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Intensive glycemic control

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https://www.readbyqxmd.com/read/29141871/potential-approaches-to-prevent-hypoglycemia-associated-autonomic-failure
#1
REVIEW
Eric Lontchi-Yimagou, Jee Young You, Michelle Carey, Ilan Gabriely, Harry Shamoon, Meredith Hawkins
Clear health benefits are associated with intensive glucose control in type 1 diabetes mellitus (T1DM). However, maintaining near-normal glycemia remains an elusive goal for many patients, in large part owing to the risk of severe hypoglycemia. In fact, recurrent episodes of hypoglycemia lead to 'hypoglycemia-associated autonomic failure' (HAAF), characterized by defective counter-regulatory responses to hypoglycemia. Extensive studies to understand the mechanisms underlying HAAF have revealed multiple potential etiologies, suggesting various approaches to prevent the development of HAAF...
November 14, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/29139080/a-review-of-insulin-resistance-in-type-1-diabetes-is-there-a-place-for-adjunctive-metformin
#2
REVIEW
Gagan Priya, Sanjay Kalra
There is a rising trend of overweight and obesity among individuals with type 1 diabetes. This is often associated with insulin resistance, increased insulin dose requirements and poor glycemic control. Insulin resistance is also seen during puberty and is strongly related to increased risk of cardiovascular disease. The role of metformin as an adjunct to ongoing intensive insulin therapy in type 1 diabetics has been evaluated in several randomized trials, including the recently concluded T1D Exchange Network trial in adolescents and the REMOVAL trial in adults...
November 14, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29133220/effects-of-exercise-and-diet-in-nonobese-asthma-patients-a-randomized-controlled-trial
#3
Louise Lindhardt Toennesen, Howraman Meteran, Morten Hostrup, Nina Rica Wium Geiker, Camilla Bjoern Jensen, Celeste Porsbjerg, Arne Astrup, Jens Bangsbo, Debbie Parker, Vibeke Backer
BACKGROUND: Behavioral interventions focusing on exercise and healthy diet improve asthma control in obese patients with asthma, but whether these interventions can lead to improvements in nonobese patients remains unclear. OBJECTIVES: In a randomized, controlled parallel-group design, we studied the effects of an 8-week intervention of either exercise (high-intensity interval training), diet (high protein/low glycemic index), or a combination of the 2, on asthma control and clinical outcomes in nonobese patients with asthma...
November 10, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29130725/-eighth-jes%C3%A3%C2%BAs-culebras-lecture-critical-care-nutrition-and-hyperglycemia-a-close-relationship
#4
Alfonso Mesejo
Critically ill patients show a metabolic response to injury that affects carbohydrate metabolism, causing hyperglycemia and an increase in glycemic variability that makes the critically ill patient susceptible to infection, resulting in morbidity and mortality increase. Also, severe hypoglycemia was detected as a consequence of intensive insulin treatment that provokes deleterious effects in their clinical evolution, so a correct monitoring of plasma glucose would contribute to reduce morbidity and mortality...
October 24, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29124325/changes-in-fat-oxidation-in-response-to-various-regimes-of-high-intensity-interval-training-hiit
#5
REVIEW
Todd Anthony Astorino, Matthew M Schubert
Increased whole-body fat oxidation (FOx) has been consistently demonstrated in response to moderate intensity continuous exercise training. Completion of high intensity interval training (HIIT) and its more intense form, sprint interval training (SIT), has also been reported to increase FOx in different populations. An explanation for this increase in FOx is primarily peripheral adaptations via improvements in mitochondrial content and function. However, studies examining changes in FOx are less common in response to HIIT or SIT than those determining increases in maximal oxygen uptake which is concerning, considering that FOx has been identified as a predictor of weight gain and glycemic control...
November 9, 2017: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/29103302/continuous-glucose-monitoring-measures-can-be-used-for-glycemic-control-in-the-icu-an-in-silico-study
#6
Tony Zhou, Jennifer L Dickson, Geoffrey M Shaw, J Geoffrey Chase
BACKGROUND: Continuous glucose monitoring (CGM) technology has become more prevalent in the intensive care unit (ICU), offering potential benefits of increased safety and reduced workload in glycemic control (GC). The drift and higher point accuracy errors of CGM devices over traditional intermittent blood glucose (BG) measures have so far limited their application in the ICU. This study delineates the trade-offs of performance, safety and workload that CGM sensors provide in GC protocols...
November 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/29096968/antidiabetic-drugs-for-stroke-prevention-in-patients-with-type-2-diabetes-the-neurologist-s-point-of-view
#7
REVIEW
Blanca Fuentes
To date, stroke prevention in patients with diabetes mellitus (DM) has been based on the control of other risk factors and comorbidities, as clinical trials aimed at intensive glycemic control have failed to prove the existence of any sort of benefit in reducing macrovascular complications. However, thanks to the FDA's requirement to evaluate the vascular risk of antidiabetic drugs, there has been significant progress in the knowledge of their benefits on the risk of vascular death, acute myocardial infarction and non-fatal stroke in patients with type 2 DM and high vascular risk...
October 30, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/29078817/long-term-effects-of-high-dose-pitavastatin-on-diabetogenicity-in-comparison-with-atorvastatin-in-patients-with-metabolic-syndrome-less-dm-study-protocol-for-a-randomized-controlled-trial
#8
Jun-Bean Park, Ji-Hyun Jung, Yeonyee E Yoon, Hack-Lyong Kim, Seung-Pyo Lee, Hyung-Kwan Kim, Yong-Jin Kim, Goo-Yeong Cho, Dae-Won Sohn
BACKGROUND: The diabetogenic action of statins remains a concern, particularly in patients at high risk for diabetes receiving intensive statin therapy. Despite the risk of diabetes with statin use being considered a potential class effect, recent studies have suggested that pitavastatin exerts neutral or favorable effects on diabetogenicity. However, no randomized trial has compared the long-term effects of pitavastatin with those of other statins on glycemic control in populations at high risk for diabetes...
October 27, 2017: Trials
https://www.readbyqxmd.com/read/29072163/effect-of-high-and-low-glycemic-index-breakfast-on-postprandial-metabolic-parameters-and-satiety-in-subjects-with-type-2-diabetes-mellitus-under-intensive-insulin-therapy-controlled-clinical-trial
#9
Daniela R Lobos, Isabella A Vicuña, Victoria Novik, Claudia A Vega
BACKGROUND AND AIM: The results of studies evaluating the metabolic effects of glycemic index (GI) in subjects with type 2 diabetes mellitus (DM2) have been contradictory. Consequently, the benefits of its application are controversial and polarized opinions of international organizations have been disclosed. The above situation leads this study to evaluate the acute effect of low and high GI breakfast on the glycemic response and satiety in subjects with DM2 under intensive insulin therapy (IIT)...
August 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29067335/sedentary-behavior-as-a-risk-factor-for-cognitive-decline-a-focus-on-the-influence-of-glycemic-control-in-brain-health
#10
REVIEW
Michael J Wheeler, Paddy C Dempsey, Megan S Grace, Kathryn A Ellis, Paul A Gardiner, Daniel J Green, David W Dunstan
Cognitive decline leading to dementia represents a global health burden. In the absence of targeted pharmacotherapy, lifestyle approaches remain the best option for slowing the onset of dementia. However, older adults spend very little time doing moderate to vigorous exercise and spend a majority of time in sedentary behavior. Sedentary behavior has been linked to poor glycemic control and increased risk of all-cause mortality. Here, we explore a potential link between sedentary behavior and brain health. We highlight the role of glycemic control in maintaining brain function and suggest that reducing and replacing sedentary behavior with intermittent light-intensity physical activity may protect against cognitive decline by reducing glycemic variability...
September 2017: Alzheimer's & Dementia: Translational Research & Clinical Interventions
https://www.readbyqxmd.com/read/29063207/cardiorespiratory-fitness-and-cardiac-autonomic-function-in-diabetes
#11
REVIEW
Martin Röhling, Alexander Strom, Gidon J Bönhof, Michael Roden, Dan Ziegler
PURPOSE OF REVIEW: This review summarizes the current knowledge on the relationship of physical activity, exercise, and cardiorespiratory fitness (CRF) with cardiovascular autonomic neuropathy (CAN) based on epidemiological, clinical, and interventional studies. RECENT FINDINGS: The prevalence of CAN increases with age and duration of diabetes. Further risk factors for CAN comprise poor glycemic control, dyslipidemia, abdominal obesity, hypertension, and the presence of diabetic complications...
October 23, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/29059214/effect-of-glycemic-control-and-type-of-diabetes-treatment-on-unsuccessful-tb-treatment-outcomes-among-people-with-tb-diabetes-a-systematic-review
#12
REVIEW
Hemant Deepak Shewade, Kathiresan Jeyashree, Preetam Mahajan, Amar N Shah, Richard Kirubakaran, Raghuram Rao, Ajay M V Kumar
BACKGROUND: Stringent glycemic control by using insulin as a replacement or in addition to oral hypoglycemic agents (OHAs) has been recommended for people with tuberculosis and diabetes mellitus (TB-DM). This systematic review (PROSPERO 2016:CRD42016039101) analyses whether this improves TB treatment outcomes. OBJECTIVES: Among people with drug-susceptible TB and DM on anti-TB treatment, to determine the effect of i) glycemic control (stringent or less stringent) compared to poor glycemic control and ii) insulin (only or with OHAs) compared to 'OHAs only' on unsuccessful TB treatment outcome(s)...
2017: PloS One
https://www.readbyqxmd.com/read/29057643/monotherapy-in-patients-with-type-2-diabetes-mellitus
#13
REVIEW
Sang Youl Rhee, Hyun Jin Kim, Seung-Hyun Ko, Kyu Yeon Hur, Nan-Hee Kim, Min Kyong Moon, Seok-O Park, Byung-Wan Lee, Kyung Mook Choi, Jin Hwa Kim
In order to improve the quality of life and to prevent chronic complications related to diabetes mellitus, intensive lifestyle modification and proper medication are needed from the early stage of diagnosis of type 2 diabetes mellitus (T2DM). When using the first medication for diabetic patients, the appropriate treatment should be selected considering the clinical characteristics of the patient, efficacy of the drug, side effects, and cost. In general, the use of metformin as the first treatment for oral hypoglycemic monotherapy is recommended because of its excellent blood glucose-lowering effect, relatively low side effects, long-term proven safety, low risk of hypoglycemia, and low weight gain...
November 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29049766/review-in-diabetes-intensive-and-standard-glycemic-control-do-not-differ-for-end-stage-kidney-disease-or-death
#14
Indranil Dasgupta, Ajay K Singh
No abstract text is available yet for this article.
October 17, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29044305/dysglycemia-in-the-critically-ill-patient-current-evidence-and-future-perspectives
#15
Ignacio Aramendi, Gastón Burghi, William Manzanares
Dysglycemia in critically ill patients (hyperglycemia, hypoglycemia, glycemic variability and time in range) is a biomarker of disease severity and is associated with higher mortality. However, this impact appears to be weakened in patients with previous diabetes mellitus, particularly in those with poor premorbid glycemic control; this phenomenon has been called "diabetes paradox". This phenomenon determines that glycated hemoglobin (HbA1c) values should be considered in choosing glycemic control protocols on admission to an intensive care unit and that patients' target blood glucose ranges should be adjusted according to their HbA1c values...
July 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29032131/association-between-type-2-diabetes-and-all-cause-hospitalization-and-mortality-in-the-uk-general-heart-failure-population-stratification-by-diabetic-glycemic-control-and-medication%C3%A2-intensification
#16
Claire A Lawson, Peter W Jones, Lucy Teece, Sandra B Dunbar, Petar M Seferovic, Kamlesh Khunti, Mamas Mamas, Umesh T Kadam
OBJECTIVES: This study sought to investigate in the general heart failure (HF) population, whether the associations between type 2 diabetes (T2D) and risk of hospitalization and death, are modified by changing glycemic or drug treatment intensity. BACKGROUND: In the general HF population, T2D confers a higher risk of poor outcomes, but whether this risk is modified by the diabetes status is unknown. METHODS: A nested case-control study in an incident HF database cohort (2002 to 2014) comparing patients with T2D with those without, for risk of all-cause first hospitalization and death...
October 4, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28983844/the-role-of-vildagliptin-in-the-therapy-of-type-2-diabetic-patients-with-renal-dysfunction
#17
REVIEW
Roberto Trevisan
Diabetes is the leading cause of chronic kidney disease, and even in the absence of albuminuria, decreased renal function in type 2 diabetes mellitus (T2DM) patients increases the risk for major adverse cardiovascular events and death. The evidence derived from recent studies suggests that intensive glucose control not only reduces the risk for microalbuminuria and macroalbuminuria but may also decrease the rate of decline of glomerular filtration rate (GFR). Although insulin therapy is widely used in patients with T2DM and renal disease, metabolic control is particularly difficult to achieve and manage because of the limited therapeutic options and the frequent comorbidities seen in this population...
December 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28983746/performance-of-granular-starch-with-controlled-pore-size-during-hydrolysis-with-digestive-enzymes
#18
Yaiza Benavent-Gil, Cristina M Rosell
Studies on porous starch have been directed to explore different industrial applications as bio-adsorbents of a variety of compounds. However, the analysis of starch digestibility is essential for food application. The objective of this study was to determine the impact of porous structure on in vitro starch digestibility. Porous starches were obtained using a range of concentrations of amyloglucosidase (AMG), α-amylase (AM), cyclodextrin-glycosyltransferase (CGTase) or branching enzyme (BE). Porous starches exhibited major content of digestible starch (DS) that increased with the intensity of the enzymatic treatment, and very low amount of resistant starch (RS)...
October 5, 2017: Plant Foods for Human Nutrition
https://www.readbyqxmd.com/read/28970655/liraglutide-as-an-alternative-to-insulin-for-glycemic-control-in-intensive-care-unit-a-randomized-open-label-clinical-study
#19
Vishesh Verma, Narendra Kotwal, Vimal Upreti, Monish Nakra, Yashpal Singh, K Anand Shankar, Amit Nachankar, K V S Hari Kumar
BACKGROUND: Intravenous insulin is the cornerstone in the management of hyperglycemia in the Intensive Care Unit (ICU). We studied the efficacy of liraglutide compared with insulin in the ICU. MATERIALS AND METHODS: In this prospective, open-labeled, randomized study, we included 120 patients (15-65 years, either sex) admitted to ICU with capillary blood glucose (CBG) between 181 and 300 mg/dl. We excluded patients with secondary diabetes and APACHE score >24...
September 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28956823/sugar-and-intense-sweetened-drinks-in-australia-a-systematic-review-on-cardiometabolic-risk
#20
REVIEW
Erin Hoare, Pia Varsamis, Neville Owen, David W Dunstan, Garry L Jennings, Bronwyn A Kingwell
Sugar-sweetened beverages (SSBs) are consumed globally, and have been associated with adverse health outcomes, including weight gain, high blood pressure, type 2 diabetes (T2D), and cardiovascular disease (CVD). There is global variation in beverage formulation in terms of glucose and fructose concentration, which may pose unique health risks linked to glycemic control for Australian consumers. However, previous systematic reviews have overlooked Australian-based literature. A systematic review was performed to synthesise evidence for the associations between consumption of SSBs and intense-sweetened beverages with clinical cardiometabolic risk factors in the Australian population...
September 28, 2017: Nutrients
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