Pub Date : 2020-12-30DOI: 10.13188/2475-5591.1000013
A49 year old female with learning disability and 2 years history of epilepsy was admitted following a siezure like activity and fall during a routine visit to her GP surgery. She had sustained injury to left knee and xray confirmed a distal femur and a patellar fracture. On admission her serum glucose was 2.0 mmol, all other routine blood tests including Full Blood Count, Renal function and Liver function test were normal. Her regular medications included Lamotrigine and Mebeverien. On the ward she had recurrent spontaneous hypoglycaemic episodes requiring regular treatment with glucose infusions. The lowest capillary blood glucose recorded was 1.9 mmol. Due to the learning disability, patient could not describe any symptoms usually experienced at the onset of hypoglycaemia. Glycated Haemoglobin (HbA1c) was 19.0 mmol (Ref range: 2041 mmol) indicating lower than normal average glucose. Random cortisol and thyroid function test were normal. She underwent left knee exploration and repair of medial retinaculum of quadriceps tendon and excision of patellar fragment. While awaiting results of further investigations, Diazoxide was initiated with good effect. The results of the specific biochemical investigations for her recurrent hypoglycaemia were consistent with endogenous hyperinsulinaemic hypoglycaemia (Table 1).
{"title":"Insulinoma Treated As Epilepsy; a Case of Misdiagnosis","authors":"","doi":"10.13188/2475-5591.1000013","DOIUrl":"https://doi.org/10.13188/2475-5591.1000013","url":null,"abstract":"A49 year old female with learning disability and 2 years history of epilepsy was admitted following a siezure like activity and fall during a routine visit to her GP surgery. She had sustained injury to left knee and xray confirmed a distal femur and a patellar fracture. On admission her serum glucose was 2.0 mmol, all other routine blood tests including Full Blood Count, Renal function and Liver function test were normal. Her regular medications included Lamotrigine and Mebeverien. On the ward she had recurrent spontaneous hypoglycaemic episodes requiring regular treatment with glucose infusions. The lowest capillary blood glucose recorded was 1.9 mmol. Due to the learning disability, patient could not describe any symptoms usually experienced at the onset of hypoglycaemia. Glycated Haemoglobin (HbA1c) was 19.0 mmol (Ref range: 2041 mmol) indicating lower than normal average glucose. Random cortisol and thyroid function test were normal. She underwent left knee exploration and repair of medial retinaculum of quadriceps tendon and excision of patellar fragment. While awaiting results of further investigations, Diazoxide was initiated with good effect. The results of the specific biochemical investigations for her recurrent hypoglycaemia were consistent with endogenous hyperinsulinaemic hypoglycaemia (Table 1).","PeriodicalId":338236,"journal":{"name":"Advances in Diabetes & Endocrinology","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123112849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-30DOI: 10.13188/2475-5591.1000014
industrial processes to prevent reactions to the animal insulins by the patients on insulin therapy. This went on until the 1980s. Through genetic engineering and intensive researches, Eli Lilly Corporation mass-produced human insulin [5]. This was a paradigm shift in insulin pharmacotherapy. Organisms such as Escherichia coli and yeasts are being used to grow human insulin through the process of Deoxyribonucleic (DNA) technology [5]. The manufactured insulins are subjected to purification processes such as high performance liquid chromatography, gel filtration and x-ray crystallography to ensure quality control. By the mid 1990’s, researchers started working on the modification of the amino acid sequencing coded by the insulin gene so as to produce insulin with better pharmacokinetic and pharmacodynamic properties. These insulins are called analogue insulins. Examples of the analogue insulins include rapid actin insulins such as (lispro, aspart and glulisine), long acting insulins (such as detemir and glargine) and ultra-long acting insulins (such as degludec). Insulin can be administered subcutaneously, intramuscularly or intravenously. Oral insulins are still under intense research while inhaled insulins have not received clinical patronization compared Abstract Prevalence of diabetes mellitus is
{"title":"Soluset Insulin Solution Treatment Algorithm (SISTA) for Hyperglycaemic Emergencies among Adults in Low Income Countries","authors":"","doi":"10.13188/2475-5591.1000014","DOIUrl":"https://doi.org/10.13188/2475-5591.1000014","url":null,"abstract":"industrial processes to prevent reactions to the animal insulins by the patients on insulin therapy. This went on until the 1980s. Through genetic engineering and intensive researches, Eli Lilly Corporation mass-produced human insulin [5]. This was a paradigm shift in insulin pharmacotherapy. Organisms such as Escherichia coli and yeasts are being used to grow human insulin through the process of Deoxyribonucleic (DNA) technology [5]. The manufactured insulins are subjected to purification processes such as high performance liquid chromatography, gel filtration and x-ray crystallography to ensure quality control. By the mid 1990’s, researchers started working on the modification of the amino acid sequencing coded by the insulin gene so as to produce insulin with better pharmacokinetic and pharmacodynamic properties. These insulins are called analogue insulins. Examples of the analogue insulins include rapid actin insulins such as (lispro, aspart and glulisine), long acting insulins (such as detemir and glargine) and ultra-long acting insulins (such as degludec). Insulin can be administered subcutaneously, intramuscularly or intravenously. Oral insulins are still under intense research while inhaled insulins have not received clinical patronization compared Abstract Prevalence of diabetes mellitus is","PeriodicalId":338236,"journal":{"name":"Advances in Diabetes & Endocrinology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130335311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-02DOI: 10.13188/2475-5591.1000012
Sheuly Ferdousi, Tania Nasreen, S. Islam, Q. Rahman, S. Selim, D. Paul, Mesbah U. Ahmed, T. Sultana
Background: Microalbuminuria is the most common aetiology of chronic kidney disease. Optimum glycemic control reduces the development and progression of diabetes-related complications and there is evidence that improved glycemic control improves outcome in diabetic subjects.
{"title":"Microalbuminuria in Type 2 Diabetes and its Relationship with Glycosylated Hemoglobin","authors":"Sheuly Ferdousi, Tania Nasreen, S. Islam, Q. Rahman, S. Selim, D. Paul, Mesbah U. Ahmed, T. Sultana","doi":"10.13188/2475-5591.1000012","DOIUrl":"https://doi.org/10.13188/2475-5591.1000012","url":null,"abstract":"Background: Microalbuminuria is the most common aetiology of chronic kidney disease. Optimum glycemic control reduces the development and progression of diabetes-related complications and there is evidence that improved glycemic control improves outcome in diabetic subjects.","PeriodicalId":338236,"journal":{"name":"Advances in Diabetes & Endocrinology","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133030168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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