Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
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Randomized Controlled Trial
Effect of dexamethasone on oral glucose tolerance in healthy adults.
To determine the dose-response and time course of action of a single dose of dexamethasone on plasma glucose and insulin dynamics in healthy adults. ⋯ A single oral dose of 8-mg dexamethasone increases blood glucose, insulin, and C-peptide levels maximally at 24 hours, 1 hour following 75-g OGTT. A dexamethasone stress test might identify persons at increased risk for type 2 diabetes.
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To describe the association of tight glycemic control with intensive insulin therapy and clinical outcome among patients in the cardiothoracic surgery intensive care unit. ⋯ The study findings suggest that acute postoperative hyperglycemia and its prompt correction with intensive insulin therapy are associated with favorable outcomes in patients in the cardiothoracic surgery intensive care unit.
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To determine the effect of a year-long, multifaceted diabetes curriculum on the knowledge of internal medicine residents. ⋯ Inpatient diabetes education targeted to PGY-1 residents modestly improves resident knowledge, especially in the targeted population. Traditional educational methods may not be adequate, and improved education is needed for trainees and attendings to provide optimal diabetes care. Strategies to improve resident education may include developing more comprehensive lectures that address fundamental concepts, focusing on all PGY levels, frequent consultation with diabetologists, and case-based discussions.
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To report a case of chronic and persistent hypoglycemia and lactic acidosis in a 74-year-old military veteran. ⋯ Our case is unique because, to our knowledge, it is the first reported case of immature B-cell lymphoma/leukemia and myelodysplasia with a complex karyotype based on extensive cytogenetic studies in a patient presenting with hypoglycemia, lactic acidosis, and central nervous system involvement by lymphoma.
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To estimate the frequency of undiagnosed vitamin B12 deficiency among patients with type 2 diabetes mellitus who had not taken metformin during at least the prior 5 years and to ascertain whether vitamin B12 deficiency among the patients with type 2 diabetes was due to nutritional deficiency or malabsorption. ⋯ We conclude that vitamin B12 deficiency is common among patients with type 2 diabetes and was related to nutrition in our study group. In addition to intensive glycemic control, vitamin B12 supplementation should be considered for treatment of diabetic neuropathy. In almost 50% of patients with low vitamin B12 levels, the deficiency was corrected with oral supplementation only. This, indeed, is an important finding, inasmuch as oral vitamin B12 supplementation is easy, convenient, and readily accepted by patients. This finding highlights the need for aggressive and early diagnosis and treatment to avoid complications of vitamin B12 deficiency.