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Hypoglycemia and management

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https://www.readbyqxmd.com/read/28319006/high-rates-of-severe-hypoglycemia-among-african-american-patients-with-diabetes-the-surveillance-prevention-and-management-of-diabetes-mellitus-supreme-dm-network
#1
Andrew J Karter, Kasia J Lipska, Patrick J O'Connor, Jennifer Y Liu, Howard H Moffet, Emily B Schroeder, Jean M Lawrence, Gregory A Nichols, Katherine M Newton, Ram D Pathak, Jay Desai, Beth Waitzfelder, Melissa G Butler, Abraham Thomas, John F Steiner
AIMS: Seven-year surveillance study (2005-2011) to evaluate race/ethnic differences in the trends in rates of severe hypoglycemia (SH) in a population of insured, at-risk adults with diabetes. METHODS: SH events were identified via any primary or principal diagnosis from emergency department or inpatient encounters among African American, Asian, Latino and White adult diabetes patients treated with insulin or secretagogues (Sulfonylureas or Meglitinides), receiving care from integrated healthcare delivery systems across the United States...
February 21, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28318091/insulin-responsive-glucagon-delivery-for-prevention-of-hypoglycemia
#2
Jicheng Yu, Yuqi Zhang, Wujin Sun, Anna R Kahkoska, Jinqiang Wang, John B Buse, Zhen Gu
Hypoglycemia, the state of abnormally low blood glucose level, is an acute complication of insulin and sulfonylurea therapy in diabetes management. Frequent insulin dosing and boluses during daily diabetes care leads to an increased risk of dangerously low glucose levels, which can cause behavioral and cognitive disturbance, seizure, coma, and even death. This study reports an insulin-responsive glucagon delivery method based on a microneedle (MN)-array patch for the prevention of hypoglycemia. The controlled release of glucagon is achieved in response to elevated insulin concentration by taking advantage of the specific interaction between insulin aptamer and target insulin...
March 20, 2017: Small
https://www.readbyqxmd.com/read/28298900/the-impact-of-bariatric-surgery-on-type-2-diabetes-mellitus-and-the-management-of-hypoglycemic-events
#3
REVIEW
Mahmoud Attia Mohamed Kassem, Michael Andrew Durda, Nicoleta Stoicea, Omer Cavus, Levent Sahin, Barbara Rogers
Recent studies discussed the benefit of bariatric surgery on obese patients diagnosed with type 2 diabetes mellitus (T2DM). Several factors play an essential role in predicting the impact of bariatric surgery on T2DM, such as ABCD score (age, BMI, C-peptide, and duration of the disease), HbA1c, and fasting blood glucose, incretins [glucagon-like peptide-1 (GLP-1) and gastric inhibitory peptide (GIP)]. DiaRem score known to include factors such as age, HbA1c, medication, and insulin usage used to predict the remission of T2DM, but it has some limitations...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28290224/inpatient-continuous-glucose-monitoring-and-glycemic-outcomes
#4
David L Levitt, Kristi D Silver, Elias K Spanakis
Continuous glucose monitoring (CGM) is commonly used in the outpatient setting to improve diabetes management. CGM can provide real-time glucose trends, detecting hyperglycemia and hypoglycemia before the onset of clinical symptoms. In 2011, at the time the Endocrine Society CGM guidelines were published, the society did not recommend inpatient CGM as its efficacy and safety were unknown. While many studies have subsequently evaluated inpatient CGM accuracy and reliability, glycemic outcome studies have not been widely published...
March 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28289908/why-should-people-with-type-1-diabetes-exercise-regularly
#5
Roberto Codella, Ileana Terruzzi, Livio Luzi
Plethoric evidence reminds of the protective effects of exercise against a number of health risks, across all ages, in the general population. The benefits of exercise for individuals with type 2 diabetes are indisputable. An in-depth understanding of energy metabolism has reasonably entailed exercise as a cornerstone in the lifestyle of almost all subjects with type 1 diabetes. Nevertheless, individuals with type 1 diabetes often fail in accomplishing exercise guidelines and they are less active than their peer without diabetes...
March 14, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/28286340/intensive-gestational-glycemic-management-and-childhood-obesity-a-systematic-review-and-meta-analysis
#6
REVIEW
L Guillemette, A Durksen, R Rabbani, R Zarychanski, A M Abou-Setta, T A Duhamel, J M McGavock, B Wicklow
BACKGROUND AND OBJECTIVES: Hyperglycemia in pregnancy is associated with increased risk of offspring childhood obesity. Treatment reduces macrosomia, however it is unclear if this effect translates into a reduced risk of childhood obesity. We performed a systematic review and meta-analysis of randomized controlled trials to evaluate the efficacy and safety of intensive glycemic management in pregnancy in preventing childhood obesity. METHODS: We searched MEDLINE, EMBASE, CENTRAL, and ClinicalTrials...
March 13, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28285645/treatment-of-reactive-hypoglycemia-with-the-macrobiotic-ma-pi-2-diet-as-assessed-by-continuous-glucose-monitoring-the-mahyp-randomized-crossover-trial
#7
Andreea Soare, Yeganeh Manon Khazrai, Lucia Fontana, Rossella Del Toro, Maria Concetta Lazzaro, Claudia Di Rosa, Antonia Buldo, Elvira Fioriti, Ernesto Maddaloni, Silvia Angeletti, Antonio Di Mauro, Rosaria Gesuita, Edlira Skrami, Dario Tuccinardi, Sara Fallucca, Mario Pianesi, Paolo Pozzilli
BACKGROUND AND AIMS: Nutritional therapy is recommended for management of reactive hypoglycemia (RH), a condition characterized by hypoglycemia that occurs within four hours after a meal. The macrobiotic Ma-Pi 2 diet improves glycemic control in subjects with type 2 diabetes. We explored the effect of this diet on outcomes in non-diabetic individuals with RH. MATERIALS AND METHODS: Twelve subjects with RH were randomized to the Ma-Pi 2 diet for three days and a control diet for three days in a randomized crossover design...
April 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28270713/empowerment-based-diabetes-self-management-education-to-maintain-glycemic-targets-during-ramadan-fasting-in-people-with-diabetes-who-are-on-conventional-insulin-a-feasibility-study
#8
Yara M Eid, Sahar I Sahmoud, Mona M Abdelsalam, Barbara Eichorst
OBJECTIVE: This study aims to assess the feasibility of promoting safe Ramadan fasting through diabetes self-management education (DSME) and to determine the effect of such education on hypoglycemic episodes. DESIGN AND METHODS: This prospective study included subjects attending Ramadan reinforcement sessions for participants in the Educational Program for People with Diabetes (EPPWD) at the Ain-Shams University Diabetes Center in Cairo, Egypt. The DSME sessions started 2-3 weeks before Ramadan and included one experimental fasting day during the first week and one during the second week...
February 2017: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/28270712/perceptions-of-adolescent-patients-of-the-lived-experience-of-type-1-diabetes
#9
Kathryn M King, Philip J King, Rahul Nayar, Scott Wilkes
The care and management of adolescents with type 1 diabetes presents numerous challenges that are inherent to the fears, attitudes, and perceptions of their illness. This qualitative study aimed to explore the "lived experience" of individuals with type 1 diabetes. In-depth interviews were conducted with 20 patients diagnosed with type 1 diabetes in their adolescent years to elicit their views, perceptions, and concerns regarding living with diabetes. All interviews were conducted and analyzed using the principles of grounded theory...
February 2017: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/28262472/the-role-of-sodium-glucose-cotransporter-2-inhibitors-in-the-management-of-type-2-diabetes
#10
REVIEW
Oren Steen, Ronald M Goldenberg
Sodium-glucose cotransporter 2 (SGTL2) inhibitors are a novel class of antihyperglycemic agents that work in an insulin-independent manner by promoting urinary glucose excretion. In addition to efficacious glucose lowering, they exert beneficial effects on blood pressure and weight while avoiding hypoglycemia unless combined with insulin or insulin secretagogues. This review explores the mechanism of action of SGLT2 inhibitors, their effects on glycated hemoglobin, weight, blood pressure and hypoglycemia, potential adverse effects, renal considerations and cardiovascular outcomes...
March 3, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28257639/management-and-long-term-evolution-of-a-patient-with-3-hydroxy-3-methylglutaryl-coenzyme-a-lyase-deficiency
#11
Juan Ignacio Muñoz-Bonet, María Del Carmen Ortega-Sánchez, José Luis León Guijarro
BACKGROUND: 3-Hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) lyase deficiency is a rare inborn error of metabolism characterized by recurrent metabolic crises caused by fasting, intercurrent illness and excessive physical exercise. Non ketotic hypoglycemia is normally the cause of primary symptoms but without an immediate treatment the illness can evolve into a worsening metabolic state resembling the Reye's syndrome that may cause the patient's death. We report a case with some clinical and therapeutic features not previously described...
January 19, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28256487/macrosomic-births-in-abuja-a-case-control-study-of-predisposing-factors-and-early-neonatal-outcome
#12
R N Akindele, L I Audu, O A Mokuolu
BACKGROUND: Although research has shown that having a macrosomic fetus could be predictive of a negative pregnancy outcome, the factors that control its incidence and the outcome of delivery management have been less well characterized in Africa. The aim of this study was to identify specific predispositions and the factors that influence the early neonatal outcome of macrosomic infants in Abuja. METHODS: Data from 120 mother and macrosomic (weighing ≥4000 g) newborn pairs, and an equal number of mother and normal weight (2500-3999 g) matched controls, delivered over a 5-month period at three large hospitals in Abuja, Nigeria, were analyzed...
March 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28256481/spectrum-and-outcome-of-neonatal-emergencies-seen-in-a-free-health-care-program-in-south-western-nigeria
#13
M T Abiodun, R O Oluwafemi
BACKGROUND: Neonatal emergencies contribute significantly to under-five morbidity and mortality in developing countries, partly due to poverty and limited access to quality healthcare in rural communities. AIMS: The aim is to evaluate the spectrum, outcome, case fatality rates (CFRs), and prognostic factors of neonatal emergencies seen in the two free health-care facilities in Ondo State. METHODS: This was a cross-sectional descriptive study of neonatal emergencies...
March 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28251898/pituitary-stalk-interruption-syndrome-a-rare-and-severe-cause-of-pituitary-deficiency-laboratory-diagnosis-of-a-newborn-case
#14
Thomas Boueilh, Corentin Bassi, Stéphanie Rouleau, Sébastien Le Crugel, Valérie Moal, Florence Boux de Casson, Régis Coutant, Delphine Mirebeau-Prunier, Pascal Reynier, Chadi Homedan
We report the case of a newborn with neonatal hypotonia associated to a micropenis and a bilateral cryptorchidia. The discovery of severe hypoglycemia at 0.22 mmol/L led to further biological investigations that revealed sharply decreased levels of several hypophyseal hormones. Altered corticotropic, somatotropic, thyreotropic, and gonadotropic axes finally suggested congenital hypophyseal insufficiency. This diagnostic was confirmed by a brain MRI (magnectic resonance imaging), which revealed a total interruption of the pituitary stalk...
March 1, 2017: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/28248127/a-pediatric-intensive-care-unit-bedside-computer-clinical-decision-support-protocol-for-hyperglycemia-is-feasible-safe-and-offers-advantages
#15
Eliotte L Hirshberg, Michael J Lanspa, Emily L Wilson, Katherine A Sward, Al Jephson, Gitte Y Larsen, Alan H Morris
BACKGROUND: Computer clinical decision support (CDS) systems are uncommon in the pediatric intensive care unit (PICU), despite evidence suggesting they improve outcomes in adult ICUs. We reasoned that a bedside CDS protocol for intravenous insulin titration, eProtocol-insulin, would be feasible and safe in critically ill children. METHODS: We retrospectively reviewed data from non-diabetic children admitted to the PICU with blood glucose (BG) ≥140 mg/dL who were managed with intravenous insulin by either unaided clinician titration or eProtocol-insulin...
March 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28245189/the-variable-clinical-phenotype-of-three-patients-with-hepatic-glycogen-synthase-deficiency
#16
Çiğdem Seher Kasapkara, Zehra Aycan, Esma Açoğlu, Saliha Senel, Melek Melahat Oguz, Serdar Ceylaner
BACKGROUND: Glycogen synthase deficiency, also known as glycogenosis (GSD) type 0 is an inborn error of glycogen metabolism caused by mutations in the GYS2 gene, which is transmitted in an autosomal recessive trait. It is a rare form of hepatic glycogen storage disease with less than 30 cases reported in the literature so far. The disorder is characterized by fasting hyperketotic hypoglycemia without hyperalaninemia or hyperlactacidemia. It is a glycogenosis with lack of liver glycogen synthesis, therefore hepatomegaly is not observed in patients with glycogen synthase deficiency...
February 28, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28236664/review-of-insulin-associated-hypoglycemia-and-its-impact-on-the-management-of-diabetes-in-south-east-asian-countries
#17
REVIEW
Su-Yen Goh, Zanariah Hussein, Achmad Rudijanto
Although the incidence of diabetes is rising in South East Asia, there is limited information regarding the incidence and manifestation of insulin-associated hypoglycemia. The aim of this review is to discuss what is currently known regarding insulin-associated hypoglycemia in South East Asia, including its known incidence and impact in the region, and how the South East Asian population with diabetes differs from other populations. We found a paucity of data regarding the incidence of hypoglycemia in South East Asia that has contributed to the adoption of Western guidelines...
February 25, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28228574/delays-in-door-to-needle-times-and-their-impact-on-treatment-time-and-outcomes-in-get-with-the-guidelines-stroke
#18
Noreen Kamal, Shubin Sheng, Ying Xian, Roland Matsouaka, Michael D Hill, Deepak L Bhatt, Jeffrey L Saver, Mathew J Reeves, Gregg C Fonarow, Lee H Schwamm, Eric E Smith
BACKGROUND AND PURPOSE: Despite quality improvement programs such as the American Heart Association/American Stroke Association Target Stroke initiative, a substantial portion of acute ischemic stroke patients are still treated with tissue-type plasminogen activator (alteplase) later than 60 minutes from arrival. This study aims to describe the documented reasons for delays and the associations between reasons for delays and patient outcomes. METHODS: We analyzed the characteristics of 55 296 patients who received intravenous alteplase in 1422 hospitals participating in Get With The Guidelines-Stroke from October 2012 to April 2015, excluding transferred patients and inpatient strokes...
February 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28225432/use-of-dipeptidyl-peptidase-4-inhibitors-in-patients-with-type-2-diabetes-and-chronic-kidney-disease
#19
Polly A Bittle
There is a need for treatment options in patients with type 2 diabetes mellitus and kidney disease to achieve glucose targets without risk of hypoglycemia. This article describes management options for these patients using glucose-lowering therapies, in particular dipeptidyl peptidase-4 inhibitors.
February 20, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28224463/liraglutide-versus-lixisenatide-long-term-cost-effectiveness-of-glp-1-receptor-agonist-therapy-for-the-treatment-of-type-2-diabetes-in-spain
#20
Pedro Mezquita-Raya, Antonio Ramírez de Arellano, Nana Kragh, Gabriela Vega-Hernandez, Johannes Pöhlmann, William J Valentine, Barnaby Hunt
INTRODUCTION: Glucagon-like peptide-1 (GLP-1) receptor agonists are used successfully in the treatment of patients with type 2 diabetes as they are associated with low hypoglycemia rates, weight loss and improved glycemic control. This study compared, in the Spanish setting, the cost-effectiveness of liraglutide 1.8 mg versus lixisenatide 20 μg, both GLP-1 receptor agonists, for patients with type 2 diabetes who had not achieved glycemic control targets on metformin monotherapy. METHODS: The IMS CORE Diabetes Model was used to project clinical outcomes and costs, expressed in 2015 Euros, over patient lifetimes...
February 21, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
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