Evaluating the impact of glucagon-like peptide-1 receptor agonists on metabolic changes in patients with type 2 diabetes on high-dose insulin.
BACKGROUND: Studies involving the glucagon-like peptide-1 receptor agonist (GLP-1 RA) liraglutide have shown reductions in hemoglobin A1c (HbA1c), weight, and insulin requirements in patients with type 2 diabetes mellitus (DM2) requiring high-dose insulin therapy. The effect of the class of GLP-1 RAs on these parameters is unknown. DATA SOURCES: A retrospective cohort analysis was conducted in patients with DM2 where a GLP-1 RA was added to high-dose insulin therapy. The primary composite outcome was the change from baseline to 9 months in HbA1c, weight, and insulin dose. RESULTS: GLP-1 RA therapy was associated with a significant reduction in HbA1c from baseline (-0.9%; P = 0.022). Weight and insulin dose were not significantly reduced from baseline. There was a moderate effect of individual agents on these outcomes, but no significant reductions were seen due to the small sample size. LIMITATIONS: Generalizability of these findings may be limited by the characteristics and size of the study population. THERAPEUTIC OPINION: The effect of GLP-1 RA therapy on HbA1c may be attributed to the medication class. The effect of individual agents on weight and insulin requirements needs further investigation.
Rentsch T; Awad M; Moorman JM; Gothard MD
American Journal of Therapeutics
2020
2020-12-29
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journalArticle
<a href="http://doi.org/10.1097/MJT.0000000000001283" target="_blank" rel="noreferrer noopener">10.1097/MJT.0000000000001283</a>
SPONTANEOUS ENDOBRONCHIAL EROSION AND EXPECTORATION OF A RETAINED INTRATHORACIC BULLET - CASE-REPORT
General & Internal Medicine; Surgery
In all four previously reported cases of endobronchial erosion from retained intrathoracic foreign objects, the object eventually required surgical removal. We report the case of a patient with a bullet in the left hemithorax who developed bronchial erosion and hemoptysis 3 months after the injury, with subsequent expectoration of the bullet. Although most foreign bodies within the thorax pose no special problems, migration of the object or the development of symptoms warrants investigation and possibly subsequent surgical removal of the object.
Saunders M S; Cropp A J; Awad M
Journal of Trauma-Injury Infection and Critical Care
1992
1992-12
Journal Article
<a href="http://doi.org/10.1097/00005373-199212000-00021" target="_blank" rel="noreferrer noopener">10.1097/00005373-199212000-00021</a>