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Category Archives: Diabetes

[Endocrinology] Insulin – Its Physiologic Effects and Their Mechanisms


General Considerations Hormones are chemical products, released in very small amounts from the cell, that exert a biologic action on a target cell. Chemical Structures of Hormones There types of hormones, including protein/peptide, steroid hormones, and amino acid-derived hormones. Let’s talk them below. Based on their chemical structure, hormones can be classified into peptides/proteins (i.e., […]

The Management of Hypertension (Clinical Evaluation)


Frequently, the only sign of essential hypertension is elevated BP. The rest of the physical examination may be completely normal. However, a complete medical evaluation including a comprehensive medical history, physical examination, and laboratory and/or diagnostic test is recommended after diagnosis to identify secondary causes, identify other CV risk factors or comorbid conditions that may […]

The Management of Dyslipidemia


Let's talk about ATP IV first, then we shall discuss how to detect, evaluate, and manage patients with lipid disorders. This thread is based on the latest clinical guideline (Circulation. 2014:S1-S45) for therapy of dyslipidemia to reduce atherosclerotic cardiovascular risk in adults (>21 years of age) and the guideline is based on the Full Panel […]

Nutrition Recommendations and Interventions for Diabetes (Part One)


Effectiveness of MNT (Medical Nutrition Therapy) Clinical trials/outcome studies of MNT have reported decreases in HbA1c of ~1% in type 1 diabetes and 1-2% in type 2 diabetes, depending on the duration of diabetes. Meta-analysis of studies in nondiabetic, free-living subjects and expert committees report that MNT reduce LDL cholesterol by 15-25 mg/dl. After initiation […]

The Management of Hyperglycemic Crises in Diabetes


Diabetic ketoacidosis (DKA) and the hyperosmolar hyperglycemic state (HHS) are the two most serious acute metabolic complications of diabetes. The triad of uncontrolled hyperglycemia, metabolic acidosis (SAG elevated metabolic acidosis), and increased total body ketone concentration characterizes DKA. HHS is characterized by severe hyperglycemia, hyperosmolality, and dehydration in the absence of significant ketoacidosis. Pathogenesis DKA […]