RESUMEN
Abnormalities of glucose metabolism are a common feature of acromegaly. Overt diabetes mellitus develops in about 10-15% of patients. We present an unusual complication of acromegaly: a 37-year old man with a 2-year history of acromegaly developed diabetic ketoacidosis 3 weeks after transsphenoidal adenomectomy. No specific cause for this sudden metabolic derangement could be demonstrated. Insulin need was very high in the first days after the onset of ketoacidosis, but was considerably reduced after initiation of treatment with octreotide and after successful re-operation.
Asunto(s)
Acromegalia/complicaciones , Cetoacidosis Diabética/diagnóstico , Adulto , Glucemia/metabolismo , Cetoacidosis Diabética/tratamiento farmacológico , Cetoacidosis Diabética/etiología , Prueba de Tolerancia a la Glucosa , Hormona de Crecimiento Humana/sangre , Humanos , Insulina/uso terapéutico , Factor I del Crecimiento Similar a la Insulina/análisis , Imagen por Resonancia Magnética , Masculino , Neoplasias Hipofisarias/diagnóstico , Neoplasias Hipofisarias/cirugía , Factores de TiempoRESUMEN
Most of type 2. diabetic patients require medication for several concomitant diseases, most important being, hypertension, ischaemic heart disease, heart failure, dyslipidaemias, obesity. Thus the risk of drug interactions is important, particularly in elderly patients. Oral antidiabetic drugs include hypoglycaemic agents (sulphonylureas, meglitenides) and biguanides (metformin), alpha-glucosidase inhibitors, tiazolinidediones. Drug interactions with antihyperglycaemic agents can be divided into pharmacokinetic and pharmacodynamic interactions. Numerous drugs due to interactions enhance hypoglycaemic action of sulphonylureas, thus increase the risk of hypoglycaemia. Several drugs may cause impairment of glycaemic control through various mechanisms in diabetic patients treated with oral antidiabetic drugs. Currently the most controversial problem is safety of combination therapy with sulphonylurea and metformin, as several observations indicated that it can increase mortality from cardio-vascular causes.
Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hipoglucemiantes/farmacología , Administración Oral , Anciano , Enfermedades Cardiovasculares/inducido químicamente , Enfermedades Cardiovasculares/mortalidad , Diabetes Mellitus Tipo 2/complicaciones , Interacciones Farmacológicas , Humanos , Hipoglucemiantes/efectos adversos , Metformina/farmacología , Compuestos de Sulfonilurea/farmacología , Tasa de SupervivenciaRESUMEN
All the vital processes in cels are dependent on its energetic metabolism. The substances of most importance are adenine phosphates. We present update knowledge about their metabolism. We noted also importance of enzymes involved in these processes. In diabetes disturbance in energetic state of the cell are obvious. We tried to find up theoretically what is the influence of diabetes on metabolism of high energetic adenine phosphates. We present probable role of these substances in development of late complications of diabetes.