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Hypoglycemia and management

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https://www.readbyqxmd.com/read/29148123/donohue-syndrome-a-review-of-literature-case-series-and-anesthetic-considerations
#1
REVIEW
Alana Kirkwood, Grant Stuart, Louise Harding
BACKGROUND: Donohue syndrome is a rare autosomal recessive disorder of insulin resistance, causing a functional defect in insulin receptor function, and affecting the ability of the insulin to bind the receptor. Features include severe hyperinsulinism and fasting hypoglycemia, along with severe failure to thrive despite feeding. An accelerated fasting state results in muscle wasting, decreased subcutaneous fat, and an excess of thick skin. A reduced thoracic diameter is accentuated by increased abdominal distension, which impacts on respiratory reserve...
November 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29144814/self-blood-glucose-monitoring-underestimates-hyperglycemia-and-hypoglycemia-as-compared-to-continuous-glucose-monitoring-in-type-1-and-type-2-diabetes
#2
Devna Mangrola, Christine Cox, Arianne S Furman, Sridevi Krishnan, Sidika E Karakas
OBJECTIVE: When glucose records from self-blood glucose monitoring (SBGM) do not reflect estimated average glucose from HgBA1, or when patients' clinical symptoms are not explained by their SBGM records, clinical management of diabetes becomes a challenge. Our objective was to determine the magnitude of differences in glucose values reported by SBGM vs. documented by continuous glucose monitoring (CGM). METHODS: The CGM was conducted by a clinical diabetes educator/registered nurse by the clinic protocol, using the Medtronic iPRO2™ system...
November 16, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/29134488/impact-of-clinical-pharmacists-intervention-on-management-of-hyperglycemia-in%C3%A2-pregnancy-in-jordan
#3
Razan Adnan Batta, Violet Kasabri, Amal Akour, Dana Hyassat, Abla Albsoul-Younes
Background and objective Hyperglycemia in pregnancy is a risk factor for cardiovascular disease and postpartum (PP) diabetes. This study aimed to assess the impact of the clinical pharmacist-assisted program (CPAP) of optimizing drug therapy and intensive education on main management outcome measures of patient knowledge about diabetes, Quality of life (QoL) as measured by SF-36 including maternal complications, fasting plasma glucose (FPG) control, and HbA1c. Method This is a randomized controlled study. Pregnant (20-28 weeks) patients with hyperglycemia received CPAP (n = 51) as compared with conventional management (n = 34)...
November 14, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29132978/intensive-care-in-severe-malaria-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#4
REVIEW
Dilip R Karnad, Mohd Basri Mat Nor, Guy A Richards, Tim Baker, Pravin Amin
Severe malaria is common in tropical countries in Africa, Asia, Oceania and South and Central America. It may also occur in travelers returning from endemic areas. Plasmodium falciparum accounts for most cases, although P vivax is increasingly found to cause severe malaria in Asia. Cerebral malaria is common in children in Africa, manifests as coma and seizures, and has a high morbidity and mortality. In other regions, adults may also develop cerebral malaria but neurological sequelae in survivors are rare...
November 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29127952/diabetes-mellitus-in-a-patient-with-glycogen-storage-disease-type-ia-a-case-report
#5
Aviva Cohn, Anupam Ohri
BACKGROUND: Glycogen storage disease type Ia is a genetic disorder that is associated with persistent fasting hypoglycemia and the inability to produce endogenous glucose. The development of diabetes with glycogen storage disease is exceedingly rare. The underlying pathogenesis for developing diabetes in these patients is unclear, and there are no guidelines for treatment. CASE PRESENTATION: We describe a case of a 34-year-old woman of South Asian descent with glycogen storage disease type Ia, who developed uncontrolled diabetes mellitus as a young adult...
November 12, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29120539/-hypertension-diabetes-hyperlipidemia-what-are-the-treatment-goals-for-the-elderly
#6
Martial Coutaz
Will my patient actually benefit from the medication that I've prescribed? Faced with an elderly, frail patient, the family doctor is often confronted by this dilemma. This article reviews the evidence that can assist clinicians in determining the best approach to treating diabetes, hypertension and hyperlipidemia in elderly patients, by defining treatment goals specific to each patients' functional and cognitive capacities. Avoiding hypoglycemia and hypotension, with all of their consequences, must remain the highest priority driving objectives for optimal management of diabetes and hypertension in the geriatric population...
November 8, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29117079/integration-of-data-to-establish-a-standard-operating-procedure-for-the-diabetic-patient-undergoing-hyperbaric-oxygen-therapy
#7
Katherine George, Dianne Ross, Lynn Rowe
PURPOSE: The purpose of this study was to describe occurrences of hypoglycemia in the diabetic population undergoing hyperbaric oxygen therapy (HBOT). We also examined 2 secondary aims: link industry standards for management of hypoglycemia in the general diabetic population to the HBOT environment; and integrate HBOT data into an electronic health record system, as patients transition across inpatient and outpatient services and settings. DESIGN: A retrospective, descriptive study...
November 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29114142/gastrointestinal-parasitic-infections-in-indian-gaddi-goat-breed-bucks-clinical-hemato-biochemical-parasitological-and-chemotherapeutic-studies
#8
Aman Dev Moudgil, Ankur Sharma, Madan Singh Verma, Ravindra Kumar, Pradeep Kumar Dogra, Pallavi Moudgil
The present study was envisaged with an aim to evaluate gastrointestinal parasitic infections in a herd of conserved Gaddi (goat) breed bucks (6-9 months of age) kept on semi-intensive feeding management. The individuals (n = 20) representing the herd were selected and divided into two groups; group I (n = 10), clinically ill and group II (n = 10), sub clinically infected individuals. The clinical examination revealed anemia, emaciation and rise in body temperature of the individuals of group I as compared to group II...
December 2017: Journal of Parasitic Diseases: Official Organ of the Indian Society for Parasitology
https://www.readbyqxmd.com/read/29109609/end-stage-renal-disease-increases-rates-of-adverse-glucose-events-when-treating-diabetic-ketoacidosis-or-hyperosmolar-hyperglycemic-state
#9
Caitlin M Schaapveld-Davis, Ana L Negrete, Joanna Q Hudson, Jagannath Saikumar, Christopher K Finch, Mehmet Kocak, Pan Hu, Megan A Van Berkel
IN BRIEF Treatment guidelines for diabetic emergencies are well described in patients with normal to moderately impaired kidney function. However, management of patients with end-stage renal disease (ESRD) is an ongoing challenge. This article describes a retrospective study comparing the rates of adverse glucose events (defined as hypoglycemia or a decrease in glucose >200 mg/dL/h) between patients with ESRD and those with normal kidney function who were admitted with diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS)...
October 2017: Clinical Diabetes: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29098553/practical-approaches-to-diagnosing-treating-and-preventing-hypoglycemia-in-diabetes
#10
REVIEW
Kathryn Evans Kreider, Katherine Pereira, Blanca I Padilla
Hypoglycemia in individuals with diabetes can increase the risk of morbidity and all-cause mortality in this patient group, particularly in the context of cardiovascular impairment, and can significantly decrease the quality of life. Hypoglycemia can present one of the most difficult aspects of diabetes management from both a patient and healthcare provider perspective. Strategies used to reduce the risk of hypoglycemia include individualizing glucose targets, selecting the appropriate medication, modifying diet and lifestyle and applying diabetes technology...
December 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29098390/errors-in-insulin-treatment-management-and-risk-of-lipohypertrophy
#11
Giuseppe Maria Pozzuoli, Mario Laudato, Maria Barone, Franco Crisci, Bianca Pozzuoli
AIMS: Lipohypertrophy (LH) represents the most common skin-related complication associated with insulin therapy. Our aim is to estimate the prevalence of LH among insulin-treated patients, to identify its association with errors in insulin injection technique and storage, and the correlation between LH, risk of hypoglycemia, and glycemic control. METHODS: Consecutive patients with T1DM or T2DM, attending a diabetes clinic for a routine visit, were administered an anonymous questionnaire investigating the modalities of insulin injection, the correct use of pen device, insulin storage, and reported frequency of hypoglycemic episodes...
November 2, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/29077488/perspectives-on-long-distance-air-travel-with-type-1-diabetes
#12
Jordan E Pinsker, Benjamen E Schoenberg, Colleen Garey, Asher Runion, Arianna Larez, David Kerr
We sought to determine the real-life experiences of individuals traveling long distance (across five or more time-zones) with type 1 diabetes (T1D). Five hundred three members of the T1D Exchange online community ( www.myglu.org ) completed a 45-question survey about their travel experiences flying long distance. The cohort was stratified by duration of T1D and whether or not participants used continuous subcutaneous insulin infusion (CSII) therapy and/or a continuous glucose monitor (CGM). In the last 5 years, 71% of participants had flown long distance...
October 27, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29073302/potential-clinical-benefits-of-a-two-bag-system-for-fluid-management-in-pediatric-intensive-care-unit-patients-with-diabetic-ketoacidosis
#13
Jacqueline P Velasco Md, Joshua Fogel PhD, Robert L Levine Md PhD, Peter Ciminera Md, David Fagan Md, Renee Bargman Md
INTRODUCTION: Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus (DM) that requires appropriate treatment with insulin and intravenous fluids. Both one-bag and two-bag systems of fluid management are used to treat pediatric diabetic ketoacidosis. AIM OF THE STUDY: We compare the one-bag and two-bag systems of fluid managementwith regard to incidence of hypoglycemia, serum bicarbonate correction, pH correction and discharge from the pediatric intensive care unit (PICU)...
2017: Pediatric Endocrinology, Diabetes, and Metabolism
https://www.readbyqxmd.com/read/29071542/infant-with-hepatomegaly-and-hypoglycemia-a-setting-for-fatty-acid-oxidation-defects
#14
Aathira Ravindranath, Gautham Pai, Anshu Srivastava, Ujjal Poddar, Surender Kumar Yachha
Fatty acid oxidation defects (FAOD) are one of the commonest metabolic liver diseases (MLDs) that can have varied presentations in different age groups. An infant presented with short history of jaundice and irritability, examination showed soft hepatomegaly. Investigations revealed non-ketotic hypoglycemia suggesting FAOD which was later confirmed as carnitine uptake defect with gas chromatography and mass spectrometry and mutation analysis. Patient improved with acute management of metabolic crisis, carnitine supplementation and corn starch therapy with reversal of encephalopathy, reduction in hepatomegaly, maintenance of euglycemia and improvement in liver function tests and creatine phosphokinase on follow up...
October 26, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29070499/identifying-and-characterizing-preventable-adverse-drug-events-for-prioritizing-pharmacist-intervention-in-hospitals
#15
Nakyung Jeon, Ben Staley, Thomas Johns, Glori Pflugfelder Lipori, Babette Brumback, Richard Segal, Almut G Winterstein
PURPOSE: The approach and results for identifying and characterizing preventable adverse drug events (pADEs) that are key targets for pharmacist medication therapy management (MTM) are summarized. METHODS: This study was part of a larger effort aimed at developing an electronic health record-based prediction model (the complexity score, or C-score) that ranks hospitalized patients according to their risk for pADEs. An environmental scan of published epidemiologic pADE studies and national patient safety priority areas was conducted...
November 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29040177/providing-self-management-education-to-patients-with-type-2-diabetes-mellitus-addressing-basic-nutrition-and-hypoglycemia
#16
Carrie Palmer
NPs and other primary care providers will continue to encounter a growing population of patients with type 2 diabetes mellitus. Helping patients engage in self-care behaviors is essential to achieve blood glucose control and prevent diabetes-related complications. This article explores opportunities to provide education to patients with diabetes mellitus on the important self-care topics of nutrition and hypoglycemia during a primary care visit.
November 16, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/29039237/sglt2-inhibitors-are-they-safe
#17
Sebastian Filippas-Ntekouan, Theodosios D Filippatos, Moses S Elisaf
Sodium-glucose linked transporter type 2 (SGLT2) inhibitors are a relatively new class of antidiabetic drugs with positive cardiovascular and kidney effects. The aim of this review is to present the safety issues associated with SGLT2 inhibitors. Urogenital infections are the most frequently encountered adverse events, although tend to be mild to moderate and are easily manageable with standard treatment. Although no increased acute kidney injury risk was evident in the major trials, the mechanism of action of these drugs requires caution when they are administered in patients with extracellular volume depletion or with drugs affecting renal hemodynamics...
October 27, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/29026743/management-of-diabetic-ketosis-and-ketoacidosis-with-intramuscular-regular-insulin-in-a-low-resource-family-medicine-setting
#18
Sudhakar Basetty, G S Yeshvanth Kumar, Martina Shalini, Ruby Pricilla Angeline, Kirubah Vasandhi David, Sunil Abraham
BACKGROUND: India is facing an epidemic of diabetes mellitus (DM). Effective management of complications of DM is a challenge in resource-poor areas of India. This study addresses the need to explore low-cost methods to manage diabetic ketosis (DK) and diabetic ketoacidosis (DKA). OBJECTIVES: To demonstrate the use of intramuscular (IM) regular insulin as a safe alternative method to control DK and DKA in a family practice setting. MATERIALS AND METHODS: A retrospective chart review was done for 34 patients admitted with DK and DKA in a family medicine unit for the urban poor over 5 years...
January 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28993453/antidiabetic-therapies-and-male-reproductive-function-where-do-we-stand
#19
Renata Santos Tavares, Sara Escada-Rebelo, Andreia F Silva, Maria Inês Sousa, Joao Ramalho-Santos, Sandra Amaral
Diabetes mellitus has been increasing at alarming rates in recent years, thus jeopardizing human health worldwide. Several antidiabetic drugs have been introduced in the market to manage glycemic levels, proven effective in avoiding, minimizing or preventing the appearance or development of diabetes mellitus-related complications. However, and despite the established association between such pathology and male reproductive dysfunction, the influence of these therapeutic interventions on such topic have been scarcely explored...
October 9, 2017: Reproduction: the Official Journal of the Society for the Study of Fertility
https://www.readbyqxmd.com/read/28990436/acceptability-of-implantable-continuous-glucose-monitoring-sensor
#20
Katharine D Barnard, Jort Kropff, Pratik Choudhary, Sankalpa Neupane, Stephen C Bain, Christoph Kapitza, Thomas Forst, Manuela Link, Colleen Mdingi, J Hans DeVries
BACKGROUND: Real-time continuous glucose monitoring is associated with significant benefits for diabetes management. Implantable sensors could overcome some challenges reportedly associated with device visibility, psychosocial functioning and sensor durability. METHODS: A psychosocial assessment was conducted to determine acceptability and impact of an implantable continuous glucose monitoring (CGM) sensor as part of the PRECISE trial. Questionnaires were administered to participants comprising the Diabetes Distress Scale, the CGM impact scale, and bespoke device satisfaction...
October 1, 2017: Journal of Diabetes Science and Technology
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