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Dysglycemia

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https://www.readbyqxmd.com/read/28225312/perspectives-on-learning-and-clinical-practice-improvement-for-diabetes-in-the-hospital-a-review-of-educational-interventions-for-providers
#1
Ariana Pichardo-Lowden, Paul Haidet, Guillermo E Umpierrez
BACKGROUND: The management inpatient hyperglycemia and diabetes requires expertise among many healthcare providers. There is limited evidence about how education for healthcare providers can result in optimization of clinical outcomes. The purpose of this critical review of the literature is to examine methods and outcomes related to educational interventions regarding the management of diabetes and dysglycemia in the hospital setting. This report provides recommendations to advance learning, curricular planning and clinical practice...
February 22, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28217821/physicians-experiences-as-patients-with-statin-side-effects-a-case-series
#2
Hayley J Koslik, Athena Hathaway Meskimen, Beatrice Alexandra Golomb
Physicians are among those prescribed statins and therefore, subject to potential statin adverse effects (AEs). There is little information on the impact of statin AEs on physicians affected by them. We sought to assess the character and impact of statin AEs occurring in physicians and retired physicians, and to ascertain whether/how personal experience of AEs moderated physicians' attitude toward statin use. Seven active or retired physicians from the United States communicated with the Statin Effects Study group regarding their personal experience of statin AEs...
December 2017: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/28217526/the-rule-of-two-thirds-in-diabetes-epidemiology
#3
Sanjay Kalra, Banshi Saboo, Rakesh Sahay, Deepak Khandelwal, Vipin Talwar, A G Unnikrishnan
This communication hypothesises a rule of two thirds which seems to operate in Indian diabetes epidemiology. Two thirds of all persons with dysglycemia are prediabetic; two thirds of all persons with diabetes are diagnosed to have the condtion; and two thirds are diagnosed before the age of 50 years. Two thirds of people with diabetes have concomitant hypetension or dyslipidemia; two thirds do not get their HbA1c assessed; and two thirds of those who do, do not achiev target values. Yet, two thirds of people with diabetes report satisfactory psychosocial health and quality of life, and adherence to dietary therapy and medication...
January 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28217517/adolescent-gynecomastia-is-associated-with-a-high-incidence-of-obesity-dysglycemia-and-family-background-of-diabetes-mellitus
#4
Bindu Kulshreshtha, Arora Arpita, Patnaik T Rajesh, Bhattacharya Sameek, Deep Dutta, Sharma Neera, Mohsin Mohd
BACKGROUND: Gynecomastia during adolescence is common though etiology is not clear. We studied the clinical and hormonal profile of adolescent patients with gynecomastia. METHODOLOGY: Patients who had onset of breast development between age 10 and 20 years were included in this study. Their clinical profile, biochemical, and hormonal parameters were studied. RESULTS: Of 94 patients with gynecomastia, 4 had hypogonadotropic hypogonadism, 4 had hypergonadotropic hypogonadism, and 1 had fibroadenosis, but in majority (90...
January 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28214004/prognostic-impact-of-combined-dysglycemia-and-hypoxic-liver-injury-on-admission-in-patients-with-st-segment-elevation-myocardial-infarction-who-underwent-primary-percutaneous-coronary-intervention-from-the-interstellar%C3%A2-cohort
#5
Ho-Jun Jang, Pyung Chun Oh, Jeonggeun Moon, Jon Suh, Hyun Woo Park, Sang-Don Park, Kyounghoon Lee, Je Sang Kim, Hyun Jong Lee, Rak Kyeong Choi, Young-Jin Choi, Woong Chol Kang, Sung Woo Kwon, Tae-Hoon Kim
Dysglycemia on admission is known to predict the prognosis of ST-segment elevation myocardial infarction (STEMI). Recently, hypoxic liver injury (HLI) has been proposed as a novel prognosticator for STEMI. We evaluated the prognostic impact of combined dysglycemia and HLI at the time of presentation in patients with STEMI who underwent primary percutaneous coronary intervention. From 2007 to 2014, 1,525 consecutive patients (79% men, mean age 61 years) who underwent primary percutaneous coronary intervention for STEMI in the INTERSTELLAR (Incheon-Bucheon Cohort of Patients Undergoing Primary PCI for Acute ST-Elevation Myocardial Infarction) cohort were analyzed retrospectively...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28145564/cost-effectiveness-of-diabetes-screening-initiated-through-a-dental-visit
#6
Matthew Neidell, Ira B Lamster, Barbara Shearer
OBJECTIVE: To analyse the cost-effectiveness of a screening programme and follow-up interventions for persons with dysglycemia who are identified during a dental visit. METHODS: This study is a secondary analysis utilizing data from two relevant publications. Those studies identified persons with dysglycemia who were seen in a dental school clinic for routine dental care and determined compliance with a recommendation to seek medical care. The response site was 59...
February 1, 2017: Community Dentistry and Oral Epidemiology
https://www.readbyqxmd.com/read/28137307/dysglycemia-associations-with-adipose-tissue-among-hiv-infected-patients-after-2-years-of-antiretroviral-therapy-in-mwanza-a-follow-up-cross-sectional-study
#7
George PrayGod, John Changalucha, Saidi Kapiga, Robert Peck, Jim Todd, Suzanne Filteau
BACKGROUND: Data on the burden of dysglycemia among HIV-infected patients on antiretroviral therapy (ART) in Africa are limited. We determined the prevalence of pre-diabetes and diabetes among HIV-infected patients who started ART when malnourished 2 to 3 years previously and investigated the association of dysglycemia with body composition. METHODS: Malnourished (body mass index (BMI) < 18.5 kg/m(2)) HIV-infected patients who were enrolled in the Nutritional Support for Africans Starting Antiretroviral Therapy (NUSTART) trial from 2011 to 2013 were followed-up from March to August 2015...
January 30, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28124259/reducing-the-prevalence-of-dysglycemia-is-the-time-ripe-to-test-the-effectiveness-of-intervention-in-high-risk-individuals-with-elevated-1%C3%A2-h-post-load-glucose-levels
#8
Michael Bergman, Ram Jagannathan, Martin Buysschaert, Jose Luis Medina, Mary Ann Sevick, Karin Katz, Brenda Dorcely, Jesse Roth, Angela Chetrit, Rachel Dankner
Identifying the earliest time point on the prediabetic continuum is critical to avoid progressive deterioration in β-cell function. Progressively rising glucose levels even within the "normal range" occur considerably late in the evolution to diabetes thus presenting an important opportunity for earlier diagnosis, treatment, and possible reversal. An elevated 1 h postprandial glucose level, not detected by current diagnostic standards, may provide an opportunity for the early identification of those at risk...
January 25, 2017: Endocrine
https://www.readbyqxmd.com/read/28121795/change-in-sedentary-time-physical-activity-bodyweight-and-hba1c-in-high-risk-adults
#9
Matthew McCarthy, Charlotte L Edwardson, Melanie J Davies, Joseph Henson, Laura Gray, Kamlesh Khunti, Thomas Yates
PURPOSE: In recent years, there has been a migration towards the use of glycated hemoglobin (HbA1c) in determining glycemic control. This study aimed to quantify the associations between changes in body weight, sedentary time and moderate to vigorous physical activity (MVPA) time with HbA1c levels over a three year period among adults at high risk of type 2 diabetes. METHODS: This study reports baseline and three year follow-up data from the Walking Away from Type 2 Diabetes study...
January 24, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28112704/evaluation-and-treatment-of-hyperglycemia-in-critically-ill-patients
#10
Andrea Balloni, Federico Lari, Fabrizio Giostra
The hyperglycemic reaction to stress is part of adaptive metabolic response to critical illness, especially hypoxia, hemorrhage and sepsis. It involves neuro-endocrine and immune pathways leading to the development of insulin resistance and hepatic glucose production by gluconeogenesis and glycogenolysis. Over the last years the concept of stress related hyperglycemia has been replaced by the concept of dysglycemia and its three domains: hyperglycemia, hypoglycemia and glycemic variability. Each of the three domains is independently associated with increased risk of mortality in patients admitted in intensive care unit and non critically ill patients, both medical and surgical...
January 16, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28107491/association-of-in-hospital-mortality-and-dysglycemia-in-septic-patients
#11
Hsiao-Yun Chao, Peng-Hui Liu, Shen-Che Lin, Chun-Kuei Chen, Jih-Chang Chen, Yi-Lin Chan, Chin-Chieh Wu, Gerald N Blaney, Zhen-Ying Liu, Cho-Ju Wu, Kuan-Fu Chen
BACKGROUND: The associations between dysglycemia and mortality in septic patients with and without diabetes are yet to be confirmed. Our aim was to analyze the association of diabetes and sepsis mortality, and to examine how dysglycemia (hyperglycemia, hypoglycemia and glucose variability) affects in-hospital mortality of patients with suspected sepsis in emergency department (ED) and intensive care units. METHODS: Clinically suspected septic patients admitted to ED were included, and stratified into subgroups according to in-hospital mortality and the presence of diabetes...
2017: PloS One
https://www.readbyqxmd.com/read/28088892/interventions-to-reduce-cardiovascular-risk-in-children-with-type-1-diabetes
#12
Jose A Canas, Samuel S Gidding, Nelly Mauras
Despite recent advances in improved glycemic control, the magnitude of lifetime risk from premature cardiovascular disease in individuals with type 1 diabetes remains at least 10 fold higher than in the general population. The availability of lipoprotein fractionation has allowed the spotlight for this increased risk to shift from dysglycemia to diabetes-induced dyslipidemia associated with insulin resistance. Interventions designed to simultaneously improve both factors can have distinct and additive effects on slowing the initiation and progression of atherosclerotic lesions...
January 13, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28081577/can-hba1c-be-used-to-screen-for-glucose-abnormalities-among-adults-with-severe-mental-illness
#13
A J Romain, E Letendre, Z Akrass, A Avignon, A D Karelis, A Sultan, A Abdel-Baki
Aim: Prediabetes and type 2 diabetes are highly prevalent among individuals with serious mental illness and increased by antipsychotic medication. Although widely recommended, many obstacles prevent these patients from obtaining a proper screening for dysglycemia. Currently, glycated hemoglobin (HbA1c), fasting glucose, and 2-hour glucose levels from the oral glucose tolerance test are used for screening prediabetes and type 2 diabetes. The objective of this study was to investigate if HbA1c could be used as the only screening test among individuals with serious mental illness...
January 12, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28062631/rule-in-and-rule-out-of-myocardial-infarction-using-cardiac-troponin-and-glycemic-biomarkers-in-patients-with-symptoms-suggestive-of-acute-coronary-syndrome
#14
Colleen Shortt, Jinhui Ma, Natasha Clayton, Jonathan Sherbino, Richard Whitlock, Guillaume Pare, Stephen A Hill, Matthew McQueen, Shamir R Mehta, P J Devereaux, Andrew Worster, Peter A Kavsak
BACKGROUND: Early rule-in/rule-out of myocardial infarction (MI) in patients presenting to the emergency department (ED) is important for patient care and resource allocation. Given that dysglycemia is a strong risk factor for MI, we sought to explore and compare different combinations of cardiac troponin (cTn) cutoffs with glycemic markers for the early rule-in/rule-out of MI. METHODS: We included ED patients (n = 1137) with symptoms suggestive of acute coronary syndrome (ACS) who had cTnI, high-sensitivity cTnI (hs-cTnI), hs-cTnT, glucose, and hemoglobin A1c (Hb A1c) measurements...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062618/use-of-biomarkers-in-predicting-the-onset-monitoring-the-progression-and-risk-stratification-for-patients-with-type-2-diabetes-mellitus
#15
REVIEW
Benjamin M Scirica
BACKGROUND: As the worldwide prevalence of type 2 diabetes mellitus (T2DM) increases, it is even more important to develop cost-effective methods to predict and diagnose the onset of diabetes, monitor progression, and risk stratify patients in terms of subsequent cardiovascular and diabetes complications. CONTENT: Nonlaboratory clinical risk scores based on risk factors and anthropomorphic data can help identify patients at greatest risk of developing diabetes, but glycemic indices (hemoglobin A1c, fasting plasma glucose, and oral glucose tolerance tests) are the cornerstones for diagnosis, and the basis for monitoring therapy...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28045401/therapeutic-approaches-targeting-inflammation-for-diabetes-and-associated-cardiovascular-risk
#16
Allison B Goldfine, Steven E Shoelson
Obesity-related sub-acute chronic inflammation has been associated with incident type 2 diabetes and atherosclerotic cardiovascular disease. Inflammation is increasingly considered to be a pathologic mediator of these commonly co-occurring diseases. A growing number of preclinical and clinical studies support the inflammatory hypothesis, but clinical trials to confirm the therapeutic potential to target inflammation to treat or prevent cardiometabolic conditions are still ongoing. There are multiple inflammatory signaling pathways...
January 3, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28039172/toward-defining-the-threshold-between-low-and-high-glucose-variability-in-diabetes
#17
Louis Monnier, Claude Colette, Anne Wojtusciszyn, Sylvie Dejager, Eric Renard, Nicolas Molinari, David R Owens
OBJECTIVE: To define the threshold for excess glucose variability (GV), one of the main features of dysglycemia in diabetes. RESEARCH DESIGN AND METHODS: A total of 376 persons with diabetes investigated at the University Hospital of Montpellier (Montpellier, France) underwent continuous glucose monitoring. Participants with type 2 diabetes were divided into several groups-groups 1, 2a, 2b, and 3 (n = 82, 28, 65, and 79, respectively)-according to treatment: 1) diet and/or insulin sensitizers alone; 2) oral therapy including an insulinotropic agent, dipeptidyl peptidase 4 inhibitors (group 2a), or sulfonylureas (group 2b); or 3) insulin...
December 30, 2016: Diabetes Care
https://www.readbyqxmd.com/read/27974345/growth-differentiation-factor-15-as-a-novel-biomarker-for-metformin
#18
Hertzel C Gerstein, Guillaume Pare, Sibylle Hess, Rebecca J Ford, Jennifer Sjaarda, Kripa Raman, Matthew McQueen, ShunFu Lee, Heinz Haenel, Gregory R Steinberg
OBJECTIVE: Metformin is a commonly used glucose-lowering drug. However, apart from glycemic measures, no biomarker for its presence or dose has been identified. RESEARCH DESIGN AND METHODS: A total of 237 biomarkers were assayed in baseline serum from 8,401 participants (2,317 receiving metformin) in the Outcome Reduction with Initial Glargine Intervention (ORIGIN) trial. Regression models were used to identify biomarkers for metformin use. RESULTS: Growth differentiation factor 15 (GDF15) was strongly linked to metformin, such that the odds of metformin use per SD increase in level varied from 3...
December 14, 2016: Diabetes Care
https://www.readbyqxmd.com/read/27965206/prior-lactation-reduces-future-diabetic-risk-through-sustained-post-weaning-effects-on-insulin-sensitivity
#19
Harpreet Bajaj, Chang Ye, Anthony J Hanley, Phil W Connelly, Mathew Sermer, Bernard Zinman, Ravi Retnakaran
Breastfeeding ≥12 months is recommended for optimal infant nutrition but may hold maternal benefits, as well. Indeed, lactation has been associated with lower long-term risk of diabetes in the mother but the mechanism by which it imparts sustained post-weaning effects on glucose tolerance remains unclear. In this context, we postulated that lactation potentially could induce post-weaning beneficial effects on glucose tolerance by modifying the natural history of insulin sensitivity and/or pancreatic beta-cell function over time...
December 13, 2016: American Journal of Physiology. Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27931981/relative-contribution-of-muscle-and-liver-insulin-resistance-to-dysglycemia-in-postmenopausal-overweight-and-obese-women-a-monet-group-study
#20
Belinda Elisha, Emmanuel Disse, Katherine Chabot, Nadine Taleb, Denis Prud'homme, Sophie Bernard, Rémi Rabasa-Lhoret, Jean-Philippe Bastard
OBJECTIVES: The relative contribution of muscle and liver insulin resistance (IR) in the development of dysglycemia and metabolic abnormalities is difficult to establish. The present study aimed to investigate the relative contribution of muscle IR vs. liver IR to dysglycemia in non-diabetic overweight or obese postmenopausal women and to determine differences in body composition and cardiometabolic indicators associated with hepatic or muscle IR. MATERIAL AND METHODS: Secondary analysis of 156 non-diabetic overweight or obese postmenopausal women...
December 5, 2016: Annales D'endocrinologie
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