Based on the recommendations of the World Health Organization, which are rooted in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study, gestational diabetes mellitus (GDM) is characterized by fasting venous plasma glucose readings of 92 mg/dL or higher, or a 1-hour post-load reading of 180 mg/dL or more, or a 2-hour post-load reading of 153 mg/dL or more, according to the international standards. A mandatory requirement for metabolic control arises when a pathological value is observed. Given the risk of postprandial hypoglycemia, we do not recommend an oral glucose tolerance test (OGTT) following bariatric surgery. For women diagnosed with gestational diabetes (GDM), nutritional counseling, blood glucose self-monitoring, and promotion of moderate-intensity physical activity, where feasible, are recommended (Evidence Level A). Maintaining blood glucose within the therapeutic parameters (fasting glucose below 95 mg/dL and one hour after meals below 140 mg/dL, evidence level B) necessitates the initiation of insulin therapy as the preferred initial treatment (evidence level A). Maternal and fetal monitoring is indispensable for reducing maternal and fetal/neonatal morbidity and perinatal mortality risks. Ultrasound examinations, routinely integrated into regular obstetric examinations, are recommended (Evidence Level A). Neonatal care for GDM infants at risk for hypoglycemia involves assessing blood glucose levels after birth and implementing suitable interventions where required. The entire family should prioritize the monitoring of child development and the promotion of healthy habits. Following childbirth, all women diagnosed with gestational diabetes mellitus (GDM) require a reevaluation of their glucose tolerance using a 75g oral glucose tolerance test (OGTT) according to WHO criteria, performed 4 to 12 weeks after delivery. To maintain normal glucose tolerance, glucose parameter monitoring (fasting glucose, random glucose, HbA1c, or an optimal oral glucose tolerance test) is advised every two to three years. All women must receive instruction at follow-up regarding the heightened probability of type 2 diabetes and cardiovascular disease. Addressing preventive measures, notably lifestyle changes like weight control and a heightened physical activity level, is critical (evidence level A).
The prevalence of type 1 diabetes mellitus (T1D) far surpasses other types of diabetes in children and adolescents, comprising over 90% of cases, in contrast to the adult diabetic population. After diagnosis, children and adolescents with Type 1 Diabetes need the care of pediatric units specializing in pediatric diabetology for optimal management. The ongoing administration of insulin constitutes the bedrock of treatment, requiring individualized adjustments that consider the patient's age and the family's routine. This age group should consider the use of diabetes technologies, specifically glucose sensors, insulin pumps, and the recently developed hybrid closed-loop systems. The initial establishment of optimal metabolic control in therapy is indicative of an enhanced long-term outcome. In managing diabetes, it is essential to provide education to patients and their families, through a multidisciplinary approach led by a pediatric diabetologist, diabetes educator, dietitian, psychologist, and social worker. Concerning pediatric diabetes management, the Austrian Pediatric Endocrinology and Diabetes Working Group (APEDO) and ISPAD (International Society for Pediatric and Adolescent Diabetes) concur on an HbA1c metabolic goal of 70% (IFCC standard), excluding cases of severe hypoglycemia. Diabetes treatment's key objectives in all pediatric age groups include ensuring high quality of life by promoting age-related physical, cognitive, and psychosocial development, screening for accompanying diseases, preventing acute complications like severe hypoglycemia and diabetic ketoacidosis, and avoiding late-onset diabetes complications.
A person's body mass index (BMI) provides a rather rudimentary assessment of their body fat content. A normal weight does not preclude the possibility of excess body fat in cases of diminished muscle mass (sarcopenia). This highlights the importance of complementary measurements of waist circumference and body fat levels, such as. The recommended procedure for analysis often involves bioimpedance (BIA). To combat diabetes, crucial lifestyle measures include adjusting one's diet and increasing physical activity levels. The treatment protocols for type 2 diabetes are now more frequently incorporating body weight as a secondary, important measurement. Weight is a crucial factor with an increasing influence on the selection of anti-diabetic treatment plans and concurrent therapies. The application of modern GLP-1 agonists and dual GLP-1/GIP agonists is escalating, given their dual-targeting action on obesity and type 2 diabetes. see more Bariatric surgery is currently suggested for those with a BMI above 35 kg/m^2 and additional health issues like diabetes, and potentially achieves at least partial remission of diabetes. However, its use must be part of an encompassing long-term care regime.
A substantial increase in the probability of developing diabetes and its complications is observed in smokers and those exposed to secondhand smoke. In spite of the possibility of weight gain and an increased risk of diabetes, quitting smoking leads to a reduction in cardiovascular and total mortality rates. For successful smoking cessation, a fundamental diagnostic approach, encompassing the Fagerstrom Test and exhaled CO levels, is required. Varenicline, Nicotine Replacement Therapy, and Bupropion are among the supporting medications. Both socio-economic standing and psychological factors have a vital effect on smoking and cessation. The use of heated tobacco products, like e-cigarettes, does not represent a healthy alternative to smoking and carries an increased risk of illness and death. The possibility of selection bias and underreporting in studies may result in an overly optimistic conclusion. Conversely, alcohol's impact on morbidity and disability-adjusted life years escalates proportionally with intake, particularly through its contribution to cancer, liver ailments, and infectious diseases.
The prevention and treatment of type 2 diabetes benefit greatly from a healthy lifestyle, and in particular, regular physical activity. Furthermore, a lack of physical activity must be acknowledged as a threat to health, and extended periods of sedentary behavior should be mitigated. Training's positive impact correlates precisely with the amount of fitness acquired, and is effective solely as long as the achieved fitness level is kept up. Cross-training programs, regardless of age or sex, demonstrate efficacy. Reproducible and reversible procedures form the basis of the methodology. Furthermore, given the substantial evidence supporting exercise referral and prescription, the Austrian Diabetes Associations seeks to integrate a physical activity advisor into its multi-professional diabetes care model. A significant shortcoming is the absence of booth-local exercise classes and counselors.
For all diabetes patients, personalized nutritional guidance from trained professionals is indispensable. Dietary therapy should prioritize the patient's needs, considering their lifestyle and the specific type of diabetes. Disease progression can be reduced and long-term health problems avoided by ensuring the patient's diet is coupled with specific metabolic objectives. For this reason, practical advice regarding portion sizes and meal planning should form the core of diabetes management, per national and international standards. Consultations provide support in managing health conditions, including dietary selection to improve health status. These practical recommendations encapsulate the key findings of current literature on nutrition and diabetes treatment.
This guideline from the Austrian Diabetes Association (ODG) proposes, on the basis of current scientific evidence, recommendations for the use and accessibility of diabetes technology (insulin pumps, CGM, HCL systems, and diabetes apps) for people with diabetes mellitus.
Hyperglycemia plays a substantial role in the development of complications for individuals with diabetes mellitus. Though lifestyle interventions are key to disease prevention and treatment, most patients with type 2 diabetes will ultimately need medication for sustained glucose control. Optimal therapeutic efficacy, safety, and cardiovascular effects require the meticulous definition of individual targets. Within this guideline, the most recent evidence-based best clinical practice data is presented for healthcare professionals' reference.
Diabetes, a complex condition with diverse causes beyond the usual, includes alterations in glucose metabolism due to various endocrine disorders, like acromegaly or hypercortisolism, or diabetes induced by drugs (e.g.). Antipsychotic medications, glucocorticoids, immunosuppressive agents, highly active antiretroviral therapy (HAART), checkpoint inhibitors, and genetic forms of diabetes (e.g.), represent a variety of therapeutic modalities. Maturity-onset diabetes of the young (MODY), neonatal diabetes, conditions associated with Down syndrome, Klinefelter syndrome, and Turner syndrome, and pancreatogenic diabetes (including examples such as .) Postoperative complications, including diabetes in its rare autoimmune or infectious forms, can include diseases such as pancreatitis, pancreatic cancer, haemochromatosis, and cystic fibrosis. see more A precise diagnosis of specific diabetes types is vital in selecting the optimal treatment strategy. see more In addition to its association with pancreatogenic diabetes, exocrine pancreatic insufficiency is frequently encountered in cases of both type 1 and long-standing type 2 diabetes.
A constellation of diverse conditions, diabetes mellitus is characterized by elevated blood glucose levels.