Diabetes Consultations Archive

Blood glucose test reliability

Blood glucose test reliability

In which disease states or at what stages of chronic kidney disease is the HbA1c test no longer reliable?

Frozen shoulder susceptibility 
in diabetic patients

Frozen shoulder susceptibility 
in diabetic patients

Why are individuals with diabetes especially prone to developing frozen shoulder?

Restrict fruit juice in a diabetic diet?

Restrict fruit juice in a diabetic diet?

Does fruit juice carry the same diabetes risk as other sugar-sweetened beverages?

Interventions for prediabetes

Interventions for prediabetes

Two clinicians disagree on a diagnosis after reviewing two-hour oral glucose tolerance test results. Who is correct?

How much insulin does it take to lower blood sugar?

How much insulin does it take to lower blood sugar?

A patient with newly diagnosed diabetes has a hemoglobin (Hb) A1c of 12.2% and glucose 350 mg/dL, despite increasing insulin (glargine [Lantus]) to 25 units. What else can be done to lower blood sugar?

Gynecomastia in a patient on dialysis

A 69-year-old man with multiple health conditions develops gynecomastia after hemodialysis. Are the two related?

Raising vs. lowering bedtime insulin

How can a clinician determine whether it's appropriate to raise or lower bedtime insulin in a patient experiencing difficulty controlling morning glucose levels?

How is microalbumin:creatinine ratio interpreted?

How is microalbumin:creatinine ratio interpreted?

When is it appropriate to refer diabetic and hypertensive patients to a renal specialist?

Maturity onset diabetes 
of the young 

What is maturity onset diabetes of the young (MODY)? How does it differ from types 1 and 2 diabetes?

Screening for B12 deficiency in diabetic patients

What is the treatment goal for B12 in a patient with diabetic neuropathy, given the wide range of normal (200-950 pg/mL)?

Consider many factors when assessing GI bleed risk

The risk for experiencing a serious GI event rises exponentially with increasing numbers of risk factors.

Are certain antidiabetes drugs better than others after gastric bypass?

Following gastric bypass surgery, many patients will still need metformin or glipizide (Glucotrol). Is there any evidence that one class of hypoglycemic agents is better absorbed than another?

Are ACE inhibitors and ARBs recommended for renal disease?

Tight glycemic, BP and cholesterol control, as well as weight reduction, exercise and smoking cessation can help prevent renal nephropathy.

Insulin detemir as first-line diabetes treatment

What are the effects of using insulin detemir as first-line treatment for type 2 diabetes?

Metformin's impact on levels of vitamin B12

How much B12 supplement is adequate for patients on metformin?

C-peptide against type 2 diabetes?

Is there any role for C-peptide in the management of type 2 diabetes mellitus?

When is it OK to stop insulin?

Is it prudent to discontinue insulin in an incarcerated man with diabetes who was started on insulin while in jail, but who wishes to stop treatment?

Blisters on swollen ankles

A black woman aged 52 years developed large (1.5-2.0 cm wide), fluid-filled blisters on her swollen ankles. There were no other symptoms, and the patient's health history was unremarkable except for anemia. What could be the cause?

Taking coenzyme Q10 with lipid-lowering meds

Does research support the addition of coenzyme Q10 for those on lipid-lowering medication?

Bringing up weight loss with children

What is the best way to tactfully discuss a child's excess weight with his or her parent?

Maturity-onset diabetes screening

What are the most recent screening and diagnostic criteria for maturity-onset diabetes of the young?

A man who can't stay warm

A 54-year-old man from India with a history of type 2 diabetes, hypertension, and dyslipidemia, has cold hands and feet despite wearing sufficient clothing. A specialist has ruled out Raynaud's disease.

Alternatives to insulin

In rural health-care settings, many patients are reluctant to use insulin.

Avoiding lactic acidosis

How high can creatinine go before you must...

Musculoskeletal effects of diabetes

A 48-year-old Caucasian woman diagnosed with type 1 diabetes at the age of 10 complains of stiffness in her wrists, elbows, knees, and ankles.

Updated Approach to New-Onset Diabetes

In light of concerns surrounding rosiglitazone (Avandia), what agent would...

Can BP Therapy Worsen Hyperglycemia?

Will using a diuretic with hydrochlorothiazide in a patient with hypertension and type 2 diabetes contribute to worsening of his hyperglycemia?

More Diabetes With Tortillas

Is there any direct relation between consumption of corn tortillas and the incidence of...

Diabetics' Alcohol Limits

Are individuals taking metformin for type 2 diabetes still allowed one or two alcoholic drinks daily?

Cholesterol goals in diabetes patients

Now that colesevelam (WelChol), a bile acid sequestrant (BAS), has been shown to decrease hemoglobin A1c (HbA1c), should it be the agent of...

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