Posts Tagged ‘Diabetes’

Adalimumab in Patients with Active Non-Infectious Uveitis

Posted by • September 8th, 2016

A 44-year-old woman with type 2 diabetes mellitus and sarcoidosis presents with a 3-week history of severe visual disturbance in both eyes. After referral to an ophthalmologist, she is diagnosed with idiopathic posterior uveitis. Her symptoms improved while receiving oral steroids over the course of 5 months. However, after completing steroid treatment, her glycemic control… Read More…

Closed-Loop Insulin Delivery during Pregnancy in Women with Type 1 Diabetes

Posted by • August 17th, 2016

A 32-year-old woman with type 1 diabetes mellitus presents to your office. She is 8 weeks pregnant. Her blood sugar has been well controlled on a standard insulin pump, but she understands that blood sugar can be more difficult to control during pregnancy.  You have previously discussed the importance of tight glucose control in pregnancy… Read More…

Liraglutide in Type 2 Diabetes

Posted by • July 28th, 2016

To assess the long-term effects of liraglutide on cardiovascular outcomes and other clinically important events, the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) trial was initiated in 2010. Patients with type 2 diabetes who had a glycated hemoglobin level of 7.0% or more were eligible if they either had not… Read More…

Coronary-Artery Bypass Grafting

Posted by • May 20th, 2016

Appropriate selection of patients for coronary-artery bypass grafting (CABG) is critical to ensure good outcomes. The evaluation of patients for CABG relies on a systematic assessment of the characteristics and coronary anatomy known to be associated with a survival benefit from CABG as compared with medical therapy or percutaneous coronary intervention (PCI). There is increasing… Read More…

Cardiovascular Safety of Empagliflozin in Patients with Type 2 Diabetes

Posted by • November 25th, 2015

You are a primary care provider and you’ve heard about a new class of anti-diabetic drugs called the “flozins,” including empagliflozin. You wonder what this drug class is and what we know about its safety and its effect on cardiovascular events. What is empagliflozin? Empagliflozin is a sodium-glucose transporter-2 (SGLT-2) inhibitor. Since glucose is freely filtered in… Read More…

Troponin and Cardiac Events in Stable Ischemic Heart Disease and Diabetes

Posted by • August 12th, 2015

Ischemic heart disease is one of the leading causes of death world-wide. The ability to risk stratify those at increased risk for cardiovascular events would be beneficial. A number of previous studies have shown that routine troponin elevation may serve as a marker of poor prognosis independent of the traditional cardiovascular risk factors (e.g., hypertension,… Read More…

Origins of Obesity in Early Childhood

Posted by • January 29th, 2014

Adults who stuff their mouths with the wrong foods and don’t move their muscles often gain weight and may develop health problems such as obesity and diabetes as a consequence. Now there’s new evidence about how this scenario applies to children. In kindergarten, more than one in four U.S. children is overweight or obese, according… Read More…

Bardoxolone Methyl in Type 2 Diabetes and Stage 4 Chronic Kidney Disease

Posted by • December 26th, 2013

Intuitively, controlling diabetic kidney disease should be easy – manage hyperglycemia, manage blood pressure. And the more control, the better, right? Unfortunately, it hasn’t been so simple. With effective treatment of hyperglycemia and control of blood pressure, the incidence of end-stage renal disease (ESRD) due to diabetes has reached a plateau in the past 10 years. But… Read More…

Poorly Controlled Diabetes Mellitus and Fatigue

Posted by • May 31st, 2013

In the latest Case Record from the Massachusetts General Hospital, a 56-year-old woman with diabetes mellitus was admitted to the hospital because of hyperglycemia and chest pain. Approximately 4 years earlier, a chest radiograph showed a solitary pulmonary nodule in the right upper lobe.  The differential diagnosis for uncontrolled diabetes includes undertreatment or misdiagnosis of… Read More…

Infective Endocarditis

Posted by • April 13th, 2013

Diagnosis of endocarditis is usually based on clinical, microbiologic, and echocardiographic findings. Treatment involves antimicrobial therapy targeted to the identified organism. Surgical indications include heart failure, uncontrolled infection, and prevention of embolic events. The latest article in our Clinical Practice series reviews diagnosis and treatment options for infective endocarditis. Infective endocarditis has an estimated annual incidence… Read More…