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https://www.readbyqxmd.com/read/28492399/acute-kidney-injury-after-pediatric-cardiac-surgery-a-secondary-analysis-of-the-safe-pediatric-euglycemia-after-cardiac-surgery-trial
#1
Joshua J Blinder, Lisa A Asaro, David Wypij, David T Selewski, Michael S D Agus, Michael Gaies, Michael A Ferguson
OBJECTIVES: To understand the effect of tight glycemic control on cardiac surgery-associated acute kidney injury. DESIGN: Secondary analysis of data from the Safe Pediatric Euglycemia after Cardiac Surgery trial of tight glycemic control versus standard care. SETTING: Pediatric cardiac ICUs at University of Michigan, C.S. Mott Children's Hospital, and Boston Children's Hospital. PATIENTS: Children 0-36 months old undergoing congenital cardiac surgery...
May 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28435461/recipient-glycemic-micro-environments-govern-therapeutic-effects-of-mesenchymal-stem-cell-infusion-on-osteopenia
#2
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
https://www.readbyqxmd.com/read/28346573/assessment-of-glycemic-control-in-nursing-home-residents-with-diabetes
#3
F Retornaz, M Grino, L Mari, C Oliver
OBJECTIVE: To describe glycemic control in nursing home residents with diabetes and to evaluate the relevance of HbA1c in the detection of hypoglycemia risk. DESIGN AND METHODS: Diabetes treatment, geriatric assessment, blood capillary glucose (n= 24,682), and HbA1c were collected from medical charts of 236 southern France nursing home residents during a 4-month period. Glycemic control was divided into four categories: tight, fair, and moderate or severe chronic hyperglycemia using the High Blood Glucose Index or the analysis of blood glucose frequency distribution...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/28328679/results-of-a-multicenter-prospective-pivotal-trial-of-the-first-inline-continuous-glucose-monitor-in-critically-ill-patients
#4
Grant V Bochicchio, Stan Nasraway, Laura Moore, Anthony Furnary, Eden Nohra, Kelly Bochicchio
BACKGROUND: We have previously demonstrated that tight glycemic control (80-120 mg/dL) improves outcome in critically injured patients. However, many centers have gotten away from aggressive glucose control due to the workload and risk of hypoglycemia. The objective of this pivotal trial is to evaluate the first in human continuous inline glucose monitor (OptiScanner) in critically ill patients. METHODS: A multicenter pivotal trial was conducted over a 1-year period (2014-2015) at four major academic centers in 200 critically ill patients...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28256333/-the-effect-of-two-different-glycemic-management-protocols-on-postoperative-cognitive-dysfunction-in-coronary-artery-bypass-surgery
#5
Pinar Kurnaz, Zerrin Sungur, Emre Camci, Nukhet Sivrikoz, Gunseli Orhun, Mert Senturk, Omer Sayin, Emin Tireli, Hakan Gurvit
INTRODUCTION: Postoperative cognitive dysfunction (POCD) is an adverse outcome of surgery that is more common after open heart procedures. The aim of this study is to investigate the role of tightly controlled blood glucose levels during coronary artery surgery on early and late cognitive decline. METHODS: 40 patients older than 50 years undergoing elective coronary surgery were randomized into two groups. In the "Tight Control" group (GI), the glycemia was maintained between 80 and 120mgdL(-1) while in the "Liberal" group (GII), it ranged between 80-180mgdL(-1)...
February 27, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28236380/my-sweetheart-is-broken-role-of-glucose-in-diabetic-cardiomyopathy
#6
REVIEW
Manoja K Brahma, Mark E Pepin, Adam R Wende
Despite overall reductions in heart disease prevalence, the risk of developing heart failure has remained 2-fold greater among people with diabetes. Growing evidence has supported that fluctuations in glucose level and uptake contribute to cardiovascular disease (CVD) by modifying proteins, DNA, and gene expression. In the case of glucose, clinical studies have shown that increased dietary sugars for healthy individuals or poor glycemic control in diabetic patients further increased CVD risk. Furthermore, even after decades of maintaining tight glycemic control, susceptibility to disease progression can persist following a period of poor glycemic control through a process termed "glycemic memory...
February 2017: Diabetes & Metabolism Journal
https://www.readbyqxmd.com/read/28217515/reported-hypoglycemia-in-type-2-diabetes-mellitus-patients-prevalence-and-practices-a-hospital-based-study
#7
Vanishree Shriraam, Shriraam Mahadevan, M Anitharani, Nalini Sirala Jagadeesh, Sreelekha Bhaskara Kurup, T A Vidya, Krishna G Seshadri
INTRODUCTION: Hypoglycemia tops the list of hurdles in preventing tight glycemic control in diabetic patients. It is even considered as a cardiovascular risk factor. However, it continues to be a neglected complication with very limited epidemiological data in our country. AIM: To study the self-reported prevalence of hypoglycemia among type 2 diabetic patients and the practices adopted by them during and after the episodes to manage and avert future occurrences...
January 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28216053/hypoglycemic-drugs-induce-antioxidant-aldehyde-dehydrogenase-activity-and-remain-high-in-patients-with-glycemic-control-in-type-2-diabetes
#8
Alejandra Picazo, Angélica S Jiménez-Osorio, Porfirio Zúñiga-Mejía, José Pedraza-Chaverri, Adriana Monroy, M Eunice Rodríguez-Arellano, Diana Barrera-Oviedo
The antioxidant system results essential to control and prevent lipid peroxidation due to stress damage in type 2 diabetes. An example is aldehyde dehydrogenase (ALDH), an enzyme that is involved in the detoxification of aldehydes formed during lipid peroxidation. This study was conducted to evaluate ALDH activity and to determine their association with hypoglycemic treatment in type 2 diabetes patients. The study population consisted of 422 Mexican subjects: a control group and type 2 diabetes patients. Type 2 diabetes patients were re-classified as those with or without hypoglycemic treatment and those with or without glycemic control (according to glycated hemoglobin (HbA1c))...
April 5, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28215180/metabolic-and-cardiovascular-ageing-indices-in-relation-to-glycated-haemoglobin-in-healthy-and-diabetic-subjects
#9
H I Shruthi Suvarna, Shailaja Moodithaya, Raghava Sharma
Ageing is a natural phenomenon that has tremendous amount of control over normal physiological functions. Evidences suggest that there is a steady increase in glycated haemoglobin levels with age, leading to accumulation of advanced glycation end products (AGE'S) which contributes to the risk of cardiovascular morbidity and mortality. Aim of the study is to evaluate the strength of association of HbA1c with metabolic and cardiovascular ageing indices in subjects between the age group of 40 to 60 yrs. A total of 220 subjects, with (n=110) and without (n=110) diabetes were assessed for the metabolic and cardiovascular ageing indices...
February 16, 2017: Current Aging Science
https://www.readbyqxmd.com/read/28128051/functional-imaging-in-the-evaluation-of-diabetic-gastroparesis
#10
Prasanna Santhanam, Wael Marashdeh, Lilja B Solnes
Introduction Gastroparesis (a complication of both type 1 and type 2 diabetes mellitus) is delayed gastric emptying in the absence of a mechanical obstruction. Overall prevalence of Gastroparesis is close to 5 % in type 1 diabetes and 1 % in type 2 diabetes. It is unclear if good glycemic control leads to delay of development and progression of gastroparesis. Methods Gastric enteric neurons as well as interstitial cells of Cajal (ICC) are depleted, truncated and are surrounded by immune infiltrates composed of macrophages...
January 26, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28118549/tight-glycemic-control-in-critically-ill-children
#11
RANDOMIZED CONTROLLED TRIAL
Michael S D Agus, David Wypij, Eliotte L Hirshberg, Vijay Srinivasan, E Vincent Faustino, Peter M Luckett, Jamin L Alexander, Lisa A Asaro, Martha A Q Curley, Garry M Steil, Vinay M Nadkarni
BACKGROUND: In multicenter studies, tight glycemic control targeting a normal blood glucose level has not been shown to improve outcomes in critically ill adults or children after cardiac surgery. Studies involving critically ill children who have not undergone cardiac surgery are lacking. METHODS: In a 35-center trial, we randomly assigned critically ill children with confirmed hyperglycemia (excluding patients who had undergone cardiac surgery) to one of two ranges of glycemic control: 80 to 110 mg per deciliter (4...
February 23, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28079150/sustained-kidney-biochemical-derangement-in-treated-experimental-diabetes-a-clue-to-metabolic-memory
#12
Antonio Anax F de Oliveira, Tiago F de Oliveira, Larissa L Bobadilla, Camila C M Garcia, Carolina Maria Berra, Nadja C de Souza-Pinto, Marisa H G Medeiros, Paolo Di Mascio, Roberto Zatz, Ana Paula de M Loureiro
The occurrence of biochemical alterations that last for a long period of time in diabetic individuals even after adequate handling of glycemia is an intriguing phenomenon named metabolic memory. In this study, we show that a kidney pathway is gradually altered during the course of diabetes and remains persistently changed after late glycemic control in streptozotocin-induced diabetic rats. This pathway comprises an early decline of uric acid clearance and pAMPK expression followed by fumarate accumulation, increased TGF-β expression, reduced PGC-1α expression, and downregulation of methylation and hydroxymethylation of mitochondrial DNA...
January 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28042054/design-and-rationale-of-heart-and-lung-failure-pediatric-insulin-titration-trial-half-pint-a-randomized-clinical-trial-of-tight-glycemic-control-in-hyperglycemic-critically-ill-children
#13
Michael Sd Agus, Ellie Hirshberg, Vijay Srinivasan, Edward Vincent Faustino, Peter M Luckett, Martha Aq Curley, Jamin Alexander, Lisa A Asaro, Kerry Coughlin-Wells, Donna Duva, Jaclyn French, Natalie Hasbani, Martha T Sisko, Carmen L Soto-Rivera, Garry Steil, David Wypij, Vinay M Nadkarni
OBJECTIVES: Test whether hyperglycemic critically ill children with cardiovascular and/or respiratory failure experience more ICU-free days when assigned to tight glycemic control with a normoglycemic versus hyperglycemic blood glucose target range. DESIGN: Multi-center randomized clinical trial. SETTING: Pediatric ICUs at 35 academic hospitals. PATIENTS: Children aged 2weeks to 17years receiving inotropic support and/or acute mechanical ventilation, excluding cardiac surgical patients...
February 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/27994380/validity-of-bedside-blood-glucose-measurement-in-critically-ill-patients-with-intensive-insulin-therapy
#14
Ata Mahmoodpoor, Hadi Hamishehkar, Kamran Shadvar, Sarvin Sanaie, Afshin Iranpour, Vahid Fattahi
BACKGROUND AND AIMS: There have been variable results on the practice of tight glycemic control, and studies have demonstrated that point-of-care (POC) glucometers have variable accuracy. Glucometers must be accurate, and many variables can affect blood glucose levels. The purpose of this study was to determine the difference between blood glucose concentrations obtained from POC glucometers and laboratory results in critically ill patients with intensive insulin therapy. MATERIALS AND METHODS: This was a descriptive study which enrolled 300 critically ill patients...
November 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27982408/glycemic-control-strategies-and-the-occurrence-of-surgical-site-infection-a-systematic-review
#15
Caroline Maria Herrero Domingos, Luciana Inaba Senyer Iida, Vanessa de Brito Poveda
OBJECTIVE: To analyze the evidence available in the scientific literature regarding the relationship between the glycemic control strategies used and the occurrence of surgical site infection in adult patients undergoing surgery. METHOD: This is a systematic review performed through search on the databases of CINAHL, MEDLINE, LILACS, Cochrane Database of Systematic Reviews and EMBASE. RESULTS: Eight randomized controlled trials were selected...
September 2016: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/27967228/safety-and-efficacy-of-personalized-glycemic-control-in-critically-ill-patients-a-2-year-before-and-after-interventional-trial
#16
James S Krinsley, Jean-Charles Preiser, Irl B Hirsch
OBJECTIVE: To determine the safety and efficacy of a change in blood glucose (BG) control protocol from a single target to 2 targets based on diabetes mellitus (DM) status and glycated hemoglobin A1C (A1C) in a cohort of critically ill patients. METHODS: This investigation includes 1,979 patients admitted to a single intensive care unit (ICU) between September 16, 2013 and September 15, 2015. The BG target was 90 to 120 mg/dL in the PRE era and 80 to 140 mg/dL for patients without diabetes (NON) and with DM with A1C <7% and 110 to 160 mg/dL for DM with A1C ≥7% (TIGHT and LOOSE protocols) in the POST era...
March 2017: Endocrine Practice
https://www.readbyqxmd.com/read/27761730/influence-of-glycemic-control-on-endogenous-circulating-ketone-concentrations-in-adults-following-traumatic-brain-injury
#17
Stephanie M Wolahan, Mayumi L Prins, David L McArthur, Courtney R Real, David A Hovda, Neil A Martin, Paul M Vespa, Thomas C Glenn
BACKGROUND: The objective was to investigate the impact of targeting tight glycemic control (4.4-6.1 mM) on endogenous ketogenesis in severely head-injured adults. METHODS: The data were prospectively collected during a randomized, within-patient crossover study comparing tight to loose glycemic control, defined as 6.7-8.3 mM. Blood was collected periodically during both tight and loose glycemic control epochs. Post hoc analysis of insulin dose and total nutritional provision was performed...
April 2017: Neurocritical Care
https://www.readbyqxmd.com/read/27693206/randomized-evidence-for-reduction-of-perioperative-mortality-an-updated-consensus-process
#18
REVIEW
Giovanni Landoni, Antonio Pisano, Vladimir Lomivorotov, Gabriele Alvaro, Ludhmila Hajjar, Gianluca Paternoster, Caetano Nigro Neto, Nicola Latronico, Evgeny Fominskiy, Laura Pasin, Gabriele Finco, Rosetta Lobreglio, Maria Luisa Azzolini, Giuseppe Buscaglia, Alberto Castella, Marco Comis, Adele Conte, Massimiliano Conte, Francesco Corradi, Erika Dal Checco, Giovanni De Vuono, Marco Ganzaroli, Eugenio Garofalo, Gordana Gazivoda, Rosalba Lembo, Daniele Marianello, Martina Baiardo Redaelli, Fabrizio Monaco, Valentina Tarzia, Marta Mucchetti, Alessandro Belletti, Paolo Mura, Mario Musu, Giovanni Pala, Massimiliano Paltenghi, Vadim Pasyuga, Desiderio Piras, Claudio Riefolo, Agostino Roasio, Laura Ruggeri, Francesco Santini, Andrea Székely, Luigi Verniero, Antonella Vezzani, Alberto Zangrillo, Rinaldo Bellomo
OBJECTIVE: Of the 230 million patients undergoing major surgical procedures every year, more than 1 million will die within 30 days. Thus, any nonsurgical interventions that help reduce perioperative mortality might save thousands of lives. The authors have updated a previous consensus process to identify all the nonsurgical interventions, supported by randomized evidence, that may help reduce perioperative mortality. DESIGN AND SETTING: A web-based international consensus conference...
April 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27648831/preventing-unnecessary-costs-of-drug-induced-hypoglycemia-in-older-adults-with-type-2-diabetes-in-the-united-states-and-canada
#19
Mathieu Boulin, Vakaramoko Diaby, Cara Tannenbaum
BACKGROUND: The costs of drug-induced hypoglycemia are a critical but often neglected component of value-based arguments to reduce tight glycemic control in older adults with type 2 diabetes. METHODS: An economic (decision-tree) analysis compared rates, costs, quality-adjusted life-years, and incremental costs per quality-adjusted life-year gained associated with mild, moderate and severe hypoglycemic events for 6 glucose-lowering medication classes in type 2 diabetic adults aged 65-79 versus those 80 years and older...
2016: PloS One
https://www.readbyqxmd.com/read/27637719/glycemic-control-mortality-and-hypoglycemia-in-critically-ill-patients-a-systematic-review-and-network-meta-analysis-of-randomized-controlled-trials
#20
Tomohide Yamada, Nobuhiro Shojima, Hisashi Noma, Toshimasa Yamauchi, Takashi Kadowaki
PURPOSE: It is unclear whether tight glycemic control is warranted in all critically ill adults. We employed network meta-analysis to examine the risk of mortality and hypoglycemia associated with different glycemic control targets in critically ill adults. METHODS: Electronic databases were searched up to 2016 for randomized controlled trials comparing various insulin regimens in critically ill adults with hyperglycemia. Two reviewers independently extracted information and evaluated quality with the Cochrane risk-of-bias tool...
January 2017: Intensive Care Medicine
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