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Hypoglycemia and management

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https://www.readbyqxmd.com/read/28106608/a-perioperative-systems-design-to-improve-intraoperative-glucose-monitoring-is-associated-with-a-reduction-in-surgical-site-infections-in-a-diabetic-patient-population
#1
Jesse M Ehrenfeld, Jonathan P Wanderer, Maxim Terekhov, Brian S Rothman, Warren S Sandberg
BACKGROUND: Diabetic patients receiving insulin should have periodic intraoperative glucose measurement. The authors conducted a care redesign effort to improve intraoperative glucose monitoring. METHODS: With approval from Vanderbilt University Human Research Protection Program (Nashville, Tennessee), the authors created an automatic system to identify diabetic patients, detect insulin administration, check for recent glucose measurement, and remind clinicians to check intraoperative glucose...
January 19, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28093996/challenges-related-to-glycemic-control-in-type-2-diabetes-mellitus-patients
#2
Masoumeh Kheirandish, Hamidreza Mahboobi, Maryam Yazdanparast, Mohammad Amjad Kamal
Diabetes mellitus (DM) is a chronic disease with long-term complications. Glycemic control is an important part in management of DM. The first line in treatment of type 2 DM (T2DM) is diet and life style change. Metformin is the first choice of medication in T2DM patients. Sulfonylureas have high risk of hypoglycemia. Glinides are associated with lower risk of hypoglycemia in comparison to sulfonylureas. Also α-glucosidase inhibitors decrease the polysacarides digestion in small intestine and less effective in comparison to metformin and sulfonylureas in lowering hemoglobin A1c (HbA1c)...
January 15, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/28088910/sodium-glucose-cotransporter-2-inhibitors-sglt2i-their-role-in-cardiometabolic-risk-management
#3
Niki Katsiki, Dimitri P Mikhailidis, Michael J Theodorakis
BACKGROUND: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a novel category of oral antidiabetic drugs that inhibit renal glucose reabsorption and increase renal glucose excretion, thus lowering plasma glucose levels. This unique mechanism of SGLT2i action is insulin independent, thus improving glycemic control without promoting hypoglycemia in the absence of exogenously administered insulin. METHODS: The present narrative review addresses the putative associations between SGLT2i and several cardiovascular (CV) and microvascular risk factors, as well as their effects on cardiac and renal function...
January 13, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28079649/factors-affecting-the-ability-of-people-with-diabetes-to-avoid-hypoglycemia
#4
Fei-Ling Wu, En-Chang Wu, Yue-Cune Chang, Wen-Yu Hu, Jyuhn-Huarng Juang, Mei Chang Yeh
BACKGROUND: Hypoglycemia is recognized as a limiting factor in diabetes management. Fear of experiencing hypoglycemia may lead to lower quality of life, impaired glycemic control, and emotional distress, all of which impair the ability of patients to self-manage their diabetes effectively. Problem solving is central to diabetes self-management and may help patients achieve effective self-care of their disease. PURPOSE: The aim of this study was to investigate the ability of people with diabetes to avoid hypoglycemia and to explore associated factors...
January 11, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/28077204/review-of-the-next-generation-of-long-acting-basal-insulins-insulin-degludec-and-insulin-glargine
#5
Matthew Stailey, Susan E Conway
Older adults are at an increased risk of developing type 2 diabetes mellitus (T2DM). Although oral agents (i.e., metformin) are the preferred first-line therapy, older adults often eventually require the addition of insulin to control their blood glucose. Long-acting insulin analogues are the preferred insulin products for older adults with T2DM. Insulin degludec and insulin glargine U-300 are both new generation long-acting insulins. When compared with the standard of care, long-acting insulin product insulin glargine U-100, insulin degludec, and insulin glargine U-300 had similar glucose-lowering effects, longer half-lives and durations of action, and a more even distribution over a 24-hour period...
January 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28074109/improvement-of-quality-of-life-through-glycemic-control-by-liraglutide-a-glp-1-analog-in-insulin-naive-patients-with-type-2-diabetes-mellitus-the-page1-study
#6
Hitoshi Ishii, Tetsuji Niiya, Yasuhiro Ono, Naoyuki Inaba, Hideaki Jinnouchi, Hirotaka Watada
BACKGROUND: In addition to achieving good glycemic control, diabetes care management aims to improve the quality of life (QOL) in patients. Treatment-associated difficulties and side effects frequently cause deterioration in QOL. Liraglutide, a GLP-1 receptor agonist, is a novel injection drug that promotes insulin secretion. It is a user-friendly, once-daily injection with fewer hypoglycemic events. In this study, we aimed to examine the effect of liraglutide therapy on QOL in patients...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28071894/noninvasive-monitoring-of-blood-glucose-with-raman-spectroscopy
#7
Rishikesh Pandey, Santosh Kumar Paidi, Tulio A Valdez, Chi Zhang, Nicolas Spegazzini, Ramachandra Rao Dasari, Ishan Barman
The successful development of a noninvasive blood glucose sensor that can operate reliably over sustained periods of time has been a much sought after but elusive goal in diabetes management. Since diabetes has no well-established cure, control of elevated glucose levels is critical for avoiding severe secondary health complications in multiple organs including the retina, kidney and vasculature. While fingerstick testing continues to be the mainstay of blood glucose detection, advances in electrochemical sensing-based minimally invasive approaches have opened the door for alternate methods that would considerably improve the quality of life for people with diabetes...
January 10, 2017: Accounts of Chemical Research
https://www.readbyqxmd.com/read/28067472/efficacy-of-basal-bolus-insulin-regimens-in-the-inpatient-management-of-non-critically-ill-patients-with-type-2-diabetes-a-systematic-review-and-meta-analysis
#8
REVIEW
Merete B Christensen, Anders Gotfredsen, Kirsten Nørgaard
BACKGROUND: Hyperglycemia during hospitalization is associated with increased rates of complications and longer hospital stays. Various insulin regimens are used in the inpatient diabetes management of non-critically ill patients. We aimed to assess the efficacy and safety of basal-bolus insulin therapy (BBI) by summarizing evidence from studies of BBI versus sliding scale insulin therapy (SSI) in the management of hospitalized non-critically ill type 2 diabetes patients. METHODS: We searched MEDLINE, EMBASE, Scopus and the Cochrane Library for studies comparing BBI therapy with SSI therapy in hospitalized non-critically ill patients with type 2 diabetes...
January 9, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28065256/a-newborn-infant-with-oxygen-desaturation-during-sleep
#9
Ashley Deschamp, Ameet Daftary
The patient is a 1-week-old boy born at 37+2 weeks' gestational age through spontaneous vaginal delivery. The pregnancy was complicated by maternal gestational diabetes mellitus and pre-eclampsia. The Apgar score was 9 at both 1 minute and 5 minutes after birth. Because of hypoglycemia at delivery that required IV dextrose, he was admitted to the local neonatal intensive care unit. His blood glucose levels quickly stabilized, dextrose administration was discontinued, and the patient began breast-feeding. On day 2 of life, the patient began having intermittent oxygen desaturation, with oxygen saturation as measured by pulse oximetry down to 70% while sleeping; he was transferred to a tertiary-care NICU for further management...
January 2017: Chest
https://www.readbyqxmd.com/read/28065242/advances-in-glycemic-characteristics-complications-and-treatment-for-patients-undergoing-total-pancreatectomy
#10
Ying Zhou, Wei-Gang Zhao
Total pancreatectomy has been mainly used to treat malignant diseases of the pancreas, di-ffuse ductal involvement, and severe chronic pancreatitis. Patients may develop pancreatic diabetes after the surgery, in whom the glucose levels fluctuate widely and are hard to control, which increases the incidence of recurrent hypoglycemia. Postoperative complications are closely associated with the glucose levels. Thus, tighter glycemic management is essential for increasing the survival of these patients. Few cases have been discribed in China...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28051306/h2o2-responsive-vesicles-integrated-with-transcutaneous-patches-for-glucose-mediated-insulin-delivery
#11
Xiuli Hu, Jicheng Yu, Chenggen Qian, Yue Lu, Anna R Kahkoska, Zhigang Xie, Xiabin Jing, John B Buse, Zhen Gu
A self-regulated "smart" insulin administration system would be highly desirable for diabetes management. Here, a glucose-responsive insulin delivery device, which integrates H2O2-responsive polymeric vesicles (PVs) with a transcutaneous microneedle-array patch was prepared to achieve a fast response, excellent biocompatibility, and painless administration. The PVs are self-assembled from block copolymer incorporated with polyethylene glycol (PEG) and phenylboronic ester (PBE)-conjugated polyserine (designated mPEG-b-P(Ser-PBE)) and loaded with glucose oxidase (GOx) and insulin...
January 4, 2017: ACS Nano
https://www.readbyqxmd.com/read/28031949/the-effect-of-frailty-should-be-considered-in-the-management-plan-of-older-people-with-type-2-diabetes
#12
REVIEW
Ahmed H Abdelhafiz, Luan Koay, Alan J Sinclair
The prevalence of diabetes is increasing especially in older age due to increased life expectancy. In old age, diabetes is associated with high comorbidity burden and increased prevalence of geriatric syndromes including frailty in addition to micro- and macro-vascular complications. The emergence of frailty may change the natural history of Type 2 diabetes from a progressive to a regressive course with increased risk of hypoglycemia. This may result in normalization of blood glucose levels and lead to a state of burnt-out diabetes in frail older people with significant weight loss...
March 2016: Future Science OA
https://www.readbyqxmd.com/read/28031946/hyperglycemia-during-the-immediate-period-following-liver-transplantation
#13
K Tuesday Werner, Patricia A Mackey, Janna C Castro, Elizabeth J Carey, Harini A Chakkera, Curtiss B Cook
AIM: High blood glucose levels in the hospital are common among transplant recipients. METHODS: Retrospective analysis, stratified by diagnosis of pretransplant diabetes mellitus (DM). RESULTS: Of 346 patients, 96 had pretransplant DM (insulin, n = 60; no insulin, n = 36) and 250 did not. Patients with pretransplant DM had higher inpatient mean glucose levels and more hyperglycemia and hypoglycemia (all p < 0.01). For patients without pretransplant DM, the need for insulin at discharge increased 23% for every 5-year age increase (odds ratio: 1...
March 2016: Future Science OA
https://www.readbyqxmd.com/read/28031781/intermittent-energy-restriction-in-type-2-diabetes-a-short-discussion-of-medication-management
#14
Sharayah Carter, Peter M Clifton, Jennifer B Keogh
AIM: To discuss type 2 diabetes mellitus (T2DM) medication changes required during the popular 5:2 intermittent energy restriction (IER) diet. METHODS: A search was conducted in MEDLINE, EMBASE, AMED, CINAHL and Cochrane library for original research articles investigating the use of very low calorie diets (VLCD) in people with T2DM. The search terms used included "VLCD" or "very low energy diet" or "very low energy restriction" or "IER" or "intermittent fasting" or "calorie restriction" or "diabetes mellitus type 2" and "type 2 diabetes"...
December 15, 2016: World Journal of Diabetes
https://www.readbyqxmd.com/read/28018153/a-pediatric-diabetic-ketoacidosis-management-protocol-incorporating-a-two-bag-intravenous-fluid-system-decreases-duration-of-intravenous-insulin-therapy
#15
Megan Veverka, Kourtney Marsh, Susan Norman, Michael Alan Brock, Monica Peng, Jennifer Shenk, Jerome Gene Chen
OBJECTIVES: Diabetic ketoacidosis (DKA) is a leading cause of morbidity and mortality in children with type 1 diabetes. We implemented a standardized DKA management protocol by using a 2-bag intravenous (IV) fluid system. The purpose of the study was to examine if the protocol improved clinical outcomes and process efficiency. METHODS: This was a retrospective study of patients who did and did not undergo the protocol. Patients were included if they were 18 years of age or younger, were diagnosed with DKA, admitted to an intensive care unit or stepdown unit, and received continuous IV insulin...
November 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28012277/chemical-and-biological-aspects-of-extracts-from-medicinal-plants-with-antidiabetic-effects
#16
Lucas F Gushiken, Fernando P Beserra, Ariane L Rozza, Patrícia L Bérgamo, Danilo A Bérgamo, Cláudia H Pellizzon
Diabetes mellitus is a chronic disease and a leading cause of death in western countries. Despite advancements in the clinical management of the disease, it is not possible to control the late complications of diabetes. The main characteristic feature of diabetes is hyperglycemia, which reflects the deterioration in the use of glucose due to a faulty or poor response to insulin secretion. Alloxan and streptozotocin (STZ) are the chemical tools that are most commonly used to study the disease in rodents. Many plant species have been used in ethnopharmacology or to treat experimentally symptoms of this disease...
July 2016: Review of Diabetic Studies: RDS
https://www.readbyqxmd.com/read/28000140/flash-glucose-sensing-technology-as-a-replacement-for-blood-glucose-monitoring-for-the-management-of-insulin-treated-type-2-diabetes-a-multicenter-open-label-randomized-controlled-trial
#17
Thomas Haak, Hélène Hanaire, Ramzi Ajjan, Norbert Hermanns, Jean-Pierre Riveline, Gerry Rayman
INTRODUCTION: Glycemic control in participants with insulin-treated diabetes remains challenging. We assessed safety and efficacy of new flash glucose-sensing technology to replace self-monitoring of blood glucose (SMBG). METHODS: This open-label randomized controlled study (ClinicalTrials.gov, NCT02082184) enrolled adults with type 2 diabetes on intensive insulin therapy from 26 European diabetes centers. Following 2 weeks of blinded sensor wear, 2:1 (intervention/control) randomization (centrally, using biased-coin minimization dependant on study center and insulin administration) was to control (SMBG) or intervention (glucose-sensing technology)...
December 20, 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/27998542/-metabolic-control-in-the-critically-ill-patient-an-update-hyperglycemia-glucose-variability-hypoglycemia-and-relative-hypoglycemia
#18
Ángel Augusto Pérez-Calatayud, Ariadna Guillén-Vidaña, Irving Santiago Fraire-Félix, Eduardo Daniel Anica-Malagón, Jesús Carlos Briones Garduño, Raúl Carrillo-Esper
BACKGROUND: Metabolic changes of glucose in critically ill patients increase morbidity and mortality. The appropriate level of blood glucose has not been established so far and should be adjusted for different populations. However concepts such as glucose variability and relative hypoglycemia of critically ill patients are concepts that are changing management methods and achieving closer monitoring. OBJECTIVES: The purpose of this review is to present new data about the management and metabolic control of patients in critical areas...
January 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/27979790/a-diabetes-self-management-program-12-month-outcome-sustainability-from-a-nonreinforced-pragmatic-trial
#19
Kate Lorig, Philip L Ritter, Ralph M Turner, Kathleen English, Diana D Laurent, Jay Greenberg
BACKGROUND: Diabetes self-management education has been shown to be effective in controlled trials. The 6-week Better Choices, Better Health-Diabetes (BCBH-D) self-management program was also associated with an improvement in health outcomes in a 6-month translation study. OBJECTIVE: The objective of this study was to determine whether a national translation of the BCBH-D self-management program, offered both Web-based and face-to-face, was associated with improvements in health outcomes (including HbA1c) and health behaviors (including recommended medical tests) 1 year after intervention...
December 15, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27967230/pathophysiology-and-management-of-hypoglycemia-in-end-stage-renal-disease-patients-a-review
#20
Roma Y Gianchandani, Shristi Neupane, Jennifer J Iyengar, Michael Heung
OBJECTIVE: This review focuses on hypoglycemia in patients with end stage renal disease (ESRD). It discusses pathophysiology of glucose metabolism in the kidney, the impact of dialysis on glucose and insulin metabolism and the challenges of glucose monitoring in ESRD. The clinical relevance of these changes are reviewed in relation to altered blood glucose targets and modification of antidiabetes therapy to prevent hypoglycemia. Based on current data and guidelines, recommendations for the outpatient and inpatient setting are provided for diabetes management in ESRD...
December 14, 2016: Endocrine Practice
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