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https://www.readbyqxmd.com/read/28650702/a-case-report-of-methadone-associated-hypoglycemia-in-an-11-month-old-male
#1
Michael S Toce, Margaret A Stefater, David T Breault, Michele M Burns
BACKGROUND: Methadone is a synthetic μ-opioid receptor agonist that is used in the management of pain, neonatal abstinence withdrawal syndrome, and opioid dependence. Overdose can cause miosis, respiratory depression, and central nervous system depression. Rarely, hypoglycemia has been reported. We present the case of an 11-month-old male who developed hypoketotic, hyperinsulinemic, hypoglycemia after an acute, unintentional methadone exposure. CASE DETAILS: The patient was a previously healthy 11-month-old male who presented in respiratory failure...
June 26, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28650348/an-update-on-type-2-diabetes-management-in-primary-care
#2
Jeffrey Waddell
Diabetes mellitus is a chronic disease impacting glucose metabolism. Type 2 diabetes mellitus (T2DM) stems from the inability of the body to utilize endogenous insulin properly. Approximately 90% to 95% of newly diagnosed cases of diabetes are T2DM. This article focuses on the initial treatment of T2DM based on the 2017 American Association of Clinical Endocrinologists and the American College of Endocrinology clinical practice guidelines. The 2017 update includes changes and additions regarding psychosocial management, physical activity, surgery, and hypoglycemia...
June 22, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28649085/a-novel-heterozygous-igf-1-receptor-mutation-associated-with-hypoglycemia
#3
Ravid Solomon-Zemler, Lina Basel-Vanagaite, David Steier, Shoashana Yakar, Eran Mel, Moshe Phillip, Lily Bazak, Danni Bercovich, Haim Werner, Liat de Vries
Mutation in the insulin-like growth factor-1 receptor (IGF1R) gene is a rare cause for intrauterine and postnatal growth disorders. Patients identified with IGF1R mutations present with either normal or impaired glucose tolerance. None of the cases described so far showed hypoglycemia. We aimed to identify the genetic basis for small for gestational age, short stature and hypoglycemia over three generations in one family. The proband, a 9-year-old male presented in infancy with recurrent hypoglycemic episodes, symmetric intrauterine growth retardation and postnatal growth retardation...
June 25, 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28648856/presentations-for-hypoglycemia-associated-with-diabetes-mellitus-to-emergency-departments-in-a-canadian-province-a-database-and-epidemiological-analysis
#4
Chris J Alexiu, Anderson Chuck, Susan E Jelinski, Brian H Rowe
AIMS: The prevalence of diabetes mellitus was reportedly 9% in 2014, making it one of the most common global chronic conditions. Hypoglycemia is an important complication of diabetes treatment. The objective of this study was to quantify and characterize hypoglycemia presentations associated with type 1 or 2 diabetes made to emergency departments (EDs) by adults in a Canadian province. METHODS: A retrospective cohort study was conducted using reliable administrative data from Alberta for a five-year period (2010/11-2014/15)...
March 11, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28648642/hpi-amf-inhibition-halts-the-development-of-the-aggressive-phenotype-of-breast-cancer-stem-cells
#5
Juan Carlos Gallardo-Pérez, Alhelí Adán-Ladrón de Guevara, Alvaro Marín-Hernández, Rafael Moreno-Sánchez, Sara Rodríguez-Enríquez
Cancer stem cells are responsible for tumor recurrence and metastasis. A new highly reproducible procedure for human breast cancer MCF-7 stem cells (BCSC) isolation and selection was developed by using a combination of hypoxia/hypoglycemia plus taxol and adriamycin for 24h. The BCSC enriched fraction (i) expressed (2-15 times) the typical stemness protein markers CD44+, ALDH1A3 and Oct 3/4; (ii) increased its clonogenicity index (20-times), invasiveness profile (>70%), migration capacity (100%) and ability to form mammospheres, compared to its non-metastatic MCF-7 counterpart...
June 22, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28648013/-retrospective-analysis-of-anesthetic-and-perioperative-management-in-patients-of-acute-fatty-liver-of-pregnancy
#6
Y Y Qu, H Zeng, X Y Guo, M Li
Objective: To retrospectively analyze the clinical characteristics of patients with acute fatty liver of pregnancy (AFLP), and to discuss perioperative and anesthetic management. Methods: A retrospective review was conducted on the records of pregnant patients with a diagnosis of acute fatty liver of pregnancy in Peking University Third Hospital from January 2007 to December 2015. 12 cases were identified. The clinical features, preoperative laboratory findings, types of delivery, anesthetic techniques for cesarean section, and the outcomes of parturients and fetus were collected and analyzed...
June 27, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28647947/continuous-glucose-monitoring-in-pediatrics-the-gap-between-potential-benefits-and-the-reality-of-utility
#7
Regina L Taddeo, Joanne T Moser, Pantea P Minnock
Continuous Glucose Monitoring (CGM) is rapidly becoming a standard of care in the management of Type 1 diabetes (T1D). Today's devices are nearly as accurate as home glucose meters. They provide glucose data every 5 minutes, alert to high and low blood glucose levels, and allow for remote monitoring of a user's glucose data and patterns. Use of CGM has many benefits including support for tighter glycemic control without increasing the risk for hypoglycemia. There is however emerging evidence of some negative aspects associated with using CGM, which may result in decreased utilization of the device as well as a decline in quality of life, especially in the pediatric population...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28645517/glucose-control-diabetes-status-and-mortality-in-critically-ill-patients-the-continuum-from-intensive-care-unit-admission-to-hospital-discharge
#8
James S Krinsley, Paula Maurer, Sharon Holewinski, Roy Hayes, Douglas McComsey, Guillermo E Umpierrez, Stanley A Nasraway
OBJECTIVE: To describe the relationships among glycemic control, diabetes mellitus (DM) status, and mortality in critically ill patients from intensive care unit (ICU) admission to hospital discharge. PATIENTS AND METHODS: This is a retrospective investigation of 6387 ICU patients with 5 or more blood glucose (BG) tests and 4462 ICU survivors admitted to 2 academic medical centers from July 1, 2010, through December 31, 2014. We studied the relationships among mean BG level, hypoglycemia (BG level <70 mg/dL [to convert to mmol/L, multiply by 0...
June 7, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28645216/iglarlixi-a-fixed-ratio-combination-of-insulin-glargine-100-u-ml-and-lixisenatide-for-the-treatment-of-type-2-diabetes
#9
Jennifer Goldman, Jennifer M Trujillo
OBJECTIVE: To review the safety and efficacy of iGlarLixi, a titratable fixed-ratio combination of insulin glargine 100 U/mL (iGlar) and lixisenatide, a glucagon-like peptide-1 receptor agonist. DATA SOURCES: A literature search of MEDLINE for all English-language primary articles through June 2016, using the terms LixiLan, iGlarLixi and insulin glargine and lixisenatide, and a search of abstracts presented at the 2016 Scientific Sessions of the American Diabetes Association were performed...
June 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28643218/empagliflozin-improves-left-ventricular-diastolic-dysfunction-in-a-genetic-model-of-type-2-diabetes
#10
Nadjib Hammoudi, Dongtak Jeong, Rajvir Singh, Ahmed Farhat, Michel Komajda, Eric Mayoux, Roger Hajjar, Djamel Lebeche
PURPOSE: Cardiovascular (CV) diseases in type 2 diabetes (T2DM) represent an enormous burden with high mortality and morbidity. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have recently emerged as a new antidiabetic class that improves glucose control, as well as body weight and blood pressure with no increased risk of hypoglycemia. The first CV outcome study terminated with empagliflozin, a specific SGLT2 inhibitor, has shown a reduction in CV mortality and in heart failure hospitalization, suggesting a beneficial impact on cardiac function which remains to be demonstrated...
June 22, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28642988/development-of-pulmonary-hypertension-during-treatment-with-diazoxide-a-case-series-and-literature-review
#11
Matthew R Timlin, Alexander B Black, Heather M Delaney, Renée I Matos, Candace S Percival
Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in infancy. The mainstay of medical management for CHI is diazoxide. Diazoxide inhibits insulin release from the pancreas, but also causes smooth muscle relaxation and fluid retention so it is typically given with chlorothiazide. In July 2015, the FDA issued a drug safety communication warning that pulmonary hypertension (PH) had been reported in 11 infants being treated with diazoxide and that the PH resolved with withdrawal of diazoxide...
June 22, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28641035/hypoglycemia-patients-and-transport-by-ems-in-alameda-county-2013-15
#12
Howard H Moffet, E Margaret Warton, Lee Siegel, Karl Sporer, Kasia J Lipska, Andrew J Karter
OBJECTIVE: To estimate the rate, characteristics, and dispositions of hypoglycemia events among persons who received care from Alameda County, California, Emergency Medical Services (EMS). METHODS: This study was based on data for 601,077 Alameda County EMS encounters during 2013-15. Subjects were defined as having hypoglycemia if EMS personnel recorded a primary impression of hypoglycemia or low blood glucose (<60 mg/dl or "unspecified low"). The outcome of interest was patient transport or non-transport to an emergency department or other care setting; we excluded 33,177 (6%) encounters which lacked clear disposition outcomes...
June 22, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28640135/hospitalization-with-hypoglycemia-in-patients-without-diabetes-mellitus-a-retrospective-study-using-a-national-inpatient-database-in-japan-2008-2012
#13
Akahito Sako, Hideo Yasunaga, Hiroki Matsui, Kiyohide Fushimi, Hidetaka Hamasaki, Hisayuki Katsuyama, Tetsuro Tsujimoto, Atsushi Goto, Hidekatsu Yanai
We aimed to examine prevalence, patient characteristics, etiology, and clinical outcomes of hospitalized patients who had hypoglycemia without a diagnosis of diabetes mellitus, using a Japanese nationwide database.This was a retrospective observational study using a national database of acute-care inpatients in Japan. Nondiabetic patients aged ≥15 years who were hospitalized for hypoglycemia were eligible. We estimated the annual numbers of hospitalized cases in Japan. We also investigated the patient characteristics, and risk factors of in-hospital mortality...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639760/-euglycemic-ketoacidosis-a-complication-of-sglt2-inhibitors
#14
Aki Mizuno, Sanaz Lolachi, Alain Pernet
Sodium-glucose cotransporter 2 (SGLT2) inhibitors constitute a new category of oral antidiabetics recently indicated for the treatment of type 2 diabetes. Their mechanism of action (inhibition of renal reabsorption of glucose) and the fact that they do not induce hypoglycemia (as monotherapy) make their clinical use interesting. Various adverse events have however been reported regarding these drugs with the euglycemic ketoacidosis being the most serious. In this article we aim to review the possible mechanism of this side effect and recommendations for use of SGLT2 inhibitors by means of a case report...
May 31, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28639756/-value-of-continuous-glucose-monitoring-in-type-2-diabetic-patients
#15
Antonella Corcillo, Sylvie Girardin, Magali Andrey, Olivier Le Dizès, François R Jornayvaz
Management of type 1 and type 2 diabetes mellitus is getting complex with the apparition of new treatments, but also new technologies. Among these, continuous glucose monitoring systems (CGMS) lead to a better glycemic control and less hypoglycemia in type 1 diabetic patients. Studies are scarce in type 2 diabetes but also seem to show a benefit, particularly in patients using insulin. Nevertheless, type 2 diabetic patients taking advantage of CGMS must be better defined. In any case, a multidisciplinary approach to the use of CGMS and interpretation of data is warranted...
May 31, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28637358/comparative-simulation-study-of-glucose-control-methods-designed-for-use-in-the-intensive-care-unit-setting-via-a-novel-controller-scoring-metric
#16
Jeremy DeJournett, Leon DeJournett
BACKGROUND: Effective glucose control in the intensive care unit (ICU) setting has the potential to decrease morbidity and mortality rates and thereby decrease health care expenditures. To evaluate what constitutes effective glucose control, typically several metrics are reported, including time in range, time in mild and severe hypoglycemia, coefficient of variation, and others. To date, there is no one metric that combines all of these individual metrics to give a number indicative of overall performance...
June 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28635331/network-meta-analysis-of-liraglutide-versus-dpp-4-inhibitors-for-the-treatment-of-type-2-diabetes-in-japanese-patients
#17
Dieter Ayers, Steve Kanters, Rachel Goldgrub, Monica Hughes, Ryo Kato, Nana Kragh
AIMS: To determine the comparative efficacy and safety of liraglutide and dipeptidyl peptidiase-4 (DPP-4) inhibitors as antidiabetics for Japanese patients with uncontrolled type 2 diabetes (T2DM). METHODS AND MATERIALS: We searched for randomized-controlled trials (RCTs) evaluating outcomes among Japanese adults with uncontrolled T2DM and including liraglutide or DPP-4 inhibitors up to August 2016. We extracted data on trial and patient characteristics, and the following outcomes: HbA1c, weight, patients meeting HbA1c <7%, patients experiencing hypoglycemic events, microalbuminuria, estimated glomerular filtration rate (eGFR) and creatinine...
June 21, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28634852/incidence-of-prolonged-qtc-and-severe-hypoglycemia-in-type-1-diabetes-the-eurodiab-prospective-complications-study
#18
Cristina Amione, Sara Giunti, Paolo Fornengo, Sabita S Soedamah-Muthu, Nish Chaturvedi, J H Fuller, Federica Barutta, Gabriella Gruden, Graziella Bruno
AIMS: To assess the independent role of severe hypoglycemia on 7-year cumulative incidence of prolonged QTc in a large cohort of patients with type 1 diabetes. METHODS: People with type 1 diabetes recruited by the EURODIAB Prospective Complications Study who had normal QTc were examined at baseline and after 7 years with standardized methods (n = 1415; mean age ± SD 32.1 ± 9.6 years; diabetes duration 14.2 ± 8.8 years). Hypoglycemic episodes were assessed by a questionnaire...
June 20, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/28633556/oxidative-stress-and-dna-damage-in-newborns-born-to-mothers-with-hyperglycemia-%C3%A2-a-prospective-cohort-study
#19
K Dulasi Durga, B Adhisivam, G Vidya, B Vishnu Bhat, Bobby Zachariahc, Chand Parkashd
BACKGROUND: Hyperglycemic mothers have increased oxidative stress during pregnancy which can adversely affect the outcome in their neonates Objectives: To measure the oxidative stress and DNA damage in newborns born to mothers with hyperglycemia and correlate their immediate outcome with the amount of oxidative stress and DNA damage. METHODS: This prospective cohort study conducted in a tertiary care teaching hospital, south India included 3 groups - newborns born to pregestational diabetic mothers (PGDM), gestational diabetic mothers (GDM) and euglycemic mothers with 24 newborns in each...
June 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28633537/extensive-assessment-of-blood-glucose-monitoring-during-postprandial-period-and-its-impact-on-closed-loop-performance
#20
Lyvia Biagi, Arthur Hirata Bertachi, Ignacio Conget, Carmen Quirós, Marga Giménez, F Javier Ampudia-Blasco, Paolo Rossetti, Jorge Bondia, Josep Vehí
BACKGROUND: Closed-loop (CL) systems aims to outperform usual treatments in blood glucose control and continuous glucose monitors (CGM) are a key component in such systems. Meals represents one of the main disturbances in blood glucose control, and postprandial period (PP) is a challenging situation for both CL system and CGM accuracy. METHODS: We performed an extensive analysis of sensor's performance by numerical accuracy and precision during PP, as well as its influence in blood glucose control under CL therapy...
June 1, 2017: Journal of Diabetes Science and Technology
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