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https://www.readbyqxmd.com/read/29910582/management-of-hyperglycemia-during-and-in-the-immediate-follow-up-of-acute-coronary-syndrome
#1
REVIEW
Jamal El Ouazzani, Amine Ghalem, Ghizlane El Ouazzani, Nabila Ismaili, Noha El Ouafi
Diabetes is a serious, frequent, and insidious morbidity and mortality risk factor in patients with coronary artery disease. It has been shown that carbohydrate metabolism disorders are common in acute coronary syndromes (ACSs): 30-40% of patients have diabetes, 25-36% have an intolerance to carbohydrates, and only 30-40% have a normal carbohydrate profile. Hyperglycemia occurring either in diabetic or nondiabetic patients is strongly associated with a poor prognosis. It increases the extent of myocardial necrosis, and the risk of recurrence acute coronary syndrome and hemodynamic complications, particularly heart failure and cardiogenic shock, reflecting the importance of optimal management of glucose metabolism abnormalities...
April 2018: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/29904447/which-factor-determines-the-duration-required-for-relief-of-glucotoxicity-by-the-intensive-insulin-therapy
#2
Hidekatsu Yanai, Mariko Hakoshima, Hiroki Adachi
No abstract text is available yet for this article.
July 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29886443/effect-of-6-months-of-hybrid-closed-loop-insulin-delivery-in-adults-with-type-1-diabetes-a-randomised-controlled-trial-protocol
#3
Sybil A McAuley, Martin I de Bock, Vijaya Sundararajan, Melissa H Lee, Barbora Paldus, Geoff R Ambler, Leon A Bach, Morton G Burt, Fergus J Cameron, Philip M Clarke, Neale D Cohen, Peter G Colman, Elizabeth A Davis, Jan M Fairchild, Christel Hendrieckx, D Jane Holmes-Walker, Jodie C Horsburgh, Alicia J Jenkins, Joey Kaye, Anthony C Keech, Bruce R King, Kavita Kumareswaran, Richard J MacIsaac, Roland W McCallum, Jennifer A Nicholas, Catriona Sims, Jane Speight, Stephen N Stranks, Steven Trawley, Glenn M Ward, Sara Vogrin, Timothy W Jones, David N O'Neal
INTRODUCTION: Manual determination of insulin dosing largely fails to optimise glucose control in type 1 diabetes. Automated insulin delivery via closed-loop systems has improved glucose control in short-term studies. The objective of the present study is to determine the effectiveness of 6 months' closed-loop compared with manually determined insulin dosing on time-in-target glucose range in adults with type 1 diabetes. METHODS AND ANALYSIS: This open-label, seven-centre, randomised controlled parallel group clinical trial will compare home-based hybrid closed-loop versus standard diabetes therapy in Australia...
June 9, 2018: BMJ Open
https://www.readbyqxmd.com/read/29870029/metformin-added-to-intensive-insulin-therapy-improves-metabolic-control-in-patients-with-type-1-diabetes-and-excess-body-fat
#4
Agnieszka Zawada, Dariusz Naskręt, Paweł Burchardt, Paweł Niedźwiecki, Stanisław Piłaciński, Bogna Wierusz-Wysocka, Marian Grzymisławski, Dorota Zozulińska-Ziółkiewicz
INTRODUCTION Bad nutritional habits and administration of insulin in supraphysiological doses lead to the development of insulin resistance and poor metabolic control in patients with type 1 diabetes. Accumulation of visceral fat is the main cause of the decrease in insulin sensitivity. OBJECTIVES We aimed to evaluate changes in anthropometric parameters, indirect measures of insulin resistance, and safety of treatment with metformin added to intensive insulin therapy in patients with type 1 diabetes and excess body fat...
May 30, 2018: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29866735/study-protocol-of-the-randomised-placebo-controlled-globe-trial-gl-p-1-f-o-r-b-ridging-of-hyperglyca-e-mia-during-cardiac-surgery
#5
Abraham H Hulst, Maarten J Visscher, Marc B Godfried, Bram Thiel, Bas M Gerritse, Thierry V Scohy, R Arthur Bouwman, Mark G A Willemsen, Markus W Hollmann, J Hans DeVries, Benedikt Preckel, Jeroen Hermanides
INTRODUCTION: Perioperative hyperglycaemia is common during cardiac surgery and associated with postoperative complications. Although intensive insulin therapy for glycaemic control can reduce complications, it carries the risk of hypoglycaemia. GLP-1 therapy has the potential to lower glucose without causing hypoglycaemia. We hypothesise that preoperative liraglutide (a synthetic GLP-1 analogue) will reduce the number of patients requiring insulin to achieve glucose values<8 mmol l-1 in the intraoperative period...
June 4, 2018: BMJ Open
https://www.readbyqxmd.com/read/29851323/-continuous-glucose-monitoring-in-clinical-practice
#6
Giacomo Gastaldi
Systems for continuous glucose monitoring (CGM) are changing the management of insulin treated patient providing dynamic glucose information. In Switzerland, CGMS are covered by the health insurance plan in case of intensive insulin therapy (> 3 injections/day) and chronic hyperglycemia, severe hypoglycemia or hypoglycaemia unawarness. The prescriptor has to be an endocrinologist. CGM technology is still expanding with a trend for new indications. Appropriate guidance is needed to keep CGMS use secure. The pillars of CGMS management are : 1) technical mastery, 2) regular reassessment of the prescription adequacy with the clinical situation, and 3) allocation of ressources dedicated to follow-up and training for both patients and caregivers...
May 30, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29788110/long-term-compliance-with-a-validated-intravenous-insulin-therapy-protocol-in-cardiac-surgery-patients-a-quality-improvement-project
#7
Guillaume Besch, Andrea Perrotti, Lucie Salomon du Mont, Raphaelle Tucella, Guillaume Flicoteaux, Aline Bondy, Emmanuel Samain, Sidney Chocron, Sebastien Pili-Floury
Quality problem: Safe and efficient blood glucose (BG) level control after cardiac surgery relies on an intensive care unit (ICU) team-based approach, including implementation of a dynamic insulin therapy protocol (ITP). Long-term compliance with such a complex protocol is poorly addressed in the literature. The aim of this study was to assess the long-term compliance of nurses with the ITP, 7 years after its implementation in the ICU. Initial assessment: A professional practice evaluation, integrated in a process of quality improvement program, was retrospectively conducted on 224 consecutive cardiac surgery patients over a 6-month period (PHASE 1)...
May 18, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29780415/comparison-of-efficacy-and-safety-of-lispro-and-aspart-evaluated-by-continuous-glucose-monitoring-system-in-patients-with-newly-diagnosed-type-2-diabetes
#8
Bing-Li Liu, Guo-Ping Yin, Feng-Fei Li, Yun Hu, Jin-Dan Wu, Mao-Yuan Chen, Lei Ye, Xiao-Fei Su, Jian-Hua Ma
Objective: To compare the effect of the rapid-acting insulin analogues (RAIAs) aspart (NovoRapid) and lispro (Prandilin) on glycemic variations by continuous glucose monitoring system (CGMS) in patients within newly diagnosed type 2 diabetes mellitus (T2DM) receiving continuous subcutaneous insulin infusion (CSII) and metformin intensive therapy. Methods: This is a single-blind randomized controlled trial. A total of 110 patients with newly diagnosed T2DM and with hemoglobin A1c (HbA1c%) above 9% was hospitalized and randomly divided into two groups: group Asp (NovoRapid group) and group Lis (Prandilin group)...
2018: International Journal of Endocrinology
https://www.readbyqxmd.com/read/29779815/use-of-standard-enteral-formula-versus-enteric-formula-with-prebiotic-content-in-nutrition-therapy-a-randomized-controlled-study-among-neuro-critical-care-patients
#9
Piril Tuncay, Fatma Arpaci, Mutlu Doganay, Deniz Erdem, Arzu Sahna, Hulya Ergun, Dilek Atabey
OBJECTIVE: To compare use of standard enteral formula versus enteric formula with prebiotic content in terms of nutrition therapy related outcomes among neurocritical care patients. METHODS: A total of 46 adult neurocritical care patients who received nutrition therapy with standard enteral formula (SEF group; n = 23) or enteral formula with prebiotic content (EFPC group; n = 23) during their hospitalization in intensive care unit (ICU) were included in this prospective randomized controlled study...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29776895/islet-transplantation-versus-insulin-therapy-in-patients-with-type-1-diabetes-with-severe-hypoglycaemia-or-poorly-controlled-glycaemia-after-kidney-transplantation-trimeco-a-multicentre-randomised-controlled-trial
#10
Sandrine Lablanche, Marie-Christine Vantyghem, Laurence Kessler, Anne Wojtusciszyn, Sophie Borot, Charles Thivolet, Sophie Girerd, Domenico Bosco, Jean-Luc Bosson, Cyrille Colin, Rachel Tetaz, Sophie Logerot, Julie Kerr-Conte, Eric Renard, Alfred Penfornis, Emmanuel Morelon, Fanny Buron, Kristina Skaare, Gwen Grguric, Coralie Camillo-Brault, Harald Egelhofer, Kanza Benomar, Lionel Badet, Thierry Berney, François Pattou, Pierre-Yves Benhamou
BACKGROUND: Islet transplantation is indicated for patients with type 1 diabetes with severe hypoglycaemia or after kidney transplantation. We did a randomised trial to assess the efficacy and safety of islet transplantation compared with insulin therapy in these patients. METHODS: In this multicentre, open-label, randomised controlled trial, we randomly assigned (1:1) patients with type 1 diabetes at 15 university hospitals to receive immediate islet transplantation or intensive insulin therapy (followed by delayed islet transplantation)...
May 15, 2018: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29771162/facilitation-of-intensive-insulin-therapy-in-the-early-primary-school-setting-narratives-of-australian-diabetes-educators
#11
Anne Marks, Nathan J Wilson, Stacy Blythe, Christine Johnston
The number of early primary school (EPS) children (aged 4-8 years) with type 1 diabetes mellitus (T1DM) rises each year. Intensive insulin therapy (IIT) can be challenging for these children, as adult support may not be available in the school setting. Diabetes educators (DEs) working in the health system facilitate school diabetes care, which can be time-consuming given the large numbers of children with diabetes. These factors are potential barriers for IIT use in the EPS setting. To explore the experiences of Australian DEs who facilitate IIT use in the EPS setting, a qualitative, narrative inquiry method was used to conduct semi-structured telephone interviews with Australian DEs (n = 13) between December 2014 and June 2016...
May 17, 2018: Comprehensive Child and Adolescent Nursing
https://www.readbyqxmd.com/read/29769112/association-between-%C3%AE-blocker-use-and-mortality-in-critically-ill-patients-a-nested-cohort-study
#12
Shmeylan A Al Harbi, Khalid A Al Sulaiman, Hani Tamim, Hasan M Al-Dorzi, Musharaf Sadat, Yaseen Arabi
BACKGROUND: β-blockers have several indications in critically ill patients and are commonly used. The aim of this study is to examine the relationship between the use of β-blockers in critically ill patients and mortality. METHODS: This was a nested cohort study in which all medical-surgical ICU patients (N = 523) enrolled in a randomized clinical trial of intensive insulin therapy (ISRCTN07413772) were grouped according to β-blocker use during ICU stay. To account for the indication of β-blockers, we constructed a propensity score using selected clinically-relevant and statistically-significant variables related to β-blocker exposure and outcome...
May 16, 2018: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29764892/intense-exercise-for-survival-among-men-with-metastatic-castrate-resistant-prostate-cancer-interval-gap4-a-multicentre-randomised-controlled-phase-iii-study-protocol
#13
Robert U Newton, Stacey A Kenfield, Nicolas H Hart, June M Chan, Kerry S Courneya, James Catto, Stephen P Finn, Rosemary Greenwood, Daniel C Hughes, Lorelei Mucci, Stephen R Plymate, Stephan F E Praet, Emer M Guinan, Erin L Van Blarigan, Orla Casey, Mark Buzza, Sam Gledhill, Li Zhang, Daniel A Galvão, Charles J Ryan, Fred Saad
INTRODUCTION: Preliminary evidence supports the beneficial role of physical activity on prostate cancer outcomes. This phase III randomised controlled trial (RCT) is designed to determine if supervised high-intensity aerobic and resistance exercise increases overall survival (OS) in patients with metastatic castrate-resistant prostate cancer (mCRPC). METHODS AND ANALYSIS: Participants (n=866) must have histologically documented metastatic prostate cancer with evidence of progressive disease on androgen deprivation therapy (defined as mCRPC)...
May 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29752345/randomized-outpatient-trial-of-single-and-dual-hormone-closed-loop-systems-that-adapt-to-exercise-using-wearable-sensors
#14
Jessica R Castle, Joseph El Youssef, Leah M Wilson, Ravi Reddy, Navid Resalat, Deborah Branigan, Katrina Ramsey, Joseph Leitschuh, Uma Rajhbeharrysingh, Brian Senf, Samuel M Sugerman, Virginia Gabo, Peter G Jacobs
OBJECTIVE: Automated insulin delivery is the new standard for type 1 diabetes, but exercise-related hypoglycemia remains a challenge. Our aim was to determine whether a dual-hormone closed-loop system using wearable sensors to detect exercise and adjust dosing to reduce exercise-related hypoglycemia would outperform other forms of closed-loop and open-loop therapy. RESEARCH DESIGN AND METHODS: Participants underwent four arms in randomized order: dual-hormone, single-hormone, predictive low glucose suspend, and continuation of current care over 4 outpatient days...
May 11, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29751841/level-of-insulin-adherence-among-diabetes-mellitus-patients-in-felege-hiwot-referral-hospital-bahir-dar-northwest-ethiopia-2017-a-cross-sectional-study
#15
Tilahun Tewabe, Selamsew Kindie
OBJECTIVES: The objective of this study was to know the level of insulin adherence and to identify factors affecting insulin adherence among diabetes mellitus patients in Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia. RESULTS: Prevalence of insulin adherence was 59.2%. Patients who are married [AOR = 0.3 (0.14-0.7)], have regular health care visit [AOR = 3.3 (1.5-7.5)] and accessing insulin with low cost [AOR = 2.9 (1.3-6.3)] were more likely to adhere insulin therapy than their counterparts...
May 11, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29750655/metabolic-risk-factors-in-adolescent-girls-with-type-1-diabetes
#16
Cíntia Castro-Correia, Rita Santos-Silva, Marta Pinheiro, Carla Costa, Manuel Fontoura
BACKGROUND: The incidence of pediatric metabolic syndrome (MS) has progressively increased. The incidence of type 1 diabetes mellitus (T1DM) has also increased. Thus, some children and adolescents with T1DM exhibit MS parameters. The aim of the study was to evaluate the presence of MS parameters in female adolescents with T1DM based on their nutritional status. METHODS: We evaluated 44 adolescents with T1DM (consecutive non-randomized sample) aged between 14 and 18 years, who were on intensive therapy with insulin...
May 11, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/29745913/benefits-of-early-screening-and-proper-treatment-in-patient-with-significant-risk-factors-for-gestational-diabetes-mellitus-case-report
#17
V Limani
Gestational diabetes mellitus (GDM) occurs in 2-9% of all pregnancies. Evidence suggests that the use of insulin in treating hyperglycemia in GDM patients reduces the risk of perinatal morbidity. Pregnancy is an exciting time in a woman's life. However, once patient is diagnosed with GDM, she will be managed more intensively. GDM is managed using diet and exercise but one in six women with GDM requires insulin. A 35-year-old woman at the 14th gestational week of her tenth pregnancy was seen for routine prenatal care...
April 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29730785/may-the-force-be-with-you-why-resistance-training-is-essential-for-subjects-with-type-2-diabetes-mellitus-without-complications
#18
REVIEW
Roberto Codella, Marta Ialacqua, Ileana Terruzzi, Livio Luzi
Physical activity, together with diet and pharmacological therapy, represents one of the three cornerstones in type 2 diabetes mellitus treatment and care. The therapeutic appeal of regular physical activity stems from: (i) its non-pharmacological nature; (ii) its beneficial effects on the metabolic risk factors associated with diabetes complications; (iii) its low costs. Evidence accumulated in the last years suggests that aerobic training-endurance training-constitutes a safe modality of intervention, achievable, and effective in diabetes treatment, whenever it is not limited by comorbidities...
May 5, 2018: Endocrine
https://www.readbyqxmd.com/read/29707091/sodium-glucose-cotransporter-2-inhibitors-reduce-prandial-insulin-doses-in-type-2-diabetic-patients-treated-with-the-intensive-insulin-therapy
#19
Mariko Hakoshima, Hidekatsu Yanai, Kouki Kakuta, Hiroki Adachi
Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are anti-diabetic drugs which improve blood glucose control by blocking reabsorption of glucose from the proximal tubule of kidney. Anti-atherosclerotic properties and cardiovascular protective effects of SGLT2i have been demonstrated by recent studies; however, the efficacy and safety of addition of SGLT2i to the intensive insulin therapy remain largely unknown. Methods: We retrospectively picked up patients hospitalized for treatment of type 2 diabetes, who had been treated by the intensive insulin therapy and whose treatment using by SGLT2i started during their hospitalization...
June 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29705217/lower-glucose-target-is-associated-with-improved-30-day-mortality-in-cardiac-and-cardiothoracic-patients
#20
Andrew M Hersh, Eliotte L Hirshberg, Emily L Wilson, James F Orme, Alan H Morris, Michael J Lanspa
BACKGROUND: Practice guidelines recommend against intensive insulin therapy in patients who are critically ill based on trials that had high rates of severe hypoglycemia. Intermountain Healthcare uses a computerized IV insulin protocol that allows choice of blood glucose (BG) targets (80-110 vs 90-140 mg/dL) and has low rates of severe hypoglycemia. We sought to study the effects of BG target on mortality in adult patients in cardiac ICUs that have very low rates of severe hypoglycemia...
April 26, 2018: Chest
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