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Intensive glycemic control

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https://www.readbyqxmd.com/read/28920012/comparative-effectiveness-for-glycemic-control-in-older-adults-with-diabetes
#1
Michael Quartuccio, Brian Buta, Rita R Kalyani
PURPOSE OF REVIEW: To review and summarize the current data for comparative effectiveness of glycemic control in older adults. RECENT FINDINGS: In the last several years, professional societies have released guidelines for glycemic control in older adults, generally recommending individualized HbA1c goals. However, recent observational studies demonstrate that many older adults remain aggressively managed and are at increased risk of hypoglycemia. Large randomized trials of older adults with diabetes have failed to show cardiovascular benefit from intensive glycemic control and show only minimal microvascular benefit...
September 2017: Current Geriatrics Reports
https://www.readbyqxmd.com/read/28918342/the-potential-effect-of-ultra-long-insulin-degludec-on-glycemic-variability
#2
REVIEW
M Rodacki, R M Carvalho, L Zajdenverg
Despite the therapeutic advances in the treatment of diabetes, metabolic control instability due to glycemic variability (GV) is frequently observed in patients with diabetes on intensive insulin therapy and is associated with hyperglycemic peaks and hypoglycemic episodes. Hyperglycemia associated with GV has been implicated in the development of chronic complications due to its pro-oxidative consequences. On the other hand, hypoglycemia can be associated with increased cardiovascular risk secondarily to adrenergic activation...
June 30, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28913822/improved-glycemic-control-in-a-patient-group-performing-7-point-profile-self-monitoring-of-blood-glucose-and-intensive-data-documentation-an-open-label-multicenter-observational-study
#3
Jochen Sieber, Frank Flacke, Manuela Link, Cornelia Haug, Guido Freckmann
INTRODUCTION: Regular self-monitoring of blood glucose (SMBG) is recommended as an integral part of therapy for all patients with diabetes treated with insulin. In the current study, the effects on glycemic control of taking 7-point SMBG profiles and using a diabetes management system (DMA) on a smartphone were investigated. METHODS: In a 12-week, open-label, multicenter, observational study, 51 patients [26 with type 1 diabetes mellitus (T1DM) and 25 with type 2 diabetes mellitus (T2DM)] were instructed to perform SMBG at least seven times a day using DMA combined with the iBGStar (®) SMBG system...
September 14, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28904479/effect-of-fat-based-versus-carbohydrate-based-enteral-feeding-on-glycemic-control-in-critically-ill-patients-a-randomized-clinical-trial
#4
Mahdieh Nourmohammadi, Omid Moradi Moghadam, Mohammad Niakan Lahiji, Sevak Hatamian, Zahra Vahdat Shariatpanahi
BACKGROUND AND AIMS: The aim of this study was to evaluate the preventive effects of high-fat enteral feeding on glycemic control and clinical outcomes in critically ill patients: a randomized clinical trial. MATERIALS AND METHODS: This study was done on 42 normoglycemic patients admitted to Intensive Care Unit (ICU). Patients were randomly classified into three groups of 14 each. Control group (A) received carbohydrate-based diet (protein: 20%, fat: 30%, and carbohydrate: 50%), study groups received two types of high-fat diet; Group B (protein: 20%, fat: 45% including half of olive oil and half sunflower oil, and carbohydrate: 35%); and Group C (protein: 20%, fat: 45% including sunflower oil, and carbohydrate: 35%) in the first 48 h of admission...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28900818/the-effects-of-chronic-aerobic-exercise-on-cardiovascular-risk-factors-in-persons-with-diabetes-mellitus
#5
REVIEW
Emily M Miele, Samuel A E Headley
PURPOSE OF REVIEW: Aerobic exercise training is a component of diabetes mellitus (DM) care guidelines due to its favorable effects on glycemic control and cardiovascular disease (CVD) risk factors. The purpose of this review is to outline the recent evidence regarding the clinical effects of chronic aerobic exercise on CVD risk factors in persons with DM and to compare the effects of varying intensities and types of exercise. RECENT FINDINGS: Among individuals with DM, all types of aerobic exercise training can impact positively on some traditional and non-traditional risk factors for CVD...
September 12, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28899347/case-report-of-hyperglycemic-nonketotic-chorea-with-rapid-radiological-resolution
#6
H M M T B Herath, S P Pahalagamage, Sunethra Senanayake
BACKGROUND: Hemichorea is a rare manifestation of nonketotic hyperglycemia that usually affects elderly Asian women with poor glycemic control. Non-contrast computerized Tomography and T1- weighted Magnetic Resonance Imaging shows characteristic hyperintense basal ganglia lesions. CASE PRESENTATION: A Fifty-seven year old Sri Lankan female presented with a two-day history of right upper limb chorea. She had been diagnosed with diabetes mellitus one year ago, but was not on any treatment and did not have any micro vascular or macro vascular complications...
September 12, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/28895637/eating-frequency-and-carbohydrate-intake-in-adolescents-with-type-1-diabetes-differ-from-those-in-their-peers-and-are-associated-with-glycemic-control
#7
Christina Baechle, Annika Hoyer, Katty Castillo-Reinado, Anna Stahl-Pehe, Oliver Kuss, Reinhard W Holl, Mathilde Kersting, Joachim Rosenbauer
Aim The diet of people with type 1 diabetes may differ from that of healthy peers due to disease-related factors that may affect the course of diabetes. This cross-sectional study sought to compare meal and snacking frequency and corresponding carbohydrate intake among adolescents with intensively-treated type 1 diabetes and healthy peers and to analyze their association with glycemic control among diabetes patients. Methods Nutritional data of 712 11- to <19-year-olds from a nationwide population-based survey on early-onset type 1 diabetes (52...
September 11, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28895030/type-2-diabetes-and-cardiovascular-prevention-the-dogmas-disputed
#8
Dario Giugliano, Maria Ida Maiorino, Giuseppe Bellastella, Katherine Esposito
In randomized controlled trials (RCTs), more intensive glucose control in patients with type 2 diabetes leads to a modest (9%) reduction in major cardiovascular events (MACE), associated with a 20% reduction of kidney events and 13% reduction of eye events. The FDA issued guidance in 2008 led to the conduct of numerous cardiovascular outcomes (CVOT) trials to assess cardiovascular safety of new antihyperglycemic therapies in patients with type 2 diabetes. The results of these trials show that insulin glargine, three different dipeptidyl peptidase-4 (DPP-4) inhibitors (saxagliptin, alogliptin, and sitagliptin) and lixisenatide (a glucagon like peptide-1 receptor agonist) produce no significant difference in CVOT when compared with usual care or placebo...
September 11, 2017: Endocrine
https://www.readbyqxmd.com/read/28883892/impact-of-post-meal-and-one-time-daily-exercise-in-patient-with-type-2-diabetes-mellitus-a-randomized-crossover-study
#9
Daizy Pahra, Nitasha Sharma, Sandhya Ghai, Abhishek Hajela, Shobhit Bhansali, Anil Bhansali
BACKGROUND: To evaluate the effectiveness of short-timed post-meal and one-time daily exercise on glycemic control in patients with T2DM. METHODS: Sixty-four T2DM patients were randomised into crossover design. Group A (n = 32) underwent post-meal exercise (moderate-intensity brisk walking covering 1500-1600 steps for 15 min, starting 15 min after each meal) from d1 to d60 followed by one-time daily exercise (45 min pre-breakfast brisk walking at stretch covering 4500-4800 steps) from d61 to d120, while it was vice versa for the group B (n = 32)...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28875724/the-long-and-winding-road-toward-personalized-glycemic-control-in-the-critically-ill
#10
James Stephen Krinsley
Hyperglycemia is very common in critically ill patients and interventional studies of intensive insulin therapy with the goal of returning ICU glycemia to normal levels have demonstrated mixed results. A large body of literature has demonstrated that diabetes, per se, is not independently associated with increased risk of mortality in this population and that the relationship of glucose metrics to mortality is different for patients with and without diabetes. Moreover, these relationships are confounded by preadmission glycemia; in this regard, patients with diabetes and good preadmission glucose control, as reflected by HbA1c levels obtained at the time of ICU admission, are similar to patients without diabetes...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28874181/effect-of-an-intensive-nutrition-intervention-of-a-high-protein-and-low-glycemic-index-diet-on-weight-of-kidney-transplant-recipients-study-protocol-for-a-randomized-clinical-trial
#11
Elis Forcellini Pedrollo, Bruna Bellincanta Nicoletto, Larissa Salomoni Carpes, Júlia de Melo Cardoso de Freitas, Julia Roberta Buboltz, Cristina Carra Forte, Andrea Carla Bauer, Roberto Ceratti Manfro, Gabriela Corrêa Souza, Cristiane Bauermann Leitão
BACKGROUND: Excessive weight gain is commonly observed within the first year after kidney transplantation and is associated with negative outcomes, such as graft loss and cardiovascular events. The purpose of this study is to evaluate the effect of a high protein and low glycemic-index diet on preventing weight gain after kidney transplantation. METHODS: We designed a prospective, single-center, open-label, randomized controlled study to compare the efficacy of a high protein (1...
September 6, 2017: Trials
https://www.readbyqxmd.com/read/28864965/pharmacological-management-of-gestational-diabetes-mellitus
#12
Geetha Mukerji, Denice S Feig
Gestational diabetes mellitus (GDM) is associated with an increased risk of adverse pregnancy outcomes in the setting of poor glycemic control. The initial management for GDM includes intensive lifestyle modification, which often requires behavioral and nutritional changes to optimize glycemic control. Pharmacotherapy for GDM is initiated when glycemic targets are not met. The rapid-acting bolus analogues aspart and lispro achieve postprandial targets with less hypoglycemia compared to regular insulin, with similar fetal outcomes...
September 2, 2017: Drugs
https://www.readbyqxmd.com/read/28860128/opioid-receptor-activation-impairs-hypoglycemic-counterregulation-in-humans
#13
Michelle Carey, Rebekah Gospin, Akankasha Goyal, Nora Tomuta, Oana Sandu, Armand Mbanya, Eric Lontchi-Yimagou, Raphael Hulkower, Harry Shamoon, Ilan Gabriely, Meredith Hawkins
Although intensive glycemic control improves outcomes in type 1 diabetes mellitus, iatrogenic hypoglycemia limits its attainment. Recurrent and/or antecedent hypoglycemia causes blunting of protective counterregulatory responses, known as Hypoglycemia-Associated Autonomic Failure (HAAF). To determine whether and how opioid receptor activation induces HAAF in humans, twelve healthy, non-diabetic subjects (7M, age 32.3 ± 2.2 yr, BMI 25.1 ± 1.0 kg/m2) participated in two study protocols in random order over two consecutive days...
August 31, 2017: Diabetes
https://www.readbyqxmd.com/read/28855239/closed-loop-control-during-intense-prolonged-outdoor-exercise-in-adolescents-with-type-1-diabetes-the-artificial-pancreas-ski-study
#14
Marc D Breton, Daniel R Cherñavvsky, Gregory P Forlenza, Mark D DeBoer, Jessica Robic, R Paul Wadwa, Laurel H Messer, Boris P Kovatchev, David M Maahs
OBJECTIVE: Intense exercise is a major challenge to the management of type 1 diabetes (T1D). Closed loop control (CLC) systems (artificial pancreas) improve glycemic control during limited intensity and short duration of physical activity (PA). However, CLC has not been tested during extended vigorous outdoor exercise common among adolescents. RESEARCH DESIGN AND METHODS: Skiing presents unique metabolic challenges: intense prolonged PA, cold, altitude, and stress/fear/excitement...
August 30, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28844353/a-systematic-review-of-interventions-for-hispanic-women-with-or-at-risk-of-gestational-diabetes-mellitus-gdm
#15
REVIEW
Mary Carolan-Olah, Maria Duarte-Gardea, Julia Lechuga
BACKGROUND AND OBJECTIVE: Gestational Diabetes Mellitus (GDM) is a serious health concern for pregnant women, with Hispanic women at particular risk for developing the condition. The aim of this review was to critically examine GDM intervention programs for Hispanic women, in the United States of America (US). METHODS: English and Spanish electronic databases were searched for relevant studies published between 1995 and 2015. Eligible study designs included randomized controlled trial, pre/post-test and quasi experimental methods...
October 2017: Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives
https://www.readbyqxmd.com/read/28841246/facility-level-variation-in-diabetes-and-blood-pressure-control-in-patients-with-diabetes-findings-from-the-veterans-affairs-national-database
#16
Hasan Rehman, Julia M Akeroyd, David Ramsey, Sarah T Ahmed, Anwar T Merchant, Sankar D Navaneethan, Laura A Petersen, Salim S Virani
BACKGROUND: Intensive glycemic and blood pressure (BP) control in diabetic patients is associated with improved cardiovascular outcomes. HYPOTHESIS: We hypothesized that there is suboptimal glycemic and BP control with significant facility-level variation in patients with diabetes. METHODS: We identified patients with diabetes receiving care in 130 facilities in the Veterans Affairs Health Care System. We assessed facility-level rates of glycemic (hemoglobin [Hb]A1c <7%), BP (BP <140/90 mmHg), and combined glycemic and BP control (HbA1c <7% and BP <140/90 mmHg), and their facility-level variation in using median rate ratios (MRR)...
August 25, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28836877/management-of-hyperglycemia-in-the-neurosurgery-patient
#17
Rene Daniel, Satya Villuri, Kevin Furlong
Hyperglycemia is associated with adverse outcomes in patients who are candidates for or underwent neurosurgical procedures. Specific concerns and settings that relate to these patients are preoperative glycemic control, intraoperative control, management in the neurological intensive care unit (NICU), and postoperative control. In each of these settings, physicians have to ensure appropriate glycemic control to prevent or minimize adverse events. The glycemic control is usually managed by a neurohospitalist in co-management with the neurosurgery team pre- and post-operatively, and by the neurocritical care team in the setting of NICU...
August 30, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28832184/type-1-diabetes-at-high-altitude-performance-of-personal-insulin-pumps-and-patient-metabolic-control
#18
Bartłomiej Matejko, Andrzej Gawrecki, Marta Wróbel, Jerzy Hohendorff, Teresa Benbenek-Klupa, Maciej T Malecki, Dorota Zozulińska-Ziółkiewicz, Tomasz Klupa
High-altitude trekking can expose people to extreme environmental conditions, like low temperatures and hypobaric hypoxia. Such extreme conditions make it more difficult for people with type 1 diabetes mellitus (T1DM) to maintain glycemic control. Intensive blood glucose monitoring using either glucose meters or continuous systems is imperative in these cases. In this observational study, we report metabolic control of T1DM patients and the performance of various insulin pumps at high altitude. All 19 patients with T1DM included in this study participated in the final step of the "5000 meters above sugar level" initiative, which involved trekking Damavand Mountain to an altitude of 5670 meters above sea level...
August 23, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28828040/association-between-aerobic-capacity-and-the-improvement-in-glycemic-control-after-the-exercise-training-in-type-2-diabetes
#19
Hideki Nojima, Masayasu Yoneda, Hiroshi Watanabe, Kiminori Yamane, Yoshihiro Kitahara, Kiyokazu Sekikawa, Hideya Yamamoto, Akihito Yokoyama, Noboru Hattori, Nobuoki Kohno
BACKGROUND: We investigated the influence of aerobic capacity on the improvement in glycemic control achieved by long-term aerobic exercise in type 2 diabetes. METHODS: Fifty-three male patients with type 2 diabetes, recruited from outpatient clinics, wore multiple-memory accelerometers and were instructed to exercise at moderate intensity for ≥30 min on ≥3 days per week over 12 months. Peak oxygen uptake (peak [Formula: see text]) and serum glycated albumin (GA) were measured at baseline and after 3, 6, 12 months...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28821468/design-and-development-of-a-stepped-care-behavioral-intervention-to-support-parents-of-young-children-newly-diagnosed-with-type-1-diabetes
#20
Marisa E Hilliard, Carrie Tully, Maureen Monaghan, Jichuan Wang, Randi Streisand
One of the most common chronic conditions of childhood, the prevalence of type 1 diabetes (T1D) in young children is increasing. Early childhood development complicates optimal T1D management and glycemic outcomes. Parents are at risk for elevated psychological distress, especially immediately following diagnosis. Few empirically supported interventions are available to support parents and promote optimal T1D management during this vulnerable period. This paper reports on the development and study design of First STEPS: Study of Type 1 in Early childhood and Parenting Support...
August 15, 2017: Contemporary Clinical Trials
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