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Biomedical subjects

L Mack-Shipman

Publications and source records attributed to L Mack-Shipman.

4 recordsLinked to original sources
PubMed2000

The role of the dental professional in diabetes care.

Diabetes mellitus, specifically type 2 diabetes, is one of the major public health issues facing the world in the 21st Century. This article summarizes the rapid changes in the management of diabetes and its impact on dental practice. The reader will find many "hyperlinks" to other diabetes information on the Internet throughout this article as these links provide greater detail. The incidence of type 1 diabetes has increased slowly, while that of type 2 diabetes has increased explosively. The worldwide incidence of type 2 is likely to double by the year 2010 due in large part to changing lifestyles, longer life expectancy, and rapid growth of ethnic and racial populations that have high prevalence rates. There are 15.7 million people or 5.9% of the population in the United States who have diabetes. While an estimated 10.3 million have been diagnosed, it is unfortunate that 5.4 million people are not aware they have the disease. Diabetic dental patient management strategies are presented. Dental professionals are urged to remain current in their knowledge of this disease in order to provide proper care for their patients.

Acute Disease↗
PubMedDate not supplied

Idiopathic hypothalamic dysfunction with precocious puberty and adipsic hypernatremia first presenting in adolescence.

BACKGROUND: Idiopathic hypothalamic dysfunction is a rare syndrome that has been described in young children. This syndrome is characterized by a disturbance of thirst regulation with hypernatremia, hyperosmolarity, and altered hypothalamic function. PATIENT REPORT: At age 6 years the reported patients presented with precocious puberty, by age 12 years she had hypernatremia presumed secondary to central diabetes insipidus and was treated with DDAVP, and at age 14 was identified to have hyperprolactinemia. At age 19 she presented with serum sodium of 185 mg/dl during an episode of illness associated with dehydration. After hydration, her sodium remained elevated. Arginine vasopressin was measurable but inappropriate to serum sodium, while urinary cyclic AMP response to vasopressin was appropriate. CONCLUSIONS: This is the first case of precocious puberty identified in association with the more classic features of idiopathic hypothalamic dysfunction, including later-onset hypernatremia, poor thermoregulatory function, obesity, and hyperprolactinemia.

Arginine Vasopressin↗
PubMedDate not supplied

Determination of insulin requirements: excessive insulin dosages common in type 1 diabetes mellitus.

OBJECTIVE: To report our experience of determining insulin requirements for initiating continuous subcutaneous insulin infusion (CSII) pump therapy, using an algorithm for intravenous administration of insulin, in patients with poorly controlled diabetes. METHODS: We describe assessment of insulin requirements and analyze data from 27 consecutive admissions. All patients had type 1 diabetes mellitus and were being converted to CSII pump therapy. Twenty-four-hour intravenous insulin requirements were used to initiate CSII pump therapy, and further dose adjustments were undertaken, to optimize glycemic control. Basal, bolus, and total daily insulin requirements were calculated before, during, and 3 months after conversion to CSII therapy. RESULTS: At entry, the mean glycohemoglobin was 11.2% (normal, 5.0 to 8.0%), and the mean daily insulin dose were 45.8 U (0.59 U/kg). Calculated daily insulin requirements using an algorithm for intravenously administered insulin were 37.3 U (0.50 U/kg). At 3 months, mean daily insulin requirements had increased to 39.2 U (0.52 U/kg), and glycohemoglobin improved to 9.4%. Most patients (78%) remained on insulin doses within 10% of the calculated requirements. All patients who were receiving more than 0.6 U/kg daily before assessment required a reduction in insulin dosage to improve glycemic control. CONCLUSION: Many patients with type 1 diabetes are receiving excessive insulin doses. An algorithm for intravenous administration of insulin may be useful for determining requirements and appropriate insulin doses for CSII pump therapy, especially in patients with poor glycemic control.

Journal Article↗