1. These are uncertain times in the field of type 2 diabetes. New drugs keep arriving, but no one seems to know which are best. Even the proper target of treatment is now disputed. Just as guidelines began to push for lower HbA1c targets, their advice collided head-on with research suggesting that this may actually increase overall mortality. So where do we really stand? ... An anxious patient tends to see the world as a dangerous place, one full of threats. This predisposition is extreme in people with post-traumatic stress disorder (PTSD), who continuously over interpret harmless events in their environment as representing severe threats. Our current theories of anxiety assume some level of unconscious processing of the environment that biases some individuals towards sensing danger. ...

Diagnostic challenge

Mr. J.B. is a 40-year-old machinist who has generally been in good health with the exception of hyperlipidemia treated with atorvastatin 20 mg daily. He presented with a two-week history of right back pain of about two weeks duration. This had been preceded by right leg pain, and he was now also noticing discomfort in the left leg as well. He denied acute trauma or injury, though he spent a lot of time standing on cement floors at work. The pain persisted when the patient was recumbent. ...