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Prescribe an SGLT2 inhibitor for heart failure in the absence of diabetes?
Koenigsberger, D, Marquez, A, Hughes, PR
The Journal of family practice. 2021;(6):E7-E9
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Abstract
An RCT demonstrates that dapagliflozin produces better cardiovascular outcomes than placebo for heart failure patients with and without diabetes.
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Clinical manifestation of non-ketotic hyperglycemia chorea: A case report and literature review.
Wang, W, Tang, X, Feng, H, Sun, F, Liu, L, Rajah, GB, Yu, F
Medicine. 2020;(22):e19801
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Abstract
INTRODUCTION Chorea is considered a special complication of diabetes mellitus. Here we report a case of chorea associated with non-ketotic hyperglycemia (NKH). PATIENT CONCERNS The patient was a 79-year-old Asian woman. She had a history of type 2 diabetes mellitus more than 30 years, but with a poor control of blood sugar. She complained of acute onset of right limb involuntary activities, and being admitted to neurology department. DIAGNOSIS The patient was then diagnosed with NKH chorea. INTERVENTIONS Intravenous infusion of insulin was given to reduce blood glucose. Haloperidol was used to control motor symptoms. OUTCOMES Her symptoms improved quickly after treatment. In the past year, the patient's blood sugar was well controlled and her chorea did not recur. LESSONS If there are sudden abnormal movements in patients, in addition to thinking of chorea, hepatolenticular degeneration and other diseases, we should also pay attention to blood sugar, especially in diabetic patients with poor blood sugar control and negative ketone, we should consider the possibility of NKK chorea. CONCLUSIONS NKH chorea is a special complication of diabetes.
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[Interest of a pharmacovigilance medical consultation: Example of metformin-induced-vitamin B12 deficiency].
Lafaurie, M, Montastruc, F
Presse medicale (Paris, France : 1983). 2019;(11 Pt 1):1216-1221
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Euglycemic Diabetic Ketoacidosis Associated With Sodium-Glucose Cotransporter Type 2 Inhibitors in Patients With Type 2 Diabetes Mellitus Receiving Oral Therapy.
Dull, RB, Spangler, ML, Knezevich, EL, Lau, BM
Journal of pharmacy practice. 2019;(2):240-243
Abstract
INTRODUCTION AND OBJECTIVE Postmarketing reports and warnings of serious adverse events such as diabetic ketoacidosis (DKA) have raised concern regarding the safety of sodium-glucose cotransporter 2 inhibitors (SGLT2i). This report describes 2 cases of symptomatic SGLT2i-associated euglycemic DKA (euDKA) leading to hospitalization in patients with type 2 diabetes mellitus (DM) previously well controlled on oral medications. CASE REPORTS Subject 1 is a 55-year-old female admitted with euDKA precipitated by infection and managed with intravenous insulin. This case was notable for a delayed diagnosis of euDKA and lack of clinical improvement despite withholding dapagliflozin. Subject 2 is a 62-year-old male admitted with euDKA precipitated by infection. His clinical condition improved rapidly and euDKA responded to withdrawal of empagliflozin alone. DISCUSSION Applying the Naranjo adverse medication reaction probability scale to each case (subject 1 score = 3 points; subject 2 score = 4 points) suggests these are possible adverse reactions to SGLT2i. Data from randomized controlled trials suggest DKA events in adults with type 2 DM receiving SGLT2i are rare and similar to placebo. However, data from a large cohort suggest these events occur more frequently and are associated with a 2-fold increased risk of DKA. CONCLUSION This class of medications may be associated with a higher real-world risk of DKA in adults with type 2 DM than previously reported. Patients prescribed these medications should receive vigilant assessment for features of traditional DKA as well as euDKA.
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Plant-based Diet for HbA1c Reduction in Type 2 Diabetes Mellitus: an Evidence-based Case Report.
Utami, DB, Findyartini, A
Acta medica Indonesiana. 2018;(3):260-267
Abstract
BACKGROUND diabetes has become a major public health concern with an estimated 180 million cases worldwide. Nutritional changes are one of the key aspects in the management of type 2 diabetes mellitus. Previous studies have suggested an association between vegetarian diets and improvements in glycemic control in type 2 diabetes mellitus, however the relationship is not well established. The aim of this report is to perform a critical appraisal to analyze whether plant-based diet reduces the HbA1c level compared to conventional diet. METHODS a comprehensive computer-based literature search was performed on June 20, 2016 using PubMed, Ovid, EBSCO, and the Cochrane Library. All abstracts and titles from the initial search results were screened, reviewed, and appraised using critical appraisal worksheets by Center of Evidence-Based Medicine, University of Oxford. RESULTS one systematic review and two RCTs met the inclusion criteria and were considered eligible for this case report. In patients with type 2 diabetes mellitus, HbA1c significantly yielded greater reduction in the plant-based group compared to conventional diet group after 22 weeks of follow up. Similarly, there was a statistically greater reduction in HbA1c level in the plant-based group after 72 weeks. Furthermore, consumption of plant-based diet was associated with a significant reduction in HbA1c. CONCLUSION in patients with type 2 diabetes mellitus, HbA1c reduction was greater in patients with plant-based diet compared to patients with conventional diet. Further research should be conducted with larger sample size and longer follow-up period.
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Managing the Course of Kidney Disease in Adults With Type 2 Diabetes: From the Old to the New.
Goldenberg, RM, Berall, M, Chan, CTM, Cherney, DZI, Lovshin, JA, McFarlane, PA, Senior, PA, Verma, S, Weinstein, JJ
Canadian journal of diabetes. 2018;(3):325-334
Abstract
Diabetic kidney disease (DKD) is a group of chronic kidney diseases that is associated with significant cardiovascular as well as all-cause morbidity and mortality. Although DKD is often progressive in nature, its evolution can be modified by intensive management of glycemia and blood pressure and inhibition of the renin-angiotensin-aldosterone system. This review provides an overview of how multifactorial interventions can provide renal protection and includes a discussion of the nonglycemic effects of incretin-based diabetes therapies (glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase 4 inhibitors) and sodium-glucose cotransporter-2 inhibitors within the kidney in patients with type 2 diabetes.
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Weight loss at a high cost: Orlistat-induced late-onset severe kidney disease.
Buysschaert, B, Aydin, S, Morelle, J, Hermans, MP, Jadoul, M, Demoulin, N
Diabetes & metabolism. 2016;(1):62-4
Abstract
AIM: This report describes a case of kidney failure secondary to orlistat, a lipase inhibitor commonly used in the treatment of obesity. CASE REPORT An 80-year-old man with type 2 diabetes who was being treated with orlistat developed rapidly progressive kidney failure. Low-grade albuminuria argued against diabetic nephropathy. Renal biopsy showed tubulointerstitial nephritis associated with numerous calcium oxalate crystals. Enteric hyperoxaluria was attributed to the orlistat treatment. The latter was stopped and the patient received calcium supplements. Six months after orlistat withdrawal, oxaluria was normalized and kidney function stabilized. CONCLUSION Oxalate nephropathy may result from hyperoxaluria secondary to orlistat treatment. This suggests that kidney function and oxaluria be closely monitored in patients taking orlistat.
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Is an SGLT2 inhibitor right for your patient with type 2 diabetes?
Lisenby, KM, Meyer, A, Slater, NA
The Journal of family practice. 2016;(9):587-93
Abstract
Metformin isn't quite doing the job or is contraindicated? Here's a look at the patients who may benefit from these agents and the monitoring required.
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[About the choice between a DPP-4 inhibitor and a SGLT 2 inhibitor tor treating type 2 diabetes].
Scheen, AJ, Paquot, N
Revue medicale de Liege. 2016;(12):579-585
Abstract
Two new classes of oral antidiabetic agents play an increasing role in the management of type 2 diabetes, dipeptidyl peptidase-4 (DPP-4) inhibitors (gliptins) and sodiumglucose cotransporters type 2 (SGLT2) inhibitors (gliflozins). After failure of a monotherapy with metformin (first pharmacological choice in type 2 diabetes), both may offer an alternative to the add-on of a sulphonylurea, especially in patients at risk of hypoglycaemia. However, the choice between a DPP-4 inhibitor and a SGLT2 inhibitor is not easy and should be oriented based upon the individual patient characteristics. The arguments in favour of one or another pharmacological class are discussed, considering a clinical case of a patient with coronary heart disease and type 2 diabetes not well controlled with metformin.
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10.
[Not Available].
Falconnier Bendik, C, Donath, MY
Therapeutische Umschau. Revue therapeutique. 2016;(6):340-8