Clinical Gems

Ramsi Ajjan John, who is a 61-year-old postman, presents to his GP with a 6-week history of increasing tiredness, polyuria and polydipsia. He has also noticed weight loss over the past 6 months (around 5 kg) and an irritating cough that seems to have coincided with him stopping smoking around …

Anne Peters, MD, and Lori Laffel, MD, MPH, Editors Jane Lee Chiang, MD, Managing Editor Andrew M. Posselt, MD, PhD, FACS, and Peter Stock, MD, PhD The goal of curing type 1 diabetes (T1D) is best achieved with beta-cell replacement therapy because this allows physiologic blood glucose control. Currently, the …

Barbara J. Anderson, PhD, CDE and Abigail K. Mansfield Marcaccio, PhD The week’s excerpt answers the following questions: What is "Miscarried Helping"? What are the steps in preventing "Miscarried Helping"? How can you foster an open provider-patient relationship? What are the steps to preventing diabetes "burnout"? How can primary care …

Anne Peters, MD, and Lori Laffel, MD, MPH, Editors Jane Lee Chiang, MD, Managing Editor Jane Lee Chiang, MD, and Stephen E. Gitelman, MD GUIDELINES Current guidelines for glycemic control from select organizations worldwide are shown in Table 6.4.19-22,62 Due to the special nature of T1D, only those guidelines that …

Anne Peters, MD, and Lori Laffel, MD, MPH, Editors Jane Lee Chiang, MD, Managing Editor Jane Lee Chiang, MD, and Stephen E. Gitelman, MD INTRODUCTION The Diabetes Control and Complications Trial (DCCT)1 was a landmark medical study conducted by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). …

Ramsi Ajjan Andrea is a 35-year old solicitor who presents with a 10-day history of constant palpitations, weakness, and irritability….

Anne Peters, MD, and Lori Laffel, MD, MPH, Editors Jane Lee Chiang, MD, Managing Editor Prevention of β-cell Destruction and Preservation for Those with Existing Type 1 Diabetes Jane Lee Chiang, MD, and Stephen E. Gitelman, MD Role of Regulatory T-cells In moving these studies from bedside back to bench, …

Barbara J. Anderson, PhD, CDE and Abigail K. Mansfield Marcaccio, PhD This week’s excerpt answers the following questions:  How do you screen patients for psychological issues at diagnosis of diabetes? When can you use the terms "a touch of sugar" and "borderline diabetes"? How important is it to address misconceptions …

Anne Peters, MD, and Lori Laffel, MD, MPH, Editors Jane Lee Chiang, MD, Managing Editor Interdiction: Prevention of Beta-cell Destruction and Preservation for Those with Existing Type 1 Diabetes Jane Lee Chiang, MD, and Stephen E. Gitelman, MD Anti-Inflammatory Agents European Nicotinamide Diabetes Intervention Trial (ENDIT). Like DPT-1, ENDIT represented …

Ramsi Ajjan This week we begin a new series of Clinical Text excerpts with a focus on case studies. Each case is presented as you would actually see it and the use of real-life experiences means the decisions and outcomes are factually based. Along the way to determining a diagnosis …