Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Jul 2020
Review[Gout arthritis: Pathogenesis, diagnostics and treatment].
The initial presentation of gouty arthritis can be a dramatic event. Chronic gout may lead to the destruction of joints, invalidity and increased mortality. ⋯ The treatment of refractory cases may be a challenge to the general practitioner and the specialist alike. The article presented here summarizes the current state of diagnostics and treatment of acute and chronic gout.
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Chronic metabolic acidosis (CMA) is a common complication of chronic kidney disease (CKD). Its treatment in patients with diabetes mellitus and CKD could also improve insulin resistance. We investigated the current therapeutic approaches in diabetes mellitus (DM) with CKD in a survey among diabetologic specialists and general practitioners with additional qualification in diabetology about their approach to CMA and cooperation with nephrologists. ⋯ Cooperation between diabetologists and nephrologists works well. Nephrologists are mainly responsible for diagnosis and treatment of CMA. However, because CMA may worsen insulin resistance, its relevance for DM treatment appears to be underestimated. Further education may be required in this field.