Clinical specialties
Andrew Schofield, Paul Schofield in The Complete SAQ Study Guide, 2019
A 28-year-old gravida 2 parity 1 attends your clinic after the midwife had repeated positive urine dipstick tests for glucose. An oral glucose tolerance test was performed prior to clinic, and it confirmed gestational diabetes. She had not been known to have diabetes prior to becoming pregnant. Name three risk factors for developing gestational diabetes? (3)Explain the mechanism behind the development of a macrosomie baby in diabetic pregnant women? (2)Name risks to the foetus in women who suffer diabetes (gestational or established) during pregnancy? (2)What is the commonest complication in the neonate post delivery? (1)She is worried that she may suffer diabetes in the future.What will you tell this lady? (2)
Evaluation of the obese patient
G. Michael Steelman, Eric C. Westman in Obesity, 2016
Laboratory tests are performed to identify metabolic problems and to tailor therapy. A fasting period of at least 10 hours prior to the drawing of the initial blood work is needed for accuracy in lipid measurements. A usual profile consists of a complete blood count, thyroid profile, and a chemical profile that includes triglycerides, cholesterol, high-density lipoprotein, and several other tests. Clean-voided, midstream urine is obtained when fasting blood is drawn. If a fasting glucose of ≥100 is detected, you may want to subsequently obtain an oral glucose tolerance test of at least 2-hour duration, with determinations at 30, 60, 90, and 120 minutes after ingestion of the test meal. Fasting insulin levels should be obtained if insulin resistance is suspected. The results of every test performed should be discussed with the patient, even if all the tests are within the normal range.
Standards of Care in Diabetes
Jack L. Leahy, Nathaniel G. Clark, William T. Cefalu in Medical Management of Diabetes Mellitus, 2000
In June of 1997 revised criteria for the diagnosis of diabetes were released. Diabetes mellitus is now diagnosed by one of three criteria: Typical symptoms of diabetes with a casual (random) plasma glucose level higher than 200 mg/dL. Casual (or random) was defined as any time of day without consideration of the time of the last meal. Classic symptoms of diabetes include polyuria, polydipsia, and unexplained weight loss.A fasting plasma glucose level of 126 mg/dL or higher. This criterion is the most significant change from prior criteria and was intended to be the major diagnostic criterion to eliminate confusion over the role of fasting plasma glucose versus an oral glucose tolerance test (OGTT). The level of 126 was chosen over the previous 140 to be consistent with the standard OGTT criteria. The decision was made to reduce the level for fasting plasma glucose from 140 to 126 mg/dL, because, as a rule, patients without diabetes had fasting levels lower than 110 mg/dL.A 2-h plasma glucose level higher than 200 during a 75-g oral glucose tolerance test. It was felt that the performance of a glucose tolerance test should rarely be necessary, as the diagnosis could most typically be made on the basis of either of the first two criteria.
siRNA: an alternative treatment for diabetes and associated conditions
Published in Journal of Drug Targeting, 2019
DM is diagnosed by performing different tests like fast plasma glucose level and is measured by glucometer. The fasting glucose level in blood ≤126 mg/dl is examined as diabetic. Oral glucose tolerance test is a technique in which fast glucose level of the patient is measured after which the glucose water, 75 g of sugar in 250 g of water for adults is administered to the patient. After administration, blood glucose level is measured at different times for minimum of 2 h. Subjects having <140 mg/dl glucose level in blood is considered as non-diabetic, subjects having 140–199 mg/dl glucose level in blood have reduced tolerance for glucose and with >200 mg/dl are considered as diabetic. Glycohemoglobin HbA1c is an advance technique which specifies the blood sugar attached to haemoglobin and oxygen-carrying protein in RBC and estimates the average blood sugar level of patient in last 2–3 months. Fast glucose level ≥200 mg/dl with ≥48 mmol/mol one-time HbA1c is to be considered as diabetic. However, DI is diagnosed by polyuria, polydipsia and blood sugar level. Excess production of dilute urine occurs which is about 20 times more than normal urination [4,5].
Fast dissolving electrospun polymeric films of anti-diabetic drug repaglinide: formulation and evaluation
Published in Drug Development and Industrial Pharmacy, 2019
Shreya Thakkar, Namdev More, Dilip Sharma, Govinda Kapusetti, Kiran Kalia, Manju Misra
The oral glucose tolerance test was performed to measure blood glucose levels. For all the groups, blood glucose level reached to peak at ∼ 60 min after glucose load (Table 2). Administration of single dose of formulations (nanofibers as well as casted film) significantly delimited increase in blood glucose level in the time period of 30–120 min in comparison to control group as well as free drug. It was found that formulations significantly decreased glucose levels compared to pure drug (*p < .05 versus pure drug). Probable reason for this effect of formulation could be due to improved solubility and dissolution of drug which would lead to faster absorption of drug by immediate release and thus improved the bioavailability of repaglinide. Results obtained from this study revealed superiority of formulation over free drug as both the formulations showed better control over blood glucose levels.
Inflammatory state does not affect the antiplatelet efficacy of potent P2Y12 inhibitors in ACS
Published in Platelets, 2021
Benedikt S. Biesinger, Aleksandra Gasecka, Thomas Perkmann, Johann Wojta, Maciej Lesiak, Marek Grygier, Ceren Eyileten, Marek Postuła, Krzysztof J. Filipiak, Aurel Toma, Christian Hengstenberg, Jolanta M. Siller-Matula
The following data were recorded on admission: demographic data (age, gender), weight, type of ACS and type of P2Y12 inhibitor administered (prasugrel, ticagrelor), cardiovascular risk factors (arterial hypertension, hyperlipidemia, smoking status, family history of coronary artery disease and diabetes mellitus), history of cardiovascular disease (prior AMI, prior PCI, carotid artery disease, peripheral artery disease), angiographic data, and pharmacotherapy administered at admission. Arterial hypertension was defined as (i) a history of hypertension and/or the use of antihypertensive drugs or (ii) repetitive resting blood pressure values above 140/90 mmHg during in-hospital measurements, applied two to four times daily. Hyperlipidemia was defined as (i) a history of lipid-lowering therapy or (ii) total cholesterol level above 200 mg/dl. Smoking was assessed as current, past, and nonsmoking. Diabetes mellitus was defined as (i) pathological oral glucose tolerance test, or (ii) a history of diabetes or anti-diabetic therapy. On admission, HbA1 c was measured in all patients and oral glucose tolerance test was performed, if necessary, to detect undiagnosed diabetes. In addition, routine laboratory parameters were recorded.
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