Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group.
Lancet; 1998 Sep 12;352(9131):854-65. PMID: 9742977
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sulfonylureas (SUs)
Oral pharmacologic treatment of type 2 diabetes mellitus: a clinical practice guideline from the American College of Physicians.
Annals of internal medicine; 2012 Feb 7;156(3):218-31. PMID: 22312141
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Whose Diabetes Treatment Recommendations are Correct?
Posted March 8, 2012 by Irl B. Hirsch, MDPrimary care physicians are expected to be experts on dozens of different disease states despite the fact that each medical problem continues to evolve, with new understanding of the disease itself and its treatments. Frankly, I see this as a near impossible task since as an endocrinologist I can barely keep up with diabetes (in reality I can’t).
Graduate Student with Atypical Symptoms
A 25-year-old graduate student originally presented to you with symptoms of a UTI. An urinanalysis showed signs of infection, as well as glycosuria.
Tailoring Clinical Practice Guidelines for Patients with Type 2 Diabetes
Posted September 21, 2011 by Sonal Singh, MD, MPHSeveral guidelines emphasize the need to use existing therapeutic options to help patients and providers achieve various treatment goals, including target glycated hemoglobin levels to improve microvascular outcomes among patients with type 2 diabetes. 1 Blood pressure medications and lipid lowering therapy and prophylactic aspirin therapy are recommended to improve cardiovascular outcomes. Influenza and pneumococcal vaccination strategies are recommended to reduce the risk of subsequent infections.
Comparative effectiveness and safety of medications for type 2 diabetes: an update including new drugs and 2-drug combinations.
Annals of internal medicine; 2011 May 3;154(9):602-13. PMID: 21403054
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Effect of antihyperglycemic agents added to metformin and a sulfonylurea on glycemic control and weight gain in type 2 diabetes: a network meta-analysis.
Annals of internal medicine; 2011 May 17;154(10):672-9. PMID: 21576535
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T2DM and Fatty Liver Disease: Is What’s Good for the Gander Good for the Goose?
Posted April 7, 2011 by Kim C. Dixon, MDFatty liver disease is the most common cause of chronic liver disease in North America[1] and is becoming one of the top reasons for liver transplantation. Fatty liver causes inflammation that can lead to fibrosis, cirrhosis, and hepatocellular carcinoma. The physiologic relationship between type 2 diabetes mellitus and fatty liver disease is complex and multifactorial.
Do Beta Cells Need Secretory Respite?
Posted October 15, 2010 by Christopher J. Rhodes, PhDEvidence that protecting pancreatic beta cells from chronic overstimulation to maintain glucose homeostasis has led to the concept of “beta cell rest” to preserve or restore beta cell function by temporarily inhibiting insulin secretion. Under normal circumstances this is unnecessary, but in obesity-linked glucose-intolerance and type 2 diabetic conditions beta cells could do with a break.
Primary Care View on Case 2: Failing Metformin
Posted September 7, 2010 by Doron Schneider, MD, FACPCase 2: Metformin Fails in T2DM Patient represents a clinical dilemma faced by every primary care doctor.