Does “Weekend Warrior” Exercise Improves Health Outcomes?
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Achieving ≥150 minutes of moderate-to-vigorous activity just 1-2 days per week as a "weekend warrior" is associated with similar disease risk reduction as the same exercise volume spaced throughout the week, suggesting that total activity time is more important than the specific pattern.
Source
Associations of "Weekend Warrior" Physical Activity With Incident Disease and Cardiometabolic Health. Circulation. 2024 Oct 15;150(16):1236-1247. doi: 10.1161/CIRCULATIONAHA.124.068669. Epub 2024 Sep 26. PMID: 39324186
The SQuiD Is Back! Subcutaneous Insulin for DKA
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SQuID is effective in managing DKA, with improvements in time to anion gap closure and ED length-of-stay compared to intravenous insulin protocols.
Source
SQuID (subcutaneous insulin in diabetic ketoacidosis) II: Clinical and operational effectiveness. Acad Emerg Med. 2024 Sep 23. doi: 10.1111/acem.15020. Epub ahead of print. PMID: 39308229.
Sedation, Aspiration, and the Risk of GLP-1 Agonists
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Patients on GLP-1 agonists might be at risk of delayed gastric emptying, which has significant implications for procedural sedation and endotracheal intubation.
Source
Use of Glucagon-Like Peptide-1-Agonists and Increased Risk of Procedural Sedation and Endotracheal Intubation in the Emergency Department. Ann Emerg Med. 2024 Aug;84(2):226-227. DOI: 10.1016/j.annemergmed.2024.03.007. PMID: 39032988.
Euglycemic SGLT2i DKA vs Type 1 Diabetes DKA
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Sodium-glucose cotransporter 2 inhibitor (SGLT2i)-associated ketoacidosis (DKA) had delayed resolution compared to type 1 diabetes (T1D)-associated DKA despite often being “milder”. This could be due to significantly lower insulin doses given in the setting of the lower plasma glucose levels often seen in this population.
Source
SGLT2 Inhibitor-Associated Ketoacidosis vs Type 1 Diabetes-Associated Ketoacidosis. JAMA Netw Open. 2024 Mar 18;7(3):e242744. doi: 10.1001/jamanetworkopen.2024.2744. PMID: 38497966
Thyroid Storm – Spoon-Feed Version
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Thyroid storm is a high-risk, low-prevalence disease that mimics multiple other emergent diagnoses due to its most common features being fever, altered mental status, and cardiovascular dysfunction.
Can Clinical or Lab Variables Predict Dehydration Severity in Children with DKA?
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Most pediatric patients with diabetic ketoacidosis (DKA) have mild to moderate dehydration. Clinical and laboratory variables in isolation are not accurate predictors of rehydration needs.
Source
Clinical and Laboratory Predictors of Dehydration Severity in Children With Diabetic Ketoacidosis. Ann Emerg Med. 2023 Apr 4;S0196-0644(23)00002-1. doi: 10.1016/j.annemergmed.2023.01.001. Online ahead of print.
New SQuID Game? SQ Insulin, DKA, and Length of Stay
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The use of a subcutaneous insulin protocol for mild-to-moderate diabetic ketoacidosis (DKA) resulted in significant reductions in ED LOS.
Source
The SQuID Protocol (Subcutaneous Insulin in Diabetic Ketoacidosis): Impacts on ED Operational Metrics. Acad Emerg Med. 2023 Feb 12. doi: 10.1111/acem.14685. Online ahead of print.
Thionamide Smackdown – PTU vs MMI for Thyroid Storm
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This comparative effectiveness study showed no significant difference in clinical outcomes or adverse effects when comparing use of propylthiouracil (PTU) and methimazole (MMI) for thyroid storm. This suggests both medications may be reasonable first-line treatment options for patients with thyroid storm.
Source
Comparison of Propylthiouracil vs Methimazole for Thyroid Storm in Critically Ill Patients. JAMA Netw Open. 2023 Apr 3;6(4):e238655. doi: 10.1001/jamanetworkopen.2023.8655.
Does Prehospital Intranasal Glucagon for Hypoglycemia Work?
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In this small study of hypoglycemic patients who received prehospital intranasal glucagon, 32% had substantial improvement, 30% had slight improvement, and 38% had no improvement. There was no clear patient characteristic that predicted response.
Source
Prehospital Intranasal Glucagon for Hypoglycemia. Prehosp Emerg Care. 2022 Mar 2;1-4. doi: 10.1080/10903127.2022.2045406. Online ahead of print.