Clinical Gems

Richard S. Beaser, MD This week’s excerpt covers the following topics: Which medications reduce insulin resistance The action of biguanides How thiazolidinediones work The risks of thiazolidinediones Liver toxicity with medications

Richard S. Beaser, MD This week’s excerpt covers the following topics: The mechanism of action for antidiabetes medications Which medications improve insulin action Which meds slow gastric absorption Which meds increase insulin secretion Which meds increase the effect of incretins How to compare diabetes meds  

Lipid abnormalities The two main lipid molecules in the plasma are triglycerides and cholesterol To make these lipid particles water-soluble, they are bound to phospholipids and lipoproteins in plasma Lipid measurements are best performed on a fasting sample. The following measurements can be done: Total cholesterol (TC) high levels are …

Treatment of type 2 diabetes (T2DM) Education of patients is very important The importance of diet and exercise should be emphasized All patients should be reviewed by a dietitian for appropriate advice Measures to induce weight loss (most of these patients are overweight) should be encouraged/implemented In the initial phases …

The Pancreas The pancreas is situated behind the posterior wall of the abdomen It can be divided into: Head: located within the duodenal curve Body connected to the head through a slight constriction (neck) Tail representing tapering of the body as it extends to the left approaching the gastric surface …

Sheri R. Colberg, PhD, and Michael C. Riddell, PhD Extreme Athletic Events Despite the challenges presented by participation in long-duration athletic events, many individuals with T1D are currently training for and participating in such events. Research in this area is lacking, but a handful of studies have attempted to investigate …

Richard S. Beaser, MD This week’s excerpt covers the following topics: Knowing the options for treatment Determining medication selection Clinical markers for the dominant underlying pathophysiology The three stages to glucose patterns

Sheri R. Colberg, PhD, and Michael C. Riddell, PhD EXERCISE WITH COMPLICATIONS OR OTHER HEALTH CONDITIONS: Relative and Absolute Contraindications The ADA and others have stressed the importance of appropriate screening procedures to clear patients for participation in exercise.157–164 For patients with T1D, all of the diabetes-associated complications (microvascular and …

Oliver, aged 46, is found to have an abnormal lipid profile, during routine tests prior to employment abroad. Total cholesterol (TC) 6.5 mmol/L Low density lipoprotein cholesterol (LDL) 5.1 mmol/L High density lipoprotein cholesterol (HDL) 0.9 mmol/L Triglycerides 1.4 mmol/L The patient is asymptomatic. What would you do? This patient …

Sheri R. Colberg, PhD, and Michael C. Riddell, PhD Hypoglycemia Associated with Physical Activity Hypoglycemia risk. Hypoglycemia is the most common negative side effect of exercise, ranging from mild to life threatening in severity. The incidence of hypoglycemia during or after a single bout of moderate-intensity exercise in children and …