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Daily Archives: Apr 11, 2017

April 11, 2017

I got to the office in Atlanta after a week at home and it looked like the sidewalks have been coated with yellow paint. But it was pollen from all the trees. Evidently the rapid changes in temperature over the past month or so had driven the pollen factor into …

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It’s Allergy Season

Female, 58 years of age, type 2 diabetes, obesity, taking (Qsymia- phentermine/topamax) for weight loss, antihypertensive for hypertension, and metformin for glucose management. Blood pressure usually in the 120-130/70-80 range, glucose averages ~120, and was losing weight. Today’s b/p 170/90, random glucose 232, c/o tinnitus. Weight was up 5 pounds since last seen 3 months ago. It’s now allergy season. After further discussion, she told me she was started on a medrol dosepak, and on her own purchased and is taking an OTC allergy medication.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #70: Regulation of Glucose Metabolism in Liver Part 6 of 11

Acute regulation of gluconeogenesis: Prior to discovery of the transcriptional mechanisms described earlier, the control of hepatic glucose metabolism was examined in great detail on the basis of substrate, allosteric, and posttranslational modification. These factors alter gluconeogenic flux rapidly (seconds to minutes) and are a critical first response to increased glucose demand.

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