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Clinical exercise physiology diabetes

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https://www.readbyqxmd.com/read/28733378/is-it-time-to-change-the-type-2-diabetes-treatment-paradigm-no-metformin-should-remain-the-foundation-therapy-for-type-2-diabetes
#1
Silvio E Inzucchi
Most treatment guidelines, including those from the American Diabetes Association/European Association for the Study of Diabetes and the International Diabetes Federation, suggest metformin be used as the first-line therapy after diet and exercise. This recommendation is based on the considerable body of evidence that has accumulated over the last 30 years, but it is also supported on clinical grounds based on metformin's affordability and tolerability. As such, metformin is the most commonly used oral antihyperglycemic agent in the U...
August 2017: Diabetes Care
https://www.readbyqxmd.com/read/28733377/is-it-time-to-change-the-type-2-diabetes-treatment-paradigm-yes-glp-1-ras-should-replace-metformin-in-the-type-2-diabetes-algorithm
#2
Muhammad Abdul-Ghani, Ralph A DeFronzo
Most treatment guidelines, including those from the American Diabetes Association/European Association for the Study of Diabetes and the International Diabetes Federation, suggest metformin be used as the first-line therapy after diet and exercise. This recommendation is based on the considerable body of evidence that has accumulated over the last 30 years, but it is also supported on clinical grounds based on metformin's affordability and tolerability. As such, metformin is the most commonly used oral antihyperglycemic agent in the U...
August 2017: Diabetes Care
https://www.readbyqxmd.com/read/28662684/atypical-blood-glucose-response-to-continuous-and-interval-exercise-in-a-person-with-type-1-diabetes-a-case-report
#3
Othmar Moser, Gerhard Tschakert, Alexander Mueller, Werner Groeschl, Thomas R Pieber, Gerd Koehler, Max L Eckstein, Richard M Bracken, Peter Hofmann
BACKGROUND: Therapy must be adapted for people with type 1 diabetes to avoid exercise-induced hypoglycemia caused by increased exercise-related glucose uptake into muscles. Therefore, to avoid hypoglycemia, the preexercise short-acting insulin dose must be reduced for safety reasons. We report a case of a man with long-lasting type 1 diabetes in whom no blood glucose decrease during different types of exercise with varying exercise intensities and modes was found, despite physiological hormone responses...
June 30, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28566776/infected-nonunion-of-tibia
#4
Milind Madhav Chaudhary
Infected nonunions of tibia pose many challenges to the treating surgeon and the patient. Challenges include recalcitrant infection, complex deformities, sclerotic bone ends, large bone gaps, shortening, and joint stiffness. They are easy to diagnose and difficult to treat. The ASAMI classification helps decide treatment. The nonunion severity score proposed by Calori measures many parameters to give a prognosis. The infection severity score uses simple clinical signs to grade severity of infection. This determines number of surgeries and allows choice of hardware, either external or internal for definitive treatment...
May 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28566125/weight-changes-in-general-practice
#5
Rasmus Køster-Rasmussen
This PhD thesis is about weight changes. What determines long-term weight changes in the adult general population? Is it possible that weight loss may not always be healthy? The present clinical guidelines for general practice advice most overweight persons and patients with type 2 diabetes to lose weight. Are the guidelines based on firm evidence?   METHODS: The back-bone of the thesis is constituted by three scientific articles based on three different population based cohort studies. Multivariable modeling and other epidemiological methods were used...
June 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28512432/whole-body-cryotherapy-in-athletes-from-therapy-to-stimulation-an-updated-review-of-the-literature
#6
REVIEW
Giovanni Lombardi, Ewa Ziemann, Giuseppe Banfi
Nowadays, whole-body cryotherapy is a medical physical treatment widely used in sports medicine. Recovery from injuries (e.g., trauma, overuse) and after-season recovery are the main purposes for application. However, the most recent studies confirmed the anti-inflammatory, anti-analgesic, and anti-oxidant effects of this therapy by highlighting the underlying physiological responses. In addition to its therapeutic effects, whole-body cryotherapy has been demonstrated to be a preventive strategy against the deleterious effects of exercise-induced inflammation and soreness...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28467922/metabolic-flexibility-in-health-and-disease
#7
REVIEW
Bret H Goodpaster, Lauren M Sparks
Metabolic flexibility is the ability to respond or adapt to conditional changes in metabolic demand. This broad concept has been propagated to explain insulin resistance and mechanisms governing fuel selection between glucose and fatty acids, highlighting the metabolic inflexibility of obesity and type 2 diabetes. In parallel, contemporary exercise physiology research has helped to identify potential mechanisms underlying altered fuel metabolism in obesity and diabetes. Advances in "omics" technologies have further stimulated additional basic and clinical-translational research to further interrogate mechanisms for improved metabolic flexibility in skeletal muscle and adipose tissue with the goal of preventing and treating metabolic disease...
May 2, 2017: Cell Metabolism
https://www.readbyqxmd.com/read/28462118/insulin-resistance-vascular-function-and-exercise
#8
REVIEW
Moon-Hyon Hwang, Sewon Lee
Insulin resistance associated with metabolic syndrome and Type 2 diabetes mellitus is an epidemic metabolic disorder, which increases the risk of cardiovascular complications. Impaired vascular endothelial function is an early marker for atherosclerosis, which causes cardiovascular complications. Both experimental and clinical studies indicate that endothelial dysfunction in vasculatures occurs with insulin resistance. The associated physiological mechanisms are not fully appreciated yet, however, it seems that augmented oxidative stress, a physiological imbalance between oxidants and antioxidants, in vascular cells is a possible mechanism involved in various vascular beds with insulin resistance and hyperglycemia...
September 2016: Integrative medicine research
https://www.readbyqxmd.com/read/28433617/induced-and-controlled-dietary-ketosis-as-a-regulator-of-obesity-and-metabolic-syndrome-pathologies
#9
Madeline K Gibas, Kelly J Gibas
A worsening epidemic of diabetes and its precursor, metabolic syndrome (MetS) is engulfing America. A healthy individual, with proper glucose regulation has an ability to switch between burning fat and carbohydrates. It has been suggested that signaling errors within this homeostatic system, characterized by impaired switching of substrate oxidation from glucose to fat in response to insulin, can contribute to the etiology of metabolic syndrome and occurs before the development of type II diabetes. Glucose regulation with restored insulin sensitivity facilitated through clinically regulated, benign dietary ketosis (BDK), may significantly reduce, regulate and reverse the adverse pathologies common to MetS and obesity...
March 28, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28432115/effects-of-exercise-on-vascular-function-structure-and-health-in-humans
#10
Daniel J Green, Kurt J Smith
Physical activity has profound impacts on the vasculature in humans. Acute exercise induces immediate changes in artery function, whereas repeated episodic bouts of exercise induce chronic functional adaptation and, ultimately, structural arterial remodeling. The nature of these changes in function and structure are dependent on the characteristics of the training load and may be modulated by other factors such as exercise-induced inflammation and oxidative stress. The clinical implications of these physiological adaptations are profound...
April 21, 2017: Cold Spring Harbor Perspectives in Medicine
https://www.readbyqxmd.com/read/28380304/cardiopulmonary-exercise-testing-in-heart-failure-patients-with-specific-comorbidities
#11
Massimo F Piepoli, Ugo Corrà, Piergiuseppe Agostoni
Exercise capacity is one of the most powerful predicting factors of life expectancy, both in patients with and without cardiac disease. Cardiopulmonary exercise testing provides a global assessment of the integrative exercise responses involving the pulmonary, cardiovascular, hematopoietic, neuropsychological, and skeletal muscle systems, which are not adequately reflected through the measurement of individual organ system function. This relatively noninvasive, dynamic, physiologic overview allows the evaluation of both submaximal and peak exercise responses, providing the physician with relevant information for clinical decision making...
April 5, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28272368/use-of-wearable-sensors-and-biometric-variables-in-an-artificial-pancreas-system
#12
Kamuran Turksoy, Colleen Monforti, Minsun Park, Garett Griffith, Laurie Quinn, Ali Cinar
An artificial pancreas (AP) computes the optimal insulin dose to be infused through an insulin pump in people with Type 1 Diabetes (T1D) based on information received from a continuous glucose monitoring (CGM) sensor. It has been recognized that exercise is a major challenge in the development of an AP system. The use of biometric physiological variables in an AP system may be beneficial for prevention of exercise-induced challenges and better glucose regulation. The goal of the present study is to find a correlation between biometric variables such as heart rate (HR), heat flux (HF), skin temperature (ST), near-body temperature (NBT), galvanic skin response (GSR), and energy expenditure (EE), 2D acceleration-mean of absolute difference (MAD) and changes in glucose concentrations during exercise via partial least squares (PLS) regression and variable importance in projection (VIP) in order to determine which variables would be most useful to include in a future artificial pancreas...
March 7, 2017: Sensors
https://www.readbyqxmd.com/read/28239013/recruitment-and-baseline-characteristics-of-participants-in-the-lifestyle-improvement-through-food-and-exercise-life-study
#13
Elizabeth Lynch, Laurin J Mack, Kelly Karavolos, Elizabeth Avery, Rebecca Liebman, Kathryn S Keim, Crystal M Glover, Leon Fogelfeld
African Americans experience poorer diabetes outcomes than non-Hispanic Whites. Few clinical trials of diabetes self-management interventions specifically target African Americans, perhaps due to well-documented barriers to recruitment in this population. This paper describes strategies used to successfully recruit 211 low-income African Americans from community clinics of a large, urban public hospital system to a randomized clinical trial of an 18-month diabetes self-management intervention. Diabetes-related physiological, psychosocial, and behavioral characteristics of the sample are reported...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/27981590/dietary-restriction-and-aerobic-exercise-attenuate-obesity-induced-lymphatic-dysfunction
#14
Shin-Haw Lee, Sina Hadipour-Lakmehsari
No abstract text is available yet for this article.
March 15, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/27796854/the-effect-of-vigorous-versus-moderate-intensity-aerobic-exercise-on-insulin-action
#15
REVIEW
Robert W McGarrah, Cris A Slentz, William E Kraus
Due to the beneficial effects on a wide range of modern medical conditions, most professional societies recommend regular aerobic exercise as part of a healthy lifestyle. Many of the exercise-related health benefits exhibit a dose-response relationship: Up to a point, more exercise is more beneficial. However, recent studies have suggested that different exercise intensities may provide distinct health benefits, independent of energy expenditure (i.e., exercise dose). One of these benefits, primarily mediated by the skeletal muscle, is exercise-related changes in insulin action and glucose homeostasis...
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27623996/review-of-pharmacokinetic-data-of-different-drug-classes-in-goto-kakizaki-rats-a-non-obese-model-for-type-2-diabetes-mellitus-case-studies-and-perspectives
#16
REVIEW
Harilal Patel, Poonam Giri, Nuggehally R Srinivas
Goto-Kakizaki (GK) rats represent a unique non-obese and lean model with manifestation of type 2 diabetes (T2DM) broadly mimicking the human T2DM development. Therefore, in addition to the use of GK rats to test the efficacy of drugs, it may represent a great tool to study the influence of altered physiological process and/or organ specific pathophysiological changes (i.e., liver, kidney, etc.) on the disposition of drugs. The objectives of the review were: (a) to compile the published pharmacokinetic data of several drugs, such as cephalexin, cyclosporine, exendin-4, gliclazide, grepafloxacin, rosuvastatin, salsalate, salicylic acid, and theophylline, in GK rats relative to normal rats; and (b) critically evaluate the possible role of physiologically altered processes on the pharmacokinetics of reviewed drugs...
April 2017: European Journal of Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/27601974/emerging-relationships-between-exercise-sensory-nerves-and-neuropathic-pain
#17
REVIEW
Michael A Cooper, Patricia M Kluding, Douglas E Wright
The utilization of physical activity as a therapeutic tool is rapidly growing in the medical community and the role exercise may offer in the alleviation of painful disease states is an emerging research area. The development of neuropathic pain is a complex mechanism, which clinicians and researchers are continually working to better understand. The limited therapies available for alleviation of these pain states are still focused on pain abatement and as opposed to treating underlying mechanisms. The continued research into exercise and pain may address these underlying mechanisms, but the mechanisms which exercise acts through are still poorly understood...
2016: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/27557542/ketogenic-diet-and-cancer-a-perspective
#18
REVIEW
Christopher Smyl
Research of the last two decades showed that chronic low-grade inflammation, elevated blood glucose and insulin levels may play role in the onset of a number of non-communicable diseases such as type 2 diabetes and some forms of cancer. Regular exercise and fasting can ameliorate high blood glucose and insulin levels as well as increase the concentration of plasma ketone bodies. These, in consequence, may lead to reduction of inflammation. Exercise or severe restriction of caloric intake is not always advisable for patients, in particular those suffering from cancer...
2016: Recent Results in Cancer Research
https://www.readbyqxmd.com/read/27531051/muscle-redox-disturbances-and-oxidative-stress-as-pathomechanisms-and-therapeutic-targets-in-early-onset-myopathies
#19
REVIEW
Maryline Moulin, Ana Ferreiro
Because of their contractile activity and their high oxygen consumption and metabolic rate, skeletal muscles continually produce moderate levels of reactive oxygen and nitrogen species (ROS/RNS), which increase during exercise and are buffered by multiple antioxidant systems to maintain redox homeostasis. Imbalance between ROS/RNS production and elimination results in oxidative stress (OxS), which has been implicated in ageing and in numerous human diseases, including cancer, diabetes or age-related muscle loss (sarcopenia)...
April 2017: Seminars in Cell & Developmental Biology
https://www.readbyqxmd.com/read/27504612/-are-visual-field-defects-reversible-visual-rehabilitation-with-brains
#20
B A Sabel
Visual field defects are considered irreversible because the retina and optic nerve do not regenerate. Nevertheless, there is some potential for recovery of the visual fields. This can be accomplished by the brain, which analyses and interprets visual information and is able to amplify residual signals through neuroplasticity. Neuroplasticity refers to the ability of the brain to change its own functional architecture by modulating synaptic efficacy. This is actually the neurobiological basis of normal learning...
February 2017: Klinische Monatsblätter Für Augenheilkunde
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