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Inpatient glycemic control

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https://www.readbyqxmd.com/read/28790874/lack-of-change-in-glucose-metabolism-in-eszopiclone-treated-primary-insomnia-patients
#1
Orfeu M Buxton, Milena K Pavlova, Shawn P O'Connor, Wei Wang, John W Winkelman
STUDY OBJECTIVES: Primary insomnia (PI) may increase diabetes risk. We tested the hypothesis that the effects of PI on glucose metabolism could be improved by 2 months of pharmacological treatment. METHODS: Adult men and women meeting clinical criteria for PI were studied (n=20, body mass index 25.1±2.7 kg/m(2), age 39.7±7.9) in a randomized, double-blind, placebo-controlled clinical trial. The study consisted of two 1-day inpatient admissions to a General Clinical Research Center separated by 2 months of at-home treatment with 3 mg eszopiclone or placebo...
2017: Nature and Science of Sleep
https://www.readbyqxmd.com/read/28745091/continuous-glucose-monitoring-use-in-type-1-diabetes-longitudinal-analysis-demonstrates-meaningful-improvements-in-hba1c-and-reductions-in-health-care-utilization
#2
Christopher G Parkin, Claudia Graham, John Smolskis
BACKGROUND: Real-time continuous glucose monitoring (rtCGM) improves glycemic control in type 1 diabetes (T1D) patients treated with continuous subcutaneous insulin infusion (CSII). However, the benefits of rtCGM in T1D patients treated with multiple daily insulin injection (MDI) therapy has not been well studied. We explored the effects of rtCGM versus self-monitoring of blood glucose (SMBG) on clinical outcomes within a large T1D population treated with either CSII or MDI therapy. METHODS: This retrospective, longitudinal analysis utilized datasets from T1D patients enrolled in a commercial health plan to assess changes in HbA1c in 187 naïve to rtCGM users and 6260 SMBG users...
May 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28699089/cardiovascular-safety-of-antidiabetic-drugs-in-the-hospital-setting
#3
REVIEW
Stacey A Seggelke, Mark C Lindsay, Ingrid Hazlett, Rebecca Sanagorski, Robert H Eckel, Cecilia C Low Wang
PURPOSE OF REVIEW: Patients with diabetes and/or stress hyperglycemia requires good glycemic control in the hospital setting, often requiring the use of glucose-lowering therapy. Standard-of-care dictates that non-insulin therapy be discontinued, with insulin therapy initiated using a basal-bolus approach. However, insulin is associated with a high risk for hypoglycemia and medical errors. Alternatives to insulin are needed in the inpatient setting, but the cardiovascular (CV) safety of non-insulin therapy is a concern...
August 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28683239/comparison-of-efficacy-and-safety-of-glargine-and-detemir-insulin-in-the-management-of-inpatient-hyperglycemia-and-diabetes
#4
Rodolfo J Galindo, Georgia M Davis, Maya Fayfman, David Reyes-Umpierrez, David Alfa, Limin Peng, Ronald Tamler, Francisco J Pasquel, Guillermo E Umpierrez
OBJECTIVE: Glargine and detemir insulin are the two most commonly prescribed basal insulin analogues for the ambulatory and inpatient management of diabetes. The efficacy and safety of basal insulin analogues in the hospital setting has not been established. METHODS: This observational study compared differences in glycemic control and outcomes in non-intensive care unit patients with blood glucose (BG) >140 mg/dL who were treated with glargine or detemir, between January 1, 2012, and September 30, 2015, in two academic centers...
September 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28664252/nutrition-and-hyperglycemia-management-in-the-inpatient-setting-meals-on-demand-parenteral-or-enteral-nutrition
#5
REVIEW
Andjela T Drincic, Jon T Knezevich, Padmaja Akkireddy
PURPOSE OF REVIEW: The goal of this paper is to provide the latest evidence and expert recommendations for management of hospitalized patients with diabetes or hyperglycemia receiving enteral (EN), parenteral (PN) nutrition support or, those with unrestricted oral diet, consuming meals on demand. RECENT FINDINGS: Patients with and without diabetes mellitus commonly develop hyperglycemia while receiving EN or PN support, placing them at increased risk of adverse outcomes, including in-hospital mortality...
August 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28567711/the-case-for-diabetes-population-health-improvement-evidence-based-programming-for-population-outcomes-in-diabetes
#6
REVIEW
Sherita Hill Golden, Nisa Maruthur, Nestoras Mathioudakis, Elias Spanakis, Daniel Rubin, Mihail Zilbermint, Felicia Hill-Briggs
PURPOSE OF REVIEW: The goal of this review is to describe diabetes within a population health improvement framework and to review the evidence for a diabetes population health continuum of intervention approaches, including diabetes prevention and chronic and acute diabetes management, to improve clinical and economic outcomes. RECENT FINDINGS: Recent studies have shown that compared to usual care, lifestyle interventions in prediabetes lower diabetes risk at the population-level and that group-based programs have low incremental medial cost effectiveness ratio for health systems...
July 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28549013/effect-of-preoperative-diabetes-management-on-glycemic-control-and-clinical-outcomes-after-elective-surgery
#7
Rajesh Garg, Brooke Schuman, Angela Bader, Shelley Hurwitz, Alexander Turchin, Patricia Underwood, Cheyenne Metzger, Raquel Rein, Meghan Lortie
OBJECTIVE: The aim of this study was to evaluate whether preoperative diabetes management can improve glycemic control and clinical outcomes after elective surgery. BACKGROUND: There is lack of data on the importance of diabetes treatment before elective surgery. Diabetes is often ignored before surgery and aggressively treated afterwards. METHODS: Patients with diabetes were identified and treated proactively before their scheduled surgeries...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28504012/inpatient-glycemic-management-in-internal-medicine-an-observational-multicenter-study-in-nanjing-china
#8
Shujie Hao, Ning Zhang, Anne Folta Fish, Xiaodan Yuan, Lin Liu, Fan Li, Zhaohui Fang, Qingqing Lou
AIMS: To evaluate the prevalence of hyperglycemia among inpatients in internal medicine, and specifically, to assess the glycemic management of inpatients in non-endocrinology departments in three large urban hospitals in China. METHODS: A multicenter observational study was conducted using electronic health records, and a survey of 1939 patients who were admitted to internal medicine units and followed until discharge. Those with previously diagnosed diabetes, newly diagnosed diabetes, or impaired fasting glucose were included...
June 9, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28502888/prospective-study-of-postoperative-glycemic-control-with-a-standardized-insulin-infusion-protocol-after-infrainguinal-bypass-and-open-abdominal-aortic-aneurysm-repair
#9
Andrea M Steely, Lisa Smith, Peter W Callas, Muriel H Nathan, Julie E Lahiri, Andrew C Stanley, Georg Steinthorsson, Daniel J Bertges
BACKGROUND: The aim of this study is to examine the effect of moderate postoperative glycemic control in diabetic and nondiabetic patients undergoing infrainguinal bypass (INFRA) or open abdominal aortic aneurysm (OAAA) repair. METHODS: In a single center prospective study, we investigated postoperative glycemic control using a standardized insulin infusion protocol after elective INFRA bypass (n = 53, 62%) and OAAA repair (n = 33, 38%) between January 2013 and March 2015...
October 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28458523/results-of-a-pilot-study-of-patient-to-patient-education-strategy-on-self-management-among-glycemic-uncontrolled-patients-with-diabetes
#10
Yingying Xiang, Pingyan Luo, Xueqin Cai, Yuqin Tang, Zhongming Wu
OBJECTIVES: The purpose of this study was to assess the efficacy and practicability of patient-to-patient (PTP) education strategy on glycemic control among patients with type 2 diabetes mellitus. METHODS: Eligible subjects from outpatient clinic were recruited and randomized to either intervention group or control group. Inpatients with poor outcomes and complications acted as mentors to share their experience with the intervention group in three tailored classes...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28429906/eating-glutinous-brown-rice-for-one-day-improves-glycemic-control-in-japanese-patients-with-type-2-diabetes-assessed-by-continuous-glucose-monitoring
#11
RANDOMIZED CONTROLLED TRIAL
Yuko Terashima, Yoshio Nagai, Hiroyuki Kato, Akio Ohta, Yasushi Tanaka
BACKGROUND AND OBJECTIVES: We investigated whether intake of non-glutinous brown rice (BR) or glutinous brown rice (GBR) for 1 day had an influence on the daily glucose profile measured by continuous glucose monitoring (CGM) when compared with intake of non-glutinous white rice (WR). METHODS AND STUDY DESIGN: A total of 37 inpatients with type 2 diabetes mellitus (T2DM) were recruited for a 3-day randomized triple cross-over trial in which they ate WR, BR, or GBR for 1 day each...
May 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28346946/association-between-a-virtual-glucose-management-service-and-glycemic-control-in-hospitalized-adult-patients-an-observational-study
#12
MULTICENTER STUDY
Robert J Rushakoff, Mary M Sullivan, Heidemarie Windham MacMaster, Arti D Shah, Alvin Rajkomar, David V Glidden, Michael A Kohn
Background: Inpatient hyperglycemia is common and is linked to adverse patient outcomes. New methods to improve glycemic control are needed. Objective: To determine whether a virtual glucose management service (vGMS) is associated with improved inpatient glycemic control. Design: Cross-sectional analyses of three 12-month periods (pre-vGMS, transition, and vGMS) between 1 June 2012 and 31 May 2015. Setting: 3 University of California, San Francisco, hospitals...
May 2, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28325206/improving-glycemic-control-safely-in-non-critical-care-patients-a-collaborative-systems-approach-in-nine-hospitals
#13
Gregory A Maynard, Diana Childers, Janet Holdych, Heather Kendall, Tom Hoag, Karen Harrison
BACKGROUND: Practice variations in insulin management and glycemic adverse events led nine Dignity Health hospitals to initiate a collaborative effort to improve hypoglycemia, uncontrolled hyperglycemia, and glycemic control. METHODS: Non-critical care adult inpatients with ≥4 point-of-care blood glucose (BG) readings in a ≥2-day period were included. Balanced glucometric goals for each hospital were individualized to improve performance by 10%-20% from baseline or achieve top performance derived from Society of Hospital Medicine (SHM) benchmarking studies...
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28323688/challenges-of-inpatient-glycemic-control
#14
Sally O Gerard, Josephine Ritchie
Hyperglycemia occurs in more than 30% of hospitalized patients. The condition has been associated with higher mortality and poor outcomes. Systems to effectively treat dysglycemia have been put into place, although many focus on critical care areas. The purpose of this article is to provide an overview of the challenges for glycemic control in non-critical care areas. Standardized order sets, critical pathways, professional education, and collaborative systems can support improved control.
July 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28319802/associations-between-home-insulin-dose-adjustments-and-glycemic-outcomes-at-hospital-admission
#15
Saira Khan, Sherita Hill Golden, Nestoras Mathioudakis
AIMS: To describe patterns of home insulin dose adjustments for non-surgical, non-critically ill patients at admission and to describe associations between these adjustments and inpatient glycemic control. METHODS: Hospital records of non-critically ill patients treated with basal insulin prior to admission were identified. After exclusion of records in which a confounding factor influencing insulin dosing was present, 258 patient-admissions over a 3-year time period were included...
May 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28225315/improving-glycemic-control-safely-in-critical-care-patients-a-collaborative-systems-approach-in-nine-hospitals
#16
MULTICENTER STUDY
Gregory A Maynard, Janet Holdych, Heather Kendall, Karen Harrison, Patricia A Montgomery, Kristen Kulasa
OBJECTIVE: Safely improve glycemic control in the critical care units of nine hospitals. METHODS: Critical care adult inpatients from nine hospitals with ≥4 point-of-care blood glucose (BG) readings over ≥2 days were targeted by collaborative improvement efforts to reduce hyper- and hypoglycemia. Balanced glucometric goals for each hospital were set targeting improvement from baseline or goals deemed desirable from Society of Hospital Medicine (SHM) benchmarking data...
May 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28123754/resource-use-associated-with-type-2-diabetes-in-africa-the-middle-east-south-asia-eurasia-and-turkey-results-from-the-international-diabetes-management-practice-study-idmps
#17
Juan J Gagliardino, Petar K Atanasov, Juliana C N Chan, Jean C Mbanya, Marina V Shestakova, Prisca Leguet-Dinville, Lieven Annemans
OBJECTIVE: Type 2 diabetes (T2D) and its complications form a global healthcare burden but the exact impact in some geographical regions is still not well documented. We describe the healthcare resource usage (HRU) associated with T2D in Africa, the Middle East, South Asia, Eurasia and Turkey. RESEARCH DESIGN AND METHODS: In the fifth wave of the International Diabetes Management Practices Study (IDMPS; 2011-2012), we collected self-reported and physician-reported cross-sectional data from 8156 patients from 18 countries across 5 regions, including different types of HRU in the previous 3-6 months...
2017: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/28115861/role-of-glycemic-control-on-hospital-related-outcomes-in-patients-with-diabetes-mellitus-undergoing-renal-transplantation
#18
Elizabeth M Lamos, Marniker A Wijesinha, Seba Ramhmdani, Laurence S Magder, Kristi D Silver
OBJECTIVE: To compare length of stay (LOS) and incidence of hypoglycemic events and infections in hospitalized patients with diabetes mellitus (DM) undergoing renal transplantation, among groups of patients defined by admission glucose and mean inpatient daily glucose. METHODS: A retrospective analysis of 190 charts of patients with DM who underwent renal transplantation over a 2-year period was conducted. Patients were grouped according to admission glucose and mean inpatient daily glucose (≤140 mg/dL, 141-180 mg/dL, and >180 mg/dL)...
2017: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
https://www.readbyqxmd.com/read/28107738/hyperglycemia-and-glycemic-variability-are-associated-with-the-severity-of-sepsis-in-nondiabetic-subjects
#19
Lukana Preechasuk, Nattakarn Suwansaksri, Nantawan Ipichart, Sathit Vannasaeng, Chairat Permpikul, Apiradee Sriwijitkamol
PURPOSE: The purpose was to compare glucose variability (GV) obtained via continuous glucose monitoring between nondiabetic sepsis patients and healthy subjects and to seek associations between GV and sepsis severity in nondiabetic sepsis patients. METHODS: Nondiabetic sepsis inpatients and healthy controls received a 72-hour continuous glucose monitoring (iPro2, Medtronic) postadmission and post-oral glucose tolerance test, respectively. The mean glucose level (MGL) along with GV represented by standard deviation (SD) and the mean amplitude of glycemic excursion (MAGE) were calculated at 24 and 72 hours...
April 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/27995593/exenatide-add-on-to-continuous-subcutaneous-insulin-infusion-therapy-reduces-bolus-insulin-doses-in-patients-with-type-2-diabetes-a-randomized-controlled-open-label-trial
#20
Feng-Fei Li, Lanlan Jiang, Liyuan Fu, Hong-Hong Zhu, Peihua Zhou, Danfeng Zhang, Xiao-Fei Su, Jin-Dan Wu, Lei Ye, Jian-Hua Ma
INTRODUCTION: The objective of this study was to investigate the effect of adding exenatide to continuous subcutaneous insulin infusion (CSII) therapy on the precise insulin doses required by type 2 diabetic patients to maintain glycemic control. METHODS: This was a single-center, randomized, controlled, open-label trial. Uncontrolled T2D patients were recruited between March 2010 and November 2011 at Nanjing First Hospital, China. Subjects were randomly assigned (1:1) to either an exenatide add-on to CSII group or a CSII therapy only (i...
February 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
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