ABSTRACT
AIMS: The choice of insulin at initiation in type 2 diabetes remains controversial. The aim of this study was to assess the occurrence of self-reported severe hypoglycaemia associated with premixed insulin analogues in routine clinical care. METHODS: A 12-month, prospective, observational, multicentre study in patients starting a commonly prescribed premixed insulin analogue (either insulin lispro 25/75 or biphasic insulin aspart 30/70, twice daily) after suboptimal glycaemic control on oral antidiabetic agents. Treatment decisions were made solely in the course of usual practice. RESULTS: Study follow-up was completed by 991 (85.5%) of the 1150 patients enrolled. At baseline, mean (SD) age was 57.9 (10.1) years; mean diabetes duration was 9.2 (5.9) years; mean haemoglobin A(1c) (HbA(1c)) was 9.9 (1.8) % and the rate of severe hypoglycaemia was 0.03 episode/patient-year. At 12 months, the rate of severe hypoglycaemia was 0.04 episode/patient-year (95% CI 0.023, 0.055 episode/patient-year) and mean insulin dose was 41.5 (19.4) units. Changes from baseline to 12 months for mean fasting plasma glucose and HbA(1c) were -5.1 mmol/l and -2.5%, respectively. CONCLUSIONS: After initiation of premixed insulin analogues in patients with type 2 diabetes in real-world settings, the incidence of severe hypoglycaemia was lower than expected from previously reported studies.
Subject(s)
Diabetes Mellitus, Type 2/drug therapy , Hypoglycemia/chemically induced , Hypoglycemic Agents/adverse effects , Insulin/analogs & derivatives , Ambulatory Care , Blood Glucose/metabolism , Body Mass Index , Body Weight , Diabetes Mellitus, Type 2/blood , Fasting/blood , Female , Glycated Hemoglobin/metabolism , Humans , Insulin/adverse effects , Male , Middle Aged , Prospective StudiesABSTRACT
Adrenal insufficiency is rarely associated with adrenal haemorrhage. In this report, a case of polycythaemia vera with adrenal haemorrhage and insufficiency has been presented.
Subject(s)
Adrenal Glands/pathology , Adrenal Insufficiency , Hemorrhage , Hydroxyurea , Polycythemia Vera , Prednisolone , Adrenal Glands/diagnostic imaging , Adrenal Glands/metabolism , Adrenal Insufficiency/drug therapy , Adrenal Insufficiency/etiology , Adrenal Insufficiency/metabolism , Adrenal Insufficiency/physiopathology , Glucocorticoids/administration & dosage , Glucocorticoids/adverse effects , Hemorrhage/complications , Hemorrhage/pathology , Hemorrhage/physiopathology , Hormone Replacement Therapy , Humans , Hydroxyurea/administration & dosage , Hydroxyurea/adverse effects , Hyperpigmentation/chemically induced , Male , Middle Aged , Nucleic Acid Synthesis Inhibitors/administration & dosage , Nucleic Acid Synthesis Inhibitors/adverse effects , Polycythemia Vera/blood , Polycythemia Vera/complications , Polycythemia Vera/physiopathology , Polycythemia Vera/therapy , Prednisolone/administration & dosage , Prednisolone/adverse effects , Radiography , Treatment OutcomeABSTRACT
OBJECTIVE: To determine the frequency of antithyroid antibodies and the presence of autoimmune thyroiditis among patients with primary Sjögren's syndrome. DESIGN: A case-control study. METHODS: 53 consecutive patients with primary Sjögren's syndrome, 30 with rheumatoid arthritis, 12 with secondary Sjögren's syndrome associated with rheumatoid arthritis, 17 with autoimmune thyroiditis, and 53 apparently healthy controls were studied for anti-TG and anti-TPO antibodies as well as serum thyroid hormones and TSH levels. RESULTS: The overall frequencies of thyroid antibodies were 6/53 (11%) in primary Sjögren's syndrome, 2/30 (7%) in rheumatoid arthritis, 2/12 (17%) in secondary Sjögren's syndrome, 4/53 (8%) in healthy controls, and 16/17 (94%) in autoimmune thyroiditis. There was no difference in the frequency of the thyroid antibodies among the groups if patients with autoimmune thyroiditis were excluded (p = 0.415 for anti-TPO; p = 0.275 for anti-TG; p = 0.696 for either anti-TG and/or anti-TPO). Only two patients with primary Sjogren's syndrome had clinical hypothyroidism associated with autoimmune thyroiditis. CONCLUSIONS: In this Turkish population, no association between primary Sjögren's syndrome and autoimmune thyroiditis was found.
