Prof. Cheuk-Chun Szeto, Dr. Winston W. S. Fung, 20180125045128
A 65-year-old lady with a background of type 2 diabetes, hyperlipidaemia and chronic immune thrombocytopenia presented to us with a 2-week history of generalized malaise and myalgia. Shortly after the onset of myalgia, she was noted to have reduced urine output and the urine was described as dark in colour. Her regular medications included prednisolone, danazol, simvastatin, metformin, and human insulin. Upon further questioning, the patient admitted that her compliance to simvastatin and danazol used to be poor. However, she recently started to take both medications regularly after repeated education.
A 55-year-old man presented with almost one year history of heat intolerance, mild palpitation and significant weight loss. Free T3 and T4 were elevated with normal TSH. Patient had suboptimal response to carbimazole therapy.
This case scenario was presented at a grand round in the Department of Medicine, The University of Hong Kong. Unlike traditional grand rounds that directly or indirectly deal with clinical challenges posed by patients, this one was equally about doctors and how they care for their charges. All doctors who tend patients dread being implicated on the receiving end of medico-legal proceedings. This topic is therefore intimately linked to the professionalism of doctors, their standing in the community, and the ethical aspects of how they interact with patients and relatives.
Asia's trusted medical magazine for healthcare professionals.
Get your MIMS Endocrinology - Malaysia digital copy today!
Women with pre-eclampsia or gestational hypertension during their first pregnancy had an increased risk of developing chronic hypertension, type 2 diabetes (T2D), and hypercholesterolaemia than those who were normotensive during pregnancy, according to a study. The risk persisted for several decades later, signalling these hypertensive disorders of pregnancy (HDP) as red flags for cardiovascular (CV) health for life.
Treatment with metformin appears to significantly reduce tuberculosis (TB) risk in patients with type 2 diabetes mellitus, a study has found. However, this protective effect diminishes with age and is absent among those with metabolic disorders.