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Diabetes complications

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https://www.readbyqxmd.com/read/28550608/shifting-paradigms-in-the-medical-management-of-type-2-diabetes-reflections-on-recent-cardiovascular-outcome-trials
#1
Faramarz Ismail-Beigi, Etie Moghissi, Mikhail Kosiborod, Silvio E Inzucchi
An important challenge in the management of patients with type 2 diabetes is cardiovascular disease (CVD) prevention. While it is well established that intensive glycemic control prevents the onset and slows the progression of certain microvascular complications, such a strategy utilized in multiple clinical trials over the past few decades has failed to show a similar benefit with regard to cardiovascular events, including mortality. Despite this, a major hope has been the discovery of glucose-lowering medications that simultaneously improve cardiovascular outcomes...
May 26, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28550239/clinical-conditions-responsible-for-hyperviscosity-and-skin-ulcers-complications
#2
Gregorio Caimi, Baldassare Canino, Rosalia Lo Presti, Caterina Urso, Eugenia Hopps
In this brief review, we have examined some clinical conditions that result to be associated to an altered hemorheological profile and at times accompanied by skin ulcers. This skin condition may be observed in patients with the following condtions, such as primary polycythemic hyperviscosity (polycythemia, thrombocytemia) treated with hydroxyurea, primary plasma hyperviscosity (multiple myeloma, cryoglobulinemia, cryofibrinogenemia, dysfibrinogenemia, and connective tissue diseases), primary sclerocythemic hyperviscosity (hereditary spherocytosis, thalassemia, and sickle cell disease)...
May 19, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28550194/the-risk-of-severe-hypoglycemia-in-type-1-diabetes-over-30-years-of-follow-up-in-the-dcct-edic-study
#3
Rose A Gubitosi-Klug, Barbara H Braffett, Neil H White, Robert S Sherwin, F John Service, John M Lachin, William V Tamborlane
OBJECTIVE: During the DCCT, intensive diabetes therapy achieving a mean HbA1c of ∼7% was associated with a threefold increase in the rate of severe hypoglycemia (defined as requiring assistance) compared with conventional diabetes therapy with a mean HbA1c of 9% (61.2 vs. 18.7 per 100 patient-years). After ∼30 years of follow-up, we investigated the rates of severe hypoglycemia in the DCCT/EDIC cohort. RESEARCH DESIGN AND METHODS: Rates of severe hypoglycemia were reported quarterly during DCCT and annually during EDIC (i...
May 26, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28549669/the-iscreen-electronic-diabetes-dashboard-a-tool-to-improve-knowledge-and-implementation-of-clinical-practice-guidelines
#4
Stacy Zahanova, Alexandra Tsouka, Mark R Palmert, Farid H Mahmud
OBJECTIVES: Clinical practice guidelines (CPG) provide evidence-based recommendations for patient care but may not be optimally applied in clinical settings. As a pilot study, we evaluated the impact of a computerized, point-of-care decision support system (CDSS) on guideline knowledge and adherence in our diabetes clinic. METHODS: iSCREEN, a CDSS, integrated with a province-wide electronic health record, was designed based on the Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada...
May 23, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28549668/patient-perspectives-on-diabetes-care-across-the-institute-of-medicine-s-six-domains-of-quality
#5
I J Halperin, G Mukerji, M Maione, P Segal, M Wolfs, J Goguen, L Jeffs
OBJECTIVES: To gather patient perspectives on quality of care provided in diabetes clinics within the framework of the Institute of Medicine's 6 domains of quality. METHODS: A qualitative study including semi-structured interviews was conducted at 5 academic hospital sites. Transcripts were analyzed using a direct content approach for themes and subthemes with saturation of themes achieved. Purposive sampling was conducted at 5 diabetes clinics (n=47 interviews)...
May 23, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28549455/inter-act-prevention-of-pregnancy-complications-through-an-e-health-driven-interpregnancy-lifestyle-intervention-study-protocol-of-a-multicentre-randomised-controlled-trial
#6
Annick Bogaerts, Lieveke Ameye, Margriet Bijlholt, Kelly Amuli, Dorine Heynickx, Roland Devlieger
BACKGROUND: Excessive maternal pre-pregnancy and gestational weight gain are related to pregnancy- and birth outcomes. The interpregnancy time window offers a unique opportunity to intervene in order to acquire a healthy lifestyle before the start of a new pregnancy. METHODS: INTER-ACT is an e-health driven multicentre randomised controlled intervention trial targeting women at high risk of pregnancy- and birth related complications. Eligible women are recruited for the study at day 2 or 3 postpartum...
May 26, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28549044/a-modified-suction-assisted-technique-of-transfer-of-diced-cartilage-graft-to-carrier-material-and-outcome-of-direct-injection-of-unwrapped-diced-cartilage-in-rhinoplasty
#7
Muhammad Mustehsan Bashir, Muhammad Sohail, Farid Ahmad Khan, Sadia Nosheen Jan, Hamid Hussain Ansari, Umer Nazir, Zohaib Hidayat
OBJECTIVE: To describe a modified suction-assisted technique (MSAT) of transfer of diced cartilage (DC) graft to a carrier material and to determine the clinical outcome of direct injection of unwrapped diced cartilage (UDC) in rhinoplasty. PLACE AND DURATION OF STUDY: Department of Plastic Surgery, KEMU, Mayo Hospital, Lahore from February 2011 to January 2015 METHODS:: Forty-seven patients of both genders with types 0 to 3 saddle nose deformity were included. Patients with types 4 and 5 saddle nose deformity, diabetes, hypertension, hepatic or renal disorders were excluded...
May 25, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28549016/liberal-bilateral-internal-thoracic-artery-use-in-people-with-diabetes-neutralizes-the-negative-impact-of-insulin-requiring-status
#8
Giuseppe Gatti, Bernardo Benussi, Marina Bollini, Gabriella Forti, Angela Poletti, Elisabetta Rauber, Marco Gabrielli, Ariella De Monte, Gianfranco Sinagra, Aniello Pappalardo
AIMS: Bilateral internal thoracic artery (BITA) grafts are underused in insulin-dependent diabetic patients because of increased risk of postoperative complications. The impact of the insulin-requiring status on outcomes after routine BITA grafting was investigated in this retrospective study. METHODS: Skeletonized BITA grafts were used in 3228 (71.6%) of 4508 consecutive patients having multivessel coronary disease who underwent isolated coronary bypass surgery at the authors' institution from January 1999 to August 2015...
May 25, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28549011/use-of-elderly-donors-in-liver-transplantation-a-paired-match-analysis-at-a-single-center
#9
Davide Ghinolfi, Quirino Lai, Daniele Pezzati, Paolo De Simone, Erion Rreka, Franco Filipponi
OBJECTIVE: To evaluate the use of elderly donors in liver transplantation (LT) and identify risk factors associated with a worse outcome. SUMMARY BACKGROUND DATA: Use of livers from very old donors could expand the donor pool but is not universally implemented. METHODS: This is a retrospective, single-center medical record review. From January 2001 to December 2014, 1354 LTs were performed. After exclusion of donors <18 years, ABO-incompatible LT, re-LT and UNOS 1 status patients, LT recipients were stratified into 2 groups based on donor age: 18-69 (n=692) vs...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28548478/influencing-of-antioxidants-gene-variants-on-risk-of-diabetes-mellitus-and-its-complications-a-systematic-review
#10
Fatemeh Bitarafan, Mehrnoosh Khodaeian, Ozra Tabatabaei-Malazy, Mahsa M Amoli
INTRODUCTION: Oxidative stress has a key role in pathophysiology of type 2 diabetes mellitus (T2DM) and its complications as a most common health problem. Due to controversial evidence regarding the association between antioxidants' gene varients and T2DM, our aim was a systematic review of the current meta-analyses. EVIDENCE ACQUISTION: All meta-analysis' studies which assessed the association of single nucleotide polymorphisms of superoxide dismutase (SOD), catalase, glutathione peroxidase (GPX), glutathione S transferase (GST), nitric oxide synthase (NOS) and nicotinamide adenine dinucleotide phosphate oxidase (NOX) with T2DM and its complications were systematically extracted from PubMed, Scopus and Web of Science databases up to January 2016...
May 26, 2017: Minerva Endocrinologica
https://www.readbyqxmd.com/read/28548453/mortality-in-type-1-diabetes-diagnosed-in-childhood-in-northern-ireland-during-1989-2012-a-population-based-cohort-study
#11
Eileen Morgan, Catherine R Black, Noina Abid, Christopher R Cardwell, David R McCance, Christopher C Patterson
OBJECTIVE: To investigate long-term mortality rates and causes of death in individuals diagnosed with type 1 diabetes before the age of 15 years during the period 1989-2012 or known to paediatric diabetes teams in 1989, in Northern Ireland. METHODS: A cohort of 3129 patients from the Northern Ireland Childhood Diabetes Register was linked to death registrations and underlying causes, coded according to ICD-9 or ICD-10. Standardized mortality ratios (SMRs) were calculated as the ratio of observed to expected deaths by sex, attained age, time since diagnosis, calendar period, and cause of death...
May 26, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28548198/-diabetic-ketoacidosis-with-mild-hyperglycemia-associated-with-the-use-of-canagliflozin-report-of-one-case-with-type-1-diabetes
#12
Victoria Novik A, Claudia García B, Daniela Oliva I
Diabetic ketoacidosis with mild hyperglycemia is a major complication of sodium-glucose cotransporter 2 inhibitors. Although its use is not approved for patients with type 1 diabetes mellitus, the drug is often prescribed with the hope of optimizing metabolic control. We report a 20 years old female with hypothyroidism and type 1 diabetes consulting for vomiting and abdominal pain. The patient had used canagliflozin during the two previous months. Laboratory showed a blood glucose of 200 mg/dl, a severe metabolic acidosis (pH 7...
March 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28547674/diagnostic-accuracy-of-various-modalities-relative-to-open-bone-biopsy-for-detection-of-long-bone-posttraumatic-osteomyelitis
#13
Vivek Chadayammuri, Benoit Herbert, Jiandong Hao, Andreas Mavrogenis, Juan C Quispe, Ji Wan Kim, Heather Young, Mark Hake, Cyril Mauffrey
BACKGROUND: Long bone posttraumatic osteomyelitis (PTOM) is a relatively common complication following surgical fixation of open fractures. There is a lacking consensus on ideal strategies for diagnostic evaluation of long bone PTOM. While open bone biopsy and culture is considered the 'gold diagnostic standard,' its cost and invasiveness are often prohibitive and have prompted the search for alternate diagnostic methods. OBJECTIVE: To evaluate the sensitivity and specificity of various diagnostic modalities relative to open bone biopsy and culture for the detection of long bone PTOM...
May 25, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28546939/demographic-features-and-visual-outcomes-of-patients-presenting-to-diabetic-photo-screening-and-treated-for-sight-threatening-retinopathy-in-fiji
#14
Riyaz Bhikoo, Neil Murray, Biu Sikivou, Stephanie Emma, Charles McGhee
AIM: To describe the demographic features and visual outcomes of patients presenting to photo-screening services, and treated for sight threatening retinopathy (STR) in a low resource setting, Fiji. METHODS: A retrospective review of all new patients who presented for diabetic photo-screening at the Diabetic Eye Clinic, Suva in 2010. Fundus images were graded using standardised guidelines. Patient demographics, retinopathy grading and visual acuity data were extracted from the database and analyzed...
2017: International Journal of Ophthalmology
https://www.readbyqxmd.com/read/28546563/microbiota-in-t-cell-homeostasis-and-inflammatory-diseases
#15
REVIEW
Naeun Lee, Wan-Uk Kim
The etiology of disease pathogenesis can be largely explained by genetic variations and several types of environmental factors. In genetically disease-susceptible individuals, subsequent environmental triggers may induce disease development. The human body is colonized by complex commensal microbes that have co-evolved with the host immune system. With the adaptation to modern lifestyles, its composition has changed depending on host genetics, changes in diet, overuse of antibiotics against infection and elimination of natural enemies through the strengthening of sanitation...
May 26, 2017: Experimental & Molecular Medicine
https://www.readbyqxmd.com/read/28546302/considerations-and-controversies-in-managing-chronic-kidney-disease-an-update
#16
REVIEW
Lalita Prasad-Reddy, Diana Isaacs, Alexander Kantorovich
PURPOSE: Current considerations and controversies surrounding the management of chronic kidney disease (CKD) are reviewed. SUMMARY: Patients diagnosed with CKD require a unique clinical approach to prevent medication toxicities and ensure appropriate management of disease-progressing comorbidities, and they require attention to commonly occurring complications that may affect disease control and impact quality of life, including anemia and CKD-bone-mineral disorder (CKD-BMD)...
June 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28546096/bone-disease-in-diabetes-another-manifestation-of-microvascular-disease
#17
REVIEW
Vikram V Shanbhogue, Stinus Hansen, Morten Frost, Kim Brixen, Anne P Hermann
Type 1 and type 2 diabetes are generally accepted to be associated with increased bone fracture risk. However, the pathophysiological mechanisms of diabetic bone disease are poorly understood, and whether the associated increased skeletal fragility is a comorbidity or a complication of diabetes remains under debate. Although there is some indication of a direct deleterious effect of microangiopathy on bone, the evidence is open to question, and whether diabetic osteopathy can be classified as a chronic, microvascular complication of diabetes remains uncertain...
May 22, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28545982/canonical-wnt-signaling-in-diabetic-retinopathy
#18
Qian Chen, Jian-Xing Ma
Diabetic retinopathy (DR) is a common eye complication of diabetes, and the pathogenic mechanism of DR is still under investigation. The canonical Wnt signaling pathway is an evolutionarily conserved pathway that plays fundamental roles in embryogenesis and adult tissue homeostasis. Wnt signaling regulates expression of multiple genes that control retinal development and eye organogenesis, and dysregulated Wnt signaling plays pathophysiological roles in many ocular diseases, including DR. This review highlights recent progress in studies of Wnt signaling in DR...
May 22, 2017: Vision Research
https://www.readbyqxmd.com/read/28545927/stem-cells-to-restore-insulin-production-and-cure-diabetes
#19
V Sordi, S Pellegrini, M Krampera, P Marchetti, A Pessina, G Ciardelli, G Fadini, C Pintus, G Pantè, L Piemonti
BACKGROUND: The advancement of knowledge in the field of regenerative medicine is increasing the therapeutic expectations of patients and clinicians on cell therapy approaches. Within these, stem cell therapies are often evoked as a possible therapeutic option for diabetes, already ongoing or possible in the near future. AIM: The purpose of this document is to make a point of the situation on existing knowledge and therapies with stem cells to treat patients with diabetes by focusing on some of the aspects that most frequently raise curiosity and discussion in clinical practice and in the interaction with the patient...
February 21, 2017: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/28545894/post-occlusive-reactive-hyperaemia-of-skin-microvasculature-and-foot-complications-in-type-2-diabetes
#20
Sean M Lanting, Alex L Barwick, Stephen M Twigg, Nathan A Johnson, Michael K Baker, Simon K Chiu, Ian D Caterson, Vivienne H Chuter
AIMS: Diabetes-related microvascular disease has been implicated in the development of foot ulceration and amputation. Assessment of microvascular function may be effective in identifying those at risk of diabetic foot complications. We investigated the relationship between active or previous foot complication and post-occlusive reactive hyperaemia (PORH) measured by laser-Doppler fluxmetry (LDF) in people with type 2 diabetes. METHODS: PORH measures were obtained from the hallux apex in 105 people with type 2 diabetes...
May 14, 2017: Journal of Diabetes and its Complications
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