- Risperidone-induced type 2 diabetes presenting with diabetic ketoacidosis. [Journal Article]
- EDEndocrinol Diabetes Metab Case Rep 2018; 2018
- A 28-year-old male presented with 2 days of vomiting and abdominal pain, preceded by 2 weeks of thirst, polyuria and polydipsia. He had recently started risperidone for obsessive-compulsive disorder....
A 28-year-old male presented with 2 days of vomiting and abdominal pain, preceded by 2 weeks of thirst, polyuria and polydipsia. He had recently started risperidone for obsessive-compulsive disorder. He reported a high dietary sugar intake and had a strong family history of type 2 diabetes mellitus (T2DM). On admission, he was tachycardic, tachypnoeic and drowsy with a Glasgow Coma Scale (GCS) of 10/15. We noted axillary acanthosis nigricans and obesity (BMI 33.2 kg/m2). Dipstick urinalysis showed ketonuria and glycosuria. Blood results were consistent with diabetic ketoacidosis (DKA), with hyperosmolar state. We initiated our DKA protocol, with intravenous insulin, fluids and potassium, and we discontinued risperidone. His obesity, family history of T2DM, acanthosis nigricans and hyperosmolar state prompted consideration of T2DM presenting with 'ketosis-prone diabetes' (KPD) rather than T1DM. Antibody markers of beta-cell autoimmunity were subsequently negative. Four weeks later, he had modified his diet and lost weight, and his metabolic parameters had normalised. We reduced his total daily insulin dose from 35 to 18 units and introduced metformin. We stopped insulin completely by week 7. At 6 months, his glucometer readings and glycated haemoglobin (HbA1c) level had normalised.
- Study to Evaluate the Changes in Polycystic Ovarian Morphology after Naturopathic and Yogic Interventions. [Journal Article]
- IJInt J Yoga 2018 May-Aug; 11(2):139-147
- CONCLUSIONS: The findings of the study indicate that Y&N interventions are efficient in bringing about beneficial changes in polycystic ovarian morphology. We speculate that a longer intervention might be required to regulate the frequency of menstrual cycle.
- A new type of familial partial lipodystrophy: distinctive fat distribution and proteinuria. [Journal Article]
- EREndocr Res 2018 May 07; :1-6
- CONCLUSIONS: We reported a form of FPLD characterized by a striking pattern of highly selective partial fat loss and proteinuria.
- Linear terra firma-forme dermatosis of the midline back. [Journal Article]
- CCutis 2018; 101(3):205-206
- Terra firma-forme dermatosis (TFFD) is a benign and likely underdiagnosed disorder with relatively few reports in the literature. A 46-year-old woman presented to our clinic with a 3-year history of ...
Terra firma-forme dermatosis (TFFD) is a benign and likely underdiagnosed disorder with relatively few reports in the literature. A 46-year-old woman presented to our clinic with a 3-year history of linear TFFD extending from the upper sacrum to the midline upper back. It initially was thought to be acanthosis nigricans or lichen simplex chronicus, and a topical steroid cream was applied without success. The lesion ultimately was removed by rubbing with isopropyl alcohol, which confirmed a diagnosis of TFFD. Due to its ability to mimic other skin diseases, TFFD should be considered when patients present with hyperkeratotic hyperpigmented lesions.
- Comparative study using fractional carbon dioxide laser versus glycolic acid peel in treatment of pseudo-acanthosis nigricans. [Journal Article]
- LMLasers Med Sci 2018 Apr 30
- Pseudo-acanthosis nigricans is a common dermatological disorder that is usually difficult to treat secondary to maceration of the skin from excessive sweating, obesity, or associated with endocrine d...
Pseudo-acanthosis nigricans is a common dermatological disorder that is usually difficult to treat secondary to maceration of the skin from excessive sweating, obesity, or associated with endocrine disorders. Fractional photothermolysis and chemical peeling have been reported to improve the condition. To determine whether fractional CO2 laser resurfacing or glycolic acid peel is more effective and safe option for therapy. Twenty Egyptian patients were included in the study where each patient was subjected to three sessions of both fractional CO2 on the right side of the neck and glycolic acid peel 70% on the left side of the neck. All patients were evaluated by a scoring system Acanthosis Nigricans Area and Severity Index (ANASI) score and three blinded dermatologists before and after treatment. Clinical improvement on the side treated by glycolic acid peel showed 43% improvement while the side treated by fractional CO2 showed 19% improvement. Glycolic acid peel shows superior results to fractional CO2 due to accelerated induced exfoliation, yet still fractional CO2 results are promising due to a presumably long-term improvement of skin texture.
- Melatonin Treatment Improves Insulin Resistance and Pigmentation in Obese Patients with Acanthosis Nigricans. [Journal Article]
- IJInt J Endocrinol 2018; 2018:2304746
- CONCLUSIONS: It was concluded that melatonin could improve cutaneous symptoms in obese patients with acanthosis nigricans by improving insulin sensitivity and inflammatory status. This trial is registered with ClinicalTrials.gov NCT02604095.
- Berardinelli-Seip Congenital Generalised Lipodystrophy. [Journal Article]
- JCJ Coll Physicians Surg Pak 2018; 28(5):406-408
- Berardinelli-Seip congenital lipodystrophy (BSCL) syndrome is a rare genetic disorder caused by dysregulation of glycemic and lipid metabolism. We report five BSCL cases with typical clinical picture...
Berardinelli-Seip congenital lipodystrophy (BSCL) syndrome is a rare genetic disorder caused by dysregulation of glycemic and lipid metabolism. We report five BSCL cases with typical clinical pictures and complications. These, to the best of our knowledge, represent the first case series from Pakistan. BSCL is characterized by marked atrophy of adipose tissue, acromegaly, acanthosis nigricans and tall stature. We could not perform genetics studies in any patient owing to non-availability of genetic laboratory in Pakistan. All the cases presented hypertriglyceridemia. One case developed hyperinsulinism controlled with metformin. There is no curative treatment and the current approach is low-fat diet and management of insulin resistance and diabetes. Recently published studies showed that leptin-replacement therapy is promising in the metabolic correction of complications of BSCL. This highlights the importance of further research in BSCL treatment.
- Increasing incidence of type 2 diabetes in New Zealand children <15 years of age in a regional-based diabetes service, Auckland, New Zealand. [Journal Article]
- JPJ Paediatr Child Health 2018 Apr 24
- CONCLUSIONS: The incidence of T2DM in children <15 years of age in New Zealand has increased progressively at 5%/year over the last 21 years. The risk was disproportionately associated with girls and children from high-risk ethnic groups.
- Genetic Analysis of Syndromic and Nonsyndromic Patients With Craniosynostosis Identifies Novel Mutations in the TWIST1 and EFNB1 Genes. [Journal Article]
- CPCleft Palate Craniofac J 2018 Jan 01; :1055665618760412
- CONCLUSIONS: The contribution of molecular genetic analysis to the diagnosis of patients with syndromic craniosynostosis was useful because some were originally misdiagnosed. Conversely, thorough clinical evaluation can guide molecular testing and result in a correct diagnosis.
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- Congenital generalized lipodystrophy in Taiwan. [Journal Article]
- JFJ Formos Med Assoc 2018 Feb 22
- CONCLUSIONS: Our findings highlight the uniqueness of the genotype and phenotype in our cohort. Further long-term surveillance for comorbidities is necessary for early detection and management of these patients.