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Diabetes Mellitus, Obesity, Lipoprotein Disorders and other Metabolic Diseases
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Insulinomas are rare tumours of the pancreas that cause hypoglycaemia because of unregulated secretion of insulin. Symptoms of hypoglycaemia may be wrongly attributed to anxiety or to neurological disease. Insulinomas classically cause fasting hypoglycaemia which typically occurs at night, but daytime symptoms may also occur. Because anxiety is common and insulinomas are rare, an algorithm (Whipple's triad) should be used to suggest the diagnosis. Whipple's triad states that: Symptoms should be associated with fasting or exercise.Hypoglycaemia is demonstrated to be present during the symptoms.Glucose relieves the symptoms.
Nonalcoholic Fatty Liver Disease
Published in Nicole M. Farmer, Andres Victor Ardisson Korat, Cooking for Health and Disease Prevention, 2022
High-fructose corn syrup differs from other sugars in contributing to NAFLD because of the metabolism difference in the liver between it and glucose. Glucose metabolism uses glucokinase and hexokinase, where in fructose metabolism, fructokinase, principally fructokinase C, is used (Jensen et al. 2018). This creates the difference between the metabolism of the two sugars. While both produce glucose, glycogen, and triglycerides, fructose metabolism reduces intercellular phosphate and ATP levels due to an increase in nucleotide turnover and uric acid accumulation, where glucose metabolism does not (Jensen et al. 2018). This leads to temporary blocking of protein synthesis and increases in oxidative stress and mitochondrial dysfunction, which are key factors in the development of NAFLD and its comorbidities (Jensen et al. 2018).
Specific Emergency Conditions in Forced Displacement Settings
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Natalie Roberts, Halfdan Holger Knudsen, Alvin Sornum, Taha Al-Taei, Barbara Scoralick Villela, Maryam Omar, Faith Traeh, Abdulkarim Ekzayez, Clare Shortall, Eric Weerts
Blood glucose should be established and monitored regularly. If a laboratory is available measuring lactate and electrolyte levels can help guide fluid treatment. A chest x-ray will help diagnose pulmonary oedema caused by smoke inhalation.
Evogliptin for the treatment option for type 2 diabetes: an update of the literature
Published in Expert Review of Clinical Pharmacology, 2022
Ping Zou, Mingxing Guo, Jingbo Hu
As reported by the International Diabetes Federation (IDF) data, approximately 463 million adults aged 20 to 79 worldwide have type 2 diabetes (T2D) as of 2019, and it is expected that 700 million will get sick by 2045 [1]. Findings from the 9th edition of the IDF Diabetes Atlas also show that 19.3% (approximately 135.6 million) of the elderly aged 65 to 99 have diabetes [2]. What is worse, traditional hypoglycemic drugs have gradually shown poor tolerance, poor compliance, and so on. Metformin-mediated anti-hypoglycemic activity cannot be maintained due to the progressive deterioration of β-cell functions [3]. Moreover, sulphonylureas treatment inevitably induces weight gains [4]. Therefore, new therapeutic strategies are needed to keep blood glucose under control and avoid hypoglycemia and other side effects. Previous studies have shown that incretin hormone (glucagon-like peptide-1, GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) play an important role in glucose homeostasis [5]. However, the plasma half-life of GLP-1 and GIP is very short, and GLP-1 is easily inactivated by dipeptidyl peptidase 4 (DPP-4) enzyme in the circulation. Therefore, the development of GLP-1 analogues (incretin hormone analogues) and DPP-4 inhibitors (incretin potentiators) to prevent rapid inactivation of GIP and GLP-1 is an effective strategy for the treatment of T2D.
Ongoing efforts to improve the management of patients with diabetes in Bangladesh and the implications
Published in Hospital Practice, 2021
Mainul Haque, Salequl Islam, Zubair Mahmood Kamal, Farhana Akter, Iffat Jahan, Md Saghir Abdur Rahim, Nusrat Sultana, Abm Muksudul Alam, M A Halim-Khan, Farzana Deeba, Muhammed Abu Bakar, Shamsun Nahar, Miliva Mozaffor, Umme Laila Urmi, Taohidur Rahman Saikat, Md Zakirul Islam, Monami Haque, Samiul Iqbal, Mohammad Monir Hossain, Nurun Naher, Eleonora Allocati, Brian Godman
Overall, lower cost biosimilars should be welcomed by all key stakeholder groups as this will help with issues of affordability, allowing more patients in Bangladesh and wider to access long-acting insulin analogues to improve their care [3,39]. This, in turn, helps decrease current rates of hypoglycemia and associated consequences. Alongside this, the authorities in Bangladesh need to increase the number of ambulatory care facilities to better diagnose and manage patients with diabetes in the first place given current concerns as well as rising rates of diabetes [16]. In addition, ensure adequate supplies of equipment are available to allow patients to monitor their blood glucose levels at home to prevent complications as this is a concern among LMICs [3,36]. We will continue to monitor this.
Ketogenic diet: overview, types, and possible anti-seizure mechanisms
Published in Nutritional Neuroscience, 2021
Mohammad Barzegar, Mohammadreza Afghan, Vahid Tarmahi, Meysam Behtari, Soroor Rahimi Khamaneh, Sina Raeisi
The LGIT, introduced in 2005, as another effective alternative dietary approach for DRE management [30]. In this dietary treatment, the extreme carbohydrate restriction of the other KDs is liberalized. The high carbohydrate-containing foods such as rice, bread potatoes, watermelon, and bagels are restricted to the low glycemic index foods which produce relatively small changes in blood glucose. A measure of a food’s tendency to cause a glucose elevation in serum is considered as the glycemic index [13,31]. The glycemic index of a specific food can be evaluated by calculating the incremental area the blood glucose response curve after administering the specified amount of that food in comparison to a same amount of the reference glucose [13]. The glycemic index of reference glucose is considered as 100 therefore, a particular food with a 50 glycemic index produces 50% of the area under the curve [31]. The diets with glycemic index less than 50 (such as meat, dairy, and some fruits and whole grain breads as well) are allowed in LGIT. This dietary treatment has nearly similar efficacy compared to the classic KD, however it is more palatable and easy to implementation [13]. The efficacy of LGIT is comparable with classic KD. Muzykewicz et al. evaluated the efficacy of LGIT in 76 DRE patients. A greater than 50% reduction in seizure frequency was recognized in 42%, 50%, 54%, 64%, and 66% of the patients after 1, 3, 6, 9, and 12 months, respectively.