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Glycemic Variablity

Chung-Huei Huang, Yu-Yao Huang, Brend Ray-Sea Hsu
BACKGROUND: Sodium-glucose cotransporter 2 inhibitors (SGLT2is, gliflozins) are associated with lower all-cause mortality than other anti-diabetic agents in patients with type 2 diabetes. In patients who may benefit from SGLT2is, but cannot add them to a dipeptidyl peptidase-4 inhibitor (DPP4i, gliptin) treatment for various reasons, replacement of the DPP4i with a SGLT2i may be considered. OBJECTIVES: Evaluate changes in metabolic parameters in patients with diabetes after replacing a DPP4i with the SGLT2i empagliflozin...
November 2018: Annals of Saudi Medicine
Jiahui Peng, Jingyi Lu, Xiaojing Ma, Lingwen Ying, Wei Lu, Wei Zhu, Yuqian Bao, Jian Zhou
No abstract text is available yet for this article.
December 11, 2018: British Journal of Nutrition
Magnus O Wijkman, Mary Dena, Sofia Dahlqvist, Sheyda Sofizadeh, Irl Hirsch, Jaakko Tuomilehto, Johan Mårtensson, Ole Torffvit, Henrik Imberg, Aso Saeed, Marcus Lind
Liraglutide is associated with blood pressure reduction in patients with type 2 diabetes. However, it is not known whether this blood pressure reduction can be predicted prior to treatment initiation, and to what extent it correlates with weight loss and with improved glycemic control during follow-up. We analyzed data from a double-blind, placebo-controlled trial, in which 124 insulin-treated patients with type 2 diabetes were randomized to liraglutide or placebo. We evaluated various baseline variables as potential predictors of systolic blood pressure (SBP) reduction, and evaluated whether changes in SBP correlated with weight loss and with improved glycemic control...
December 5, 2018: Journal of Clinical Hypertension
Sara L Davis, Anne-Marie Kaulfers, John E Lochman, S A Morrison, Erica R Pryor, Marti Rice
Despite adequate insulin regimens and concurrent treatments for Type 1 diabetes (T1D), many children have trouble achieving glycemic control, as evidenced by elevated HbA1c levels. Maternal and child depressive symptoms, as well as child perceived stress, are associated with less optimal glycemic control. Cortisol, a stress hormone, may mediate the relationships among depressive symptoms, perceived stress, and glycemic control. The purposes of this pilot study were to (1) examine the feasibility of collecting salivary samples to measure cortisol change in prepubertal school-age children diagnosed with T1D and (2) determine effect sizes for the relationships among maternal depressive symptoms and child depressive symptoms, perceived stress, cortisol levels, and glycemic control...
December 5, 2018: Biological Research for Nursing
Agnieszka Stelmaszyk, Anna Wesołowska, Karolina Pomieczyńska, Saule Iskakova, Magdalena Frydrychowicz, Grzegorz Dworacki, Marzena Dworacka
Introduction: Cardiovascular risk in the course of diabetes depends greatly on glycemic variability which is even more significant than chronic hyperglycemia. Optimal management of diabetes involves a multidisciplinary approach focused in particular on decreasing the risk of atherosclerosis. Therefore, our purpose was to evaluate the impact of dapagliflozin on glucose excursions and related proatherogenic changes in the aortic wall. Methods and materials: Animal model of type 2 diabetes rich-fat/STZ rats was used...
December 2018: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
Jaehyun Bae, Gyuri Kim, Yong-Ho Lee, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha
INTRODUCTION: Comparisons of the glycemic durability between thiazolidinediones (TZDs) and dipeptidyl peptidase-4 (DPP-4) inhibitors remain insufficient. This study aimed to find clues for the differences in glycemic durability between TZDs and DPP-4 inhibitors by comparing the insulin resistance and β-cell function among patients using these agents. METHODS: A total of 241 patients with type 2 diabetes mellitus (T2DM) treated with either pioglitazone (a TZD) or DPP-4 inhibitors as combination therapy with metformin for at least 1 year were analyzed...
December 1, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Hirotaka Watada, Masanari Shiramoto, Shinya Ueda, Weifeng Tang, Michiko Asano, Fredrik Thoren, Hyosung Kim, Toshitaka Yajima, David W Boulton, Eiichi Araki
AIMS: To assess the pharmacokinetics/pharmacodynamics (PK/PD) of dapagliflozin, a sodium-glucose co-transporter 2 inhibitor that increases urinary glucose excretion (UGE), and its major metabolite, dapagliflozin-3-O-glucuronide (D3OG), in Japanese patients with type 1 diabetes (T1D) and inadequate glycemic control (HbA1c 7-10%). MATERIALS AND METHODS: Japanese patients (18-65 years) with inadequately controlled T1D were randomized 1:1:1 to dapagliflozin 5 mg, 10 mg, or placebo (n=14 each) once daily for seven days with adjustable insulin...
November 30, 2018: Diabetes, Obesity & Metabolism
Henry Zelada, Lisa B VanWagner, Teresa Pollack, Devan Higginbotham, Lihui Zhao, Amy Yang, Mark E Molitch, Amisha Wallia
Background: Posttransplant hyperglycemia has been associated with increased risks of transplant rejection, infections, length of stay, and mortality. Methods: To establish a predictive model to identify nondiabetic recipients at risk for developing postliver transplant (LT) hyperglycemia, we performed this secondary, retrospective data analysis of a single-center, prospective, randomized, controlled trial of glycemic control among 107 adult LT recipients in the inpatient period...
October 2018: Transplantation Direct
Sneha Sehwag, Rohit Upadhyay, Madhusweta Das
An optimization and multivariate accelerated shelf-life testing (MASLT) was demonstrated to develop a low glycemic (GI) whole jamun ( Syzygium cumini L.) confection (WJC) with soft texture and fruity hedonics targeted for diabetic strata. The hydrocolloids viz., agar (1-3 g), pectin (1-3 g), and polydextrose (24-28 g) were optimized [mixture design (MD)] to obtain hydrocolloid mix (HM) with a soft texture. Next, whole jamun ingredients viz, jamun pulp (JP) (20-30 g), seed powder (JSP) (1-5 g), and HM (25-35 g) were optimized (MD + PCA) for satisfactory texture, total polyphenolic content (TPC), and fruity hedonics...
December 2018: Journal of Food Science and Technology
Michael C Riddell, Dessi P Zaharieva, Michael Tansey, Eva Tsalikian, Gil Admon, Zoey Li, Craig Kollman, Roy W Beck
OBJECTIVE: To evaluate the pattern of change in blood glucose concentrations and hypoglycemia risk in response to prolonged aerobic exercise in adolescents with type 1 diabetes (T1D) that had a wide range in pre-exercise blood glucose concentrations. RESEARCH DESIGN AND METHODS: Individual blood glucose responses to prolonged (~60 min) moderate-intensity exercise were profiled in 120 youth with T1D. RESULTS: The mean pre-exercise blood glucose concentration was 178±66 mg/dL, ranging from 69 to 396 mg/dL, while the mean change in glucose during exercise was -76±55 mg/dL (mean±SD), ranging from +83 to -257 mg/dL...
November 22, 2018: Pediatric Diabetes
Cristina Galarregui, María Ángeles Zulet, Irene Cantero, Bertha Araceli Marín-Alejandre, José Ignacio Monreal, Mariana Elorz, Alberto Benito-Boillos, José Ignacio Herrero, Josep Antoni Tur, Itziar Abete, José Alfredo Martínez
BACKGROUND: Dietary total antioxidant capacity (TAC), glycemic index (GI), and glycemic load (GL) are accepted indicators of diet quality, which have an effect on diet⁻disease relationships. The aim of this study was to evaluate potential associations of dietary TAC, GI, and GL with variables related to nutritive status and insulin resistance (IR) risk in cardiometabolic subjects. METHODS: A total of 112 overweight or obese adults (age: 50.8 ± 9 years old) were included in the trial...
November 20, 2018: International Journal of Molecular Sciences
Vijay Srinivasan
Numerous studies have examined the strategy of tight glucose control (TGC) with intensive insulin therapy (IIT) to improve clinical outcomes in critically ill adults and children. Although early studies of TGC with IIT demonstrated improved outcomes at the cost of elevated hypoglycemia rates, subsequent studies in both adults and children have not demonstrated any benefit from such a strategy. Differences in patient populations, variable glycemic targets, and glucose control protocols, inconsistency in attaining these targets, heterogeneous intermittent sampling, and measurement techniques, and variable expertise in protocol implementation are possible reasons for the contrasting results from these studies...
2018: Frontiers in Pediatrics
Alan Maloney, Julio Rosenstock, Vivian Fonseca
Model-based meta-analysis was used to compare glycemic control, weight changes and hypoglycemia risk across 24 antihyperglycemic drugs used to treat type 2 diabetes. Electronic searches identified 229 randomized controlled studies comprising 121,914 patients. To ensure fair and unbiased treatment comparisons, the analyses adjusted for important differences between studies, including duration of treatment, baseline glycated hemoglobin, and drug dosages. At the approved doses, glycemic control was typically greatest with glucagon-like peptide 1 receptor agonists (GLP-1RAs), and least with dipeptidyl peptidase-4 (DPP-4) inhibitors...
November 20, 2018: Clinical Pharmacology and Therapeutics
Fukashi Ishibashi, Miki Taniguchi, Aiko Kosaka, Harumi Uetake, Mitra Tavakoli
OBJECTIVE: To investigate the impact of normalizing HbA1c by extensive HbA1c control (EHC) on neuropathy outcome measures (NOMs), nephropathy, and retinopathy in type 2 diabetes. RESEARCH DESIGN AND METHODS: Detailed clinical and neurological examinations were performed in two cohorts of 38 patients with uncontrolled type 2 diabetes patients (HbA1c 9.6% [81.4 mmol/mol]) at baseline and after glycemic control (GC) with or without EHC by diet restriction and hypoglycemic agents over 4 years along with 48 control subjects with normal glucose tolerance (NGT) and 34 subjects with impaired glucose tolerance (IGT) only at baseline...
November 19, 2018: Diabetes Care
Tuna Bilecik
PURPOSE: To present the early metabolic effects of sleeve gastrectomy with transit bipartition (SG + TB) procedure in female obese patients with type 2 diabetes mellitus (T2DM). METHODS: This prospective clinical study was carried out between January 2016 and June 2017. Inclusion criteria were female participants under 60 years old with T2DM, body mass index ≥ 40 kg/m2 and HbA1c level ≥ 8%. All patients underwent to SG + TB procedure. Primary outcomes were the glycemic control variables, and the secondary outcomes were weight loss and dyslipidemia levels up to the last follow-up point...
November 17, 2018: Obesity Surgery
Bamini Gopinath, Victoria M Flood, George Burlutksy, Gerald Liew, Paul Mitchell
PURPOSE: We aimed to examine the prospective association between dietary glycemic index (GI) and glycemic load (GL) of foods consumed, intakes of carbohydrates and fiber, and the ability to perform activities of daily living (ADL) in older adults. METHODS: A total of 844 participants from the Blue Mountains Eye Study aged 60 years or older were examined from 2002-2004 to 2007-2009. Dietary information was collected using a validated, semi-quantitative food-frequency questionnaire...
November 17, 2018: European Journal of Nutrition
Guillermo E Umpierrez, Boris P Kovatchev
Glycated hemoglobin A1c (A1C) levels have traditionally been the gold standard for assessing glycemic control and treatment efficacy in patients with type 2 diabetes. However, A1C does not take into account fluctuations in blood glucose levels known as glycemic variability (GV). In recent years, GV has become increasingly clinically relevant, because of a better understanding of the need to reach target A1C while avoiding hypoglycemia. GV relates to both hyperglycemia and hypoglycemia, and has been associated with poorer quality of life...
December 2018: American Journal of the Medical Sciences
Lei Zhu, Xiuxia Li, Yishan Liu, Kehu Yang, Gaojing Jing, Yajing Chen, Zhimin Dou, Qiming Chen, Jian Liu
OBJECTIVE: To systematically evaluate the effect of different administration methods of hydrocortisone on blood glucose in patients with septic shock. METHODS: The Cochrane Library, PubMed, Web of Science, Embase, CNKI, CBM, Wanfang, and VIP databases were searched from foundation to December 31st, 2017 for the randomized controlled trials (RCTs) about hydrocortisone on blood glucose of different drug-deliver ways in patients with septic shock. In addition, the citation retrievals were performed by the literature references...
October 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Hong Wang, Yifan Cheng, Siyan Chen, Xianmei Li, Zhenguo Zhu, Wanli Zhang
BACKGROUND: The association between hemoglobin A1c (HbA1c) and clinical outcomes of acute ischemic stroke is uncertain. We aimed to evaluate the association between initial hemoglobin A1c level and clinical outcome after acute ischemic stroke. METHODS: A total of 408 patients with first-ever acute ischemic stroke were included in this study. We divided the patients into three groups according to HbA1c level: low HbA1c level (HbA1c <5.7%), moderate HbA1c level (HbA1c 5...
November 8, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Sameer Mokeem, Sara Abdulaziz Alfadda, Nouf Al-Shibani, Mohammed Alrabiah, Rana Sulaiman Al-Hamdan, Fahim Vohra, Tariq Abduljabbar
BACKGROUND: Clinical and radiographic status around short dental implants in patients with different glycemic levels remains unexplored. PURPOSE: To determine the clinical and radiographic bone level (RBL) around short dental implants in type-2 diabetes mellitus (T2DM), prediabetic, and non-diabetic patients. MATERIALS AND METHODS: Participants were grouped into three groups based on HbA1c levels: T2DM (Group-1); prediabetic patients (Group-2); and non-diabetic subjects (Group-3)...
November 9, 2018: Clinical Implant Dentistry and related Research
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