Tag Archives: diabetes
Type 1 Diabetes Mellitus and an Artificial Pancreas
Written by Neil Kurtzman | 17th July 2018Clinical endocrinology can be defined in one sentence. It is the study of diseases that are characterized by too much or too little of a hormone or by over or under responsiveness to a hormone. That’s it. The rest is detail. Type 1 diabetes is due to the lack of insulin secondary to autoimmune impairment…
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More on Diabetes and Tight Blood Pressure Control
Written by Neil Kurtzman | 12th July 2010In May I commented on a study in the New England Journal of Medicine that failed to show a benefit in lowering systolic blood pressure below 130 mm Hg. Well, now there’s another such study. This one is in the Journal of the American Medical Association. “Patients were categorized into 3 groups by their average…
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Progress With An Artifical Pancreas
Written by Neil Kurtzman | 17th May 2010For decades physicians have wondered why the development of an artificial pancreas has been so slow. Such a device should be the perfect treatment for patients with type 1 diabetes. An artificial pancreas would combine the already available insulin pump with a sensing device that would monitor blood sugar thus enabling insulin to be infused…
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Diabetes and Blood Pressure Control
Written by Neil Kurtzman | 7th May 2010It’s been standard clinical practice for some time to aim for a lower blood pressure in diabetic patients with hypertension compared to hypertensive patients with normal glucose metabolism. Like so much in medicine this approach was based on surmise rather than evidence. The thinking went along these lines. Diabetics are at greatly increased risk for…
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Diagnosis of Diabetes
Written by Neil Kurtzman | 29th August 2009The diagnosis of diabetes mellitus is officially based on measurement of fasting blood sugar or two hour post glucose blood sugar. Unofficially many physicians have used HbA1c to diagnose the disease. A few years ago I was on a panel discussing hypertension. A difficult case was presented. There was a question as to whether this…
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More on Angiotensin Blockade and Diabetic Nephropathy
Written by Neil Kurtzman | 6th July 2009I recently reviewed a paper that indicated that angiotensin blockade with an angiotensin receptor blocker (ARB) did not protect against the development of diabetic nephropathy in diabetic patients with normal renal function. Despite what that paper concluded angiotensin blockade with and an angiotensin converting enzyme (ACE) inhibitor offered protection. Two papers in the July 7…
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Angiotensin Blockade and Diabetic Nephropathy
Written by Neil Kurtzman | 30th June 2009The July 2 issue of the New England Journal of Medicine has an article on the prevention of diabetic nephropathy and retinopathy that will elicit much attention. It concludes “Early blockade of the renin-angiotensin system in patients with type 1 diabetes did not slow nephropathy progression but slowed the progression of retinopathy.” An accompanying editorial…
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