Plasma Bile Acids More Closely Align With Insulin Resistance, Visceral and Hepatic Adiposity Than Total Adiposity.

Context: The etiological mechanism of bile acid (BA) effects on insulin resistance and obesity is unknown.

Objective: This work aimed to determine whether plasma BAs are elevated in human obesity and/or insulin resistance.

Methods: This observational study was conducted at an academic research center.

Routine glucose assessment in the emergency department for detecting unrecognised diabetes: a cluster randomised trial.

Objective: To determine whether routine blood glucose assessment of patients admitted to hospital from emergency departments (EDs) results in higher rates of new diagnoses of diabetes and documentation of follow-up plans.

Design, Setting: Cluster randomised trial in 18 New South Wales public district and tertiary hospitals, 31 May 2011 - 31 December 2012; outcomes follow-up to 31 March 2016.

Participants: Patients aged 18 years or more admitted to hospital from EDs.

Longitudinal Changes in Insulin Resistance in Normal Weight, Overweight and Obese Individuals.

Background: Large cohort longitudinal studies have almost unanimously concluded that metabolic health in obesity is a transient phenomenon, diminishing in older age. We aimed to assess the fate of insulin sensitivity per se over time in overweight and obese individuals.

Methods: Individuals studied using the hyperinsulinaemic-euglycaemic clamp at the Garvan Institute of Medical Research from 2008 to 2010 ( = 99) were retrospectively grouped into Lean (body mass index (BMI) < 25 kg/m) or overweight/obese (BMI ≥ 25 kg/m), with the latter further divided into insulin-sensitive (Ob) or insulin-resistant (Ob), based on median clamp M-value (M/I, separate cut-offs for men and women).

Treatment of Clinically Positive Cervical Lymph Nodes by Limited Local Node Excision and Adjuvant Radiotherapy in Melanoma Patients with Major Comorbidities.

Introduction: When cervical lymph nodes are clinically positive for metastatic melanoma, surgeons may be hesitant to recommend a therapeutic complete lymph node dissection if the patient is elderly or has major comorbidities. A limited local node excision of the clinically positive nodes only, followed by adjuvant radiotherapy to the entire node field, may be an effective alternative in such patients.

Methods: All patients who had presented with a primary head and neck melanoma or an unknown primary site and had subsequently undergone limited local node excision and adjuvant radiotherapy for macroscopically involved cervical nodes between 1993 and 2010 at a tertiary referral center were selected for study.

Euglycaemic diabetic ketoacidosis in patients using sodium-glucose co-transporter 2 inhibitors.

Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are an increasingly prescribed class of medication for type 2 diabetes mellitus. Euglycaemic diabetic ketoacidosis (euDKA) has been reported in association with SGLT2i use. Clinicians need to understand how to recognise and treat this complication.

Bone Turnover Is Suppressed in Insulin Resistance, Independent of Adiposity.

Context: The contribution of insulin resistance vs adiposity to bone mineral density (BMD), bone turnover, and fractures in humans remains unclear.

Objective: To evaluate BMD and bone turnover markers (BTMs) in lean (n = 18) and overweight/obese individuals with (n = 17) and without (n = 34, insulin-sensitive [Obsensitive, n=15] or insulin-resistant [Obresistant, n=19] by homeostasis model assessment insulin resistance) diabetes mellitus.

Design: Observational study.

Skeletal muscle and plasma lipidomic signatures of insulin resistance and overweight/obesity in humans.

Objective: Alterations in lipids in muscle and plasma have been documented in insulin-resistant people with obesity. Whether these lipid alterations are a reflection of insulin resistance or obesity remains unclear.

Methods: Nondiabetic sedentary individuals not treated with lipid-lowering medications were studied (n = 51).

Long-term glycaemic control (HbA1c), not admission glucose, predicts hospital re-admission in diabetic patients.

Background: Diabetic patients are commonly hyperglycaemic on presentation. Admission hyperglycaemia is associated with adverse outcomes, particularly prolonged hospitalisation. Improving inpatient glycaemia may reduce length of hospital stay (LOS) in diabetic patients.