Internal Medicine

Diabetes

Questions discussed in this category

What is the optimal BP target for patients with diabetes and hypertension to reduce their risk of MI/stroke?

1 Answer available

Are recurrent UTIs a contraindication to SGLT2i use?

4 Answers available

Is GLP-1 therapy a viable treatment option for a patient with Type 2 Diabetes complicated by atherosclerotic heart disease and cholelithiasis?

If not, would you consider a prophylactic cholecystectomy?

2 Answers available

After what time frame off GLP-1 RA therapy should you restart at the lowest starting dose?

Patients may have to stop glp1 a therapy due to supply issues or for other reasons. If they are off for 4 weeks, is it ok to restart at the same dose ...

2 Answers available

Should we be more cautious with the use of GLP 1 R agonist therapy in patients with Type 1 diabetes mellitus and obesity given the increased risk of cardiovascular disease with high body weight variability?

Prattichizzo et al., PMID 39468384

1 Answer available

Would you recommend statin initiation in a young adult patient (age < 40) with type 1 diabetes mellitus and LDL cholesterol levels greater than 100 without any cardiovascular risk factors?

1 Answer available

Should we recommend SGLT2i initiation at discharge to all patients hospitalized with acute myocardial infarction?

Butler et al., PMID 38587237

1 Answer available

How many days prior to surgery do you recommend stopping SGLT2 inhibitors and when is it safe to resume therapy?

1 Answer available

Is there a role for use of GLP1 R agonist or dual agonist therapy for management of post bariatric hypoglycemia and dumping syndrome?

1 Answer available

How do you approach managing patients with diabetic kidney disease and proteinuria who develop hypoglycemia after initiation of a SGLT2 inhibitor?

1 Answer available

When and how should we be stopping GLP-1 Receptor Agonist/Dual Agonist therapy?

1 Answer available

How do you counsel patients on semaglutide or tirzepatide in light of potential cancer risks?

Do you avoid using these agents only in patients with history of medullary thyroid cancer or pancreatic cancer? Are there other cancer risks we should...

1 Answer available

Do you recommend early oral nutrition when managing diabetic ketoacidosis?

Some data showed early enteral nutrition improves outcomes in DKA. Some thought that enteral nutrition could counteract the insulin gtt.

1 Answer available

Do you recommend adding low-dose Aspirin for primary prevention in patients with Type 2 Diabetes on Eliquis for another indication?

1 Answer available

Does oral semaglutide provide similar cardiovascular risk reduction benefits as injectable semaglutide?

1 Answer available

How do the results of the ESPRIT trial, which evaluated the impact of an SBP target of <120 mmHg on preventing major cardiovascular events, influence your blood pressure management goals for hypertensive patients with diabetes or a history of stroke?

ESPRIT Trial

1 Answer available

Do you recommend the use of GLP1 R agonist therapy in patients with T1DM for weight loss?

3 Answers available

How do you counsel patients on the use of compounded weight loss medications?

3 Answers available

What is the typical timeline for remission of autoimmune hypoglycemia?

1 Answer available

Is Metformin contraindicated in patients using long term oxygen therapy at home?

Liang et al., PMID 35900801

1 Answer available

How do you adjust your management strategy to address the unique needs of anuric end-stage kidney disease patients when treating diabetic ketoacidosis?

1 Answer available

Do you use the homeostatic model assessment (HOMA) to assess for insulin resistance and change your clinical management of patients?

3 Answers available

Should GLP1 R agonists be used as first line glucose lowering agents in patients with ESKD and DM2?

1 Answer available

Under what circumstances would you test for hypercortisolism in a patient with insulin resistance?

1 Answer available

Is ABI (Ankle Brachial index) lower limb arterial doppler not recommended if patient already has arterial stents in the legs, and if so, what other imaging modality would you consider as first-line?

1 Answer available

How do you adjust your HbA1c goal for managing diabetes in elderly patients with multiple chronic illnesses but no limitations in performing self-care tasks?

1 Answer available

Papers discussed in this category

BMC endocrine disorders, 2024 Nov 18

Risk of Hepatocellular Carcinoma with Glucagon-like Peptide-1 receptor agonist treatment in patients: a systematic review and meta-analysis.

International urology and nephrology, 2024 Nov 04

Effect of GLP-1 receptor agonists on prostate cancer risk reduction: a systematic review and meta-analysis.

Cancers, 2024 Sep 22

Risk of Esophageal and Gastric Cancer in Patients with Type 2 Diabetes Receiving Glucagon-like Peptide-1 Receptor Agonists (GLP-1 RAs): A National Analysis.

The New England journal of medicine, 2024 Apr 06

Empagliflozin after Acute Myocardial Infarction.

Diabetes research and clinical practice, 1994 Jan

Insulin autoimmune syndrome (Hirata disease): clinical features and epidemiology in Japan.

Clinical endocrinology, 2020 Feb 26

Management of Insulin Autoimmune Hypoglycaemia: Single-centre experience from Western India with systematic review of world literature.

Frontiers in pharmacology, 2023 Mar 16

Glucagon-like peptide-1 receptor agonists as add-on therapy to insulin for type 1 diabetes mellitus.

Nutrition & diabetes, 2019 Nov 04

Double or hybrid diabetes: A systematic review on disease prevalence, characteristics and risk factors.

Diabetes, obesity & metabolism, 2019 Aug 19

Double diabetes: A distinct high-risk group?

BMC endocrine disorders, 2021 Sep 16

The association between overweight/obesity and double diabetes in adults with type 1 diabetes; a cross-sectional study.

Lancet (London, England), 2024 Jun 27

Lowering systolic blood pressure to less than 120 mm Hg versus less than 140 mm Hg in patients with high cardiovascular risk with and without diabetes or previous stroke: an open-label, blinded-outcome, randomised trial.

The New England journal of medicine, 2016 Sep 15

Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes.

Diabetes care, 2024 Aug 01

Hyperglycemic Crises in Adults With Diabetes: A Consensus Report.

The New England journal of medicine, 2023 Nov 11

Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes.

JAMA internal medicine, 2022 May 01

Association of Glucagon-Like Peptide-1 Receptor Agonist Use With Risk of Gallbladder and Biliary Diseases: A Systematic Review and Meta-analysis of Randomized Clinical Trials.

The New England journal of medicine, 2024 Nov 13

Tirzepatide for Obesity Treatment and Diabetes Prevention.

Frontiers in endocrinology, 2023 Oct 16

Safety issues of tirzepatide (pancreatitis and gallbladder or biliary disease) in type 2 diabetes and obesity: a systematic review and meta-analysis.

N Engl J Med, 2015 Nov 09

A Randomized Trial of Intensive versus Standard Blood-Pressure Control.

Diabetes care, 2025 Jan 01

10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes-2025.

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