NEJM Diabetes

NEJM Diabetes 2017-01-13T09:58:28+00:00

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NEJM - Colección Diabetes

Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis
ver resumen
Clinically apparent brain injuries occur in 0.5 to 0.9% of episodes of diabetic ketoacidosis in children; these brain injuries manifest as sudden neurologic decline and are often associated with morbidity and mortality. Among patients without obvious neurologic decline during treatment for diabetic…

Fluid Composition, Infusion Rate, and Brain Injury in Diabetic Ketoacidosis
ver resumen
Diabetic ketoacidosis constitutes a profound metabolic disturbance of energy homeostasis with a distinct biochemical profile that is characterized by hyperglycemia, ketonemia, metabolic acidosis, and electrolyte abnormalities. It is caused by deficiency of insulin, the hallmark of type 1 diabetes…

Clinical Assessment of Peripheral Arterial Disease of the Lower Limbs
ver resumen

Change in Overweight from Childhood to Early Adulthood and Risk of Type 2 Diabetes
ver resumen
Lifestyle interventions that are aimed at weight loss in adults have been found to delay the onset of type 2 diabetes in persons who are at high risk for the condition. In children, it is now well established that higher body-mass index (BMI) values, even at levels far below current overweight…

Lithium-Induced Nephropathy
ver resumen
A 59-year-old man with a history of bipolar disorder was admitted to the hospital after a fall. He received a diagnosis of multiple fractures of the head and spine; the fractures were managed nonoperatively. During the hospitalization, his urine output was noted to range from 4 to 6 liters per day.…

Adjunctive Treatments for Type 1 Diabetes
ver resumen
The proliferation of new drug treatments for type 2 diabetes in the United States in the past 15 years, with more than 17 drugs approved in six new classes of antidiabetic drugs, has been promoted by several factors. First, the recognition of the importance of intensive glycemic control to reduce…

Effects of Sotagliflozin Added to Insulin in Patients with Type 1 Diabetes
ver resumen
The incidence of type 1 diabetes, which currently affects 29 million adults worldwide, is rising. In the United States, the number of patients with type 1 diabetes who are younger than 20 years of age may triple within 30 years. Less than one third of adults with type 1 diabetes achieve a glycated…

Necrotizing Soft-Tissue Infections
ver resumen
Necrotizing fasciitis is a surgical diagnosis characterized by friability of the superficial fascia, dishwater-gray exudate, and a notable absence of pus. This and other necrotizing soft-tissue infections have multiple causes, risk factors, anatomical locations, and pathogenic mechanisms, but all…

Cause, Pathogenesis, and Treatment of Nonalcoholic Steatohepatitis
ver resumen
Fatty liver disease is the most common liver disease in the world. About 25% of adults in the United States have fatty livers in the absence of excessive alcohol consumption, a condition termed nonalcoholic fatty liver disease. More than a quarter of adults with nonalcoholic fatty liver disease are…

ACE Inhibitors and Statins in Adolescents with Type 1 Diabetes
ver resumen
Children with type 1 diabetes are at higher risk for long-term renal and cardiovascular disease and death than the general population, and adolescence is a period of risk for the development of complications, since adequate glycemic control is difficult to achieve. Rapid increases in albumin…

Evaluation and Management of Lower-Extremity Ulcers
ver resumen
Lower-extremity ulcers are very common, with an estimated prevalence of 1 to 2% among U.S. adults, and they have a major effect on public health. Lower-extremity ulcers are divided into two groups — leg ulcers and foot ulcers — because of differences in causes, pathogenesis, and treatment. Even…

Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes
ver resumen
The risk of death from any cause among persons with type 2 diabetes is up to twice that of the general population, and the risk of death from cardiovascular causes is up to four times that of the general population. Improved glycemic control has been shown to improve microvascular outcomes, but a…

Weight and Metabolic Outcomes 12 Years after Gastric Bypass
ver resumen
The first surgical procedure performed specifically for weight loss took place in 1954. Since then, bariatric procedures have become less invasive and safer, and insights regarding the beneficial metabolic effects of such procedures have led to additional indications for these procedures.…

A New Chapter for Diabetic Kidney Disease
ver resumen
Many clinical outcomes have improved over the past two decades for people living with diabetes. However, relatively little progress has been made in the treatment of diabetic kidney disease. Among adults with diabetes in the United States, the prevalence of diabetic kidney disease has remained…

Liraglutide and Renal Outcomes in Type 2 Diabetes
ver resumen
Persons with type 2 diabetes mellitus, particularly those with evidence of cardiovascular disease, are at high risk for chronic kidney disease. In most countries, diabetic kidney disease is reported to be the leading cause of dialysis-dependent chronic kidney disease. Efforts to blunt the global…

Efficacy and Safety of Degludec versus Glargine in Type 2 Diabetes
ver resumen
Cardiovascular complications remain two to four times more common among patients with type 2 diabetes than among persons without diabetes. Observational studies have suggested that patients with type 2 diabetes who require insulin have increased rates of cardiovascular events. However, a large…

Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes
ver resumen
Type 2 diabetes mellitus is associated with a substantial risk of cardiovascular and renal disease. The use of inhibitors of sodium–glucose cotransporter 2 (SGLT2) results in favorable effects on biomarkers, including glycemia, blood pressure, weight, intrarenal hemodynamics, and albuminuria, and…

Insulin-Mediated Lipohypertrophy
ver resumen
Figure 1.

Diabetic Foot Ulcers and Their Recurrence
ver resumen
Complications of diabetes that affect the lower extremities are common, complex, and costly. Foot ulceration is the most frequently recognized complication. In a community-based study in the northwestern United Kingdom, the prevalence of active foot ulcers identified at screening among persons with…

Risk of Diabetic Ketoacidosis after Initiation of an SGLT2 Inhibitor
ver resumen
To the Editor: Inhibitors of sodium–glucose cotransporter 2 (SGLT2) decrease plasma glucose by blocking the reabsorption of glucose at the proximal tubule. Case reports have suggested that SGLT2 inhibitors may be associated with an increased risk of diabetic ketoacidosis, which led to a warning…

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