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Intensive glycemic control

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https://www.readbyqxmd.com/read/27908250/hypoglycemia-and-cardiac-arrhythmia-mechanisms-evidence-base-and-current-recommendations
#1
Sitara Gulrukh Khan, Mohammed Shahriar Huda
BACKGROUND: With the use of intensive insulin therapy and insulin secretagogues to optimize glycemic control in diabetes, hypoglycemia continues to present a clinical challenge. Hypoglycemia has been implicated in nocturnal sudden death in type 1 diabetes, and the mechanism underlying this is postulated to be cardiac arrhythmia. OBJECTIVE: This article reviews the evidence surrounding hypoglycemia and cardiac arrhythmia. METHODS: A structured search of the Pubmed bibliographic database was undertaken, and relevant peer-reviewed articles on the topic were included in the review...
December 1, 2016: Current Diabetes Reviews
https://www.readbyqxmd.com/read/27894316/dietary-patterns-in-obese-pregnant-women-influence-of-a-behavioral-intervention-of-diet-and-physical-activity-in-the-upbeat-randomized-controlled-trial
#2
Angela C Flynn, Paul T Seed, Nashita Patel, Suzanne Barr, Ruth Bell, Annette L Briley, Keith M Godfrey, Scott M Nelson, Eugene Oteng-Ntim, Sian M Robinson, Thomas A Sanders, Naveed Sattar, Jane Wardle, Lucilla Poston, Louise M Goff
BACKGROUND: Understanding dietary patterns in obese pregnant women will inform future intervention strategies to improve pregnancy outcomes and the health of the child. The aim of this study was to investigate the effect of a behavioral intervention of diet and physical activity advice on dietary patterns in obese pregnant woman participating in the UPBEAT study, and to explore associations of dietary patterns with pregnancy outcomes. METHODS: In the UPBEAT randomized controlled trial, pregnant obese women from eight UK multi-ethnic, inner-city populations were randomly assigned to receive a diet/physical activity intervention or standard antenatal care...
November 29, 2016: International Journal of Behavioral Nutrition and Physical Activity
https://www.readbyqxmd.com/read/27884157/manual-versus-automated-monitoring-accuracy-of-glucose-ii-manage-ii
#3
Cláudia Righy Shinotsuka, Alexandre Brasseur, David Fagnoul, Timothy So, Jean-Louis Vincent, Jean-Charles Preiser
BACKGROUND: Intravascular continuous glucose monitoring (CGM) may facilitate glycemic control in the intensive care unit (ICU). We compared the accuracy of a CGM device (OptiScanner®) with a standard reference method. METHODS: Adult patients who had blood glucose (BG) levels >150 mg/dl and required insertion of an arterial and central venous catheter were included. The OptiScanner® was inserted into a multiple-lumen central venous catheter. Patients were treated using a dynamic-scale insulin algorithm to achieve BG values between 80 and 150 mg/dl...
November 25, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27878572/a-comparison-of-two-insulin-infusion-protocols-in-the-medical-intensive-care-unit-by-continuous-glucose-monitoring
#4
Christophe E M De Block, Peter Rogiers, Philippe G Jorens, Tom Schepens, Cosimo Scuffi, Luc F Van Gaal
BACKGROUND: Achieving good glycemic control in intensive care units (ICU) requires a safe and efficient insulin infusion protocol (IIP). We aimed to compare the clinical performance of two IIPs (Leuven versus modified Yale protocol) in patients admitted to medical ICU, by using continuous glucose monitoring (CGM). This is a pooled data analysis of two published prospective randomized controlled trials. CGM monitoring was performed in 57 MICU patients (age 64 ± 12 years, APACHE-II score 28 ± 7, non-diabetic/diabetic: 36/21)...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27875539/secular-trends-in-admissions-and-mortality-rates-from-diabetes-mellitus-in-the-central-belt-of-ghana-a-31-year-review
#5
Osei Sarfo-Kantanka, Fred Stephen Sarfo, Eunice Oparebea Ansah, Benjamin Eghan, Nana Kwame Ayisi-Boateng, Emmanuel Acheamfour-Akowuah
INTRODUCTION: Diabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a significant proportion of diabetes cases are now found. Longitudinal profiling of in-patient admissions and mortality trends from diabetes provide useful insights into the magnitude of the burden of diabetes, serve as a sentinel on the state of out-patient diabetes care and provide effective tools for planning, delivering and evaluating the health care needs relating to the disease in sub-Saharan Africa...
2016: PloS One
https://www.readbyqxmd.com/read/27875061/glycemic-control-reduces-infections-in-post-liver-transplant-patients-results-of-a-prospective-randomized-study
#6
Amisha Wallia, Kathleen Schmidt, Diana Johnson Oakes, Teresa Pollack, Nicholas Welsh, Susan Kling-Colson, Suruchi Gupta, Candice Fulkerson, Grazia Aleppo, Neehar Parikh, Josh Levitsky, J P Norvell, Alfred Rademaker, Mark E Molitch
CONTEXT: Prior studies have shown a relationship between glycemic control and post-transplant morbidity. OBJECTIVE: We conducted a prospective randomized controlled trial in post liver transplant patients, evaluating intensive inpatient glycemic control and effects on outcomes to 1 year. Research Design and Intervention: 164 patients (blood glucose (BG) > 180 mg/dL) were randomized to two target groups: BG 140 mg/dL (N= 82) and 180 mg/dL (N= 82). Patients were initiated on insulin drips and then converted to subcutaneous basal bolus insulin therapy by our Glucose Management Service...
November 22, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27872156/association-between-blood-pressure-and-adverse-renal-events-in-type-1-diabetes
#7
Elaine Ku, Charles E McCulloch, Michael Mauer, Stephen E Gitelman, Barbara A Grimes, Chi-Yuan Hsu
OBJECTIVE: To compare different blood pressure (BP) levels in their association with the risk of renal outcomes in type 1 diabetes and to determine whether an intensive glycemic control strategy modifies this association. RESEARCH DESIGN AND METHODS: We included 1,441 participants with type 1 diabetes between the ages of 13 and 39 years who had previously been randomized to receive intensive versus conventional glycemic control in the Diabetes Control and Complications Trial (DCCT)...
December 2016: Diabetes Care
https://www.readbyqxmd.com/read/27850123/483-postoperative-glycemic-control-in-a-cardiovascular-intensive-care-unit-beyond-the-insulin-infusion
#8
Maria Zhorne
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27848229/ambulatory-screening-of-diabetic-neuropathy-and-predictors-of-its-severity-in-outpatient-settings
#9
M S Qureshi, M Iqbal, S Zahoor, J Ali, M U Javed
INTRODUCTION: Diabetic neuropathy is one of the most common causes of chronic neuropathic symptomatology and the most disabling and difficult-to-treat diabetic microangiopathic complication. The neuropathies associated with diabetes are typically classified into generalized, focal and multifocal varieties. There exists a scarcity of literature studying the correlation of different patient- and disease-related variables with severity of neuropathy. OBJECTIVES: This study aims to delineate the prevalence of diabetic neuropathy in type 2 diabetes, describe its characteristics and find out predictors of its severity...
November 15, 2016: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/27821581/association-between-the-use-of-long-acting-insulin-and-hypoglycemia-in-nondiabetic-patients-in-the-surgical-intensive-care-unit
#10
Jordan Masse, Christopher Alan Giuliano, Sara Brown, Renee Alexander Paxton
PURPOSE: The purpose of this study was to examine the association between long-acting insulin and hypoglycemia in nondiabetic surgical intensive care patients. METHODS: This single-center, retrospective cohort study evaluated glycemic control in nondiabetic critically ill surgical patients receiving long-acting insulin plus sliding scale versus those receiving sliding scale alone. Patients were matched based on sliding scale order and type of surgery. The primary outcome was the proportion of patients who experienced hypoglycemia (glucose values <70 mg/dL)...
November 7, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27818228/computerized-insulin-order-sets-and-glycemic-control-in-hospitalized-patients
#11
Bertha Wong, Muhammad M Mamdani, Catherine H Y Yu
OBJECTIVE: To evaluate the impact of computerized provider order entry subcutaneous insulin order sets on inpatient glycemic control and ordering behavior. METHODS: This was an interrupted time series study of non-intensive care patients at an urban teaching hospital. The primary outcome was proportion of capillary blood glucose in optimal range (4.0-10.0 mmol/L [72 -180 mg/dL]) during the six months before and after a change to a computerized provider order entry-integrated insulin order set...
November 3, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27804850/interval-exercise-therapy-for-type-2-diabetes
#12
Hidetaka Hamasaki
BACKGROUND: Regular exercise improves glycemic control and reduces cardiovascular risk and mortality in patients with type 2 diabetes. Continuous moderate- to high-intensity exercise has been recommended to manage type 2 diabetes; however, only approximately 30% of diabetic patients achieve the recommended levels of physical activity. The reasons for not engaging in regular exercise vary; however, one of the common reasons is lack of time. Recently, the effectiveness of short-duration interval exercise such as high-intensity interval training and interval walking has been observed...
November 1, 2016: Current Diabetes Reviews
https://www.readbyqxmd.com/read/27776251/the-effects-of-exenatide-twice-daily-compared-to-insulin-lispro-added-to-basal-insulin-in-latin-american-patients-with-type-2-diabetes-a-retrospective-analysis-of-the-4b-trial
#13
Silvia Beatriz Gorban de Lapertosa, Gustavo Frechtel, Elise Hardy, Leobardo Sauque-Reyna
AIMS: Socioeconomic changes in Latin American countries have led to an increased prevalence of type 2 diabetes (T2D). We examined the effects of exenatide twice daily (BID) or insulin lispro, each added to insulin glargine, in Latin American patients with T2D. METHODS: This was a subgroup analysis of patients from Argentina and Mexico in the 4B study (N=114). Patients with glycated hemoglobin (HbA1c) of 7.0-10.0% (53-86mmol/mol) after 12weeks of intensive basal insulin optimization were randomized to exenatide BID or thrice-daily insulin lispro added to insulin glargine and metformin...
October 8, 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/27776003/aerobic-exercise-training-modalities-and-prediabetes-risk-reduction
#14
Chip P Rowan, Michael C Riddell, Norman Gledhill, Veronica K Jamnik
PURPOSE: Prediabetes is linked to several modifiable risk factors, in particular, physical activity participation. The optimal prescription for physical activity remains uncertain. This pilot study aimed to investigate the effectiveness of continuous moderate intensity (CON) versus high intensity interval (HIIT) aerobic training in persons with prediabetes. Outcome measures included hemoglobin A1c (A1C), body composition, musculoskeletal and aerobic fitness. METHODS: Participants (n= 35) were recruited and screened using a questionnaire plus capillary blood point-of-care A1C analysis...
October 21, 2016: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/27766967/an-individual-approach-to-feline-diabetes-care-a-case-report-and-literature-review
#15
Moira S Lewitt, Emma Strage, David Church
BACKGROUND: Achieving insulin independence is emerging as a realistic therapeutic goal in the management of feline diabetes mellitus. CASE PRESENTATION: The management of an 11-year-old spayed female Burmese cat presenting with diabetes mellitus after corticosteroid administration is described. Remission was achieved after the frequency of insulin administration was increased to four times a day, and supported by intensive home blood glucose monitoring and a high protein, low carbohydrate diet...
October 20, 2016: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/27753873/ish-aha-2-a-case-of-chronic-indolent-pheochromocytoma-which-caused-medically-controlled-hypertension-but-treatment-resistant-diabetes-mellitus
#16
Hae-Young Lee, Chan-Soon Park, Sang-Hoon Na, Kyung-Jin Kim, Chan Joo Lee, Sungha Park
A 47-year-old woman was admitted via emergency department due to dyspnea NYHA Fc II-III aggravated for 2 months after upper respiratory infection. Her height and body weight were 161 cm / 67 kg. Initial vital signs were 110/70 mmHg - 112 BPM - 24/min - 36.5°C. Chest PA showed cardiomegaly and pulmonary congestion (Figure 1). B-natriuretic peptide level was markedly increased (2002 pg/mL, normal range ≤ 100 pg/mL). The echocardiographic examination showed severely dilated LV cavity (61/72 mm) and severe LV systolic dysfunction (EF 28%) with normal left ventricular wall thickness (9/11 mm) (Figure 2)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27736708/corticosteroids-and-neuromuscular-blockers-in-development-of-critical-illness-neuromuscular-abnormalities-a-historical-review
#17
Susan R Wilcox
Weakness is common in critically ill patients, associated with prolonged mechanical ventilation and increased mortality. Corticosteroids and neuromuscular blockade (NMB) administration have been implicated as etiologies of acquired weakness in the intensive care unit. Medical literature since the 1970s is replete with case reports and small case series of patients with weakness after receiving high-dose corticosteroids, prolonged NMB, or both. Several risk factors for weakness appear in the early literature, including large doses of steroids, the dose and duration of NMB, hyperglycemia, and the duration of mechanical ventilation...
September 26, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27735930/prenatal-visit-utilization-and-outcomes-in-pregnant-women-with-type-ii-and-gestational-diabetes
#18
E B Carter, M G Tuuli, A O Odibo, G A Macones, A G Cahill
OBJECTIVE: To investigate the association between the number of prenatal visits (PNVs) and pregnancy outcomes in women with gestational diabetes (GDM) and Type 2 diabetes mellitus (DM). STUDY DESIGN: A 4-year prospective cohort study of women with GDM and DM and was conducted. Patients ⩾75th percentile for number of PNVs were compared with those ⩽25th percentile. The primary outcomes were large for gestational age (LGA) with birth weight >90% and neonatal intensive care unit (NICU) admission for >24 h...
October 13, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27730074/evaluation-of-accuracy-of-ambulatory-glucose-profile-in-an-outpatient-setting-in-children-with-type-1-diabetes
#19
Anjana Hulse, Suahma Rai, K M Prasanna Kumar
BACKGROUND: In children with type 1 diabetes, intensive diabetes management has been demonstrated to reduce long-term microvascular complications. At present, self-monitoring of blood glucose (SMBG) by patients at home and glycated hemoglobin estimation every 3 months are used to monitor glycemic control in children. Recently, ambulatory glucose profile (AGP) is increasingly being used to study the glycemic patterns in adults. However, accuracy and reliability of AGP in children have not been evaluated yet...
September 2016: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27729569/chikungunya-virus-infection-and-diabetes-mellitus-a-double-negative-impact
#20
Eddy Jean-Baptiste, Julia von Oettingen, Philippe Larco, Frédérica Raphaël, Nancy Charles Larco, Marie Marcelle Cauvin, René Charles
The impact of chikungunya virus (CHIKV) infection on diabetic patients (DPs) has not been described. We aimed to compare clinical features of CHIKV infection in DPs and nondiabetic patients (NDPs), and to evaluate its effects on glycemic control among DP. We recorded clinical information and, in DP, glycemic control. Forty-six DPs and 53 NDPs aged ≥ 20 years living in Haiti, with acute CHIKV infection, were studied. Diabetes duration was 7.1 ± 6.1 years. The most common acute CHIKV clinical manifestations were arthralgia (100...
October 10, 2016: American Journal of Tropical Medicine and Hygiene
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