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Hypoglycemia and management

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https://www.readbyqxmd.com/read/28530490/role-of-continuous-glucose-monitoring-in-clinical-trials-recommendations-on-reporting
#1
Oliver Schnell, Katharine Barnard, Richard Bergenstal, Emanuele Bosi, Satish Garg, Bruno Guerci, Thomas Haak, Irl B Hirsch, Linong Ji, Shashank R Joshi, Maarten Kamp, Lori Laffel, Mathieu Chantal, William H Polonsky, Frank Snoek, Philip Home
Thanks to significant improvements in the precision, accuracy, and usability of continuous glucose monitoring (CGM), its relevance in both ambulatory diabetes care and clinical research is increasing. In this study, we address the latter perspective and derive provisional reporting recommendations. CGM systems have been available since around the year 2000 and used primarily in people with type 1 diabetes. In contrast to self-measured glucose, CGM can provide continuous real-time measurement of glucose levels, alerts for hypoglycemia and hyperglycemia, and a detailed assessment of glycemic variability...
May 22, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28526416/treatment-strategy-for-type-2-diabetes-with-obesity-focus-on-glucagon-like-peptide-1-receptor-agonists
#2
REVIEW
Qiuhe Ji
PURPOSE: The progressive nature of type 2 diabetes mellitus (T2DM) calls for step-wise intensification of therapy for maintaining normal glycemic levels and lowering cardiovascular (CV) risk. Because obesity is a prominent risk factor and comorbidity of T2DM, it further elevates the CV risk in T2DM. Therefore, it is vital to manage weight, obesity, and glycemic parameters for effective T2DM management. Few oral antidiabetic drugs (sulfonylureas and thiazolidinediones) and insulin are not suitable for obese patients with T2DM because these drugs cause weight gain...
May 16, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28526182/pharmacologic-management-of-type-2-diabetes-mellitus-available-therapies
#3
James Thrasher
Choices for the treatment of type 2 diabetes mellitus (T2DM) have multiplied as our understanding of the underlying pathophysiologic defects has evolved. Treatment should target multiple defects in T2DM and follow a patient-centered approach that considers factors beyond glycemic control, including cardiovascular risk reduction. The American Association of Clinical Endocrinologists/American College of Endocrinology and the American Diabetes Association recommend an initial approach consisting of lifestyle changes and monotherapy, preferably with metformin...
May 12, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28523334/large-pleural-tumor-revealed-by-severe-hypoglycemia-doege-potter-syndrome
#4
Irina Ruxandra Strâmbu, Diana Gabriela Leonte, Ciprian Nicolae Bolca
AIM: Doege-Potter syndrome is a rare condition consisting of a mesenchymal tumor, either benign or malignant, accompanied by severe hypoglycemia. The syndrome was first described independently by two American physicians, Karl Walter Doege (1867-1932) and Roy Pilling Potter (1879-1968), in 1930, but it was not before 1988 that it was associated with non-islet cell tumor production of insulin growth factor (IGF) that induces hypoglycemia as a paraneoplastic syndrome. CASE PRESENTATION: We present the case of a 61-year-old woman with severe hypoglycemia that induced seizures...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28520705/disparities-in-diabetes-deaths-among-children-and-adolescents-united-states-2000-2014
#5
Sharon Saydah, Giuseppina Imperatore, Yiling Cheng, Linda S Geiss, Ann Albright
Diabetes is a common chronic disease of childhood affecting approximately 200,000 children and adolescents in the United States (1). Children and adolescents with diabetes are at increased risk for death from acute complications of diabetes, including hypoglycemia and diabetic ketoacidosis (2,3); in 2012, CDC reported that during 1968-2009, diabetes mortality among U.S. persons aged ≤19 years declined by 61% (4). CDC observed disparities by race during 1979-2004, with black children and adolescents dying from diabetes at twice the rate of white children and adolescents (5)...
May 19, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28520532/effectiveness-of-smartguard-technology-in-the-prevention-of-nocturnal-hypoglycemia-after-prolonged-physical-activity
#6
Lenka Petruzelkova, Klara Pickova, Zdenek Sumnik, Jan Soupal, Barbora Obermannova
BACKGROUND: The prevention of postexercise nocturnal hypoglycemia after prolonged physical activity using sensor-augmented pump (SAP) therapy with predictive low-glucose management (PLGM) has not been well studied. We conducted a study at a pediatric diabetes camp to determine whether a SAP with PLGM reduces the frequency of nocturnal hypoglycemia after prolonged physical activity more effectively than a SAP with a carbohydrate intake algorithm. METHODS: During a 1-week sport camp, 20 children (aged 10-13 years) with type 1 diabetes (T1D) managed by SAP therapy either with (n = 7) or without PLGM (n = 13) were studied...
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28510792/a-systematic-review-of-proinsulin-secreting-pancreatic-neuroendocrine-tumors
#7
Timothy D Murtha, Beatrice C Lupsa, Sachin Majumdar, Dhanpat Jain, Ronald R Salem
BACKGROUND: Pancreatic neuroendocrine tumors (PNETs) are a heterogeneous group of islet cell-derived neoplasms with a propensity toward hormone production. Among PNETs, proinsulin-secreting tumors (proinsulinomas) are exceedingly rare. The objective of this study is to collect and summarize the existing literature to provide a comprehensive evaluation of this uncommon disease. METHODS: A systematic review was performed to characterize the clinicopathologic features of proinsulinoma...
May 16, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28504012/inpatient-glycemic-management-in-internal-medicine-an-observational-multicenter-study-in-nanjing-china
#8
Shujie Hao, Ning Zhang, Anne Folta Fish, Xiaodan Yuan, Lin Liu, Fan Li, Zhaohui Fang, Qingqing Lou
Aims To evaluate the prevalence of hyperglycemia among inpatients in internal medicine, and specifically, to assess the glycemic management of inpatients in non-endocrinology departments in three large urban hospitals in China. Methods A multicenter observational study was conducted using electronic health records, and a survey of 1939 patients who were admitted to internal medicine units and followed until discharge. Those with previously diagnosed diabetes, newly diagnosed diabetes, or impaired fasting glucose were included...
May 13, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28502028/hypoglycemia-following-bariatric-surgery-our-31-year-experience
#9
Alex D Michaels, J Hunter Mehaffey, W Brenton French, Bruce D Schirmer, Jennifer L Kirby, Peter T Hallowell
PURPOSE: The purposes of this study are to identify the cumulative incidence of post-bariatric surgery hypoglycemia (PBSH), describe its symptomatology, and characterize treatment patterns at a large academic institution. MATERIALS AND METHODS: All patients who underwent bariatric surgery at a single institution from 1985 to 2015 were identified using a clinical database, administrative billing data identified patients who were treated for hypoglycemia, and chart reviews were performed to make a diagnosis of PBSH based on Whipple's triad...
May 13, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28491923/risk-factors-for-death-in-bangladeshi-children-under-5-years-of-age-hospitalized-for-diarrhea-and-severe-respiratory-distress-in-an-urban-critical-care-ward
#10
Tahmina Alam, Tahmeed Ahmed, Monira Sarmin, Lubaba Shahrin, Farzana Afroze, Sharifuzzaman, Shamima Akhter, K M Shahunja, Abu Sadat Mohammad Sayeem Bin Shahid, Pradip Kumar Bardhan, Mohammod Jobayer Chisti
Children with diarrhea hospitalized for respiratory distress often have fatal outcome in resource-limited settings, although data are lacking on risk factors for death in such children. We sought to evaluate clinical predictors for death in such children. In this prospective cohort study, we enrolled under-5 children with diarrhea admitted with severe respiratory distress to the intensive care unit of Dhaka Hospital of International Centre for Diarhoeal Disease Research, Bangladesh, from September 2014 through September 2015...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28488182/successful-management-of-pregnancies-in-patients-with-inherited-disorders-of-ketone-body-metabolism
#11
Raashda Ainuddin Sulaiman, Maha Al-Nemer, Rubina Khan, Munirah Almasned, Bedour S Handoum, Zuhair N Al-Hassnan
Patients with succinyl-CoA:3-oxoacid CoA transferase (SCOT) deficiency and 3-hydroxy-3-methylglutaryl (HMG)-CoA lyase deficiency are at increased risk of developing metabolic acidosis and hypoglycemia during pregnancy, delivery, and postpartum period. This can be fatal if not treated appropriately. Pregnancy in such patients should be managed in a specialist center by a multidisciplinary team including metabolic physician, high-risk obstetrician, and metabolic dietician. We report two pregnancies in women with SCOT deficiency and HMG-CoA lyase deficiency, which were successfully managed at this tertiary care center...
May 10, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28483010/pharmacist-managed-diabetes-center-interventions-ensure-quality-and-safety-in-elderly-patients
#12
Geoffrey Twigg, John Motsko, Jennifer Thomas, Tosin David
OBJECTIVES: This quality-improvement study aimed to replicate historical Patient Safety Clinical Pharmacy Services Collaborative results in high-risk Medicare beneficiaries with diabetes to achieve reductions in A1C, adverse drug events (ADEs), and potential ADEs (pADEs). DESIGN: The model included an interdisciplinary team led by a pharmacist located inside a community pharmacy to provide disease state management and medication therapy management (MTM) to the study population...
May 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28476117/time-series-modelling-to-forecast-prehospital-ems-demand-for-diabetic-emergencies
#13
Melanie Villani, Arul Earnest, Natalie Nanayakkara, Karen Smith, Barbora de Courten, Sophia Zoungas
BACKGROUND: Acute diabetic emergencies are often managed by prehospital Emergency Medical Services (EMS). The projected growth in prevalence of diabetes is likely to result in rising demand for prehospital EMS that are already under pressure. The aims of this study were to model the temporal trends and provide forecasts of prehospital attendances for diabetic emergencies. METHODS: A time series analysis on monthly cases of hypoglycemia and hyperglycemia was conducted using data from the Ambulance Victoria (AV) electronic database between 2009 and 2015...
May 5, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28472507/a-case-report-of-hypoglycemia-and-hypogammaglobulinemia-david-syndrome-in-a-patient-with-a-novel-nfkb2-mutation
#14
Rayhan A Lal, Laura K Bachrach, Andrew R Hoffman, Jingga Inlora, Shannon Rego, Michael P Snyder, David B Lewis
Context: DAVID syndrome (Deficient Anterior pituitary with Variable Immune Deficiency) is a rare disorder in which children present with symptomatic ACTH deficiency preceded by hypogammaglobulinemia from B-cell dysfunction with recurrent infections, termed common variable immunodeficiency (CVID). Subsequent whole exome sequencing studies have revealed germline heterozygous C-terminal mutations of NFKB2 as either a cause of DAVID syndrome or of CVID without clinical hypopituitarism. However, to the best of our knowledge there have been no cases in which the endocrinopathy has presented in the absence of a prior clinical history of CVID...
May 3, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28467934/ppar%C3%AE-promotes-running-endurance-by-preserving-glucose
#15
Weiwei Fan, Wanda Waizenegger, Chun Shi Lin, Vincenzo Sorrentino, Ming-Xiao He, Christopher E Wall, Hao Li, Christopher Liddle, Ruth T Yu, Annette R Atkins, Johan Auwerx, Michael Downes, Ronald M Evans
Management of energy stores is critical during endurance exercise; a shift in substrate utilization from glucose toward fat is a hallmark of trained muscle. Here we show that this key metabolic adaptation is both dependent on muscle PPARδ and stimulated by PPARδ ligand. Furthermore, we find that muscle PPARδ expression positively correlates with endurance performance in BXD mouse reference populations. In addition to stimulating fatty acid metabolism in sedentary mice, PPARδ activation potently suppresses glucose catabolism and does so without affecting either muscle fiber type or mitochondrial content...
May 2, 2017: Cell Metabolism
https://www.readbyqxmd.com/read/28466634/update-on-pancreatic-transplantation-on-the-management-of-diabetes
#16
Carlo Lombardo, Vittorio G Perrone, Gabriella Amorese, Fabio Vistoli, Walter Baronti, Piero Marchetti, Ugo Boggi
Pancreas transplantation is the only therapy that can restore insulin independence in beta-cell penic diabetic recipients. Because of the need for life-long immunosuppression and the intial surgical risk associated with the transplant procedure, Pancreas transplantation is a therapeutic option only in selected diabetic patients. Based on renal function, three main populations of diabetic recipients of a pancreas transplant can be identified: uremic patients, post-uremic patients (following successful kidney transplantation), and non-uremic patients...
May 2, 2017: Minerva Medica
https://www.readbyqxmd.com/read/28466396/utilization-of-simulated-patients-to-assess-diabetes-and-asthma-counseling-practices-among-community-pharmacists-in-qatar
#17
Bridget Paravattil, Nadir Kheir, Adil Yousif
Background Patient counseling is one of the most important services a pharmacist can provide to patients. Studies have shown that counseling provided by pharmacists may prevent medication related problems and improve adherence to medication therapy. Objective To explore counseling practices among community pharmacists using simulated patients and to determine if patient, pharmacist, and pharmacy characteristics influence the counseling provided by community pharmacists. Setting Private community pharmacies within Qatar...
May 2, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28464767/heterogeneity-of-type-1-diabetes-the-effect-of-ethnicity
#18
Mustafa Tosur, Maria Jose Redondo
BACKGROUND: Most of the current understanding of type 1 diabetes (T1D) etiology and pathogenesis stemmed from studies conducted in majoritarily Non-Hispanic White (NHW) populations. However, evidence is emerging that unique mechanisms of disease may contribute to the development of T1D in individuals of Hispanic ethnicity. OBJECTIVE: We reviewed the currently available literature on genetic, immunologic, metabolic and clinical characteristics of T1D in Hispanic as compared with NHW individuals...
May 1, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28463898/glucose-kinetics-an-update-and-novel-insights-into-its-regulation-by-glucagon-and-glp-1
#19
Amalia Gastaldelli, Melania Gaggini, Ralph DeFronzo
PURPOSE OF REVIEW: Glucagon and GLP-1 share the same origin (i.e., proglucagon); primarily GLP-1 is generated from intestinal L-cells and glucagon from pancreatic α-cell, but intestinal glucagon and pancreatic GLP-1 secretion is likely. Glucose kinetics are tightly regulated by pancreatic hormones insulin and glucagon, but other hormones, including glucagon-like peptide-1 (GLP-1), also play an important role. The purpose of this review is to describe the recent findings on the mechanisms by which these two hormones regulate glucose kinetics...
April 29, 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/28459036/consensus-statement-on-dose-modifications-of-antidiabetic-agents-in-patients-with-hepatic-impairment
#20
REVIEW
Kalyan Kumar Gangopadhyay, Parminder Singh
Liver disease is an important cause of mortality in type 2 diabetes mellitus (T2DM). It is estimated that diabetes is the most common cause of liver disease in the United States. Virtually, entire spectrum of liver disease is seen in T2DM including abnormal liver enzymes, nonalcoholic fatty liver disease, cirrhosis, hepatocellular carcinoma, and acute liver failure. The treatment of diabetes mellitus (DM) in cirrhotic patients has particular challenges as follows: (1) about half the patients have malnutrition; (2) patients already have advanced liver disease when clinical DM is diagnosed; (3) most of the oral antidiabetic agents (ADAs) are metabolized in the liver; (4) patients often have episodes of hypoglycemia...
March 2017: Indian Journal of Endocrinology and Metabolism
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