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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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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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See detailDiabete sucre et decompensation cardiaque: specificites ethiopathogeniques et therapeutiques.
De Flines, Jenny ULg; Scheen, André ULg

in Revue Médicale Suisse (2006), 2(76), 1893-61898-900

Diabetes mellitus increases by 2.5 to 5 the relative risk of congestive heart failure. Besides the classical risk factors of congestive heart failure such as obesity, arterial hypertension and coronary ... [more ▼]

Diabetes mellitus increases by 2.5 to 5 the relative risk of congestive heart failure. Besides the classical risk factors of congestive heart failure such as obesity, arterial hypertension and coronary artery disease that are frequently associated to type 2 diabetes, a diabetic cardiomyopathy plays also a role. This specific complication is related to metabolic factors and oxidative stress, leading to muscular cell apoptosis and fibrosis. The management of a diabetic patient with congestive heart failure has several specificities not only concerning the treatment of cardiac insufficiency but most importantly concerning antidiabetic therapy. The relationship between glitazones, peripheral oedema and risk of congestive heart failure is currently raising much interest and controversies. [less ▲]

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See detailDiabete sucre iatrogene: l'exemple des anti-psychotiques atypiques.
Scheen, André ULg; De Hert, M.

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 ▲]

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See detailLe diabete sucre: epilogue.
Scheen, André ULg; Lefebvre, Pierre ULg

in Revue Médicale de Liège (2005), 60(5-6), 628-31

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See detailLe diabete sucre: une maladie exemplative a bien des egards. Preambule.
Scheen, André ULg; Kulbertus, Henri ULg

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

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See detailDiabète, convention et trajet de soins
RADERMECKER, Régis ULg

in Actualités Innovations Médecine (2010), (12), 21-22

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See detailDiabète, hypertension artérielle et angiopathie: comparaison chez les patients diabétiques insulino-dépendants et non insulino-dépendants.
PAQUOT, Nicolas ULg; SCHEEN, André ULg; Malembré, G. et al

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

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See detailDiabète, hypertension artérielle et insuffisance rénale
Krzesinski, Jean-Marie ULg

Conference (2003, April 17)

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See detailLe diabete: de la connaissance clinique a la preoccupation de sante publique.
Scheen, André ULg

in Journal de la Société de Biologie (2007), 201(2), 133-40

Diabetes mellitus is a chronic disease whose prevalence is increasing worldwide. It remains associated with a high risk of severe complications, essentially micro- and macro-vascular complications. Type 1 ... [more ▼]

Diabetes mellitus is a chronic disease whose prevalence is increasing worldwide. It remains associated with a high risk of severe complications, essentially micro- and macro-vascular complications. Type 1 diabetes is an auto-immune disease that leads to the destruction of insulin-secreting B cells and therefore requires an intensive optimised exogenous insulin therapy. Type 2 diabetes is a polygenic disease whose expression is favoured by inadequate lifestyle, leading to obesity. It combines a relative insulin secretory defect and insulin resistance, the latter being associated with various other cardiovascular risk factors. Treatment consists of lifestyle modifications first, then the prescription of various glucose-lowering oral drugs and finally, when requested, insulin therapy. A multi-risk intervention is mandatory to improve the cardiovascular prognosis. The prevention of diabetes and its complications is a major public health objective. [less ▲]

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