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https://www.readbyqxmd.com/read/28645302/untangling-glycaemia-and-mortality-in-critical-care
#1
Vincent Uyttendaele, Jennifer L Dickson, Geoffrey M Shaw, Thomas Desaive, J Geoffrey Chase
BACKGROUND: Hyperglycaemia is associated with adverse outcomes in the intensive care unit, and initial studies suggested outcome benefits of glycaemic control (GC). However, subsequent studies often failed to replicate these results, and they were often unable to achieve consistent, safe control, raising questions about the benefit or harm of GC as well as the nature of the association of glycaemia with mortality and clinical outcomes. In this study, we evaluated if non-survivors are harder to control than survivors and determined if glycaemic outcome is a function of patient condition and eventual outcome or of the glycaemic control provided...
June 24, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28630246/ominous-triad-triggered-by-high-dose-glucocorticosteroid-therapy
#2
Sarah Bär, Fritz Daudel, Thomas Zueger
Glucocorticosteroids (CS) play a key role in the treatment of numerous diseases. Nonetheless, they can be accompanied by several adverse effects. We present the case of a 51-year-old woman who was treated with high-dose CS for a relapse of her multiple sclerosis. After 5 days of treatment, the patient developed severe diabetic ketoacidosis, hypertriglyceridemia and acute pancreatitis-a potentially life-threatening triad which has previously been described, in our case, however, for the first time as a complication of CS therapy...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28624504/proinsulin-protects-against-age-related-cognitive-loss-through-anti-inflammatory-convergent-pathways
#3
Rubén Corpas, Alberto M Hernández-Pinto, David Porquet, Catalina Hernández-Sánchez, Fatima Bosch, Arantxa Ortega-Aznar, Francesc Comellas, Enrique J de la Rosa, Coral Sanfeliu
Brain inflammaging is increasingly considered as contributing to age-related cognitive loss and neurodegeneration. Despite intensive research in multiple models, no clinically effective pharmacological treatment has been found yet. Here, in the mouse model of brain senescence SAMP8, we tested the effects of proinsulin, a promising neuroprotective agent that was previously proven to be effective in mouse models of retinal neurodegeneration. Proinsulin is the precursor of the hormone insulin but also upholds developmental physiological effects, particularly as a survival factor for neural cells...
June 15, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28613947/the-effects-of-basal-insulin-suspension-at-the-start-of-exercise-on-blood-glucose-levels-during-continuous-versus-circuit-based-exercise-in-individuals-with-type-1-diabetes-on-continuous-subcutaneous-insulin-infusion
#4
Dessi Zaharieva, Loren Yavelberg, Veronica Jamnik, Ali Cinar, Kamuran Turksoy, Michael C Riddell
BACKGROUND: Exercise causes glycemic disturbances in individuals with type 1 diabetes (T1D). Continuous moderate-intensity aerobic exercise (CON) generally lowers blood glucose (BG) levels and often leads to hypoglycemia. In comparison, circuit-based exercise (CIRC) may attenuate the drop in BG. The goal of this study is to contrast the effects of basal insulin suspension at the onset of two different forms of exercise (CON vs. CIRC). METHODS: Twelve individuals (six men and six women) with T1D on insulin pump therapy were recruited for the study...
June 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28609547/intensive-insulin-therapy-combined-with-metformin-is-associated-with-reduced-glucose-variability-and-nocturnal-hypoglycemia-in-patients-with-type-2-diabetes
#5
Yifei Zhang, Zhiyun Zhao, Shujie Wang, Wei Zhu, Yiran Jiang, Shouyue Sun, Chen Chen, Kai Wang, Liangshan Mu, Jinyi Cao, Yingxia Zhou, Weiqiong Gu, Jie Hong, Weiqing Wang, Guang Ning
BACKGROUND: The effect on glucose variability in patients with intensive insulin therapy has not been fully understood. This observational study investigated the different glucose variability and hypoglycemia pattern in type 2 diabetes patients treated with continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI) with or without metformin administration. METHODS: During hospitalization, totally 501 patients with poor glycemic control and in initial treatment with either CSII alone (n = 187), CSII + Metformin (n = 81), MDI alone (n = 146) or MDI + Metformin (n = 87), were involved in the final analysis...
June 13, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28586518/combination-therapy-with-multiple-oral-hypoglycaemic-agents-together-with-short-term-basal-insulin-in-new-onset-type-2-diabetes-mellitus-with-marked-hyperglycaemia
#6
S Ray, J J Mukherjee
Type 2 diabetes mellitus is characterized by the relentless loss of β-cell function, which is partly attributable to glucotoxicity and lipotoxicity. Prolonged exposure to excess glucose and oxidative stress leads to β-cell destruction [1,2]. Evidence suggests that early intensive intervention to achieve normoglycaemia can preserve β-cell function, probably by correcting glucotoxicity and lipotoxicity [3]. This article is protected by copyright. All rights reserved.
June 6, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28572099/nurse-directed-blood-glucose-management-in-a-medical-intensive-care-unit
#7
Friederike Compton, Robert Ahlborn, Torsten Weidehoff
BACKGROUND: Insulin-delivery algorithms for achieving glycemic control in the intensive care unit require frequent checks of blood glucose level and thus increase nursing workload. Hypoglycemia is a serious complication associated with intensive insulin therapy. OBJECTIVES: To evaluate a nurse-directed protocol for blood glucose management that allows individualized insulin delivery within a predefined blood glucose corridor, intended to avoid hypoglycemia while maintaining adequate control of blood glucose level without increasing nursing workload...
June 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28571934/intensive-glycemic-control-in-younger-and-older-u-s-adults-with-type-2-diabetes
#8
Sarah Casagrande, Catherine C Cowie, Judith E Fradkin
AIMS: To determine the extent to which older vs. younger adults with diabetes intensively control glycemia. METHODS: Participants were age≥40years who self-reported a physician diagnosis of diabetes in the 2009-2014 National Health and Nutrition Examination Surveys (N=1554). Intensive glycemic control was defined as A1c<7.0% and taking insulin, sulfonylureas, or ≥2 glycemic medications. Logistic regression was used to determine the adjusted odds of intensive control in older (≥65years) vs...
May 18, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28550194/the-risk-of-severe-hypoglycemia-in-type-1-diabetes-over-30-years-of-follow-up-in-the-dcct-edic-study
#9
Rose A Gubitosi-Klug, Barbara H Braffett, Neil H White, Robert S Sherwin, F John Service, John M Lachin, William V Tamborlane
OBJECTIVE: During the DCCT, intensive diabetes therapy achieving a mean HbA1c of ∼7% was associated with a threefold increase in the rate of severe hypoglycemia (defined as requiring assistance) compared with conventional diabetes therapy with a mean HbA1c of 9% (61.2 vs. 18.7 per 100 patient-years). After ∼30 years of follow-up, we investigated the rates of severe hypoglycemia in the DCCT/EDIC cohort. RESEARCH DESIGN AND METHODS: Rates of severe hypoglycemia were reported quarterly during DCCT and annually during EDIC (i...
May 26, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28544654/hypogonadism-in-testicular-cancer-patients-is-associated-with-risk-factors-of-cardiovascular-disease-and-the-metabolic-syndrome
#10
C Bogefors, S Isaksson, J Bobjer, M Kitlinski, I Leijonhufvud, K Link, A Giwercman
More than 95% of testicular cancer are cured but they are at increased long-term risk of cardiovascular disease. The risk of cardiovascular disease and treatment intensity was reported, but it is unknown whether this effect of cancer therapy is direct or indirect, mediated through androgen deficiency. Our aim was, therefore, to evaluate whether testicular cancer patients have increased the prevalence of risk factors of cardiovascular disease and if these risk factors are associated with hypogonadism and/or the cancer treatment given...
May 23, 2017: Andrology
https://www.readbyqxmd.com/read/28541131/clinical-use-of-continuous-glucose-monitoring-in-adults-with-type-1-diabetes
#11
David Slattery, Pratik Choudhary
With the emphasis on intensive management of type 1 diabetes, data from studies support frequent monitoring of glucose levels to improve glycemic control and reduce glucose variability, which can be related to an increase in macro and microvascular complications. However, few perform capillary blood glucose that frequently. There are currently two available alternatives that this review will discuss, continuous glucose monitoring (CGM) and flash glucose monitoring. CGM has become an important diagnostic and therapeutic option in optimizing diabetes management...
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28539618/effect-of-exenatide-after-short-time-intensive-insulin-therapy-on-glycaemic-remission-maintenance-in-type-2-diabetes-patients-a-randomized-controlled-trial
#12
Xiulin Shi, Yalin Shi, Ning Chen, Mingzhu Lin, Weijuan Su, Huijie Zhang, Changqin Liu, Haiqu Song, Fangsen Xiao, Peiying Huang, Liying Wang, Wei Liu, Jinyang Zeng, Bing Yan, Qi Liu, Suhuan Liu, Shuyu Yang, Xiaoying Li, Zhibin Li, Xuejun Li
Early short-term intensive insulin (STII) therapy can induce drug-free glycemic remission for up to 1 year in half of newly diagnosed type 2 diabetic mellitus (T2DM) patients. Whether exenatide following STII therapy will induce higher long-term glycaemic remission is currently unknown. To assess the effect of STII+ exenatide therapy, compared with STII only, on maintenance of glycaemic remission in newly diagnosed T2DM patients. In this randomized, parallel-group, open-label, controlled trial, 129 patients (66 in STII+ exenatide group and 63 in STII only group) firstly completed 3-week STII therapy, then STII+ exenatide group was treated with exenatide for 12 weeks further...
May 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28488346/predictors-of-glycemic-control-in-the-first-year-of-diagnosis-of-childhood-onset-type-1-diabetes-a-systematic-review-of-quantitative-evidence
#13
REVIEW
Veena Mazarello Paes, Dimitrios Charalampopoulos, Julie Edge, David Taylor-Robinson, Terence Stephenson, Rakesh Amin
Early glycemic control is associated with reduced future vascular complications risk in type 1 diabetes (T1D). The aim of this study was to systematically review evidence on the predictors of glycemic control within 12 months of diagnosis of childhood onset T1D. Inclusion criteria for the electronic search were: interventional and observational studies that assessed and quantified an association between the predictor and glycemic control within 12 months of diagnosis of childhood onset T1D. A total of 17 915 articles were identified from 6 databases and 20 studies were finally included in the analysis...
May 10, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28487297/mechanisms-in-endocrinology-towards-the-clinical-translation-of-stem-cell-therapy-for-type-1-diabetes
#14
Daniel Espes, Joey Lau Börjesson, Per-Ola Carlsson
Insulin producing cells derived from human embryonic stem cells (hESCs) or induced pluripotent stem cells (iPSCs) have for long been a promising, but elusive treatment far from clinical translation into type 1 diabetes therapy. However, the field is now on the verge of moving such insulin-producing cells into clinical trials. Although stem cell therapies provide great opportunities, there are also potential risks such as teratoma formation associated with the treatment. Many considerations are needed on how to proceed with clinical translation, including whether to use hESCs or iPSCs, and whether encapsulation of tissue will be needed...
May 9, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28476321/murine-model-and-mechanisms-of-treatment-induced-painful-diabetic-neuropathy
#15
Juliet M Nicodemus, Cynthia Enriquez, Alexandra Marquez, Carlos J Anaya, Corinne G Jolivalt
Diabetes mellitus represents a group of metabolic diseases that are characterized by hyperglycemia caused by either lack of insulin production or a reduced ability to respond to insulin. It is estimated that there were 347 million people worldwide who suffered from diabetes in 2008 and incidence is predicted to double by 2050. Neuropathy is the most common complication of long-term diabetes and approximately 30% of these subjects develop chronic neuropathic pain. A distinct acute, severe form of neuropathic pain, called insulin neuritis or treatment-induced painful neuropathy of diabetes (TIND), may also occur shortly after initiation of intensive glycemic control, with an incidence rate of up to 10...
June 23, 2017: Neuroscience
https://www.readbyqxmd.com/read/28474496/an-arduous-journey-from-human-pluripotent-stem-cells-to-functional-pancreatic-%C3%AE-cells
#16
REVIEW
Larry Sai Weng Loo, Hwee Hui Lau, Joanita Binte Jasmen, Chang Siang Lim, Adrian Kee Keong Teo
Type 1 and type 2 diabetes are caused by a destruction and decrease in the number of functional insulin-producing β cells, respectively; therefore, the generation of functional β cells from human embryonic stem cells and human induced pluripotent stem cells, collectively known as human pluripotent stem cells (hPSCs), for potential cell replacement therapy and disease modelling is an intensely investigated area. Recent scientific breakthroughs enabled derivation of large quantities of human pancreatic β-like cells in vitro, although with varied glucose-stimulated insulin secretion kinetics...
May 4, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28443261/diabetes-mellitus-caused-by-secondary-hemochromatosis-after-multiple-blood-transfusions-in-2-patients-with-severe-aplastic-anemia
#17
Hyun Jin Kim, Yoon-Myung Kim, Eungu Kang, Beom Hee Lee, Jin-Ho Choi, Han-Wook Yoo
Hemochromatosis is an inherited or secondary disorder caused by excessive iron storage leading to multiple organ damage. We describe 2 patients with diabetes mellitus caused by hemochromatosis secondary to multiple blood transfusions due to severe aplastic anemia. Subject 1, who was diagnosed with severe aplastic anemia at 15 years of age, received multiple red blood cell transfusions before he underwent autologous peripheral blood stem cell transplantation (PBSCT) at 22 years of age. At 21 years of age, hyperglycemia was detected with increased hemoglobin A1c and serum ferritin levels, 9...
March 2017: Annals of Pediatric Endocrinology & Metabolism
https://www.readbyqxmd.com/read/28440768/clinical-and-metabolic-profile-of-patients-with-latent-autoimmune-diabetes-in-adults-in-specialized-care-in-madrid
#18
Alfonso Arranz Martín, Edurne Lecumberri Pascual, Miguel Ángel Brito Sanfiel, Víctor Andía Melero, Lia Nattero Chavez, Iván Sánchez López, Gloria Cánovas Molina, Francisco Arrieta Blanco, Noemí González Perez Del Villar
OBJECTIVE: To report the clinical characteristics of patients with latent autoimmune diabetes in adults (LADA), and to ascertain their metabolic control and associated chronic complications. METHODS: Patients with DM attending specialized medical care in Madrid who met the following criteria: age at diagnosis of DM >30years, initial insulin independence for at least 6months and positive GAD antibodies were enrolled. Clinical profiles, data on LADA diagnosis, associated autoimmunity, C-peptide levels, therapeutic regimen, metabolic control, and presence of chronic complications were analyzed...
January 2017: Endocrinol Diabetes Nutr
https://www.readbyqxmd.com/read/28440211/a-cluster-randomised-trial-cost-effectiveness-analysis-and-psychosocial-evaluation-of-insulin-pump-therapy-compared-with-multiple-injections-during-flexible-intensive-insulin-therapy-for-type-1-diabetes-the-repose-trial
#19
Simon Heller, David White, Ellen Lee, Julia Lawton, Daniel Pollard, Norman Waugh, Stephanie Amiel, Katharine Barnard, Anita Beckwith, Alan Brennan, Michael Campbell, Cindy Cooper, Munyaradzi Dimairo, Simon Dixon, Jackie Elliott, Mark Evans, Fiona Green, Gemma Hackney, Peter Hammond, Nina Hallowell, Alan Jaap, Brian Kennon, Jackie Kirkham, Robert Lindsay, Peter Mansell, Diana Papaioannou, David Rankin, Pamela Royle, W Henry Smithson, Carolin Taylor
BACKGROUND: Insulin is generally administered to people with type 1 diabetes mellitus (T1DM) using multiple daily injections (MDIs), but can also be delivered using infusion pumps. In the UK, pumps are recommended for patients with the greatest need and adult use is less than in comparable countries. Previous trials have been small, of short duration and have failed to control for training in insulin adjustment. OBJECTIVE: To assess the clinical effectiveness and cost-effectiveness of pump therapy compared with MDI for adults with T1DM, with both groups receiving equivalent structured training in flexible insulin therapy...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28435461/recipient-glycemic-micro-environments-govern-therapeutic-effects-of-mesenchymal-stem-cell-infusion-on-osteopenia
#20
Bing-Dong Sui, Cheng-Hu Hu, Chen-Xi Zheng, Yi Shuai, Xiao-Ning He, Ping-Ping Gao, Pan Zhao, Meng Li, Xin-Yi Zhang, Tao He, Kun Xuan, Yan Jin
Therapeutic effects of mesenchymal stem cell (MSC) infusion have been revealed in various human disorders, but impacts of diseased micro-environments are only beginning to be noticed. Donor diabetic hyperglycemia is reported to impair therapeutic efficacy of stem cells. However, whether recipient diabetic condition also affects MSC-mediated therapy is unknown. We and others have previously shown that MSC infusion could cure osteopenia, particularly in ovariectomized (OVX) mice. Here, we discovered impaired MSC therapeutic effects on osteopenia in recipient type 1 diabetes (T1D)...
2017: Theranostics
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