Pam Brown
GP in Swansea
Citation: Brown P (2024) Diabetes Distilled: Diabetes remission in the real world. Diabetes & Primary Care 26: 145–7
Diabetes remission is achievable at scale in the real world, according to early results from the NHS Type 2 Diabetes Path to Remission programme published in Lancet Diabetes & Endocrinology. Of 7540 people referred to the programme between September 2020 and December 2022, a total of 1740 started the total diet replacement section of the programme before January 2022, and 960 (55%) completed the programme. Mean weight loss for the 1710 who started the programme and had follow-up data available was 9.4 kg (8.3%), with a mean weight loss of 10.3 kg (9.3%) among the 945 who completed the programme. Amongst the 945 who completed the programme and had two HbA1c measurements, 32% achieved remission, with mean weight loss of 15.9 kg (14.4%), while overall 27% of those who started the programme achieved remission regardless of whether they completed. Remission rates are lower than in trials such as DiRECT and DIADEM-I, despite similar levels of weight loss. The authors highlight that an additional 17% of participants met the HbA1c targets for remission but continued on metformin and may otherwise have achieved remission. These early results confirm that type 2 diabetes remission is indeed possible at scale in the real world, outside of clinical trials.
Pam Brown GP in Swansea
Citation: Brown P (2024) Diabetes Distilled: Impact of metformin timing on glucose and GLP-1 response. Diabetes & Primary Care 26: 143–4
Glucose-lowering effects in response to normal-release metformin are greater when the drug is given 30 or 60 minutes before, rather than with, food, according to this small study in people with well-controlled type 2 diabetes published in Diabetologia. Endogenous GLP-1 secretion increased when metformin 1000 mg was given 30 or 60 minutes prior to a glucose infusion, whereas there was no increase when the metformin was administered at the same time as the glucose. The results suggest that, if tolerated, administering standard release metformin before meals may lead to improved postprandial glycaemic control.
原创： 胡大夫 负压引流与创面修复
今天和省人民医院朋友聊天，关于吃药‘偏方’‘秘方’等等的后遗症，没有最惨，只有更惨！
胡海涛 负压引流与创面修复
老年女患，65岁，双手痛风性关节炎并急性发作，高热、疼痛剧烈，入院时尿酸580umol/L.
原创： 胡海涛 负压引流与创面修复
洗脚时的热水烫伤，是糖尿病足溃疡的一个常见原因！
一个特殊案例：内分泌科的一个糖足，主管医生四次电话催急会诊，要求转科，看到患者，是2019年最严重的烂脚!
负压引流与创面修复 以下文章来源于普外时间 ，作者胡海涛
腹部切口全层感染并裂开，在普外科并不少见，它的出现对医生和患者都是灾难！丁香园论坛有战友分享两例超过一个月的伤口：
伤口世界平台生态圈，以“关爱人间所有伤口患者”为愿景，连接、整合和拓展线上和线下的管理慢性伤口的资源，倡导远程、就近和居家管理慢性伤口，解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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