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Daily Archives: Nov 21, 2017

Nov. 21, 2017

Last month, Bill, a cycling friend of mine, asked if I knew a good physician in the area. He was from Maine and this was the winter that he and his spouse were making their move to Florida permanent. My first choice was my own physician as he is a …

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Do You “Make Room” for Your Patients?

Female, 67 years of age, type 2 diabetes, class 2 diabetes, depression, hyperlipidemia, vitamin D deficiency plus more. Her A1C is 6.8% and her lipids are within goal. Her random glucose 2 hours after eating cookies was 118 today. Her glucose lowering meds are Trulicity, metformin, and Jardiance. She takes them as prescribed. Her endocrinologist recommended she meet with me. She refused until he recommended she see me the same day she was coming in to see another health care provider for her monthly infusion for another disease process to make getting here easier.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #100: Pathogenesis of nonalcoholic fatty liver disease (NAFLD) Part 2

Cause of NAFLD: obesity and abnormalities in adipose tissue. Although both NAFLD and the MetS can occur in nonobese subjects, the prevalence of NAFLD is markedly increased in obesity as is that of the MetS. In the third National Health and Nutrition Examination Survey (NHANES), the prevalence of NAFLD averaged 7.5% and 6.7% in normal-weight men and women but was 57 and 44% in persons with a body mass index (BMI) greater than 35 kgm−2.

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