcross\tthe\tplacenta.\tFurthermore,\toral\tagents,\tsuch\tas\nmetformin,\tare\ttypically\tnot\tsufficient\tin\tovercoming\tthe\tinsulin\tresistance\tin\tT2DM\tand\tare\nineffective\tin\tT1DM\t(\nADA,\t2018\n).\tPreviously\tGDM\twas\tdefined\tas\tany\tdegree\tof\tglucose\ti... | [
-0.027399122714996338,
-0.006016867235302925,
0.06367450952529907,
-0.04124625027179718,
-0.09235037118196487,
-0.014306468889117241,
0.10415340214967728,
0.03148846700787544,
0.015770766884088516,
0.04749370738863945,
0.12314102053642273,
-0.019154343754053116,
-0.0011052595218643546,
0.0... |
).\tPreviously\tGDM\twas\tdefined\tas\tany\tdegree\tof\tglucose\tintolerance\nwith\tonset\tor\tfirst\trecognition\tduring\tpregnancy.\tHowever,\tthe\tnumber\tof\tpregnant\twomen\twith\nundiagnosed\tdiabetes\thas\tincreased,\tand\n\ttherefore\tit\thas\tnow\tbeen\trecommended\tthat\twomen\twith | [
0.014628293924033642,
-0.005797904916107655,
0.05687684193253517,
-0.01086766179651022,
-0.09596001356840134,
0.023743920028209686,
0.1367240995168686,
-0.002137413714081049,
-0.005987733136862516,
0.07093902677297592,
0.09114594012498856,
-0.00871273409575224,
-0.020819611847400665,
0.011... |
therefore\tit\thas\tnow\tbeen\trecommended\tthat\twomen\twith\nrisk\tfactors\tfor\tdiabetes\tshould\tbe\tscreened\tfor\tundiagnosed\tT2DM\tat\tthe\tfirst\tprenatal\tvisit,\tusing\nstandard\tdiagnostic\tcriteria.\tWomen\tfound\tto\thave\tdiabetes\tin\tthe\tfirst\ttrimester\tshould\treceive\ta\ndiagnosis\tof\tovert,\tnot... | [
0.03700479865074158,
-0.018378373235464096,
0.018277650699019432,
-0.025941744446754456,
-0.09997282922267914,
0.0027974380645900965,
0.06666603684425354,
0.01757054775953293,
-0.029626084491610527,
0.06452783197164536,
0.07713382691144943,
-0.002192096784710884,
0.004958073142915964,
0.02... |
diagnosis\tof\tovert,\tnot\tgestational,\tdiabetes\t(\nADA,\t2018\n).\nAll\twomen\tnot\tpreviously\tknown\tto\thave\tdiabetes\tshould\tbe\tscreened\tfor\tGDM\tat\t24\tto\n\t28\tweeks\tof\ngestation.\tGDM\tis\tdiagnosed\tmost\toften\tduring\tthe\tsecond\tor\tthird\ttrimester\tof\tpregnancy\tbecause | [
-0.020314373075962067,
-0.011976090259850025,
0.014802245423197746,
-0.029243364930152893,
-0.07371242344379425,
-0.015752065926790237,
0.06981754302978516,
0.06728719919919968,
-0.04695975035429001,
0.03463106229901314,
0.08521449565887451,
0.011837420985102654,
0.020150981843471527,
0.01... |
of\tthe\tincrease\tin\tinsulin-antagonist\thormone\tlevels\tand\tinsulin\tresistance\tthat\tnormally\toccurs\tat\nthis\ttime.\tLaboratory\tassessment\tof\themoglobin\tA1C,\tpreviously\tknown\tas\tHb\tA1C,\tat\t24\tto\t28\nweeks\tof\tgestation\tas\ta\tscreening\tfor\tGDM\tdoes\tnot\tfunction\tas\twell\tas\tthe\tglucose\... | [
0.04506324231624603,
-0.057359881699085236,
0.01862739585340023,
-0.04979199171066284,
-0.08725991100072861,
0.027241092175245285,
0.08787345886230469,
0.0580056756734848,
0.024013036862015724,
0.11158263683319092,
0.08963603526353836,
-0.027201030403375626,
0.023658864200115204,
0.0702294... |
(GTT).\tGDM\tscreening\tcan\tbe\taccomplished\twith\teither\tof\ttwo\tstrategies\t(for\tmore\tdetails,\tsee\t\nTable\n14.5\n\tin\t\nChapter\t14\n):\n1.\t\n“One-step”\t75-g\toral\tglucose\ttolerance\ttest\t(OGTT)\tor\n2.\t\n“Two-step”\tapproach\twith\ta\t50-g\t(nonfasting)\tscreen\tfollowed\tby\ta\t100-g\tOGTT\tfor\ttho... | [
-0.09954617917537689,
0.024444300681352615,
0.013052773661911488,
-0.09953518211841583,
-0.05164662003517151,
-0.02912009134888649,
0.09208554029464722,
0.02741261012852192,
-0.027357283979654312,
0.012290334329009056,
0.12536127865314484,
-0.039637401700019836,
0.03747664764523506,
0.0057... |
who\tscreen\tpositive.\nFor\ta\tcomprehensive\tmultisystem\tchecklist\tfor\tpeople\twith\tdiabetes,\tplease\trefer\tto\tthe\tdocument\nAmerican\n\tDiabetes\tAssociation\tStandards\tof\tMedical\tCare\tin\tDiabetes\n,\twhich\tis\tpublished\tyearly\nonline\tfor\tfree. | [
0.002175199566408992,
-0.05345175042748451,
0.030208643525838852,
-0.027605408802628517,
-0.06246345117688179,
0.02732226811349392,
0.15999683737754822,
-0.00879968423396349,
-0.022240977734327316,
0.05146374553442001,
0.0691109150648117,
-0.06561450660228729,
0.005763619672507048,
-0.0010... |
During\tpregnancy,\ttreatment\tto\tnormalize\tmaternal\tblood\tglucose\tlevels\treduces\tthe\trisk\tof\nadverse\tmaternal,\tfetal,\tand\tneonatal\toutcomes.\tExtra\tglucose\tfrom\tthe\tmother\tcrosses\tthe\tfetal\nplacenta\tand\tthe\tfetus’\tpancreas\tresponds\tby\treleasing\textra\tinsulin\tto\tcope\twith\tthe\texcess... | [
-0.007940337993204594,
-0.061284925788640976,
0.03929601609706879,
0.030921222642064095,
-0.1242288202047348,
0.01915588602423668,
0.09070988744497299,
0.033726565539836884,
0.04759509861469269,
0.04270577058196068,
0.07236070185899734,
-0.0027868859469890594,
-0.0013761862646788359,
-0.00... |
The\texcess\tglucose\tis\tconverted\tto\tfat,\twhich\tresults\tin\t\nmacrosomia\n\t(a\tlarger\tthan\tnormal\tbaby).\nThe\tfetus\n\tmay\tbecome\ttoo\tlarge\tfor\ta\tnormal\tbirth\tresulting\tin\tthe\tneed\tfor\tC-section.\tNeonatal\nhypoglycemia\tat\tbirth\tis\tanother\tcommon\tproblem.\tThe\tabove-normal\tlevels\tof\tm... | [
0.00611930200830102,
-0.045866966247558594,
0.033152420073747635,
0.018313564360141754,
-0.10315781086683273,
0.003721486544236541,
0.07029467076063156,
0.004661134909838438,
0.0014630078803747892,
0.08397762477397919,
0.10673201084136963,
-0.050912778824567795,
0.009675645269453526,
0.033... |
have\tcaused\tthe\tfetus\tto\tproduce\textra\tinsulin.\tHowever,\tafter\tbirth\tthe\textra\tglucose\tis\tno\tlonger\navailable\tto\tthe\tfetus,\tbut\tuntil\tthe\tpancreas\tcan\tadjust,\tthe\tneonate\tmay\trequire\textra\tglucose\nthrough\tintravenous\n\tfeedings\tfor\ta\tday\tor\ttwo\tto\tkeep\tblood\tglucose\tlevels\t... | [
0.004129273351281881,
-0.02652263641357422,
0.06125978007912636,
-0.04126599803566933,
-0.1330520063638687,
0.023290641605854034,
0.07908695191144943,
-0.013241268694400787,
0.014301116578280926,
0.07548154145479202,
0.11346404254436493,
-0.0242710430175066,
0.049787040799856186,
-0.004248... |
feedings\tfor\ta\tday\tor\ttwo\tto\tkeep\tblood\tglucose\tlevels\tnormal.\nGDM\tdoes\tnot\tcause\tcongenital\tanomalies.\tSuch\tmalformations\toccur\tin\twomen\twith\tdiabetes\nbefore\tpregnancy\twho\thave\tuncontrolled\tblood\tglucose\tlevels\tduring\tthe\tfirst\t6\tto\t8\tweeks\tof\npregnancy\twhen\tfetal\torgans\tar... | [
-0.004711517598479986,
-0.032945021986961365,
0.04133755713701248,
-0.0011519690742716193,
-0.10703126341104507,
0.0077211325988173485,
0.0621517039835453,
-0.01834467053413391,
-0.02074838988482952,
0.0342232808470726,
0.1307428628206253,
-0.041620705276727676,
0.01920422539114952,
-0.011... |
pregnancy,\tthe\tfetal\torgans\twere\tformed\tbefore\thyperglycemia\n\tbecame\ta\tproblem.\nWhen\toptimal\tblood\tglucose\tlevels\tare\tnot\tbeing\tmaintained\twith\tMNT\tor\tthe\trate\tof\tfetal\tgrowth\nis\texcessive,\tpharmacologic\ttherapy\tis\tneeded\t(\nADA,\t2018\n).\tResearch\tsupports\tthe\tuse\tof\tinsulin, | [
-0.0044624474830925465,
-0.051339633762836456,
0.014881174080073833,
0.0039023852441459894,
-0.05450926348567009,
0.020695919170975685,
0.07768476754426956,
0.03844524919986725,
-0.012150082737207413,
0.07203677296638489,
0.07873222976922989,
-0.005727150943130255,
-0.024966750293970108,
-... |
ADA,\t2018\n).\tResearch\tsupports\tthe\tuse\tof\tinsulin,\ninsulin\tanalogs,\tmetformin,\tand\tglyburide\tduring\tpregnancy.\tWomen\twith\tGDM\tshould\tbe\tscreened\nfor\tdiabetes\t4\tto\t12\tweeks\tpostpartum\tand\tshould\thave\tlifelong\tscreening\tfor\tthe\tdevelopment\n\tof\ndiabetes\tor\tprediabetes\tat\tleast\te... | [
-0.022578783333301544,
0.003753337077796459,
0.0383414700627327,
0.007608499377965927,
-0.06784532964229584,
0.0300610214471817,
0.10615908354520798,
0.012717804871499538,
-0.06718254834413528,
0.047861672937870026,
0.05558204650878906,
0.006538483779877424,
-0.040213726460933685,
0.014214... |
ADA,\t2018\n).\tSee\t\nTable\t29.1\n\tfor\ta\tcriteria\tfor\tthe\ndiagnosis\tof\tdiabetes\tand\tprediabetes. | [
-0.03697352483868599,
-0.024844616651535034,
-0.041975073516368866,
0.04081426560878754,
-0.03667617589235306,
0.04843827337026596,
0.12552738189697266,
0.0497933104634285,
-0.053684163838624954,
-0.007544113323092461,
0.009775233455002308,
-0.007253298070281744,
-0.09659962356090546,
0.03... |
TABLE\t29.1\nCriteria\tfor\tthe\tDiagnosis\tof\tDiabetes\tMellitus\tand\tIncreased\tRisk\tfor\tDiabetes\t(Prediabetes)\nDiagnosis\nCriteria\nDiabetes\nA1C\t≥6.5%\t(≥48\tmmol/mol).\tThe\ttest\tshould\tbe\tperformed\tin\ta\tlaboratory\tusing\ta\tmethod\nthat\tis\tNGSP\tcertified\tand\n\tstandardized\tto\tthe\tDCCT\tassay... | [
0.041644785553216934,
-0.0016713676741346717,
-0.010866147466003895,
-0.002637492725625634,
-0.05749211832880974,
-0.0001953539758687839,
0.08930220454931259,
0.051832765340805054,
-0.018116267397999763,
0.0538470633327961,
0.062207140028476715,
-0.050398483872413635,
0.003177237929776311,
... |
that\tis\tNGSP\tcertified\tand\n\tstandardized\tto\tthe\tDCCT\tassay.\n*\nOR\nFPG\t≥126\tmg/dL\t(≥7.0\tmmol/L).\tFasting\tis\tdefined\tas\tno\tcaloric\tintake\tfor\tat\tleast\t8\thr.\n*\nOR\n2-h\tPG\t≥200\tmg/dL\t(≥11.1\tmmol/L)\tduring\tan\tOGTT.\tThe\ttest\tshould\tbe\tperformed\tas\ndescribed\tby\tthe\tWHO,\tusing\t... | [
-0.039437323808670044,
-0.03233190253376961,
0.048065345734357834,
-0.031449176371097565,
-0.04405399039387703,
-0.0467127189040184,
0.047593098133802414,
0.039823319762945175,
0.01479259692132473,
0.0250993762165308,
0.04873098433017731,
-0.040484338998794556,
0.03994110971689224,
0.03615... |
anhydrous\tglucose\tdissolved\tin\twater.\n*\nOR\nIn\tpatients\twith\tclassic\tsymptoms\tof\thyperglycemia\tor\thyperglycemic\n\tcrisis,\ta\trandom\nPG\t≥200\tmg/dL\t(≥11.1\tmmol/L)\nPrediabetes\n*\nFPG\t100-125\tmg/dL\t(5.6-6.9\tmmol/L)\t(impaired\tfasting\tglucose)\nOR\n2-h\tPG\tduring\t75-g\tOGTT\t140-199\tmg/dL\t(7... | [
-0.0434199683368206,
-0.0232875794172287,
0.043963074684143066,
0.010785204358398914,
-0.050004664808511734,
-0.021239962428808212,
0.00965751800686121,
0.1331716924905777,
-0.027770839631557465,
0.005432309582829475,
0.0028575335163623095,
-0.00562700442969799,
0.06010691821575165,
0.0365... |
OR\nA1C\t5.7%-6.4%\t(39-47\tmmol/mol)\n*\nIn\tthe\tabsence\tof\tunequivocal\thyperglycemia,\tresults\tshould\tbe\tconfirmed\tby\trepeat\ttesting.\n*\nFor\tall\tthree\ttests,\trisk\tis\tcontinuous,\textending\n\tbelow\tthe\tlower\tlimit\tof\tthe\trange\tand\tbecoming\tdisproportionately\tgreater\tat\tthe\thigher\tend\to... | [
-0.0017287095542997122,
-0.0700673758983612,
-0.009077337570488453,
-0.03786911815404892,
-0.09173301607370377,
-0.05264456942677498,
0.08470562845468521,
0.07003992795944214,
-0.030862389132380486,
0.047505710273981094,
0.03317948803305626,
-0.013229831121861935,
0.047606341540813446,
0.0... |
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