Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 2 de 2
Filter
Add more filters










Database
Language
Publication year range
1.
J Palliat Med ; 22(1): 109-111, 2019 Jan.
Article in English | MEDLINE | ID: mdl-30633698

ABSTRACT

Intraosseous (IO) access is normally reserved for emergencies and critical care conditions when venous cannulation is not possible. Nonetheless, we present a case of IO insertion to a 56-year-old man, tetraplegic for many years due to progressive spinal muscular atrophy and with refractory suffering. The IO access was used for palliative sedation with propofol in a home care setting. The patient died after 11 days of palliative care, of which the last 4 days were with palliative sedation using an IO cannula as a vascular access. No complications were noted from this route of administration. We advocate the use of IO access in the palliative care of terminal ill patients when a venous cannulation is not possible.


Subject(s)
Hypnotics and Sedatives/administration & dosage , Infusions, Intraosseous , Palliative Care/methods , Propofol/administration & dosage , Terminally Ill , Drug Administration Routes , Home Care Services , Humans , Male , Middle Aged , Muscular Atrophy, Spinal/drug therapy , Pain/drug therapy , Patient Safety , Quadriplegia/drug therapy , Terminal Care
2.
Eur J Endocrinol ; 164(2): 239-45, 2011 Feb.
Article in English | MEDLINE | ID: mdl-21088056

ABSTRACT

OBJECTIVES: The optimal treatment of latent autoimmune diabetes in adults (LADA) is not established. We explored whether early insulin treatment, which has shown beneficial effects in rodents and in human pilot studies, would result in better preservation of ß-cell function or metabolic control, compared with conventional treatment. SUBJECTS AND METHODS: Glucagon-stimulated C-peptide and HbAlc were evaluated at baseline and after 12, 24 and 36 months in 37 patients recently diagnosed with diabetes, aged ≥ 30 years, non-insulin-requiring and GADAb and/or ICA positive. Twenty patients received early insulin and 17 received conventional treatment (diet ± oral hypoglycaemic agents (OHA), metformin, some and/or sulfonylurea) and insulin when necessary. RESULTS: Level of metabolic control, HbAlc, was preserved in the early insulin treated, while it significantly deteriorated in the conventionally treated. There was no significant difference between the groups in C-peptide after 12, 24 or 36 months, or in the decline of C-peptide. Only baseline C-peptide predicted a C-peptide of ≥ 0.5 nmol/l at 36 months. Gender, body mass index, antibody titres or HbAlc did not influence the levels of C-peptide or HbAlc at baseline or end-of-study, or the decline in C-peptide. Among the diet ± OHA-treated, 5/17 (30%) developed insulin dependency during the follow-up. No major hypoglycaemic events occurred. CONCLUSIONS: Early insulin treatment in LADA leads to better preservation of metabolic control and was safe. Superior preservation of C-peptide could not be significantly demonstrated. Only baseline level of C-peptide significantly influenced C-peptide level after 3 years. Further studies exploring the best treatment in LADA are warranted.


Subject(s)
Diabetes Mellitus, Type 1/metabolism , Insulin-Secreting Cells/metabolism , Insulin/therapeutic use , Adult , Aged , Aged, 80 and over , Analysis of Variance , C-Peptide/blood , Diabetes Mellitus, Type 1/therapy , Female , Follow-Up Studies , Glucagon/pharmacology , Glycated Hemoglobin , Humans , Insulin/metabolism , Insulin-Secreting Cells/drug effects , Male , Middle Aged , Regression Analysis , Sweden , Treatment Outcome
SELECTION OF CITATIONS
SEARCH DETAIL
...