Diabete et grossesse: impact de l'inertie medicale et de l'observance therapeutique.

in Revue Médicale de Liège (2010), 65(5-6), 399-404

Pregnancy and infant outcomes are related to maternal blood glucose profile. Managing preexisting diabetes and achieving euglycaemia before and during the pregnancy reduce the risk for complications ... [more ▼]

Pregnancy and infant outcomes are related to maternal blood glucose profile. Managing preexisting diabetes and achieving euglycaemia before and during the pregnancy reduce the risk for complications. Screening, diagnosis and treatment of gestational diabetes are important issues from a public health point of view, more particularly because of the progression of this disease due to obesity epidemics among young people. Pregnancy in a diabetic woman is a critical situation where neither clinical inertia nor patient's non-compliance could be accepted. [less ▲]

Diabète et hypertension artérielle

Conference (2003, February 15)

Le diabete gestationnel

in Revue Médicale de Liège (2005), 60(5-6, May-Jun), 338-43

Gestational diabetes mellitus is one of the major medical complications of pregnancy. This review describes the short and long term consequences of this affection, the screening strategy and the diagnosis ... [more ▼]

Gestational diabetes mellitus is one of the major medical complications of pregnancy. This review describes the short and long term consequences of this affection, the screening strategy and the diagnosis approach. The obstetrical management and the diabetes treatment with dietary strategies reducing carbohydrate intake and minimising the postprandial glucose levels are explained. Insulin treatment indication, place of insulin analogues, and use of oral antihyperglycaemic agents are also discussed. [less ▲]

Le diabete gestationnel: physiopathologie et signification pronostique pour la mere.

in Revue Médicale de Liège (1999), 54(5), 434-9

Pregnancy is associated with important changes in mother metabolism, especially in late gestation, among which a decreased glucose tolerance caused by insulin resistance. In some of these women, glucose ... [more ▼]

Pregnancy is associated with important changes in mother metabolism, especially in late gestation, among which a decreased glucose tolerance caused by insulin resistance. In some of these women, glucose intolerance is increased by a defect in B-cell function and diabetes mellitus occurs. These women who develop a gestational diabetes need a close follow-up because they are at high risk for further development of diabetes, especially type 2 diabetes. [less ▲]

Le diabète insipide central : l'étiologie n'est pas toujours évidente

in Actualité Médicale Belge (1994), 444

Le diabète insulinodépendant

in Revue Médicale de Liège (1996), 51(11), 684-94

Par son caractère chronique et la gravité de ses complications à long terme, le diabète insulino-dépendant (DID) constitue une véritable leçon de modestie pour le médecin à la fin de ce siècle. Le DID est ... [more ▼]

Par son caractère chronique et la gravité de ses complications à long terme, le diabète insulino-dépendant (DID) constitue une véritable leçon de modestie pour le médecin à la fin de ce siècle. Le DID est un modèle de maladie autoimmune spécifique d'organe et même d'une cellule particulière, la cellule ß insulino-sécrétrice des îlots de Langerhans dans le pancréas. Parler de maladie autoimmune signifie aussi rupture de la tolérance immunitaire vis-à-vis d'un composant du Soi. La connaissance des mécanismes responsables de la tolérance de la cellule ß et la compréhension des phénomènes génétiques et environnementaux impliqués dans sa rupture permettront la mise au point d'une prévention efficace, voire d'une éradication complète du DID. La vaccination 'tolérogène' basée sur la connaissance des antigènes thymiques responsables de l'éducation immunitaire au Soi constitute une de ces voies d'avenir prometteuse. [less ▲]

Un diabete peut en cacher un autre.

in Revue Médicale de Liège (2002), 57(5), 267-9

The abrupt interruption of insulin therapy in a severely obese diabetic woman submitted to a protein-sparing modified fast in a metabolic ward led to a severe ketoacidosis. This complication occurred ... [more ▼]

The abrupt interruption of insulin therapy in a severely obese diabetic woman submitted to a protein-sparing modified fast in a metabolic ward led to a severe ketoacidosis. This complication occurred because the patient had type 1 rather than type 2 diabetes, and the diagnosis of ketoacidosis was delayed because of confusion between ketonuria resulting from insulin deprivation and ketonuria associated with carbohydrate and energy restriction. This case report illustrates the danger of accepting an apparently obvious diagnosis which might be in fact erroneous. More particularly, it points out the importance of a correct differential diagnosis between C-peptide positive insulin-requiring type 2 diabetes and C-peptide negative (insulin-dependent) type 1 diabetes. [less ▲]

Diabete sucre iatrogene: l'exemple des anti-psychotiques atypiques.

in Revue Médicale de Liège (2005), 60(5-6), 455-60

As an example of iatrogenic diabetes, we discuss the problem of diabetes mellitus in patients receiving atypical antipsychotics. The risk of diabetes mellitus appears to be different according to various ... [more ▼]

As an example of iatrogenic diabetes, we discuss the problem of diabetes mellitus in patients receiving atypical antipsychotics. The risk of diabetes mellitus appears to be different according to various molecules with, by decreasing order, clozapine, olanzapine, risperidone and quetiapine, and finally amisulpride, aripiprazole and ziprasidone. A careful analysis of published case reports and series indicates the existence of two different problems: 1) the rather common development of impaired glucose tolerance or diabetes mellitus (often associated with metabolic syndrome) related to weight gain in individuals at risk for type 2 diabetes; and 2) the occurrence of rare cases of acute metabolic episodes with severe ketoacidosis and/or pancreatitis whose pathophysiological mechanisms remain largely unknown. Generally speaking, the pathophysiology involves both increased insulin resistance and deficient insulin secretion. Cautious metabolic monitoring of patients receiving atypical antipsychotics is recommended, and the selection of the appropriate drug should be influenced by the metabolic profile of the various molecules and the metabolic risk of the patients who should be treated with atypical antipsychotics. [less ▲]

Le diabete sucre: une maladie exemplative a bien des egards. Preambule.

in Revue Médicale de Liège (2005), 60(5-6), 269-72

Diabète, hypertension artérielle et angiopathie: comparaison chez les patients diabétiques insulino-dépendants et non insulino-dépendants.

in Archives des Maladies du Coeur et des Vaisseaux (1991), 84(suppl 1), 35