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Glycemic variability

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https://www.readbyqxmd.com/read/28928674/the-gly-16-allele-of-the-g16r-single-nucleotide-polymorphism-in-the-%C3%AE-2-adrenergic-receptor-gene-augments-the-glycemic-response-to-adrenaline-in-humans
#1
Kim Z Rokamp, Jonatan M Staalsø, Morten Zaar, Peter Rasmussen, Lonnie G Petersen, Rikke V Nielsen, Niels H Secher, Niels V Olsen, Henning B Nielsen
Cerebral non-oxidative carbohydrate consumption may be driven by a β2-adrenergic mechanism. This study tested whether the 46G > A (G16R) single nucleotide polymorphism of the β2-adrenergic receptor gene (ADRB2) influences the metabolic and cerebrovascular responses to administration of adrenaline. Forty healthy Caucasian men were included from a group of genotyped individuals. Cardio- and cerebrovascular variables at baseline and during a 60-min adrenaline infusion (0.06 μg kg(-1) min(-1)) were measured by Model flow, near-infrared spectroscopy and transcranial Doppler sonography...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28928117/risk-factors-for-severe-hypoglycemia-in-black-and-white-adults-with-diabetes-the-atherosclerosis-risk-in-communities-aric-study
#2
Alexandra K Lee, Clare J Lee, Elbert S Huang, A Richey Sharrett, Josef Coresh, Elizabeth Selvin
OBJECTIVE: Severe hypoglycemia is a rare but important complication of type 2 diabetes. Few studies have examined the epidemiology of hypoglycemia in a community-based population. RESEARCH DESIGN AND METHODS: We included 1,206 Atherosclerosis Risk in Communities (ARIC) Study participants with diagnosed diabetes (baseline, 1996-1998). Severe hypoglycemic events were identified through 2013 by ICD-9 codes from claims for hospitalizations, emergency department visits, and ambulance use...
September 19, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28922296/trajectories-of-glycemic-change-in-a-national-cohort-of-adults-with-previously-controlled-type-2-diabetes
#3
Rozalina G McCoy, Che Ngufor, Holly K Van Houten, Brian Caffo, Nilay D Shah
BACKGROUND: Individualized diabetes management would benefit from prospectively identifying well-controlled patients at risk of losing glycemic control. OBJECTIVES: To identify patterns of hemoglobin A1c (HbA1c) change among patients with stable controlled diabetes. RESEARCH DESIGN: Cohort study using OptumLabs Data Warehouse, 2001-2013. We develop and apply a machine learning framework that uses a Bayesian estimation of the mixture of generalized linear mixed effect models to discover glycemic trajectories, and a random forest feature contribution method to identify patient characteristics predictive of their future glycemic trajectories...
September 15, 2017: Medical Care
https://www.readbyqxmd.com/read/28921914/comparison-of-relation-between-multiple-parameters-of-glycemic-variability-and-coronary-plaque-vulnerability-assessed-by-virtual-histology-intravascular-ultrasound
#4
Natsu Otowa-Suematsu, Kazuhiko Sakaguchi, Hisako Komada, Tomoaki Nakamura, Anna Sou, Yushi Hirota, Masaru Kuroda, Toshiro Shinke, Ken-Ich Hirata, Wataru Ogawa
AIMS/INTRODUCTION: Increased glycemic variability is an important contributing factor to coronary artery disease. Although various parameters of glycemic variability can be derived by continuous glucose monitoring, the clinical relevance of individual parameters has remained unclear. We have now analyzed the relation of such parameters to coronary plaque vulnerability MATERIALS AND METHODS: The standard deviation of glucose levels (SD glucose), mean amplitude of glycemic excursions (MAGE), continuous overlapping net glycemic action calculated every 1 h (CONGA-1), and mean of daily differences (MODD) were calculated from continuous glucose monitoring data for 53 subjects hospitalized for percutaneous coronary intervention...
September 16, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28921908/biphasic-insulin-aspart-30-reduces-glycemic-variability-to-a-greater-degree-than-insulin-detemir-a-randomized-controlled-trial-of-once-daily-insulin-regimens-using-continuous-glucose-monitoring
#5
Daisuke Tsujino, Rimei Nishimura, Yoshiko Onda, Chiaki Seo, Kiyotaka Ando, Kazunori Utsunomiya
INTRODUCTION: We compared the efficacy of insulin detemir and biphasic insulin aspart-30 given in the morning as an add-on to oral hypoglycemic agents (OHAs) in type 2 diabetic patients. MATERIALS AND METHODS: This study enrolled 30 patients with poorly controlled type 2 diabetes (8%≤HbA1c<11%) being treated with OHA mono- or combination therapy with biguanides, sulfonylureas, or thiazolidinediones. The patients were randomly assigned to insulin detemir (group D) or insulin aspart-30 (group A) given in the morning as add-on to OHAs...
September 16, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28918342/the-potential-effect-of-ultra-long-insulin-degludec-on-glycemic-variability
#6
REVIEW
M Rodacki, R M Carvalho, L Zajdenverg
Despite the therapeutic advances in the treatment of diabetes, metabolic control instability due to glycemic variability (GV) is frequently observed in patients with diabetes on intensive insulin therapy and is associated with hyperglycemic peaks and hypoglycemic episodes. Hyperglycemia associated with GV has been implicated in the development of chronic complications due to its pro-oxidative consequences. On the other hand, hypoglycemia can be associated with increased cardiovascular risk secondarily to adrenergic activation...
June 30, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28916591/continuous-glucose-monitoring-in-very-preterm-infants-a-randomized-controlled-trial
#7
Alfonso Galderisi, Andrea Facchinetti, Garry M Steil, Paulina Ortiz-Rubio, Francesco Cavallin, William V Tamborlane, Eugenio Baraldi, Claudio Cobelli, Daniele Trevisanuto
BACKGROUND AND OBJECTIVES: Impaired glucose control in very preterm infants is associated with increased morbidity, mortality, and poor neurologic outcome. Strategies based on insulin titration have been unsuccessful in achieving euglycemia in absence of an increase in hypoglycemia and mortality. We sought to assess whether glucose administration guided by continuous glucose monitoring (CGM) is more effective than standard of care blood glucose monitoring in maintaining euglycemia in very preterm infants...
September 15, 2017: Pediatrics
https://www.readbyqxmd.com/read/28913745/management-of-type-1-diabetes-in-the-hospital-setting
#8
REVIEW
Carlos E Mendez, Guillermo E Umpierrez
PURPOSE OF REVIEW: The purpose of this article was to review recent guideline recommendations on glycemic target, glucose monitoring, and therapeutic strategies, while providing practical recommendations for the management of medical and surgical patients with type 1 diabetes (T1D) admitted to critical and non-critical care settings. RECENT FINDINGS: Studies evaluating safety and efficacy of insulin pump therapy, continuous glucose monitoring, electronic glucose management systems, and closed loop systems for the inpatient management of hyperglycemia are described...
September 14, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28913365/frequency-and-predictors-of-self-reported-hypoglycemia-in-insulin-treated-diabetes
#9
Samir Malkani, Anupam Kotwal
AIMS: Hypoglycemia is a limiting factor for achieving stringent glycemic control in diabetes. This study analyzes the frequency and predictors of hypoglycemia in insulin-treated diabetes in an ambulatory setting. METHODS: A retrospective chart review was performed to study self-monitored blood glucose (SMBG) data for 3 months prior to a patient's HbA1c test. RESULTS: Hypoglycemia occurred more frequently in type 1 than in type 2 diabetes; however, 19% of type 2 diabetes patients did experience at least one episode of severe hypoglycemia...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28911302/what-is-the-real-efficacy-of-beta-blockers-for-the-treatment-of-essential-hypertension
#10
Christian Höcht, Facundo M Bertera, Julieta S Del Mauro, Yanina Santander Plantamura, Carlos A Taira, Ariel H Polizio
OBJECTIVE: This review covers the pharmacokinetics and pharmacodynamic of β-blockers, the rationale for their use, some recent controversies in its use for managing hypertension, as well as, the beneficial properties of the third-generation β-blockers beyond hypertension. BACKGROUND: The efficacy and safety of -blockers in the treatment of hypertension and other cardiovascular diseases have been established during more than 50 years of clinical experience. Recent updates of clinical guidelines have downgraded the use of -blockers for the treatment of uncomplicated hypertension to second and third line therapy...
June 7, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28885369/influencing-factors-of-glycemic-variability-in-hospitalized-type-2-diabetes-patients-with-insulin-therapy-a-strobe-compliant-article
#11
Ya Huang, Chunni Heng, Jing Wei, Xiaorui Jing, Xiaoguang Wang, Guohong Zhao, Junfeng Hou, Qingquan Liu, Kai Jiao
Previous studies have shown that glucose fluctuation is closely related to oxidative stress and diabetic complications. However, only few studies have evaluated the influencing factors of glycemic variability (GV) in type 2 diabetes (T2D) patients so far.This was a cross-sectional study design. A total of 366 cases of hospitalized patients with T2D using insulin therapy, whom received continuous glucose monitoring from January 2014 to December 2016, were enrolled for this study. The evaluation variables of GV included standard deviation of blood glucose, coefficient of variation (CV%), mean amplitude of glycemic excursion, and absolute means of daily differences...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28883231/the-assessment-of-the-efficacy-of-dipeptidyl-peptidase-4-inhibitors-in-patients-with-glucocorticoid-induced-diabetes-by-continuous-glucose-monitoring
#12
Yusuke Yata, Michihiro Hosojima, Hideyuki Kabasawa, Tomomi Ishikawa, Ryohei Kaseda, Noriaki Iino, Yoshiki Suzuki, Akihiko Saito, Ichiei Narita
Objective The administration of glucocorticoids usually causes a mild increase in fasting glucose levels and a greater dose-dependent increase in postprandial values in patients without pre-existing diabetes mellitus. Patients with persistent hyperglycemia due to glucocorticoid therapy sometimes require insulin therapy, which might result in increased weight gain and more episodes of hypoglycemia, some of which are severe. On the other hand, scant evidence is available on the efficacy of oral hypoglycemic agents in treating glucocorticoid-induced diabetes...
September 6, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28880933/range-of-glucose-as-a-glycemic-variability-and-3-month-outcome-in-diabetic-patients-with-acute-ischemic-stroke
#13
Young Seo Kim, Chulho Kim, Keun-Hwa Jung, Hyung-Min Kwon, Sung Hyuk Heo, Beom Joon Kim, Young Dae Kim, Jeong-Min Kim, Seung-Hoon Lee
Glycemic variability (GV) is reportedly a predictor for poor outcome in various clinical conditions. We aimed to assess whether GV during hospital admission is associated with poor outcomes in patients with acute ischemic stroke (AIS) and diabetes. We prospectively enrolled consecutive patients with AIS from the registry of 6 tertiary hospitals between January 2013 and December 2014. For the GV index, we used a glucose level range that was divided into 4 quartiles. Multivariable binary and ordinal logistic regression analyses were performed to determine the association between GV and the modified Rankin Scale score (3-6) at 3 months...
2017: PloS One
https://www.readbyqxmd.com/read/28870122/diabetes-fatalism-and-its-emotional-distress-subscale-are-independent-predictors-of-glycemic-control-among-lebanese-patients-with-type-2-diabetes
#14
Ola Sukkarieh-Haraty, Leonard E Egede, Joelle Abi Kharma, Maya Bassil
BACKGROUND: Achieving and sustaining optimal glycemic control in type 2 diabetes (T2DM) is difficult because of socio-cultural and psychosocial factors including diabetes fatalism. Diabetes fatalism is 'a complex psychological cycle characterized by perceptions of despair, hopelessness, and powerlessness'. PURPOSE: The purpose of this paper is to explore whether diabetes fatalism and other psychosocial and socio-cultural variables are correlates of glycemic control in Lebanese population with T2DM...
September 4, 2017: Ethnicity & Health
https://www.readbyqxmd.com/read/28868826/determinants-of-long-term-durable-glycemic-control-in-new-onset-type-2-diabetes-mellitus
#15
Kyoung Jin Kim, Ju Hee Choi, Kyeong Jin Kim, Jee Hyun An, Hee Young Kim, Sin Gon Kim, Nam Hoon Kim
BACKGROUND: Long-term durable glycemic control is a difficult goal in the management of type 2 diabetes mellitus (T2DM). We evaluated the factors associated with durable glycemic control in a real clinical setting. METHODS: We retrospectively reviewed the medical records of 194 new-onset, drug-naïve patients with T2DM who were diagnosed between January 2011 and March 2013, and were followed up for >2 years. Glycemic durability was defined as the maintenance of optimal glycemic control (glycosylated hemoglobin [HbA1c] <7...
August 2017: Diabetes & Metabolism Journal
https://www.readbyqxmd.com/read/28867097/nutritional-composition-in-relation-to-glycemic-potential-of-popular-indian-rice-varieties
#16
V S S Prasad, A Hymavathi, V Ravindra Babu, T Longvah
Diabetes, a chronic hyperglycemic disorder, is a public health concern in India. High glycemic carbohydrate foods are linked to higher risk of diabetes. The chemical composition and in vivo glycemic potential of popular Indian rice varieties namely Jaya, Lalat, NDR-97, PR-113, Salivahana, Sasyasree, Savithri, Tellahamsa, Triguna, Varalu and one hybrid DRRH-3, having wide agronomical and grain morphological features were studied. Nutrient composition varied prominently among different varieties. Resistant starch (RS) content (2...
January 1, 2018: Food Chemistry
https://www.readbyqxmd.com/read/28862933/quality-of-care-of-the-initial-patient-cohort-of-the-diabetes-collaborative-registry-%C3%A2
#17
Suzanne V Arnold, Abhinav Goyal, Silvio E Inzucchi, Darren K McGuire, Fengming Tang, Sanjeev N Mehta, Laurence S Sperling, Thomas M Maddox, Daniel Einhorn, Nathan D Wong, Niklas Hammar, Peter Fenici, Kamlesh Khunti, Carolyn S P Lam, Mikhail Kosiborod
BACKGROUND: Although guidelines and performance measures exist for patients with diabetes mellitus, achievement of these metrics is not well known. The Diabetes Collaborative Registry(®) (DCR) was formed to understand the quality of diabetes mellitus care across the primary and specialty care continuum in the United States. METHODS AND RESULTS: We assessed the frequency of achievement of 7 diabetes mellitus-related quality metrics and variability across the Diabetes Collaborative Registry(®) sites...
August 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28856591/tsh-oscillations-in-young-patients-with-type-1-diabetes-may-be-due-to-glycemic-variability
#18
G Bellastella, M I Maiorino, L Scappaticcio, O Casciano, M Petrizzo, M Caputo, V A Paglionico, D Giugliano, K Esposito
PURPOSE: A relationship between thyroid dysfunction and diabetes mellitus has been described by several authors but the role of glycemic variability is still unclear. We planned the present study to evaluate the influence of glycemic variability on thyroid hormones and TSH concentrations in patients with type 1 diabetes mellitus (T1DM). METHODS: Seventy-seven young patients with T1DM were enrolled and evaluated for basal glucose concentrations, HbA1c, thyroid hormones and TSH concentrations...
August 30, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28855892/albuminuria-reduction-after-high-dose-of-vitamin-d-in-patients-with-type-1-diabetes-mellitus-a-pilot-study
#19
João Soares Felício, Alana Ferreira de Oliveira, Amanda Soares Peixoto, Ana Carolina Contente Braga de Souza, João Felício Abrahão Neto, Franciane Trindade Cunha de Melo, Carolina Tavares Carvalho, Manuela Nascimento de Lemos, Sávio Diego Nascimento Cavalcante, Fabricio de Souza Resende, Márcia Costa Dos Santos, Ana Regina Motta, Luísa Corrêa Janaú, Elizabeth Sumi Yamada, Karem Miléo Felício
BACKGROUND: Some studies suggest an association between diabetic kidney disease (DKD) and vitamin D (VD), but there is no data about the effect of high dose of VD on DKD in type 1 diabetes mellitus (T1DM). Our pilot study aims to evaluate albuminuria reduction in patients with T1DM supplemented with high dose of VD. METHODS: 22 patients received doses of 4,000 and 10,000 IU/day of cholecalciferol for 12 weeks according to patient's previous VD levels. They were submitted to continuous glucose monitoring system, 24 hours ambulatory blood pressure monitoring and urine albumin-to-creatinine ratio before and after VD supplementation...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28855269/roles-of-increased-glycemic-variability-glp-1-and-glucagon-in-hypoglycaemia-after-roux-en-y-gastric-bypass
#20
George Tharakan, Preeshila Behary, Nicolai Jacob Wewer Albrechtsen, Harvinder Chahal, Julia Kenkre, Alexander D Miras, Ahmed R Ahmed, Jens Juul Holst, Steve R Bloom, Tricia Mei Mei Tan
Objective Roux-en-Y Gastric Bypass (RYGB) surgery is currently the most effective treatment for diabetes and obesity. An increasingly recognized complication of RYGB surgery is postprandial hypoglycemia (PPH). The pathophysiology of PPH remains unclear with multiple mechanisms suggested including nesidioblastosis, altered insulin clearance and increased glucagon-like-1 peptide (GLP-1) secretion. Whilst many PPH patients respond to dietary modification, some have severely disabling symptoms. Multiple treatments have been trialled ranging from acarbose, to both GLP-1 agonists and antagonists, even to reversal of RYGB...
August 30, 2017: European Journal of Endocrinology
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