Clinical Gems

Anne Peters, MD, and Lori Laffel, MD, MPH, Editors Jane Lee Chiang, MD, Managing Editor Prevention of Beta-cell Destruction and Preservation for Those with Existing Type 1 Diabetes Jane Lee Chiang, MD, and Stephen E. Gitelman, MD Current therapies and technologies offer a means to live with type 1 diabetes …

Elizabeth Blair, MSN, PARN, BC, CDE The week’s excerpt answers the following questions: What different learning styles do children and adults have? How can life experiences be used as part of the learning process? What are the challenges of educating older adults? How can the power of self-confidence be used …

Anne Peters, MD, and Lori Laffel, MD, MPH, Editors Jane Lee Chiang, MD, Managing Editor Marion J. Franz, MS, RD, CDE; Alison B. Evert, MS, RD, CDE; Gail Spiegel, MS, RD, CDE; Carol Brunzell, RD, CDE; Joyce Green Pastors, MS, RD, CDE; Joshua J. Neumiller, PharmD, CDE, CGP, FASCP; Laurie …

Christina Kanaka-Gantenbein, MD, PhD Acidosis management  Severe acidosis is reversible by fluid and insulin replacement. Insulin stops lipolysis and further ketone production and allows ketoacids to be metabolized, generating bicarbonate.4 Moreover, treatment of hypovolemia improves tissue perfusion and renal function, thereby increasing the excretion of organic acids. Controlled trials have …

Anne Peters, MD, and Lori Laffel, MD, MPH, Editors Jane Lee Chiang, MD, Managing Editor Marion J. Franz, MS, RD, CDE; Alison B. Evert, MS, RD, CDE; Gail Spiegel, MS, RD, CDE; Carol Brunzell, RD, CDE; Joyce Green Pastors, MS, RD, CDE; Joshua J. Neumiller, PharmD, CDE, CGP, FASCP; Laurie …

Elizabeth Blair, MSN, PARN, BC, CDE The week’s excerpt addresses the following questions: How can you understand your patients’ behaviors? What is the emotional component? What lies behind a person’s choice or behavior? What expectations can you expect from your patients? How can you enhance the learning process? When should …

Anne Peters, MD, and Lori Laffel, MD, MPH, Editors Jane Lee Chiang, MD, Managing Editor Marion J. Franz, MS, RD, CDE; Alison B. Evert, MS, RD, CDE; Gail Spiegel, MS, RD, CDE; Carol Brunzell, RD, CDE; Joyce Green Pastors, MS, RD, CDE; Joshua J. Neumiller, PharmD, CDE, CGP, FASCP; Laurie …

Christina Kanaka-Gantenbein, MD, PhD First-line management The goals of first-line management of DKA are:4 Correct dehydration Correct acidosis and reverse ketosis Restore blood glucose to near normal values Avoid complications, such as cerebral edema Identify and treat any precipitating event…..

Anne Peters, MD, and Lori Laffel, MD, MPH, Editors Jane Lee Chiang, MD, Managing Editor Marion J. Franz, MS, RD, CDE; Alison B. Evert, MS, RD, CDE; Gail Spiegel, MS, RD, CDE; Carol Brunzell, RD, CDE; Joyce Green Pastors, MS, RD, CDE; Joshua J. Neumiller, PharmD, CDE, CGP, FASCP; Laurie …

Christina Kanaka-Gantenbein, MD, PhD Definition of emergency Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with Type 1 diabetes mellitus (T1D). Mortality is mainly related to the occurrence of cerebral edema, while only a minority of deaths are attributed to other causes.1,2 …