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Diabetes Care
Explore four decades of research illustrating the biphasic growth patterns in fetuses of diabetic and obese women, an essential yet overlooked factor in preventing childhood obesity. The comprehensive findings may redefine your approach to perinatal care and shape healthier futures for your patients.
Endocrinology, Diabetes, Metabolism June 14th 2023
Journal of Pharmacy Practice (JPP)
Investigating how an insulin bolus affects the management of diabetic ketoacidosis reveals startling new information. In the diabetes field, experts widely use insulin as a core treatment for diabetic ketoacidosis (DKA). However, the debate over the best dosage and method of administration, specifically concerning the use of an initial insulin bolus, continues. This study evaluates the safety and effectiveness of this insulin bolus in DKA treatment. Employing a retrospective chart review, researchers examined patient outcomes for DKA treatment with and without an insulin bolus. They included 59 patients in the bolus group, and 108 in the non-bolus group. The study primarily tracked whether the administration of insulin had to be interrupted, or if patients experienced hypoglycemia or hypokalemia within eight hours of starting insulin. Comparing baseline characteristics, the groups showed no significant differences. Most patients exhibited mild DKA. Results revealed that adverse effects—particularly hypokalemia—occurred significantly more often in the bolus group (45.8% versus 25%, P = .003). Additionally, while time to anion gap closure was shorter in the bolus group, this did not reach statistical significance (6:39 versus 9:00, P = .063). Similarly, non-significant differences emerged in time to discontinuation of insulin infusion and time to ICU and hospital discharge. […]
Clinical Pharmacology May 31st 2023
Annals of Internal Medicine
A retrospective cohort study was conducted to investigate the effectiveness of glucagon-like peptide-1 receptor agonists (GLP1RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) in preventing major adverse cardiac events (MACE) for individuals without preexisting cardiovascular disease. The study included US veterans aged 18 or older who were receiving care from the Veterans Health Administration. The cohort consisted of patients who added either GLP1RA, SGLT2i, or dipeptidyl peptidase-4 inhibitors (DPP4i) to their existing diabetes treatments. The outcomes measured were MACE and heart failure hospitalization. The results showed that the addition of GLP1RA was associated with a lower incidence of MACE and heart failure compared to DPP4i. However, the addition of SGLT2i did not show a significant association with primary prevention of MACE.
Cardiology May 18th 2023
Per the Standards, “diabetes management in older adults requires regular assessment of medical, psychological, functional, and social domains. Older adults with diabetes have higher rates of premature death, functional disability, accelerated muscle loss, and coexisting illnesses … and … are also at greater risk for several common geriatric syndromes, such as polypharmacy, cognitive impairment, depression, urinary incontinence, injurious falls, persistent pain, and frailty. All these can impair their self-management.”
Endocrinology, Diabetes, Metabolism April 12th 2023
Eye Health Academy
Participants should be better able to discuss anti-VEGF therapy outcomes in patients with moderate-severe and severe nonproliferative diabetic retinopathy after taking part in this educational activity with Drs. Susan Bressler, Mark Dunbar, and Ruth Weinstock, and understand the importance of prompt referral and early diagnosis to reduce or even prevent the vision-threatening complications of diabetes.
Endocrinology, Diabetes, Metabolism January 26th 2023
A layered approach to care is described with lifestyle interventions being a key feature of the updated recommendations. The recommendations now include therapies proven to improve cardiovascular and kidney outcomes in patients with diabetes and CKD.
Cardiology January 19th 2023