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To determine the acute effects of insulin on lipoprotein metabolism, we have followed the plasma lipoprotein lipid and apolipoprotein levels during insulin therapy for the first 24 hr in 13 patients with diabetic ketoacidosis. Corrections were made for plasma volume changes during treatment. Before insulin treatment, mean plasma triglyceride and cholesterol(More)
The effects of individual psychotropic medications on serum prolactin concentrations are described, and recommendations for dealing with adverse effects are provided. Hyperprolactinemia can result in galactorrhea, amenorrhea, irregular menses, and anovulation; in men, impotence and azoospermia, with or without lactation and gynecomastia, can occur.(More)
1 D iabetic ketoacidosis (DKA) and the hyperosmolar hyperglycemic state (HHS) are the two most serious acute metabolic complications of diabetes. DKA is responsible for more than 500,000 hospital days per year (1,2) at an estimated annual direct medical expense and indirect cost of 2.4 billion USD (2,3). Table 1 outlines the diagnostic criteria for DKA and(More)
The use of phosphate therapy in the management of diabetic ketoacidosis (DKA) has been controversial, particularly with respect to the effect of phosphate intermediates on tissue oxygenation. In a prospective randomized study we evaluated the effect of phosphate (8.5 mmol/h or approximately 6 g phosphate/24 h) (experimental group) vs. no phosphate therapy(More)
Glycohemoglobin (HbA1c) estimation is the gold standard for assessing long-term glycemic control in diabetic patients. Some hemoglobin variants interfere with HbA1c assay, thus, limiting its utility. Over 150,000 diabetic patients are estimated to have hemoglobin variants in the United States; but this number may be up to 30% in some parts of the world.(More)
We studied the efficacy of low-dose (0.1 U/kg/h) and high-dose (1..0 U/kg/h) insulin, given randomly to children with diabetic ketoacidosis (DKA) by continuous intravenous infusion without a loading dose. Plasma glucose reached 250 mg/dl in 3.4 +/- 0.4 h with the high-dose insulin group compared with 5.4 +/- 0.5 h with the low-dose insulin group (P < 0.01).(More)
Since in normal persons the hypoglycemic effect of low-dose intramuscular exceeds that of subcutaneous insulin we studied the effect of routes of insulin therapy in diabetic ketoacidosis. Forty-five patients with diabetic ketoacidosis entered a randomized prospective protocol with insulin administered either intravenously, subcutaneously or intramuscularly.(More)
We compared low-dose insulin regimens in a prospective randomized trial in 30 patients with diabetic ketoacidosis. One group received a loading dose of 0.44 U/kg body weight of regular insulin half intramuscularly and half intravenously followed by 7 U/h intramuscularly, whereas the other group received a loading dose of 0.44 U/kg intravenously followed(More)
CONTEXT Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) cause major morbidity and significant mortality in patients with diabetes mellitus. For more than 30 yr, our group, in a series of prospective, randomized clinical studies, has investigated the pathogenesis and evolving strategies of the treatment of hyperglycemic crises. This(More)