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Hyperglycemia in critical patient

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https://www.readbyqxmd.com/read/29778648/impact-of-insulin-on-the-intestinal-microcirculation-in-a-model-of-sepsis-related-hyperglycemia
#1
Alexa Caldwell, Jan Niklas Morick, Anne-Marie Jentsch, Annette Wegener, Dragan Pavlovic, Nadia Al-Banna, Christian Lehmann
BACKGROUND: Sepsis involves dysfunctional glucose metabolism. Among patients with sepsis, hyperglycemia is frequent and insulin administration has been evaluated for glycemic control to improve patient outcomes. Only few studies have examined the hyperglycemic microcirculation and the impact of insulin on the microvasculature in sepsis. OBJECTIVE: To study the functional capillary density (FCD) and leukocyte activation within the intestinal microcirculation in endotoxin-induced experimental sepsis...
May 17, 2018: Microvascular Research
https://www.readbyqxmd.com/read/29777520/relationship-of-eating-patterns-and-metabolic-parameters-and-teneligliptin-treatment-interim-results-from-post-marketing-surveillance-in-japanese-type-2-diabetes-patients
#2
Takashi Kadowaki, Masakazu Haneda, Hiroshi Ito, Kazuyo Sasaki, Sonoe Hiraide, Miyuki Matsukawa, Makoto Ueno
INTRODUCTION: Healthy eating is a critical aspect of the prevention and management of type 2 diabetes (T2DM). Disrupted eating patterns can result in poor glucose control and increase the likelihood of diabetic complications. Teneligliptin inhibits dipeptidyl peptidase-4 activity for 24 h and suppresses postprandial hyperglycemia after all three daily meals. This interim analysis of data from the large-scale post-marketing surveillance of teneligliptin (RUBY) in Japan examined eating patterns and their relationship with metabolic parameters and diabetic complications...
May 17, 2018: Advances in Therapy
https://www.readbyqxmd.com/read/29756955/multicenter-study-of-parenteral-nutrition-in-non-critically-ill-elderly-patients-compared-to-younger-patients-study-iaios-pn-incidence-and-assessment-of-iatrogenesis-in-older-subjects-receiving-parenteral-nutrition
#3
Javier Mateu-de Antonio, David Berlana, Montserrat Pons-Bussom, Maria B Badia-Tahull, María Teresa Miana-Mena, Beatriz Martínez-Castro, Neus Sunyer-Esquerrà, Mónica Sanmartin-Suñer, Juan González-Valdivieso, Elisabet Leiva-Badosa, Eva Martínez-Bernabé, Anna Murgadella-Sancho, Nuria Mirerachs-Aranda, Anna Vila-Bundó, Jordi Fernández-Morató, María Teresa Vitales-Farrero
OBJECTIVE: this study assessed the incidence of hyperglycemia, hypertriglyceridemia, and liver function test (LFT) alterations among patients older and younger than 65 years receiving parenteral nutrition (PN). A secondary objective was to compare the incidence of any of these three events. MATERIAL AND METHODS: inclusion criteria were non-critically ill adult inpatients receiving PN for ≥ 7 days in 15 hospitals in Spain. Exclusion criteria were hyperglycemia, hypertriglyceridemia, LFT alterations, sepsis, shock, pancreatic/hepatobiliary surgery, renal failure, diabetes mellitus (DM) type 1, insulin-treated DM type 2, acute DM complications, or obesity prior to PN...
February 27, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29725969/differences-in-glycemic-control-in-diabetic-and-non-diabetic-patients-with-parenteral-nutrition-using-a-basal-plus-correction-insulin-regimen-an-observational-retrospective-study
#4
Analía Ramos, Fernanda Rabasa, Lilian Mendoza, Joana Cardenete, Pedro Gill, Alba Morilla, Daniel Cardona, Antonio Pérez
INTRODUCTION: Hyperglycemia is a frequent complication of parenteral nutrition (PN) in patients both with and without diabetes mellitis (DM). The aim of this study was to evaluate the quality of glucose control achieved with basal plus-correction insulin in surgical patients with and without a history of DM receiving PN. METHODS: Retrospective evaluation of a protocol applied during the period of January 2013-December 2015. The insulin dose was started at 0.4 and 0...
May 3, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29713388/post-operative-stress-hyperglycemia-is-a-predictor-of-mortality-in-liver-transplantation
#5
Elena Giráldez, Evaristo Varo, Ipek Guler, Carmen Cadarso-Suarez, Santiago Tomé, Patricia Barral, Antonio Garrote, Francisco Gude
Background: A significant association is known between increased glycaemic variability and mortality in critical patients. To ascertain whether glycaemic profiles during the first week after liver transplantation might be associated with long-term mortality in these patients, by analysing whether diabetic status modified this relationship. Method: Observational long-term survival study includes 642 subjects undergoing liver transplantation from July 1994 to July 2011...
2018: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/29688879/managing-diabetes-in-patients-hospitalized-in-internal-medicine-units
#6
Irit Hochberg
Diabetes and hyperglycemia are present in over one-third of inpatients in internal medicine units and are associated with worse prognosis in multiple morbidities. Treatment of inpatient hyperglycemia is usually with basal bolus insulin in a dose calculated by the patient's weight, with lower doses recommended in patients who are at a higher risk for hypoglycemia. Other antihyperglycemic medications and insulin regimens can be used in selected patients. There are no adequately powered studies on the effect of improving glycemic control on hospitalization outcomes in non-critically ill patients in internal medicine units, and in most patients a modest glucose target of 140-180 mg/dL is recommended...
April 19, 2018: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/29661504/stress-induced-hyperglycemia-on-complications-in-non-critically-elderly-hospitalized-patients
#7
F J Carrasco-Sánchez, J Carretero-Gómez, R Gómez-Huelgas, M A Garcia-Ordoñez, M V Pardo-Ortega, B de Escalante-Yanguela, L Mateos-Polo, F Formiga, J Ena
AIMS: Hospital complications and hyperglycemia are common in elderly patients during hospitalization. Our aim was to analyze the relationship between hyperglycemia and hospital complications in an ageing population. METHODS: We conducted an observational study to evaluate the association between maximum blood glucose (MBG) levels and hospital complications. Patients were stratified according to the quartiles of MBG levels. Diabetes mellitus (DM) was determined by patient history and/or admission glycated hemoglobin (HbA1c) level ≥6...
April 13, 2018: Revista Clínica Española
https://www.readbyqxmd.com/read/29657375/comparison-of-glycemic-control-between-continuous-regular-insulin-infusion-and-single-dose-subcutaneous-insulin-glargine-injection-in-medical-critically-ill-patients
#8
Rungsun Bhurayanontachai, Tharittamon Rattanaprapat, Chanon Kongkamol
Background and Aims: This study aimed to compare glycemic control between continuous intravenous regular insulin infusion and single-dose subcutaneous insulin glargine injection in medical critically ill patients. Subjects and Methods: A prospective noninferiority study was conducted in medical critically ill patients who developed hyperglycemia and required regular insulin infusion by the Intensive Care Unit glycemic control protocol. The eligible patients were switched from the daily regular insulin requirement to single-dose subcutaneous insulin glargine injection by a 100% conversion dose...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29649637/angiogenesis-impairment-by-the-nadph-oxidase-triggered-oxidative-stress-at-the-bone-implant-interface-critical-mechanisms-and-therapeutic-targets-for-implant-failure-under-hyperglycemic-conditions-in-diabetes
#9
Xiao-Fan Hu, Lin Wang, Geng Xiang, Wei Lei, Ya-Fei Feng
Mechanism underlying the diabetes-induced poor osteointegration of implants remains elusive, making it a challenge to develop corresponding solutions. Here, we studied the role of angiogenesis in the diabetes-induced poor bone repair at the bone-implant interface (BII) and the related mechanisms. In vivo, titanium screws were implanted in the femurs of mice, and, in vitro, vascular endothelial cell (VEC) was cultured on titanium surface. Results showed that, compared with normal milieu (NM), diabetic milieu (DM) led to angiogenesis inhibition around implants which resulted in reduced osteoprogenitors and poor bone formation on BII in vivo...
April 9, 2018: Acta Biomaterialia
https://www.readbyqxmd.com/read/29556093/hypertension-with-diabetes-mellitus-physiology-and-pathology
#10
REVIEW
Mitsuru Ohishi
Elevated blood pressure is closely related to increased circulatory fluid volume and peripheral vascular resistance. Patients with diabetes mellitus experience increased peripheral artery resistance caused by vascular remodeling and increased body fluid volume associated with insulin resistance-induced hyperinsulinemia and hyperglycemia. Both of these mechanisms elevate systemic blood pressure. Thus, fully understanding the pathophysiology of hypertension in diabetes mellitus requires knowing the natural history of type 2 diabetes...
March 19, 2018: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/29550034/overfeeding-associated-hyperglycemia-and-injury-response-homeostasis-in-critically-ill-neonates
#11
Tina Tian, Joshua Coons, Hong Chang, Walter J Chwals
BACKGROUND: Injury severity induces a proportionate acute metabolic stress response, associated with increased risk of hyperglycemia. We hypothesized that excess caloric delivery (overfeeding) during high stress states would increase hyperglycemia and disrupt response homeostasis. METHODS: Gestational age, daily weight, total daily caloric intake, serum C-reactive protein (CRP), prealbumin, and blood glucose concentrations in all acutely-injured premature NICU infants requiring TPN over the past 3years were reviewed...
December 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29501063/tight-glycemic-control-in-critically-ill-pediatric-patients-a-systematic-review-and-meta-analysis
#12
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
https://www.readbyqxmd.com/read/29492325/management-of-concomitant-metabolic-encephalopathy-and-meningioma-with-vasogenic-edema-and-impending-herniation
#13
Ramsis F Ghaly, Armen Haroutunian, Kenneth D Candido, Nebojsa Nick Knezevic
Background: Altered mental status describes impaired mental functioning ranging from confusion to coma and indicates an illness, either metabolic or structural in nature. Metabolic causes include hypothyroidism, hyperuremia, hypo/hyperglycemia, hypo/hypernatremia, and encephalopathy. The structural causes include tumors, brain hemorrhage, infection, and stroke. To our knowledge, this is the first case in which a patient presented with altered mental status from both metabolic (myxedema coma) and structural diseases (frontal meningioma) with vasogenic edema and midline shift...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29479638/critical-care-management-of-stress-induced-hyperglycemia
#14
REVIEW
Ilse Vanhorebeek, Jan Gunst, Greet Van den Berghe
PURPOSE OF REVIEW: We discuss key studies that have set the scene for the debate on the efficacy and safety of tight glycemic control in critically ill patients, highlighting important differences among them, and describe the ensuing search towards strategies for safer glucose control. RECENT FINDINGS: Differences in level of glycemic control, glucose measurement and insulin administration, expertise, and nutritional management may explain the divergent outcomes of the landmark studies on tight glycemic control in critical illness...
February 26, 2018: Current Diabetes Reports
https://www.readbyqxmd.com/read/29459791/different-enteral-nutrition-formulas-have-no-effect-on-glucose-homeostasis-but-on-diet-induced-thermogenesis-in-critically-ill-medical-patients-a-randomized-controlled-trial
#15
Marlene Wewalka, Andreas Drolz, Berit Seeland, Mathias Schneeweiss, Monika Schmid, Bruno Schneeweiss, Christian Zauner
BACKGROUND/OBJECTIVES: Hyperglycemia is common in critically ill patients and associated with increased mortality. It has been suggested that different nutrition formulas may beneficially influence glucose levels in surgical intensive care patients. In this prospective randomized clinical cohort study we investigated glucose homeostasis in response to different enteral nutrition formulas in medical critically ill patients. SUBJECTS/METHODS: 60 medical critically ill patients were randomized to receive continuous fat-based (group A, n = 30) or glucose-based enteral nutrition (group B, n = 30) for seven days...
April 2018: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29457786/intracellular-lipid-metabolism-impairs-%C3%AE-cell-compensation-during-diet-induced-obesity
#16
Risheng Ye, Ruth Gordillo, Mengle Shao, Toshiharu Onodera, Zhe Chen, Shiuhwei Chen, Xiaoli Lin, Jeffrey A SoRelle, Xiaohong Li, Miao Tang, Mark P Keller, Regina Kuliawat, Alan D Attie, Rana K Gupta, William L Holland, Bruce Beutler, Joachim Herz, Philipp E Scherer
The compensatory proliferation of insulin-producing β cells is critical to maintaining glucose homeostasis at the early stage of type 2 diabetes. Failure of β cells to proliferate results in hyperglycemia and insulin dependence in patients. To understand the effect of the interplay between β cell compensation and lipid metabolism upon obesity and peripheral insulin resistance, we eliminated LDL receptor-related protein 1 (LRP1), a pleiotropic mediator of cholesterol, insulin, energy metabolism, and other cellular processes, in β cells...
March 1, 2018: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29443547/modeling-heart-failure-risk-in-diabetes-and-kidney-disease-limitations-and-potential-applications-of-transverse-aortic-constriction-in-high-fat-fed-mice
#17
Wei Sheng Tan, Thomas P Mullins, Melanie Flint, Sarah L Walton, Helle Bielefeldt-Ohmann, David A Carter, Meera R Gandhi, Hayley R McDonald, Joan Li, Karen M Moritz, Melissa E Reichelt, Linda A Gallo
There is an increased incidence of heart failure in individuals with diabetes mellitus (DM). The co-existence of kidney disease in DM exacerbates the cardiovascular prognosis. Researchers have attempted to combine the critical features of heart failure, using transverse aortic constriction, with DM in mice but variable findings have been reported. Furthermore, kidney outcomes have not been assessed in this setting thus its utility as a model of heart failure in DM and kidney disease is unknown. We generated a mouse model of obesity, hyperglycemia and mild kidney pathology by feeding male C57BL/6J mice a high fat diet (HFD)...
February 14, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29442175/common-models-used-for-inpatient-diabetes-management
#18
REVIEW
Andjela T Drincic, Padmaja Akkireddy, Jon T Knezevich
PURPOSE OF REVIEW: Diabetes affects about a third of all hospitalized patients and up to 50% of inpatients go on to experience hyperglycemia. Despite strong evidence supporting the importance of adequate glycemic control, as well detailed guidelines from major national organizations, many patients continue to have hypo- and hyperglycemia during their hospital stay. While this may be partially related to provider and patient-specific factors, system-based barriers continue to pose a major obstacle...
February 14, 2018: Current Diabetes Reports
https://www.readbyqxmd.com/read/29439517/hyperglycemia-alters-the-structure-and-hemodynamics-of-the-developing-embryonic-heart
#19
Taylor B Lawson, Devon E Scott-Drechsel, Venkat Keshav Chivukula, Sandra Rugonyi, Kent L Thornburg, Monica T Hinds
Congenital heart defects (CHDs) represent the most common form of human birth defects; approximately one-third of heart defects involve malformations of the outflow tract (OFT). Maternal diabetes increases the risk of CHD by 3-5 fold. During heart organogenesis, little is known about the effects of hyperglycemia on hemodynamics, which are critical to normal heart development. Heart development prior to septation in the chick embryo was studied under hyperglycemic conditions. Sustained hyperglycemic conditions were induced, raising the average plasma glucose concentration from 70 mg/dL to 180 mg/dL, akin to the fasting plasma glucose of a patient with diabetes...
February 12, 2018: Journal of Cardiovascular Development and Disease
https://www.readbyqxmd.com/read/29430446/models-of-disuse-muscle-atrophy-therapeutic-implications-in-critically-ill-patients
#20
REVIEW
Esther Barreiro
Skeletal muscle weakness is common in the intensive care units (ICU). Approximately 50% of patients under mechanical ventilation for more than 7 days show signs of ICU-acquired muscle weakness. In these patients, muscle weakness may be the result of axonal polyneuropathy, myopathy or a combination of both. The commonest risk factors in patients with ICU-acquired weakness (AW) are the severity and duration of the systemic inflammatory response, duration of the stay in the ICU and of mechanical ventilation, hyperglycemia, hypoalbuminemia, parenteral nutrition, and administration of corticosteroids and of neuromuscular blocking agents...
January 2018: Annals of Translational Medicine
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