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hypoglycemia unawareness

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https://www.readbyqxmd.com/read/28888148/hypoglycemia-awareness-among-insulin-treated-patients-with-diabetes-in-malaysia-a-cohort-subanalysis-of-the-hat-study
#1
Zanariah Hussein, Nor Azmi Kamaruddin, Siew Pheng Chan, Anand Jain, Shweta Uppal, Wan Mohamad Wan Bebakar
AIMS: The present Malaysian cohort analysis determined the prevalence of hypoglycemia among patients with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) attending primary care- or hospital-based diabetes clinics in Malaysia and their awareness of the symptoms of hypoglycemia. METHODS: The Hypoglycemia Assessment Tool (HAT) study was a non-interventional, 6-month retrospective and 4-week prospective analysis of hypoglycemic events in 24 countries, using self-assessment questionnaires and diaries among patients with T1DM/T2DM aged ≥18years, using insulin for >12months...
August 14, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28796932/factors-associated-with-greater-benefit-of-a-national-reimbursement-policy-for-blood-glucose-test-strips-in-adult-patients-with-type-1-diabetes-a-prospective-cohort-study
#2
Sang-Man Jin, Jong Ha Baek, Sunghwan Suh, Chang Hee Jung, Woo Je Lee, Cheol-Young Park, Hae Kyung Yang, Jae Hyoung Cho, Byung-Wan Lee, Jae Hyeon Kim
AIMS/INTRODUCTION: We aimed to identify factors independently associated with greater benefit of a national reimbursement policy for blood glucose test strips in adult patients with type 1 diabetes (T1DM), in terms of glycemic control and rate of severe hypoglycemia. MATERIALS AND METHODS: This was a prospective cohort study of 466 adult patients with T1DM from five tertiary referral hospitals who registered for a national reimbursement program for blood glucose strips and were then followed-up for 12 months...
August 10, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28719066/insights-into-optimal-basal-insulin-titration-in-type-2-diabetes-results-of-a-quantitative-survey
#3
Lori Berard, Mireille Bonnemaire, Marie Mical, Steve Edelman
AIMS: Basal insulin (BI) treatment initiation and dose titration in type 2 diabetes (T2DM) are often delayed. Such "clinical inertia" results in poor glycemic control and high risk of long-term complications. This survey aimed to determine healthcare professional (HCP) and patient attitudes to BI initiation and titration. METHODS: An online survey (July-August 2015) including HCPs and patients with T2DM in the USA, France and Germany. Patients were ≥18 years old and had been on BI for 6-36 months, or discontinued BI within the previous 12 months...
July 18, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28683068/prediction-of-nocturnal-hypoglycemia-unawareness-by-fasting-glucose-levels-or-post-breakfast-glucose-fluctuations-in-patients-with-type-1-diabetes-receiving-insulin-degludec-a-pilot-study
#4
Hiroshi Takahashi, Rimei Nishimura, Yoshiko Onda, Kiyotaka Ando, Daisuke Tsujino, Kazunori Utsunomiya
OBJECTIVE: To evaluate whether nocturnal asymptomatic hypoglycemia (NAH) can be predicted by fasting glucose levels or post-breakfast glucose fluctuations in patients with type 1 diabetes (T1D) receiving insulin degludec. METHODS: Patients with T1D receiving insulin degludec underwent at-home CGM assessments. Indices for glycemic variability before and after breakfast included fasting glucose levels and the range of post-breakfast glucose elevation. For comparison, the patients were classified into those with NAH and those without...
2017: PloS One
https://www.readbyqxmd.com/read/28632818/benefits-of-islet-transplantation-as-an-alternative-to-pancreas-transplantation-retrospective-study-of-more-than-10-ten-years-of-experience-in-a-single-center
#5
Barbora Voglová, Martina Zahradnická, Peter Girman, Jan Kríž, Zuzana Berková, Tomáš Koblas, Ema Vávrová, Lenka Németová, Lucie Kosinová, David Habart, Eva Fábryová, Eva Dovolilová, Ivan Leontovyc, Tomáš Neškudla, Jan Peregrin, Jozef Kovác, Kvetoslav Lipár, Matej Kocík, Tomáš Marada, Jirí Svoboda, František Saudek
BACKGROUND: Pancreas transplantation (PTx) represents the method of choice in type 1 diabetic patients with conservatively intractable hypoglycemia unawareness syndrome. In 2005, the Institute for Clinical and Experimental Medicine (IKEM) launched a program to investigate the safety potential of islet transplantation (ITx) in comparison to PTx. AIM: This study aims to compare the results of PTx and ITx regarding severe hypoglycemia elimination, metabolic control, and complication rate...
2017: Review of Diabetic Studies: RDS
https://www.readbyqxmd.com/read/28589447/cognitive-neurophysiologic-and-metabolic-sequelae-of-previous-hypoglycemic-coma-revealed-by-hyperinsulinemic-hypoglycemic-clamp-in-type-1-diabetic-patients
#6
Alberto Maran, Cristina Crepaldi, Franco Del Piccolo, Ian Macdonald, Lisa Zarantonello, Angelo Avogaro, Piero Amodio
To examine the relationship between electroencephalographic (EEG) activity and hypoglycemia unawareness, we investigated early parameters of vigilance and awareness of various symptom categories in response to hypoglycemia in intensively treated type 1 diabetic (T1DM) patients with different degrees of hypoglycemia unawareness. Hypoglycemia was induced with a hyperinsulinemic-hypoglycemic clamp in six T1DM patients with a history of hypoglycemia unawareness previous severe hypoglycemic coma (SH) and in six T1DM patients without (C) history of hypoglycemia unawareness previous severe hypoglycemic coma...
June 6, 2017: Metabolic Brain Disease
https://www.readbyqxmd.com/read/28466634/update-on-pancreatic-transplantation-on-the-management-of-diabetes
#7
REVIEW
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, posturemic patients (following successful kidney transplantation), and non-uremic patients...
October 2017: Minerva Medica
https://www.readbyqxmd.com/read/28376647/real-time-continuous-glucose-monitoring-facilitates-feelings-of-safety-in-older-adults-with-type-1-diabetes-a-qualitative-study
#8
Michelle L Litchman, Nancy A Allen
BACKGROUND: Older adults with long-standing type 1 diabetes (T1D) have a higher risk for hypoglycemia and hypoglycemia unawareness. Hypoglycemia can be dangerous, even fatal. Real-time continuous glucose monitoring (RT-CGM) effectively supports diabetes management and well-being in adult and pediatric populations. Little is known about older adults and RT-CGM use. The purpose of this study was to identify why RT-CGM was important for diabetes management in individuals with T1D 65 years of age...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28201960/hypoglycemia-and-glucocorticoid-free-immunosuppression-are-related-with-low-dehydroepiandrosterone-sulfate-level
#9
Martina Zahradnicka, Frantisek Saudek, Kvetoslav Lipar, Jelena Skibova
BACKGROUND: Low dehydroepiandrosterone sulfate (DHEAS) levels and a high cortisol/DHEAS ratio are associated with higher mortality in elderly, dialyzed, and immunocompromised patients. The role of these hormones in patients with hypoglycemia unawareness (hypo) or in pancreas or islet recipients treated by glucocorticoid-free immunosuppressive regimen (IS) has not been studied. OBJECTIVE: The aim of this study was to determine the effects of IS and of recurrent hypoglycemia on DHEAS and adrenocorticotropic hormone (ACTH) levels in patients with type-1 diabetes (T1DM)...
February 13, 2017: Endocrine, Metabolic & Immune Disorders Drug Targets
https://www.readbyqxmd.com/read/28160765/the-use-of-complementary-and-alternative-medicine-among-dialysis-patients
#10
Ronit Koren, Hadas Zafrir Danieli, Keren Doenyas-Barak, Tomer Ziv-Baran, Ahuva Golik
Context • The use of complementary and alternative medicine (CAM) has been on the rise in the last decade. Subpopulations of patients with chronic diseases are at risk for adverse events and potential drug-herb interactions, among them dialysis patients. Objective • The study aimed to evaluate the prevalence of CAM consumption among dialysis patients and to search for potential interactions. Design • The study was cross-sectional, based on questionnaires. Setting • The study occurred in the hemodialysis unit at Assaf Harofeh Medical Center (Zeriffin, Israel)...
January 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28118048/hypoglycemia-associated-eeg-changes-following-antecedent-hypoglycemia-in-type-1-diabetes-mellitus
#11
Anne-Sophie Sejling, Troels W Kjaer, Ulrik Pedersen-Bjergaard, Line S Remvig, Christian S Frandsen, Linda Hilsted, Jens Faber, Jens Juul Holst, Lise Tarnow, Jakob Skadkær Møller, Martin N Nielsen, Birger Thorsteinsson, Claus B Juhl
BACKGROUND: Recurrent hypoglycemia has been shown to blunt hypoglycemia symptom scores and counterregulatory hormonal responses during subsequent hypoglycemia. We therefore studied whether hypoglycemia-associated electroencephalogram (EEG) changes are affected by an antecedent episode of hypoglycemia. METHODS: Twenty-four patients with type 1 diabetes mellitus (10 with normal hypoglycemia awareness, 14 with hypoglycemia unawareness) were studied on 2 consecutive days by hyperinsulinemic glucose clamp at hypoglycemia (2...
February 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28001445/long-term-efficacy-and-safety-of-sensor-augmented-insulin-pump-therapy-with-low-glucose-suspend-feature-in-patients-with-type-1-diabetes
#12
Ana María Gómez, Lisseth Fernanda Marín Carrillo, Oscar Mauricio Muñoz Velandia, Martín Alonso Rondón Sepúlveda, Carol M Arévalo Correa, Edwin Mora Garzón, Maria Camila Cuervo Diaz, Diana Cristina Henao Carrillo
BACKGROUND: Literature supports short-term efficacy and safety of Sensor Augmented Insulin Pump (SAP) therapy in patients with type 1 diabetes (T1D). However, no data are available showing long-term outcomes. Our study describes the long-term outcomes of SAP therapy with low-glucose suspend feature (SAP+LGS) in hypoglycemia in a Colombian population with T1D and hypoglycemia. METHODS: A cohort study was conducted with T1D patients receiving SAP+LGS therapy who initiated this therapy because of hypoglycemia at San Ignacio University Hospital diabetes center in Bogotá, Colombia...
February 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27990829/-islet-transplantation-as-a-treatment-for-hypoglycemia-unawareness-syndrome-evaluation-of-the-pilot-program-and-comparison-with-pancreas-transplantation
#13
COMPARATIVE STUDY
Martina Zahradnická, Peter Girman, Jan Kříž, Zuzana Berková, Tomáš Koblas, Ema Vávrová, Lucie Kosinová, David Habart, Eva Fábryová, Eva Dovolilová, Tomáš Neškudla, Jan Peregrin, Jozef Kováč, Květoslav Lipár, Matěj Kočík, Lenka Németová, Jiří Svoboda, František Saudek
Islet transplantation (ITx) started in 2005 in IKEM as a potentially safer alternative to pancreas transplantation (PTx), which so far had represented the method of choice in type-1 diabetic patients with conservatively intractable hypoglycemia unawareness syndrome. The aim of the study was to compare these two methods with regard to severe hypoglycemia elimination and to frequency of complications.Up to November 2015 a total number of 48 patients underwent ITx. The results from 22 patients with hypoglycemia unawareness were statistically analyzed...
December 0: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/27834283/cerebral-glycogen-in-humans-following-acute-and-recurrent-hypoglycemia-implications-on-a-role-in-hypoglycemia-unawareness
#14
Gülin Öz, Mauro DiNuzzo, Anjali Kumar, Amir Moheet, Ameer Khowaja, Kristine Kubisiak, Lynn E Eberly, Elizabeth R Seaquist
Supercompensated brain glycogen levels may contribute to the development of hypoglycemia-associated autonomic failure (HAAF) following recurrent hypoglycemia (RH) by providing energy for the brain during subsequent periods of hypoglycemia. To assess the role of glycogen supercompensation in the generation of HAAF, we estimated the level of brain glycogen following RH and acute hypoglycemia (AH). After undergoing 3 hyperinsulinemic, euglycemic and 3 hyperinsulinemic, hypoglycemic clamps (RH) on separate occasions at least 1 month apart, five healthy volunteers received [1-(13)C]glucose intravenously over 80+ h while maintaining euglycemia...
August 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27651425/long-term-prediction-of-severe-hypoglycemia-in-type-1-diabetes-is-it-really-possible
#15
Marie Moth Henriksen, Louise Færch, Birger Thorsteinsson, Ulrik Pedersen-Bjergaard
BACKGROUND: Prediction of risk of severe hypoglycemia (SH) in patients with type 1 diabetes is important to prevent future episodes, but it is unknown if it is possible to predict the long-term risk of SH. The aim of the study is to assess if long-term prediction of SH is possible in type 1 diabetes. METHODS: A follow-up study was performed with 98 patients with type 1 diabetes. At baseline and at follow-up, the patients filled in a questionnaire about diabetes history and complications, number of SH in the preceding year and state of awareness, and HbA1c and C-peptide levels were measured...
November 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/27571180/long-term-improvement-in-glucose-control-and-counterregulation-by-islet-transplantation-for-type-1-diabetes
#16
Michael R Rickels, Amy J Peleckis, Eileen Markmann, Cornelia Dalton-Bakes, Stephanie M Kong, Karen L Teff, Ali Naji
CONTEXT: Islet transplantation has been shown to improve glucose counterregulation and hypoglycemia symptom recognition in patients with type 1 diabetes (T1D) complicated by severe hypoglycemia episodes and symptom unawareness, but long-term data are lacking. OBJECTIVE: To assess the long-term durability of glucose counterregulation and hypoglycemia symptom responses 18 months after intrahepatic islet transplantation and associated measures of glycemic control during a 24-month follow-up period...
November 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27517510/long-term-effects-of-islet-transplantation
#17
D Jane Holmes-Walker, Thomas W H Kay
PURPOSE OF REVIEW: Islet transplantation has made great progress in recent years. This is a remarkable technical feat but raises the question of what the long-term benefits and risks are for type I diabetes recipients. RECENT FINDINGS: Graft survival continues to improve, and recent multicenter studies show that islet transplantation is particularly effective to prevent hypoglycemic events even in those who do not become insulin-independent and to achieve excellent glycemic control...
October 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27330121/islet-transplantation-for-hypoglycemia-unawareness-severe-hypoglycemia-caveat-emptor
#18
David M Harlan
No abstract text is available yet for this article.
July 2016: Diabetes Care
https://www.readbyqxmd.com/read/27142345/hypoglycemia-in-children-with-type-1-diabetes-unawareness-is-a-concrete-risk
#19
S Franchini, L Comegna, G Prezioso, A Blasetti
No abstract text is available yet for this article.
September 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27091198/filling-the-knowledge-gap-in-diabetes-management-during-ramadan-the-evolving-role-of-trial-evidence
#20
REVIEW
Saud Al Sifri, Kashif Rizvi
UNLABELLED: Muslim patients with type 2 diabetes (T2D) who fast during Ramadan face challenges in diabetes management due to substantial alterations in lifestyle and treatment that frequently accompany the decision to fast. International guidelines for treating T2D do not fully address the clinical issues unique to fasting, and other guidance documents lack the large and high-quality evidence base available for non-fasting conditions. We reviewed 10 randomized controlled trials and 20 observational studies in T2D during Ramadan to assess the quality of evidence and identify issues in trial design that should be addressed in future studies...
June 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
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