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Neurology

New Evidence Suggests Pioglitazone Reduces Dementia Risk 42%

And the longer the pioglitazone treatment the lower the risk for developing dementia…. Previous studies confirm that diabetes patients have a higher risk of developing dementia than non-diabetics. Michael Heneka and colleagues conducted a prospective cohort study in 145,928 non-insulin dependent diabetes mellitus aged from 60 or older, who were ...

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Practical Diabetes Care, 3rd Ed., Excerpt #25: Diabetic Neuropathy Part 5 of 5

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David Levy, MD, FRCP      Erectile dysfunction This is the commonest neuropathic complication: 20% of men have erectile dysfunction (ED) at diagnosis, increasing to 34% at 12 years (UKPDS). The prevalence in a newly diagnosed Kuwaiti population was 30%, and nearly 50% in a large survey of Canadians attending their primary-care physicians ...

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Practical Diabetes Care, 3rd Ed., Excerpt #24: Diabetic Neuropathy Part 4 of 5

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David Levy, MD, FRCP      Mononeuropathies and other focal syndromes Peripheral mononeuropathies Upper limb Carpal tunnel syndrome (median nerve) Carpal tunnel syndrome is very common (remember the association with primary hypothyroidism, especially in type 1 diabetes) and may present with atypical symptoms, as it is often superimposed on diabetic polyneuropathy. Consider it ...

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Practical Diabetes Care, 3rd Ed., Excerpt #23: Diabetic Neuropathy Part 3 of 5

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David Levy, MD, FRCP      Charcot neuroarthropathy Charcot neuroarthropathy is a serious and poorly understood condition associated with rapid destruction of bones and joints and resulting in bone fragmentation. It occurs only in patients with advanced sensory and autonomic neuropathy, and is characteristic of long-duration type 1 diabetes with other microvascular complications, ...

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Practical Diabetes Care, 3rd Ed., Excerpt #22: Diabetic Neuropathy Part 2 of 5

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David Levy, MD, FRCP      Foot ulceration The ulcerated, infected and possibly gangrenous foot is a common reason for hospital admission. Anatomically, diabetic foot ulceration is restricted to the region distal to the ankle; proximal lesions are more likely ischemic, vasculitic, venous, or to have another underlying cause. Most ulcers are predominantly ...

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Practical Diabetes Care, 3rd Ed., Excerpt #21: Diabetic Neuropathy Part 1 of 5

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David Levy, MD, FRCP      Introduction The devastating consequences of diabetic neuropathy are seen every day both in hospital – more bed days are taken up with the consequences of diabetic foot ulceration than any other diabetic complication – and in primary care, where sensory symptoms, especially pain, and autonomic neuropathy, especially ...

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