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https://www.readbyqxmd.com/read/28128051/functional-imaging-in-the-evaluation-of-diabetic-gastroparesis
#1
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
#2
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...
24, 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
#3
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
#4
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
#5
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
#6
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
#7
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 status and glycated hemoglobin (A1C) in a cohort of critically ill patients. Methods This investigation includes 1,979 patients admitted to a single intensive care unit between September 16, 2013 and September 15, 2015. The BG target was 90-120 mg/dL in the PRE era and 80-140 mg/dL for patients without diabetes (NON) and diabetes patients (DM) with A1C < 7% and 110-160 mg/dL for DM with A1C > 7% (TIGHT and LOOSE protocols) in the POST era...
December 14, 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27761730/influence-of-glycemic-control-on-endogenous-circulating-ketone-concentrations-in-adults-following-traumatic-brain-injury
#8
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...
October 19, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27693206/randomized-evidence-for-reduction-of-perioperative-mortality-an-updated-consensus-process
#9
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...
August 2, 2016: 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
#10
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
#11
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
https://www.readbyqxmd.com/read/27596020/real-world-canagliflozin-utilization-glycemic-control-among-patients-with-type-2-diabetes-mellitus-a-multi-database-synthesis
#12
Wing Chow, Gavin Miyasato, Fotios K Kokkotos, Robert A Bailey, Erin K Buysman, Henry J Henk
PURPOSE: Randomized controlled trials have found that treatment of type 2 diabetes mellitus with canagliflozin, a sodium glucose co-transporter 2 inhibitor, is associated with significant reductions in glycosylated hemoglobin (HbA1c) levels. However, very few studies have evaluated the effectiveness of sodium glucose co-transporter 2 inhibitors in a real-world context. This data synthesis aims to examine the demographic characteristics and glycemic control among patients treated with canagliflozin in clinical practice, using results obtained from 2 US-specific retrospective administrative claims databases...
September 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27554778/effect-of-hypoglycemia-on-the-incidence-of-revision-in-total-knee-arthroplasty
#13
Martin W Roche, Tsun Yee Law, Jacob J Triplet, Zachary S Hubbard, Jennifer Kurowicki, Sam Rosas
BACKGROUND: It is well established that diabetic patients undergoing total knee arthroplasty (TKA) are more susceptible to infection, problematic wound healing, and overall higher complication rates. However, a paucity in current literature exists. The purpose of this study was to determine the effect of hypoglycemia on TKA revision (rTKA) incidence by analyzing a national private payer database for procedures performed between 2007 and 2015 Q1 Q2. METHODS: A retrospective review of a national private payer database within the PearlDiver Supercomputer application for patients undergoing TKA with blood glucose levels from 20 to 219 mg/mL, in 10-mg/mL increments, was conducted...
July 25, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27553599/glycemic-control-for-patients-with-type-2-diabetes-mellitus-our-evolving-faith-in-the-face-of-evidence
#14
René Rodríguez-Gutiérrez, Victor M Montori
BACKGROUND: We sought to determine the concordance between the accumulating evidence about the impact of tight versus less tight glycemic control in patients with type 2 diabetes mellitus since the publication of UKPDS (UK Prospective Diabetes Study) in 1998 until 2015 with the views about that evidence published in journal articles and practice guidelines. METHODS AND RESULTS: We searched in top general medicine and specialty journals for articles referring to glycemic control appearing between 2006 and 2015 and identified the latest practice guidelines...
September 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/27544297/diabetes-and-sexuality
#15
REVIEW
Fuat Kizilay, Helena Elizabeth Gali, Ege Can Serefoglu
INTRODUCTION: Deterioration in sexual functioning is one of the major and serious complications of diabetes. This common metabolic disorder not only affects sexuality through microvascular and nerve damage but also has psychological aspects. In men, the primary complications are erectile dysfunction, ejaculatory dysfunction, and loss of libido. Women similarly experience sexual problems, including decreased libido and painful intercourse. AIM: To summarize the effects of diabetes on sexuality, evaluate the impact of diabetes on sexual function, and assess the conventional and novel treatment approaches based on recent studies...
January 2017: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/27524280/hypoglycemia-frailty-and-dementia-in-older-people-with-diabetes-reciprocal-relations-and-clinical-implications
#16
Ahmed H Abdelhafiz, Emily McNicholas, Alan J Sinclair
The relationships between hypoglycemia, frailty and dementia appear to be reciprocal and can lead to a vicious circle. Frailty appears to be a crucial factor increasing the risk for both hypoglycemia and dementia, initiating the reciprocal relationships. Weight loss is likely to be the underlying risk factor for frailty. Many frail older people with diabetes seem to have unnecessarily tight glycemic control, being treated with hypoglycemic medications that likely increase the risk of hypoglycemia. As patients get older with significant weight loss their glycemic targets should be reviewed, and reduction or even withdrawal of their hypoglycemic medications should be considered...
November 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/27510392/impact-of-glycemic-control-and-metformin-use-on-the-recurrence-and-progression-of-non-muscle-invasive-bladder-cancer-in-patients-with-diabetes-mellitus
#17
Ji Hoon Ahn, Seung Il Jung, Sang Un Yim, Sun Woo Kim, Eu Chang Hwang, Dong Deuk Kwon
The purpose of the present study was to determine the potential relationships of glycemic control and use of metformin with non-muscle invasive bladder cancer characteristics. We reviewed data from 645 patients with non-muscle invasive bladder cancer between January 2004 and May 2015. We analyzed the association of pre and post-operative glycemic control and use of metformin with clinical characteristics of bladder tumors. We also analyzed the association of glycemic control and use of metformin with recurrence-free and progression-free survivals...
September 2016: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27479624/vision-loss-in-older-adults
#18
Allen L Pelletier, Ledy Rojas-Roldan, Janis Coffin
Vision loss affects 37 million Americans older than 50 years and one in four who are older than 80 years. The U.S. Preventive Services Task Force concludes that current evidence is insufficient to assess the balance of benefits and harms of screening for impaired visual acuity in adults older than 65 years. However, family physicians play a critical role in identifying persons who are at risk of vision loss, counseling patients, and referring patients for disease-specific treatment. The conditions that cause most cases of vision loss in older patients are age-related macular degeneration, glaucoma, ocular complications of diabetes mellitus, and age-related cataracts...
August 1, 2016: American Family Physician
https://www.readbyqxmd.com/read/27472253/ketosis-after-cardiopulmonary-bypass-in-children-is-associated-with-an-inadequate-balance-between-oxygen-transport-and-consumption
#19
Philippe Klee, Delphine Arni, Sonja Saudan, Valérie M Schwitzgebel, Ruchika Sharma, Oliver Karam, Peter C Rimensberger
OBJECTIVES: Hyperglycemia after cardiac surgery and cardiopulmonary bypass in children has been associated with worse outcome; however, causality has never been proven. Furthermore, the benefit of tight glycemic control is inconsistent. The purpose of this study was to describe the metabolic constellation of children before, during, and after cardiopulmonary bypass, in order to identify a subset of patients that might benefit from insulin treatment. DESIGN: Prospective observational study, in which insulin treatment was initiated when postoperative blood glucose levels were more than 12 mmol/L (216 mg/dL)...
September 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27472251/clinical-impact-of-accurate-point-of-care-glucose-monitoring-for-tight-glycemic-control-in-severely-burned-children
#20
Nam K Tran, Zachary R Godwin, Amanda N Steele, Steven E Wolf, Tina L Palmieri
OBJECTIVES: The goal of this study was to retrospectively evaluate the clinical impact of an accurate autocorrecting blood glucose monitoring system in children with severe burns. Blood glucose monitoring system accuracy is essential for providing appropriate intensive insulin therapy and achieving tight glycemic control in critically ill patients. Unfortunately, few comparison studies have been performed to evaluate the clinical impact of accurate blood glucose monitoring system monitoring in the high-risk pediatric burn population...
September 2016: Pediatric Critical Care Medicine
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