RESUMO
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.
Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemia/induzido quimicamente , Hipoglicemiantes/efeitos adversos , Insulina/análogos & derivados , Assistência Ambulatorial , Glicemia/metabolismo , Índice de Massa Corporal , Peso Corporal , Diabetes Mellitus Tipo 2/sangue , Jejum/sangue , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Insulina/efeitos adversos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
Adrenal insufficiency is rarely associated with adrenal haemorrhage. In this report, a case of polycythaemia vera with adrenal haemorrhage and insufficiency has been presented.
Assuntos
Glândulas Suprarrenais/patologia , Insuficiência Adrenal , Hemorragia , Hidroxiureia , Policitemia Vera , Prednisolona , Glândulas Suprarrenais/diagnóstico por imagem , Glândulas Suprarrenais/metabolismo , Insuficiência Adrenal/tratamento farmacológico , Insuficiência Adrenal/etiologia , Insuficiência Adrenal/metabolismo , Insuficiência Adrenal/fisiopatologia , Glucocorticoides/administração & dosagem , Glucocorticoides/efeitos adversos , Hemorragia/complicações , Hemorragia/patologia , Hemorragia/fisiopatologia , Terapia de Reposição Hormonal , Humanos , Hidroxiureia/administração & dosagem , Hidroxiureia/efeitos adversos , Hiperpigmentação/induzido quimicamente , Masculino , Pessoa de Meia-Idade , Inibidores da Síntese de Ácido Nucleico/administração & dosagem , Inibidores da Síntese de Ácido Nucleico/efeitos adversos , Policitemia Vera/sangue , Policitemia Vera/complicações , Policitemia Vera/fisiopatologia , Policitemia Vera/terapia , Prednisolona/administração & dosagem , Prednisolona/efeitos adversos , Radiografia , Resultado do TratamentoRESUMO
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.