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See detailLa diabete de type 2: approaches diagnostiques, objectifs glycemiques et strategies therapeutiques.
Scheen, André ULg; Paquot, Nicolas ULg

in Revue Médicale de Liège (1999), 54(8), 659-66

Type 2 diabetes is a prevalent disease, with high morbidity and mortality rates, which is usually managed by general practitioners. We will discuss the new diagnostic approaches, the glycaemic goals and ... [more ▼]

Type 2 diabetes is a prevalent disease, with high morbidity and mortality rates, which is usually managed by general practitioners. We will discuss the new diagnostic approaches, the glycaemic goals and the therapeutic strategies which may contribute to improve both adequate management and prognosis of diabetic patients with type 2 diabetes. As far as possible, the management should be both individualized and integrated, not only focused on blood glucose control but also on the correction of other vascular risk factors frequently associated with diabetes (mainly arterial hypertension and dyslipidaemias). Obviously, the reduction of the incidence and severity of microangiopathy and macroangiopathy diabetic complications would require a tight collaboration between general practitioners and specialized physicians. [less ▲]

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See detailLe diabete de type 2: voyage au coeur d'une maladie complexe.
SCHEEN, André ULg; Paquot, Nicolas ULg

in Revue Médicale de Liège (2012), 67(5-6), 326-31

The prevalence of type 2 diabetes is rapidly growing worldwide and this metabolic disease nowadays represents a major public health concern. Besides the effects of aging, such a progression results from ... [more ▼]

The prevalence of type 2 diabetes is rapidly growing worldwide and this metabolic disease nowadays represents a major public health concern. Besides the effects of aging, such a progression results from the interaction of several phenomena among which (1) a rather common genetic (polygenic) predisposing pattern, (2) epigenetic mechanisms, at least partially linked to nutritional disturbances during gestation influencing fetal programming, and especially, (3) a deleterious societal environment promoting the development of obesity by giving free access to excess food (rich in calories, sucrose and lipids) and markedly limiting spontaneous physical activity, or exposing to pollutants that could exert a toxic effect on the B cell. Such an obesogenic environment, already present in young age, leads to an epidemics of "diabesity". A better knowledge of the natural history of type 2 diabetes opens perspectives for the prevention of this complex disease. When type 2 diabetes is already present, a global therapeutic approach targeting environment by the promotion of lifestyle changes and the correction of all risk factors is mandatory to reduce the incidence of complications, essentially cardiovascular diseases. [less ▲]

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See detailLe diabete du sujet age: du defi epidemiologique a une approche personnalisee.
Scheen, André ULg; Paquot, Nicolas ULg; Bauduceau, B.

in Revue medicale de Liege (2014), 69(5-6), 323-8

Diabetes mellitus is a common chronic disease in the elderly, being either a known disease with a long history (type 1 or even more often type 2 diabetes) and then frequently associated with various ... [more ▼]

Diabetes mellitus is a common chronic disease in the elderly, being either a known disease with a long history (type 1 or even more often type 2 diabetes) and then frequently associated with various diabetic complications, or a recently diagnosed diabetes that may, however, have been ignored for a rather long time. In this latter case, diabetes may present as the occurrence or aggravation of one or several geriatric syndromes that overall result in a loss of autonomy. The global geriatric assessment, the estimation of life expectancy and the justification of glucose-lowering treatments should be performed at regular intervals in elderly diabetic people as they determine the right choice of glucose target levels and the best selection of glucose-lowering agents. Medications that can induce hypoglycaemia should ideally be avoided, especially in the frailty older population. The benefit-risk ratio of the proposed therapies should be analyzed first, and then regularly reassessed because of a potentially rapidly progressing condition. The recommended approach is a tailored management of diabetes that should integrate the clinical, functional and psycho-social aspects of elderly individuals. [less ▲]

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See detailDiabète et autocontrôle
RADERMECKER, Régis ULg

in Revue de l'Association Belge du Diabète (2011), 54(2), 18-21

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See detailDiabète et dysautonomie
WANG, François-Charles ULg; Mackels, Paul; Bielen, Françoise

Conference (1993)

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See detailDiabete et grossesse: impact de l'inertie medicale et de l'observance therapeutique.
Pintiaux, Axelle ULg; Chabbert-Buffet, N.; Philips, Jean-Christophe ULg et al

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 ▲]

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See detailDiabète et grossesse: l'attitude du pédiatre
Battisti, Oreste ULg

Conference (1997, May 30)

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See detailDiabète et hypertension artérielle
Krzesinski, Jean-Marie ULg

Conference (2003, February 15)

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See detailDiabète et nutrition artificielle : principes de prise en charge
Quilliot, Didier; Malgras, Aurélie; PAQUOT, Nicolas ULg et al

in Nutrition Clinique et Metabolisme (2013), 27(4), 230-235

At home as in the hospital, the diabetic patients are at high risk of malnutrition. In patients with hyperglycemia in artificial nutrition, the primary objective is to to cover their protein needs and ... [more ▼]

At home as in the hospital, the diabetic patients are at high risk of malnutrition. In patients with hyperglycemia in artificial nutrition, the primary objective is to to cover their protein needs and their caloric needs and to optimize accordingly the antidiabetic treatment. Insulin therapy is the treatment of choice. The use of low glycaemic index is probably better, especially for oral supplementation. An equivalent parenteral carbohydrate intake has a hyperglycaemic effect more important than with the oral or enteral way. The management of hyperglycemia in artificial nutrition requires defining glycemic goals, tailored to the patient, to the type and the sequences of artificial nutrition, establishing patterns of insulin therapy and providing accurate adaptation rules. Above the basal requirement, insulin therapy sufficient to meet caloric exposure must be prescribed appropriate in timing with the artificial nutrition. The use of sliding scale as monotherapy is ineffective. This management requires forming the nurse team. The acute phase has passed, the disease stabilized, it is sometimes possible to introduce oral antidiabetic drugs and stop insulin. In this case, we apply the same prescription rules to these drugs as for the patient fed orally. [less ▲]

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See detailDiabète et Ramadan : représentations et pratiques de santé des patients et des soignants et intérêts de l'éducation thérapeutique du patient
Smaoui, N; Böhme, P; Collin, JF et al

in Diabètes & Métabolism (2012), 38(2), 47-48

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See detailLe diabete gestationnel
Pintiaux, Axelle ULg; Foidart, Jean-Michel ULg

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 ▲]

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See detailLe diabete gestationnel: definition, depistage et traitement.
Geronooz, I.; Scheen, André ULg; Foidart, Jacqueline ULg

in Revue Médicale de Liège (1999), 54(5), 429-33

Defined as glucose intolerance with onset or first recognition during pregnancy, gestational diabetes mellitus represents in fact an heterogeneous clinical entity which may concern 1 to 4% of all pregnant ... [more ▼]

Defined as glucose intolerance with onset or first recognition during pregnancy, gestational diabetes mellitus represents in fact an heterogeneous clinical entity which may concern 1 to 4% of all pregnant women in our country. Its adverse effects on the mother and her child, the need for a universal screening and the mode of screening are still controversial. Screening may be made either by a first test with a 50 g oral glucose load (the so-called O'Sullivan test), confirmed if positive by a 100 g oral glucose tolerance test (OGTT), or at first glance by a 75 g OGTT performed between the 24th and 28th weeks of gestation. The treatment of gestational diabetes is based on diet. In case of diet failure to obtain good glucose control, insulin therapy should be proposed. [less ▲]

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See detailLe diabete gestationnel: physiopathologie et signification pronostique pour la mere.
Geronooz, I.; Scheen, André ULg; Lefebvre, Pierre ULg

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 ▲]

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See detailDiabete gestationnel: signification pronostique pour l'enfant.
Geronooz, I.; Scheen, André ULg; Senterre, Jacques ULg

in Revue Médicale de Liège (1999), 54(6), 517-21

Gestational diabetes, even if it seems to induce far less foetal complications than classical type 1 or type 2 diabetes mellitus, may be deleterious for the child. We will successively consider the ... [more ▼]

Gestational diabetes, even if it seems to induce far less foetal complications than classical type 1 or type 2 diabetes mellitus, may be deleterious for the child. We will successively consider the complications that could affect the child during gestation, during the neonatal period and during adult life. These consequences for the offspring require optimal screening and management of gestational diabetes mellitus. [less ▲]

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See detailLe diabète insipide central : l'étiologie n'est pas toujours évidente
Geenen, Vincent ULg

in Actualité Médicale Belge (1994), 444

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See detailDiabete insipide dans le cadre d'un carcinome pulmonaire a petites cellules: un paradoxe?
Schleich, FLorence ULg; Bustin, F.; Bosquee, Léon ULg et al

in Annales d'Endocrinologie (2005), 66(4), 355-60

We observed oat-cell lung carcinoma in a man who presented with diabetes insipidus. The chest radiograph showed a suspect nodule within a context of major nicotine addiction. Histopathological examination ... [more ▼]

We observed oat-cell lung carcinoma in a man who presented with diabetes insipidus. The chest radiograph showed a suspect nodule within a context of major nicotine addiction. Histopathological examination of the transbronchial biopsy confirmed the diagnosis of oat-cell carcinoma. Brain CT revealed metastasis to the pituitary gland and the pituitary stalk. Vasopressin was undetectable. This case illustrates an uncommon clinical presentation of small-cell lung carcinoma. Oat-cell carcinoma can modify osmoregulation in two different ways. Only sporadic cases of neurogenic diabetes insipidus due to the primary involvement of small-cell lung carcinoma have been reported. More often, this type of lung tumor is associated with inappropriate antidiuretic hormone secretion. [less ▲]

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Peer Reviewed
See detailLe diabète insulinodépendant
Geenen, Vincent ULg

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 ▲]

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See detailLe diabete non insulinodependant: de la physiopathologie au traitement.
Scheen, André ULg; Lefebvre, Pierre ULg

in Bulletin et Mémoires de l'Académie Royale de Médecine de Belgique (1996), 151(7-9), 395-402402-5

Non-insulin-dependent (or type 2) diabetes mellitus is a common, underdiagnosed and growing disease in our society. It is responsible for increased morbidity and mortality and represents an important ... [more ▼]

Non-insulin-dependent (or type 2) diabetes mellitus is a common, underdiagnosed and growing disease in our society. It is responsible for increased morbidity and mortality and represents an important public health problem. This polygenic disease is often expressed late in life and its evolution is accelerated by environmental factors leading to obesity. It combines defects in both insulin secretion and insulin action, and such defects are present in various proportions according to the type of patient and the stage of the disease. Diet and physical activity recommendations are the basis of the treatment. Current pharmacological approaches aim at improving insulin secretion and/or insulin cellular action. After secondary failure to oral drugs, insulin therapy should be initiated, the patient becoming "insulin-requiring". A synergy should be searched in the combination of various therapeutic modalities in order to improve the glycaemic control. [less ▲]

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See detailUn diabete peut en cacher un autre.
Scheen, André ULg

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 ▲]

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