keyword
https://read.qxmd.com/read/38397994/hypoglycemia-unawareness-a-review-on-pathophysiology-and-clinical-implications
#21
REVIEW
Laura Hölzen, Bernd Schultes, Sebastian M Meyhöfer, Svenja Meyhöfer
Hypoglycemia is a particular problem in people with diabetes while it can also occur in other clinical circumstances. Hypoglycemia unawareness describes a condition in which autonomic and neuroglycopenic symptoms of hypoglycemia decrease and hence are hardly perceivable. A failure to recognize hypoglycemia in time can lead to unconsciousness, seizure, and even death. The risk factors include intensive glycemic control, prior episodes of severe hypoglycemia, long duration of diabetes, alcohol consumption, exercise, renal failure, and sepsis...
February 8, 2024: Biomedicines
https://read.qxmd.com/read/38382049/increasing-aerobic-exercise-intensity-fails-to-consistently-improve-the-glycemic-response-in-people-living-with-prediabetes-or-type-2-diabetes-mellitus-the-intensity-trial
#22
JOURNAL ARTICLE
Travis J Hrubeniuk, Danielle R Bouchard, Brendon J Gurd, Martin Sénéchal
Some individuals with prediabetes or type 2 diabetes mellitus (T2DM) who engage in exercise will not experience the anticipated improvements in glycemic control, referred to as non-responders. Increasing exercise intensity may improve the proportion of individuals who become responders. The objectives were to: 1) Identify responders and non-responders based on changes in glycated hemoglobin (HbA1c) in individuals with prediabetes or T2DM following 16 weeks of aerobic exercise; 2) Investigate if increasing exercise intensity enhances the responders' status for individuals not previously responding favourably to the intervention...
February 21, 2024: Applied Physiology Nutrition and Metabolism
https://read.qxmd.com/read/38377319/the-health-economics-of-automated-insulin-delivery-systems-and-the-potential-use-of-time-in-range-in-diabetes-modeling-a-narrative-review
#23
JOURNAL ARTICLE
Chantal Mathieu, Waqas Ahmed, Pieter Gillard, Ohad Cohen, Robert Vigersky, Simona de Portu, Asli Zeynep Ozdemir Saltik
Intensive therapy with exogenous insulin is the treatment of choice for individuals living with type 1 diabetes (T1D) and some with type 2 diabetes, alongside regular glucose monitoring. The development of systems allowing (semi-)automated insulin delivery (AID), by connecting glucose sensors with insulin pumps and algorithms, has revolutionized insulin therapy. Indeed, AID systems have demonstrated a proven impact on overall glucose control, as indicated by effects on glycated hemoglobin (HbA1c), risk of severe hypoglycemia, and quality of life measures...
March 2024: Diabetes Technology & Therapeutics
https://read.qxmd.com/read/38377316/exercising-safely-with-the-minimed%C3%A2-780g-automated-insulin-delivery-system
#24
JOURNAL ARTICLE
David N O'Neal, Dessi P Zaharieva, Dale Morrison, Olivia McCarthy, Kirsten Nørgaard
The physical and psychological benefits of exercise are particularly pertinent to people with type 1 diabetes (T1D). The variability in subcutaneous insulin absorption and the delay in offset and onset in glucose lowering action impose limitations, given the rapidly varying insulin requirements with exercise. Simultaneously, there are challenges to glucose monitoring. Consequently, those with T1D are less likely to exercise because of concerns regarding glucose instability. While glucose control with exercise can be enhanced using automated insulin delivery (AID), all commercially available AID systems remain limited by the pharmacokinetics of subcutaneous insulin delivery...
March 2024: Diabetes Technology & Therapeutics
https://read.qxmd.com/read/38367595/the-effect-of-chrono-nutritional-manipulation-of-carbohydrate-intake-on-sleep-macrostructure-a-randomized-controlled-trial
#25
JOURNAL ARTICLE
Angelos Vlahoyiannis, Eleni Andreou, Panagiotis Bargiotas, George Aphamis, Giorgos K Sakkas, Christoforos D Giannaki
BACKGROUND & AIMS: Over the years, there is a rapid increase in the prevalence of inadequate sleep and its detrimental consequences. Yet, the impact of prolonged nutritional interventions on sleep optimization remains unexplored. To examine the effect of carbohydrate manipulation combined with exercise training on sleep macro-structure. METHODS: Forty-two healthy, trained male volunteers were recruited for this study. The 4-week intervention consisted of three groups: i) Sleep Low-No Carbohydrates (SL-NCHO): participants consumed all their carbohydrate intake at regular intervals prior to evening training, ii) Sleep High-Low Glycemic Index (SH-LGI) and iii) Sleep High-High Glycemic Index (SH-HGI): Carbohydrate intake was spread throughout the day, both prior (60% of total CHO intake) and after evening training (40% of total CHO intake)...
February 15, 2024: Clinical Nutrition
https://read.qxmd.com/read/38365663/resolution-of-insulin-resistance-lactic-acidosis-and-decrease-in-mechanical-support-requirements-in-patients-post-orthotopic-heart-transplant-with-the-use-of-long-acting-insulin-glargine
#26
JOURNAL ARTICLE
Ribal Darwish, Eva Chen, Steven Minear, Cedric Sheffield
OBJECTIVE: This study investigates the efficacy of using a long-acting insulin analog, along with the infusion of regular insulin, in achieving appropriate glycemic control and correcting lactic acidosis in patients post orthotopic heart transplant who demonstrate severe lactic acidosis and insulin resistance. METHODS: This was a retrospective study of two cohorts (IRB FLA 20-003) of patients post orthotopic heart transplant with severe lactic acidosis and insulin resistance who were admitted to a tertiary intensive care unit and treated with (group 1) or without long-acting insulin analog (group 2) within the first 24 h of admission to the intensive care unit...
February 16, 2024: Journal of Cardiothoracic Surgery
https://read.qxmd.com/read/38356161/continuous-glucose-monitors-and-reduced-diabetes-related-hospitalizations-in-patients-with-type-2-diabetes-and-chronic-kidney-disease
#27
JOURNAL ARTICLE
Katia L Hannah, Poorva M Nemlekar, Matthew L Johnson, Daniel R Cherñavvsky, Gregory J Norman
BACKGROUND: There is a heightened risk of glycemic variability in patients with diabetes and chronic kidney disease (CKD). This glycemic variability could lead to hypoglycemic or hyperglycemic crises. We hypothesized that initiation of continuous glucose monitoring (CGM), which provides a glucose measurement every 1-5 minutes, could reduce the incidence of hospitalizations for patients with type 2 diabetes (T2D) and CKD. METHODS: A retrospective analysis of US administrative claims data from the Optum Clinformatics© Database was conducted...
February 15, 2024: Kidney360
https://read.qxmd.com/read/38347569/the-double-burden-type-1-diabetes-and-heart-failure-a-comprehensive-review
#28
REVIEW
María Teresa Julián, Alejandra Pérez-Montes de Oca, Josep Julve, Nuria Alonso
Heart failure (HF) is increasing at an alarming rate, primary due to the rising in aging, obesity and diabetes. Notably, individuals with type 1 diabetes (T1D) face a significantly elevated risk of HF, leading to more hospitalizations and increased case fatality rates. Several risk factors contribute to HF in T1D, including poor glycemic control, female gender, smoking, hypertension, elevated BMI, and albuminuria. However, early and intensive glycemic control can mitigate the long-term risk of HF in individuals with T1D...
February 12, 2024: Cardiovascular Diabetology
https://read.qxmd.com/read/38345856/electronic-interactive-games-for-glycemic-control-in-individuals-with-diabetes-systematic-review-and-meta-analysis
#29
REVIEW
WenQi Yao, YiBing Han, Li Yang, Ying Chen, ShengZhe Yan, YanZhen Cheng
BACKGROUND: Several electronic interventions have been used to improve glycemic control in patients with diabetes. Electronic interactive games specific to physical activity are available, but it is unclear if these are effective at improving glycemic control in patients with diabetes. OBJECTIVE: This study aimed to determine the effects of electronic game-based interventions on glycemic control in patients with diabetes. METHODS: Relevant studies that were published before April 1, 2023, were searched from 5 databases: PubMed, Embase, Web of Science, Scopus, and Cochrane Library...
February 12, 2024: JMIR Serious Games
https://read.qxmd.com/read/38344584/insulin-pump-therapy-vs-multiple-daily-insulin-injections-for-glycemic-control-in-children-with-type-1-diabetes-a-systematic-review-and-meta-analysis
#30
REVIEW
Ernesto Calderon Martinez, Jaqueline L Castillo, Stephin Zachariah Saji, Daniel Stein, Tayyaba J Khan, Rosa F Guardado Williams, Irma D Munguía, Victor Sebastian Arruarana, Karen Velasquez
Type 1 diabetes mellitus (T1DM), characterized by the autoimmune destruction of pancreatic beta cells and consequent insulin deficiency, leads to various complications. Management primarily focuses on optimal glycemic control through intensive insulin therapy, either via multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) using insulin pumps, which offer flexibility and improved basal insulin delivery. Despite the benefits of insulin pumps, such as reduced hypoglycemia risk and better mealtime insulin management, they pose challenges such as complexity in site changes and potential ketoacidosis due to tubing issues...
January 2024: Curēus
https://read.qxmd.com/read/38335020/care-partner-engagement-in-secure-messaging-between-patients-with-diabetes-and-their-clinicians-cohort-study
#31
JOURNAL ARTICLE
Wagahta Semere, Andrew J Karter, Courtney R Lyles, Mary E Reed, Leah Karliner, Celia Kaplan, Jennifer Y Liu, Jennifer Livaudais-Toman, Dean Schillinger
BACKGROUND: Patient engagement with secure messaging (SM) via digital patient portals has been associated with improved diabetes outcomes, including increased patient satisfaction and better glycemic control. Yet, disparities in SM uptake exist among older patients and racial and ethnic underserved groups. Care partners (family members or friends) may provide a means for mitigating these disparities; however, it remains unclear whether and to what extent care partners might enhance SM use...
February 9, 2024: JMIR Diabetes
https://read.qxmd.com/read/38313848/individualized-intensive-insulin-therapy-of-diabetes-not-only-the-goal-but-also-the-time
#32
EDITORIAL
Yun Hu, Hong-Jing Chen, Jian-Hua Ma
Intensive insulin therapy has been extensively used to control blood glucose levels because of its ability to reduce the risk of chronic complications of diabetes. According to current guidelines, intensive glycemic control requires individualized glucose goals rather than as low as possible. During intensive therapy, rapid blood glucose reduction can aggravate microvascular and macrovascular complications, and prolonged overuse of insulin can lead to treatment-induced neuropathy and retinopathy, hypoglycemia, obesity, lipodystrophy, and insulin antibody syndrome...
January 15, 2024: World Journal of Diabetes
https://read.qxmd.com/read/38295867/insulin-infusion-protocols-for-blood-glucose-management-in-critically-ill-patients-a-scoping-review
#33
JOURNAL ARTICLE
Miao Huang, Ruiqi Yang, Dong Pang, Xiuni Gan
BACKGROUND: Continuous insulin infusion is a method for maintaining blood glucose stability in critically ill patients with hyperglycemia. Many insulin infusion protocols have been applied in intensive care units. Understanding the content of these protocols can help clinical staff choose the most appropriate and convenient protocol and promote best practices in managing glucose levels in critically ill adult patients. OBJECTIVE: To examine the types of insulin infusion therapies performed for blood glucose management in critically ill patients...
February 1, 2024: Critical Care Nurse
https://read.qxmd.com/read/38293950/effect-of-intensive-lifestyle-intervention-on-cardiovascular-risk-factors-analysis-from-the-perspective-of-long-term-variability
#34
JOURNAL ARTICLE
Lixiang He, Menghui Liu, Xiaodong Zhuang, Yue Guo, Peng Wang, Zhuoming Zhou, Zhuohui Chen, Longyun Peng, Xinxue Liao
BACKGROUND: An association between variability of cardiovascular risk factors and cardiovascular events has been reported. We examined whether intensive lifestyle intervention (ILI) for weight loss decreased variability of cardiovascular risk factors with a view to additional cardiometabolic benefits. METHODS AND RESULTS: This study was a post hoc secondary analysis of the Look AHEAD (Action for Health in Diabetes) study. Cardiovascular risk factors were measured at 1-year intervals for 4 years in 4249 adults with overweight or obesity and type 2 diabetes who were randomly assigned to ILI or diabetes support and education...
January 31, 2024: Journal of the American Heart Association
https://read.qxmd.com/read/38292109/an-orthopedic-perspective-on-diabetic-foot-attack-a-case-report
#35
Aakaash Venkatesan, Chandan Noel, Waleed Akeel
INTRODUCTION: Diabetic foot attack (DFA), also known as diabetic foot ulceration, is a severe and potentially limb-threatening complication of diabetes mellitus. It refers to the development of open sores or ulcers on the feet of individuals with diabetes, often leading to infections, tissue damage, and, in extreme cases, amputation. The underlying cause of DFAs is multifactorial and involves a complex interplay of various factors, including peripheral neuropathy, peripheral arterial disease, foot deformities, impaired wound healing, and poor glycemic control...
January 2024: Journal of Orthopaedic Case Reports
https://read.qxmd.com/read/38262002/poor-glycemic-control-is-associated-with-more-rapid-kidney-function-decline-after-the-onset-of-diabetic-kidney-disease
#36
JOURNAL ARTICLE
Hetal S Shah, Janet B McGill, Irl B Hirsch, Chunyi Wu, Andrzej Galecki, Ian H de Boer, Michael Mauer, Alessandro Doria
BACKGROUND: The role of glycemic control and its variability on the rate of kidney function decline after the onset of diabetic kidney disease (DKD) remains unclear. METHODS: The association between baseline HbA1c and rates of estimated GFR (eGFR) loss during follow-up was examined by mixed-effects linear regression in 530 individuals with type 1 diabetes and early-to-moderate DKD from the Preventing Early Renal Loss (PERL) trial, and 2,378 individuals with type 2 diabetes and established DKD from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial...
January 23, 2024: Journal of Clinical Endocrinology and Metabolism
https://read.qxmd.com/read/38261822/non-analgesic-benefits-of-combined-thoracic-epidural-analgesia-with-general-anesthesia-in-on-pump-pediatric-cardiac-surgery-a-prospective-observational-study
#37
JOURNAL ARTICLE
Alok Kumar, Ravi Kapoor, Shubham Mishra, Ankur Joshi, Nikhil Tiwari, H R Ramamurthy
BACKGROUND: The use of thoracic epidural analgesia in infants and children could attenuate the stress response and thereby improve the outcomes associated with cardiac surgery. METHODS: This study is a prospective observational study conducted on 118 patients admitted for cardiac surgery. All patients received thoracic epidural analgesia. Laboratory investigations including inflammatory markers, markers for different organ functions, and intensive care unit parameters were collected at different time points (preoperative, immediate postoperative, on day 1, and day 2)...
2024: Medical Journal, Armed Forces India
https://read.qxmd.com/read/38252762/optimal-medical-management-of-atherosclerotic-intracranial-stenosis
#38
REVIEW
Ashley M Wabnitz, Tanya N Turan
Reducing the high risk of recurrent stroke in patients with symptomatic intracranial atherosclerotic stenosis (sICAS) has proven to be challenging, but aggressive medical management, with intensive risk factor control and antithrombotic therapy, has been shown to be beneficial. High-intensity statins are recommended for patients with atherosclerotic stroke, including sICAS. Ezetimibe and PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors are beneficial for those who fail to reach low-density lipoprotein targets or those with statin intolerance...
February 2024: Stroke; a Journal of Cerebral Circulation
https://read.qxmd.com/read/38246509/effects-of-intensive-glycemic-control-on-microvascular-outcomes-in-type-2-diabetes-mellitus-are-modified-by-long-term-hba-1c-variability-a-post-hoc-analysis-of-the-accord-trial
#39
JOURNAL ARTICLE
Jia-Min Wang, Meng-Yuan Miao, Yi-Ping Jia, Xiao-Wen Wang, Xian-Bo Wu, Zhong-Xiao Wan, Yan Zheng, Li-Qiang Qin, Fu-Rong Li, Guo-Chong Chen
AIMS: To assess the impact of long-term visit-to-visit variability in HbA1c on microvascular outcomes in type 2 diabetes mellitus (T2DM), and its influence on the effects of intensive glycemic control. METHODS: Included were participants with T2DM enrolled in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) who had at least three measurements of HbA1c prior to new-onset microvascular outcomes, namely nephropathy, retinopathy and neuropathy. Variability in HbA1c was defined as the coefficient of variation (CV) across HbA1c measurements obtained from enrollment to the transition from intensive to standard glycemic therapy...
January 19, 2024: Diabetes Research and Clinical Practice
https://read.qxmd.com/read/38240484/society-of-critical-care-medicine-guidelines-on-glycemic-control-for-critically-ill-children-and-adults-2024
#40
JOURNAL ARTICLE
Kimia Honarmand, Michael Sirimaturos, Eliotte L Hirshberg, Nicholas G Bircher, Michael S D Agus, David L Carpenter, Claudia R Downs, Elizabeth A Farrington, Amado X Freire, Amanda Grow, Sharon Y Irving, James S Krinsley, Michael J Lanspa, Micah T Long, David Nagpal, Jean-Charles Preiser, Vijay Srinivasan, Guillermo E Umpierrez, Judith Jacobi
RATIONALE: Maintaining glycemic control of critically ill patients may impact outcomes such as survival, infection, and neuromuscular recovery, but there is equipoise on the target blood levels, monitoring frequency, and methods. OBJECTIVES: The purpose was to update the 2012 Society of Critical Care Medicine and American College of Critical Care Medicine (ACCM) guidelines with a new systematic review of the literature and provide actionable guidance for clinicians...
January 19, 2024: Critical Care Medicine
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