Very-low-calorie diet-based intensive lifestyle intervention for remission of type 2 diabetes: Real-world experience in a South Asian population.

AIMS: Very low-calorie diet (VLCD) can induce weight loss and diabetes remission (DR) amongst people with obesity and recent-onset type 2 diabetes (T2D). We aimed to determine the effectiveness and acceptability of VLCD in achieving DR amongst Sri Lankan adults with T2D. METHODS: A retrospective analysis was conducted in a diabetes practice where VLCD-based Diabetes Remission Programme (VDRP) was offered for adults (>18 years) with T2D for <3 years and body mass index over 25 kg/m2. VLCD (~800 kcal/day, provided with/without diet replacement formula) was offered for 8-12 weeks, followed by gradual food reintroduction and exercise. DR was defined as HbA1c <6.5% at least 3 months after stopping glucose-lowering medications. RESULTS: A total of 170 participants who enrolled in the VDRP (mean age 38.4 years [±11.1], men 68%, mean baseline HbA1c 86.9 [±18.1] mmol/mol (10.1 [±2.1]%), median duration of T2D 2 years [IQR 1-2]) and 87 (51%) of them followed the programme (attended at least one follow-up visit). Amongst the individuals who followed the VDRP, 40.2% achieved DR (35/87), compared with 2.4% (2/83) amongst those who did not follow the VDRP (aHR 9.3, 95% CI 2.2-16.4, p = 0.002). The proportion achieving normoglycaemia (HbA1c < 6.5%) but continued to take glucose-lowering medication was 20/87 among VDRP followers and 20/85 amongst VDRP non-followers. The commonest reasons for not following the VDRP were too restrictive dietary quantity (92%) and difficulties in finding recommended food items (67%). Majority (79%) would recommend VDRP to others. CONCLUSIONS: VDRP is effective in achieving T2D remission amongst Sri Lankan adults with recently diagnosed T2D and obesity. Over half of the participants followed the programme and over 75% would recommend it to others, indicating good acceptability.

Efectos de bajas dosis de droperidol-fentanil sobre la presión de perfusión cerebral en pacientes con lesión expansiva intracraneal / Effects of low doses of droperidol-fetanyl on cerebral perfusion pressure in patients with expansive intracranial lesion

Se analizó el efecto del droperidol-fentanil (DF) proporción 50: 1) administrado como premedicación inmediata en cinco pacientes con lesiones expansivas intracraneales, sobre la Presión Intracraneal (PIC), Presión Arterial Media (PAM) y Presion de Perfusión Cerebral (PPC). Las determinaciones fueron efectuadas en el período basal, sobreelevando la cabeza 35- y siete minutos después de haber administrado el fármaco. Se concluyó que el DF en pacientes respirando espontáneamente al disminuir la PAM y aumentar la PIC, produce un pinzamiento riesgoso de la PPC. El aumento de la PIC podría explicarse por el incremento de la pCO2 arterial, excepto en un caso