Dr Jeffrey Kalei

Myxoedema coma is an extreme form of hypothyroidism that has a high mortality. It is rare, but it can occur in patients with undiagnosed or undertreated hypothyroidism.

Thyroid storm is a life-threatening, severe physiologic reaction to uncontrolled hyperthyroidism.

Subclinical hyperthyroidism occurs in an asymptomatic patient with normal T4 and T3.

Subclinical hypothyroidism occurs in an asymptomatic patient with a TSH > 4 mU/L with normal T4 and T3. Subclinical hypothyroidism is common in older patients. 10% of patients more than 55 years old have elevated TSH. The risk of progression…

Maturity-onset diabetes of the young (MODY) is an autosomal dominant form of diabetes that presents before the age of 25. It is caused by mutations in genes that play a role in beta-cell function. Some of these genes include HNF1A,…

Hypoglycaemia occurs when glucose concentration falls below 3.3 mmol The threshold for the onset of hypoglycemic symptoms varies with patients. Severe symptomatic hypoglycemia occurs in most adults at blood glucose levels ≤ 2.2-2.8 mmol Hypoglycemia in patients with diabetes is…

Hyperosmolar hyperglycemic state (HHS) commonly occurs in patients with type 2 diabetes who have concomitant illnesses, which cause reduced fluid intake. It is characterized by extreme hyperglycemia and hyperosmolarity without significant ketosis. The mortality rate is higher for HHS than…

DKA is an acute, major life-threatening complication of Diabetes characterized by hyperglycemia, ketoacidosis, and ketonuria. It occurs when there is absolute or relative insulin deficiency, which inhibits glucose entry into the cell. The liver then rapidly produces ketones as an…