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3mo

Did you know? A randomized crossover trial published in August 2025 demonstrated that a DASH diet modified for type 2 diabetes (DASH4D) significantly improved glycemic control. Adults with T2D on the DASH4D regimen experienced greater reductions in mean CGM glucose and increased time in the target range compared to standard U.S. dietary patterns. Improvements were most pronounced in participants with elevated baseline A1C.

Could evidence-based dietary frameworks like DASH4D enhance existing treatment plans for patients with complex metabolic profiles?

NCCN Guidelines

Could evidence-based dietary frameworks like DASH4D enhance existing treatment plans for patients with complex metabolic profiles?

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3mo
The Diagnosis and Treatment of Sarcopenia and Sarcopenic Obesity - PubMed

The Diagnosis and Treatment of Sarcopenia and Sarcopenic Obesity - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/39838543/

A targeted and structured approach to the detection and treatment of sarcopenia and sarcopenic obesity can make a major contribution to the maintenance or improvement of these patients' functionality and...

Sarcopenia and sarcopenic obesity impair function, increase risks, and affect quality of life in aging populations. Early screening, resistance training, and nutritional interventions are essential for prevention and management.

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3mo

I use clinical factors based on the approved indications to minimize coverage hassles. Long-term adherence is generally good if there is good tolerance and efficacy. These are truly miracle drugs for many.

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3mo

getting coverage is the main challenge in my area, pts are open to start weight loss medications but they cannot afford it and oral medications give only minimal weight loss. many pts do not realize that weight loss medications are frequently taken for life and they nod need to exercise and follow a well balanced diet so they can achieve the best...

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4mo
case study

Patient Background: A 75-year-old woman presents with progressive weight loss, generalized weakness, easy bruising, and poorly controlled hypertension. On exam, she has thin skin with ecchymoses, proximal muscle weakness, and hypokalemia (serum potassium 2.9 mmol/L).

Family History: The patient reported no family history of hormonal disorders, malignancy, or pituitary pathology relevant to her presentation.

Assessment and Diagnosis: Evaluation revealed elevated 24-hour urinary free cortisol (UFC), elevated morning (8 am) serum cortisol, and non-suppression on a low-dose dexamethasone suppression test (LDDST), with elevated ACTH. Pituitary MRI was negative, and Ga-68 DOTATATE PET/CT showed no ectopic lesion. Bilateral inferior petrosal sinus sampling (BIPSS) with CRH stimulation confirmed MRI-negative, ACTH-dependent Cushing’s disease, although features such as marked weight loss and hypokalemia initially raised suspicion for ectopic ACTH secretion.

Suggested treatment plan: The patient declined surgery and opted for medical therapy with an adrenal steroidogenesis inhibitor plus a dopamine agonist.

Patient education: The patient was educated on the importance of medication adherence and avoidance of drug–drug interactions. She was specifically advised to avoid concurrent use of gastric acid–reducing agents, which can impair treatment absorption and effectiveness.

Follow-up: Medical therapy led to normalization of UFC, improved potassium levels, blood pressure, and glycemic control, along with a 15-lb weight gain. A relapse occurred after initiation of an acid-suppressing medication, which compromised drug absorption. Discontinuation restored efficacy, with rapid normalization of hormone levels and a 50-lb weight gain, improving mobility and strength.

  1. What clinical features in this case suggested ectopic ACTH over typical Cushing’s disease? Answer Severe hypokalemia and marked weight loss suggested ectopic ACTH, unlike the usual weight gain in pituitary Cushing’s disease.
  2. Given the MRI-negative status, what key test confirmed Cushing’s disease and ruled out ectopic ACTH? Answer Bilateral inferior petrosal sinus sampling (BIPSS) showed a post-CRH central-to-peripheral ACTH ratio >3, confirming a pituitary source of ACTH despite negative imaging.
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