Hazrat Bilal

Hazrat Bilal �Alhamdulillah,
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A rare new form of diabetes was just officially recognized. The condition is linked to   during early life, one that’s n...
10/06/2025

A rare new form of diabetes was just officially recognized.

The condition is linked to during early life, one that’s now been formally classified by the International Federation.

Unlike other types, type 5 isn’t caused by or lifestyle factors but by poor nutrition in childhood that stunts the development of the pancreas. It mostly affects people in countries and may impact 20–25 million people globally. Their bodies produce little , not because of immune damage like in type 1, but because their never developed properly.

Rodent studies support this, showing that a low-protein diet during or adolescence leads to underdeveloped insulin-producing cells. This new classification show how the term "diabetes" covers a wide range of conditions. Type 1 is an autoimmune disease needing lifelong insulin. Type 2, the most common, is linked to body weight and lifestyle but also has strong genetic links, especially in some ethnic groups. It can often be treated with diet, drugs like metformin, or even reversed through sustained weight loss. diabetes appears during pregnancy due to hormonal changes and usually resolves after birth. There are also several rare types of diabetes, such as neonatal diabetes present from birth and caused by specific genes. Another rare type is type 3c, which results from pancreas damage, often from cancer or pancreatitis. The recognition of Type 5 diabetes pushes diabetes care beyond high-income countries and shows that global treatment approaches need to consider the different causes.

Type 2 Diabetes management  TreatmentThe first step in managing Type 2   is to initiate treatment with  . If necessary, ...
15/05/2025

Type 2 Diabetes management
Treatment
The first step in managing Type 2 is to initiate treatment with . If necessary, SGLT2i can be added, particularly for patients with chronic heart failure or established disease (CVD) and a high QRISK score (>10%).

Treatments
If Metformin is or not , alternative treatments can be considered, including DPP4i, , SU, and SGLT2i.


If monotherapy is not effective, combination therapy can be initiated. The preferred combinations include:
- Metformin + DPP4i, Pioglitazone, or
- Metformin + SGLT2i + DPP4i, Pioglitazone, or Sulfonylurea (triple therapy)


The treatment preferences based on specific characteristics, such as:
- CVD/HF/High Risk CVD/CKD: SGLT2i
- Weight concerns: GLP-1
- : SU

# # Triple Not Effective
If triple therapy is not effective, consider switching one out for a GLP-1 receptor agonist, particularly for patients with a BMI >35 or those who would benefit from weight loss.


Insulin therapy can be initiated when necessary, with options including:
- Insulin (OD or BD) as first-line treatment
- Isophane + Short Acting (Mixed) if >75mmol/mol
- Detemir/Glargine if assistance is needed (carers)

Targets
The HbA1c targets for different patient groups, including:
- Diet: 48mmol/mol
- Metformin/Single drug not associated with hypos: 48mmol/mol
- Drug treatment associated with hypos: 53mmol/mol
- Step up in treatment when HbA1c: 58mmol/mol

Risk Reduction
The guidance on CVD risk reduction, including:
- QRISK >10%: Atorvastatin 20mg
- (No CKD):

Insuline type made easy.
07/05/2025

Insuline type made easy.



Chest pain
07/05/2025

Chest pain

02/05/2025

The Scale (GCS) is a neurological scale used to assess a patient's level of consciousness.

# # Components
The GCS consists of three components:

1. *Eye Opening*: Scores range from 1 (no eye opening) to 4 (spontaneous eye opening).
2. *Verbal Response*: Scores range from 1 (no verbal response) to 5 (oriented and conversational).
3. *Motor Response*: Scores range from 1 (no motor response) to 6 (obeys commands).

# # Scoring
The total GCS score ranges from 3 (deep coma) to 15 (fully awake and responsive).

# # # Significance
The GCS is widely used in:

1. * assessment*: To evaluate the severity of injuries.
2. * monitoring*: To track changes in a patient's level of consciousness over time.
3. * *: To help predict patient outcomes.

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Labs:
25/04/2025

Labs:

Physical Examination:
25/04/2025

Physical Examination:

Address

Lahore

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