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Hypoglycemia and management

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https://www.readbyqxmd.com/read/28812381/retrospective-review-of-sglt2-inhibitor-exposures-reported-to-13-poison-centers
#1
Scott E Schaeffer, Carol DesLauriers, Henry A Spiller, Alfred Aleguas, Salvador Baeza, Mark L Ryan
BACKGROUND: SGLT2 inhibitors are a new class of oral antidiabetics prescribed in the United States since 2013. They act by inhibiting reabsorption of glucose in the proximal convoluted tubule of the kidney, allowing excess glucose to be excreted. Little has been reported regarding effects of non-therapeutic exposure to this class of medication. METHODS: Retrospective records from 13 poison centers were examined for human exposures to SGLT2 inhibitors between 1st January 2013 and 31st December 2016...
August 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28811807/impact-of-24-hour-helpline-service-for-people-with-diabetes
#2
Farrukh Ahmed, Asim-Bin-Zafar, Musarrat Riaz, Erum Ghafoor, Rabia Abdul Rehman, Qutub Uddin
OBJECTIVE: To evaluate the impact and effectiveness of 24-hour helpline service in providing information and educating patients about self-management of diabetes. METHOD: The study was conducted at Baqai Institute of Diabetology & Endocrinology (BIDE), a tertiary diabetes care center, Karachi, Pakistan. People with diabetes attending the outpatient department from November 2012 to October 2014 were included in this study. After providing diabetes education, a helpline number was provided for emergency situations...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28811776/role-of-ramadan-specific-diabetes-education-rsde-a-prospective-study
#3
Muhammad Yakoob Ahmedani, Shahid Ahsan, Muhammad Saif Ul Haque
OBJECTIVE: To observe the role of Ramadan Specific Diabetes Education (RSDE) in the management of fasting patients with diabetes. METHODS: This prospective study was carried out at out-patients department (OPD) of Baqai Institute of Diabetology & Endocrinology (BIDE), in 2012. Recruitment of patients started a month prior to Ramadan. Muslim patients with diabetes whether had their first or on follow up visit to the OPD and showed intention to hold fast in the month of Ramadan, were included...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28799484/pharmacology-and-perioperative-considerations-for-diabetes-mellitus-medications
#4
Stephen Aniskevich, J Ross Renew, Ryan M Chadha, Joan M Irizarry-Alvarado
BACKGROUND: Given the prevalence of diabetes mellitus in modern society, health care providers are frequently tasked with managing glucose control in the perioperative period. When determining perioperative diabetes management, the clinician must balance the need to maintain relative euglycemia at the time of surgery with preventing hypoglycemia or hyperglycemia in a fasting surgical patient. This balance requires an understanding of the pharmacology of these medications, the type of surgery, and the patient's degree of diabetic control...
August 10, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28795013/management-of-diabetes-mellitus-in-children-and-adolescents-engaging-in-physical-activity
#5
REVIEW
Silpa Nadella, Justin A Indyk, Manmohan K Kamboj
Regular physical activity is an important component in the management of both type 1 and type 2 diabetes mellitus (T1DM and T2DM), as it has the potential to improve glycemic control, delay cardiovascular complications, and increase overall well-being. Unfortunately, many children and adolescents with diabetes do not partake in regular exercise and physical activity for multiple reasons. This review identifies the barriers to participation from the aspect of the patient, caregiver, and the healthcare provider...
July 2017: Translational pediatrics
https://www.readbyqxmd.com/read/28794822/overview-of-glucagon-like-peptide-1-receptor-agonists-for-the-treatment-of-patients-with-type-2-diabetes
#6
Kelvin Lingjet Tran, Young In Park, Shalin Pandya, Navin John Muliyil, Brandon David Jensen, Kovin Huynh, Quang T Nguyen
BACKGROUND: It is estimated that 29.1 million people or 9.3% of the US population have diabetes, which contributes to considerable medical and financial burden. Type 2 diabetes mellitus is characterized by insulin resistance and insulin secretion impairment leading to hyperglycemia. The presence of insulin resistance is strongly correlated with obesity. OBJECTIVE: This article reviews the available glucagon-like peptide-1 (GLP-1) receptor agonists and their role in the management of patients with diabetes, to help guide the selection of the most suitable agent for the individualized treatment of patients with type 2 diabetes...
June 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28781218/risk-factors-for-nocturnal-hypoglycemia-in-insulin-treated-patients-with-type-2-diabetes-a-secondary-analysis-of-observational-data-derived-from-an-integrated-clinical-trial-database
#7
Jay P Bae, Ran Duan, Haoda Fu, Byron J Hoogwerf
PURPOSE: A trade-off exists in most diabetes therapies between the benefits of good glycemic control and the morbidity of hypoglycemia. Balancing these factors to achieve desired outcomes is a key consideration for personalized diabetes therapy. Hypoglycemia at night (nocturnal hypoglycemia [NH]) is a common but often under-reported problem in insulin-treated patients with type 2 diabetes. To better understand the risk for NH, we pooled data from multiple clinical trials of insulin treatment and specifically examined NH risk factors in relation to glycemic goals...
August 3, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28780057/top-down-mass-spectrometric-immunoassay-for-human-insulin-and-its-therapeutic-analogs
#8
Dobrin Nedelkov, Eric E Niederkofler, Paul E Oran, Scott Peterman, Randall W Nelson
Measurement of insulin and its therapeutic analogs is important in diabetes, hypoglycemia, sports anti-doping and toxicology. Commercial insulin immunoassays fail to detect commonly prescribed insulin analogs. Because of their unique sequences and masses, these analogs are readily measured and distinguished with mass spectrometric (MS) assays. Reviewed here is an insulin mass spectrometric immunoassay (MSIA) that combines micro-scale immunoaffinity capture with sensitive MS detection of insulin and its therapeutic analogs...
August 2, 2017: Journal of Proteomics
https://www.readbyqxmd.com/read/28771572/comparison-of-glyburide-and-insulin-in-the-management-of-gestational-diabetes-a-meta-analysis
#9
Rongjing Song, Ling Chen, Yue Chen, Xia Si, Yi Liu, Yue Liu, David M Irwin, Wanyu Feng
OBJECTIVE: The aim of this meta-analysis was to determine the efficacy and safety of glyburide as a treatment for gestational diabetes mellitus (GDM) compared to insulin. METHODS: A meta-analysis was conducted to compare the management of gestational diabetes with glyburide and insulin. Studies fulfilling all of the following inclusion criteria were included in this meta-analysis: subjects were women with gestational diabetes requiring drug treatment; the comparison treatment included glyburide vs insulin; one or more outcomes (maternal or neonatal) should be provided in the individual study; the study design should be a randomized control trial...
2017: PloS One
https://www.readbyqxmd.com/read/28771387/minimizing-glycemic-fluctuations-in-patients-with-type-2-diabetes-approaches-and-importance
#10
Paresh Dandona
Glycemic fluctuations, characterized by short-term oscillations in plasma glucose, are important when managing type 2 diabetes (T2D) and may be considered a target of glucose-lowering therapies. Continuous glucose monitoring (CGM) has been used to evaluate the effects of different treatments on glycemic fluctuations. This review examines approaches to and the importance of minimizing glycemic fluctuations among patients with T2D. Measures of HbA1c, fructosamine, and glycated albumin reflect a long-term average of plasma glucose, and are therefore unable to provide an accurate measure of short-term glycemic oscillations...
August 3, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28768698/the-future-advances-in-therapeutic-approach-and-management-strategies-for-men1
#11
Rachel S van Leeuwaarde, Joanne M de Laat, Carolina R C Pieterman, Koen M A Dreijerink, Menno Vriens, Gerlof D Valk
Multiple endocrine neoplasia type 1 is a rare autosomal inherited disorder associated with a high risk for patients to simultaneously develop tumours of the parathyroid glands, duodeno-pancreatic neuroendocrine tumors and tumors of the anterior pituitary gland. Early identification of MEN1 in patients enables presymptomatic screening of manifestations which makes timely interventions possible with the intention to prevent morbidity and mortality. Causes of death nowadays have shifted towards local or metastatic progression of malignant neuro endocrine tumors...
August 2, 2017: Endocrine-related Cancer
https://www.readbyqxmd.com/read/28761651/type-2-diabetes-patient-s-perspective-on-ramadan-fasting-a-qualitative-study
#12
Jun Yang Lee, Chee Piau Wong, Christina San San Tan, Nazrila Hairizan Nasir, Shaun Wen Huey Lee
OBJECTIVE: We evaluated the beliefs, experience and diabetes management strategies of type 2 diabetes mellitus (T2DM) Muslim patients that chose to fast during Ramadan. RESEARCH DESIGN AND METHODS: A semistructured focus group interview was conducted with 53 participants with T2DM. Participants were purposefully sampled and asked to share their perspective on Ramadan fasting. All interviews were audio recorded, transcribed verbatim and analyzed thematically. RESULTS: Participants reported optimism towards fasting during Ramadan, as they believed that fasting was beneficial to their overall well-being, and a time for family bonding...
2017: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/28758978/dietary-approaches-in-the-management-of-diabetic-patients-with-kidney-disease
#13
REVIEW
Gang Jee Ko, Kamyar Kalantar-Zadeh, Jordi Goldstein-Fuchs, Connie M Rhee
Chronic kidney disease (CKD) is one of the most prevalent complications of diabetes, and patients with diabetic kidney disease (DKD) have a substantially higher risk of cardiovascular disease and death compared to their non-diabetic CKD counterparts. In addition to pharmacologic management strategies, nutritional and dietary interventions in DKD are an essential aspect of management with the potential for ameliorating kidney function decline and preventing the development of other end-organ complications. Among DKD patients with non-dialysis dependent CKD, expert panels recommend lower dietary protein intake of 0...
July 31, 2017: Nutrients
https://www.readbyqxmd.com/read/28756769/continuous-glucose-monitoring-in-the-icu-clinical-considerations-and-consensus
#14
REVIEW
James S Krinsley, J Geoffrey Chase, Jan Gunst, Johan Martensson, Marcus J Schultz, Fabio S Taccone, Jan Wernerman, Julien Bohe, Christophe De Block, Thomas Desaive, Pierre Kalfon, Jean-Charles Preiser
Glucose management in intensive care unit (ICU) patients has been a matter of debate for almost two decades. Compared to intermittent monitoring systems, continuous glucose monitoring (CGM) can offer benefit in the prevention of severe hyperglycemia and hypoglycemia by enabling insulin infusions to be adjusted more rapidly and potentially more accurately because trends in glucose concentrations can be more readily identified. Increasingly, it is apparent that a single glucose target/range may not be optimal for all patients at all times and, as with many other aspects of critical care patient management, a personalized approach to glucose control may be more appropriate...
July 31, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28755062/how-low-can-you-go-reducing-rates-of-hypoglycemia-in-the-non-critical-care-hospital-setting
#15
REVIEW
Kristen Kulasa, Patricia Juang
PURPOSE OF REVIEW: The purpose of this review is to discuss strategies to reduce rates of hypoglycemia in the non-critical care setting. RECENT FINDINGS: Strategies to reduce hypoglycemia rates should focus on the most common causes of iatrogenic hypoglycemia. Creating a standardized insulin order set with built-in clinical decision support can help reduce rates of hypoglycemia. Coordination of blood glucose monitoring, meal tray delivery, and insulin administration is an important and challenging task...
September 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28753046/levetiracetam-in-toxic-seizures
#16
Ted Lee, Brandon J Warrick, Preeyaporn Sarangarm, Robert L Alunday, Silas Bussmann, Susan C Smolinske, Steven A Seifert
BACKGROUND/OBJECTIVES: The use of levetiracetam (LEV) in the management of drug-induced seizures has not been systematically investigated. Repetitive and continuous seizures that do not respond to benzodiazepines require second line therapy. Levetiracetam has a unique receptor binding site, rapid absorption, no known cardiac effects at therapeutic doses, and is theoretically a good candidate for use in drug-induced seizures. We evaluate the safety of LEV and its association with seizure cessation in this retrospective chart review of patients who received LEV as a control agent in drug-induced seizures...
July 28, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28748706/the-development-of-new-composite-metrics-for-the-comprehensive-analytic-and-visual-assessment-of-hypoglycemia-using-the-hypo-triad
#17
Andreas Thomas, John Shin, Boyi Jiang, Chantal McMahon, Ralf Kolassa, Robert A Vigersky
BACKGROUND: Quantifying hypoglycemia has traditionally been limited to using the frequency of hypoglycemic events during a given time interval using data from blood glucose (BG) testing. However, continuous glucose monitoring (CGM) captures three parameters-a Hypo-Triad-unavailable with BG monitoring that can be used to better characterize hypoglycemia: area under the curve (AUC), time (duration of hypoglycemia), and frequency of daily episodes below a specified threshold. METHODS: We developed two new analytic metrics to enhance the traditional Hypo-Triad of CGM-derived data to more effectively capture the intensity of hypoglycemia (IntHypo) and overall hypoglycemic environment called the "hypoglycemia risk volume" (HypoRV)...
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28748191/the-yin-and-yang-between-plasma-glucose-levels-and-cortisol-replacement-therapy-in-schmidt-s-syndrome
#18
Christopher A Newton, Eleni Sheehan, Kathleen Wyne, Kenneth Cusi, Julio Leey, Hans K Ghayee
Objective: To illustrate how steroid replacement in adrenal insufficiency can influence the development of hypoglycemia in a patient with type 1 diabetes mellitus (T1D). Methods: We describe the case of a 36-year-old female patient with T1D and Addison's disease (Schmidt's syndrome) on multiple daily insulin injections who presented with recurrent hypoglycemia despite being on physiological replacement doses of hydrocortisone. Results: With the assistance of continuous glucose monitoring technology, a pattern of nocturnal hypoglycemia was clearly identified...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28747209/hypoglycemic-effects-of-acacia-nilotica-in-type-ii-diabetes-a-research-proposal
#19
Nasibeh Roozbeh, Leili Darvish, Fatemeh Abdi
OBJECTIVE: Diabetes mellitus is a common metabolic disorder throughout the world which can negatively affect the function of various body organs. Due to their availability and few side effects, herbal medicines have been proposed as suitable alternatives in the management of diabetes. Previous studies have confirmed the anti diabetic properties of Acacia nilotica. The hypoglycemic effects of this plant have been attributed to its role in stimulating the islets of Langerhans to produce more insulin...
July 26, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28745095/an-enhanced-model-predictive-control-for-the-artificial-pancreas-using-a-confidence-index-based-on-residual-analysis-of-past-predictions
#20
Alejandro J Laguna Sanz, Francis J Doyle, Eyal Dassau
BACKGROUND: Model predictive control (MPC) performance depends on the accuracy of the prediction model implemented by the controller. Complex physiology and modeling limitations often prevent the ability to provide long and accurate glucose predictions, which results in the need to account for prediction errors. METHOD: Optimal insulin dosage by Zone-MPC is calculated by solving an optimization problem in which a scalar index is minimized by penalizing relative input deviations and glucose predictions out of the reference zone...
May 2017: Journal of Diabetes Science and Technology
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