Clinical Gems

Richard S. Beaser, MD This week’s excerpt addresses the following topics: How to develop a medical care plan How to develop the initial assessment What the medical history should detail What the physical exam should include   

Sheri R. Colberg, PhD, and Michael C. Riddell, PhD Physical Activity: Regulation of Glucose Metabolism, Clinical Management Strategies, and Weight Control Introduction  Engaging in regular physical activity is an effective measure to protect against a number of health risks across all ages. Physical activity is known to reduce the risk …

Ramzi Ajjan, MRCP, Med Sci, PhD   Acute confusion in an 82-year-old with known type 2 diabetes Brian, an 82-year-old gentleman with known type 2 diabetes, is brought to A&E with general deterioration and acute confusion. What differential diagnoses would you consider and what would you do?…

Please note that the source for this excerpt was misidentified on our initial publication. We have since corrected this mistake with the correct attribution. Richard S. Beaser, MD Introduction  The current term "type 2 diabetes" represents an evolution in terminology reflecting a progression in the understanding of this condition. The …

Ramsi Ajjan Iwona is a 30-year-old woman with known type 1 diabetes for 12 years. She visits her GP complaining of tiredness and weight gain. Her HbA1c levels over the past 7 years have ranged between 6.4 and 7.1%, but her most recent test showed an HbA1c of 8.3%.   …

Anne Peters, MD, and Lori Laffel, MD, MPH, Editors Jane Lee Chiang, MD, Managing Editor Continuous Subcutaneous Insulin Infusion (CSII) PEDIATRICS David Maahs, MD, PhD, and H. Peter Chase, MD Standard of Care A consensus statement on the use of insulin pump therapy, CSII, in youth with type 1 diabetes (T1D) …

Osama Hamdy, MD, PhD, FACE This week’s excerpt covers the following topics: The role of cytokine hormones How cytokines are involved in the inflammatory processes The role of leptin and cardiovascular mortality How to diagnosis visceral adiposity What is the liptoxicity theory The protective effect of a large hip circumference …

Anne Peters, MD, and Lori Laffel, MD, MPH, Editors Jane Lee Chiang, MD, Managing Editor PEDIATRICS – Jane Lee Chiang, MD, and Georgeanna J. Klingensmith, MD ADULTS – Irl B. Hirsch, MD 1. Basal insulin accounts for ~50% of total daily dose: i. LAA (insulin glargine, detemir, degludec) or NPH if LAA …

Ramsi Ajjan Richard, a 20-year-old man, is referred to the diabetes clinic with newly diagnosed diabetes (fasting glucose on two occasions more than 10 mmol/L. He has had osmotic symptons (polyuria and polydipsia) for at least 6 months and his weight has recently increased by about 14 kg….

Anne Peters, MD, and Lori Laffel, MD, MPH, Editors Jane Lee Chiang, MD, Managing Editor PEDIATRICS – Jane Lee Chiang, MD, and Georgeanna J. Klingensmith, MD ADULTS – Irl B. Hirsch, MD INTRODUCTION Normal Physiology The normal pancreas deftly releases basal insulin, superimposed with bursts of insulin for rising glucose levels associated …