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Management of hospitalized type 2 diabetes mellitus patients

exacerbate acute illness. This results in a vicious cycle of uncontrolled blood sugar and worsening of the disease. [ 3 ] Randomized clinical trials in no critically and critically ill patients with type 2 diabetes mellitus (T2DM) proved that by improving glycemic control, we could reduce all of them. Consequently, the hospital objectives for T2DM patients must include improved glycemic control (preventing hypo- and hyperglycemia) so that they can reduce hospital complications, systemic infections, hospital stay, and hospitalization cost and provide an effective

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Clinical conundrums in the management of diabetic ketoacidosis in the elderly

Introduction Diabetes mellitus (DM) and its complications cost billions of dollars to the taxpayer. According to the American Diabetes Association (ADA), the cost of DM to the tax payer was $245 billion in 2012. This is a change from $174 billion in 2007 when the cost was last examined. Majority of the cost is incurred in the inpatient care of diabetes. The problem gets compounded by the increasingly elderly population that is diabetic. [ 1 ] In the United States, more than 25% of elderly patients are diabetic and the number is rapidly increasing. Shrestha

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Renin–angiotensin–aldosterone system in insulin resistance and metabolic syndrome

Introduction Obesity is now assuming epidemic proportions worldwide. Elevated arterial pressure is a frequent complication of excess body weight, and both obesity and hypertension are components of insulin-resistance syndrome [ 1 , 2 ] . Many obese hypertensive patients tend to develop type-2 diabetes mellitus, which further increases their cardiovascular risk. While lifestyle modification is the key to weight and blood pressure reduction, pharmacological intervention remains essential to lowering blood pressure to target levels in obese patients with

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The relation of anthropometric measurements and insulin resistance in patients with polycystic kidney disease

Introduction Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease which is associated with progressive deterioration of renal functions. [ 1 ] End-stage renal disease (ESRD) is observed in 25% of patients aged <50 years and 50% of patients aged <60 years. [ 2 ] Insulin resistance (IR) accompanies diabetes mellitus (DM), hypertension, dyslipidemia, glucose intolerance, and hyperuricemia in metabolic and cardiovascular disorders (CVDs). [ 3 ] There are controversial reports in terms of IR in patients with ADPKD

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Elevated lactic acid during ketoacidosis: pathophysiology and management

, congenital enzyme deficiencies, thiamine deficiencies and diabetes mellitus, [ 1 ] and also alcohol abuse, which may induce a lactic acid under-use or an increased production. [ 2 , 3 ] The authors describe a rare complication of type 1 Diabetes Mellitus (T1DM), leading to a major and persistent expression of a type B lactic acidosis during ketoacidosis. Rationale of the study: The author would like to report a rare clinical entity that could bring a message to the scientific community. Case presentation A 16-year-old female patient diagnosed T1DM from the age of

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Loose ends in the eradication of Helicobacter pylori infection

] low compliance, [ 4 ] and hypersecretion of hydrochloric acid. [ 5 ] However, the evidence is scarce for other factors, particularly the impact biotype, [ 6 ] smoking, [ 7 ] diabetes mellitus (DM), [ 8 ] and previous treatment failure. In particular, it is unknown whether the body mass index (BMI) influences in a clinically significant way the pharmacokinetics and/or pharmacodynamics of the drugs involved in eradication (in particular, the proton pump inhibitors and antibiotics). Furthermore, to date, studies are in most cases controlled in relation to the

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Intrahepatic portosystemic shunt in a young female: Views from a developing country

history of liver disease, diabetes mellitus, abdominal trauma, use of oral contraceptive pills, alcohol intake, changes in her mental status or the use of any over the counter medications. Her general physical examination was unremarkable. Her initial workup showed her viral markers to be negative (HbsAg, anti HCV). Laboratory investigations were all normal apart from a low serum hemoglobin (9.1 g/dL), low serum albumin (2.8 g/dL) and a slightly raised ESR (25 mm/h). Her liver function tests were slightly deranged with a total bilirubin 0.93 IU/L, direct bilirubin 0

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Effect of weight reduction on histological activity and fibrosis of lean nonalcoholic steatohepatitis patient

) anthropometric information including weight, height, BMI and waist circumference, c) glycemic status and insulin resistance (HOMA-IR), d) liver biochemistry (alanine transaminase [ALT], aspartate aminotransferase [AST], gamma-glutamyltrasferase [GGT]), e) liver histopathology (NAS score and fibrosis), and f) other comorbid conditions like diabetes mellitus (DM), dyslipidemia, hypertension, and so on. Similar data were collected at the end of the follow-up for 1 year. Patients were followed-up monthly for the first 3 months and three monthly up to 1 year. During the study

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Endoscopic Ultrasound-guided Gastroenterostomy: A Promising Alternative to Surgery

Nieto J et al EUS-guided gastroenterostomy: a multicenter study comparing the direct and balloon-assisted techniques Gastrointest Endosc 2018 87 1215 21 61 Zhu L, Mo Z, Yang X, Liu S, Wang G, Li P, et al. Effect of laparoscopic Roux-en-Y gastroenterostomy with BMI<35 kg/m(2) in type 2 diabetes mellitus. Obes Surg 2012;22:1562–7. 10.1007/s11695-012-0694-0 22692669 Zhu L Mo Z Yang X Liu S Wang G Li P et al Effect of laparoscopic Roux-en-Y gastroenterostomy with BMI<35 kg/m(2) in type 2 diabetes mellitus Obes Surg 2012 22

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Treatment of ventilator-associated pneumonia with high-dose colistin under continuous veno-venous hemofiltration

were enrolled in this study. Patient characteristics and outcome were depicted in Table 1 . All patients were endotracheally intubated, ventilated in pressure-controlled mode and initiated on CVVH at the start of COL therapy. The mean age was 57 ± 14 years. APACHE II score at ICU admission was 26 ± 11, which corresponds to a predicted mortality of approximately 55%. The most frequent comorbidities were congestive heart failure/ischemic cardiomyopathy ( n = 5) and type 2 diabetes mellitus ( n = 3). One patient had chronic kidney disease. All except one patient

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