Ehlerscallesen3564

To determine whether adrenal crisis (AC) identification may be affected by the definition of hypotension.

Delays in AC diagnosis can result in adverse outcomes. AC-related cardiovascular compromise may vary according to baseline blood pressure and may be associated with delayed AC detection in some patients.

A retrospective study of paired systolic blood pressure (sBP) measurements in hospitalized patients with primary AI (PAI).

Patients with PAI and an acute illness admitted for urgent treatment between 2000 and 2017.

A comparison between sBP on hospital arrival and on discharge. Hypotension was classified as either absolute hypotension (sBP 100mg or lower) or relative hypotension (sBP over 100mg but at least 20mmHg lower than discharge sBP).

Of 152 admissions with paired blood pressure measurements, 46 (30.3%) included a medically diagnosed AC. Ropsacitinib clinical trial Absolute hypotension was found in 38 (25.0%) records, and a further 21 (13.8%) patients were classified as having relative hypotension. Patients aged 65years and older had the lowest (14.8%, n=8) proportion with absolute hypotension but the highest (27.8%, n=15) with relative hypotension. Use of either absolute or relative hypotension as the criterion for AC diagnosis increased the proportion of patients with an AC by 28.3% and the proportion of patients with an AC in the oldest age group by 130%.

Failure to detect cardiovascular compromise is common in older AI patients, may underestimate the AC rate in this group, and delay essential treatment. Relative hypotension may play a role in AC diagnosis.

Failure to detect cardiovascular compromise is common in older AI patients, may underestimate the AC rate in this group, and delay essential treatment. Relative hypotension may play a role in AC diagnosis.

To determine whether de-escalating from advanced insulin therapy (AIT) to the combined use of metformin, an SGLT2 inhibitor, a GLP1 receptor agonist and basal insulin is the better option than multiple daily insulin injections (MDI) in obese patients with poorly controlled T2DM.

This was a 16-week, prospective, randomized, controlled trial. Twenty-two obese patients with T2DM on AIT were randomized to intervention (step-down) or control (MDI) group. In the intervention group, all prandial insulin injections were discontinued, but the patient remained on basal insulin and metformin, to which an SGLT2i and a GLP1 RA were added. In the control group, the patient remained on MDI.

Compared to control group (

=8), A1c was significantly lower at week 4 (9.54% vs 8.25%;

=.0088) and week 16 (9.7% vs 7.31%;

<.001) in intervention group (

=10). In intervention group, compared to baseline, there was a significant decrease in weight (-16.38 pounds;

=.003), BMI (-3.06;

<.001), LDL cholesterol (-15.7mgoption than continuing MDI in these patients.

To determine the factors associated with poor glycemic control in children (1-10years), adolescents (11-18years) and young adults (19-40years) with Type 1 Diabetes Mellitus (T1DM) in Kilimanjaro Christian Medical Center (KCMC) in Moshi, Mount Meru Regional Referral Hospital (MMRRH) and Meru District Hospital (MDH) in Arusha, Tanzania.

Cross sectional study of 150 participants conducted from January to June 2019, data was collected by structured questionnaire and analyzed using SPSS version 23.

The mean HbA1c was 12.3±2.2%, 146 had poor glycemic control (HbA1c>7.5%). BMI, insulin regime and caretaker education were associated with poor glycemic control. There were 16 participants diagnosed in DKA and the most frequently reported complications in the prior 3months were hyperglycemia (n=25), DKA (n=18) and hypoglycemia (n=4).

Glycemic control is still very poor particularly in adolescents. Significant associations with glycemic control were higher BMI, insulin regime and guardian education. The study revealed lower prevalence of DKA at diagnosis compared to previous studies.

Glycemic control is still very poor particularly in adolescents. Significant associations with glycemic control were higher BMI, insulin regime and guardian education. The study revealed lower prevalence of DKA at diagnosis compared to previous studies.

The aim of the present study was to assess beta cell function based on an oral glucose tolerance test (OGTT) in participants with single islet autoantibody or an intravenous glucose tolerance test (IvGTT) in participants with multiple islet autoantibodies.

Healthy participants in Sweden and Finland, between 2 and 49.99years of age previously identified as positive for a single (n=30) autoantibody to either insulin, glutamic acid decarboxylase, islet antigen-2, zinc transporter 8 or islet cell antibodies or multiple autoantibodies (n=46), were included. Participants positive for a single autoantibody underwent a 6-point OGTT while participants positive for multiple autoantibodies underwent an IvGTT. Glucose, insulin and C-peptide were measured from OGTT and IvGTT samples.

All participants positive for a single autoantibody had a normal glucose tolerance test with 120minutes glucose below 7.70mmol/L and HbA1c values within the normal range (<42mmol/mol). Insulin responses to the glucose challenge on OGTT ranged between 13.0 and 143 mIU/L after 120minutes with C-peptide values between 0.74 and 4.60nmol/L. In Swedish participants, the first-phase insulin response (FPIR) on IvGTT was lower in those positive for three or more autoantibodies (n=13; median 83.0 mIU/L; range 20.0-343) compared to those with two autoantibodies (n=15; median 146 mIU/L; range 19.0-545;

=.0330).

Participants positive for a single autoantibody appeared to have a normal beta cell function. Participants positive for three or more autoantibodies had a lower FPIR as compared to participants with two autoantibodies, supporting the view that their beta cell function had deteriorated.

Participants positive for a single autoantibody appeared to have a normal beta cell function. Participants positive for three or more autoantibodies had a lower FPIR as compared to participants with two autoantibodies, supporting the view that their beta cell function had deteriorated.