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Exercise Associated Hypoglycemia

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https://www.readbyqxmd.com/read/28855239/closed-loop-control-during-intense-prolonged-outdoor-exercise-in-adolescents-with-type-1-diabetes-the-artificial-pancreas-ski-study
#1
Marc D Breton, Daniel R Cherñavvsky, Gregory P Forlenza, Mark D DeBoer, Jessica Robic, R Paul Wadwa, Laurel H Messer, Boris P Kovatchev, David M Maahs
OBJECTIVE: Intense exercise is a major challenge to the management of type 1 diabetes (T1D). Closed loop control (CLC) systems (artificial pancreas) improve glycemic control during limited intensity and short duration of physical activity (PA). However, CLC has not been tested during extended vigorous outdoor exercise common among adolescents. RESEARCH DESIGN AND METHODS: Skiing presents unique metabolic challenges: intense prolonged PA, cold, altitude, and stress/fear/excitement...
August 30, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28728559/effect-of-insulin-therapy-and-dietary-adjustments-on-safety-and-performance-during-simulated-soccer-tests-in-people-with-type-1-diabetes-study-protocol-for-a-randomized-controlled-trial
#2
Javier Calvo-Marín, Gabriel Torrealba-Acosta, Matthew Campbell, Jesse Gaboury, Ajmol Ali, Chih Hao Chen-Ku
BACKGROUND: Despite the reduction in glycemic derangement in patients with type 1 diabetes mellitus (T1D) through dietary and therapeutic adjustments implemented before, during and after continuous exercise, evidence for its effectiveness with intermittent forms of exercise, such as soccer, is still lacking. METHODS/DESIGN: We designed a study protocol for a randomized, crossover, double-blinded, controlled trial, for the evaluation of the effect that a strategy of dietary and therapeutic modifications may have on safety and performance of persons with T1D in soccer training sessions and cognitive testing...
July 20, 2017: Trials
https://www.readbyqxmd.com/read/28685973/efficacy-and-tolerability-of-the-new-autoinjected-suspension-of-exenatide-once-weekly-versus-exenatide-twice-daily-in-patients-with-type-2-diabetes
#3
Carol H Wysham, Julio Rosenstock, Marion L Vetter, Fang Dong, Peter Öhman, Nayyar Iqbal
AIMS: To simplify administration of aqueous exenatide once weekly, which requires reconstitution, the exenatide microspheres have been reformulated in a ready-to-use autoinjector with a Miglyol diluent (exenatide QWS-AI). This study compared the efficacy and safety of exenatide QWS-AI with the first-in-class glucagon-like peptide-1 receptor agonist exenatide twice daily (BID). MATERIALS AND METHODS: This randomized, open-label, controlled study in patients with type 2 diabetes using diet and exercise or taking stable oral glucose-lowering medication randomized patients 3:2 to either exenatide QWS-AI (2 mg) or exenatide BID (10 μg) for 28 weeks...
July 7, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28673573/exercise-for-type-1-diabetes-mellitus-management-general-considerations-and-new-directions
#4
Juliano Boufleur Farinha, Maurício Krause, Josianne Rodrigues-Krause, Alvaro Reischak-Oliveira
Type 1 diabetes mellitus (T1DM) is characterized by the loss of insulin secreting cells due to a directed autoimmune process, which is linked to oxidative stress and inflammation. Exercise training is known to induce several benefits by reducing inflammation and improving antioxidant defenses. In this context, exercise training may be considered as an efficient and relatively inexpensive non-pharmacological tool for diabetes treatment, added to the usual insulin administration. Unfortunately, most people with T1DM do not reach the recommended levels of physical activity due to concerns with hypoglycemic episodes...
July 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28556176/lixisenatide-a-once-daily-prandial-glucagon-like-peptide-1-receptor-agonist-for-the-treatment-of-adults-with-type-2-diabetes
#5
REVIEW
Jennifer M Trujillo, Jennifer Goldman
Lixisenatide, a short-acting glucagon-like peptide-1 receptor agonist (GLP-1 RA), has been available in Europe since 2013 and was recently approved in the United States for the treatment of type 2 diabetes (T2D) as an adjunct to diet and exercise. The objective of this systematic review is to describe the pharmacology, pharmacokinetics, safety, and efficacy of lixisenatide in patients with T2D. We conducted a search of the EMBASE database, limited to human studies with abstracts available in English. Published conference abstracts, limited to the American Diabetes Association (ADA) and the European Association for the Study of Diabetes meetings in 2015, as well as abstracts presented at the ADA meeting in 2016, were also screened...
August 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28502112/sglt2-inhibitor-luseogliflozin-added-to-glucagon-like-peptide-1-receptor-agonist-liraglutide-improves-glycemic-control-with-bodyweight-and-fat-mass-reductions-in-japanese-patients-with-type-2-diabetes-a-52-week-open-label-single-arm-study
#6
Yutaka Seino, Daisuke Yabe, Takashi Sasaki, Atsushi Fukatsu, Hisae Imazeki, Hidekazu Ochiai, Soichi Sakai
AIMS/INTRODUCTION: To evaluate the safety and efficacy of luseogliflozin added to liraglutide monotherapy in Japanese individuals with type 2 diabetes (T2D). MATERIALS AND METHODS: This 52-week, multicenter, open-label, single-arm clinical study enrolled Japanese patients who had inadequate glycemic control with diet/exercise and liraglutide monotherapy. Major efficacy endpoints included the changes from baseline in HbA1c, fasting plasma glucose (FPG), and bodyweight...
May 14, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28251726/outcomes-of-algorithm-based-modifications-of-insulinotherapy-during-exercise-in-mdi-vs-insulin-pump-treated-children-with-type-1-diabetes-results-from-the-tread-diab-study
#7
S Moniotte, M Owen, T Barrea, A Robert, P A Lysy
OBJECTIVES: To evaluate the evolution of subcutaneous glucose (SG) after a standardized aerobic exercise in children and adolescents treated with continuous subcutaneous insulin infusion (CSII) or multiple daily injection (MDI) regimen before and after adaptation of insulin doses. RESEARCH DESIGN AND METHODS: Eleven CSII- and 13 MDI-treated patients performed 2 30-minute sessions of moderate to vigorous (70% of age-based maximal heart rate) exercise on a treadmill under continuous glucose monitoring (CGM)...
March 2, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28229636/exercise-partially-reverses-the-inhibitory-effect-of-caffeine-on-liver-gluconeogenesis-in-type-1-diabetic-rats-with-hypoglycemia
#8
E H Gilglioni, C M Ghuidotti, V R Vilela, C Bataglini, J P Furlan, J A Berti, Mmd Pedrosa, Vaf Godoi
The purpose was to determine the possible effects of exercise and/or caffeine on hypoglycemia and liver gluconeogenesis in diabetic rats. These were divided into four subgroups: (a) intraperitoneal insulin only, (b) exercise bout before insulin, (c) caffeine after insulin, and (d) exercise bout before and caffeine after insulin. The marked glycemic drop 45 min after insulin (0 min = 229.00, 45 min = 75.75) was considerably reduced (p < 0.05) by caffeine or exercise (45 min: exercise = 127...
September 2016: Physiology International
https://www.readbyqxmd.com/read/28210986/the-role-of-the-pharmacist-in-managing-type-2-diabetes-with-glucagon-like-peptide-1-receptor-agonists-as-add-on-therapy
#9
REVIEW
Jerry Meece
The prevalence and associated clinical burden of type 2 diabetes (T2D) is increasing in the USA and other countries. As a consequence, the role of the pharmacist in managing T2D is expanding, and it is becoming increasingly important for pharmacists to have a complete understanding of the disease course and treatment options. Pharmacists have a key role in the use of injectable therapies, including incretin-based treatment with glucagon-like peptide-1 receptor agonists (GLP-1RAs). This article discusses the role of the pharmacist in the management of patients with T2D, particularly with respect to the use of GLP-1RAs to achieve glycemic control...
February 16, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28063503/does-oral-glutamine-improve-insulin-sensitivity-in-adolescents-with-type-1-diabetes
#10
RANDOMIZED CONTROLLED TRIAL
Lournaris Torres-Santiago, Nelly Mauras, Jobayer Hossain, Arthur L Weltman, Dominique Darmaun
OBJECTIVE: The decline in insulin sensitivity (SI) associated with puberty increases the difficulty of achieving glycemic control in adolescents with type 1 diabetes (T1D). The aim of this study was to determine whether glutamine supplementation affects blood glucose by enhancing SI in adolescents with T1D. METHODS: Thirteen adolescents with T1D (HbA1C 8.2 ± 0.1%) were admitted to perform afternoon exercise (four 15-min treadmill/5-min rest cycles of exercise) on two occasions within a 4-wk period...
February 2017: Nutrition
https://www.readbyqxmd.com/read/27989545/physical-activity-and-sedentary-behavior-levels-in-children-and-adolescents-with-type-1-diabetes-using-insulin-pump-or-injection-therapy-the-importance-of-parental-activity-profile
#11
Isabelle Michaud, Mélanie Henderson, Laurent Legault, Marie-Eve Mathieu
In children and adolescents, treatments for type 1 diabetes (T1D) have recently evolved with the introduction of the insulin pump. However, little is known about how a pump is associated with physical activity (PA) patterns. The goal of the study was to examine the activity profile of Canadian children and adolescents with T1D according to their insulin treatment (pump vs. injections), as well as barriers to exercise and parental lifestyle habits. A self-administered questionnaire was completed by 188 subjects with T1D aged 6 to 17 and their parents at the endocrinology clinic of Sainte-Justine's University Hospital Center (Montreal, Canada)...
December 8, 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/27979790/a-diabetes-self-management-program-12-month-outcome-sustainability-from-a-nonreinforced-pragmatic-trial
#12
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. The 6-week Better Choices, Better Health-Diabetes (BCBH-D) self-management program was also associated with an improvement in health outcomes in a 6-month translation study. OBJECTIVE: The objective of this study was to determine whether a national translation of the BCBH-D self-management program, offered both Web-based and face-to-face, was associated with improvements in health outcomes (including HbA1c) and health behaviors (including recommended medical tests) 1 year after intervention...
December 15, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27855237/insulin-autoimmune-syndrome-a-rare-cause-of-postprandial-hypoglycemia
#13
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
#14
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
#15
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
#16
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)...
June 24, 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
#17
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
#18
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
#19
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
#20
REVIEW
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
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