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  Diabetes is an epidemic in the United States and is clearly one of the most common problems seen in primary care (predicable), defined as a fasting glucose between 100 and 126 mg / dl, which increases the risk heart attack and stroke, even if the type 2 diabetes does not develop . Probably due to the high incidence of obesity and physical inactivity in the United States. At diagnosis of diabetes among adults is 50% with coronary artery disease , 20% had retinopathy and 20% micro .
Among the many chronic diseases encountered in primary care , diabetes requires more self-management than others. It not only does the patient to adhere to a special diet, but still adjusts your insulin dose and after glucose .
The proper education of a new diabetic requires a lot of time, time which is often not reimbursed adequately. Therefore, having a health professional dedicated to the management of these patients properly.

Covering all aspects of the management of diabetes, metabolic syndrome , gestational diabetes , patients who need oral medications to those who can benefit from new agents, such as inhibitors of DEPP- IV , inhaled insulin or inciting mime tics . When starting treatment with insulin in patients with type 2 diabetes ? If the continuation of oral agents, while the patient is treated with insulin? Maybe you have a patient in your practice that could benefit from using an insulin pump . How the transition to a patient multiple injection therapy insulin pump? As the primary care physician himself,

It is clear from numerous studies that the complications of coronary artery disease , blindness , amputations and kidney failure are greatly reduced when treatment is aggressive. We were accused of therapeutic inertia , and, unfortunately , the data support this view . This inertia is especially true when it comes to using insulin to control the disease. Too often use M € S € needle as a threat to ensure compliance with our recommendations , saying, AA € SI not stick to your diet and exercise program will get you started on insulin.â From € AA € S M € needle is no longer a significant 31 -gauge needles in pens problem, inhaled insulin is now available , and oral insulin are just around the corner , we must educate the patient from the beginning that natural disease progression requires insulin replacement tomorrow, as a thyroid gland does not require thyroid supplements .

Too little attention to emotional poses load diabetes is given . The stress of having to be constantly vigilant in the management of the activity, food and medicines, as well as feelings of guilt that can follow a worsening of the condition requires that we constantly evaluate how the patient is emotionally cope with their illness .

The fact that depression is twice as common in diabetics and that the two conditions and significantly increase the risk of mortality, especially coronary heart disease, means that we must be vigilant in monitoring these patients for depression and / or exhaustion. Emotional distress leads to a lack of motivation for self- care, reduced respect, and a sense of powerlessness over the disease.

There are fears of complications and long-term frustration of constantly having to deal with this devastating chronic disease. We expect patients to feel anxious to get cancer and what it means for your quality of life, but how often do we give the same attention and support to those equally concerned about their future with
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