Revue médicale de Bruxelles
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Delirium is a disturbance of consciousness, cognition and perception that occurs frequently in medically ill patients. Although it is associated with increased morbidity and mortality, it is often not recognised. Predisposing factors are believed to have multiplicative effects and include dementia, advanced age and male gender. ⋯ Although it has been shown to be efficacious, the prevention of delirium is underutilised. Prevention consists of aggressive management of known risk factors and early detection. The intervention had not always significant effect on the severity of delirium or on recurrence rates; this finding suggests that primary prevention of delirium is probably the most effective treatment strategy.
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The increasing prevalence of type 2 diabetes in the USA has closely paralleled the increase in childhood obesity noted there, but now across the Western world and therefore in Belgium. (Pre)type 2 diabetes is preceded by insulin resistance which must be diagnosed and treated. In Belgium, type 1 diabetes is the predominant (97%) form of diabetes in young people (< 2,000 cases under the age of 18 years). Type 1 diabetes is an auto-immune disease which is more aggressive in younger children. ⋯ In the twice-daily injection regimen, the allocation of carbohydrates throughout the day is essential. Due to their pharmakokinetic characteristics, rapid-acting and long-acting insulin analogues have specific indications in both the twice-daily injection regimen and the basal-bolus insulin therapy. They improve quality of life, without necessarily reducing HbA1c.