Endocrinology

Tight glucose control cuts heart risk

August 10, 2009

Intensive treatment to lower glucose levels in patients with type 2 diabetes does appear to significantly reduce coronary events without increasing the risk of death.
 

FDA accepts application for once-weekly exenatide

July 13, 2009

The agency will review the New Drug Application submitted for once-weekly exenatide as a subcutaneous injectable treatment of type 2 diabetes.
 

Triglycerides linked to diabetic neuropathy and amputations

June 24, 2009

Serum triglyceride levels may allow clinicians to predict which patients with type 2 diabetes will develop neuropathy, while fenofibrate therapy can reduce the risk of diabetes-related amputations by more than a third.
 

Boosting pancreatic beta cells

Question by Shah Niranjan, MD, Roslyn Heights, N.Y.; response by Lyle Mitzner, MD April 20, 2009

Is there a role for sitagliptin in enhancing pancreatic beta-cell function or quantity? Our expert discusses the issue.
 

Switch meds for this patient with diabetes?

Question from Mostafa M. Rehab, MD, Greensburg, Ind; response by Lyle D. Mitzner, MD March 27, 2009

Can this patient's insulin glargine dose be increased? If so, how high? Should he be switched to insulin detemir?
 

Overactive bladder reduced in obese women who lose weight

March 04, 2009

You can add incontinence relief to the list of benefits obese patients gain when they shed pounds, according to a recent NIH-funded clinical trial.
 

Hepatitis C treatment different for Hispanics

March 02, 2009

A new study has found evidence that ethnicity may determine how patients respond to treatment for hepatitis C. In an open-label, nonrandomized trial, Hispanic whites did not fare as well as white patients who were not Hispanic.
 

Apidra SoloSTAR insulin pen approved

February 27, 2009

The FDA has approved a new prefilled disposable insulin pen from sanofi-aventis.
 

Erectile dysfunction common in men with diabetes

February 20, 2009

Nearly 25% of type 2 diabetic men in the Action for Health in Diabetes study reported having complete erectile dysfunction, according to a new article.
 

From the Editorial Board: I thought I knew how to manage diabetes

By Daniel G. Federman, MD February 19, 2009

The ACCORD, ADVANCE, and other trials have suggested a shifting landscape in diabetes treatment. After you read what this physician thinks, let us know your thoughts.
 

Subcutaneous vs. IV insulin

Question from Dennis A. Fito, MD, Oklahoma City; response by Lyle Mitzner, MD February 17, 2009

Can administering subcutaneous insulin every one to two hours substitute of IV insulin therapy?
 

Correcting diabetic ketoacidosis

Question by Dennis A. Fito, MD, Oklahoma City; response by Lyle Mitzner, MD February 17, 2009

Which is better for correcting the potassium level in diabetic ketoacidosis—potassium phosphate or potassium chloride?
 

When to adjust thyroid hormone dosing

Question by Louis H. McCormick, MD, Franklin, La.; response by Christopher Ruser, MD February 14, 2009

Should you adjust thyroid hormone dosing based on the TSH or the free thyroxine level?
 

Decreasing thyroid-stimulating hormone

Question by Louis H. McCormick, MD, Franklin, La.; answer by Christopher Ruser, MD February 13, 2009

Besides hyperthyroidis, what can cause thyroid-stimulating hormone levels to drop?
 

Early recognition of diabetes complications

Lyle Mitzner, MD February 06, 2009

Too often patients focus on daily goals of diabetes management, but don't let them lose sight of the ultimate goal: preventing end-organ damage.
 

Contemporary insulin administration

Question asked by Steven Schwartz, MD, Bronx, N.Y., and answered by Lyle Mitzner, MD February 05, 2009

An update on administering insulin
 

ARBs and ACE inhibitors for proteinuria

Question asked by Absar Qureshi, MD, Columbus, Ohio, and answered by Edgar V. Lerma, MD January 09, 2009

Can we prescribe the ARBs and the ACE inhibitors in insurance company formularies for the treatment of diabetic nephropathy, or must we push for specific agents?
 

Kidney marker warns of heart disease, diabetes

November 20, 2008

A new meta-analysis confirmed "a strong and continuous association between urinary proteinuria and subsequent risk of coronary heart disease (CHD)." Meanwhile, a team of French scientists has tied excessive UAE levels to substantially higher risks of developing diabetes in men.
 

Study redeems tight glucose control

October 15, 2008

After being called into question by two large studies earlier this year, the benefits of intensive glycemic control in type 2 diabetes recently got some support from another long-term trial.
 

Pre-glucose tolerance test diet

Question submitted by G. Tadros, MD, Wilmington, Del., and answered by Daniel G. Tobin, MD October 06, 2008

What are the dietary recommendations for the three days preceding the oral glucose tolerance test (OGTT)? Many centers offering the OGTT...
 

Blood sugar discrepancies

Question raised by G. Tadros, MD, Wilmington, Del. and answered by Daniel G. Tobin, MD September 18, 2008

Many of my diabetic patients see a difference (as much as 15-20 mg/dL) in their blood glucose when samples are taken from different parts of the body. Do you have any suggestions for those who don't like finger sticks?
 

Advocating what works for diabetes

By Carl Sherman August 01, 2008

The ADA takes a practical approach, backing treatments that have demonstrated benefit.
 

Cholesterol goals in diabetes patients

Question raised by John S. Rajapakse, MD, Woodbridge, N.J. and answered by Susan Kashaf, MD, MPH July 01, 2008

Now that colesevelam (WelChol), a bile acid sequestrant (BAS), has been shown to decrease hemoglobin A1c (HbA1c), should it be the agent of choice (rather than ezetimibe [Zetia]) in diabetic patients who have not reached their cholesterol goals after using maximum doses of a statin?
 

Subclinical hypothyroid monitoring

Question by Ferdinand M. Rivera, MD, Salinas, P.R.; answer by Susan Kashaf, MD, MPH May 15, 2008

A patient's insurer will not pay for thyroid testing more often than twice a year. Is retesting the TSH alone sufficient for adjusting levothyroxine doses?
 

Role of hemoglobin A1c in diabetes therapy

Question by Bhavana Japi, MD, New Hyde Park, N.Y.,; response by Susan Kashaf, MD, MPH April 30, 2008

Should therapy for a diabetes patient be adjusted if his hemoglobin A1c (HbA1c) is 110 mg/dL? Also, should a person be considered prediabetic if her fasting blood sugar is normal but her HbA1c is >6? How do you control fasting blood sugar if a person is on oral meds?
 

Fatigue, pre-syncope, and GI symptoms in a diabetic patient

CASE AND ANALYSIS BY KASHIF MEMON, MD January 23, 2008

Weeklong nonspecific symptoms turn out to be early warning signs of a potentially fatal disorder.
 

Diabetic patients' alcohol limits

Question by Mario E. Palacios, MD, Woodstown, N.J. and answered by Christopher Ruser, MD December 18, 2007

Are patients taking metformin for type 2 diabetes still allowed one or two alcoholic drinks daily?
 

Asymptomatic erythematous plaque on the hand of a diabetic patient

By Saira J. George, MD, and Sylvia Hsu, MD December 14, 2007

A 35-year-old Caucasian woman with diabetes mellitus was referred to us for evaluation and assessment of a slowly enlarging lesion that had first appeared on her hand eight weeks earlier. On physical examination, there was a non-scaly, annular erythematous plaque on the dorsum of the patient's right hand. The lesion was asymptomatic.
 

Another antidiabetic combo

Question raised by Tom Perry, MD, Phoenix and answered by Daniel G. Tobin, MD November 21, 2007

Can sitagliptin and glyburide be used in combination?
 

Pruritic rash on the lower extremities of a hypertensive diabetic

By Erin Reese, MD, and Julia R. Nunley, MD September 11, 2007

A 45-year-old man had a four-week history of an "itchy, bumpy rash" on his knees and other parts of his legs. His past medical history was significant for diabetes mellitus and hypertension. A year ago, he began hemodialysis for chronic renal failure....
 

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