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Easy Spirit Adriane 0U6Bx3oK
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Intensify lifestyle therapy and optimize glycemic control for patients with elevated triglyceride levels (≥150 mg/dL [1.7 mmol/L]) and/or low HDL cholesterol (<40 mg/dL [1.0 mmol/L] for men, <50 mg/dL [1.3 mmol/L] for women). C

Recommendations

In adults with diabetes, it is reasonable to obtain a lipid profile (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides) at the time of diagnosis, at the initial medical evaluation, and at least every 5 years thereafter in patients under the age of 40 years. In younger patients with longer duration of disease (such as those with youth-onset type 1 diabetes), more frequent lipid profiles may be reasonable. A lipid panel should also be obtained immediately before initiating statin therapy. Once a patient is taking a statin, LDL cholesterol levels should be assessed 4–12 weeks after initiation of statin therapy, after any change in dose, and on an individual basis (e.g., to monitor for medication adherence and efficacy). In cases where patients are adherent but the LDL cholesterol level is not responding, clinical judgment is recommended to determine the need for and timing of lipid panels. In individual patients, the highly variable LDL cholesterol–lowering response seen with statins is poorly understood ( 50 ). Clinicians should attempt to find a dose or alternative statin that is tolerable, if side effects occur. There is evidence for benefit from even extremely low, less than daily statin doses ( ECCO Shape Tie Up Ballerina gJc2EhO0Ei
).

In adults not taking statins or other lipid-lowering therapy, it is reasonable to obtain a lipid profile at the time of diabetes diagnosis, at an initial medical evaluation, and every 5 years thereafter if under the age of 40 years, or more frequently if indicated. E

Obtain a lipid profile at initiation of statins or other lipid-lowering therapy, 4–12 weeks after initiation or a change in dose, and annually thereafter as it may help to monitor the response to therapy and inform adherence. E

Recommendations

For patients of all ages with diabetes and atherosclerotic cardiovascular disease, high-intensity statin therapy should be added to lifestyle therapy. A

For patients with diabetes aged <40 years with additional atherosclerotic cardiovascular disease risk factors, the patient and provider should consider using moderate-intensity statin in addition to lifestyle therapy. C

For patients with diabetes aged 40–75 years A and >75 years B without atherosclerotic cardiovascular disease, use moderate-intensity statin in addition to lifestyle therapy.

In clinical practice, providers may need to adjust the intensity of statin therapy based on individual patient response to medication (e.g., side effects, tolerability, LDL cholesterol levels, or percent LDL reduction on statin therapy). For patients who do not tolerate the intended intensity of statin, the maximally tolerated statin dose should be used. E

In VS Code, we default the language support for a file based on its filename extension. However, at times you may wish to change language modes, to do this click on the language indicator - which is located on the right hand of the Status Bar. This will bring up the Select Language Mode drop-down where you can select another language for the current file.

Select Language Mode

Tip : You can get the same drop-down by running the Change Language Mode command ( Ctrl+K M ).

Change Language Mode

VS Code associates a language mode with a specific language identifier so that various VS Code features can be enabled based on the current language mode.

A language identifier is often (but not always) the lowercased programming language name. Note that casing matters for exact identifier matching ('Markdown' != 'markdown'). Unknown language files have the language identifier plaintext .

You can see the list of currently installed languages and their identifiers in the Change Language Mode ( Ctrl+K M ) drop-down.

You can find a list of known identifiers in the language identifier reference .

You can add new file extensions to an existing language with the files.associations Shellys LondonHankie 4u22QK
.

For example, the setting below adds the .myphp file extension to the php language identifier:

IntelliSense ( Ctrl+Space ) will show you the available language identifiers.

Now you know that VS Code has support for the languages you care about. Read on...

Q: Can I contribute my own language service?

A: Yes you can! Check out the example language server in the VS Code Extension Authoring documentation.

Q: What if I don't want to create a full language service, can I reuse existing TextMate bundles?

A: Yes, you can also add support for your favorite language through TextMate colorizers. See Themes, Snippets, and Colorizers topic in the Extension Authoring section to learn how to integrate TextMate .tmLanguage syntax files into VS Code.

Q: Can I map additional file extensions to a language?

A: Yes, with the files.associations Jessica Simpson Cloe q52G8sf8Q
you can map file extensions to an existing language either globally or per workspace.

Here is an example that will associate more file extensions to the PHP language:

You can also configure full file paths to languages if needed. The following example associates all files in a folder somefolder to PHP:

If your child is overweight, he or she may need to lose weight (or stay at the same weight and not gain more). This depends on his or her age, development, and other risk factors.

Physical activity is extremely important. It helps the body use insulin correctly and helps control weight. Your child does not have to start a rigorous exercise program, but being more active can help control blood sugar. For example, your child could play outside with friends, take brisk walks with family members, and take part in individual or team sports.

Experts recommend that teens and children (starting at age 6) do moderate to vigorous activity at least 1 hour every day. footnote 1 And 3 or more days a week, what they choose to do should:

It's okay for them to be active in smaller blocks of time that add up to 1 hour or more each day.

Limit your child's screen time. Have your child take breaks from computer, cell phone, and TV use and be active instead.

Your child may need medicines if eating healthy meals and getting regular physical activity have not lowered your child's blood sugar to his or her target level.

Your child's blood sugar level may need to be checked regularly, for example, before breakfast and 2 hours after meals.

If your child has high blood pressure or high cholesterol, those conditions need to be treated.

Some children have very high blood sugar levels when they are diagnosed with type 2 diabetes. A child with a very high blood sugar level may develop the serious chemical imbalance Eric Michael Juniper lw1beTX4xq
and need to be treated with insulin in a hospital. After blood sugar returns to a target level, the child usually no longer needs insulin. His or her own body may start making enough insulin again.

Treating diabetes with medicine increases the risk for Clarks Gelata Italia c0iiR
episodes. Your child's doctor will determine the target range for your child's blood sugar that will prevent damage from diabetes while causing as few low blood sugar episodes as possible.

The lifestyle changes needed to control diabetes can be especially hard for a child or teen. Your child will have a better chance of being successful if the whole family is involved. Eating a healthy diet and getting regular exercise may help other family members avoid diabetes.

Teens who have depression or an eating disorder may have difficulty keeping their blood sugar at a healthy level. Also, teens who smoke or use alcohol or other drugs have problems with blood sugar control. Support groups may help teens deal with diabetes management issues, which can improve the teens' perception of diabetes care and blood sugar control.

Healthy meals, physical activity, and weight control can help prevent diabetes or can prevent or delay complications if your child has diabetes. A registered dietitian can help you build a healthy meal plan for your child. Your doctor, exercise specialist, or certified diabetes educator also can help your child find ways to become more physically active.

Call a doctor if your child:

Check with your doctor if your child:

Watchful waiting is a period of time during which you and your doctor observe your child's symptoms or condition without using medical treatment. Watchful waiting is not appropriate if:

Most doctors can diagnose diabetes. After your child has been diagnosed, your doctor will work with you to build a treatment plan that fits your child's needs. Health professionals who may be involved in the treatment of children with type 2 diabetes include:

Exams and Tests

Many children have no symptoms before they are diagnosed with type 2 diabetes.

If a doctor suspects that your child may have type 2 diabetes, he or she will do a medical history, physical exam, and blood glucose testing. If the results of these tests meet the criteria for diagnosing diabetes established by the American Diabetes Association (ADA), your child has diabetes.

Other possible tests

If it is hard to tell whether your child has type 2 or type 1 diabetes, your doctor may do a C-peptide test or test for autoantibodies. (Autoantibodies are produced when the body's Donald J Pliner Srrr iQfIK1xtmJ
does not work right.) For example, many people with type 1 diabetes produce the autoantibody zinc transporter 8 (ZnT8Ab). People with type 2 diabetes do not produce ZnT8Ab. These tests may not be able to confirm the type of diabetes your child has. Getting a definite diagnosis may take months or years. In either case, your child's sugar levels will need to be controlled right away.

Monitoring tests if diagnosed with diabetes

Because your child is at risk for diabetes complications (eye, heart, kidney, nerve, liver, and blood vessel problems), he or she needs to see a doctor regularly for tests to monitor type 2 diabetes .

Early detection

If your child is overweight and gets little or no exercise, he or she may be at risk for type 2 diabetes . Early detection and treatment for type 2 diabetes can prevent or delay problems from the disease.

Treatment of type 2 diabetes in children focuses on keeping blood sugar levels within a Bearpaw Penelope DcSxoMT
. Children may need higher blood sugar goals than adults, because their bodies are still developing. Also, they may not be able to recognize symptoms of low blood sugar . To reach his or her target blood sugar, your child needs to eat healthy meals of appropriate portion size and get daily exercise. Treatment also may include medicine.

A healthy diet with the right amount of calories will help your child achieve target blood sugar levels and maintain a healthy weight. The meal plan designed for your child will spread carbohydrates (starches and sugary foods) throughout the day. This helps prevent high blood sugar after meals as well as weight gain . A registered dietitian can design a meal plan that not only fits your child's needs but also is a healthy eating plan for your family. For more information, see the topic Healthy Eating for Children .

  • Journal of Oncology Practice is published by American Society of Clinical Oncology and produced in conjunction with Harborside.