Type 2 diabetes mellitus management in Canada: is it improving?

Objective: To gain insight into the current management of patients with type 2 diabetes mellitus by Canadian primary care physicians.

Method: A total of 479 primary care physicians from across Canada submitted data on 5123 type 2 diabetes patients whom they had seen on a single day on or around World Diabetes Day, November 14, 2012.

Results: Mean glycated hemoglobin (A1C) was 7.

Inhaled insulin improves glycemic control when substituted for or added to oral combination therapy in type 2 diabetes: a randomized, controlled trial.

Background: Patients with type 2 diabetes who do not achieve glycemic control with oral agent therapy eventually require insulin.

Objective: To determine the effect on glycemic control of inhaled insulin alone or added to dual oral therapy (insulin secretagogue and sensitizer) after failure of dual oral therapy.

Design: Open-label, randomized, controlled trial.

MEASURE: A proposed assessment framework for developing best practice recommendations for wound assessment.

The effective management of nonhealing wounds is based on a complete patient history, a detailed initial assessment of the wound, and an analysis of probable causative factors. This information is used to individualize a management strategy to the underlying pathophysiology preventing healing and to implement appropriate wound interventions. Regular reassessment of progress toward healing and appropriate modification of the intervention are also necessary.

Diabetic foot ulcers. Pathophysiology, assessment, and therapy.

Objective: To review underlying causes of diabetic foot ulceration, provide a practical assessment of patients at risk, and outline an evidence-based approach to therapy for diabetic patients with foot ulcers.

Quality Of Evidence: A MEDLINE search was conducted for the period from 1979 to 1999 for articles relating to diabetic foot ulcers. Most studies found were case series or small controlled trials.

Use of layered compression bandages in diabetic patients. Experience in patients with lower leg ulceration, peripheral edema, and features of venous and arterial disease.

Layered compression therapy for venous leg ulcers and ulcers associated with chronic leg edema has been shown to be an effective treatment in patients with adequate arterial circulation. However, no study has looked specifically at compression therapy in the diabetic population. This clinical case review examines outcomes in two groups of diabetic patients with edema and either venous ulcers or preulcerative conditions.

I-131 metaiodobenzylguanidine uptake in a parathyroid adenoma.

We describe a patient with multicentric small bowel carcinoids, severe hypertension, primary hyperparathyroidism, and multiple parathyroid adenomas. Intense uptake of I-131 metaiodobenzylguanidine (MIBG) occurred in a parathyroid adenoma. There was no biochemical evidence of catecholamine secretion by the tumor but elevated serum levels of parathyroid hormone were demonstrated.