Internal medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
Lispro is superior to regular insulin in transient intensive insulin therapy in type 2 diabetes.
The optimal approach to relatively recent onset type 2 diabetes patients is still unknown. We speculated that the use of short-acting insulin analogs might be of particular benefit in this context. ⋯ Two-week intensive insulin therapy with lispro appeared to be more effective than that with regular insulin in type 2 diabetes in attaining both more rapid beta-cell rest and greater suppression of glucagon. These changes may provide significant long-term benefits.
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We report a 70-year-old man who presented symptoms resembling those of meningoencephalitis and who was subsequently diagnosed as having a crowned dens syndrome. The patient exhibited severe neck pains, headache, high fever and a pain in his knee joints together with symptoms of the central nervous system. The patient's cerebrospinal fluid was almost clear and showed no sign of viral infection. ⋯ A tomographic examination of the neck showed periodontoid calcification. The patient was first treated with non-steroidal anti-inflammatory drug, but its effect was only minimal. On the other hand, the administration of corticosteroid resulted in a dramatic improvement in his condition.