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Glycemic control for diabetes patient

Brad P Dieter, Radica Z Alicic, Katherine R Tuttle
Diabetic kidney disease (DKD), one of the most common and severe microvascular complications of diabetes, is the leading cause of chronic kidney disease and end-stage kidney disease worldwide. Since the development of renin-angiotensin system inhibition nearly three decades ago, no new therapeutic agents have received regulatory approval for treatment of DKD. Glucagon like peptide-1 (GLP-1) receptor agonists, a class of newer anti-hyperglycemic agents, have shown promise for prevention of DKD onset and progression...
August 15, 2018: American Journal of Physiology. Renal Physiology
Rupali Malik, Ilavarasi Vanidassane, Neelima Jain
Background - Reduced lung function in diabetes has been described for long but its clinical importance is not yet clear. Also, limited literature is available regarding its association with sugar control, and its correlation with inflammatory markers. Thus, we aimed to study the pulmonary function test abnormalities and systemic inflammation in type 2 diabetes mellitus. Methods 100 patients of type 2 diabetes were divided into two groups depending on control of diabetes (group A-HbA1C≤7% and group B-HbA1C >7%)...
August 15, 2018: Advances in Respiratory Medicine
Mohd Noor Azreey Mukri, Wei-Yen Kong, Ruslinda Mustafar, Syahrul Sazliyana Shaharir, Shamsul Azhar Shah, Abdul Halim Abdul Gafor, Rozita Mohd, Rizna Abdul Cader, Lydia Kamaruzaman
Introduction: Hyperuricemia is associated with chronic kidney disease (CKD) progression and poor cardiovascular outcomes. We studied the effect of febuxostat on estimated glomerular filtration rate (eGFR), proteinuria and monitored the safety profile of the medication. Material and Methods: This is a prospective open-label, randomized study in CKD stage 3 and 4 patients with diabetic nephropathy and asymptomatic hyperuricemia. Patients were randomized into febuxostat 40 mg daily and no treatment group using block randomization method and were followed up for 6 months...
2018: EXCLI journal
Michael M Kheir, Timothy L Tan, Matthew Kheir, Mitchell G Maltenfort, Antonia F Chen
BACKGROUND: Perioperative hyperglycemia has many etiologies, including medication, impaired glucose tolerance, uncontrolled diabetes mellitus, or stress, the latter of which is common in patients postoperatively. Our study investigated the influence of postoperative blood glucose levels on periprosthetic joint infection after elective total joint arthroplasty to determine a threshold for glycemic control for which surgeons should strive during a patient's hospital stay. METHODS: A single-institution retrospective review was conducted on 24,857 primary total joint arthroplasties performed from 2001 to 2015...
August 15, 2018: Journal of Bone and Joint Surgery. American Volume
Nanny N M Soetedjo, Susan M McAllister, Cesar Ugarte-Gil, Adela G Firanescu, Katharina Ronacher, Bachti Alisjahbana, Anca L Costache, Carlos Zubiate, Stephanus T Malherbe, Raspati C Koesoemadinata, Yoko V Laurence, Fiona Pearson, Sarah Kerry-Barnard, Rovina Ruslami, David A J Moore, Mihai Ioana, Leanie Kleynhans, Hikmat Pernama, Philip C Hill, Maria Mota, Gerhard Walzl, Hazel M Dockrell, Julia A Critchley, Reinout van Crevel
OBJECTIVE: To describe the characteristics and management of Diabetes mellitus (DM) patients from low- and middle-income countries (LMIC). METHODS: We systematically characterized consecutive DM patients attending public health services in urban settings in Indonesia, Peru, Romania and South Africa, collecting data on DM treatment history, complications, drug treatment, obesity, HbA1c, and cardiovascular risk profile; and assessing treatment gaps against relevant national guidelines...
August 14, 2018: Tropical Medicine & International Health: TM & IH
Yawei Xu, Yuanyuan Zhang, Yongjiao Yang, Li Liu, Yegang Chen, Xiaoqiang Liu
The aim of this study was to estimate the prevalence and correlates of erectile dysfunction (ED) in a sample of Chinese type 2 diabetic men. Between October 2016 and April 2017, male patients with type 2 diabetes mellitus treated in our diabetes outpatient clinic were recruited in this study. The participants were asked to complete a short version of the International Index of Erectile Function (IIEF-5), which was a validated and self-administered questionnaire for the diagnosis and grading of ED severity. All patients screened for erectile function also underwent detailed physical examination, and interviewed for demographic and medical history...
August 13, 2018: International Journal of Impotence Research
Neda Laiteerapong, Sandra A Ham, Yue Gao, Howard H Moffet, Jennifer Y Liu, Elbert S Huang, Andrew J Karter
OBJECTIVE: To examine for a legacy effect of early glycemic control on diabetic complications and death. RESEARCH DESIGN AND METHODS: This cohort study of managed care patients with newly diagnosed type 2 diabetes and 10 years of survival (1997-2013, average follow-up 13.0 years, N = 34,737) examined associations between HbA1c <6.5% (<48 mmol/mol), 6.5% to <7.0% (48 to <53 mmol/mol), 7.0% to <8.0% (53 to <64 mmol/mol), 8.0% to <9.0% (64 to <75 mmol/mol), or ≥9...
August 13, 2018: Diabetes Care
Julia A Critchley, Iain M Carey, Tess Harris, Stephen DeWilde, Fay J Hosking, Derek G Cook
OBJECTIVE: Diabetes mellitus (DM) increases the risk of infections, but the effect of better control has not been thoroughly investigated. RESEARCH DESIGN AND METHODS: With the use of English primary care data, average glycated hemoglobin (HbA1c ) during 2008-2009 was estimated for 85,312 patients with DM ages 40-89 years. Infection rates during 2010-2015 compiled from primary care, linked hospital, and mortality records were estimated across 18 infection categories and further summarized as any requiring a prescription or hospitalization or as cause of death...
August 13, 2018: Diabetes Care
Alexandra Migdal, Martin Abrahamson, Anne Peters, Nan Vint
Type 2 Diabetes Mellitus (T2DM) is a growing problem in the United States, affecting 30.3 million Americans, or 9.4% of the US population. Given that T2DM is a progressive disease, intensification of rapid acting insulin (RAI) to address hyperglycemia is often required. The American Diabetes Association and the European Association for the Study of Diabetes recommend individualizing the treatment approach to glucose control, considering factors such as age, health behaviors, comorbidities, and life expectancy...
August 14, 2018: Annals of Medicine
Sachiya Ikeda, Yasuki Takano, Dietmar Schwab, Agnes Portron, Nahoko Kasahara-Ito, Tomohisa Saito, Satofumi Iida
PURPOSE: Tofogliflozin is an orally available selective inhibitor of sodium-glucose co-transporter 2 for treatment of type 2 diabetes mellitus (T2DM). Two studies were conducted to evaluate the effect of renal impairment on pharmacokinetics and pharmacodynamics of tofogliflozin. METHODS: The studies were: 1) single dose study in T2DM patients with normal renal function and mild, moderate and severe renal impairment, and 2) multiple dose study for 24 weeks in T2DM patients with normal renal function and moderate renal impairment...
August 13, 2018: Drug Research
Hannah Lewis, Robert Egerman, Amir Kazory, Maryam Sattari
Diabetes in pregnancy increases the risk of adverse maternal, obstetric, fetal, and neonatal outcomes. Internists can reduce these risks by optimizing glycemic control before conception and providing effective counseling on strategies to reduce the risks associated with pregnancy and diabetes. Routine screening of reproductive-age women with diabetes should include a comprehensive physical examination and laboratory tests to identify at-risk patients and begin strategic management. A review of medications for teratogenic potential is also needed...
August 2018: Cleveland Clinic Journal of Medicine
Eugenio Cersosimo, John M Miles
BACKGROUND & INTRODUCTION: The advent of the sodium-glucose cotransporter-2 inhibitors [SGLT-2i] provides an additional tool to combat diabetes and complications. The use of SGLT-2i leads to effective and durable glycemic control with important reductions in body weight/fat and blood pressure. These agents may delay beta-cell deterioration and improve tissue insulin sensitivity, which might slow the progression of the disease. METHODS & RESULTS: In response to glycosuria, a compensatory rise in endogenous glucose production, sustained by a decrease in plasma insulin with an increase in glucagon has been described...
August 13, 2018: Current Diabetes Reviews
Emily D Parker, Eric T Wittbrodt, Jeffrey T McPheeters, Juan P Frias
INTRODUCTION: Dapagliflozin (DAPA) and sitagliptin (SITA) have proven effective at maintaining glycemic control with minimal side effects in clinical trials; however, a direct comparison of the two therapies is lacking. This study compared healthcare costs and utilization between type 2 diabetes (T2D) patients who initiated DAPA and SITA in a real-world setting. METHODS: This was a retrospective study of health plan enrollees in two US commercial claims databases or Medicare Part D...
August 12, 2018: Diabetes, Obesity & Metabolism
Danya A Fox, Nazrul Islam, Shazhan Amed
BACKGROUND AND OBJECTIVES: To access care, pediatric type 1 diabetes (T1D) patients living in British Columbia (BC), Canada, travel to the sole tertiary pediatric hospital (BC Children's Hospital; BCCH), or they receive community care from pediatric endocrinologists and/or pediatricians. We sought to determine whether HbA1C and patient reported outcomes were associated with (i) distance to clinic and (ii) tertiary vs. community care. METHODS: Patients were recruited from T1D clinics across BC...
August 12, 2018: Pediatric Diabetes
Kai Liu, Bin Wang, Rui Zhou, He-Dong Lang, Li Ran, Jian Wang, Ling Li, Chao Kang, Xiao-Hui Zhu, Qian-Yong Zhang, Jun-Dong Zhu, Steve Doucette, Jing X Kang, Man-Tian Mi
Background: The combined effect of a low-carbohydrate, high-protein (LCHP) diet and omega-3 (n-3) polyunsaturated fatty acid (PUFA) supplementation on patients with type 2 diabetes (T2D) is not known. Objective: The aim of this study was to evaluate the effect of an LCHP diet combined with ω-3 (LCHP+ω-3) on glycemic control in patients with T2D. Design: In this randomized, double-blind, parallel-controlled trial, 122 newly diagnosed participants with T2D were randomly assigned to receive a high-carbohydrate, low-protein diet with low ω-3 PUFAs [control (CON)], an LCHP, ω-3, or LCHP+ω-3 diet for 12 wk...
August 1, 2018: American Journal of Clinical Nutrition
Nick A Iarrobino, Beant S Gill, Mark Bernard, Rainer J Klement, Maria Werner-Wasik, Colin E Champ
Introduction: Epidemiologic data indicate diabetes confers an augmented risk of lung cancer development, yet the relationship between hyperglycemia, metabolic agents, and prognosis is unclear. We analyzed the impact of hyperglycemia, anti-diabetic agents, and statins on outcomes in non-small cell lung cancer (NSCLC) patients undergoing chemoradiation. Method and Materials: In total, data from 170 patients with stage III NSCLC treated at the University of Pittsburgh Medical Center between 2001 and 2014 were obtained for analysis...
2018: Frontiers in Oncology
Enrico Torre, Giacomo Matteo Bruno, Sergio Di Matteo, Chiara Martinotti, Martina Oselin, Maria Chiara Valentino, Alessio Parodi, Luigi Carlo Bottaro, Giorgio Lorenzo Colombo
Background: Diabetes represents a relevant public health problem worldwide due to its increasing prevalence and socioeconomic burden. There is no doubt that tight glycemic control reduces the development of diabetic complications such as the long-term costs related to the disease. The aim of our model was to calculate total direct costs associated with the two treatments considered in DUAL VII study, and hence evaluate the potential economic benefits for the National Health System (NHS) deriving from the use of insulin degludec plus liraglutide (IDegLira) in a once-daily fixed combination...
2018: ClinicoEconomics and Outcomes Research: CEOR
Shuhei Nakanishi, Hidenori Hirukawa, Masashi Shimoda, Fuminori Tatsumi, Kenji Kohara, Atsushi Obata, Tomohiko Kimura, Seizo Okauchi, Tomoe Kinoshita, Junpei Sanada, Yoshiro Fushimi, Momoyo Nishioka, Akiko Mizoguchi, Tomoatsu Mune, Kohei Kaku, Hideaki Kaneto
AIMS/INTRODUCTION: This study examined the association between the onset of micro- and macroangiopathy in type 2 diabetes subjects (T2DM) and levels of HbA1c described in "Evidence-based Practice Guideline for the Treatment for Diabetes in Japan 2013" (KD) or those indicated in "the Japan Diabetes Society and the Japan Geriatrics Society Joint Committee on Improving Care for Elderly Patients with Diabetes" (JDS/JGS). MATERIALS AND METHODS: Eligible for this study were T2DM who visited the outpatient clinic at Kawasaki Medical School Hospital between 2000 and 2016 and received follow-up for more than two years...
August 12, 2018: Journal of Diabetes Investigation
Julius Ho, Karen Bachman-Carter, Shelley Thorkelson, Kristi Anderson, Jennifer Jaggi, Chris Brown, Katrina Nelson, Cameron Curley, Caroline King, Sid Atwood, Sonya Shin
BACKGROUND: Native American communities experience greater burden of diabetes than the general population, including high rates of Type 2 diabetes among women of childbearing age. Diabetes in pregnancy is associated with risks to both the mother and offspring, and glycemic control surrounding the pregnancy period is of vital importance. METHODS: A retrospective chart review was conducted at a major Navajo Area Indian Health Service (IHS) hospital, tracking women with pre-existing diabetes who became pregnant between 2010 and 2012...
August 10, 2018: BMC Health Services Research
Jan Brož, Denisa Janíčková Žďárská, Jana Urbanová, Marek Brabec, Viera Doničová, Radka Štěpánová, Emil Martinka, Milan Kvapil
INTRODUCTION: The aim of the study was to determine the level of metabolic control in type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) patients in the Czech and Slovak Republics. METHODS: A non-interventional prospective (observational) study was conducted from January 2015 until April 2016 in routine clinical practice settings at 141 centers in the Czech and Slovak Republics. Data were analyzed from a total of 425 patients with T1DM and 1034 patients with T2DM, proportionally corresponding to the number of patients in both countries...
August 9, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
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