Journal of investigative medicine : the official publication of the American Federation for Clinical Research
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Diuretics are one of the most common causes of severe hyponatremia. The responsible pathogenetic mechanisms remain unclear. Serum uric acid concentration has been proposed as an index of differentiating between two pathophysiologic constructs of diuretic-induced hyponatremia-extracellular volume depletion and syndrome of inappropriate antidiuretic hormone secretion (SIADH)-like state-but its discriminating value has not been verified in large series of patients. Here we attempt to illuminate the pathophysiology of diuretic-induced hyponatremia by focusing on uric acid homeostasis. Additionally, we analyze the epidemiology and clinical characteristics of the disorder. ⋯ Diuretics are the most common cause of community-developed hyponatremia. The serum uric acid level effectively discriminates between two biochemical profiles of diuretic-induced hyponatremia, one consistent with extracellular volume depletion and another that simulates SIADH.
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Clinical Trial
Effects of multiple daily insulin injections on peripheral glucose disposal in Latin Americans with type 2 diabetes mellitus.
To evaluate the effects of insulin in multiple daily injections (MDI) on peripheral glucose disposal in Latin American patients with type 2 diabetes. ⋯ Despite a significant improvement in glycemic control, MDI did not seem to increase the insulin-mediated glucose disposal rate. Underlying obesity and increased percent body fat may have been the most counteracting factors on the potential improvement in insulin sensitivity expected with insulin monotherapy.