The Journal of family practice
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Worsening nausea, vomiting, and dizziness for 2-months, resulting in a 20-pound weight loss. Pruritus. Ataxia. Mild hearing loss, with reoccurring episodes of falls.
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When used in conjunction with the standard of care, 1 g intravenous (IV) tranexamic acid given 1 to 3 hours after delivery is associated with a significant reduction in maternal mortality from postpartum hemorrhage (PPH) (strength of recommendation: A, randomized controlled trial [RCT] and Cochrane review).
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It is widely known that the extent of time spent in a state of hyperglycemia increases the risk of complications for patients with type 2 diabetes (T2D). However, despite the availability of many antihyperglycemic agents, success in managing T2D has not dramatically improved in recent years. Indeed, therapeutic inertia-the failure to initiate or intensify treatment-is a well-characterized phenomenon. ⋯ They go on to discuss iGlarLixi and iDegLira (fixed-ratio combinations of insulin glargine/ lixisenatide and insulin degludec/liraglutide, respectively), which have been shown to be effective in patients with A1C ≥9%. The speakers discuss the positive outcomes associated with a shorter interval between diagnosis and intensive insulin treatment, and the benefits of timely treatment intensification. They also provide practical advice for counseling patients to achieve an effective transition to injectable medication.
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The location of the patient's lesions and multiple risk factors suggested that an uncommon disorder was at work.