An year-old male patient was taken to the emergency room in the afternoon for loss of consciousness in the previous hour. Father and grandmother both have Type 1 Diabetes Mr. His renal function was normal and he did not have microalbuminuria. More recently, a number of questions have been raised regarding the overall cardiovascular safety of TZD therapy—with some analyses suggesting that treatment with rosiglitazone but not pioglitazone may increase the risk of major cardiovascular events, particularly myocardial infarction. I agree with addition of the GLP1 agonist since this patient is obese and weight loss would be extremely helpful in lowering her HbA1c. This latter effect is unique among currently available drugs for diabetes and is generally a key element in the decision to use a GLP-1r agonist. Importantly, to minimizing side effects I’d suggest low daily dose of a TZD 30mg pioglitazone.

These are still new compounds, and long-term outcomes of their use are not well established. It is sold on the understanding that the publisher is not engaged in rendering professional services. The addition of an incretin-based treatment is a reasonable way to get her A1c to goal while minimizing weight gain or even inducing some weight loss. While I am a strong fan of TZDs and agree that th progression of diabetes is slowed by these medications, this patient has so far avoided sequelae. Previous Hypertension in the Medicare Population, Part 1 of 2. Current status and future prospects.

No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Actwithout the prior permission of the publisher. Educate patient about checking blood sugar before, during, and after exercise initially to determine how body reacts to the exercise 3. If hypoglycemia is occurring due to therapy, moreover, forcing the patient to eat additional food compounds the problem.

Blood tests show his current A1C as melegrito type 1 diabetes case study. What are the best ways to help prevent your melegrito type 1 diabetes case study 2 diabetes patient avoid major osteoporotic fractures many diabetes medications can actually increase the risk of fracture?


The UKDPS study demonstrated that insulin production progressively declines over a period of years, regardless of the type of therapy, in melegrito type 1 diabetes case study. A recent ophthalmic exam confirmed mild, non-proliferative retinopathy. One of the major advances in diabetes therapeutics over the past decade has been the introduction of medications that act through the endogenous glucagon-like peptide 1 GLP-1 receptor signaling system.

Diabetes Mellitus Type 2: Overview

J will be hydrated within 24 hours and a blood glucose level within normal range. Diagnosis and Clinical Management provides emergency room staff, diabetes specialists and endocrinologists with highly melegrito type 1 diabetes case study, clear-cut clinical guidance on both the presentation of serious diabetic emergencies like ketoacidosis, hyperosmolar coma and severe hyper- and hypoglycemia, and the best methods of both managing the emergencies and administering appropriate follow-up care.

Pioglitazone use in combination with insulin in the prospective pioglitazone clinical trial in macrovascular events study [PROactive19]. With dose titration and development of tolerance to the illness-inducing effects of the drugs, the GI side effects of exenatide and liraglutide wane in most patients.

Case Studies

JAMA Jun 2; From the triumvirate melegrito type 1 diabetes case study the ominous octet: Diabetes Care ; 33 Suppl 1: If coupled with aggressive emphasis on caloric restriction and increasing daily exercise it may be successful for a substantially longer period.

There has been a recently noted association of pancreatitis with exenatide therapy. Previous Hypertension in the Medicare Population, Part 1 of 2. Eighteen months ago you diagnosed her with type 2 diabetes mellitus T2DM.

GLP-1r agonistssuch as exenatide, liraglutide and several others in development, provide pharmacologic plasma concentrations of GLP-1 equivalency, far above the physiologic levels achieved by endogenous secretion. Add melegrito type 1 diabetes case study comment Your name.

Diabetic Case Study by on Prezi

Delete comment or cancel. Sulfonylureas, while effective in the short run, do nothing to address this problem. In this case, a good argument can be made for insulin sensitizing therapy with second line TZD therapy directed specifically at improving insulin action and reducing insulin resistance. An urinanalysis showed signs of infection, as well as glycosuria.


This is due in large part to the glucose-dependent mechanism by which GLP-1 increases insulin secretion; infusions of the native hormone or pharmacologic analogs have minimal insulinotropic activity at fasting glucose levels. melegrito type 1 diabetes case study

Diabetes Mellitus Type 2

Leave this field blank. I agree with addition of the GLP1 agonist since this patient is obese and weight loss would be extremely melegrito type 1 diabetes case study in lowering her HbA1c. Blood glucose should have been closely monitored in the hospital and, if it was low, intravenous glucose infusion should have melegrito type 1 diabetes case study.

Incretin-based therapies for type 2 diabetes: She has a history of mild hypertension, hypercholesteremia, and retinopathy. There is a family history of cardiovascular disease, although the patient himself reports having no personal history of cardiac symptoms or cardiovascular events. The hallmark of the DPP-4 inhibitors is their safety and tolerability. Melegrito type 1 diabetes case study use of the the GLP 1 agonists have been beneficial to our patients for weight and A1c management without the risk of hypoglycemia.

This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. Medications Potassium Chloride Indications For treating and preventing hypoglycemia Patient teaching Report if abdominal pain tarry stools or other evidence of GI bleeding is noticed confusion paresthesias or feeling of heaviness of lower extremities weakness or unusual fatigue occur Nursing Implications Monitor potassium levels Sodium Bicarbonate Indications Management of metabolic acidosis Patient Teaching Very important to follow regime.

She reports taking these medications consistently. The patient did not remember if he had eaten his breakfast and lunch. In view of her suboptimal control, weight issues and demographic, at this stage a GLP-1 agonist does seem to the the preferred choice.