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Hypoglycemia and management

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https://www.readbyqxmd.com/read/29332635/fear-of-hypoglycemia-in-patients-with-type-2-diabetes-the-role-of-interoceptive-accuracy-and-prior-episodes-of-hypoglycemia
#1
Jennifer Grammes, Manuela Schäfer, Andrea Benecke, Ulrike Löw, Alena-Lynn Klostermann, Thomas Kubiak, Michael Witthöft
OBJECTIVE: Fear of hypoglycemia (FoH) is a limiting factor for diabetes self-management and can have detrimental effects on quality of life. However, relatively little is known about its underlying mechanisms. In line with findings on patients with anxiety disorders, we hypothesized that interoceptive accuracy (IA) might be positively linked to FoH in patients with type 2 diabetes (T2DM). METHODS: 133 patients with T2DM were screened according to the extreme quartiles of the Hypoglycemia Fear Survey worry subscale (HFS-W)...
February 2018: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/29332422/unexpected-management-behaviors-in-adolescents-with-type-1-diabetes-using-sensor-augmented-pump-therapy
#2
Mary Binsu Abraham, Kristine Heels, Jennifer A Nicholas, Carol Cole, Rebecca Gebert, Julie Klimek, Tracey Jopling, Geoffrey Ambler, Fergus Cameron, Elizabeth Davis, Timothy W Jones
BACKGROUND: Continuous glucose monitoring can improve glycemic outcomes in individuals with type 1 diabetes. However, the constant exposure to real-time glucose levels can sometimes lead the individual to make some risky choices to address the glycemic excursions. Hence, the purpose of this study was to explore the aberrant management behaviors of youth with type 1 diabetes on sensor-augmented pump therapy (SAPT). METHODS: Participants in a clinical trial using SAPT on Medtronic MiniMed™ 640G pump who experienced deteriorating glycemic control or unexplained hypoglycemia were identified by the health care professional...
January 1, 2018: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29316236/long-term-safety-and-efficacy-of-tofogliflozin-add-on-to-insulin-in-patients-with-type-2-diabetes-results-from-a-52-week-multicenter-randomized-double-blind-open-label-extension-phase-4-study-in-japan-j-step-ins
#3
Yasuo Terauchi, Masahiro Tamura, Masayuki Senda, Ryoji Gunji, Kohei Kaku
AIMS: To evaluate the long-term safety and efficacy of tofogliflozin as an add-on treatment to insulin over 52 weeks. MATERIALS AND METHODS: This 52-week, multicenter, Phase 4 study consisted of a 16-week, randomized, double-blind, placebo-controlled phase and a 36-week open label extension phase (NCT02201004). Japanese patients with type 2 diabetes mellitus aged 20-75 years with suboptimal glycemic control (7.5%-10.5%) on insulin monotherapy (basal-bolus, bolus, premix [low and high], and basal) or on combination therapy of basal insulin and dipeptidyl peptidase-4 inhibitor were eligible for participation...
January 5, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29314873/2018-aaha-diabetes-management-guidelines-for-dogs-and-cats
#4
Ellen Behrend, Amy Holford, Patty Lathan, Renee Rucinsky, Rhonda Schulman
Diabetes mellitus (DM) is a common disease encountered in canine and feline medicine. The 2018 AAHA Diabetes Management Guidelines for Dogs and Cats revise and update earlier guidelines published in 2010. The 2018 guidelines retain much of the information in the earlier guidelines that continues to be applicable in clinical practice, along with new information that represents current expert opinion on controlling DM. An essential aspect of successful DM management is to ensure that the owner of a diabetic dog or cat is capable of administering insulin, recognizing the clinical signs of inadequately managed DM, and monitoring blood glucose levels at home, although this is ideal but not mandatory; all topics that are reviewed in the guidelines...
January 2018: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/29313579/pancreatic-exocrine-insufficiency-in-type-1-and-2-diabetes-therapeutic-implications
#5
Rupjyoti Talukdar, D Nageshwar Reddy
The objective of the present review is to focus on pancreatic exocrine insufficiency that is associated with Type 1 and 2 diabetes, its clinical and therapeutic implications, including the utility and efficacy of pancreatin supplementation. A literature search was conducted on Pubmed / Medline to identify relevant articles using terms pancreatic exocrine insufficiency in diabetes mellitus patients, pathophysiology, prevalence, treatment and management published between 2006-2016 in English language. Meta-analysis has revealed the prevalence of PEI in patients with type-1 and type-2 diabetes mellitus to be 37...
September 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29301189/congenital-hyperinsulinism-diagnostic-and-management-challenges-in-a-developing-country-case-report
#6
Cheri Mathews John, Prakash Agarwal, Suriyakumar Govindarajulu, Sandhya Sundaram, Senthil Senniappan
Management of congenital hyperinsulinemia of infancy (CHI) is challenging. A 4-month-old female infant with persistent hypoglycemia and elevated insulin levels was diagnosed with CHI. Gallium-68 DOTANOC positron emission tomography/computed tomography (PET/CT) scan (68Ga-labeled [1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetic acid]-1-NaI3-octreotide) demonstrated focal disease in the body of the pancreas. Genetic studies indicated paternal inheritance, making focal disease likely. She was started on diazoxide therapy with partial improvement in blood glucose levels...
December 2017: Annals of Pediatric Endocrinology & Metabolism
https://www.readbyqxmd.com/read/29290532/thrombolysis-alert-in-hassan-ii-university-teaching-hospital-of-fez-morocco-a-prospective-study-of-2-years
#7
Moussa Toudou Daouda, Siham Bouchal, Naima Chtaou, Aouatef Midaoui, Zouahyr Souirti, Faouzi Belahsen
BACKGROUND: Thrombolysis alert (TA) is a procedure triggered every time a patient consults for sudden focal neurological deficit within 4.5 hours. OBJECTIVE: We aimed to determine firstly the etiological profile of TA and secondly to evaluate the delays in the management not only of thrombolyzed patients but also of nonthrombolyzed patients to determine the intrahospital delays to optimize. METHODS: Patients aged over 18 years who consulted for sudden focal neurological deficit within 4...
December 29, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29289540/a-randomized-controlled-study-comparing-a-dpp4-inhibitor-linagliptin-and-basal-insulin-glargine-in-patients-with-type-2-diabetes-in-long-term-care-and-skilled-nursing-facilities-linagliptin-ltc-trial
#8
Guillermo E Umpierrez, Saumeth Cardona, David Chachkhiani, Maya Fayfman, Sahebi Saiyed, Heqiong Wang, Priyathama Vellanki, J Sonya Haw, Darin E Olson, Francisco J Pasquel, Theodore M Johnson
OBJECTIVES: Safe and easily implemented treatment regimens are needed for the management of patients with type 2 diabetes mellitus (T2DM) in long-term care (LTC) and skilled nursing facilities. DESIGN: This 6-month open-label randomized controlled trial compared the efficacy and safety of a DPP4 inhibitor (linagliptin) and basal insulin (glargine) in LTC residents with T2DM. SETTINGS: Three LTC institutions affiliated with a community safety-net hospital, US Department of Veterans Affairs and Emory Healthcare System in Atlanta, Georgia...
December 27, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29285445/comparison-of-two-protocols-in-the-management-of-glucocorticoid-induced-hyperglycemia-among-hospitalized-patients
#9
Om J Lakhani, Surender Kumar, Sudhir Tripathi, Mitali Desai, Chandani Seth
Context: There is limited literature focusing on the management of glucocorticoid-induced hyperglycemia (GCIH). Aims: The primary objective was to compare the mean blood glucose between the experimental group (new protocol) and the control group (standard protocol) in the management of GCIH. The secondary objective was to compare other parameters of glycemic efficacy, variability, and safety parameters. Methods: This was a randomized, open-labeled, parallel arm trial...
November 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29285339/medium-chain-acyl-coa-dehydrogenase-deficiency-in-a-premature-infant
#10
Steven F Dobrowolski, Lina Ghaloul-Gonzalez, Jerry Vockley
Medium-chain acyl-CoA dehydrogenase deficiency (MCADD) is identified by newborn screening (NBS). The natural history of MCADD includes metabolic decompensation with hypoglycemia, hyperammonemia, seizures, coma, and death. NBS enables expectant management thus severe symptoms are rare in managed patients. We report premature birth of an MCADD affected infant and resultant management challenges. Nutritional support advanced from parenteral nutrition at 24 hours to enteral feeds. A NBS sample was collected day 2, positive results for MCADD was reported day six, and diagnostic tests were performed day seven...
November 21, 2017: Pediatric Reports
https://www.readbyqxmd.com/read/29276423/hypoglycemia-when-to-treat
#11
REVIEW
Venkat Reddy Kallem, Aakash Pandita, Girish Gupta
Hypoglycemia is the most common metabolic disorder encountered in neonates. The definition of hypoglycemia as well as its clinical significance and management remain controversial. Most cases of neonatal hypoglycemia are transient, respond readily to treatment, and are associated with an excellent prognosis. Persistent hypoglycemia is more likely to be associated with abnormal endocrine conditions, such as hyperinsulinemia, as well as possible neurologic sequelae. Manifestations of hypoglycemia include seizures which can result in noteworthy neuromorbidity in the long haul...
2017: Clinical Medicine Insights. Pediatrics
https://www.readbyqxmd.com/read/29276400/challenges-and-unmet-needs-in-basal-insulin-therapy-lessons-from-the-asian-experience
#12
REVIEW
Wing Bun Chan, Jung Fu Chen, Su-Yen Goh, Thi Thanh Huyen Vu, Iris Thiele Isip-Tan, Sony Wibisono Mudjanarko, Shailendra Bajpai, Maria Aileen Mabunay, Pongamorn Bunnag
Basal insulin therapy can improve glycemic control in people with type 2 diabetes. However, timely initiation, optimal titration, and proper adherence to prescribed basal insulin regimens are necessary to achieve optimal glycemic control. Even so, glycemic control may remain suboptimal in a significant proportion of patients. Unique circumstances in Asia (eg, limited resources, management of diabetes primarily in nonspecialist settings, and patient populations that are predominantly less educated) coupled with the limitations of current basal insulin options (eg, risk of hypoglycemia and dosing time inflexibility) amplify the challenge of optimal basal insulin therapy in Asia...
2017: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
https://www.readbyqxmd.com/read/29276256/evaluation-of-insulin-use-and-hypoglycemia-in-hospitalized-elderly-patients
#13
Quyen N Bach, Rod A Gilmore, Melody C Sheffield, W Anthony Hawkins
Background: Routine administration of correctional insulin is no longer recommended as a primary strategy to treat hyperglycemia in hospitalized patients. Studies have demonstrated significant improvement in glycemic control in patients treated with basal and correctional insulin (B+C) versus correctional insulin alone (C). However, the effect of C or B+C on hypoglycemic events is not well understood. Objective: The objective of this study was to investigate the effect of B+C versus C on hypoglycemic events in hospitalized elderly patients...
December 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29276238/treatment-of-hypertriglyceridemia-induced-acute-pancreatitis-with-insulin-heparin-and-gemfibrozil-a-case-series
#14
Drayton A Hammond, Laura Finlay
Hypertriglyceridemia is the third most common worldwide cause of acute pancreatitis. Resolving the underlying etiology is imperative for optimal management. This is especially true with regard to hypertriglyceridemia, as this etiology may cause more severe acute pancreatitis and worse symptoms than other causes of the disease. Many pharmacological treatment options for hypertriglyceridemia-induced acute pancreatitis (HTGP) have been proposed; however, the safety and efficacy for specific treatment regimens remain nebulous...
November 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29273897/impact-of-flash-glucose-monitoring-on-hypoglycaemia-in-adults-with-type-1-diabetes-managed-with-multiple-daily-injection-therapy-a-pre-specified-subgroup-analysis-of-the-impact-randomised-controlled-trial
#15
Per Oskarsson, Ramiro Antuna, Petronella Geelhoed-Duijvestijn, Jens Krӧger, Raimund Weitgasser, Jan Bolinder
AIMS/HYPOTHESIS: Evidence for the effectiveness of interstitial glucose monitoring in individuals with type 1 diabetes using multiple daily injection (MDI) therapy is limited. In this pre-specified subgroup analysis of the Novel Glucose-Sensing Technology and Hypoglycemia in Type 1 Diabetes: a Multicentre, Non-masked, Randomised Controlled Trial' (IMPACT), we assessed the impact of flash glucose technology on hypoglycaemia compared with capillary glucose monitoring. METHODS: This multicentre, prospective, non-masked, RCT enrolled adults from 23 European diabetes centres...
December 23, 2017: Diabetologia
https://www.readbyqxmd.com/read/29251064/risk-of-hypoglycemia-during-insulin-infusion-directed-by-paper-protocol-versus-electronic-glycemic-management-system-in-critically-ill-patients-at-a-large-academic-medical-center
#16
Marina Rabinovich, Jessica Grahl, Emily Durr, Rita Gayed, Katleen Chester, Raymie McFarland, Barbara McLean
BACKGROUND: Insulin infusions are commonly utilized to control hyperglycemia in critically ill patients and decrease hyperglycemia associated complications. Safety concerns have been raised in trials evaluating methods of glycemic control regarding the incidence of hypoglycemia and its relationship to increased mortality. Electronic glycemic management systems (eGMS) may result in less variable blood glucose (BG) control and less hypoglycemia. This study aimed to compare BG control, time in target BG range, and the rate of hypoglycemia when critically ill patients were managed with an insulin infusion guided by paper-based protocol (PBP) versus eGMS...
December 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29250698/genetic-disorder-in-carbohydrates-metabolism-hereditary-fructose-intolerance-associated-with-celiac-disease
#17
Daniela Păcurar, Gabriela Leşanu, Irina Dijmărescu, Iulia Florentina Ţincu, Mihaela Gherghiceanu, Dumitru Orăşeanu
Celiac disease (CD) has been associated with several genetic and immune disorders, but association between CD and hereditary fructose intolerance (HFI) is extremely rare. HFI is an autosomal recessive disease caused by catalytic deficiency of aldolase B (fructose-1,6-bisphosphate aldolase). We report the case of a 5-year-old boy suffering from CD, admitted with an initial diagnosis of Reye's-like syndrome. He presented with episodic unconsciousness, seizures, hypoglycemia, hepatomegaly and abnormal liver function...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/29243325/camp-based-multi-component-intervention-for-families-of-young-children-with-type-1-diabetes-a-pilot-and-feasibility-study
#18
Olga T Gupta, Marsha MacKenzie, Angie Burris, Bonnie B Jenkins, Nikki Collins, Molly Shade, Eileen Santa-Sosa, Sunita M Stewart, Perrin C White
BACKGROUND: Managing type 1 diabetes mellitus (T1DM) in preschool-aged children has unique challenges that can negatively impact glycemic control and parental coping. OBJECTIVE: To evaluate the impact of a camp-based multi-component intervention on glycated hemoglobin A1c (HbA1c) in young children with T1DM and psychosocial measures for their parents. SUBJECTS AND METHODS: Two separate cohorts of 18 children (ages 3-5 years) and their families participated in a camp-based intervention that included didactic and interactive parent education, child-centered education and family-based recreational activities...
December 15, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/29238721/macrovascular-complications-in-patients-with-diabetes-and-prediabetes
#19
REVIEW
Dou Huang, Marwan Refaat, Kamel Mohammedi, Amin Jayyousi, Jassim Al Suwaidi, Charbel Abi Khalil
Diabetes is a significant health problem worldwide, and its association with cardiovascular disease (CVD) was reported in several studies. Hyperglycemia and insulin resistance seen in diabetes and prediabetes lead to an increase in reactive oxygen species, which triggers intracellular molecular signaling. The resulting prothrombotic state and increase in inflammatory mediators expedite atherosclerotic changes and the development of macrovascular complications. Individuals with diabetes or prediabetes have a higher risk of developing myocardial infarction, stroke, and peripheral artery disease...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29237289/safely-converting-an-entire-academic-medical-center-from-sliding-scale-to-basal-bolus-insulin-via-implementation-of-the-eglycemic-management-system
#20
Rosalina Newsom, Christopher Patty, Emma Camarena, Regina Sawyer, Raymie McFarland, Thomas Gray, Melanie Mabrey
OBJECTIVE: Hyperglycemia is common in the inpatient setting and providers frequently rely on sliding scale insulin. This case study reviews the experience of one hospital moving from high utilization of sliding scale to basal bolus insulin therapy. METHOD: This Retrospective Quality Improvement Study describes the journey of clinicians at a 580-bed hospital to convert from high usage of SSI to BBI. Hyperglycemic adult patients prescribed insulin, with/without a diagnosis of diabetes, were included...
December 1, 2017: Journal of Diabetes Science and Technology
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