Diabetes serum concentration

Some laxatives (e.g., bulk-forming agents) contain significant amounts of sodium or sugar and may be unsuitable for salt-restricted or diabetic patients. When low-sodium or sugar-free products are not used, monitor serum concentrations of sodium and glucose as needed with chronic use. 

Gram-negative coverage is indicated for patients with diabetes, HIV infection, prosthetic valves, or those receiving immunosuppressive agents (gentamicin 2 mg/kg intravenously with serum concentration monitoring). 

Nickel that has been absorbed into the blood stream is primarily excreted in the urine. Therefore, individuals with kidney dysfunction are likely to be more sensitive to nickel. The increased sensitivity of persons with kidney disfunction is also suggested by increased serum concentrations of nickel in dialysis patients (Hopfer et al. 1989). Because diabetics often have kidney damage, and because of the hyperglycemic effects of nickel observed in animal studies, the sensitivity of diabetics to nickel is also likely to be increased. 

Polydipsia and polyuria are common but reversible concomitants of lithium treatment, occurring at therapeutic serum concentrations. The principal physiologic lesion involved is loss of responsiveness to antidiuretic hormone (nephrogenic diabetes insipidus). Lithium-induced diabetes insipidus is resistant to vasopressin but responds to amiloride. 

Wulffele MG, Kooy A, Lehert P, Bets D, Ogterop JC, Borger van den Burg B, Donker AJM, Stehouwer CDA. Effects of short-term treatment with metformin on serum concentrations of homocysteine, folate and vitamin B12 in type 2 diabetes mellitus a randomized, placebo- controlled trial. J Intern Med 2003 254 455-63. 

Two patients with diabetes mellitus developed lithium toxicity (serum concentrations 3.3 and 3.0 mmol/1) in association with impaired consciousness, and hyperglycemia that resolved after intravenous insulin and fluids (683). 

Difficulty in attaining a therapeutic serum concentration of lithium despite increased doses was attributed to increased renal clearance due to the osmotic effect of glycosuria in a 44-year-old man with poorly controlled diabetes mellitus (682). 

The effect of PJ consumption by patients with CAS on their serum oxidative state was measured also as serum concentration of antibodies against Ox-LDL.31 A significant (p < 0.01) reduction in the concentration of antibodies against Ox-LDL by 24 and 19% was observed after 1 and 3 months of PJ consumption, respectively (from 2070 61 EU/mL before treatment to 1563 69 and 1670 52 F.lI/mL after 1 and 3 months of PJ consumption, respectively). Total antioxidant status (TAS) in serum from these patients was substantially increased by 2.3-fold (from 0.95 0.12 nmol/L at baseline up to 2.20 0.25 nmol/L after 12 months of PJ consumption). These results indicate that PJ administration to patients with CAS substantially reduced their serum oxidative status and could thus inhibit plasma lipid peroxidation. The susceptibility of the patient s plasma to free radical-induced oxidation decreased after 12 months of PJ consumption by 62% (from 209 18 at baseline to 79 6 nmol of peroxides/milliliter). The effect of PJ consumption on serum oxidative state was recently measured also in patients with non-insulin-dependent diabetes mellitus (NIDDM). Consumption of 50 mL of PJ per day for a period of 3 months resulted in a significant reduction in serum lipid peroxides and thiobarbituric acid reactive substance (TBAR) levels by 56 and 28%, respectively.32... 

A 47-year-old woman, who was taking lithium (serum concentration 0.7 mmol/1) for bipolar I disorder, developed an acute abdominal syndrome (394). She had a recent history of drinking about 4 1 of fluid a day. After surgery, she developed nephrogenic diabetes insipidus, with 19 1/day intake and 15 1/day output. The diuresis fell to 8 1/day over the next 10 days. 

In a cross-sectional study of 12 octogenarians (average age 84 years) who had taken lithium for an average of 54 months (mean serum concentration 0.42 mmol/1), none became toxic and none had to stop treatment because of adverse effects. Transient renal function abnormalities were noted one patient developed nephrogenic diabetes insipidus and one became hypothyroidic (510). For lithium therapy in very old people, the authors advised close monitoring in a specialized setting. 

Observational data have suggested that HRT users may have a better profile of liver function tests. One randomised placebo-controlled study involving 50 women with type 2 diabetes demonstrated that HRT containing oestradiol 1 mg and norethisterone 0.5 mg significantly improved serum concentrations of liver enzymes. The authors hypothesised that this might be due to HRT causing a reduction in liver fat content. However, further work in this area to understand the significance and mechanisms by which this occurs was recommended [12]. 

Buschard K, Fredman P, Bog-Hansen E, Blomqvist M, Hedner J, Rasttim L, Lindblad U (2005) Low serum concentration of sulfatide and presence of sulfated lactosylcertimid are associated with Type 2 diabetes. The Skaraborg Project. Diabet Med 22 1190-1198 Butt AM, Kiff J, Hubbard P, Berry M (2002) Synantocytes new functions for novel NG2... 

Following oral administration of 750 mg of three different tablet formulations to 8 subjects, mean peak plasma-acetohexamide concentrations of about 28, 40, and 44 ig/ml were attained 2 hours after a dose mean peak plasma concentrations of ( —)-l-hydroxyhexamide averaged about 30 i.g/ml (J. W. Kleberer o/., J. pharm. Sci., 1977, 66, 635-638). After daily oral doses of 0.5 g to 18 subjects, an average serum concentration of 42 pg/ml was reported 3 to 5 hours after the dose (J. Sheldon er a/.. Diabetes, 1965,14, 362-367). 

A number of studies have reported low serum concentrations of retinol and high concentrations of /3-carotene in patients with insulin-dependent diabetes melUtus. Krill and coworkers (1997) showed that up to one-third of nondiabetic first-degree relatives of patients with diabetes also showed a low serum retinol carotene ratio, implying a genetic predisposition to low activity of carotene dioxygenase, possibly associated with insuUn-dependent diabetes. 

Blatter Garin, M.C., James, R.W., Dussoix, P., Blanche, M., Passa, P., Froguel P., Ruiz, J. (1997). Paraoxonase polymorphism Met-Leu 54 is associated with modified serum concentrations of the enzyme. A possible link between the paraoxonase gene and increased risk of cardiovascular disease in diabetes. J. Clin. Invest. 99 62-6. 

Carbonic anhydrase inhibitors should be used with caution in patients with respiratory acidosis or those with severe loss of respiratory capacity, and in patients with diabetes mellitus. They are contraindicated in patients with hepatic disease or insufficiency, reduced serum concentrations of sodium or potassium, adrenocortical insufficiency, hyperchloremic acidosis, or severe renal disease or dysfunction. They should also be avoided in patients taking salicylates. 

Lee DH, Lee IK, Song K. A strong dose-response relation between serum concentrations of persistent organic pollutants and diabetes Results from the National Health and Examination Survey 1999-2000. Diabetes Care 2006 29(7) 1638-44. 

A progressive spectrum of thyroid test result anomalies accompanies NTIs in euthyroid patients (the euthyroid sick syndrome )(Figure 52-6 and Box 52-5). The earliest and most common changes that occur are a reduction in the serum concentrations of total and free Tj, sometimes to extremely low concentrations, and an elevation in the serum concentration of rT (the lowTj state ). These changes have been ascribed to a block in the 5 deiodinases that convert T4 to T3 in peripheral tissue. Acute and chronic nutritional problems, poorly controlled diabetes meUitus, and drugs such as hydrocortisone and beta blockers can also inhibit this conversion. 

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