Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Insulin resistance is a characteristic feature of glucose intolerance in myotonic dystrophy type 1 (DM1). DM1 patients with dysglycaemia have liver insulin resistance as well as muscle insulin resistance, and also abnormality of insulin secretion. Insulin resistance in DM1 might result in multiple metabolic defects. Low level of fasting plasma glucose is a characteristic feature in the early stage of glucose intolerance in DM1, Early intervention against insulin resistance in DM1 is suggested because glucose intolerance could deteriorate in a certain degree of cases. Metformin treatment is useful to improve insulin resistance in DM1. Diabetic patients with DM1 usually show mild hyperglycemia. However, poorly controlled patients with hyperglycemic pattern tending to rise from morning to evening exist. Intensive insulin therapy might be necessary in such cases. We should pay attention to hypoglycemia due to hyperinsulinemia, pseudo improvement of glucose control according to exacerbated dysphagia, and acute aggravation caused by infections, at a bedside.
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PMID:[Glucose intolerance in myotonic dystrophy type 1]. 2319 82

Euglycaemic diabetic ketoacidosis is a term describing features of diabetic ketoacidosis but with normoglycaemia. We present a case of a perioperative diagnosis of euglycaemic ketoacidosis in a patient not known to be diabetic, and the subsequent management of the patient. A 65-year-old lady was scheduled for re-exploration of a giant paraoesophageal hernia, which had been initially repaired over six weeks previously. She developed dysphagia soon after the initial surgery and had low caloric intake. Arterial blood gases performed intraoperatively revealed metabolic acidosis with a normal lactate level. It did not respond to intravenous fluid therapy and sodium bicarbonate. Euglycaemic ketoacidosis was confirmed with raised serum ketone level. Insulin and dextrose infusions were commenced and she was managed in intensive care unit where the metabolic acidosis resolved over a 12-h period.
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PMID:Perioperative diagnosis of euglycaemic ketoacidosis. 2897 62