Insulin secretion in liver transplant recipients following conversion to a prolonged release tacrolimus formulation.

Background: Post liver transplant diabetes mellitus (PLTDM) occurs in 10-40% of liver transplant recipients and is associated with increased morbidity and mortality. An important cause of PLTDM is tacrolimus induced, concentration-dependent, inhibition of insulin secretion.

Objective: To determine if a newly licenced formulation of tacrolimus (Envarsus-PA), which achieves peak tacrolimus concentrations 20-30% lower than other tacrolimus formulations has less of an inhibitory effect on insulin secretion.

Diabetes and Osteoporosis: Part II, Clinical Management.

Diabetes-induced osteoporosis is characterized by an increase in fracture risk. FRAX, the most widely used tool, underestimates the risk of fracture in both type 1 and type 2 diabetes. Specific adjustments to FRAX can help to better identify patients with diabetes at increased risk of fracture and select those at high fracture risk for treatment.

Diabetes and Osteoporosis: Part I, Epidemiology and Pathophysiology.

Both diabetes and osteoporosis are increasingly prevalent diseases, in part owing to aging populations worldwide. Epidemiologic data have shown that other organs may be adversely affected by diabetes, including the skeleton, in what has become known as diabetes-induced osteoporosis, which represents the combined impact of conventional osteoporosis with the additional fracture burden attributed to diabetes. There is an increased risk of fracture in patients with Type 1 and Type 2 diabetes, and some antidiabetic medications also may contribute to increased risk of fracture in diabetes.

Diabetes and Bone Disease.

The World Health Organization estimates that diabetes mellitus occurs in more than 415 million people; this number could double by the year 2040. Epidemiologic data have shown that the skeletal system may be a target of diabetes-mediated damage, leading to the development of diabetes-induced osteoporosis. T1D and T2D have been associated with an increased risk of fracture.

DXA-Based Measurements in Diabetes: Can They Predict Fracture Risk?

In the absence of a fragility fracture, osteoporosis is usually diagnosed from bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA). Osteoporosis is an increasingly prevalent disease, as is diabetes [in particular type 2 diabetes (T2D)], in part due to aging populations worldwide. It has been suggested that an increased risk of fracture may be another complication ensuing from longstanding diabetes.

Spine-Hip Thickness Difference Measured by Dual-Energy X-ray Absorptiometry Is Associated With Diabetes Mellitus in Women and Men.

Abdominal adiposity is strongly associated with a range of chronic metabolic and cardiovascular morbidities, including type 2 diabetes mellitus, and may play a causal role in their development. Dual-energy X-ray absorptiometry (DXA) of the lumbar spine and hip is widely used for assessment of osteoporosis and also measures tissue thickness. We hypothesized that the difference in spine and hip tissue thickness from regional DXA scans might provide an index of relative abdominal adiposity and serve as a risk factor for the presence of diabetes.

Preoperative therapeutic apheresis for severe medically refractory amiodarone-induced thyrotoxicosis: a case report.

Introduction: Amiodarone is associated with thyroid dysfunction and life-threatening thyrotoxicosis. In medically refractory cases, or where medical therapy is contraindicated, thyroidectomy may be required. To decrease perioperative thyroid storm and to reduce overall surgical risk, apheresis may be considered preoperatively to restore euthyroidism.

Estimation of trochanteric soft tissue thickness from dual-energy X-ray absorptiometry.

Low body mass index is considered to be an important risk factor for fractures in postmenopausal women, in part reflecting its association with lower bone mineral density (BMD). In contrast, obesity is thought to be protective against fracture because of higher BMD and reduced transmitted force of falls as a result of soft tissue padding. Dual-energy X-ray absorptiometry (DXA) is most widely used for the assessment of osteoporosis.