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Intensive glycemic control

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https://www.readbyqxmd.com/read/29775079/improved-glycemic-control-with-minimal-change-in-medication-regimen-complexity-in-a-pharmacist-endocrinologist-diabetes-intense-medical-management-dimm-tune-up-clinic
#1
Candis M Morello, Taylor Rotunno, John Khoan, Jan D Hirsch
BACKGROUND: Gaining glycemic control in patients with type 2 diabetes (T2D) usually requires more complicated medication regimens. Increased medication regimen complexity (MRC) negatively impacts adherence and clinical outcomes. OBJECTIVE: Compare MRC change in patients with uncontrolled T2D referred to a collaborative pharmacist-endocrinologist Diabetes Intense Medical Management (DIMM) clinic "tune up" model versus similar patients receiving usual primary care provider (PCP) care over 6 months...
May 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29773578/relationship-between-glycated-hemoglobin-and-stroke-risk-a-systematic-review-and-meta-analysis
#2
REVIEW
John Peter Mitsios, Elif Ilhan Ekinci, Gregory Peter Mitsios, Leonid Churilov, Vincent Thijs
BACKGROUND: Diabetes mellitus is a major risk factor for ischemic stroke. Rising hemoglobin A1c (HbA1c ) levels are associated with microvascular diabetes mellitus complication development; however, this relationship has not been established for stroke risk, a macrovascular complication. METHODS AND RESULTS: We conducted a systematic review and meta-analysis of observational cohort and nested case-control cohort studies assessing the association between rising HbA1c levels and stroke risk in adults (≥18 years old) with and without type 1 or type 2 diabetes mellitus...
May 17, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29760928/aneurysmal-subarachnoid-hemorrhage-intensive-care-for-improving-neurological-outcome
#3
REVIEW
Tomoya Okazaki, Yasuhiro Kuroda
Background: Aneurysmal subarachnoid hemorrhage is a life-threatening disease requiring neurocritical care. Delayed cerebral ischemia is a well-known complication that contributes to unfavorable neurological outcomes. Cerebral vasospasm has been thought to be the main cause of delayed cerebral ischemia, and although several studies were able to decrease cerebral vasospasm, none showed improved neurological outcomes. Our target is not cerebral vasospasm but improving neurological outcomes...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29745913/benefits-of-early-screening-and-proper-treatment-in-patient-with-significant-risk-factors-for-gestational-diabetes-mellitus-case-report
#4
V Limani
Gestational diabetes mellitus (GDM) occurs in 2-9% of all pregnancies. Evidence suggests that the use of insulin in treating hyperglycemia in GDM patients reduces the risk of perinatal morbidity. Pregnancy is an exciting time in a woman's life. However, once patient is diagnosed with GDM, she will be managed more intensively. GDM is managed using diet and exercise but one in six women with GDM requires insulin. A 35-year-old woman at the 14th gestational week of her tenth pregnancy was seen for routine prenatal care...
April 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29745912/clinical-case-report-on-acute-pancreatitis-with-concomitant-t2dm-and-hypertriglyceridemia
#5
T Magradze, E Shelestova
Authors present a clinical case review of a 46-years-old, otherwise healthy female patient, presented with acute abdominal pain. Examination and full work-up established a diagnosis of acute pancreatitis, T2DM and hypertriglyceridemia; based on family history, inherited hypertriglyceridemia was suspected. Elevated TG values associated with diabetes dramatically increase the risk of developing MI. Subsequent to the pancreatitis treatment protocol completion, the patient has fully recovered from acute pancreatitis...
April 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29743883/treatment-of-diabetic-mice-with-a-combination-of-ketogenic-diet-and-aerobic-exercise-via-modulations-of-ppars-gene-programs
#6
Qiang Zhang, Lingyan Xu, Jie Xia, Dongmei Wang, Min Qian, Shuzhe Ding
Type 2 diabetes is a prevalent chronic disease arising as a serious public health problem worldwide. Diet intervention is considered to be a critical strategy in glycemic control of diabetic patients. Recently, the low-carbohydrate ketogenic diet is shown to be effective in glycemic control and weight loss. However, hepatic lipid accumulation could be observed in mice treated with ketogenic diet. On the other hand, exercise is a well-known approach for treating nonalcoholic fatty liver disease. We thus hypothesize that the combination of ketogenic diet and exercise could improve insulin sensitivity, while minimizing adverse effect of hepatic steatosis...
2018: PPAR Research
https://www.readbyqxmd.com/read/29733433/statin-therapy-on-glycemic-control-in-type-2-diabetic-patients-a-network-meta-analysis
#7
J Y Cui, R R Zhou, S Han, T S Wang, L Q Wang, X H Xie
WHAT IS KNOWN AND OBJECTIVE: Statins are the cornerstone of primary and secondary prevention of cardiovascular diseases (CVDs) and are effective for the prevention of vascular events in diabetic patients. Diabetes mellitus is an important risk factor for CVDs .The majority of patients with diabetes mellitus benefits from statin therapy. According to the recent clinical guidelines of the American College of Cardiology and the American Heart Association, moderate-intensity or high-intensity statin therapy should be used as the primary prevention for individuals with diabetes mellitus, aged between 40 and 75 years and with low-density lipoprotein cholesterol (LDL-C) from 70 to 189 mg/dL...
May 7, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29730785/may-the-force-be-with-you-why-resistance-training-is-essential-for-subjects-with-type-2-diabetes-mellitus-without-complications
#8
REVIEW
Roberto Codella, Marta Ialacqua, Ileana Terruzzi, Livio Luzi
Physical activity, together with diet and pharmacological therapy, represents one of the three cornerstones in type 2 diabetes mellitus treatment and care. The therapeutic appeal of regular physical activity stems from: (i) its non-pharmacological nature; (ii) its beneficial effects on the metabolic risk factors associated with diabetes complications; (iii) its low costs. Evidence accumulated in the last years suggests that aerobic training-endurance training-constitutes a safe modality of intervention, achievable, and effective in diabetes treatment, whenever it is not limited by comorbidities...
May 5, 2018: Endocrine
https://www.readbyqxmd.com/read/29725871/novel-risk-engine-for-diabetes-progression-and-mortality-in-usa-building-relating-assessing-and-validating-outcomes-bravo
#9
Hui Shao, Vivian Fonseca, Charles Stoecker, Shuqian Liu, Lizheng Shi
BACKGROUND: There is an urgent need to update diabetes prediction, which has relied on the United Kingdom Prospective Diabetes Study (UKPDS) that dates back to 1970 s' European populations. OBJECTIVE: The objective of this study was to develop a risk engine with multiple risk equations using a recent patient cohort with type 2 diabetes mellitus reflective of the US population. METHODS: A total of 17 risk equations for predicting diabetes-related microvascular and macrovascular events, hypoglycemia, mortality, and progression of diabetes risk factors were estimated using the data from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial (n = 10,251)...
May 3, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29724682/metabolic-surgery-for-inadequately-controlled-type-2-diabetes-in-nonseverely-obese-japanese-a-prospective-single-center-study
#10
Yosuke Seki, Kazunori Kasama, Kazuki Yasuda, Eri Kikkawa, Naoki Watanabe, Yoshimochi Kurokawa
BACKGROUND: The beneficial effects of metabolic surgery on weight loss, glycemic control, and cardiovascular improvement for the morbidly obese patient has been vast and undeniable. It is also expected to be effective in diabetic patients with less severe obesity, but the evidence is yet to yield significant impact. OBJECTIVE: In this study, we investigate the impact of metabolic surgery on inadequately controlled type 2 diabetes in Japanese patients with mild obesity...
March 21, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29707918/the-combined-effect-of-high-intensity-intermittent-training-and-vitamin-d-supplementation-on-glycemic-control-in-overweight-and-obese-adults
#11
Hannah Margaret Lithgow, Geraint Florida-James, Melanie Leggate
High-intensity intermittent training (HIIT) has been shown to reduce the risk of chronic conditions including the development of type 2 diabetes mellitus (T2DM). Independently, a low vitamin D status has also been linked to the prevalence of T2DM. The aim of this study was to investigate if there was a synergistic metabolic effect of HIIT and vitamin D supplementation on glycemic control. A total of 20 male and female participants (age, 34 ± 9 year; BMI, 31.4 ± 2.8 kg·m-2 ) completed 6 weeks HIIT, and were randomized to ingest 100 μg·day-1 of vitamin D3 or placebo...
May 2018: Physiological Reports
https://www.readbyqxmd.com/read/29694290/the-effect-of-clinical-pharmacist-led-comprehensive-medication-management-on-chronic-disease-state-goal-attainment-in-a-patient-centered-medical-home
#12
Jarred Prudencio, Timothy Cutler, Stephanie Roberts, Stephanie Marin, Machelle Wilson
BACKGROUND: Clinical pharmacy services were initiated at 7 of 11 clinics within a primary care network (PCN), which was designated as a patient-centered medical home and was affiliated with a large academic medical center in October 2014. The goal of the service was to target patients with uncontrolled chronic conditions, specifically diabetes. Patients met with a clinical pharmacist through individual clinic and telephonic appointments, in addition to usual appointments with physicians as needed...
May 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29686181/the-effectiveness-of-aerobic-exercise-in-improving-peripheral-nerve-functions-in-type-2-diabetes-mellitus-an-evidence-based-case-report
#13
Listya Tresnanti Mirtha, Viandini Permatahati
BACKGROUND: peripheral neuropathy is known as one of most common complication in diabetes mellitus type 2 patient. This complication is caused by uncontrolled condition of blood glucose level in long periode. Regular physical activity in moderate to high intensity is beneficial in management of diabetes mellitus. This report aimed to know the effectiveness of aerobic exercise in causing improved peripheral functions in type 2 diabetes mellitus. METHODS: literature searching using several related keywords in Medline®, Pubmed®, and Cochrane library, following inclusion and exclusion criteria...
January 2018: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/29677007/near-continuous-glucose-monitoring-makes-glycemic-control-safer-in-icu-patients
#14
Jean-Charles Preiser, Olivier Lheureux, Aurelie Thooft, Serge Brimioulle, Jacques Goldstein, Jean-Louis Vincent
OBJECTIVES: Tight glycemic control using intermittent blood glucose measurements is associated with a risk of hypoglycemia. Glucose concentrations can now be measured near continuously (every 5-15 min). We assessed the quality and safety of glycemic control guided by a near-continuous glucose monitoring system in ICU patients. DESIGN: Prospective, cluster-randomized, crossover study. SETTING: Thirty-five-bed medico-surgical department of intensive care with four separate ICUs...
April 19, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29657375/comparison-of-glycemic-control-between-continuous-regular-insulin-infusion-and-single-dose-subcutaneous-insulin-glargine-injection-in-medical-critically-ill-patients
#15
Rungsun Bhurayanontachai, Tharittamon Rattanaprapat, Chanon Kongkamol
Background and Aims: This study aimed to compare glycemic control between continuous intravenous regular insulin infusion and single-dose subcutaneous insulin glargine injection in medical critically ill patients. Subjects and Methods: A prospective noninferiority study was conducted in medical critically ill patients who developed hyperglycemia and required regular insulin infusion by the Intensive Care Unit glycemic control protocol. The eligible patients were switched from the daily regular insulin requirement to single-dose subcutaneous insulin glargine injection by a 100% conversion dose...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29652278/effects-of-glargine-insulin-on-glycemic-control-in-patients-with-diabetes-mellitus-type-ii-undergoing-off-pump-coronary-artery-bypass-graft
#16
Hemang Gandhi, Alpesh Sarvaia, Amber Malhotra, Himanshu Acharya, Komal Shah, Jeevraj Rajavat
Background: The prevalence of diabetes mellitus in patients requiring coronary artery bypass grafting (CABG) is noticeably high (20%-30%). These patients have inferior perioperative outcome, reduced long-term survival, and high risk of recurrent episodes of angina. To improve perioperative outcome surgical unit defined satisfactory glycemic control is desired during this period. Hence, the aim of our study is to compare the efficacy of glargine insulin combination with continuous human insulin infusion for perioperative glycemic control in patients with diabetes undergoing CABG...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29651052/management-of-glycemic-variation-in-diabetic-patients-receiving-parenteral-nutrition-by-continuous-subcutaneous-insulin-infusion-csii-therapy
#17
Feng-Fei Li, Wen-Li Zhang, Bing-Li Liu, Dan-Feng Zhang, Wei Chen, Li Yuan, Mao-Yuan Chen, Xiao-Fang Zhai, Jin-Dan Wu, Xiao-Fei Su, Lei Ye, Hong-Yong Cao, Jian-Hua Ma
To compare the continuous subcutaneous insulin infusion (CSII) or insulin glargine based multiple injections (MDI) therapy on glycemic variations in diabetic patients receiving PN outside of intensive care settings. This was a single-center, randomized, open-label trial. Patients with type 2 diabetes (T2D) who were receiving parenteral nutrition (PN) were recruited. After baseline data were collected, recruited patients were then randomized 1:1 to a CSII group or a MDI group. All patients were subjected to a 4-day retrospective Continuous Glucose Monitoring (CGM)...
April 12, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29650049/variation-in-general-supportive-and-preventive-intensive-care-management-of-traumatic-brain-injury-a-survey-in-66-neurotrauma-centers-participating-in-the-collaborative-european-neurotrauma-effectiveness-research-in-traumatic-brain-injury-center-tbi-study
#18
Jilske A Huijben, Victor Volovici, Maryse C Cnossen, Iain K Haitsma, Nino Stocchetti, Andrew I R Maas, David K Menon, Ari Ercole, Giuseppe Citerio, David Nelson, Suzanne Polinder, Ewout W Steyerberg, Hester F Lingsma, Mathieu van der Jagt
BACKGROUND: General supportive and preventive measures in the intensive care management of traumatic brain injury (TBI) aim to prevent or limit secondary brain injury and optimize recovery. The aim of this survey was to assess and quantify variation in perceptions on intensive care unit (ICU) management of patients with TBI in European neurotrauma centers. METHODS: We performed a survey as part of the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study...
April 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29582538/mobile-phone-applications-and-self-management-of-diabetes-a-systematic-review-with-meta-analysis-meta-regression-of-21-randomized-trials-and-grade
#19
Can Hou, Qian Xu, Sha Diao, Jonathan Hewitt, Jiayuan Li, Ben Carter
We conducted a systematic review with meta-analysis of randomized controlled trials that evaluated the effect of diabetes apps. 1550 participants from 21 studies were included. For type 1 diabetes, a significant 0.49% reduction in HbA1c was seen (95%CI 0.04 to 0.94; I2 =84%), with unexplained heterogeneity and a low GRADE of evidence. For type 2 diabetes, using diabetes apps was associated with a mean reduction of 0.57% (95%CI 0.32 to 0.82, I2 =77%). The results had severe heterogeneity that was explained by the frequency of HCP feedback...
March 27, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29581797/exercise-therapy-for-patients-with-type-2-diabetes-a-narrative-review
#20
REVIEW
Hidekatsu Yanai, Hiroki Adachi, Yoshinori Masui, Hisayuki Katsuyama, Akiko Kawaguchi, Mariko Hakoshima, Yoko Waragai, Tadanao Harigae, Hidetaka Hamasaki, Akahito Sako
To achieve excellent glycemic control in patients with type 2 diabetes, an adequate prescription of exercise therapy is required. The meta-analyses proposed that high-intensity training improves metabolic parameters in patients with pre-diabetes or type 2 diabetes and low physical activity is associated with an increased risk of incident type 2 diabetes. Here, we would introduce literatures about effects of physical activity on mortality, cardiovascular events, and metabolic parameters, to encourage understanding of exercise therapy, and then describe how to prescribe exercise therapy for patients with type 2 diabetes...
May 2018: Journal of Clinical Medicine Research
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