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Use of Oral Glycemic Drugs in CKD
The use of oral glycemic drugs in patients with Chronic Kidney Disease (CKD) requires careful consideration due to altered drug metabolism and excretion associated with kidney dysfunction. Metformin, often the first-line treatment for type 2 diabetes, may be used with caution in mild to moderate CKD but is contraindicated in advanced stages due to the risk of lactic acidosis. Sulfonylureas, except for gliclazide and glimepiride, are generally avoided in CKD because of the prolonged hypoglycemia risk. DPP-4 inhibitors are safer options but may require dose adjustments based on renal function. SGLT2 inhibitors, beneficial for their cardiovascular and renal protective effects, are increasingly recommended, though some are contraindicated in severe CKD. GLP-1 receptor agonists offer a safer profile for CKD patients, with liraglutide and semaglutide being viable options. Ultimately, individualized treatment, frequent monitoring, and adjustments of oral hypoglycemic agents are crucial in managing diabetes in CKD patients.
About the Speaker
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Dr. Adarsh K.S.
Consultant in Dept of Endocrinology, Manipal Hospitals,Bangalore
Adarsh K S is a distinguished Consultant in the Department of Endocrinology at Manipal Hospitals in Bangalore, with an extensive educational background comprising an MBBS, MD in Medicine, and a DM in Endocrinology from some of India's prestigious institutes.
Upcoming Case Discussions
Endometriosis- Updates
Endometriosis is a chronic gynecological condition where endometrial-like tissue grows outside the uterus, causing pelvic pain, dysmenorrhea, dyspareunia, and infertility. The ectopic tissue responds to hormonal changes, leading to inflammation, adhesions, and scarring. Diagnosis is based on clinical symptoms, imaging (ultrasound, MRI), and confirmed by laparoscopy with biopsy. Treatment includes NSAIDs, hormonal therapy (OCPs, progestins, GnRH analogs), and surgical excision for severe cases. Fertility treatments like IVF may be needed. While not curable, early diagnosis and management can relieve symptoms and improve quality of life.
Case-Based Approach to Managing GI Malignancies
A Case-Based Approach to managing gastrointestinal (GI) malignancies involves applying a personalized, patient-centered strategy using specific case details to guide treatment decisions. It emphasizes a multidisciplinary team approach, where oncologists, surgeons, pathologists, and radiologists collaborate to determine the best course of action based on tumor type, stage, and patient factors. This method allows for tailored treatment plans, integrating surgery, chemotherapy, radiotherapy, and targeted therapies to optimize outcomes. By discussing individual cases, this approach also aids in identifying potential challenges and refining management protocols to improve patient care.
Acne: Disorders and Treatment Approaches
Acne is a common dermatological condition caused by clogged pores, excess sebum production, bacterial growth, and inflammation. It can manifest as blackheads, whiteheads, papules, pustules, or cysts, often leading to scarring if untreated. Various factors, including hormonal changes, diet, stress, and genetics, influence its severity. Treatment approaches range from topical and oral medications, such as retinoids, antibiotics, and hormonal therapy, to advanced procedures like chemical peels and laser therapy. A personalized skincare regimen, along with lifestyle modifications, plays a crucial role in managing and preventing acne.
Role of Telemedicine in Modern Healthcare
Telemedicine plays a crucial role in modern healthcare by enabling remote consultations, reducing the need for in-person visits, and improving access to medical expertise. It enhances patient care through real-time diagnosis, chronic disease management, and mental health support. By integrating AI and digital health technologies, telemedicine streamlines workflows and optimizes healthcare delivery. It is especially beneficial in rural and underserved areas, bridging gaps in specialist care. As technology advances, telemedicine continues to revolutionize healthcare, making it more efficient, accessible, and patient-centered.
Cardiac Rehabilitation
Cardiac rehabilitation is a structured program designed to improve cardiovascular health after heart-related conditions such as heart attacks, heart failure, or surgeries like bypass or stenting. It includes supervised exercise, heart-healthy lifestyle education, nutrition counseling, stress management, and medication guidance. The goal is to enhance heart function, reduce the risk of future heart problems, and improve overall well-being. A multidisciplinary team, including doctors, physiotherapists, and dietitians, tailors the program to each patient’s needs. Regular participation in cardiac rehab lowers mortality rates, prevents hospital readmissions, and promotes long-term cardiovascular health, making it an essential part of heart disease recovery.