Practical Diabetes最新文献

{"title":"Anxiety and depression among patients attending a multidisciplinary foot clinic","authors":"Abdullah Almaqhawi, A. Morrison, R. Berrington, M. Kong","doi":"10.1002/pdi.2444","DOIUrl":"https://doi.org/10.1002/pdi.2444","url":null,"abstract":"Aim: Diabetic foot ulcers (DFUs) are linked to morbidity, decreased mobility, and feelings of isolation, powerlessness and sadness. The aim of our study was to explore the prevalence of anxiety and depression symptoms in adult patients with DFU.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"5 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89236253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atorvastatin","authors":"Calum Richardson, Gerry McKay, Andrea Llano","doi":"10.1002/pdi.2450","DOIUrl":"https://doi.org/10.1002/pdi.2450","url":null,"abstract":"High cholesterol, in particular increased low-density lipoprotein (LDL), is a significant, modifiable risk factor in the development of cardiovascular disease (CVD). In people with diabetes, the risk of CVD is greatly increased and is the leading cause of morbidity and mortality. People with diabetes typically have a triad of elevated fasting and postprandial triglycerides, elevated LDL cholesterol and a relative reduction in high-density lipoprotein (HDL) cholesterol. While exercise, diet and tighter glycaemic control can contribute to improvements in the lipid profile, statins offer the biggest risk reduction with respect to CVD; every 1mmol/L reduction in LDL-C with statin therapy is associated with a 22% reduction in cardiovascular events.1 Statins may also have additional cardiovascular protective effects via their action on platelets, endothelium and atherosclerotic plaques. Statins therefore have an important role in the primary and secondary prevention of CVD. The pharmacology of atorvastatin is shown in Figure 1. HMG-CoA reductase catalyses the reduction of 3-hydroxy-3-methylglutaryl-coenzyme A to mevalonate, the rate limiting step of the hepatic pathway of cholesterol synthesis. Shorter-acting statins such as simvastatin should be taken at night as most cholesterol synthesis takes place when dietary intake is lowest. Atorvastatin has a longer half-life and can be taken at any time. Atorvastatin has oral bioavailability of 14% after first pass metabolism and is highly plasma protein bound. It is metabolised by the CYP450 system (CYP3A4) and eliminated in bile. CYP3A4 inhibitors such as clarithromycin, ciclosporin and ketoconazole can significantly increase plasma concentrations of atorvastatin and co-administration should be avoided or the dose of atorvastatin reduced. Atorvastatin has been studied in people with and without diabetes. It is well tolerated, efficacious and has minimal adverse events. A Cochrane review of 296 trials in 38,817 participants found that treatment with 10–80mg of atorvastatin was associated with a reduction in LDL-C of 37.1–51.7%.2 The Anglo-Scandinavian Cardiac Outcomes Trial – Lipid Lowering Arm (ASCOT-LLA) examined the effect on atorvastatin on the primary prevention of CVD. In all, 10,305 patients with hypertension and at least three cardiovascular risk factors were randomised to 10mg atorvastatin or placebo. The primary outcome was the combined endpoint of non-fatal myocardial infarction (MI) and fatal coronary heart disease (CHD). The trial was terminated early because of the reduction in coronary events and stroke. Treatment with atorvastatin was associated with a relative risk reduction in the primary endpoint of 36% compared with placebo (HR 0.64, 95% CI 0.5–0.83, p=000.5) and a 27% risk reduction in stroke (HR 0.73, 95% CI 0.56–00.96, p=0.0236).3 The efficacy of atorvastatin in the secondary prevention of CVD was demonstrated in the Treating to New Targets (TNT) trial. In this large-scale randomised t","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135288592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual infections and diabetes: necrotising fasciitis","authors":"R. Hillson","doi":"10.1002/pdi.2441","DOIUrl":"https://doi.org/10.1002/pdi.2441","url":null,"abstract":"","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"67 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76700731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latest audit shows the Diabetes Prevention Programme is pressing ahead in tackling non‐diabetic hyperglycaemia and type 2 risk","authors":"S. Chaplin","doi":"10.1002/pdi.2443","DOIUrl":"https://doi.org/10.1002/pdi.2443","url":null,"abstract":"Findings from the latest National Diabetes Audit of the NHS Diabetes Prevention Programme (DPP) may point the way forward in reducing the incidence of type 2 diabetes.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"88 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77249808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged diabetic ketoacidosis due to SGLT2 inhibitor use and low‐carbohydrate diet","authors":"S. M. Mung, Ines Fonseca, S. Azmi, L. Balmuri","doi":"10.1002/pdi.2446","DOIUrl":"https://doi.org/10.1002/pdi.2446","url":null,"abstract":"A 59‐year‐old gentleman was admitted with diabetic ketoacidosis (DKA). His medication history included a sodium‐glucose co‐transporter 2 (SGLT2) inhibitor for the past six years. Relevant history includes undertaking a low‐carbohydrate diet for four months.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"2 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72513435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teplizumab – preventative approaches to type 1 diabetes mellitus","authors":"J. Seewoodhary, Ângela Silveira","doi":"10.1002/pdi.2448","DOIUrl":"https://doi.org/10.1002/pdi.2448","url":null,"abstract":"Immunotherapies offer the potential to reprogramme the immune system to halt autoimmune destruction of insulin‐producing β‐cells within the pancreas, dealing with the root cause of type 1 diabetes (T1DM) for the first time. Leading on from this, teplizumab, the first drug in this class, has been found to delay the onset of T1DM by an average of three years in people stratified high risk for developing T1DM. This review will critically consider the evidence basis underlying the utility of teplizumab in the management of T1DM. Copyright © 2023 John Wiley & Sons.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"1 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76723501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes: my life and nursing – from glass syringes to hybrid closed loops","authors":"J. Charlton","doi":"10.1002/pdi.2438","DOIUrl":"https://doi.org/10.1002/pdi.2438","url":null,"abstract":"","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"245 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77240813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case series of diabetic ketoacidosis associated with SGLT2 inhibitors","authors":"S. Zac-Varghese, S. Mathew, Daniel Go, P. Winocour","doi":"10.1002/pdi.2455","DOIUrl":"https://doi.org/10.1002/pdi.2455","url":null,"abstract":"Sodium‐glucose cotransporter 2 inhibitors (SGLT2i) are increasingly initiated as treatment for type 2 diabetes due to favourable cardiorenal characteristics. However, studies have identified an increased risk of diabetic ketoacidosis (DKA).","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"1 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81325017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic consequences of gender‐affirming hormone therapy in transgender adult persons","authors":"Nadia Vloemans, M. Al-Mrayat","doi":"10.1002/pdi.2453","DOIUrl":"https://doi.org/10.1002/pdi.2453","url":null,"abstract":"As more individuals seek to align their physical characteristics with their gender identity, transgender health care is a growing medical field which is no longer the remit of a few selected clinicians. Gender‐affirming hormone therapy (GAHT) is a mainstay treatment in gender reassignment and its medium‐ to long‐term metabolic sequelae are gradually emerging. Although hampered by the scarcity of prospective controlled studies involving large diverse cohorts, evidence suggests a potential adverse impact for at least some cardiovascular disease (CVD) risk factors. If left unmanaged, this could manifest in a higher CVD events rate for this treatment group. Increased vigilance and awareness among health care professionals about the consequential risks of GAHT are important for proactive mitigation of this. Copyright © 2023 John Wiley & Sons.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"32 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85498735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin administration delegation in care homes and care settings","authors":"S. Cradock, L. Houghton, S. Gregory, Jane Rowney","doi":"10.1002/pdi.2439","DOIUrl":"https://doi.org/10.1002/pdi.2439","url":null,"abstract":"","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"46 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87529752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}