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Exercise Associated Hypoglycemia

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https://www.readbyqxmd.com/read/27855237/insulin-autoimmune-syndrome-a-rare-cause-of-postprandial-hypoglycemia
#1
Pooja Sahni, Nitin Trivedi, Abdulkadir Omer
: A 65-year-old obese Caucasian woman presented with symptomatic postprandial hypoglycemic episodes, resolution of symptoms with carbohydrate intake and significantly elevated anti-insulin antibody levels. She did not have any evidence for the use of oral antidiabetic medications, insulin, herbal substances, performing strenuous exercise or history of bariatric surgery. Fingerstick blood glucose readings revealed blood sugar of 35 mg/dL and 48 mg/dL, when she had these symptoms. Her medical history was significant for morbid obesity, hypothyroidism and gastro esophageal reflux disease...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27548105/spontaneous-hypoglycemia-after-islet-autotransplantation-for-chronic-pancreatitis
#2
Yu Kuei Lin, Charles Faiman, Philip C Johnston, R Matthew Walsh, Tyler Stevens, Rita Bottino, Betul A Hatipoglu
CONTEXT: Spontaneous hypoglycemia has been reported in patients after total pancreatectomy (TP) and islet autotransplantation (IAT) with maintained insulin independence. Details surrounding these events have not been well described. OBJECTIVE: The objective of the study was to determine the frequency and characteristics of spontaneous hypoglycemia in patients undergoing TP-IAT and/or to ascertain predictive or protective factors of its development. DESIGN: This was an observational cohort study in 40 patients who underwent TP-IAT from August 2008 to May 2014, with a median follow-up of 34 months...
October 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27380934/do-youth-with-type-1-diabetes-exercise-safely-a-focus-on-patient-practices-and-glycemic-outcomes
#3
Alissa J Roberts, Joyce P Yi-Frazier, Karen E Aitken, Connor A Mitrovich, Michael F Pascual, Craig E Taplin
OBJECTIVE: Insulin adjustments have been shown to reduce glycemic excursions during and after exercise, but little is known about their use in youth with type 1 diabetes (T1D). We aimed to assess practices in youth with T1D around exercise, assess factors that influence practices, and examine associations between key behaviors and glycemic outcomes. RESEARCH DESIGN AND METHODS: We developed the 'Type 1 Diabetes Report of Exercise Practices Survey (T1D-REPS)' and piloted this tool in 100 youth with T1D on an insulin pump...
July 6, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27342265/benefits-of-diabetes-self-management-for-health-plan-members-a-6-month-translation-study
#4
Kate Lorig, Philip L Ritter, Ralph M Turner, Kathleen English, Diana D Laurent, Jay Greenberg
BACKGROUND: Diabetes self-management education has been shown to be effective in controlled trials. However, few programs that meet American Association of Diabetes Educators standards have been translated into widespread practice. OBJECTIVE: This study examined the translation of the evidence-based Better Choices, Better Health-Diabetes program in both Internet and face-to-face versions. METHODS: We administered the Internet program nationally in the United States (n=1010)...
2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27329025/glycemic-control-during-consecutive-days-with-prolonged-walking-exercise-in-individuals-with-type-1-diabetes-mellitus
#5
Jan-Willem van Dijk, Thijs M Eijsvogels, Jean Nyakayiru, Tim H A Schreuder, Maria T Hopman, Dick H Thijssen, Luc J C van Loon
AIMS: Despite its general benefits for health, exercise complicates the maintenance of stable blood glucose concentrations in individuals with type 1 diabetes. The aim of the current study was to examine changes in food intake, insulin administration, and 24-h glycemic control in response to consecutive days with prolonged walking exercise (∼8h daily) in individuals with type 1 diabetes. METHODS: Ten individuals with type 1 diabetes participating in the worlds' largest walking event were recruited for this observational study...
July 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/27217489/effects-of-%C3%AE-aminobutyric-acid-a-receptor-activation-on-counterregulatory-responses-to-subsequent-exercise-in-individuals-with-type-1-diabetes
#6
Maka S Hedrington, Maia Mikeladze, Donna B Tate, Lisa M Younk, Ian Davis, Stephen N Davis
The effects of γ-aminobutyric acid (GABA) A receptor activation on physiologic responses during next-day exercise in type 1 diabetes are unknown. To test the hypothesis that GABA A activation with the benzodiazepine alprazolam would blunt counterregulatory responses during subsequent exercise, 29 (15 male, 14 female) individuals with type 1 diabetes (HbA1c 7.8 ± 1%) were studied during separate 2-day protocols. Day 1 consisted of morning and afternoon 2-h euglycemic or 2.9 mmol/L hypoglycemic clamps with or without 1 mg alprazolam given 30 min before each clamp...
September 2016: Diabetes
https://www.readbyqxmd.com/read/27158520/effect-of-tighter-glycemic-control-on-cardiac-function-exercise-capacity-and-muscle-strength-in-heart-failure-patients-with-type-2-diabetes-a-randomized-study
#7
Roni Nielsen, Henrik Wiggers, Henrik Holm Thomsen, Ann Bovin, Jens Refsgaard, Jan Abrahamsen, Niels Møller, Hans Erik Bøtker, Helene Nørrelund
OBJECTIVES: In patients with type 2 diabetes (T2D) and heart failure (HF), the optimal glycemic target is uncertain, and evidence-based data are lacking. Therefore, we performed a randomized study on the effect of optimized glycemic control on left ventricular function, exercise capacity, muscle strength, and body composition. DESIGN AND METHODS: 40 patients with T2D and HF (left ventricular ejection fraction (LVEF) 35±12% and hemoglobin A1c (HbA1c) 8.4±0.7% (68±0...
2016: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/26854518/sodium-glucose-cotransporter-2-inhibitors-an-evidence-based-practice-approach-to-their-use-in-the-natural-history-of-type-2-diabetes
#8
Stanley S Schwartz, Intekhab Ahmed
Objective The sodium-glucose cotransporter 2 (SGLT-2) inhibitors are an important addition to available treatments for patients with type 2 diabetes (T2D) as an adjunct to modifications in diet and exercise. SGLT-2 inhibitors may be prescribed alone or as add-on treatment in patients receiving metformin, sulfonylureas, thiazolidinediones, dipeptidyl peptidase-4 inhibitors, and/or insulin across the natural history of the disease. Inhibition of SGLT-2, which is responsible for approximately 90% of renal glucose reabsorption, increases urinary glucose excretion and lowers blood glucose concentrations...
May 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/26654858/impact-of-current-and-emerging-glucose-lowering-drugs-on-body-weight-in-type-2-diabetes
#9
REVIEW
David C W Lau, Hwee Teoh
Type 2 diabetes is a progressive disease, and most people with diabetes will eventually require adjunctive pharmacotherapy to optimize their glycemic control. As the majority of people with type 2 diabetes are overweight or obese, weight management is an essential component of diabetes management to improve their overall health and quality of life. Many of the currently available glucose-lowering drugs are associated with weight gain, which makes it challenging for both prescribing clinicians and patients. The 2015 Canadian Diabetes Association Clinical Practice Guidelines interim update on the pharmacologic management of type 2 diabetes recommend individualization of therapy and glycemic targets...
December 2015: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/26630914/impact-of-chronic-sleep-disturbance-for-people-living-with-t1-diabetes
#10
Katharine Barnard, Janet James, David Kerr, Peter Adolfsson, Asher Runion, George Serbedzija
AIM: The aim was to explore personal experiences and to determine the impact of impaired sleep on well-being and diabetes-related activities/decision making among a cohort of people living with T1D. METHOD: Adults with T1D over the age of 18 and parents/carers of children with T1D were invited to complete an online questionnaire about their quality and quantity of sleep. Questions included impact of sleep on diabetes-related decision making, effective calculation of bolus doses, important aspects of psychosocial functioning, and frequency of waking...
May 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/26448850/effects-of-post-exercise-honey-drink-ingestion-on-blood-glucose-and-subsequent-running-performance-in-the-heat
#11
Nur Syamsina Ahmad, Foong Kiew Ooi, Mohammed Saat Ismail, Mahaneem Mohamed
BACKGROUND: Glycogen depletion and hypoglycemia have been associated with fatigue and decrement of performance during prolonged exercise. OBJECTIVES: This study investigated the effectiveness of Acacia honey drink as a post-exercise recovery aid on glucose metabolism and subsequent running performance in the heat. PATIENTS AND METHODS: Ten subjects participated in this randomized cross-over study. All subjects performed 2 trials. In each trial, all subjects went through a glycogen depletion phase (Run-1), 2-hour rehydration phase and time trial running phase (Run-2)...
September 2015: Asian Journal of Sports Medicine
https://www.readbyqxmd.com/read/26423061/dulaglutide-a-review-in-type-2-diabetes
#12
REVIEW
Celeste B Burness, Lesley J Scott
Dulaglutide (Trulicity™) is a once-weekly subcutaneously administered glucagon-like peptide-1 (GLP-1) receptor agonist produced by recombinant DNA technology and approved in numerous countries as an adjunct to diet and exercise for the treatment of adults with type 2 diabetes (T2DM). In randomized controlled trials in patients with T2DM, dulaglutide monotherapy was noninferior to once-daily subcutaneous liraglutide monotherapy and significantly more effective than oral metformin monotherapy in improving glycemic control at 26 weeks...
December 2015: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
https://www.readbyqxmd.com/read/26409797/gestational-diabetes-among-saudi-women-prevalence-risk-factors-and-pregnancy-outcomes
#13
Eman Mohammed Alfadhli, Eman Naguib Osman, Taghreed Hamza Basri, Nazneen Sameer Mansuri, Magda Hassanein Youssef, Somayah Ahmed Assaaedi, Bushra Awad Aljohani
BACKGROUND AND OBJECTIVES: The prevalence of gestational diabetes (GDM) has increased recently worldwide, mainly due to adoption of the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. The objectives of this study were to determine the prevalence of GDM in Saudi women and to assess risk factors and pregnancy outcomes using the IADPSG criteria. DESIGN AND SETTING: A prospective descriptive study of pregnant Saudi women presenting at the Maternity and Children Hospital, Medina, Saudi Arabia, between October 2011 and June 2014...
May 2015: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/26133177/exercise-in-youth-with-type-1-diabetes
#14
REVIEW
Alissa J Roberts, Craig E Taplin
Exercise is important in the management of type 1 diabetes mellitus (T1DM). Modern diabetes care includes the goal that all youth meet guidelines for regular physical activity. Evidence suggests regular physical activity improves cardiovascular health, lipid profiles, psychosocial wellbeing and, possibly, glycemic control in youth with T1DM. However, exercise is especially problematic for children and adolescents because wide glycemic excursions commonly occur during and after exercise and may increase the risk of severe hypoglycemia...
2015: Current Pediatric Reviews
https://www.readbyqxmd.com/read/26132997/potential-place-of-sglt2-inhibitors-in-treatment-paradigms-for-type-2-diabetes-mellitus
#15
REVIEW
Yehuda Handelsman
OBJECTIVE: Following the first Food and Drug Administration (FDA) approval in 2013, sodium glucose cotransporter 2 (SGLT2) inhibitors have generated much interest among physicians treating patients with type 2 diabetes mellitus (T2DM). Here, the role in treatment with this drug class is considered in the context of T2DM treatment paradigms. METHODS: The clinical trials for the SGLT2 inhibitors are examined with a focus on canagliflozin, dapagliflozin, and empagliflozin...
September 2015: Endocrine Practice
https://www.readbyqxmd.com/read/26037553/brain-glycogen-decreases-during-intense-exercise-without-hypoglycemia-the-possible-involvement-of-serotonin
#16
Takashi Matsui, Shingo Soya, Kentaro Kawanaka, Hideaki Soya
Brain glycogen stored in astrocytes, a source of lactate as a neuronal energy source, decreases during prolonged exercise with hypoglycemia. However, brain glycogen dynamics during exercise without hypoglycemia remain unknown. Since intense exercise increases brain noradrenaline and serotonin as known inducers for brain glycogenolysis, we hypothesized that brain glycogen decreases with intense exercise not accompanied by hypoglycemia. To test this hypothesis, we employed a well-established acute intense exercise model of swimming in rats...
July 2015: Neurochemical Research
https://www.readbyqxmd.com/read/26019878/insulin-therapy-and-dietary-adjustments-to-normalize-glycemia-and-prevent-nocturnal-hypoglycemia-after-evening-exercise-in-type-1-diabetes-a-randomized-controlled-trial
#17
Matthew D Campbell, Mark Walker, Richard M Bracken, Daniel Turner, Emma J Stevenson, Javier T Gonzalez, James A Shaw, Daniel J West
INTRODUCTION: Evening-time exercise is a frequent cause of severe hypoglycemia in type 1 diabetes, fear of which deters participation in regular exercise. Recommendations for normalizing glycemia around exercise consist of prandial adjustments to bolus insulin therapy and food composition, but this carries only short-lasting protection from hypoglycemia. Therefore, this study aimed to examine the impact of a combined basal-bolus insulin dose reduction and carbohydrate feeding strategy on glycemia and metabolic parameters following evening exercise in type 1 diabetes...
2015: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/26001653/exercise-associated-glucose-metabolism-in-individuals-with-type-1-diabetes-mellitus
#18
REVIEW
Lia Bally, Markus Laimer, Christoph Stettler
PURPOSE OF REVIEW: The primary focus of this review is threefold: first, to summarize available knowledge on exercise-associated glucose metabolism in individuals with type 1 diabetes mellitus (T1DM); second, to elucidate physiological mechanisms predisposing to glycemic variations in patients in T1DM; and third, to describe novel approaches derived from physiological perceptions applicable to stabilize exercise-related glycemia in individuals with T1DM. RECENT FINDINGS: Recent studies corroborate the concept that despite partial differences in counter-regulatory mechanisms individuals with T1DM do not fundamentally differ in their glucose response to exercise when compared with healthy individuals if studies are performed under standardized conditions with insulin and glucose levels held close to physiological ranges...
July 2015: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/25941657/initiating-insulin-therapy-in-children-and-adolescents-with-type-1-diabetes-mellitus
#19
Subhash Kumar Wangnoo
The primary clinical goals to be achieved with insulin initiation are elimination of ketosis and hyperglycemia with prevention of chronic complications. Insulin therapy is the mainstay in management of type 1 diabetes, which should be aimed at achieving good glycemic control, with achievement of hemoglobin A1c (HbA1c) <7.5%, pre-meal self-monitored blood glucose (SMBG) of 90-130 mg/dL, bed time SMBG of 100-140 mg/dL, mean blood glucose level of 120-160 mg/dL and no ketonuria. Two classes of insulin are available for use in T1DM viz...
April 2015: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/25894262/-treatment-of-elderly-diabetic-patients
#20
Zdeněk Rušavý, Michal Žourek
Type 2 diabetes has become a pandemic disease over the past 50 years. Its incidence increases the most rapidly in the senior population, i.e. among people older than 65. In a number of countries 1/4 of the people with diabetes are now older than 65 years. Geriatrics now examines numerous differences regarding the senior patients, which often lead to somewhat different therapeutic procedures as compared to the treatment of other adult patients. This paper aims to show some different aspects of the treatment of an elderly patient with diabetes...
April 2015: Vnitr̆ní Lékar̆ství
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