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https://www.readbyqxmd.com/read/29730391/pharmacotherapy-for-hyperglycemia-in-pregnancy-the-new-insulins
#1
REVIEW
Yoel Toledano, Eran Hadar, Moshe Hod
Hyperglycemia in pregnancy may lead to adverse maternal, fetal and neonatal outcomes. Tight glycemic control is prudent in order to reduce pregnancy complications. For many years, the gold standard pharmacological therapy during pregnancy was human insulin. Recently, insulin analogues were also introduced to clinical use in pregnancy. This brief review aims to summarize the information on the efficacy and safety of insulin analogue therapy during gestation. The strengths and pitfalls of insulin analogue administration during gestation, compared with human insulin, are presented...
May 3, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29709217/glycogenic-hepatopathy
#2
Johad Khoury, Yaniv Zohar, Naim Shehadeh, Tarek Saadi
BACKGROUND: Glycogenic hepatopathy (GH) is a disorder associated with uncontrolled diabetes mellitus, most commonly type 1, expressed as right upper quadrant abdominal pain, hepatomegaly and increased liver enzymes. The diagnosis may be difficult, because laboratory and imaging tests are not pathognomonic. Although GH may be suggested based on clinical presentation and imaging studies, the gold standard for diagnosis is a liver biopsy, showing a significant accumulation of glycogen within the hepatocytes...
April 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/29677007/near-continuous-glucose-monitoring-makes-glycemic-control-safer-in-icu-patients
#3
Jean-Charles Preiser, Olivier Lheureux, Aurelie Thooft, Serge Brimioulle, Jacques Goldstein, Jean-Louis Vincent
OBJECTIVES: Tight glycemic control using intermittent blood glucose measurements is associated with a risk of hypoglycemia. Glucose concentrations can now be measured near continuously (every 5-15 min). We assessed the quality and safety of glycemic control guided by a near-continuous glucose monitoring system in ICU patients. DESIGN: Prospective, cluster-randomized, crossover study. SETTING: Thirty-five-bed medico-surgical department of intensive care with four separate ICUs...
April 19, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29673064/successful-pregnancy-and-delivery-after-simultaneous-islet-kidney-transplantation
#4
Michela Assalino, Michele Podetta, Sandrine Demuylder-Mischler, Katyuska Francini, Nadine Pernin, Jean-Pierre Randin, Domenico Bosco, Axel Andres, Thierry Berney
Allogeneic islet of Langerhans transplantation is a recognized beta-cell replacement therapy for patients affected by type 1 diabetes mellitus. Type 1 diabetes mellitus is a condition associated with an increased risk of adverse outcomes for pregnant women and fetuses. We report the case of a 29-year-old woman with type 1 diabetes mellitus, who underwent successful allogeneic islet transplantation with simultaneous kidney transplantation. She achieved durable insulin independence after 2 islet infusions. Pregnancy was desired and planned 2 years after the last islet infusion...
April 19, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29667921/glycemic-control-of-type-2-diabetes-mellitus-across-stages-of-renal-impairment-information-for-primary-care-providers
#5
Lili Tong, Sharon Adler
Chronic kidney disease (CKD) is a frequent complication of type 2 diabetes mellitus (T2DM) and elevates individuals' risk for cardiovascular disease, the leading cause of morbidity and mortality in T2DM. Achieving and maintaining tight glycemic control is key to preventing development or progression of CKD; however, improving glycemic control may be limited by effects of renal impairment on the efficacy and safety of T2DM treatments, necessitating dosing adjustments and careful evaluation of contraindications...
April 18, 2018: Postgraduate Medicine
https://www.readbyqxmd.com/read/29658190/the-2018-update-of-the-american-college-of-physicians-glycemic-management-recommendations-an-invitation-to-continued-inertia
#6
Javier Morales, Merces Assumpcao-Morales
The management of type 2 diabetes has become increasingly controversial. Tight control has been advocated for years however, there was a recent revision that was published by the American College of Physicians in which limitations were made to liberalize glycemic goals for most diabetics to target level of between 7 and 8%. In recent years, the evolution of diabetes care has been such that more potent drugs with low risk of hypoglycemic potential, when used in the absence of insulin or secretagogues, have made their way into the market place...
April 15, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29650049/variation-in-general-supportive-and-preventive-intensive-care-management-of-traumatic-brain-injury-a-survey-in-66-neurotrauma-centers-participating-in-the-collaborative-european-neurotrauma-effectiveness-research-in-traumatic-brain-injury-center-tbi-study
#7
Jilske A Huijben, Victor Volovici, Maryse C Cnossen, Iain K Haitsma, Nino Stocchetti, Andrew I R Maas, David K Menon, Ari Ercole, Giuseppe Citerio, David Nelson, Suzanne Polinder, Ewout W Steyerberg, Hester F Lingsma, Mathieu van der Jagt
BACKGROUND: General supportive and preventive measures in the intensive care management of traumatic brain injury (TBI) aim to prevent or limit secondary brain injury and optimize recovery. The aim of this survey was to assess and quantify variation in perceptions on intensive care unit (ICU) management of patients with TBI in European neurotrauma centers. METHODS: We performed a survey as part of the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study...
April 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29619751/basal-bolus-insulin-therapy-with-gla-300-during-hospitalization-reduces-nocturnal-hypoglycemia-in-patients-with-type-2-diabetes-mellitus-a-randomized-controlled-study
#8
Fumitaka Okajima, Yuko Nakamura, Yuji Yamaguchi, Yuki Shuto, Katsuhito Kato, Hitoshi Sugihara, Naoya Emoto
INTRODUCTION: Although reduction in the incidence of nocturnal hypoglycemia, as estimated by symptom or self-monitored plasma glucose, was shown to be more pronounced with 300 units/mL insulin glargine (Gla-300) than with 100 units/mL insulin glargine (Gla-100) in type 2 diabetes patients, the exact frequency of nocturnal hypoglycemia estimated with continuous glucose monitoring (CGM) has not been reported. METHODS: Forty patients with type 2 diabetes who were admitted for glycemic control with basal-bolus insulin therapy (BBT) were randomized into the Gla-100 and Gla-300 groups...
April 4, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29596943/the-berlin-declaration-a-call-to-action-to-improve-early-actions-related-to-type-2-diabetes-how-can-specialist-care-help
#9
Antonio Ceriello, James Gavin, Andrew J M Boulton, Rick Blickstead, Margaret McGill, Itamar Raz, Shaukat Sadikot, David Wood, Xavier Cos, Kamlesh Khunti, Sanjay Kalra, Ashok Kumar Das, Cutberto Espinosa López
Diabetes is a major global epidemic and places a huge burden on healthcare systems worldwide. The complications of type 2 diabetes (T2D) and related hospitalizations are major contributors to this burden, and there is strong evidence that the risk for these can be reduced by early action to identify and prevent people at high risk of T2D and ensure tight glycemic control in those with established disease. In response to this, the Berlin Declaration was developed by four working groups of experts and ratified by healthcare professionals from 38 countries...
March 26, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29584894/parity-increases-insulin-requirements-in-pregnant-women-with-type-1-diabetes
#10
Gitte O Skajaa, Jens Fuglsang, Ulla Kampmann, Per G Ovesen
Context: Tight glycemic control throughout type 1 diabetes pregnancies is crucial and knowledge about which factors that affect insulin sensitivity could improve the outcome for both mother and offspring. Objective: The purpose of the study was to evaluate insulin requirements in women with type 1 diabetes during pregnancy and test whether parity affects insulin requirements. Design: We conducted an observational cohort study consisting of women with type 1 diabetes who gave birth at Aarhus University Hospital, Denmark from 2004-2014...
March 22, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29580578/glycemic-control-as-primary-prevention-for-diabetic-kidney-disease
#11
REVIEW
Richard J MacIsaac, George Jerums, Elif I Ekinci
Improving strategies to prevent the development and progression of CKD is a highly desirable outcome for all involved in the care of patients with diabetes. This is because CKD is a major factor contributing to morbidly and mortality in patients with diabetes. Furthermore, diabetes is the leading cause of ESRD in most developed countries. Although tight glucose control is now an established modality for preventing the development and progression of albuminuria, evidence is now accumulating to suggest that it can also ameliorate glomerular filtration rate loss and possibly progression to ESRD...
March 2018: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29580352/weight-loss-and-glycemic-control-after-sleeve-gastrectomy-results-from-a-middle-eastern-center-of-excellence
#12
Khalid Al Khalifa, Ahmed Al Ansari, May Showaiter
Obesity and its associated metabolic disorders are strongly linked to both morbidity and mortality. Sleeve gastrectomy (SG) has been established as an effective means of weight loss for obese patients as well as a treatment for type 2 diabetes mellitus (T2DM). This study was designed to examine the short- and midterm outcomes of patients who underwent SG in a Middle Eastern Center of Excellence, a military training teaching hospital. The clinical outcomes of 59 patients with impaired glucose tolerance and T2DM who underwent SG between 2011 and 2014 with at least one and up to four years of follow-up were studied...
February 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29545773/impact-of-normoglycemia-in-reducing-microvascular-complications-in-patients-with-type-2-diabetes-a-follow-up-study
#13
Fukashi Ishibashi, Mitra Tavakoli
Aims: Hyperglycemia is associated with an increased risk of microvascular complications in patients with type 2 diabetes. The aim of the present study was to investigate whether the reduction of the levels of HbA1c by tight glycemic control (GC) decreases the rate of microvascular complications and improves the neurological measures in patients with type 2 diabetes. Methods: Detailed clinical and neurological examinations including corneal confocal microscopy (CCM) were performed in 141 Japanese patients with type 2 diabetes and 60 age-matched control subjects at baseline and follow-up with GC for 4 years...
2018: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29527307/compliance-with-guidelines-for-disease-management-in-diabetes-results-from-the-swissdiab-registry
#14
Katrin E Schimke, Frida Renström, Sandro Meier, Christoph Stettler, Michael Brändle
Objective: Tight glycemic control and aggressive treatment of additional cardiovascular risk factors can substantially reduce risk of diabetes-related complications. In 2013, the Swiss Society of Endocrinology and Diabetology (SSED) established national criteria on good disease management in diabetes, but little is known about compliance in clinical care. Here we assessed to what extent patients from two tertiary care centers in the German-speaking part of Switzerland enrolled in the Swiss Diabetes (SwissDiab) Registry adhere to the SSED criteria...
2018: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/29519916/hyperglycemia-drives-intestinal-barrier-dysfunction-and-risk-for-enteric-infection
#15
Christoph A Thaiss, Maayan Levy, Inna Grosheva, Danping Zheng, Eliran Soffer, Eran Blacher, Sofia Braverman, Anouk C Tengeler, Oren Barak, Maya Elazar, Rotem Ben-Zeev, Dana Lehavi-Regev, Meirav N Katz, Meirav Pevsner-Fischer, Arieh Gertler, Zamir Halpern, Alon Harmelin, Suhail Aamar, Patricia Serradas, Alexandra Grosfeld, Hagit Shapiro, Benjamin Geiger, Eran Elinav
Obesity, diabetes, and related manifestations are associated with an enhanced, but poorly understood, risk for mucosal infection and systemic inflammation. Here, we show in mouse models of obesity and diabetes that hyperglycemia drives intestinal barrier permeability, through GLUT2-dependent transcriptional reprogramming of intestinal epithelial cells and alteration of tight and adherence junction integrity. Consequently, hyperglycemia-mediated barrier disruption leads to systemic influx of microbial products and enhanced dissemination of enteric infection...
March 23, 2018: Science
https://www.readbyqxmd.com/read/29501063/tight-glycemic-control-in-critically-ill-pediatric-patients-a-systematic-review-and-meta-analysis
#16
Lvlin Chen, Tiangui Li, Fang Fang, Yu Zhang, Andrew Faramand
BACKGROUND: Hyperglycemia is prevalent in patients in the pediatric intensive care unit. The purpose of this study was to describe the benefits and risks of tight glucose control (TGC) in critically ill children. METHODS: A systemic review and meta-analysis of the literature was carried out on randomized controlled trials of TGC in critically ill children admitted to the pediatric intensive care unit. The databases searched were Medline, Embase, and CENTRAL databases until May 1, 2017...
March 4, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29491123/the-role-of-renal-dipeptidyl-peptidase-4-in-kidney-disease-renal-effects-of-dipeptidyl-peptidase-4-inhibitors-with-a-focus-on-linagliptin
#17
REVIEW
Keizo Kanasaki
Emerging evidence suggests that dipeptidyl peptidase-4 (DPP-4) inhibitors used to treat type 2 diabetes may have nephroprotective effects beyond the reduced renal risk conferred by glycemic control. DPP-4 is a ubiquitous protein with exopeptidase activity that exists in cell membrane-bound and soluble forms. The kidneys contain the highest levels of DPP-4, which is increased in diabetic nephropathy. DPP-4 inhibitors are a chemically heterogeneous class of drugs with important pharmacological differences. Of the globally marketed DPP-4 inhibitors, linagliptin is of particular interest for diabetic nephropathy as it is the only compound that is not predominantly excreted in the urine...
February 28, 2018: Clinical Science (1979-)
https://www.readbyqxmd.com/read/29479638/critical-care-management-of-stress-induced-hyperglycemia
#18
REVIEW
Ilse Vanhorebeek, Jan Gunst, Greet Van den Berghe
PURPOSE OF REVIEW: We discuss key studies that have set the scene for the debate on the efficacy and safety of tight glycemic control in critically ill patients, highlighting important differences among them, and describe the ensuing search towards strategies for safer glucose control. RECENT FINDINGS: Differences in level of glycemic control, glucose measurement and insulin administration, expertise, and nutritional management may explain the divergent outcomes of the landmark studies on tight glycemic control in critical illness...
February 26, 2018: Current Diabetes Reports
https://www.readbyqxmd.com/read/29475019/diastolic-blood-pressure-is-a-potentially-modifiable-risk-factor-for-preeclampsia-in-women-with-pre-existing-diabetes
#19
Sidse Kjærhus Nørgaard, Marianne Jenlev Vestgaard, Isabella Lindegaard Jørgensen, Björg Ásbjörnsdóttir, Lene Ringholm, Harold David McIntyre, Peter Damm, Elisabeth Reinhardt Mathiesen
AIMS: To identify early clinical, modifiable risk factors for preeclampsia present at first antenatal visit and assess the prevalence of pregnancy-related hypertensive disorders in women with pre-existing diabetes treated with tight glycemic and blood pressure (BP) control. METHODS: A population-based cohort study of 494 women with pre-existing diabetes (307 and 187 women with type 1 and type 2 diabetes, respectively), included at their first antenatal visit from 2012 to 2016...
April 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29425836/the-impact-of-a-daily-smartphone-based-feedback-system-among-women-with-gestational-diabetes-on-compliance-glycemic-control-satisfaction-and-pregnancy-outcome-a-randomized-controlled-trial
#20
Hadas Miremberg, Tal Ben-Ari, Tal Betzer, Hagit Raphaeli, Rose Gasnier, Giulia Barda, Jacob Bar, Eran Weiner
BACKGROUND: Patient compliance and tight glycemic control have been demonstrated to improve outcome in pregnancies complicated by gestational diabetes mellitus. The use of advanced technological tools, including smartphone-based platforms, to improve medical care and outcomes has been demonstrated in various fields of medicine, but only a few small studies were performed with gestational diabetes mellitus patients. OBJECTIVE: We aimed to study the impact of introducing a smartphone-based daily feedback and communication platform between gestational diabetes mellitus patients and their physicians, on patient compliance, glycemic control, pregnancy outcome, and patient satisfaction...
April 2018: American Journal of Obstetrics and Gynecology
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