We started today by discussing an approach to weight loss. A very useful classification is to divide causes with decreased appetite from those with increased appetite. Remember also the big categories: cancer, endocrine, psychological/psychiatric and access to food. CMAJ has a great review of weight loss in the elderly from our local experts.We also touched on the criteria for Hyperosmolar Hyperglycemic State (calling in HONK is becoming passe). Though decreased level of consciousness is common (seen in over 50%) it is not always seen.
Finally we talked about the evidence for preventing --or delaying-- diabetes in persons with IGT/IFG. Check out the landmark Diabetes Prevention Program (DPP) study to learn more about it. The lifestyle modification arm showed a 60% reduction in progression to diabetes after 3 years, compared to a 30% reducation in those receiving metformin. Now if we could all just find the time to exercise....
1 comment :
Nice post. I like the link to the NEJM article - looks like lifestyle choices are still important.
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