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Clinical Case 047: Not so sweet feet

This week a classic Australian remote area case.  There is so much to discuss on this case!  But I have isolated a few key points to put under the microscope, and get your input / expertise. 47 yo. Aboriginal woman has returned to the ED complaining of painless purulent lesions on her left foot.  She […]

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Life in Broome is sweet, a bit too sweet.

Broome is one of the centres of Aboriginal Health care in Australia.  One of the biggest disease burdens in the Aboriginal population is type 2 diabetes.  The stats are scary, and the complications of this potentially managable disease are rife in our community.  From preventable blindness to end-stage diabetic nephropathy – this is a crippling […]

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Clinical Case 007: DKA update

This 35 yo man had a 20 year history of well controlled type 1 DM, on tds Novorapid + nocte Lantus.  Never had an episode of DKA, some hypos. Presented to ED at midnight with a history of vomiting and polyuria since 08:00.  Had been trying to drink water and had taken a small dose […]

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Medical Myths 001: Metformin mythology

Metformin is a good drug.  Has been 1st line oral diabetic agent for years and is effective for other problems – PCOS etc. However, it has for a long time been shrouded by the perception that it causes lactic acidosis and is therefore a bit dangerous…  but is this true?  Looking at the literature there […]