Classification and Diagnosis of Diabetes.

The incidence and prevalence of diabetes are increasing significantly globally and within the United States. Many individuals with diabetes are undiagnosed. The underlying causes of diabetes vary widely and are different in type 1 diabetes, type 2 diabetes, atypical diabetes, and gestational diabetes. It is important for clinicians to recognize the signs and symptoms of diabetes and use the proper diagnostic tools to diagnose diabetes.

Pharmacology-Insulin.

Insulin is an important treatment in diabetes, and understanding insulin pharmacokinetics is vital to clinical practice. The primary care physician should be knowledgeable about the decision for use, initiation of treatment and titration as well as common pitfalls such as hypoglycemia and cost.

Time-Restricted Feeding and Potential for Type 2 Diabetes Mellitus: A Narrative Review.

Intermittent fasting (IF) is an increasingly popular strategy for weight loss and improved metabolic health. IF regimes involve deliberate implementation of fasting windows ranging from 12 to 72 hours. During these fasting windows, individuals reduce their caloric intake by 75% to 100%. Such strategies show promise and are increasingly socially popular, but many effects are not completely understood. Specifically, the effects of time-restricted feeding (TRF), a specific form of IF in which participants undergo daily fasting periods lasting about 16 hours, is among the most popular yet under-studied regimens. This review finds that TRF may produce mild weight loss and improved function of insulin. TRF also likely produces cardiovascular effects, such as decreased blood pressure and fasting blood triglycerides. TRF, like other forms of IF, may encourage fat loss specifically when combined with exercise. The manuscripts identified in this narrative literature review were analyzed for the potential benefit for patients with type 2 diabetes mellitus, and limitations of summarized content were noted. While these studies support some suspected benefits of TRF, they also legitimize the need for future TRF studies, since conclusions are greatly limited by a paucity of evidence.

Vitamin D Deficiency, Its Role in Health and Disease, and Current Supplementation Recommendations.

Vitamin D deficiency has been identified as a common metabolic/endocrine abnormality. Despite known dietary sources of vitamin D and the role of sunlight in its production, much of the US population may have inadequate levels of serum 25-hydroxyvitamin D. Deficiency of vitamin D can be caused by a variety of health conditions, but studies on the effects of vitamin D supplements have had mixed results. This evidence-based clinical review discusses what is currently known about vitamin D and what areas need further research to clarify its role in health and disease.