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Code List: Res30: Diabetes Mellitus

Research article: Renin-angiotensin system blockade and risk of acute kidney injury: a population-based cohort study Reference: Kathryn E Mansfield, Dorothea Nitsch, Liam Smeeth, Krishnan Bhaskaran, Laurie A Tomlinson(2015) Renin-angiotensin system blockade and risk of acute kidney injury: a population-based cohort study. Submitted, doi: Link to article Abstract Objective: To investigate whether there is an association between use of ACE inhibitors (ACEI) and angiotensin receptor blockers (ARB), and risk of acute kidney injury (AKI). Design: A time-updated, new-user cohort study among people initiating common antihypertensives (ACEI/ARB, beta-blockers, calcium channel blockers and thiazide diuretics) in primary care between April 1997 and March 2014. Participants: Adults initiating antihypertensive drug treatment, with at least one year of registration prior to first prescription, identified from UK primary care practices contributing to the Clinical Practice Research Datalink and eligible for linkage to hospital records data from the Hospital Episode Statistics database. Main outcome measures: Incidence rate ratio (RR) for first episode of AKI during time exposed to ACEI/ARB compa Continue reading >>

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Popular Questions

  1. Double-Helix, BSN

    Metformin should be held on the day of surgery for a couple of reasons: 1. There is concern with decreased renal function in the peri-operative period. This is actually the primary reason for stopping the medication. 2. The patient is not eating food. Yes, stress might raise insulin levels, but the patient may not be feeling enough stress to raise the blood sugar significantly. Remember that Metformin works over an extended period of time- about 12 hours. The risk of hypoglycemia when continuing Metformin while NPO is much greater than the risk of hyperglycemia from the stress response. The medication can be resumed after the surgery, when the patient is eating a normal diet again. In diabetic patients, the best way to control post-operative blood glucose when they are still NPO is with insulin.
    Here's one link that explains this. You can also type "Metformin before surgery" into Google and you'll get several other links that answer your question.

  2. Silverdragon102

    Also to mention before certain tests not just surgery is Metformin held
    eg Giving IV iodine contrast and also ?radiopaque

  3. CP2013

    Sorry to hijack this post, but a family member just had a surgery for varicose veins in his leg, where the veins were removed from the groin to the ankle in both legs I believe.
    They told him to take half of his regular metformin dose, as he does not use insulin.
    What would the rationale be for this then? Is it because they were planning on d/c approximately 4 hours post op? They sent him home the same day, and resumed eating and taking daily metformin.
    Diabetes is interesting for sure, it seems like while there are similarities among diabetics, they still are very much individuals! Always nice to be reminded of that. Thanks!

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