Diabetes

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Over the past 8 years, fragile vesicles,painful ruptured bullae, and erosionshave developed on the sun-exposed skinof a 57-year-old man. Some of the vesicleserupt at sites of minor trauma; othersarise spontaneously. A corticosteroidcream prescribed by another practitionerfor presumed atopic dermatitisfailed to clear the lesions.

In recent years, 2 large randomized,controlled studies have documentedthe efficacy of the anticonvulsantgabapentin in the management ofpainful diabetic neuropathy (PDN)1and post-herpetic neuralgia (PHN).2Although vastly different in origin,these 2 neuropathies have exhibitedsome similarities in their response totherapeutic agents of various classes.The discovery that yet another typeof pharmaceutical is useful in treatingpain from either PDN or PHN hasraised questions about the similaritiesand differences in the managementof these 2 painful neuropathicsyndromes.

ROCKVILLE, Md. -- Against the background of the growing incidence of type 2 diabetes and obesity in the United States came news this year about the first new insulin delivery system in 80 years, as well as new categories of drugs for type 2 disease.

CAPE TOWN, South Africa -- The thiazolidinedione Avandia (rosiglitazone) has a more durable response than two older oral type 2 diabetes agents, but it was more expensive and had more side effects, researchers reported here.

NEW YORK -- Uncomplicated diabetes does not affect 10-year heart transplant survival, but patients with diabetes-related renal disease or stroke do not do as well, reported surgeons here.

ROCKVILLE, Md. -- The FDA approved Januvia (sitagliptin) today, the first dipetidyl peptidase-4 (DDP-4) inhibitor, an oral agent for type 2 diabetes as monotherapy or in combination with Glucophage (metformin) or a PPAR agonist.

A 54-year-old woman with a 10-year history of insulin-dependent type 2 diabetes mellitus was referred by her optometrist because of the recent onset of blurrinessin her right eye. Her optometrist told her that new blood vessel growth and leakage had developed.

EDMONTON, Alberta -- Two years after receiving transplants of insulin-producing beta islet cells, only five of 36 patients with type 1 diabetes remained free of the need for insulin injections, reported investigators in a small multinational trial.

CHICAGO -- Patients with type 2 diabetes who are chronically sleep deprived may have impaired glucose control and more serious complications of type 2 diabetes, researchers here found.

CHICAGO -- Patients with type 2 diabetes who are chronically sleep deprived may have impaired glucose control and more serious complications of type 2 diabetes, researchers here found.

In patients with diabetes who have end-stage renal disease and CHF, the choice of oral medications is limited because metformin is contraindicated. Glipizide has a 5% renal clearance and is relatively safe. Studies suggest that glimepiride is the safest of the sulfonylureas.

WASHINGTON -- The Physicians Committee for Responsible Medicine, a crusading group that has long ranked vegetarianism high on its agenda, has made a compelling case for a low-fat vegan diet to improve glycemic control.