RESOURCES

We offer below a list of links and documents that we believe can be of interest for some patients. If you know something else and want to be add, please send us by email

HELPING DOCUMENTS


Educative materials and links to online resources are provide as general information about diabetes and other endocrine diseases. Our goal is to provide additional informative documents without never try to replace your personal discussion of your doubts with your doctor



FIRST
VISIT REPORT


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TRAVEL LETTER


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FOOD
COMPOSITION TABLE


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FREQUENTLY ASKED QUESTIONS (FAQ’s)


  • What are the normal glucose readings?
  • What is Pre-diabetes?
  • When is it consider a person has diabetes?
  • Does any kind of insulin exist that does not need an injection to be administer?
  • How long is the duration of a slow acting insulin? Why do some diabetics only inject once and some 2 or more times per day?
  • What vaccines are recommend for diabetics?
  • What is the Unit’s Converter?
  • Preventive Check-ups
What are the normal glucose readings?

It depends if you check glucose levels when fasting or after a meal. Fasting is between 70 and 100 mg/dl and after a meal or an oral glucose load test between 70 and 140 mg/dl.

If you consider de A1c test the normal range is between 4.5 and 5.6 % (25.7 and 37.7 mmol/mol).

What is Pre-diabetes?

Again, It depends if you check fasting or after a meal. Fasting is between 100 and 126 mg/dl and after a meal or an oral glucose load test between 140 and 200 mg/dl.

If you consider de A1c test the pre-diabetes range is between 5.7 and 6.4 % (38.8 and 46.4 mmol/mol)

When is it consider a person has diabetes?

When you have a reading over 126 fasting or over 200 after a meal or any moment during an oral glucose load test.

If you consider de A1c test the diabetes range is 6.5 % or higher (47.5 mmol/mol or higher)

Does any kind of insulin exist that does not need an injection to be administer?

Yes, in the US is commercially available a rapid acting insulin (Afrezza R ) to administer via inhalation. It is recommend for type 2 diabetes as a prandial insulin, before each meal.

How long is the duration of a slow acting insulin? Why do some diabetics only inject once and some 2 or more times per day?

The duration of each insulin dose (slow or fast) will depend among other factors of insulin type, injection site and dose. Moreover, especially slow insulin, have a variability coefficient that consists in a different effect for potency and duration in the same person with the same dose injected in the same site at the same time.

What vaccines are recommend for diabetics?

Diabetics per se do not require a different vaccination calendar to non-diabetics with the same age. Hepatitis B vaccine has been recommend after several outbreaks of B hepatitis in the institutionalized elderly after sharing injection devices. Recommended Vaccination Calendar for people living in Spain (Children and adults) is available on the web page of the Vaccination Spanish Association. On this web site, you can find advice for vaccines when traveling abroad.

What is the Unit’s Converter?

In UK and some former colonies (US, Myanmar, Liberia) the Imperial Metric System (pound, gallon, inch, feet, yard, mile, etc.) is used. In the rest of the World the Decimal Metric System (kilogram, meter, litre) is used.

In Diabetes control in the UK, the units are millimols per litre (mmol/L) when checking glucose levels in blood. In the rest of the World the units are milligrams per decilitre (mg/dl). The unit conversion is easy because 1 mmol/L is equal to 18 mg/dl but for making the conversion easier in both senses we made an Excel sheet.

Glicated or Glicosilated Hemoglobin or A1c is a marker of diabetes control in the last 2-3 months and their numbers correspond to an Estimated Average Glucose (EAG) in that period. The units are a percentage (%) and recently an absolute value in mmols/mol, usually laboratories give the A1c results in both units (% and mmols/mol).

In the same Excel sheet are included the equivalent value of glucose in mmols/L and mg/dl, and their correspondent A1c in % and mmol/mol so with an A1c reading we can know the estimated average glucose in the last few months in both units.

Archivo descargable: Units Converter Glucose-A1c

Preventive Check-ups

A preventive check-up is a medical exam in order to diagnose a disease in an early stage, usually which still has no symptoms and, normally, is easier to treat.

Following a healthy lifestyle is the best way to keep healthy, live longer and with a better quality of life but this is not a garantee that we will never have a serious illness. It’s important to get vaccines, and perform check-ups and preventive exams following our family doctor’s recommendations attending our risk factors.

Nowadays there exists a big debate between specialists on preventive medicine and public health about it’s worth to perform preventive health exams on an apparently healthy and asymptomatic population. Also it’s on debate at what age, with what frequency and over what risk level should be done preventive exams to get a positive balance between the number of false positive and false negative results and the benefit of an early diagnosis.

Although from an epidemiologic point of view the population of Spain or Britain are not equivalent to the US population, I believe that the more reliable recommendations are from the US Health Department Preventive Task Force accessible in this link. Clicking on the label “Information for Health Professionals” we can find Guide to Clinical Preventive Services, 2014 and what is very useful, a formula to assess your risk of several medical conditions, the ePSS Electronic Preventive Services Selector. The last one is available in several formats: Apps, Windows, IPhone, Web, Android … and introducing our age, sex, smoking habits and sexual activity returns a personalized recommendation about what exams are recommended and NOT recommended documenting each indication or contraindication with the available scientific evidence applicable in each case.


INTERESTING LINKS


All the educational material and links to on-line resources are provided as general information about diabetes and other related diseases. Our idea is to give you additional information sources that never will replace the discussion of your doubts and worries with your doctor.


Dr. Gómez Trujillo Diabetes Center

Desde hace 20 años, la consulta del Dr. Francisco M. Gómez Trujillo, en Fuengirola (Málaga), da un servicio de calidad y un trato individualizado a cada paciente, ya que las necesidades de cada persona son únicas y diferentes.

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