…By inhibiting SGLT2, these drugs produce coupled sodium and glucose loss in approximately a 1:1 stoichiometric relationship. The resulting glucosuria and natriuresis reduce proximal…

…the more myocardium can be salvaged. Call the PCI service in parallel with drug treatment and transport planning [1,5]. Symptom duration Under 12 hours…

…to alteplase and is simpler to administer, since the whole dose is given as a bolus [1,2]. In a meta analysis of three phase…

…help matter more than a single measured value [2]. Level Plasma glucose Meaning : : : Level 1, alert value < 3.9 mmol/L but at least…

…of poisons. Stabilisation according to ABCDE, the plasma glucose, a blood gas and an ECG all come before complete identification of the substance. Treatment of…

…continued Red flags and pitfalls Stopping basal insulin in type 1 diabetes. The single most dangerous prescribing decision on a ward. Not prescribing glucose measurement…

…fibrinogen, plasminogen activator inhibitor 1, serum viscosity, asymmetric dimethylarginine, homocysteine, white blood cell count, proinflammatory cytokines and C reactive protein. Increased urinary albumin/creatinine ratio…

…body, cardiac myocytes use ATP (adenosine triphosphate) as the primary energy source. ATP is produced by metabolizing carbohydrates (glucose), fats or proteins, whichever is available…

…and care settings [2]. Practical first actions Do the following in parallel, not sequentially: 1. Check previous creatinine values and establish the time course. 2…

…acute phase protein Thyroid Test Reference : : TSH 0.4–4.0 mIU/L Free T4 12–22 pmol/L Free T3 3.1–6.8…

…and ACTH first only if this does not delay treatment. Plus fluid and glucose Adrenal crisis: hypotension that does not respond to fluid, abdominal pain…

…and increased mortality [3,4]. Do this first 1. Assess vital signs and level of consciousness immediately. 2. Check oxygen saturation and capillary glucose. 3…

…while the osmolality is corrected cautiously [1,3]. Euglycaemic DKA Euglycaemic DKA means ketosis and metabolic acidosis despite a normal or only moderately raised glucose…

…body. 6. Check the plasma potassium after about 1 hour and follow the plasma glucose closely for at least 6 hours after insulin. 7. Contact…

…joint. Known hypersensitivity to the preparations. Relative: Poorly controlled diabetes — expect a raised blood glucose for 2–5 days. Suspected or known tendon rupture. No…

…maximum infusion rate. Rapid overview Time from seizure onset Action : : 0 to 5 minutes ABCDE, start timing, glucose, monitoring, intravenous or intraosseous access, a targeted…

…red meat. The principal evidence supported patterns are Mediterranean type and DASH style diets. Their effects are multidimensional and cannot be adequately inferred from changes…

…shift. For decades, the management of type 2 diabetes mellitus (T2DM) and obesity was siloed, with clinicians focusing primarily on hemoglobin A1c (HbA1c) reduction, blood…

Cardiology Endocrinology & metabolism Definition and Pathophysiology Type 2 diabetes mellitus (T2DM) is a major cardiovascular risk condition. It is associated with a two to four…

…induce cardiac arrest or cause profound cardiopulmonary depression. Table 1 delineates substances for which specific antidotes are available. The detrimental effects of these substances can…

…sterile gauze, and a fenestrated drape for injection. A needle of 0.8–1.2 × 50 mm for large joints (knee, shoulder), 0.5–0…

…imaging, the blood count or contact with the patient's own clinic delay empirical antibiotics [1]. A practical target: give the first dose of broad…

…mmol sodium bicarbonate per mL) for bolus and infusion, and glucose 50 mg/mL as carrier solution according to local protocol. Potassium chloride for infusion…

…imaging evaluate blood flow related tracer retention, whereas metabolic 18F fluorodeoxyglucose (18F FDG) PET assesses myocardial glucose metabolism. Areas with reduced perfusion but preserved 18F…

…risk factors. It includes maintenance of favourable blood pressure, body mass index, cholesterol and glucose levels, together with a low salt, low cholesterol diet, regular…

…Sinoatrial block Junctional rhythm First degree AV block Second degree AV block Mobitz type 1 (Wenckebach block) Pauses up to 4 seconds in patients with…