Clinically Significant Diuretic-Induced Glucose Intolerance

1988 ◽  
Vol 22 (12) ◽  
pp. 969-972 ◽  
Author(s):  
N. Kathryn Lowder ◽  
Henry I. Bussey ◽  
Nancy J. Sugarek
Keyword(s):  
Blood Glucose ◽  
Glucose Intolerance ◽  
Mexican Americans ◽  
Mexican American ◽  
Blood Glucose Concentration ◽  
Fasting Blood Glucose ◽  
American Woman ◽  
History Of ◽  
Clinically Significant

Diuretic-induced glucose intolerance is cited frequently as a problem of only limited clinical significance. In certain populations, such as Mexican-Americans, this effect may be much more dramatic. A 50-year-old obese Mexican-American woman presented with a three-month history of increased thirst and frequent urination. A fasting blood glucose concentration of 365 mg/dL prompted initiation of chlorpropamide therapy. A review of her medical history revealed that a thiazide diuretic was started six months previously. A reduction in thiazide dose and potassium supplementation together with chlorpropamide therapy controlled the patient's blood glucose. Subsequently, all three medications were discontinued, and the patient remained normoglycemic during a full year of follow-up. The temporal relationship between symptomatic diabetes and hydrochlorothiazide therapy incriminates the diuretic as the most probable cause.

Mexican American Identity: Regional Differentiation in New Mexico

2018 ◽  
Vol 6 (2) ◽  
pp. 179-194 ◽  
Author(s):  
Casandra D. Salgado
Keyword(s):  
New Mexico ◽  
Mexican Americans ◽  
Mexican American ◽  
Mexican Immigrants ◽  
Ethnic Identification ◽  
Regional Differentiation ◽  
Defensive Strategy ◽  
Long Time ◽  
History Of ◽  
Mexican American Identity

Existing research inadequately addresses the variation in Mexican Americans’ patterns of ethnic identification. Drawing on 78 interviews, I address this question by exploring how conceptions of ancestry and nationality shape ethnic identification among New Mexico’s long-standing Mexican American population, Nuevomexicanos. I find that Nuevomexicanos emphasized their ties to Spanish heritage within the history of New Mexico to explain their ethnicity and to construct their identity in opposition to Mexican immigrants. Although Nuevomexicanos varied in their claims to Mexican ancestry, they generally prioritized their roots in the original Spanish settlement of New Mexico to emphasize distinctions in ancestry, nationality, and regionality from Mexican immigrants. Moreover, despite Nuevomexicanos’ persistent claims to Spanish ancestry, they did not perceive themselves as racially White. Instead, Spanish ancestry was integral to Nuevomexicano identity because it enabled them to highlight their regional ties to New Mexico and long-time American identities. Thus, I argue that Nuevomexicanos’ enduring claims to Spanish ancestry represent a defensive strategy to enact dissociation from stigmatized Mexican immigrants. Overall, these findings show that Mexican Americans’ dissociation strategies are contingent on how they define themselves as members of an ethnic and national community. These findings also indicate that “Mexican American” as an identity term is a loosely maintained membership category among “Mexican Americans” because of their intragroup heterogeneity.

Coexistence of intracranial and spinal cavernous malformations: a study of prevalence and natural history

2006 ◽  
Vol 104 (3) ◽  
pp. 376-381 ◽  
Author(s):  
Aaron A. Cohen-Gadol ◽  
Jeffrey T. Jacob ◽  
Diane A. Edwards ◽  
William E. Krauss
Keyword(s):  
Family History ◽  
Natural History ◽  
Mr Imaging ◽  
Neurological Deficits ◽  
Cavernous Malformations ◽  
Recurrent Hemorrhage ◽  
Long Term Follow Up ◽  
History Of ◽  
Clinically Significant

Object The purpose of this study was to examine the prevalence of intracranial cavernous malformations (CMs) in a large series of predominantly Caucasian patients with spinal cord CMs. The authors also studied the natural history of spinal CMs in patients who were treated nonoperatively. Methods The medical records of 67 consecutive patients (32 female and 35 male patients) in whom a spinal CM was diagnosed between 1994 and 2002 were reviewed. The patients’ mean age at presentation was 50 years (range 13–82 years). Twenty-five patients underwent resection of the lesion. Forty-two patients in whom the spinal CM was diagnosed using magnetic resonance (MR) imaging were followed expectantly. Thirty-three (49%) of 67 patients underwent both spinal and intracranial MR imaging. All available imaging studies were reviewed to determine the coexistence of an intracranial CM. Fourteen (42%) of the 33 patients with spinal CMs who underwent intracranial MR imaging harbored at least one cerebral CM in addition to the spinal lesion. Six (43%) of these 14 patients did not have a known family history of CM. Data obtained during the long-term follow-up period (mean 9.7 years, total of 319 patient-years) were available for 33 of the 42 patients with a spinal CM who did not undergo surgery. Five symptomatic lesional hemorrhages (neurological events), four of which were documented on neuroimaging studies, occurred during the follow-up period, for an overall event rate of 1.6% per patient per year. No patient experienced clinically significant neurological deficits due to recurrent hemorrhage. Conclusions As many as 40% of patients with a spinal CM may harbor a similar intracranial lesion, and approximately 40% of patients with coexisting spinal and intracranial CMs may have the nonfamilial (sporadic) form of the disease. Patients with symptomatic spinal CMs who are treated nonoperatively may have a small risk of clinically significant recurrent hemorrhage. The findings will aid in evaluation of surveillance images and in counseling of patients with spinal CMs, irrespective of family history.

Hypoglycaemia in the treatment of diabetes mellitus

2011 ◽  
pp. 1849-1861
Author(s):  
Pratik Choudhary ◽  
Stephanie A. Amiel
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Blood Glucose Concentration ◽  
Cerebral Metabolism ◽  
Chronic Complications ◽  
Glucose Levels ◽  
Patients With Diabetes ◽  
Treatment Of Diabetes ◽  
Clinically Significant ◽  
The Brain

Hypoglycaemia (low blood glucose concentration) is the most important acute complication of the pharmacological treatment of diabetes mellitus. Low blood glucose impairs brain (and, potentially, cardiac) function. The brain has minimal endogenous stores of energy, with small amounts of glycogen in astroglial cells. The brain is therefore largely dependent on circulating glucose as the substrate to fuel cerebral metabolism and support cognitive performance. If blood glucose levels fall sufficiently, cognitive dysfunction is inevitable. In health, efficient glucose sensing and counterregulatory mechanisms exist to prevent clinically significant hypoglycaemia. These are impaired by diabetes and by its therapies. Patients with diabetes rank fear of hypoglycaemia as highly as fear of chronic complications such as nephropathy or retinopathy (1). Fear of hypoglycaemia, hypoglycaemia itself and attempts to avoid hypoglycaemia limit the degree to which glycaemic control can be intensified to reduce the risk of chronic complications of diabetes both for type 1 and type 2 diabetes.

scholarly journals Prevalence and Risk Factors for Glucose Intolerance among Saudi Women with Gestational Diabetes

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Hayfaa Wahabi
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Gestational Diabetes ◽  
Glucose Intolerance ◽  
Fasting Blood Glucose ◽  
Positive Family History ◽  
Family History Of Diabetes ◽  
Saudi Women ◽  
History Of ◽  
One Year

Objectives. The objective of this study was to determine the incidence and risk factors of glucose intolerance one year after delivery in women with gestational diabetes (GDM). Methods. All women who had GDM and completed one year since delivery at King Khalid University Hospital were contacted to participate in the study. Based on to the American Diabetes Association criteria and the results of fasting blood glucose (FPG) and HbA1c, participants were classified into three groups: diabetic, impaired glucose tolerance (IGT), and normal. The incidence of diabetes and IGT was calculated. Clinical, biochemical, and sociodemographic predictors of glucose intolerance were compared between the three groups. Odds ratio (OR) for risk factors with P value less than 0.05 was calculated. Results. From a total 316 eligible women, 133 fulfilled the inclusion criteria and agreed to participate in the study. From the study participants, 58 (44%) women were normoglycemic, 60 (45%) women had IGT, and 15 (11%) women were diabetic. The odds of developing IGT or diabetes increased to nearly fourfold when women needed insulin for the control of GDM during pregnancy (OR 3.8, 95% CI 0.81–18.3, P=0.08) and to nearly one-and-a-half-fold when they have positive family history of T2DM (OR 1.2, 95% CI 0.74–2.09, P=0.40). Nevertheless, none of the odds ratios was statistically significant. Conclusion. The incidence of postpartum hyperglycemia (diabetes and IGT) is very high in Saudi women with GDM. Family history of diabetes and insulin treatment of GDM may be predictors of postpartum hyperglycemia.

scholarly journals Preliminary Results on the Effectiveness of a Nutrition Intervention in Lowering Diabetes Risk in Prediabetic People Living with HIV (PLWH) in MASH Cohort (OR36-06-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Alicia Sneij Perez ◽  
Adriana Campa ◽  
Leslie Seminario ◽  
Sabrina Martinez ◽  
Fatma Huffman ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Intervention Group ◽  
Nutrition Intervention ◽  
Control Group ◽  
Reactive Protein ◽  
Research Initiative ◽  
Significant Difference ◽  
Hs Crp

Abstract Objectives The objective of this study is to assess the effectiveness of a 6-month nutrition intervention to improve glycemic parameters and inflammation in prediabetic PLWH on stable ART with undetectable HIV viral load. Methods A 6-month randomized, controlled nutrition intervention was conducted in prediabetic PLWH. The study participants for the intervention were recruited from the Miami Adult Studies for HIV (MASH) cohort at the FIU-Borinquen Research Clinic. Upon their consent, the participants were randomized into the intervention group or the control group. Participants randomized in the intervention group met once a month for approximately 1 hour where they received medical nutrition therapy, nutrition counseling and nutrition education; participants randomized into the control group received educational material at baseline. Blood was drawn at baseline and at 6-month to measure fasting blood glucose (FBG) and high sensitivity C-reactive protein (hs-CRP). Results A total of 38 participants were recruited and randomized into either the intervention group (n = 20) or the control group (n = 18). We found that the FBG for the 6-month follow-up for the intervention group was significantly lower than the baseline FBG values of the same study group (paired t-test; P = 0.031). No significant difference was found in the control group between the baseline and 6-month fasting blood glucose values (P = 0.068). Moreover, no significant difference was found in pre/post C-reactive protein (CRP) levels in the intervention or control group (paired t-test; P = 0.404 and P = 0.117 respectively). There was a significant difference in CRP levels at baseline (P = 0.028) between the study groups but no difference at the 6-month follow up (Mann Whitney U test: P = 0.430). Conclusions The results from this intervention support the notion that a nutrition intervention is effective in prediabetic PLWH to lower diabetes risk by significantly lowering fasting blood glucose and may be implemented into larger scale interventions; however, no significant changes was seen in hs-CRP values between the 2 groups. Funding Sources National Institute of General Medical Sciences (NIGMS): Research Initiative for Scientific Enhancement (RISE), Biomedical Research Initiative (BRI) Grant, National Institute on Drug Abuse 5U01DA040381-03 and FIU-Dissertation Funding.

Legally White, Socially “Mexican”: The Politics of De Jure and De Facto School Segregation in the American Southwest

2012 ◽  
Vol 82 (2) ◽  
pp. 202-225 ◽  
Author(s):  
Rubén Donato ◽  
Jarrod Hanson
Keyword(s):  
Mexican Americans ◽  
Mexican American ◽  
State Level ◽  
American Southwest ◽  
Boards Of Education ◽  
School Segregation ◽  
School Officials ◽  
State Statutes ◽  
De Jure Segregation ◽  
History Of

The history of Mexican American school segregation is complex, often misunderstood, and currently unresolved. The literature suggests that Mexican Americans experienced de facto segregation because it was local custom and never sanctioned at the state level in the American Southwest. However, the same literature suggests that Mexican Americans experienced de jure segregation because school officials implemented various policies that had the intended effect of segregating Mexican Americans. Rubén Donato and Jarrod S. Hanson argue in this article that although Mexican Americans were legally categorized as “White,” the American public did not recognize the category and treated Mexican Americans as socially “colored” in their schools and communities. Second, although there were no state statutes that sanctioned the segregation of Mexican Americans, it was a widespread trend in the American Southwest. Finally, policies and practices historically implemented by school officials and boards of education should retroactively be considered de jure segregation.

Outcomes of septoplasty

2000 ◽  
Vol 122 (2) ◽  
pp. 228-232 ◽  
Author(s):  
Noah S. Siegel ◽  
Richard E. Gliklich ◽  
Farhan Taghizadeh ◽  
Yuchiao Chang
Keyword(s):  
Health Survey ◽  
General Health ◽  
Short Form ◽  
Female Gender ◽  
Normative Values ◽  
History Of ◽  
Clinically Significant ◽  
The Impact ◽  
Specific Health

A prospective nonrandomized study of consecutive patients presenting to the Massachusetts Eye and Ear Infirmary for septoplasty was conducted to evaluate patient-based outcome. Patients received statistically validated measures of general health status (Short Form-12) and nasal specific health (Nasal Health Survey) before and 6 and 12 months after surgery. Multiple perioperative patient- and surgeon-dependent treatment variables were also evaluated to determine the impact on outcome. A total of 161 patients were entered into the study, and 93 were available for statistical analysis. At 9 months the mean follow-up (range 6–12 months), both symptom and medication subscores of the Nasal Health Survey, and the total score demonstrated significant improvement ( P < 0.05); 71% of patients had clinically significant improvement as determined by at least a 50% decrease in duration of nasal symptoms. Measures of general health did not differ significantly from normative values at baseline and did not change after surgical intervention. Predictor analysis revealed that female gender and a history of previous nasal surgery predicted worse outcome.

Sign in / Sign up

Export Citation Format

Share Document