Various discussion exists concerning ketone bodies (KB) for beneficial effects. In 2021, the American College of Cardiology (ACC) has presented the therapeutic potential of KB for cardiovascular (CV) disease. KB cover 10-15% of cardiac production of ATP, elevation of cardiac energetics, and reduction of cardiac remodeling, inflammation, and oxidative stress.
The patient was a 74-year-old female with type 2 diabetes mellitus (T2DM) treated on Humalog mix 25 twice a day. As social history, she has worked long years for growing and harvesting lotus roots. It gives physically heavy loading, which brings unstable glycemic daily control. She had to titrate minute regulation every time. For stable glucose variability, the treatment was changed to Xultophy, which is a specific combined agent of Insulin Degludec and Liraglutide (IDeg/Lira) once a day. Then, detailed glucose monitoring showed a better daily profile of blood glucose, irrespective of heavy or light work. It showed the bio-psycho-social benefit of Xultophy.
Diabetes and osteoporosis have been highly prevalent. Insulin therapy may increase risk of fracture. According to a cohort study (n=216,624), patients who changed to insulin therapy showed hazard ratio of fractures 1.5, with 1.6/1.8 of hip/vertebral fractures. Elevated hypoglycemic risk may be involved in greater episodes of falls with fractures.
Hyperuricemia is a clinical important problem and its prevalence has been increased. Latest topics are described. The guideline adequately managing gout was published from American College of Rheumatology (ACR). Various optimal uses of urate-lowering therapy (ULT) were presented. The cardiorenal effects of hyperuricemia have been investigated for years. Regarding the patients on chronic kidney disease (CKD) and high risk of progression, ULT with allopurinol did not show the decline in eGFR compared to the control. Recently, dotinurad that is a new selective urate reabsorption inhibitor (SURI) would be applied to medical practice. Low-dose dotinurad showed satisfactory pharmacological efficacy.
Reduces glucose (sugar) levels in your body by increasing the amount of sugar you pass in your urine Canagliflozin (Invokana®), Dapagliflozin (ForxigaTM), Empagliflozin (JardianceTM) • Canagliflozin 100 mg may be increased to 300 mg (Your dose may depend on your kidney function) • Dapagliflozin 5 mg may be increased to 10 mg • Empagliflozin 10 mg may be increased to 25 mg Take once a day as directed by your healthcare provider • Take it as soon as you remember • If more than 12 hours has passed since your missed dose, then skip the missed dose and take the next dose at the regularly prescribed time • Do not double your dose to
