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Hypoglycemia prevention

Shuzhen Zhu, Xiaoya Gao, Kaibin Huang, Yong Gu, Yafang Hu, Yongming Wu, Zhong Ji, Qing Wang, Suyue Pan
Glibenclamide (GBC) is an antidiabetic drug that is in a class of medications known as sulfonylureas, which play critical roles in attenuating brain edema and reducing mortality in ischemic stroke patients. Therapeutic hypothermia (TH) is another robust neuroprotectant that prevents brain swelling and improves the neurological outcomes of stroke patients. However, whether the combination of GBC and TH can be used as a reliable neuroprotectant in ischemic stroke remains largely unknown. We used the middle cerebral artery occlusion (MCAO) rat model as well as oxygen and glucose deprivation-reoxygenation (OGD/R) endothelial cells as ischemic stroke models to investigate the efficacy and mechanisms of treating ischemic stroke with the combination of GBC and TH...
August 2018: Aging and Disease
Karina L Arce-López, Juan Vicencio-Rivas, José Iglesias-Leboreiro, Isabel Bernárdez-Zapata, Mario E Rendón-Macías, Ariela Braverman-Bronstein
Introducción: El bajo peso neonatal (< 2.5 kg o < percentil 10) se atribuye a causas constitucionales (pequeño para la edad gestacional [PEG]) o a la restricción en el crecimiento intrauterino (RCIU), con riesgos posnatales diferentes. En ausencia de una valoración fetal-placentaria prenatal adecuada, resulta difícil establecerlo. El conocer los antecedentes maternos de enfermedades gestacionales (AMEG): hipertensión arterial (HTA), hipotiroidismo, Diabetes Mellitus (DM) gestacional y otra; pudiera orientar a la diferenciación y el manejo...
2018: Boletín Médico del Hospital Infantil de México
Yunbing Ma, Qian Wang, Debria Joe, Manqi Wang, Matthew D Whim
Hypoglycemia activates the counterregulatory response (CRR), a neural-endocrine reflex that restores euglycemia. Although effective if occasionally activated, repeated induction of the CRR leads to a decline in responsiveness and prolonged exposure to hypoglycemia. The mechanism underlying this impairment is not known. We found that the reduction in epinephrine release that characterizes a suppressed CRR involves a long-lasting form of sympatho-adrenal synaptic plasticity. Using optogenetically evoked catecholamine release, we show that recurrent hypoglycemia reduced the secretory capacity of mouse adrenal chromaffin cells...
August 6, 2018: Journal of Clinical Investigation
Nicole Ehrhardt, Enas Al Zaghal
Real-time continuous glucose monitoring (RT-CGM) provides real time glucose readings to participants wearing the device. The ability to see changes in glucose has the potential to provide immediate feedback to users on food choices and physical activity. The National Diabetes Prevention Program is currently the only reimbursable intervention for diabetes prevention and weight loss. The purpose of this article is to review the CGM literature on measurements other than Hemoglobin A1c (HbA1c) changes and hypoglycemia and discuss RT-CGM potential use as a behavior modification tool for lifestyle changes and weight reduction in people with prediabetes and type 2 diabetes (T2D)...
August 1, 2018: Journal of Diabetes Science and Technology
Ashraf Soliman, Husam Salama, Hilal Al Rifai, Vincenzo De Sanctis, Sawsan Al-Obaidly, Mai Al Qubasi, Tawa Olukade
AIMS OF THE STUDY: We describe the impact of different forms of dysglycemia on maternal and neonatal health. This research is a part of the PEARL-Peristat Maternal and newborn registry, funded by Qatar National Research Fund (QNRF) Doha, Qatar. METHODS: A population-based retrospective data analysis of 12,255 women with singleton pregnancies screened during the year 2016-2017, of which 3,027 women were identified with gestation diabetes mellitus (GDM) during pregnancy and 233 were diabetic before pregnancy...
May 23, 2018: Acta Bio-medica: Atenei Parmensis
Elizabeth D Brooks, Dustin J Landau, Jeffrey I Everitt, Talmage T Brown, Kylie M Grady, Lauren Waskowicz, Cameron R Bass, John D'Angelo, Yohannes G Asfaw, Kyha Williams, Priya S Kishnani, Dwight D Koeberl
BACKGROUND: Glycogen storage disease type Ia (GSD Ia) in dogs closely resembles human GSD Ia. Untreated patients with GSD Ia develop complications associated with glucose-6-phosphatase (G6Pase) deficiency. Survival of human patients on intensive nutritional management has improved; however, long-term complications persist including renal failure, nephrolithiasis, hepatocellular adenomas (HCA), and a high risk for hepatocellular carcinoma (HCC). Affected dogs fail to thrive with dietary therapy alone...
July 24, 2018: Journal of Inherited Metabolic Disease
Noriaki Maruyama, Masanori Abe
BACKGROUND: For diabetes patients without nephropathy, glycemic control is important to reduce the risk or delay the progression of diabetes complications, including nephropathy. In diabetes patients on hemodialysis, good glycemic control is necessary to improve prognosis. Many factors influence the blood glucose level of diabetes patients on hemodialysis, such as factors associated with end-stage kidney disease and factors related to hemodialysis. Therefore, since glucose metabolism in diabetes patients on hemodialysis has unique characteristics, it is necessary to manage blood glucose in these patients with specific guidelines...
2018: Contributions to Nephrology
Connie M Rhee, Csaba P Kovesdy, Amy S You, John J Sim, Melissa Soohoo, Elani Streja, Miklos Z Molnar, Alpesh N Amin, Kevin Abbott, Danh V Nguyen, Kamyar Kalantar-Zadeh
RATIONALE & OBJECTIVE: Diabetic patients with declining kidney function are at heightened risk for hypoglycemia. We sought to determine whether hypoglycemia-related hospitalizations in the interval before dialysis therapy initiation are associated with post-end-stage renal disease (ESRD) mortality among incident patients with ESRD with diabetes. STUDY DESIGN: Observational cohort study. SETTING & PARTICIPANTS: US veterans from the national Veterans Affairs database with diabetes and chronic kidney disease transitioning to dialysis therapy from October 2007 to September 2011...
July 20, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Anna R Kahkoska, John B Buse
No abstract text is available yet for this article.
August 2018: Diabetes Care
Judith Belle Brown, Sonja M Reichert, Yashoda Valliere, Susan Webster-Bogaert, Alexandria Ratzki-Leewing, Stewart B Harris
INTRODUCTION: A significant body of research exists on the impact of the social determinants of health (SDoHs) on diabetes care and general health outcomes. However, less is known about health care practitioners' (HCPs') perspectives and experiences regarding the impact of the SDoHs on their patients with Type I and Type 2 diabetes mellitus and how this affects the prevention and treatment of hypoglycemia. METHOD: A descriptive qualitative study, derived from the InHypo-DM (Canada) research program...
July 12, 2018: Families, Systems & Health: the Journal of Collaborative Family Healthcare
Jun Yang, Lei Li, Yimeng Shi, Xiaolei Xie
The Continuous Glucose Monitoring System (CGMS) is an effective tool which enables the users to monitor their blood glucose (BG) levels. Based on the CGM data, we aim at predicting future BG levels so that appropriate actions can be taken in advance to prevent hyperglycemia or hypoglycemia. Due to the time-varying non-stationarity of CGM data, verified by Augmented Dickey-Fuller (ADF) test and Analysis of Variance (ANOVA), an Autoregressive Integrated Moving Average (ARIMA) model with an adaptive identification algorithm of model orders is proposed in the prediction framework...
May 25, 2018: IEEE Journal of Biomedical and Health Informatics
A G Sharma, S K Kanwal, V Chhapola, V Kumar
Fructose-1, 6-bisphosphatase 1 (FBP1) deficiency is an autosomal recessive disorder of gluconeogenesis resulting in severe and recurrent life-threatening episodes of hypoglycemia and lactic acidosis in infancy. We report a 16 month-old girl who presented with recurrent episodes of vomiting, rapid breathing, lactic acidosis, hyperuricemia, and hypertriglyceridemia. Genetic analysis revealed a novel compound heterozygous mutation in FBP1 gene confirming the diagnosis of FBP1 deficiency. The patient was managed with treatment of acute episodes and preventive long-term dietary modifications...
July 2018: Journal of Postgraduate Medicine
Hamdiye Arda Sürücü, Hatice OKur Arslan
Introduction: As well as its negative effect on the subcutaneous tissues, lipohypertrophy has negative effects on clinical data. The purpose of this study was to examine the frequency of lipohypertrophy, risk factors and perceived barriers preventing rotation in individuals with type 2 diabetes. Methods: This descriptive cross-sectional study was conducted at Diabetes Education Center and Endocrine and Metabolism Clinic of a university hospital and Diabetes Education and Monitoring Center in a private hospital in Turkey between June 2016- April 2017...
June 2018: Journal of Caring Sciences
Alberto Catanese, Débora Garrido, Paul Walther, Francesco Roselli, Tobias M Boeckers
Acute mismatch between metabolic requirements of neurons and nutrients/growth factors availability characterizes several neurological conditions such as traumatic brain injury, stroke and hypoglycemia. Although the effects of this mismatch have been investigated at cell biological level, the effects on synaptic structure and function are less clear. Since synaptic activity is the most energy-demanding neuronal function and it is directly linked to neuronal networks functionality, we have explored whether nutrient limitation (NL) affects the ultrastructure, function and composition of pre and postsynaptic terminals...
July 4, 2018: Journal of Cerebral Blood Flow and Metabolism
Yu Zhou, Lishan Huang, Wenting Zheng, Jingjing An, Zhidong Zhan, Linxi Wang, Zhou Chen, Libin Liu
Recurrent non-severe hypoglycemia (RH) can lead to cognitive dysfunction in diabetic patients, although the involved mechanisms remain unclear. Here, we aimed to investigate the mechanism underlying RH-induced cognitive deficits with a focus on mitochondrial homeostasis. To establish a model that mimicked RH in type 1 diabetic (T1DM) patients receiving insulin therapy, streptozotocin (STZ)-induced mice with T1DM were subjected to recurrent, twice-weekly, insulin injections over 4 weeks. We found that RH disrupted the mitochondrial fine structure, reduced the number of mitochondria, and upregulated the expression of mitochondrial dynamics and mitophagy markers, including dynamin-related protein 1 (Drp1), Bcl-2/adenovirus E1B 19-kDa-interacting protein-3 (BNIP3), and LC3 in the hippocampus of T1DM mice...
July 3, 2018: American Journal of Physiology. Endocrinology and Metabolism
Nandita Mehta, Gurleen Kaur
Glutaric aciduria Type 1 (GA-1) is an autosomal recessive metabolic disorder that results from deficiency of enzyme glutaryl-CoA dehydrogenase. This gives rise to elevated neurotoxic glutaric acid and 3-hydroxyglutaric acid as well as nontoxic glutarylcarnitine in body fluids. The enzyme defect leads to secondary damage to central nervous system due to the accumulation of glutaric acid. Approximately 90% people will develop the neurological disease during a finite period of brain development (3-36 months) following an acute encephalopathic crisis often precipitated by gastroenteritis, immunization, surgical intervention, and intercurrent febrile illness...
April 2018: Anesthesia, Essays and Researches
Kris van Keulen, Wilma Knol, Svetlana V Belitser, Paul D van der Linden, Eibert R Heerdink, Toine C G Egberts, Arjen J C Slooter
OBJECTIVES: To investigate whether diabetes and glucose dysregulation (hyperglycemia and/or hypoglycemia) are associated with ICU delirium. DESIGN: Prospective cohort study. SETTING: Thirty-two-bed mixed intensive care in a tertiary care center. PATIENTS: Critically ill patients admitted to the ICU with transitions of mental status from awake and nondelirious to delirious or remaining awake and nondelirious on the next day...
June 27, 2018: Critical Care Medicine
Petros Thomakos, Andriani Vazeou, Dimitris Sakkas, Georgios Panagopoulos, Kostas Anifantakis, Penelope Smyrnaki, Theodosia Arvanitaki, Euridiki Kyrlaki, Nikolaos Kefalogiannis, Dimitris Mamoulakis, Aggelos Pappas, Asimina Mitrakou
Background: Continuous Subcutaneous Insulin Infusion (CSII) and Continuous Glucose Monitoring Systems (CGMS) have been proven very effective in diabetes management. Aim: This study evaluated the usefulness of these devices during prolonged, intense physical activity in an uncontrolled natural environment away from the clinical research center. Design: Non-randomized, prospective, observational study. Methods: During the summer thirty-eight participants with Type 1 Diabetes crossed the Samaria gorge, the 2nd largest gorge in Europe (17 km)...
June 23, 2018: QJM: Monthly Journal of the Association of Physicians
Raye-Ann deRegnier
No abstract text is available yet for this article.
July 2018: Journal of Pediatrics
Sunil S Gupta, Kavita S Gupta, Sachin S Gathe, Parvinder Bamrah, Shlok S Gupta
BACKGROUND: Lipohypertrophy (LH) at insulin injection sites is a common but preventable complication in type 1 diabetes mellitus (T1DM). We evaluated the prevalence, contributing risk factors, and consequences of LH, specifically the glycemic variability (GV) among T1DM patients. METHODS: This is a cross-sectional study conducted at a tertiary care center in India, wherein 139 subjects with T1DM were randomly selected and evaluated for the presence of LH through visual and palpation examinations...
July 2018: Diabetes Technology & Therapeutics
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