Classification of Hypoglycemia

Hypoglycemia is the major limiting factor in the glycemic management of type 1 and type 2 diabetes. Recommendations from the International Hypoglycaemia Study Group regarding the classification of hypoglycemia considers a blood glucose <54 mg/dL (3.0 mmol/L) detected by self-monitoring of blood glucose (SMBG), continuous glucose monitoring (CGM) (for at least 20 min), or laboratory measurement of plasma glucose as sufficiently low to indicate serious, clinically significant hypoglycemia that should be included in reports of clinical trials of glucose-lowering drugs for the treatment of diabetes. However, a glucose alert value of </=70 mg/dL (3.9 mmol/L) can be important for therapeutic dose adjustment of glucose-lowering drugs in clinical care and is often related to symptomatic hypoglycemia. Severe hypoglycemia is defined as severe cognitive impairment requiring assistance from another person for recovery.

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Recommendations for Fluid Resuscitation in Acutely Ill Patients

Although the use of resuscitation fluids is one of the most common interventions in medicine, no currently available resuscitation fluid can be considered to be ideal. In light of recent highquality evidence, a reappraisal of how resuscitation fluids are used in acutely ill patients is now required. The selection, timing, and doses of intravenous fluids should be evaluated as carefully as they are in the case of any other intravenous drug, with the aim of maximizing efficacy and minimizing iatrogenic toxicity.

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American Diabetes Association Recommendations for the Screening of Asymptomatic Persons for Diabetes

The American Diabetes Association (ADA) and the Veterans Health Administration (VHA) recommend diabetes screening beginning at 45 years of age; the ADA advises earlier screening in patients with risk factors.

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Recommendations for the Use of Ambulatory Blood-Pressure Monitoring

In addition to the prediction of cardiovascular risk, ambulatory blood-pressure monitoring, when used in conjunction with clinic blood-pressure assessments, is of potential value in a variety of other clinical conditions. Some of these conditions are:

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The 2008 ACR Recommendations for Rheumatoid Arthritis Treatments

  • Initiating treatment with methotrexate or Arava (leflunomide) was recommended for most rheumatoid arthritis patients.
  • Methotrexate plus Plaquenil (hydroxychloroquine) was recommended for rheumatoid arthritis patients with moderate to high disease activity.

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