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Glycemic control operation

Thomas H Inge, Lori M Laffel, Todd M Jenkins, Marsha D Marcus, Natasha I Leibel, Mary L Brandt, Morey Haymond, Elaine M Urbina, Lawrence M Dolan, Philip S Zeitler
Importance: Because of the substantial increase in the occurrence of type 2 diabetes in the pediatric population and the medical complications of this condition, therapies are urgently needed that will achieve better glycemic control than standard medical management. Objective: To compare glycemic control in cohorts of severely obese adolescents with type 2 diabetes undergoing medical and surgical interventions. Design, Setting, and Participants: A secondary analysis of data collected by the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) and Treatment Options of Type 2 Diabetes in Adolescents and Youth (TODAY) consortia was performed...
March 12, 2018: JAMA Pediatrics
Meena Bedi, David M King, Carlos Mendez, Barbara Slawski, John A Charlson, Donald A Hackbarth, John C Neilson
BACKGROUND: Uncontrolled blood glucose impacts key phases of the wound healing process. Various factors have been associated with postoperative wound complications in soft tissue sarcomas; however, the association of postoperative early morning blood glucose with wound complications, if any, remains to be determined. Because blood glucose levels may be modified, understanding whether glucose levels are associated with wound complications has potential therapeutic importance. QUESTIONS/PURPOSES: The purposes of this study were (1) to evaluate if postoperative early morning blood glucose is associated with the development of wound complications in soft tissue sarcomas; (2) to determine a blood glucose cutoff that may be associated with an increased risk of wound complications; and (3) to evaluate if patients with diabetes have higher postoperative blood glucose and an associated increased risk of wound complications...
March 2018: Clinical Orthopaedics and related Research
Johannes M Werzowa, Marcus D Säemann, Alexander Mohl, Michael Bergmann, Christopher C Kaltenecker, Wolfgang Brozek, Andreas Thomas, Michael Haidinger, Marlies Antlanger, Johannes J Kovarik, Chantal Kopecky, Peter X K Song, Klemens Budde, Julio Pascual, Manfred Hecking
Treating hyperglycemia in previously non-diabetic individuals with exogenous insulin immediately after kidney transplantation reduced the odds of developing Posttransplantation Diabetes Mellitus (PTDM) in our previous proof-of-concept clinical trial. We hypothesized that insulin-pump therapy with maximal insulin dosage during the afternoon would improve glycemic control compared to basal insulin and standard-of-care. In a multi-center, randomized, controlled trial testing insulin isophane for PTDM prevention, we added a third study arm applying continuous subcutaneous insulin lispro infusion (CSII) treatment...
2018: PloS One
Beatriz Barquiel, Lucrecia Herranz, Diego Meneses, Óscar Moreno, Natalia Hillman, Mª Ángeles Burgos, José Luis Bartha
OBJECTIVES: Our aim was to investigate the greatest gestational weight gain (GWG) without adverse pregnancy complications in women with gestational diabetes mellitus (GDM) and morbid obesity. METHODS: An observational retrospective study including 3284 patients with single pregnancies and GDM was completed. Of the patients, 131 (4.0%) were classified as having pre-pregnancy morbid obesity (BMI ≥ 35 kg/m2 ). Perinatal complications were compared among BMI groups...
March 1, 2018: Maternal and Child Health Journal
Samir Abu Gazala, Elad Horwitz, Rachel Ben-Haroush Schyr, Aya Bardugo, Hadar Israeli, Ayat Hija, Jonathan Schug, Soona Shin, Yuval Dor, Klaus H Kaestner, Danny Ben-Zvi
Bariatric surgery dramatically improves glycemic control, yet the underlying molecular mechanisms remain controversial due to confounding weight loss. We performed sleeve gastrectomy (SG) on obese and diabetic leptin receptor-deficient mice ( db / db ). One week post-surgery, mice weighed 5% less and displayed improved glycemia compared to sham-operated controls and islets from SG mice displayed reduced expression of diabetes markers. One month post-surgery SG mice weighed more than pre-operatively, but remained near-euglycemic and displayed reduced hepatic lipid droplets...
February 23, 2018: Diabetes
Akina Tohya, Atsushi Kohjitani, Sachi Ohno, Kaoru Yamashita, Yozo Manabe, Mitsutaka Sugimura
Background: Secretion of hormones, which antagonize the action of insulin, is facilitated in response to surgery, and acute resistance to the action of insulin develops. Our aim is to elucidate the effects of intraoperative glycemic control by glucose-insulin (GI) infusion on postoperative complications and outcomes in major oral and maxillofacial surgery. Findings: Thirty patients aged ≥ 60 years undergoing a radical operation of oral malignant tumors with tissue reconstruction (≥ 8 h) were analyzed...
2018: JA Clin Rep
Ana M Gómez, Oscar M Muñoz, Alejandro Marin, Maria Camila Fonseca, Martin Rondon, María Alejandra Robledo Gómez, Andrei Sanko, Dilcia Lujan, Maira García-Jaramillo, Fabian Mauricio León Vargas
INTRODUCTION: Recent publications frequently introduce new indexes to measure glycemic variability (GV), quality of glycemic control, or glycemic risk; however, there is a lack of evidence supporting the use of one particular parameter, especially in clinical practice. METHODS: A cohort of type 2 diabetes mellitus (T2DM) patients in ambulatory care were followed using continuous glucose monitoring sensors (CGM). Mean glucose (MG), standard deviation, coefficient of variation (CV), interquartile range, CONGA1, 2, and 4, MAGE, M value, J index, high blood glucose index, and low blood glucose index (LBGI) were estimated...
February 1, 2018: Journal of Diabetes Science and Technology
Woo Sik Yu, Chang Young Lee, Seong Yong Park, Jee Won Suh, Kyoung Shik Narm, Dae Joon Kim, Kyung Young Chung, Jin Gu Lee
BACKGROUND: For diabetic patients with lung cancer, blood glucose levels and medications such as metformin and statins may influence survival. OBJECTIVES: This study aimed to determine prognostic survival factors for diabetic patients with resected non-small cell lung cancer. PATIENTS AND METHODS: Between January 2005 and December 2013, 301 patients with type 2 diabetes mellitus who underwent curative resection for non-small cell lung cancer were identified and reviewed retrospectively...
February 6, 2018: Journal of Surgical Oncology
Jourdan M Cancienne, Mark D Miller, James A Browne, Brian C Werner
PURPOSE: To determine the association between glycemic control and infection following knee arthroscopy, and to determine the clinical utility of a threshold HbA1c level. METHODS: A national database identified patients who underwent knee arthroscopy from 2007 to 2016. Patients with concomitant open portions, more complex knee procedures, procedures performed for infection and patients with prior septic knee arthritis were excluded. Patients with an HbA1c level checked within 3 months of surgery were compared to control groups of nondiabetics and diabetics undergoing knee arthroscopy without a perioperative HbA1c...
February 2, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Natsuhiro Yamamoto, Tomoya Irie, Shunsuke Takaki, Osamu Yamaguchi, Takahisa Goto
PURPOSE: Hyperglycemia is a common issue in infants after cardiac surgery for congenital heart disease. Poor glycemic control is suspected to be associated with adverse postoperative outcomes. This study was performed to investigate clinical factors contributing to hyperglycemia in the perioperative period in infats. METHODS: A total of 69 infants (aged 1-12 months) who were admitted to Yokohama City University Hospital Intensive Care Unit (ICU) after surgical repair of congenital heart diseases with cardiopulmonary bypass (CPB) were retrospectively analysed...
January 12, 2018: Journal of Anesthesia
Phong Ching Lee, Kwang Wei Tham, Sonali Ganguly, Hong Chang Tan, Alvin Kim Hock Eng, John B Dixon
BACKGROUND: In Asia, metabolic-bariatric surgery (MBS) rates have grown rapidly in parallel with rising prevalence of obesity and type 2 diabetes (T2D). OBJECTIVE: The objective of this study was to identify factors that influence glycemic outcomes and diabetes remission 12 months after sleeve gastrectomy (SG) or gastric bypass (GB) in a multiethnic Asian cohort. SETTING: The study's setting was in a tertiary hospital in Singapore. METHODS: Data from 145 T2D patients who had SG (37%) or GB (63%) and at least 1-year follow-up were analyzed...
December 26, 2017: Obesity Surgery
Maria Divani, Panagiotis I Georgianos, Triantafyllos Didangelos, Fotios Iliadis, Areti Makedou, Apostolos Hatzitolios, Vassilios Liakopoulos, Dimitrios M Grekas
BACKGROUND: Glycated hemoglobin A1c (HbA1c) among diabetic hemodialysis patients continues to be the standard of care, although its limitations are well recognized. This study evaluated glycated albumin (GA) and glycated serum protein (GSP) as alternatives to HbA1c in detecting glycemic control among diabetic hemodialysis patients using continuous-glucose-monitoring (CGM)-derived glucose as reference standard. METHODS: A CGM system (iPRO) was applied for 7 days in 37 diabetic hemodialysis patients to determine glycemic control...
2018: American Journal of Nephrology
Fedra Fallahian, Ali Ardestani, Elisha Pranckevicius, Chandrajit P Raut, Ali Tavakkoli, Eric G Sheu
BACKGROUND: The metabolic and immunologic properties of adipose tissue are linked to the pathogenesis of type 2 diabetes mellitus. Lipomatous tumors, such as liposarcomas, are rare but can reach significant size. We hypothesized that some lipomatous tumors are metabolically active and can alter systemic glucose homeostasis. METHODS: We performed a retrospective study of patients who underwent resection of a lipomatous tumor at a tertiary cancer referral center (2004-2015)...
February 2018: Journal of Surgical Research
Brian C Werner, Victor A Teran, Jourdan Cancienne, D Nicole Deal
BACKGROUND: The primary goal of the study was to evaluate the association of hemoglobin A1c (HbA1c) levels in diabetic patients with the incidence of surgical site infection (SSI) following open carpal tunnel release (CTR). Our secondary objective was to calculate an HbA1c level in diabetic patients that predicted SSI after open CTR. METHODS: A national private-payer insurance database was queried for patients who underwent open CTR using Current Procedural Terminology (CPT) code 64721...
December 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
Baris Saglam, Sezer Uysal, Sadik Sozdinler, Omer Erbil Dogan, Banu Onvural
Background: The oral glucose tolerance test (OGTT) is the current established method performed worldwide to diagnose gestational diabetes mellitus (GDM). The purpose of this study was to assess the utility of the use of long- and short-term markers of glycemic status. Methods: The study group was composed of 80 pregnant women, 40 with GDM and 40 with normal glucose tolerance. GDM was diagnosed with the American Diabetes Association criteria. Glycemic markers were measured in the OGTT blood samples of women at 24-28 weeks of gestation...
December 2017: Therapeutic Advances in Endocrinology and Metabolism
Alessandra S M Matheus, Maria de Fátima B da Matta, Eliete Leão S Clemente, Maria de Lourdes G Rodrigues, Débora Cristina T Valença, Marília B Gomes
OBJECTIVES: To find out an normality value for microvascular response (physiological and pharmacological) assessed through laser speckle contrast imaging (LSCI) based on Endo-PAT, which identifies the ones with Endothelial Dysfunction (ED) in patients with Type 1 Diabetes (T1D). METHODS: Patients with T1D, aged ≥12years underwent a clinical-epidemiological questionnaire. Fasting blood samples were obtained (lipid profile, glycemic control and levels of C-reactive protein)...
December 2, 2017: Microvascular Research
Ryan Stallard, Vic Sahai, John W Drover, Shannon Chun, Christian Keresztes
BACKGROUND: Diabetes remission is defined as the return of glycemic control in the absence of medication or insulin use after bariatric surgery. We sought to identify and assess the clinical utility of a predictive model for remission of type 2 diabetes mellitus in a population seeking bariatric surgery. METHOD: A retrospective cohort design was applied to presurgical data on patients referred for Roux-en-Y gastric bypass (RYGB) or vertical sleeve gastrectomy (VSG)...
March 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
Tarik Wasfie, Anthony Tabatabai, Ravi Hedni, Linda Hollern, Kimberly Barber, Brian Shapiro
BACKGROUND: Dexamethasone adds a unique challenge to glycemic control, and it may complicate patient care if there is an association between intra-operative dexamethasone and blood glucose levels. METHODS: We analyzed 396 diabetic patients who underwent general anesthesia for various surgical procedures and were hospitalized post-operatively for at least 24 h between January 2015 and June 2016. Patients were classified into two groups-those who received dexamethasone intra-operatively and those who did not...
March 2018: American Journal of Surgery
E Grong, C Nord, I B Arbo, M Eriksson, B E Kulseng, U Ahlgren, R Mårvik
PURPOSE: Metabolic surgery alters the secretion of gastrointestinal hormones that influence glycemic control. Elevated gastrin has been suggested to benefit patients with type 2 diabetes and has been reported following sleeve gastrectomy in rats. The present study compares the effect of hypergastrinemia following sleeve gastrectomy with proton-pump inhibitor therapy on glycemic control and beta-cell mass in lean, diabetic animals. METHODS: Thirty-three diabetic Goto-Kakizaki rats were randomized into pantoprazole + sham operation (GK-PPI), sleeve gastrectomy (GK-SG) and vehicle + sham operation (GK-V)...
November 22, 2017: Journal of Endocrinological Investigation
Dong Wang, Zhi-Gang Ji, Han-Zhong Li, Yu-Shi Zhang
OBJECTIVE: To assess whether adrenalectomy may improve biochemical and metabolic impairment for patients with subclinical Cushing syndrome (SCS) due to adrenal incidentaloma (AI) compared with conservative management. METHODS: A total of 87 patients with SCS due to AI in Peking Union Medical College Hospital between September 2011 and January 2016 have been treated. Forty-eight patients underwent laparoscopic adrenalectomy (operative group), whereas 39 were managed conservatively (control group)...
October 31, 2017: Cancer Biomarkers: Section A of Disease Markers
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