Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association
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Exp. Clin. Endocrinol. Diabetes · Jan 2008
Prevalence of undiagnosed Type-2-diabetes mellitus and impaired fasting glucose in German primary care: data from the German Metabolic and Cardiovascular Risk Project (GEMCAS).
Primary care physicians are gatekeepers of the healthcare system and thus responsible for screening, prevention and treatment of diabetes. Little is known about the prevalence of diabetes, impaired fasting glucose and factors that are associated with the risk of future development of diabetes and subsequent cardiovascular disease in unselected patients presenting to general practitioners. ⋯ Approximately 15.7% of individuals in Germany consulting a primary care physician are affected from either diabetes (known and unknown) or impaired fasting glucose and face a substantially elevated cardiovascular risk score. This study demonstrated that using a simplified blood glucose screening algorithm considering risk markers like higher age, male gender, low HDL-cholesterol, high triglycerides and a family history of diabetes may well serve as a suitable screening approach for undiagnosed diabetes and impaired fasting glucose in primary care practice.
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Exp. Clin. Endocrinol. Diabetes · Oct 2007
Management of diabetes mellitus and hospital-related hyperglycemia in patients of a medical ICU, with the use of two "down-to-earth" protocols: a feasibility study.
Optimal control of blood glucose in the ICU has been shown to significantly decrease mortality and morbidity of severely ill patients. The purpose of the present project was to develop and implement undemanding, "down-to-earth" protocols, enabling tight glucose control in critically ill patients, in the setting of a city hospital ICU with limited personnel and facilities. ⋯ The combined implementation of the two protocols presents a simple, safe and effective way of pursuing normoglycemia in critically ill patients.
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Exp. Clin. Endocrinol. Diabetes · Jun 2007
Case ReportsCardiovascular collapse associated with beta blockade in thyroid storm.
We describe three cases of thyroid storm who developed sudden cardiorespiratory arrest soon after the administration of propranolol orally. CASE 1: A 43 years old Chinese lady presented with complaints of fever and chills. She had a urinary tract infection and also had signs of overt thyrotoxicosis. ⋯ All three patients developed cardiorespiratory arrest soon after the administration of propranolol orally. We conclude that in selective patients who have low output cardiac failure in association with severe thyrotoxicosis, it maybe advisable to avoid use of a beta blocker. A safer alternative is the use of ultra short-acting beta-blockers, such as intravenous esmolol, with extreme caution.
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Exp. Clin. Endocrinol. Diabetes · Jun 2007
Comparative Study Clinical TrialInfluence of body mass index on measured and calculated androgen parameters in adult women with Hirsutism and PCOS.
There is growing evidence that obesity in women lead to a more severe form of hyperandrogenism and other endocrine abnormalities which may have some health implications later in life. Obese females are at higher risk for metabolic syndrome due to severe hyperandrogenemia. Calculated values for free testosterone are equivalent to those obtained by equilibrium dialysis, which is one of the reference measurement procedures (RMP) for estimation of free testosterone and may be capable of replacing values estimated using RMP's. ⋯ In both the Hirsutism and PCOS-group there was a positive correlation between BMI and TT, cFT, and cBT, while BMI was negatively correlated with SHBG. In summary, in adult women with Hirsutism and PCOS obesity is associated with increased levels of TT and decreased levels of SHBG resulting in significant elevated calculated free and bioavailable testosterone levels. Obesity might lead to a more severe form of hyperandrogenism with elevated calculated free and bioavailable testosterone in the study population.
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Exp. Clin. Endocrinol. Diabetes · Feb 2007
Review Case ReportsAn unusual cause of severe hypoglycaemia in type 1 diabetes mellitus. Antepartum pituitary failure: a case report and literature review.
We describe an unusual cause of severe hypoglycaemia, secondary to hypopituitarism as a result of antepartum pituitary failure, in a pregnant patient with type 1 diabetes mellitus (T1DM). Antepartum pituitary failure is a very rare condition, which has been reported only in a very small number of pregnant patients with diabetes and presents with an acute onset headache and a sub-arachnoid haemorrhage-like picture. It is a potentially fatal condition to the mother and the child if not recognised and treated. Our case report highlights the importance of thinking about hypopituitarism, as a cause of recurrent hypoglycaemia in pregnant patients with T1DM as missing the diagnosis could be fatal to the mother and child.