Keterangan
Recent challenges in diabetes management involves, maximum use of therapies to have suitable glycemic,blood pressure and lipid control and to reduce the chance of complications,and awareness of patients on self-management and improving patients lifestyle and dietary habits.
Today our guest will be telling us about the complications and the management of diabetes
Ringkasan
- A 68-year-old man with type 2 diabetes, managed with premixed insulin, experienced recent fasting hyperglycemia despite a normal HbA1c of 5.6%. A continuous glucose monitor revealed nighttime hypoglycemia followed by rebound hyperglycemia in the morning, indicating Somogyi phenomenon. This was linked to the patient frequently missing his bedtime snack, leading to low glucose levels during the night.
- The Somogyi phenomenon occurs when the body reacts to low blood sugar during the night by releasing counter-regulatory hormones, leading to a surge in blood glucose levels in the morning. Counter-regulatory hormones include glucagon, cortisol, growth hormone, and epinephrine. It's often triggered by factors like missing bedtime snacks, taking excessive insulin before bed, or poor glycemic control.
- A 22-year-old with type 1 diabetes, who stopped taking insulin for a week, presented with coma and acidotic breathing, but urine ketones were negative. The most probable cause of negative ketones in the urine is excretion of beta-hydroxybutyrate, which is not detected in standard urine tests, as opposed to acetatoacetate. The patient was presenting a case of DKA.
- A 46-year-old obese woman with a history of weight gain, hypertension, and long-term steroid use for 10 years, had elevated fasting and two-hour glucose values in an oral glucose tolerance test. Steroid should be tapered and stop with the dosage as well as a non-healing ulcer on her leg.
- When tapering steroids, the insulin dose should also be reduced gradually to maintain blood glucose levels and prevent hypoglycemia. Abruptly stopping steroids can cause adrenal crisis, while increasing insulin as steroid dose decreases would risk hypoglycemia. Thiazolidinediones are not ideal insulin sensitizers due to their weight gain side effect.
Contoh Sertifikat
Tentang Pembicara
Dr. Swati Panbude
Asisten Profesor, Biokimia, Datta Megha Institute of Medical Sciences, Wardha
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