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DHEA-S A Marker of Vascular Abnormalities in Diabetics

Dec 28, 2004

DHEA-S (Serum dehydroepiandrosterone sulfate) concentrations correlate inversely with urinary albumin excretion in men with type 2 diabetes.

DHEA inhibits atherosclerosis and plaque progression in animal models, the authors explain, and low DHEA levels may contribute to insulin resistance, Dr. Michiaki Fukui from Kyoto Prefectural University of Medicine, Japan and colleagues note. They therefore examined the relationship between urinary albumin excretion and serum DHEA-S concentrations in 357 men with type 2 diabetes.

The investigators hypothesized that DHEA might be a causal intermediate linking urinary albumin excretion to cardiovascular disease in diabetic patients.

Serum DHEA-S concentrations were significantly lower in patients with microalbuminuria (1014.4 ng/mL) or macroalbuminuria (866.5 ng/mL) than in patients with normoalbuminuria (1232.6 ng/mL), the authors report.

They found a small but significant inverse correlation between serum DHEA-S concentration and log urinary albumin excretion.
Body mass index, glycosylated hemoglobin, and systolic blood pressure were higher and serum HDL cholesterol concentrations were lower in patients with microalbuminuria than in patients with normoalbuminuria, the report indicates.

Similarly, glycosylated hemoglobin, total cholesterol, and triglyceride concentrations were higher and serum HDL cholesterol concentrations were lower in patients with macroalbuminuria.

In a multiple regression analysis, serum DHEA-S concentration, duration of diabetes, glycosylated hemoglobin, body mass index, and systolic blood pressure were all independent determinants of urinary albumin excretion.

"The present data demonstrate that DHEA may be a causal intermediate in the relationship between degree of urinary albumin excretion and cardiovascular disease in male patients with type 2 diabetes," the researchers conclude.

Dr. Fukui stated that, "Serum DHEA-S concentration is a useful marker of microvascular complications as well as macrovascular complications in diabetic patients."
Diabetes Care 2004;27:2893-2897


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Medication Errors Involving Reminyl and Amaryl
36 reports of prescriptions that were either incorrectly written, interpreted, labeled or filled due to the similarity in names between Reminyl and Amaryl.

These reports include instances in which Reminyl was prescribed but Amaryl was incorrectly dispensed, leading to various adverse events including severe hypoglycemia (lowering of blood sugar). There were two reports of death subsequent to the medication error.

There have been errors in prescribing and dispensing of the medications Reminyl (galantamine hydrobromide), a Janssen-Ortho prescription medication for mild to moderate Alzheimer’s disease, and Amaryl for diabetes. These errors have led to adverse events including two reports of death. As patients or caregivers, you can help in avoiding such errors by: asking your physician to repeat the name of any medicine he or she prescribes; asking your physician or nurse to clearly write down the name of the medication so you have it when you go to the pharmacy; requesting a product brochure for the medication where available from your physician; asking your pharmacist to double-check that you have received the right medication; reading any package inserts that accompany your prescriptions.