Diabetes y osteoporosis: acción de las hormonas gastrointestinales sobre el hueso / Diabetes and osteoporosis: action of gastrointestinal hormones on the bone

Mujer de 62 años, que consulta para valoración de tratamiento de diabetes mellitus tipo 2 (DM2) de 4 años de evolución, en tratamiento con metformina 850mg/12h, sin complicaciones crónicas asociadas. Presenta hipertensión y dislipemia. Tratada con candesartán/hidroclorotiazida 32/12,5mg/día y atorvastatina 40mg/día. Pesaba 92kg y medía 162cm (IMC:35,1kg/m2). En el último control analítico, glucemia basal 168mg/dl y HbA1c 7,5%. La microalbuminuria era negativa. Las cifras de presión arterial y el perfil lipídico se encontraban dentro de los objetivos terapéuticos. Hace 2 años tuvo una fractura de Colles no traumática en la muñeca izquierda motivo por el que toma un suplemento de calcio y vitamina D diariamente y bifosfonato alendronato una vez por semana. En resumen, nos encontramos ante una mujer con obesidad y DM2, con un control metabólico inadecuado, que además presenta antecedentes de fractura por fragilidad. ¿Cómo debe ser evaluada y tratada esta paciente?(AU)

A 62-year-old woman consulted for evaluation of treatment for her type 2 diabetes diagnosed four years ago. He had been received treatment with metformin 850mg twice, with no chronic associated complications. She had hypertension and dyslipidemia. She was being treated with candesartan/hydrochlorothiazide 32/12.5mg and atorvastatin 40mg. Her weight was 92kg and height 162cm (BMI, 35.1kg/m2). The last analysis showed fasting glucose 168mg/dl and glycated hemoglobin 7.5%, Microalbuminuria was negative. Blood pressure and lipid profile were within the therapeutic range. Two years ago she suffered a nontraumatic Colle's fracture in her left arm for which she was taking a daily calcium and vitamin D supplement and weekly alendronate. In summary, this is an obese female patient with type 2 diabetes mellitus and inadequate metabolic control, She also has a history of fragility fracture. How should this patient be evaluated and treated?(AU)

Diabetes and osteoporosis: Action of gastrointestinal hormones on the bone. / Diabetes y osteoporosis: acción de las hormonas gastrointestinales sobre el hueso.

A 62-year-old woman consulted for evaluation of treatment for her type 2 diabetes diagnosed four years ago. He had been received treatment with metformin 850mg twice, with no chronic associated complications. She had hypertension and dyslipidemia. She was being treated with candesartan/hydrochlorothiazide 32/12.5mg and atorvastatin 40mg. Her weight was 92kg and height 162cm (BMI, 35.1kg/m(2)). The last analysis showed fasting glucose 168mg/dl and glycated hemoglobin 7.5%, Microalbuminuria was negative. Blood pressure and lipid profile were within the therapeutic range. Two years ago she suffered a nontraumatic Colle's fracture in her left arm for which she was taking a daily calcium and vitamin D supplement and weekly alendronate. In summary, this is an obese female patient with type 2 diabetes mellitus and inadequate metabolic control, She also has a history of fragility fracture. How should this patient be evaluated and treated?

A new variant of spondylometaphyseal dysplasia with autosomal dominant mode of inheritance.

Clinical and radiographic evaluation of an infant boy and his father revealed findings suggesting a new variant of spondylometaphyseal dysplasia with an apparently autosomal dominant mode of inheritance. The main clinical findings included short stature and marked ligamentous laxity in the infant. X-ray findings included severe and peculiar multiple metaphyseal involvement and striking vertebral undermineralisation in the infant, and platyspondyly in the father. However, all the epiphyses were normal. Laboratory studies were essentially normal except for an extremely raised serum alkaline phosphatase in the infant. The uniqueness of these findings suggests a new variant of the spondylometaphyseal dysplasias, distinct from the cases described initially by Kozlowski et al and subsequent investigators.

Nictitating membrane in trisomy 18 syndrome.

A 2,290-g infant boy born after a 43-week gestation had the classic, somatic, and dermatoglyphic findings of trisomy 18 (Edwards) syndrome. The diagnosis was established cytogenetically. A bilateral nictitating membrane was present. In contrast to those in lower species this membrane was established horizontally and moved cephalad for closure. Thus, the membrane occasionally coverd the conjunctiva and cornea completely, giving the impression of corneal clouding. Postmortem studies were not permitted.