Marianna Blyumin-Karasik1 | Jessica Colon2 | Sophie Gaer1 | Isabella Vigil1 | Sylvie Nguyen2 | Jordan Rosen1
1 Precision Skin & Body Institute, Davie, Florida, USA | 2Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, Florida, USA
Correspondence: Marianna Blyumin-Karasik (该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。)
Received: 12 May 2025 | Revised: 7 August 2025 | Accepted: 12 August 2025
Funding: The authors received no specific funding for this work.
Keywords: aesthetic | cosmeceuticals | hypochlorous acid | integrated skincare | laser treatment | photoaging | resurfacing laser
Carmine Piccolo1 · Sara de Candia1 · Annalisa Natalicchio1 · Sergio Di Molfetta1 · Irene Caruso1 · Luigi Laviola1 · Francesco Giorgino1 · Gian Pio Sorice
Received: 16 December 2025 / Accepted: 11 March 2026 © The Author(s) 2026
Abstract
Aims Phenylketonuria and type 1 diabetes are lifelong metabolic disorders requiring complex and potentially conflicting nutritional strategies. Their coexistence is rare, yet management may become particularly challenging during transition from pediatric to adult care. We describe the case of a young adult with phenylketonuria who developed type 1 diabetes.
Methods A 27-year-old man with longstanding phenylketonuria was referred to an adult metabolic-diabetes center after the diagnosis of type 1 diabetes. Clinical, biochemical, nutritional, and continuous glucose monitoring data were reviewed. The intervention included structured therapeutic education, transition from fixed insulin doses to a dynamic regimen based on carbohydrate counting, and revision of medical nutrition therapy using phenylketonuria-adapted low-protein foods and sugar-free phenylalanine-free amino acid supplements.
Results At diagnosis, HbA1c was 11.5%, with markedly reduced C-peptide levels and high titer anti-GAD antibodies. Ini-tial diabetes management was associated with poor adherence to the phenylketonuria diet, increased intake of conventional protein sources, and elevated phenylalanine levels. After individualized insulin titration and nutritional intervention, HbA1c improved from 11.5% to 7.8%, phenylalanine levels decreased from 842 to 705 μmol/L, insulin requirement declined from 0.55 to 0.3 IU/kg/day, and continuous glucose monitoring showed improved glycemic control without increased hypoglyce-mia. The Glycemia Risk Index improved from high-risk Zone E to low-intermediate-risk Zone B.
Conclusions This case highlights the need for personalized multidisciplinary care integrating continuous glucose monitor-ing, carbohydrate counting, and phenylketonuria specific nutrition to optimize both metabolic conditions.
Keywords Phenylketonuria · Type 1 diabetes · CGM · multidisciplinary approach
原创： 胡海涛 负压引流与创面修复
近日处理多位慢性伤口患者，他们的病程时间都大于五月，最长患者达六年，并且有相同的经历——换药、换药、换药，吃抗生素、抗生素、抗生素！
刘晗 负压引流与创面修复
是不是 瘘了？
原创： 十六点五 中山二院糖尿病足中心
男性，24岁，3年前外院诊断“下丘脑生殖细胞瘤”，进行γ刀治疗后，长期应用“氢化可的松”早晚各2片维持，半年前不慎损伤左小腿下部外侧皮肤，之后长期不愈合，收入院。
含银的敷料是目前治疗糖尿病足的主流敷料，有各种剂型，包括泡沫状、胶冻态、液态、粉末态、膏态等等，生产的厂家的非常多，其中的质量良莠不齐，很难鉴别。
进一步的清创就到了骨骼，对于骨髓炎最彻底的治疗方法就是去除被细菌侵袭的骨，正常的骨骼一般是浅黄色，如果发白或者变黑，往往就提示这段骨头可能活性比较差，另外，还有一种是面积比较大的骨暴露，一般的肉芽组织很难爬上去，因此，对于坏死的骨头及较大面积的骨暴露，一般需要清除。
皮下组织中的脂肪组织在足部分布广泛，而皮下脂肪中血管分布非常少，在相对或绝对缺血的糖尿病足中，脂肪组织边缘的是否出血不是其是否存活的可靠指标。
伤口世界平台生态圈，以“关爱人间所有伤口患者”为愿景，连接、整合和拓展线上和线下的管理慢性伤口的资源，倡导远程、就近和居家管理慢性伤口，解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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