Practical diabetes international : the journal for diabetes care teams worldwide最新文献

{"title":"Does diabetes put you at risk of tetanus","authors":"H. Soulsby, D. Russell-Jones","doi":"10.1002/PDI.1530","DOIUrl":"https://doi.org/10.1002/PDI.1530","url":null,"abstract":"This 81-year-old man with a history of type 2 diabetes presented with a cramping right arm, trismus, stiffness in the jaw, swallowing and breathing difficulties. He developed respiratory failure shortly after admission so was intubated on the intensive therapy unit where he received tetanus immunoglobulin and a course of metronidazole. Kilic et al. compared the level of tetanus antitoxin between patients with type 2 diabetes and healthy controls. They found a statistically significant difference between the groups, with people with diabetes having lower antitoxin levels. A further study shows that serum levels of tetanus antibody significantly decrease in diabetic patients older than 50 years of age. Among patients with diabetes only 55.9% had protective levels of antitoxin when aged 50-64 compared to 73.8% of controls. Copyright © 2010 John Wiley & Sons. Copyright © 2010 John Wiley & Sons, Ltd.","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"14 4","pages":"381-382"},"PeriodicalIF":0.0,"publicationDate":"2010-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1530","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024712","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":"Catamenial hyperglycaemia: an important cause of recurrent diabetic ketoacidosis","authors":"D. Sennik, J. Clark, K. Foster, S. Zachariah","doi":"10.1002/PDI.1531","DOIUrl":"https://doi.org/10.1002/PDI.1531","url":null,"abstract":"We report the case of a female patient with type 1 diabetes mellitus with recurrent episodes of diabetic ketoacidosis (DKA ) despite previously good control and treatment with continuous subcutaneous insulin infusion (CSII ). It was noted that her episodes of uncontrolled hyperglycaemia with DKA were occurring monthly and before her menstrual periods. This effect required an increase in her basal insulin infusion rate by as much as four-fold. The phenomenon of DKA associated with the menstrual cycle has been recognised previously and is termed ‘catamenial’ DKA. We discuss the prevalence, possible causes and clinical management of catamenial DKA. Copyright © 2010 John Wiley & Sons.","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"2 4","pages":"385-386"},"PeriodicalIF":0.0,"publicationDate":"2010-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1531","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024726","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":"The Association of British Clinical Diabetologists: recommendations following suspension of rosiglitazone (Avandia)","authors":"N. Goenka, A. Roberts, S. Rowles, B. Ryder, P. Winocour","doi":"10.1002/PDI.1525","DOIUrl":"https://doi.org/10.1002/PDI.1525","url":null,"abstract":"For all new prescriptions of thiazolidinediones, pioglitazone must be used \u0000 \u0000 \u0000 \u0000 \u0000Patients already taking rosiglitazone should have a medication review in order to consider alternative therapy \u0000 \u0000 \u0000 \u0000 \u0000Replacement therapy should be tailored according to the clinical needs of the individual patient and should be in line with existing NICE guidance when possible. \u0000 \u0000 \u0000 \u0000 \u0000Those patients whose glycaemic control requires consideration of alternatives to sulphonylureas and metformin should have an assessment of cardiovascular risk status, heart failure, osteoporosis fracture risk, weight, hepatic and renal function, hypoglycaemia and pancreatitis risk \u0000 \u0000 \u0000 \u0000 \u0000Patients already taking rosiglitazone who do not wish to change to alternative therapy should be advised that it is not possible to continue rosiglitazone as this therapy has been suspended and will be withdrawn \u0000 \u0000 \u0000 \u0000 \u0000Prior evidence of heart failure or impairment of left ventricular function remains a strict contraindication for the use of any thiazolidinediones. Osteoporosis and previous fracture may also be considered a contraindication to a thiazolidinedione","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1525","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024071","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":"How not to die from diabetes in a mountain hut","authors":"M. Lean","doi":"10.1002/PDI.1533","DOIUrl":"https://doi.org/10.1002/PDI.1533","url":null,"abstract":"","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"1 1","pages":"400-400"},"PeriodicalIF":0.0,"publicationDate":"2010-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1533","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024771","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":"Statins should be routinely prescribed in all adults with diabetes","authors":"R. Drummond, M. Lyall, J. McKnight","doi":"10.1002/PDI.1534","DOIUrl":"https://doi.org/10.1002/PDI.1534","url":null,"abstract":"","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"14 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1534","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024839","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":"Handbook of Diabetes. By Rudy Bilous and Richard Donnelly. 4th Edition Published by Wiley‐Blackwell 2010 Price: 248 pages ISBN: 978 1 4051 8409 0","authors":"A. Begg","doi":"10.1002/PDI.1520","DOIUrl":"https://doi.org/10.1002/PDI.1520","url":null,"abstract":"","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"18 1","pages":"343-343"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1520","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024381","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":"The Association of British Clinical Diabetologists (ABCD) nationwide exenatide audit","authors":"R. Ryder, K. Thong, M. Cull, AP Mills, C. Walton, P. Winocour","doi":"10.1002/PDI.1522","DOIUrl":"https://doi.org/10.1002/PDI.1522","url":null,"abstract":"In December 2008, to accelerate understanding of a new agent, the Association of British Clinical Diabetologists (ABCD) launched a nationwide audit on the use of exenatide in clinical practice. A password-protected online questionnaire for collection of anonymised patient data was established and diabetes specialists in the UK were given persistent encouragement to submit data on their exenatide-treated patients. Baseline and latest HbA1c, weight, body mass index (BMI), waist circumference, blood pressure and lipids were compared and adverse events related to exenatide were quantified. A total of 315 contributors from 126 centres submitted data on 6717 patients (54.9% male) – mean baseline age was 54.9 years, HbA1c 9.47% (80mmol/mol), weight 113.8kg, BMI 39.8kg/m2. Of these, 4551 and 4385 had dated baseline and latest HbA1c and weight respectively. Mean (±SE) HbA1c fell by 0.73±0.03% (p<0.001) and weight by 5.9±0.1kg (p<0.001) at a median (range) of 26.1(6.6–164.1) and 26.0(6.6–159.0) weeks respectively. The following parameters also showed significant falls (p<0.001): BMI 2.2±0.1kg/m2, waist circumference 5.1±0.3cm, systolic blood pressure 3.6±0.6mmHg, total cholesterol 0.16±0.03mmol/L and HDL cholesterol 0.03±0.01mmol/L. Triglycerides decreased by 0.14±0.06mmol/L (p=0.009). The change in diastolic blood pressure was not statistically significant. In all, 23.7% of patients reported gastrointestinal side effects with 7.2% having to stop exenatide permanently. Hypoglycaemia rates were 3.3% before and 5.6% after exenatide use (p<0.001). After scrutiny, one case of pancreatitis and four cases of renal failure occurring in patients on exenatide had no obvious alternate cause. All other reported side effects had <1% incidence. The rate of exenatide discontinuation was 19.9% throughout the span of the audit, most commonly due to gastrointestinal side effects (36.1%) and lack of glycaemic or weight benefit (33.8%). This large scale audit confirmed the effectiveness of exenatide in clinical use and highlighted rare associated adverse events. Importantly, we have successfully demonstrated a novel approach by a national specialist society to independently monitor the efficacy and safety of a new treatment. Copyright © 2010 John Wiley & Sons. Practical Diabetes Int 2010; 27(8): 352–357","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"83 1","pages":"352"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1522","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024439","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":"Bilateral cataracts as the presenting feature of type 1 diabetes","authors":"M. Macleod, L. McLaren, G. Jones","doi":"10.1002/PDI.1515","DOIUrl":"https://doi.org/10.1002/PDI.1515","url":null,"abstract":"334 Pract Diab Int October 2010 Vol. 27 No. 8 Copyright © 2010 John Wiley & Sons Case report Our patient, a 29-year-old female nursing student from Zimbabwe, described a six-month history of gradual deterioration in her eyesight. She had attended the optician on several occasions in that time and was reassured there was no abnormality. Her eyesight continued to deteriorate and she attended her GP who diagnosed bilateral cataracts. She was referred for urgent surgery but, in the interim, lost her eyesight completely and attended eye casualty. On examination she had snowflake cataracts bilaterally (Figure 1) and was admitted for urgent surgery. During pre-operative assessment she was found to have a random blood glucose of 26mmol/L and urinary glucose of 3+ and ketones of 2+. On further questioning, the patient described osmotic symptoms (polyuria and polydipsia) and recurrent candidal infection over a timescale similar to that of the visual loss. She had also lost approximately 30kg in weight over the previous year but had attributed this to a diet she had been on. She denied lethargy or any other symptoms on systemic enquiry. She had no significant past medical history, no family history of diabetes or cataract, and was not on any regular medication. She was transferred to the acute medical receiving ward. Venous bicarbonate was 16 and arterial blood gas measurement revealed a mild metabolic acidosis. HbA1c was 18.2% (175mmol/mol) confirming prolonged hyperglycaemia. She was commenced on an insulin sliding scale and then converted to subcutaneous insulin. This was administered by nursing staff because of her visual impairment. Urgent cataract surgery was carried out on the left eye and eyesight was restored. She was discharged home on a basal bolus regimen and further surgery was arranged for the right eye.","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"77 1","pages":"334-334"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1515","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024291","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":"More than meets the eye: the ACCORD trial and use of statin‐fibrate combination in type 2 diabetes mellitus","authors":"G. Watts, F. Karpe","doi":"10.1002/PDI.1511","DOIUrl":"https://doi.org/10.1002/PDI.1511","url":null,"abstract":"powerful predictor of cardiovascular disease (CVD) in type 2 diabetes, with low-density lipoprotein (LDL) being the most atherogenic lipoprotein. Accordingly, the first priority of lipid-regulating treatment is to lower the plasma concentration of LDL-cholesterol. This is efficaciously achieved with a statin, as evidenced by several excellent clinical endpoint trials.1 While the importance of correcting hyperglycaemia is well established, the significance of dyslipidaemia and its treatment for preventing progression of diabetic microangiopathy, particularly retinopathy, remains undefined.","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"59 4","pages":"326-328"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1511","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024167","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":"Exenatide-induced hypomagnesaemia causing seizures","authors":"John W Foote Consultant Physician, M. K. C. Physician","doi":"10.1002/pdi.1513","DOIUrl":"https://doi.org/10.1002/pdi.1513","url":null,"abstract":"","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"10 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/pdi.1513","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51024201","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}