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hospital glycemic

Fraser Magee, Michael Bailey, David V Pilcher, Johan Mårtensson, Rinaldo Bellomo
PURPOSE: To investigate the relationship between dysglycemia and hospital mortality in patients with and without a preadmission diagnosis of insulin treated diabetes mellitus (ITDM). MATERIALS AND METHODS: An observational multicentre cohort study using the ANZICS-APD database on adult patients admitted to ICU with sepsis between January 1st 2006 and December 31st 2015. Four domains of dysglycemia were investigated (highest, mean and lowest blood glucose levels and glycemic variability: the absolute difference between the highest and lowest level)...
March 3, 2018: Journal of Critical Care
Kenichi Matsushita, Kazumasa Harada, Tetsuro Miyazaki, Takamichi Miyamoto, Kiyoshi Iida, Shuzou Tanimoto, Mayuko Yagawa, Makoto Takei, Yuji Nagatomo, Toru Hosoda, Hideaki Yoshino, Takeshi Yamamoto, Ken Nagao, Morimasa Takayama
The relationship between glycemic control and outcome in patients with heart failure (HF) remains contentious. A recent study showed that patients with HF with mid-range ejection fraction (HFmrEF) more frequently had comorbid diabetes relative to other patients. Herein, we examined the association between glycosylated hemoglobin (HbA1c) and in-hospital mortality in acute HF patients with reduced, mid-range, and preserved EF. A multicenter retrospective study was conducted on 5205 consecutive patients with acute HF...
March 14, 2018: Heart and Vessels
Andra E Duncan, Daniel I Sessler, Hiroaki Sato, Tamaki Sato, Keisuke Nakazawa, George Carvalho, Roupen Hatzakorzian, Takumi Codere-Maruyama, Alaa Abd-Elsayed, Somnath Bose, Tamer Said, Maria Mendoza-Cuartas, Hyndhavi Chowdary, Edward J Mascha, Dongsheng Yang, A Marc Gillinov, Thomas Schricker
BACKGROUND: Hyperinsulinemic normoglycemia augments myocardial glucose uptake and utilization. We tested the hypothesis that hyperinsulinemic normoglycemia reduces 30-day mortality and morbidity after cardiac surgery. METHODS: This dual-center, parallel-group, superiority trial randomized cardiac surgical patients between August 2007 and March 2015 at the Cleveland Clinic, Cleveland, Ohio, and Royal Victoria Hospital, Montreal, Canada, to intraoperative glycemic management with (1) hyperinsulinemic normoglycemia, a fixed high-dose insulin and concomitant variable glucose infusion titrated to glucose concentrations of 80 to 110 mg · dl; or (2) standard glycemic management, low-dose insulin infusion targeting glucose greater than 150 mg · dl...
March 14, 2018: Anesthesiology
Pedapati Radhakrishna, Kolar Vishwanath Vinod, Akkilagunta Sujiv, Rathinam Palamalai Swaminathan
Background: Glycosylated hemoglobin (HbA1c) has not been evaluated extensively for diabetes and prediabetes diagnosis and short-term variability of fasting plasma glucose (FPG), 2-h PG post-75 g glucose load (2 hPG) and HbA1c has not been studied among Indians. Objectives: The study aimed to compare the sensitivity of HbA1c, FPG and 2 hPG for diabetes and prediabetes diagnosis as per the American Diabetes Association criteria, assess short-term variability of three tests and determine optimal HbA1c cutoffs for diabetes and prediabetes diagnosis among high-risk south Indians...
January 2018: Indian Journal of Endocrinology and Metabolism
Annie Dude, Charlotte M Niznik, Emily D Szmuilowicz, Alan M Peaceman, Lynn M Yee
Achieving maternal euglycemia in women with pregestational and gestational diabetes mellitus is critical to decreasing the risk of neonatal hypoglycemia, as maternal blood glucose levels around the time of delivery are directly related to the risk of hypoglycemia in the neonate. Many institutions use continuous insulin and glucose infusions during the intrapartum period, although practices are widely variable. At Northwestern Memorial Hospital, the "Management of the Perinatal Patient with Diabetes" policy and protocol was developed to improve consistency of management while also allowing individualization appropriate for the patient's specific diabetic needs...
March 13, 2018: American Journal of Perinatology
Ashley Ratliff, Amy Nishnick, Robert DeChicco, Rocio Lopez
BACKGROUND: Hyperglycemia is a common adverse event associated with parenteral nutrition (PN); however, there is no consensus on optimal glucose monitoring. Unnecessary point-of-care (POC) blood glucose (BG) testing can result in additional healthcare cost and discomfort to the patient. This study's aim was to determine whether decreasing the frequency of POC glucose testing in patients receiving PN can reduce costs without increasing the frequency of glycemic events. METHODS: This study examined adult, noncritically ill patients who require PN and are managed by a nutrition support team...
March 12, 2018: Nutrition in Clinical Practice
Mansooreh Samimi, Adeleh Dadkhah, Hamed Haddad Kashani, Maryam Tajabadi-Ebrahimi, Elahe Seyed Hosseini, Zatollah Asemi
Data on the effects of synbiotic supplementation on glycemic control, lipid profiles, and atherogenic index of plasma (AIP) of women with polycystic ovary syndrome (PCOS) are limited. The purpose of this study was to assess the effects of synbiotic supplementation on glycemic control and lipid profiles in women with PCOS. A prospective, randomized, double-blind, placebo-controlled trial was done at the Naghavi Hospital affiliated to Kashan University of Medical Sciences, Kashan, Iran, between April 2017 and June 2017...
March 12, 2018: Probiotics and Antimicrobial Proteins
Aldo Bonaventura, Fabrizio Montecucco
Corticosteroids are widely diffused drugs. An important side effect is the impairment of glycemic control both in patients with known diabetes and in normoglycemic ones potentially leading to steroid-induced diabetes mellitus (SIDM). In this review based on papers released on PubMed, MEDLINE, and EMBASE from January 2015 to October 2017, we summarized and discussed main updates about the definition, the diagnosis, and the pathophysiology of steroid-induced hyperglycemia (SIH), with a look to new therapies. Main alterations responsible for the diabetogenic effect of corticosteroids are a negative impact on insulin sensitivity along with a derangement on insulin secretion, explaining the typical post-prandial hyperglycemia linked to the promotion of gluconeogenesis...
March 9, 2018: Diabetes Research and Clinical Practice
Vajihe Izadi, Fahimeh Haghighatdoost, Parisa Moosavian, Leila Azadbakht
BACKGROUND: There are no investigations regarding the effects of consuming low-energy-dense diets rich in multiple functional foods on weight-loss maintenance, inflammatory markers, and cardiovascular disease (CVD) risk factors simultaneously. METHOD: This randomized controlled trial design was conducted on 90 men and women who were under a previous weight loss diet. Three months of intervention with recruitment at Allzahra Hospital, Isfahan, Iran, was done. Intervention was conducted following achieving 7-11 kg weight loss...
March 12, 2018: Journal of the American College of Nutrition
Dorte Glintborg, Katrine Hass Rubin, Mads Nybo, Bo Abrahamsen, Marianne Andersen
BACKGROUND: Polycystic ovary syndrome (PCOS) is associated with obesity and low grade inflammation and the risk for cardiovascular disease (CVD) could be increased in PCOS. METHODS: National register-based study including women with PCOS and no previous diagnosis of CVD, hypertension, or dyslipidemia. PCOS Denmark (N = 18,112) included women with PCOS in the Danish National Patient Register. PCOS Odense University Hospital (OUH, N = 1165) was an embedded cohort including premenopausal women with PCOS and clinical and biochemical examination...
March 8, 2018: Cardiovascular Diabetology
Daisuke Matsutani, Masaya Sakamoto, Hiroyuki Iuchi, Souichirou Minato, Hirofumi Suzuki, Yosuke Kayama, Norihiko Takeda, Ryuzo Horiuchi, Kazunori Utsunomiya
BACKGROUND: It is presently unclear whether glycemic variability (GV) is associated with baroreflex sensitivity (BRS), which is an early indicator of cardiovascular autonomic neuropathy. The present study is the first to examine the relationships between BRS and GV measured using continuous glucose monitoring (CGM). METHODS: This was a multicenter, prospective, open-label clinical trial. A total of 102 patients with type 2 diabetes were consecutively recruited for this study...
March 7, 2018: Cardiovascular Diabetology
Caitlin W Hicks, Joseph K Canner, Nestoras Mathioudakis, Ronald L Sherman, Kathryn Hines, Christopher Lippincott, James H Black, Christopher J Abularrage
BACKGROUND: Socioeconomic deprivation is associated with poor glycemic control and higher hospital admission rates in patients with diabetes. We sought to quantify the effects of neighborhood socioeconomic deprivation on wound healing among a cohort of patients with diabetic foot ulceration (DFU) treated in a multidisciplinary setting. METHODS: Socioeconomic disadvantage was calculated for all patients using the area deprivation index (ADI) stratified by quartile (from ADI-0: least through ADI-3: most)...
April 2018: Journal of Surgical Research
Yohannes Tekalegn, Adamu Addissie, Tedla Kebede, Wondimu Ayele
BACK GROUND: Diabetes is increasing at an alarming rate throughout the world and about 80% of diabetic cases live in low and middle income countries. Glycemic control is the most important predictor for diabetic related complications and deaths. Identifying factors associated with glycemic control help health care providers and patients to work in the areas that reduce risks of diabetic related complications and deaths. OBJECTIVES: The aim of this study is to assess the magnitude and factors associated with glycemic control among type 2 diabetic patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia...
2018: PloS One
Helen Phelan, Bruce King, Donald Anderson, Patricia Crock, Prudence Lopez, Carmel Smart
BACKGROUND: Young children with type 1 diabetes (T1D) present unique challenges for intensive diabetes management. We describe an intensive diabetes program adapted for young children and compare glycemic control, anthropometry, dietary practices and insulin regimens before and after implementation. METHODS: Cross sectional data from children with T1D aged ≥0.5 to <7.0 years attending the John Hunter Children's Hospital (JHCH), Australia in 2004, 2010 and 2016 were compared...
March 4, 2018: Pediatric Diabetes
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
Christina R Whitehouse, Nancy C Sharts-Hopko, Suzanne C Smeltzer, David A Horowitz
The aim of the current study was to compare outcomes for older adults with type 2 diabetes mellitus and obesity following participation in a transitional care intervention that included diabetes self-management education (DSME) and homecare. The three groups analyzed comprised an inpatient DSME plus homecare group (n = 35); an inpatient DSME only group (n = 100); and a group who received usual care (n = 45). Outcomes of interest included rehospitalization rates and hemoglobin A1C (A1C) for up to 1-year post hospital discharge...
March 1, 2018: Research in Gerontological Nursing
Mazhar Hussain, Muhammad Zafar Majeed Babar, Lubna Akhtar, Muhammad Shahbaz Hussain
Background and Objective: Increased neutrophil lymphocyte ratio (NLR) is a marker as well as predictor of various cardiac and non cardiac disorders. Our aim was to assess the relationship between NLR and different level of glycemic control in type 2 diabetic patients. Methods: An observational study was conducted at diabetic clinic of Sheikh Zayed Medical College/Hospital, Rahim Yar Khan from September 2016 to February 2017 in which 330 type 2 diabetic patients were randomly divided in to three groups based upon diabetes control according to ADA criteria...
November 2017: Pakistan Journal of Medical Sciences Quarterly
Atsushi Tanaka, Sho Komukai, Yoshisato Shibata, Hiroyoshi Yokoi, Yoshihiro Iwasaki, Tomohiro Kawasaki, Kenji Horiuchi, Koichi Nakao, Takafumi Ueno, Hitoshi Nakashima, Masahiro Tamashiro, Yutaka Hikichi, Mitsuhiro Shimomura, Motoko Tago, Shigeru Toyoda, Teruo Inoue, Atsushi Kawaguchi, Koichi Node
Pioglitazone has superior antiatherosclerotic effects compared with other classes of antidiabetic agents, and there is substantial evidence that pioglitazone improves cardiovascular (CV) outcomes. However, there is also a potential risk of worsening heart failure (HF). Therefore, it is clinically important to determine whether pioglitazone is safe in patients with type 2 diabetes mellitus (T2DM) who require treatment for secondary prevention of CV disease, since they have an intrinsically higher risk of HF...
February 27, 2018: Heart and Vessels
Ali Janati, Mohamad Ali Sarabchian, Bahram Mohaghegh, Naser Aghmohamadzadeh, Hesam Seyedin, Masumeh Gholizadeh, Edris Hasanpoor
Background: Type 2 Diabetes is a main concern of public health in contemporary world with remarkable mortality, delayed complications and health costs. Governments are obliged to improve the quality of health care and consider appropriate strategies to reduce the costs. An alternative strategy for hospital services is care at home. Therefore, this study was aimed to evaluate the cost-effectiveness of home-based and hospital-based diabetes care. Methods: A quasi-experimental, pre-test and post-test design was conducted in Northwest Iran...
November 2017: Ethiopian Journal of Health Sciences
Da Young Lee, Jeongwoon Park, Dooah Choi, Hong-Yup Ahn, Sung-Woo Park, Cheol-Young Park
This randomized, controlled, open-label study conducted in Kangbuk Samsung Hospital evaluated the effectiveness, reproducibility, and durability of tailored mobile coaching (TMC) on diabetes management. The participants included 148 Korean adult policyholders with type 2 diabetes divided into the Intervention-Maintenance (I-M) group (n = 74) and Control-Intervention (C-I) group (n = 74). Intervention was the addition of TMC to typical diabetes care. In the 6-month phase 1, the I-M group received TMC, and the C-I group received their usual diabetes care...
February 26, 2018: Scientific Reports
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