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  1. Article: Re: Real Practice Assessment of Persistent Symptoms After Initiation of Levothyroxine.

    Bell, David S H

    Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

    2024  

    Language English
    Publishing date 2024-04-09
    Publishing country United States
    Document type Letter
    ZDB-ID 1473503-9
    ISSN 1530-891X
    ISSN 1530-891X
    DOI 10.1016/j.eprac.2024.04.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5034: Show issues Location:
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    Zs.MO 508: Show issues

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  2. Article: The Consequences of Lowering Vitamin B12 With Chronic Metformin Therapy.

    Bell, David S H

    Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

    2023  Volume 29, Issue 11, Page(s) 928–929

    MeSH term(s) Humans ; Metformin/therapeutic use ; Vitamin B 12/therapeutic use ; Hypoglycemic Agents/therapeutic use ; Diabetes Mellitus, Type 2/drug therapy
    Chemical Substances Metformin (9100L32L2N) ; Vitamin B 12 (P6YC3EG204) ; Hypoglycemic Agents
    Language English
    Publishing date 2023-08-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1473503-9
    ISSN 1530-891X
    ISSN 1530-891X
    DOI 10.1016/j.eprac.2023.08.010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: The potential for improved outcomes in the prevention and therapy of diabetic kidney disease through 'stacking' of drugs from different classes.

    Bell, David S H / Jerkins, Terri

    Diabetes, obesity & metabolism

    2024  

    Abstract: Aggressive therapy of diabetic kidney disease (DKD) can not only slow the progression of DKD to renal failure but, if utilized at an early enough stage of DKD, can also stabilize and/or reverse the decline in renal function. The currently recognized ... ...

    Abstract Aggressive therapy of diabetic kidney disease (DKD) can not only slow the progression of DKD to renal failure but, if utilized at an early enough stage of DKD, can also stabilize and/or reverse the decline in renal function. The currently recognized standard of therapy for DKD is blockade of the renin-angiotensin system with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs). However, unless utilized at a very early stage, monotherapy with these drugs in DKD will only prevent or slow the progression of DKD and will neither stabilize nor reverse the progression of DKD to renal decompensation. Recently, the addition of a sodium-glucose cotransporter-2 inhibitor and/or a mineralocorticoid receptor blocker to ACE inhibitors or ARBs has been clearly shown to further decelerate the decline in renal function. The use of glucagon-like peptide-1 (GLP-1) agonists shown promise in decelerating the progression of DKD. Other drugs that may aid in the deceleration the progression of DKD are dipeptidyl peptidase-4 inhibitors, pentoxifylline, statins, and vasodilating beta blockers. Therefore, aggressive therapy with combinations of these drugs (stacking) should improve the preservation of renal function in DKD.
    Language English
    Publishing date 2024-03-22
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1454944-x
    ISSN 1463-1326 ; 1462-8902
    ISSN (online) 1463-1326
    ISSN 1462-8902
    DOI 10.1111/dom.15559
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  4. Article ; Online: Detecting and treating the protean manifestations of diabetic autonomic neuropathy.

    Bell, David S H

    Diabetes, obesity & metabolism

    2023  Volume 25, Issue 5, Page(s) 1162–1173

    Abstract: The manifestations of diabetic autonomic neuropathy (DAN) are protean and clinically involve multiple systems, including the cardiovascular system, the gastrointestinal system, the genitourinary system as well as the sweat glands (sudomotor dysfunction) ... ...

    Abstract The manifestations of diabetic autonomic neuropathy (DAN) are protean and clinically involve multiple systems, including the cardiovascular system, the gastrointestinal system, the genitourinary system as well as the sweat glands (sudomotor dysfunction) and the gallbladder. In addition, cardiac autonomic neuropathy (CAN) is associated with a correctible inability to appreciate and correct hypoglycaemia. While not a clinical problem, pupillary involvement should be the clue and the catalyst to investigate for other manifestations of DAN. This review outlines a practical approach to detecting and investigating the manifestations of DAN. Of particular importance is early detection of cardiovascular involvement where prompt therapy through glycaemic control can decrease the severity of CAN and decelerate the frequency and severity of retinopathy and nephropathy in addition to decreasing cardiovascular events and mortality. CAN also plays a role in accelerating other diabetic complications such as acute ischaemic stroke, heart failure, medial artery calcinosis, foot ulcers, peripheral artery disease and Charcot joints. Many therapies of DAN are available, which should not only decrease morbidity and mortality from DAN, but also improve the patient's quality of life. However, the therapies available are largely symptomatic.
    MeSH term(s) Humans ; Diabetic Neuropathies/diagnosis ; Diabetic Neuropathies/etiology ; Diabetic Neuropathies/therapy ; Brain Ischemia ; Quality of Life ; Autonomic Nervous System Diseases/complications ; Autonomic Nervous System Diseases/diagnosis ; Stroke/complications ; Diabetes Mellitus
    Language English
    Publishing date 2023-02-26
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1454944-x
    ISSN 1463-1326 ; 1462-8902
    ISSN (online) 1463-1326
    ISSN 1462-8902
    DOI 10.1111/dom.15004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5442: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Combine and Conquer: With Type 2 Diabetes Polypharmacy Is Essential Not Only to Achieve Glycemic Control but Also to Treat the Comorbidities and Stabilize or Slow the Advancement of Diabetic Nephropathy.

    Bell, David S H

    Journal of diabetes research

    2022  Volume 2022, Page(s) 7787732

    Abstract: The concept of polypharmacy in the type 2 diabetic patient is both historic and redundant. A combination of three or more medications usually at doses which are less than those utilized for monotherapy is efficacious not only in the therapy of ... ...

    Abstract The concept of polypharmacy in the type 2 diabetic patient is both historic and redundant. A combination of three or more medications usually at doses which are less than those utilized for monotherapy is efficacious not only in the therapy of hyperglycemia but also in the therapy of the comorbidities of hypertension and hyperlipidemia. In addition, multiple medications are now accepted as being necessary to reduce albuminuria and decelerate the decline in renal function in the patient with diabetic nephropathy.
    MeSH term(s) Albuminuria/drug therapy ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/epidemiology ; Diabetic Nephropathies/drug therapy ; Diabetic Nephropathies/epidemiology ; Glycemic Control ; Humans ; Polypharmacy
    Language English
    Publishing date 2022-08-04
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2711897-6
    ISSN 2314-6753 ; 2314-6753
    ISSN (online) 2314-6753
    ISSN 2314-6753
    DOI 10.1155/2022/7787732
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Diabetic Mononeuropathies and Diabetic Amyotrophy.

    Bell, David S H

    Diabetes therapy : research, treatment and education of diabetes and related disorders

    2022  Volume 13, Issue 10, Page(s) 1715–1722

    Abstract: This brief review describes the etiology, pathophysiology, clinical features, therapy and prognosis of the diabetic mononeuropathies and diabetic amyotrophy and neuropathic cachexia. Mononeuropathies include cranial neuropathies, of which the oculomotor ... ...

    Abstract This brief review describes the etiology, pathophysiology, clinical features, therapy and prognosis of the diabetic mononeuropathies and diabetic amyotrophy and neuropathic cachexia. Mononeuropathies include cranial neuropathies, of which the oculomotor nerve is most commonly affected, and are thought to be due to microvascular occlusion. Peripherally, entrapment neuropathies occur in both the upper and lower limbs and are due to compression of an already damaged nerve in anatomically restricted channels. Diabetic radiculopathies occur in the dermatones of the thorax and abdomen, mimicking intraabdominal or intrathoracic pathology. I also describe the features of the rare but very distinctive diabetic amyotrophy and neuropathic cachexia. Overall, the prognosis from these conditions is excellent with residual pain or muscle weakness being rare with the exception of diabetic amyotrophy where the prognosis is dependent upon cooperation with intensive rehabilitation. Therapies include "watchful waiting," physical therapy and rarely surgical intervention, which may be urgently needed for nerve decompression and reversal of motor defects.
    Language English
    Publishing date 2022-08-15
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2566702-6
    ISSN 1869-6961 ; 1869-6953
    ISSN (online) 1869-6961
    ISSN 1869-6953
    DOI 10.1007/s13300-022-01308-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Metformin-induced vitamin B12 deficiency can cause or worsen distal symmetrical, autonomic and cardiac neuropathy in the patient with diabetes.

    Bell, David S H

    Diabetes, obesity & metabolism

    2022  Volume 24, Issue 8, Page(s) 1423–1428

    Abstract: Metformin blocks the absorption of vitamin B12 through a mechanism that has not been established but could be because of interference with the calcium-dependent binding of the intrinsic factor vitamin B12 complex to the cubam receptor in the terminal ... ...

    Abstract Metformin blocks the absorption of vitamin B12 through a mechanism that has not been established but could be because of interference with the calcium-dependent binding of the intrinsic factor vitamin B12 complex to the cubam receptor in the terminal ileum. The subsequent deficiency of vitamin B12 may cause or accelerate distal symmetrical and autonomic neuropathy in the patient with diabetes. Several observational studies and meta-analyses have reported a significant association between metformin utilization and vitamin B12 deficiency. Prospective studies have shown that not only do metformin utilizers have lower vitamin B12 levels but they also have higher frequencies of distal symmetrical polyneuropathy and autonomic neuropathy (including cardiac denervation, which is associated with increased incidences of cardiac arrhythmias, cardiac events and mortality). Therefore, periodic monitoring of vitamin B12 is recommended in all patients who utilize metformin, particularly if metformin has been used for over 5 years at which stage hepatic stores of vitamin B12 would probably be depleted. Factors that accelerate the loss of hepatic vitamin B12 stores are proton pump inhibitors, bariatric surgery, being elderly and having an increased turnover of red blood cells. If serum vitamin B12 levels are borderline, measurement of methylmalonic acid and homocysteine levels can detect vitamin B12 deficiency at its earliest stage. Therapies include prophylactic calcium and vitamin B12 supplements, metformin withdrawal, replenishing vitamin B12 stores with intramuscular or oral vitamin B12 therapy and regular monitoring of vitamin B12 levels and vitamin B12 supplements if metformin continues to be utilized. With adequate vitamin B12 replacement, while symptoms of neuropathy may or may not improve, objective findings of neuropathy stabilize but do not improve.
    MeSH term(s) Aged ; Calcium ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Humans ; Hypoglycemic Agents/adverse effects ; Metformin/adverse effects ; Peripheral Nervous System Diseases/epidemiology ; Peripheral Nervous System Diseases/etiology ; Prospective Studies ; Vitamin B 12/adverse effects ; Vitamin B 12 Deficiency/chemically induced ; Vitamin B 12 Deficiency/complications
    Chemical Substances Hypoglycemic Agents ; Metformin (9100L32L2N) ; Vitamin B 12 (P6YC3EG204) ; Calcium (SY7Q814VUP)
    Language English
    Publishing date 2022-05-20
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1454944-x
    ISSN 1463-1326 ; 1462-8902
    ISSN (online) 1463-1326
    ISSN 1462-8902
    DOI 10.1111/dom.14734
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    Zs.A 5442: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  8. Article ; Online: In praise of pioglitazone: An economically efficacious therapy for type 2 diabetes and other manifestations of the metabolic syndrome.

    Bell, David S H / Jerkins, Terri

    Diabetes, obesity & metabolism

    2023  Volume 25, Issue 11, Page(s) 3093–3102

    Abstract: Pioglitazone improves glycaemic control, not only by lowering insulin resistance, but also by improving beta cell function. Because of the improved beta cell function the glycaemic control that occurs with pioglitazone is prolonged. Pioglitazone has ... ...

    Abstract Pioglitazone improves glycaemic control, not only by lowering insulin resistance, but also by improving beta cell function. Because of the improved beta cell function the glycaemic control that occurs with pioglitazone is prolonged. Pioglitazone has positive effects not only on cardiac risk factors and surrogate measures of cardiovascular disease, it also lowers the incidence of cardiac events in patients with diabetes. The recurrence of transient ischaemic attack and ischaemic stroke is also reduced in non-diabetic, insulin-resistant subjects. Utilized at preclinical stages (but not later) of heart failure, pioglitazone improves diastolic function and avoids progression to heart failure. Pioglitazone, through suppression of atrial remodelling, also decreases the incidence of atrial fibrillation. The manifestations of diseases associated with insulin resistance (non-alcoholic steatohepatitis and polycystic ovary disease) are also improved with pioglitazone. Pioglitazone may possibly improve psoriasis and other dermopathies. Pioglitazone is therefore an inexpensive and efficacious drug for the insulin-resistant subject with diabetes that is underutilized because of biases that have evolved from the toxicities of other thiazolidinediones.
    MeSH term(s) Female ; Humans ; Pioglitazone/therapeutic use ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/chemically induced ; Metabolic Syndrome/complications ; Metabolic Syndrome/drug therapy ; Insulin Resistance ; Hypoglycemic Agents/adverse effects ; Brain Ischemia ; Stroke/chemically induced ; Thiazolidinediones/therapeutic use ; Heart Failure/complications ; Insulin/therapeutic use
    Chemical Substances Pioglitazone (X4OV71U42S) ; Hypoglycemic Agents ; Thiazolidinediones ; Insulin
    Language English
    Publishing date 2023-08-03
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1454944-x
    ISSN 1463-1326 ; 1462-8902
    ISSN (online) 1463-1326
    ISSN 1462-8902
    DOI 10.1111/dom.15222
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Exogenous Insulin Antibody Syndrome (EIAS) Presenting in an Elderly, Long-Term Patient with Type 1 Diabetes Mellitus that Resolved with Low-Cost Outpatient Therapy with Mycophenolate Mofetil and Regular Insulin by Pump.

    Jerkins, Terri / Stockham, Katherine / Bell, David S H

    Diabetes therapy : research, treatment and education of diabetes and related disorders

    2024  

    Abstract: Exogenous insulin antibody syndrome (EIAS) has until recently been a rarely described complication of exogenous insulin therapy. EIAS results not only in hyperglycemia, but also in hypoglycemia and occasionally in ketoacidosis (DKA). The incidence of ... ...

    Abstract Exogenous insulin antibody syndrome (EIAS) has until recently been a rarely described complication of exogenous insulin therapy. EIAS results not only in hyperglycemia, but also in hypoglycemia and occasionally in ketoacidosis (DKA). The incidence of EIAS is increasing probably due to an overall increase in autoimmunity associated with the coronavirus disease 2019 (Covid-19) epidemic resulting in increasing binding of insulin by antibodies. Herein, we describe a case of EIAS occurring in an elderly patient with longstanding type 1 diabetes mellitus (T1DM) who had progressive loss of glycemic control. It responded positively, as we have previously described, to oral mycophenolate mofetil and the use of soluble regular insulin delivered by continuous subcutaneous insulin infusion (CSII). Therefore, EIAS is an increasingly frequent cause of hyperglycemia with and without DKA, and hypoglycemia in subjects with T1DM. Once diagnosed, they can be treated with mycophenolate mofetil and soluble insulin in an outpatient setting, which will decrease the rate of hospitalization and lower the expense of therapy.
    Language English
    Publishing date 2024-04-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2566702-6
    ISSN 1869-6961 ; 1869-6953
    ISSN (online) 1869-6961
    ISSN 1869-6953
    DOI 10.1007/s13300-024-01573-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: DEATH FROM DIABETES IN IRELAND/HISTORY.

    David Bell, S H

    The Ulster medical journal

    2020  Volume 89, Issue 2, Page(s) 130–131

    MeSH term(s) Diabetes Mellitus/epidemiology ; Humans ; Ireland/epidemiology
    Language English
    Publishing date 2020-10-21
    Publishing country Northern Ireland
    Document type Journal Article
    ZDB-ID 603342-8
    ISSN 2046-4207 ; 0041-6193
    ISSN (online) 2046-4207
    ISSN 0041-6193
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