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22. Sabatine MS, Giugliano RP, Keech AC, et al.; FOURIER Steering Committee and Investigators. Evolocumab and clinical outcomes in patients with cardiovascular disease. . 2017;376(18):1713–1722.

23. James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8) [published correction appears in JAMA . 2014;311(17):1809]. . 2014;311(5):507–520.

24. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults [published online ahead of print November 7, 2017]. J Am Coll Cardiol . [subscription required]. Accessed February 20, 2018.

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27. Bangalore S, Bhatt DL, Steg PG, et al. β-blockers and cardiovascular events in patients with and without myocardial infarction: post hoc analysis from the CHARISMA trial. . 2014;7(6): 872–881.

28. Poole-Wilson PA, Swedberg K, Cleland JG, et al. Comparison of carvedilol and metoprolol on clinical outcomes in patients with chronic heart failure in the Carvedilol Or Metoprolol European Trial (COMET): randomised controlled trial. . 2003;362(9377):7–13.

29. Belsey J, Savelieva I, Mugelli A, Camm AJ. Relative efficacy of antianginal drugs used as add-on therapy in patients with stable angina: a systematic review and meta-analysis. . 2015;22(7):837–848.

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33. Bangalore S, Parkar S, Messerli FH. Long-acting calcium antagonists in patients with coronary artery disease: a meta-analysis. . 2009;122(4):356–365.

34. Chaitman BR, Pepine CJ, Parker JO, et al.; Combination Assessment of Ranolazine In Stable Angina (CARISA) Investigators. Effects of ranolazine with atenolol, amlodipine, or diltiazem on exercise tolerance and angina frequency in patients with severe chronic angina: a randomized controlled trial. . 2004;291(3):309–316.

35. Khera S, Kolte D, Aronow WS. Use of ranolazine in patients with stable angina pectoris. . 2014;128(3):251–258.

36. Stone PH, Gratsiansky NA, Blokhin A, Huang IZ, Meng L; ERICA Investigators. Antianginal efficacy of ranolazine when added to treatment with amlodipine: the ERICA (Efficacy of Ranolazine in Chronic Angina) trial. . 2006;48(3):566–575.

37. Gerstein HC, Miller ME, Byington RP, et al.; Action to Control Cardiovascular Risk in Diabetes Study Group. Effects of intensive glucose lowering in type 2 diabetes. . 2008;358(24):2545–2559.

38. ACCORD Study Group. Nine-year effects of 3.7 years of intensive glycemic control on cardiovascular outcomes. . 2016;39(5):701–708.

39. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33) [published correction appears in Lancet . 1999;354(9178): 602]. . 1998;352(9131):837–853.

40. Gerstein HC, Miller ME, Byington RP, et al.; Action to Control Cardiovascular Risk in Diabetes Study Group. Effects of intensive glucose lowering in type 2 diabetes. . 2008;358(24):2545–2559.

41. Patel A, MacMahon S, Chalmers J, et al.; ADVANCE Collaborative Group. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. . 2008;358(24):2560–2572.

42. Turnbull FM, Abraira C, Anderson RJ, et al.; Control Group. Intensive glucose control and macrovascular outcomes in type 2 diabetes [published correction appears in Diabetologia . 2009;52(1):2470]. . 2009;52(11):2288–2298.

43. Hong J, Zhang Y, Lai S, et al.; SPREAD-DIMCAD Investigators. Effects of metformin versus glipizide on cardiovascular outcomes in patients with type 2 diabetes and coronary artery disease. . 2013;36(5):1304–1311.

44. Marso SP, Daniels GH, Brown-Frandsen K, et al.; LEADER Steering Committee; LEADER Trial Investigators. Liraglutide and cardiovascular outcomes in type 2 diabetes. . 2016;375(4):311–322.

45. Marso SP, Bain SC, Consoli A, et al.; SUSTAIN-6 Investigators. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. . 2016;375(19):1834–1844.

46. Zinman B, Wanner C, Lachin JM, et al.; EMPA-REG OUTCOME Investigators. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. . 2015;373(22):2117–2128.

47. Antithrombotic Trialists' Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients [published correction appears in BMJ . 2002;324(7330):141]. . 2002;324(7329):71–86.

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49. Levine GN, Bates ER, Bittl JA, et al. 2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. . 2016;68(10):1082–1115.

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Young children can't tell if they have low blood sugar as well as adults can. Also, after your child has had diabetes for a long time, he or she may not notice low blood sugar symptoms anymore. This raises the chance that your child could have low blood sugar emergencies. If you are worried about your child's blood sugar, do a Gianvito Rossi Crossover Slide Sandals outlet affordable yN211Br
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Both low and high blood sugar can cause problems and need to be treated. Your doctor will suggest how often your child's blood sugar should be checked.

See your child's doctor at least every 3 to 6 months to check how well the treatment is working. During these visits, the doctor will do some tests to see if your child's blood sugar is under control. Based on these results, the doctor may change your child's treatment plan.

When your child is 10 years old or starts puberty, he or she will start having exams and tests to look for any problems from diabetes.

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Health Tools help you make wise health decisions or take action to improve your health.


Type 1 diabetes develops because the body's immune system destroys beta cells in a part of the pancreas called the islet tissue. Beta cells produce insulin. So children with type 1 diabetes can't make their own insulin. Experts do not know what causes this to happen. But the cause may involve family history and maybe environmental factors like diet or infections.

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Causes of high blood sugar

Causes of low blood sugar


Because your child has type 1 diabetes, he or she will experience high and low blood sugar levels from time to time. High blood sugar usually develops slowly over hours or days, so you can treat the symptoms before they become severe and require medical attention. On the other hand, your child's blood sugar level can drop to dangerously low levels in minutes.

Be alert for:

How can you tell the difference?

Sometimes it's hard to distinguish between high and low blood sugar symptoms , especially if your child is very young. Test your child's blood sugar whenever you think it may be high or low so that you can treat it appropriately. If your child has symptoms of very high blood sugar, such as a fruity breath odor, vomiting, and/or belly pain, seek emergency care. These symptoms may point to free shipping cheap Prada Patent Leather Embellished Loafers free shipping eastbay NjVMXQTz
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Every child experiences type 1 diabetes differently.

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Low blood sugar

Very low blood sugar is a frightening experience for you and your child. But if low blood sugar levels are treated quickly and appropriately, your child should have no lasting effects.

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Make sure your child's caregivers, such as school nurses, know:

Let your doctor know if your child is having frequent episodes of low blood sugar. You can use this form (What is a PDF document?) to keep a record of your child's very high or very low blood sugar levels.

High blood sugar

Very high blood sugar puts your child at risk for diabetic ketoacidosis , a life-threatening emergency. Skipping insulin injections, stress, illness, injury, and puberty can trigger high blood sugar. Because blood sugar levels usually rise slowly, you can treat symptoms early and, most often, prevent diabetic ketoacidosis.

High blood sugar can also lead to:

What can be done?

The best way to help your child with type 1 diabetes live a long and healthy life is to keep his or her blood sugar levels within a target range. Work with your child's doctor, and monitor blood sugar levels frequently.

What Increases Your Risk

Risk factors for very high or low blood sugar levels in a child with type 1 diabetes include:

Call 911 or other emergency services right away if your child:

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