Diabetes mellitus decompensated

The most serious side effects early in ACS are hypotension, bradycardia, and heart block. Initial acute administration of //-blockers is not appropriate for patients presenting with decompensated heart failure. However, therapy may be attempted in most patients before hospital discharge after treatment of acute heart failure. Diabetes mellitus is not a contraindication to //-blocker use. If possible intolerance to //-blockers is a concern (e.g., due to chronic obstructive pulmonary disease), a short-acting drug such as metoprolol or esmolol should be administered IV initially. 

History of hypersensitivity to sulfonamides or thiazide diuretics, renal decompensation, anuria. Cautions Severe renal disease, impaired hepatic function, diabetes mellitus, elderly/debilitated,... 

Of special interest are discoveries of transient atypical albumins which may be observed only in disease. Scheurlen (S14) and Wuhrmann (W32) have described a patient with diabetes mellitus, who during several years showed the double anomaly only when her diabetes was out of control. On the first occasion when it was found, she had acute cystopyelitis. The additional albumin band disappeared after treatment, but appeared again at renewed decompensation. On later occasions the anomaly appeared during precomatose episodes, after which it disappeared again. More lately, however, the double albumin band has become constantly present in the plasma of this patient (W32). 

Qualraro Consoli G, Magno M, Caretta F, Nardozza A, Ceriello A, Giugliano D. Hydroxychloroquine in decompensated, treatment-refractccy nc insulin-dependent diabetes mellitus. Anew job for an old dmg Ann Intern MeJ ( 9 ) 112,678-81. 

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