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diabetes mellitus guidelines

Tomoko Negishi, Paaladinesh Thavendiranathan, Kazuaki Negishi, Thomas H Marwick
OBJECTIVES: This study sought to evaluate the hypothesis that global longitudinal strain (GLS) guidance of cardioprotective therapy would improve cardiac function of at-risk patients undergoing potentially cardiotoxic chemotherapy, compared with usual care. BACKGROUND: The conventional criteria for diagnosis of chemotherapy-related cardiac dysfunction (CTRCD) are dependent on the recognition of heart failure symptoms and/or changes in left ventricular ejection fraction...
June 8, 2018: JACC. Cardiovascular Imaging
Niki Katsiki, Konstantinos Tsioufis, Dilek Ural, Massimo Volpe
There is an unmet need to prevent cardiovascular disease and chronic kidney disease development and progression worldwide. Losartan, the first angiotensin receptor blocker, was shown to exert significant cardioprotective and renoprotective effects in the LIFE (Losartan Intervention for Endpoint Reduction in Hypertension) and RENAAL (Reduction of Endpoints in NIDDM With the Angiotensin II Antagonist Losartan) trials. Losartan significantly prevented stroke and decreased serum uric acid levels and the rates of new-onset diabetes mellitus and atrial fibrillation...
June 15, 2018: Journal of Clinical Hypertension
Michael Laxy, Edward C F Wilson, Clare E Boothby, Simon J Griffin
OBJECTIVE: To assess the fidelity of general practitioners' (GPs) adherence to a long-term pragmatic trial protocol. DESIGN: Retrospective analyses of electronic primary care records of participants in the pragmatic cluster-randomised ADDITION (Anglo-Danish-Dutch Study of Intensive Treatment In People with Screen Detected Diabetes in Primary Care)-Cambridge trial, comparing intensive multifactorial treatment (IT) versus routine care (RC). Data were collected from the date of diagnosis until December 2010...
June 14, 2018: BMJ Open
John S Leeds, Marios Hadjivassiliou, Solomon Tesfaye, David S Sanders
Objectives: Lower gastrointestinal symptoms are not well characterized in people with type 1 diabetes, and the effects on quality of life and glycemic control are unknown. This study aimed to determine the prevalence of lower gastrointestinal symptoms and the effects on glycemic control and quality of life, and to investigate for underlying causes. Research design and methods: This is a prospective, cohort study in secondary care. Patients with type 1 diabetes completed a gastrointestinal symptom questionnaire and the Short Form 36 V...
2018: BMJ Open Diabetes Research & Care
Michael P Carson, Cande V Ananth, Cynthia Gyamfi-Bannerman, John Smulian, Ronald J Wapner
The rate of gestational diabetes has doubled, and identifying the 30% with persistent postpartum dysglycemia (prediabetes or diabetes mellitus) is important because low-cost interventions have been proven to prevent overt diabetes mellitus, improve health for women, and potentially decrease the risk for birth defects in future pregnancies. Consensus guidelines continue to recommend a 4- to 12-week postpartum 2-hour oral glucose tolerance test (OGTT) despite persistent reports that only 35% of women complete the test...
June 6, 2018: Obstetrics and Gynecology
Sukhdeep S Basra, Tracy Y Wang, DaJuanicia N Simon, Karen Chiswell, Salim S Virani, Mahboob Alam, Vijay Nambi, Ali E Denktas, Anita Deswal, Biykem Bozkurt, Christie M Ballantyne, Eric D Peterson, Hani Jneid
BACKGROUND: Ticagrelor is a P2Y12 receptor inhibitor with superior clinical efficacy compared with clopidogrel. However, it is associated with reduced efficacy when combined with a high-dose aspirin. METHODS AND RESULTS: Patients in the acute coronary treatment and intervention outcomes network (ACTION) Registry-Get With The Guidelines (GWTG) with acute myocardial infarction from October 2013 through December 2014 were included in the study (167 455 patients; 622 sites)...
June 9, 2018: Journal of the American Heart Association
Shamala Ayadurai, V Bruce Sunderland, Lisa Bg Tee, Siti Norlina Md Said, H Laetitia Hattingh
BACKGROUND: A review of pharmacist diabetes intervention studies revealed lack of structured process in providing diabetes care which consequently produced varied results from increased to minimal improvements. This study aimed to determine the effectiveness of a structured clinical guidelines tool, the Simpler™ tool, in the delivery of diabetes care. The primary outcome was significant improvement in HbA1c (glycated haemoglobin). Secondary outcomes were improved lipid profiles and blood pressure (BP)...
June 7, 2018: Journal of Diabetes
Huiqun Wu, Yufang Wei, Yujuan Shang, Wei Shi, Lei Wang, Jingjing Li, Aimin Sang, Lili Shi, Kui Jiang, Jiancheng Dong
Type 2 diabetes mellitus (T2DM) is a common chronic disease, and the fragment data collected through separated vendors makes continuous management of DM patients difficult. The lack of standard of fragment data from those diabetic patients also makes the further potential phenotyping based on the diabetic data difficult. Traditional T2DM data repository only supports data collection from T2DM patients, lack of phenotyping ability and relied on standalone database design, limiting the secondary usage of these valuable data...
June 6, 2018: Journal of Medical Systems
Alexander Nast, Lasse Amelunxen, Matthias Augustin, Wolf-Henning Boehncke, Corinna Dressler, Matthew Gaskins, Peter Härle, Bernd Hoffstadt, Joachim Klaus, Joachim Koza, Ulrich Mrowietz, Hans-Michael Ockenfels, Sandra Philipp, Kristian Reich, Thomas Rosenbach, Berthold Rzany, Martin Schlaeger, Gerhard Schmid-Ott, Michael Sebastian, Ralph von Kiedrowski, Tobias Weberschock
The German guideline for the treatment of psoriasis vulgaris was updated using GRADE methodology. The guideline is based on a systematic literature review completed on December 1, 2016, and on a formal consensus and approval process. The second part of this short version of the guideline covers the following special patient populations and treatment situations: tuberculosis screening before and during psoriasis treatment, choice of psoriasis treatment for individuals wishing to have children, as well as during pregnancy and breast-feeding, and patients with joint involvement and vaccinations...
June 2018: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
S DeSouza, H Yoon, R Singh, M Petrov
INTRODUCTION: There have been many reports of altered pancreas size in diseases of the endocrine and exocrine pancreas, but few attempts to quantify such changes. The aim of this study was to conduct a systematic literature review, documenting the methodology and quantitative data in studies reporting on pancreas size. MATERIALS AND METHODS: Three electronic databases (EMBASE, Scopus, and MEDLINE) were searched by two reviewers independently. Studies of humans were included if they compared pancreas size (reported as pancreas diameters, areas, and/or lengths) between diseased populations and controls...
June 5, 2018: Clinical Anatomy
Benjamin Lazarus, Aozhou Wu, Jung-Im Shin, Yingying Sang, G Caleb Alexander, Alex Secora, Lesley A Inker, Josef Coresh, Alex R Chang, Morgan E Grams
Importance: Approximately 1 million patients in the United States with type 2 diabetes mellitus and mild-to-moderate kidney disease do not receive guideline-directed therapy with metformin. This may reflect uncertainty regarding the risk of acidosis in patients with chronic kidney disease. Objective: To quantify the association between metformin use and hospitalization with acidosis across the range of estimated glomerular filtration rate (eGFR), accounting for change in eGFR stage over time...
June 4, 2018: JAMA Internal Medicine
Sumito Sunagawa, Takashi Shirakura, Noboru Hokama, Chisayo Kozuka, Masato Yonamine, Toyotaka Namba, Satoko Morishima, Sawako Nakachi, Yukiko Nishi, Tomomi Ikema, Shiki Okamoto, Chieko Matsui, Naoki Hase, Mizuho Tamura, Michio Shimabukuro, Hiroaki Masuzaki
AIMS/INTRODUCTION: There is a controversy whether hyperuricemia is an independent risk for cardiometabolic diseases. Serum level of uric acid is affected by a wide variety of factors involved in its production and excretion. On the other hand, evidence has accumulated that locally and systemically activated xanthine oxidase (XO), a rate limiting enzyme for production of uric acid, is linked to metabolic derangement in humans and rodents. We therefore explored the clinical implication of plasma XO activity in patients with type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS)...
June 3, 2018: Journal of Diabetes Investigation
Innocent Ijezie Chukwuonye, Okechukwu Samuel Ogah, Ernest Ndukaife Anyabolu, Kenneth Arinze Ohagwu, Ogbonna Collins Nwabuko, Uwa Onwuchekwa, Miracle Erinma Chukwuonye, Emmanuel Chukwuebuka Obi, Efosa Oviasu
Background: The aim of this study was to identify and discuss published population-based studies carried out in Nigeria that have information on the prevalence of chronic kidney disease (CKD) and have also used the Kidney Disease Outcomes Quality Initiative (KDOQI) practice guidelines in defining CKD, with emphasis on the performance of three estimating equations for glomerular filtration rate (GFR) - Modification of Diet in Renal Disease (MDRD), Cock-croft-Gault, and CKD epidemiology collaboration (CKD-EPI) creatinine equation...
2018: International Journal of Nephrology and Renovascular Disease
Vasilios G Athyros, Michael Doumas, Konstantinos P Imprialos, Konstantinos Stavropoulos, Eleni Georgianou, Alexandra Katsimardou, Asterios Karagiannis
The authors review the association between diabetes mellitus (DM) and aberrations of lipid metabolism related to DM, diabetic dyslipidemia (DD). DM is considered as a major health burden worldwide and one of the most important modifiable cardiovascular disease (CVD) risk factors. This applies to both the developed and the developing countries, especially the latter. While patients with type 1 DM, 10% of all DM cases, usually do not have dyslipidemia, DD is frequent among patients with type 2 DM (T2DM) (prevalence > 75%) and is mainly a mixed dyslipidemia [increase in triglycerides (TGs), low high-density lipoprotein cholesterol (HDL-C), and small-dense (atherogenic), low-density lipoprotein cholesterol (LDL-C) particles]...
March 2018: Hormones: International Journal of Endocrinology and Metabolism
Kirsten S Dorans, Katherine T Mills, Yang Liu, Jiang He
BACKGROUND: Hypertension is a major risk factor for cardiovascular disease and all-cause mortality. Compared with prior guidelines, the 2017 American College of Cardiology/American Heart Association (ACC/AHA) hypertension guideline recommends lower blood pressure thresholds for defining hypertension, for initiating antihypertensive medication, and for antihypertensive medication treatment goals. METHODS AND RESULTS: To better understand potential impacts of the 2017 guideline, we studied trends in mean systolic blood pressure and diastolic blood pressure, prevalence and burden of hypertension, and proportion of controlled hypertension in the US adult population aged ≥20 from 1999 through 2016...
June 1, 2018: Journal of the American Heart Association
L S Vest, F M Koraishy, Z Zhang, N N Lam, M A Schnitzler, V R Dharnidharka, D Axelrod, A S Naik, T A Alhamad, B L Kasiske, G P Hess, K L Lentine
While guidelines support metformin as a therapeutic option for diabetic patients with mild-to-moderate renal insufficiency, the frequency and outcomes of metformin use in kidney transplant recipients are not well described. We integrated national U.S. transplant registry data with records from a large pharmaceutical claims clearinghouse (2008-2015). Associations (adjusted hazard ratio, 95% LCL aHR95% UCL ) of diabetes regimens (with and excluding metformin) in the first year post-transplant with patient and graft survival over the subsequent year were quantified by multivariate Cox regression, adjusted for recipient, donor, and transplant factors and propensity for metformin use...
May 31, 2018: Clinical Transplantation
P Gendron, C Lajoie, L Laurencelle, F Trudeau
Background: Female firefighters are in the minority in the Québec firefighter population and worldwide. To our knowledge, no study has focused on cardiovascular risk factors in female firefighters, and further research in this area is needed to evaluate and reduce the risk of on-duty sudden cardiac death. Aims: To evaluate the prevalence of cardiovascular disease (CVD) risk factors in female firefighters in Québec. Methods: A cross-sectional study using an online questionnaire to evaluate lifestyle and CVD risk factors and symptoms...
May 28, 2018: Occupational Medicine
Anaar Siletz, Christopher P Childers, Claire Faltermeier, Emily S Singer, Q Lina Hu, Clifford Y Ko, Stephen L Kates, Melinda Maggard-Gibbons, Elizabeth Wick
Background: Enhanced recovery pathways (ERPs) have been shown to improve patient outcomes in a variety of contexts. This review summarizes the evidence and defines a protocol for perioperative care of patients with hip fracture and was conducted for the Agency for Healthcare Research and Quality safety program for improving surgical care and recovery. Study Design: Perioperative care was divided into components or "bins." For each bin, a semisystematic review of the literature was conducted using MEDLINE with priority given to systematic reviews, meta-analyses, and randomized controlled trials...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Kuan-Chun Chen, Wei-Hsian Yin, Chih-Cheng Wu, Shih-Hung Chan, Yen-Wen Wu, Kuo Yang Wang, Kuan-Cheng Chang, Juey-Jen Hwang, Wen-Chol Voon, I-Chang Hsieh, Jun-Ted Chong, Wei-Shiang Lin, Chih-Neng Hsu, Kwo-Chang Ueng, Chih-Ping Hsia, Ju-Chi Liu, Jong-Shiuan Yeh, Guang-Yuan Mar, Jhih-Yuan Shih, Jen-Yuan Kuo, Hsuan-Ming Tsao, Wei-Kung Tseng, Cheng-Hsu Yang, Chao-Chien Chang, Chern-En Chiang, Meng-Heng Lei, Jeng-Feng Lin, Kou-Gi Shyu
Background: Patients with acute coronary syndrome (ACS) and diabetes mellitus (DM) receive less aggressive treatment and have worse outcomes in Taiwan. We sought to explore whether the current practices of prescribing guideline-directed medical therapy (GDMT) for ACS and clinical outcomes have improved over time. Methods: A total of 1534 consecutive diabetic patients with ACS were enrolled between 2013 and 2015 from 27 hospitals in the nationwide registry initiated by the Taiwan Society of Cardiology (the TSOC ACS-DM Registry)...
May 2018: Acta Cardiologica Sinica
Mukesh M Agarwal
The world's pre-eminent diabetes, obstetric, endocrine, and health organizations advocate a plethora of diverse algorithms for the screening, diagnosis, management, and follow-up of gestational diabetes mellitus (GDM). Additionally, there are regional recommendations of local health societies. Several of these proposals for GDM are contentious because some of them were developed from unscientific studies, based on expert-opinion, catered to preserve resources, and subjectively modified for convenience. Due to the wide variety of choices available, the approach to GDM can be extremely diverse even within the same hospital...
May 28, 2018: Journal of Clinical Medicine
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