Hyperosmolar hyperglycaemic state as a stroke cause or stroke mimic: an illustrative case and review of literature.

Hyperosmolar hyperglycaemic state (HHS) is a life-threatening metabolic complication of type 2 diabetes (T2DM) that often presents with neurological symptoms. A 74-year-old man with known T2DM presented to the emergency department with collapse, left-sided weakness and slurred speech (National Institutes of Health Stroke Scale (NIHSS) 3) and a biochemical profile consistent with HHS. When he further deteriorated (NIHSS 20), he was managed for concurrent ischaemic stroke.

Measurement of Peak C-Peptide at Diagnosis Informs Glycemic Control but not Hypoglycemia in Adults With Type 1 Diabetes.

Context: High-residual C-peptide in longer-duration type 1 diabetes (T1D) is associated with fewer hypoglycemic events and reduced glycemic variability. Little is known about the impact of C-peptide close to diagnosis.

Objective: Using continuous glucose monitoring (CGM) data from a study of newly diagnosed adults with T1D, we aimed to explore if variation in C-peptide close to diagnosis influenced glycemic variability and risk of hypoglycemia.

Persistent C-peptide is associated with reduced hypoglycaemia but not HbA in adults with longstanding Type 1 diabetes: evidence for lack of intensive treatment in UK clinical practice?

Aims: Most people with Type 1 diabetes have low levels of persistent endogenous insulin production. The Diabetes Control and Complications Trial showed that close to diagnosis preserved endogenous insulin was associated with lower HbA , hypoglycaemia and complication rates, when intensively treated. We aimed to assess the clinical impact of persistent C-peptide on rate of hypoglycaemia and HbA in those with long duration (> 5 years) Type 1 diabetes.

Idiopathic peripheral vitreous membranes.

An unusual case of bilateral prepapillary glial sheets and peripheral vitreal membranes is described. Such membranes are seldom reported in the literature. A retinal specialist concurred that the avascular membranes, present in the inferior retinae of both eyes, were congenital because the membranes were bilateral and symmetrical and because the patient had no other sign of retinal or systemic conditions associated with membrane formation.

Postpump retinopathy.

Postpump syndrome is a systemic manifestation which occurs somewhat frequently after cardiac surgery when cardiopulmonary bypass (CPB) is used. It is probably caused by platelet injury secondary to plasma contact with the CPB machinery. Damaged platelets aggregate and result in small emboli which course throughout the body, causing short-lived infarcts in the smaller blood vessels in multiple organs including the eyes where the result is retinopathy.