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https://www.readbyqxmd.com/read/29141871/potential-approaches-to-prevent-hypoglycemia-associated-autonomic-failure
#1
REVIEW
Eric Lontchi-Yimagou, Jee Young You, Michelle Carey, Ilan Gabriely, Harry Shamoon, Meredith Hawkins
Clear health benefits are associated with intensive glucose control in type 1 diabetes mellitus (T1DM). However, maintaining near-normal glycemia remains an elusive goal for many patients, in large part owing to the risk of severe hypoglycemia. In fact, recurrent episodes of hypoglycemia lead to 'hypoglycemia-associated autonomic failure' (HAAF), characterized by defective counter-regulatory responses to hypoglycemia. Extensive studies to understand the mechanisms underlying HAAF have revealed multiple potential etiologies, suggesting various approaches to prevent the development of HAAF...
November 14, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/29138984/11%C3%AE-hydroxysteroid-dehydrogenases-and-hypertension-in-the-metabolic-syndrome
#2
REVIEW
Matthew A Bailey
The metabolic syndrome describes a clustering of risk factors-visceral obesity, dyslipidaemia, insulin resistance, and salt-sensitive hypertension-that increases mortality related to cardiovascular disease, type 2 diabetes, cancer, and non-alcoholic fatty liver disease. The prevalence of these concurrent comorbidities is ~ 25-30% worldwide, and metabolic syndrome therefore presents a significant global public health burden. Evidence from clinical and preclinical studies indicates that glucocorticoid excess is a key causal feature of metabolic syndrome...
November 14, 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/29134977/metformin-effects-are-augmented-by-chronic-intermittent-cold-stress-in-high-fat-diet-fed-male-wistar-rats
#3
A O Ige, O I Iwaloye, E O Adewoye
This study investigated the effects of metformin on some glucose regulatory indices in high fat diet (HFD) fedmale Wistar rats exposed to room temperature and chronic intermittent cold stress (CICS). Thirty rats were randomly dividedinto 5 groups. Group 1(control) was maintained on standard rat chow while groups 2-5 were maintained on HFD for 8weeksrespectively prior to experimental procedures. Control, group 2(HFD untreated) and group 3(HFD+metformin (250mg/kg)were exposed to room temperature while groups 4(HFD untreated+CICS) and 5(HFD+CICS+metformin) were exposed toCICS for 21days...
June 30, 2017: Nigerian Journal of Physiological Sciences: Official Publication of the Physiological Society of Nigeria
https://www.readbyqxmd.com/read/29129636/inflammation-mediated-muscle-metabolic-dysregulation-local-and-remote-to-the-site-of-major-abdominal-surgery
#4
Krishna K Varadhan, Dumitru Constantin-Teodosiu, Despina Constantin, Paul L Greenhaff, Dileep N Lobo
BACKGROUND & AIMS: Postoperative hyperglycaemia is common in patients having major surgery and is associated with adverse outcomes. This study aimed to determine whether bacteraemia contributed to postoperative systemic inflammation, and whether increases in the expression of muscle mRNAs and proteins reflecting increased muscle inflammation, atrophy and impaired carbohydrate oxidation were evident at the time of surgery, and both local and distant to the site of trauma, and could be associated with impaired glucoregulation...
November 2, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29120451/effect-of-maternal-smoking-on-stress-physiology-in-healthy-neonates
#5
C Haslinger, H Bamert, M Rauh, T Burkhardt, L Schäffer
OBJECTIVE: To assess the impact of maternal smoking during pregnancy (MSDP) on the neonatal hypothalamic-pituitary-adrenal axis. STUDY DESIGN: In a prospective observational study, salivary cortisol and cortisone levels were measured at the fourth day of life during resting conditions and in response to a pain-induced stress event in healthy neonates whose mothers smoked cigarettes during each stage of pregnancy and compared with controls. RESULTS: Neonates in the control group (n=70) exhibited a physiologic stress response with a significant increase in cortisol (1...
November 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29109870/acute-onset-panhypopituitarism-nearly-missed-by-initial-cosyntropin-testing
#6
Claudine A Blum, Daniel Schneeberger, Matthias Lang, Janko Rakic, Marc Philippe Michot, Beat Müller
Introduction: Diagnosis of adrenal crisis and panhypopituitarism in patients with septic shock is difficult but crucial for outcome. Case: A 66-year-old woman with metastasized breast cancer presented to the ED with respiratory insufficiency and septic shock after a 2-day history of the flu. After transfer to the ICU, corticosteroids were started in addition to antibiotics, as the patient was vasopressor-nonresponsive. Diabetes insipidus was diagnosed due to polyuria and treated with 4 mg desmopressin...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29095232/the-impact-of-connshing-s-syndrome-mild-cortisol-excess-in-primary-aldosteronism-drives-diabetes-risk
#7
Felix Beuschlein, Martin Reincke, Wiebke Arlt
No abstract text is available yet for this article.
December 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/29089364/primary-adrenal-insufficiency-in-adult-population-a-portuguese-multicentre-study-by-the-adrenal-tumours-study-group
#8
Lia Ferreira, Joao Silva, Susana Garrido, Carlos Bello, Diana Oliveira, Hélder Simões, Isabel Paiva, Joana Guimarães, Marta Ferreira, Maria Teresa Pereira, Rita Bettencourt-Silva, Ana Filipa Martins, Tiago Silva, Vera Fernandes, Maria Ferreira
INTRODUCTION: Primary adrenal insufficiency (PAI) is a rare but severe and potentially life-threatening condition. No previous studies have characterized Portuguese patients with PAI. AIMS: To characterize the clinical presentation, diagnostic workup, treatment and follow-up of Portuguese patients with confirmed PAI. METHODS: This multicentre retrospective study examined PAI patients in 12 Portuguese hospitals. RESULTS: We investigated 278 patients with PAI (55...
October 31, 2017: Endocrine Connections
https://www.readbyqxmd.com/read/29077038/effects-of-late-gestational-fetal-exposure-to-dexamethasone-administration-on-the-postnatal-hypothalamus-pituitary-adrenal-axis-response-to-hypoglycemia-in-pigs
#9
René Schiffner, Guadalupe L Rodríguez-González, Florian Rakers, Marius Nistor, Peter W Nathanielsz, Teodora Daneva, Matthias Schwab, Thomas Lehmann, Martin Schmidt
BACKGROUND: Prenatal glucocorticoid administration alters the activity of the fetal hypothalamic-pituitary-adrenocortical axis (HPAA), and correspondingly the adenocorticotropic hormone (ACTH) and cortisol levels after birth. The dosages required for these effects are critically discussed. Activation of the HPAA is related to metabolic syndrome and diabetes mellitus. Hypoglycemia is the classic side effect of antidiabetic treatment. We hypothesized that a low dosage of dexamethasone in late pregnancy alters the HPAA response to hypoglycemia in pigs...
October 27, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29067249/serum-dehydroepiandrosterone-sulfate-in-assessing-the-integrity-of-the-hypothalamic-pituitary-adrenal-axis
#10
Suranut Charoensri, Laor Chailurkit, Dittapol Muntham, Pongamorn Bunnag
OBJECTIVE: To evaluate the relationship between age- and gender-adjusted dehydroepiandrosterone sulfate (DHEA-S) levels and low-dose adrenocorticotropic hormone (ACTH) stimulation in assessing the integrity of the hypothalamic-pituitary-adrenal (HPA) axis, in patients who were at risk of HPA insufficiency, including those currently being treated with glucocorticoids. METHODS: Forty-six participants with a suspicion of secondary adrenal insufficiency were recruited from the Diabetes and Endocrinology Clinic at Ramathibodi Hospital, Mahidol University, Bangkok...
March 2017: Journal of Clinical & Translational Endocrinology
https://www.readbyqxmd.com/read/29051779/childhood-maltreatment-and-inflammation-among-pregnant-women-with-gestational-diabetes-mellitus-a-pilot-study
#11
Margaret Bublitz, Suzanne De La Monte, Susan Martin, Lucia Larson, Ghada Bourjeily
BACKGROUND: Women with childhood maltreatment histories are at increased risk for adverse birth outcomes. Mechanisms explaining this link are poorly understood. Past research is limited by sampling pregnant women at low risk for adverse maternal and neonatal outcomes. METHODS: This pilot study was a secondary data analysis of 24 women with gestational diabetes mellitus; 17% of the sample also reported a maltreatment history. Women provided a blood sample to measure inflammatory cytokines and insulin resistance, and saliva samples to measure diurnal cortisol...
September 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/29041003/depression-in-the-context-of-medical-disorders-new-pharmacological-pathways-revisited
#12
Undine E Lang, Marc Walter
The depressive state has been characterised as one of elevated inflammation, changed cardiovascular parameters and a deranged metabolic situation all of which holds promise for a better understanding and handling of treatment-resistance in affective disorders as well as for future developments in treatment algorithms. In this context several biomarkers are differentially regulated by antidepressant treatment and connected to metabolic, inflammatory, cardiovascular and apoptotic components of the pathophysiology, i...
October 17, 2017: Neuro-Signals
https://www.readbyqxmd.com/read/29032494/the-effects-of-add-on-exenatide-to-insulin-on-glycemic-variability-and-hypoglycemia-in-patients-with-type-1-diabetes-mellitus
#13
L-L Jiang, S-Q Wang, B Ding, J Zhu, T Jing, L Ye, K-O Lee, J-D Wu, J-H Ma
OBJECTIVE: To investigate the effect of add-on exenatide to insulin on glycemic excursion and the counter-regulatory hormone in response to hypoglycemia in patients with type 1 diabetes mellitus (T1DM). METHODS: 30 patients with T1DM were recruited and randomly assigned to exenatide + insulin-treated group (group 1, n = 15) or insulin-only-treated group (group 2, n = 15) for 4 weeks. All patients had continuous glucose monitor system (CGMS) applied at before (week-0) and after (week-4) treatment to evaluate the glycemic variability...
October 14, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/29032078/efficacy-and-safety-of-once-monthly-pasireotide-in-cushing-s-disease-a-12-month-clinical-trial
#14
André Lacroix, Feng Gu, Wilson Gallardo, Rosario Pivonello, Yerong Yu, Przemysław Witek, Marco Boscaro, Roberto Salvatori, Masanobu Yamada, Libuse Tauchmanova, Michael Roughton, Shoba Ravichandran, Stephan Petersenn, Beverly M K Biller, John Newell-Price
BACKGROUND: Cushing's disease is a rare debilitating endocrine disorder for which few prospective interventional studies have been done. We report results of the first phase 3 trial assessing long-acting intramuscular pasireotide in patients with Cushing's disease. METHODS: In this phase 3 clinical trial we recruited patients aged 18 years or older with persistent, recurrent, or de-novo (non-surgical candidates) Cushing's disease who had a mean urinary free cortisol (mUFC) concentration (from three 24 h samples) of 1·5-5·0 times the upper limit of normal (ULN), a normal or greater than normal morning plasma adrenocorticotropic hormone concentration, and a pituitary source of Cushing's syndrome, from 57 sites across 19 countries...
October 12, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28969495/prolonged-hypothalamic-pituitary-adrenal-axis-activation-after-acute-coronary-syndrome-in-the-genesis-praxy-cohort
#15
Andrew R Tang, Doreen M Rabi, Kim L Lavoie, Simon L Bacon, Louise Pilote, Gregory A Kline
Background Glucocorticoid excess has been linked with cardiovascular disease. Little is known about the long-term cortisol response in patients after acute coronary syndrome. Design The objective of this study was to describe the distribution of salivary cortisol in the post-acute phase of acute coronary syndrome and to describe the association of late-night salivary cortisol with cardiovascular risk factors. Methods We used late-night salivary cortisol measurements post-discharge to estimate hypothalamic-pituitary-adrenal axis activity in 309 patients aged 18-55 years enrolled in the GENESIS-PRAXY study from January 2009-April 2013...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28962047/comparison-of-1%C3%A2-mg-versus-2%C3%A2-mg-dexamethasone-suppression-test-in-patients-with-obesity
#16
Sandrine Andrea Urwyler, Nina Cupa, Mirjam Christ-Crain
In this study, we compared the 2 mg dexamethasone suppression test (DST) with the gold-standard 1 mg DST in obese patients in order to reduce the false-positive rate for Cushing's syndrome (CS). The primary endpoint was the comparison of serum cortisol levels after 1 mg versus 2 mg DST in patients with a BMI >30 kg/m(2) and at least one additional feature of the metabolic syndrome. Secondary endpoints were comparison of salivary cortisol and ACTH levels, respectively. Fifty-four obese patients were included...
November 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28956262/daily-salivary-cortisol-and-cortisone-rhythm-in-patients-with-adrenal-incidentaloma
#17
Filippo Ceccato, Mattia Barbot, Nora Albiger, Giorgia Antonelli, Marialuisa Zilio, Marco Todeschini, Daniela Regazzo, Mario Plebani, Carmelo Lacognata, Maurizio Iacobone, Franco Mantero, Marco Boscaro, Carla Scaroni
BACKGROUND AND AIM: Impaired cortisol rhythm is a characteristic feature of Cushing's Syndrome, nevertheless late night salivary cortisol (LNSC) is not suitable to detect subclinical hypercortisolism in patients with adrenal incidentaloma (AI). We studied daily salivary cortisol (F) and cortisone (E) rhythm in patients with AI. MATERIALS AND METHODS: Six saliva samples were collected from awakening to night in 106 patients with AI and 40 controls. F and E were measured with LC-MS/MS and daily F exposure was calculated with the area under the curve (AUC)...
September 27, 2017: Endocrine
https://www.readbyqxmd.com/read/28937294/hypertensive-crisis-in-pregnancy-due-to-a-metamorphosing-pheochromocytoma-with-postdelivery-cushing-s-syndrome
#18
Katharina Langton, Matthias Gruber, Jimmy Masjkur, Charlotte Steenblock, Mirko Peitzsch, Jörn Meinel, Jacques Lenders, Stefan Bornstein, Graeme Eisenhofer
Pheochromocytomas in pregnancy are rare but potentially lethal. Even rarer is the combination of pheochromocytoma in pregnancy with subsequent development of ectopic Cushing's syndrome. We report a 36-year-old woman, previously diagnosed with essential hypertension, who developed severe hypertension in pregnancy complicated by insulin-dependent gestational diabetes. A cesarean section was performed at 32 weeks following a hypertensive crisis after routine administration of betamethasone. Postnatal persistence of signs and symptoms of catecholamine excess led to the diagnosis of a left adrenal pheochromocytoma...
September 22, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28931368/depression-differed-by-midnight-cortisol-secretion-alexithymia-and-anxiety-between-diabetes-types-a-cross-sectional-comparison
#19
Eva O Melin, Maria Thunander, Mona Landin-Olsson, Magnus Hillman, Hans O Thulesius
BACKGROUND: Increased prevalence of depression is found in both type 2 diabetes (T2D) and type 1 diabetes (T1D). Melancholia and atypical depression differ by cortisol secretion and clinical features. The aim was to compare the clinical presentation of T1D and T2D patients in relation to self-reported depression, self-reported anxiety, alexithymia, obesity, and midnight salivary cortisol (MSC). METHODS: Comparative cross-sectional design. The participants were consecutively recruited from one hospital diabetes outpatient clinic: 24 T2D patients (31-59 years) and 148 T1D patients (32-59 years)...
September 20, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28924262/prenatal-glucocorticoid-exposure-modifies-endocrine-function-and-behaviour-for-3-generations-following-maternal-and-paternal-transmission
#20
Vasilis G Moisiadis, Andrea Constantinof, Alisa Kostaki, Moshe Szyf, Stephen G Matthews
Fetal exposure to high levels of glucocorticoids programs long-term changes in the physiologic stress response and behaviours. However, it is not known whether effects manifest in subsequent generations of offspring following maternal (MT) or paternal (PT) transmission. We treated pregnant guinea pigs with three courses of saline or synthetic glucocorticoid (sGC) at a clinically relevant dose. Altered cortisol response to stress and behaviours transmitted to juvenile female and male F2 and F3 offspring from both parental lines...
September 18, 2017: Scientific Reports
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