Journal of Diabetes and Clinical Research

We recently published our multi-institutional experience performing primary robot-assisted retroperitoneal lymph node dissection (RA-RPLND) for men with non-seminomatous germ cell tumor (NSGCT). We concluded that primary RA-RPLND for NSGCT can be performed safely with low complication rates, acceptable early oncologic outcomes, and lower overall theoretical chemotherapy burden. In this commentary, we explore outcomes in clinical stage I patients stratified by clinical risk factors (RF) and estimate reductions in chemotherapy burden.

Gastric cancer (GC), also known as stomach cancer, is a worldwide health problem. Anatomically, it can occur from the gastroesophageal junction to distal portions of the stomach. Considering both sexes, worldwide, it is the 5th most common neoplasm (5.7%) and the 3rd cause of mortality among malignancies, leading to approximately 782,000 deaths in 2018. The incidence varies geographically but 50% of new cases are diagnosed in developed countries. High incidence is observed in Asia, Latin America, and in the central and eastern parts of Europe. There are several ways to classify GC, but the most used is Lauren’s Classification, which proposes two main histological groups: intestinal and diffuse. This classification is important because there are marked etiological, pathological, and epidemiological differences between the subgroups, guiding the clinical approach for each patient.

In 2017, approximately 424.9 million adults (age 20- 79 yrs) were affected by diabetes, with 4 million deaths. Global diabetes burden is estimated to increase up to 628.9 million people. Moreover, diabetes care costed approximately $727 billion in 2017.

Lactulose, either as crystals or liquid syrup, is a frequently prescribed osmotic laxative agent in patients with diabetes mellitus (DM). During the manufacturing process, carbohydrate impurities can arise which could increase blood glucose levels with a possible impact on glycemic control. This important issue has now been addressed for the first time in individuals with type 2 DM. A recent RCT confirmed that there is no need to consider carbohydrate impurities in oral lactulose products administered at the recommended doses of 20 g/day and 30 g/day for blood glucose management.

This is a commentary on the recent work by our group on fasting during Ramadan by young people with diabetes which was published as ISPAD Clinical Practice Consensus Guidelines. In this commentary, themes of selected studies published following the guidelines release are highlighted.