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Hyperglycemia in critical patient

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https://www.readbyqxmd.com/read/28528862/crocetin-restores-diabetic-endothelial-progenitor-cell-dysfunction-by-enhancing-no-bioavailability-via-regulation-of-pi3k-akt-enos-and-ros-pathways
#1
Wei Cao, Jinjin Cui, Shufeng Li, Donghui Zhang, Yibo Guo, Qiannan Li, Ying Luan, Xian Liu
AIMS: Endothelial progenitor cell (EPC) dysfunction underlies a critical risk factor in diabetic vascular complications due to function defect in restoring endothelium injury. Crocetin has attracted increasing attention in several vascular-related diseases. In present study, we aimed to explore the role of crocetin in diabetic EPC dysfunction. MAIN METHODS: EPCs were isolated from bone marrow in diabetic mice and identified using the fluorescence staining and flow cytometry...
May 18, 2017: Life Sciences
https://www.readbyqxmd.com/read/28526186/cardiovascular-protection-in-the-treatment-of-type-2-diabetes-a-review-of-clinical-trial-results-across-drug-classes
#2
Francesco Paneni, Thomas F Lüscher
Patients with type 2 diabetes (T2DM) have a significantly higher risk of developing cardiovascular disease (CVD)-namely myocardial infarction, heart failure, and stroke. Despite clear advances in the prevention and treatment of CVD, the impact of T2DM on CVD outcome remains high and continues to escalate. Available evidence indicates that the risk of macrovascular complications increases with the severity of hyperglycemia, thus suggesting that the relation between metabolic disturbances and vascular damage is approximately linear...
May 15, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28515940/nivolumab-induced-autoimmune-diabetes-mellitus-presenting-as-diabetic-ketoacidosis-in-a-patient-with-metastatic-lung-cancer
#3
James Luke Godwin, Shuchie Jaggi, Imali Sirisena, Pankaj Sharda, Ajay D Rao, Ranee Mehra, Colleen Veloski
BACKGROUND: Advances in cancer immunotherapy have generated encouraging results in multiple malignancies refractory to standard chemotherapies. As the use of immune checkpoint inhibitors (ICI) proliferates, the incidence of autoimmune side effects associated with these agents, termed immune related adverse events (irAE), is expected to increase. The frequency of significant irAE in ICI treated patients is about 10-20% and early recognition is critical to prevent serious morbidity and even mortality...
2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28511644/relationship-between-glycemic-levels-and-treatment-outcome-among-critically-ill-children-admitted-into-emergency-room-in-enugu
#4
Nwachinemere Davidson Uleanya, Elias Chikee Aniwada, Ikenna Chidiebele Nwokoye, Ikenna Kingsley Ndu, Christopher Bismarck Eke
BACKGROUND: Critically ill children are those in need of immediate attention on arrival to an emergency room. The importance of glycemic level measurement as well as maintaining the patency of the airway, effective breathing and circulation cannot be overemphasied. It has been highlighted that the peak hyperglycemia and hypoglycemia predict poor prognosis, longer lengths of hospital stay and higher mortality. The study aims to assess the relationship between glycemic level and treatment outcomes as well as length of hospital stay...
May 16, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28504650/neutrophil-derived-s100-calcium-binding-proteins-a8-a9-promote-reticulated-thrombocytosis-and-atherogenesis-in-diabetes
#5
Michael J Kraakman, Man K S Lee, Annas Al-Sharea, Dragana Dragoljevic, Tessa J Barrett, Emilie Montenont, Debapriya Basu, Sarah Heywood, Helene L Kammoun, Michelle Flynn, Alexandra Whillas, Nordin M J Hanssen, Mark A Febbraio, Erik Westein, Edward A Fisher, Jaye Chin-Dusting, Mark E Cooper, Jeffrey S Berger, Ira J Goldberg, Prabhakara R Nagareddy, Andrew J Murphy
Platelets play a critical role in atherogenesis and thrombosis-mediated myocardial ischemia, processes that are accelerated in diabetes. Whether hyperglycemia promotes platelet production and whether enhanced platelet production contributes to enhanced atherothrombosis remains unknown. Here we found that in response to hyperglycemia, neutrophil-derived S100 calcium-binding proteins A8/A9 (S100A8/A9) interact with the receptor for advanced glycation end products (RAGE) on hepatic Kupffer cells, resulting in increased production of IL-6, a pleiotropic cytokine that is implicated in inflammatory thrombocytosis...
May 15, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28497374/the-effect-of-insulin-administration-on-c-peptide-in-critically-ill-patients-with-type-2-diabetes
#6
Marco Crisman, Luca Lucchetta, Nora Luethi, Luca Cioccari, Que Lam, Glenn M Eastwood, Rinaldo Bellomo, Johan Mårtensson
BACKGROUND: In critically ill patients with permissive hyperglycemia, it is uncertain whether exogenous insulin administration suppresses or enhances c-peptide secretion (a marker of pancreatic beta-cell response). We aimed to explore this effect in patients with type 2 diabetes. METHODS: We prospectively enrolled a cohort of 45 critically ill patients with type 2 diabetes managed according to a liberal glucose protocol (target blood glucose 10-14 mmol/l). We recorded the administration of insulin and oral hypoglycemic agents and measured plasma c-peptide as surrogate marker of endogenous insulin secretion on the first two consecutive days in ICU...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28495827/hyperbaric-oxygen-reduces-infarction-volume-and-hemorrhagic-transformation-through-atp-nad-sirt1-pathway-in-hyperglycemic-middle-cerebral-artery-occlusion-rats
#7
Qin Hu, Anatol Manaenko, Hetao Bian, Zongduo Guo, Jun-Long Huang, Zhen-Ni Guo, Peng Yang, Jiping Tang, John H Zhang
BACKGROUND AND PURPOSE: Energy depletion is a critical factor leading to cell death and brain dysfunction after ischemic stroke. In this study, we investigated whether energy depletion is involved in hyperglycemia-induced hemorrhagic transformation after ischemic stroke and determined the pathway underlying the beneficial effects of hyperbaric oxygen (HBO). METHODS: After 2-hour middle cerebral artery occlusion, hyperglycemia was induced by injecting 50% dextrose (6 mL/kg) intraperitoneally at the onset of reperfusion...
May 11, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28468528/improving-physical-health-of-patients-with-severe-mental-disorders-a-critical-review-of-lifestyle-psychosocial-interventions
#8
Corrado De Rosa, Gaia Sampogna, Mario Luciano, Valeria Del Vecchio, Benedetta Pocai, Giuseppina Borriello, Vincenzo Giallonardo, Micaela Savorani, Federica Pinna, Maurizio Pompili, Andrea Fiorillo
People with severe mental disorders have a mortality rate that is more than two times higher than the general population, with at least a decade of potential years of life lost. People with mental disorders have a significantly higher risk of obesity, hyperglycemia and metabolic syndrome, which are related to modifiable risk factors, such as heavy smoking, poor physical activities, and inappropriate unhealthy diet, which can be improved through lifestyle changes. Areas covered: Lifestyle behaviours are amenable to change through the adoption of specific psychosocial interventions, and several approaches have been promoted...
May 3, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28444346/resistant-starch-as-a-novel-dietary-strategy-to-maintain-kidney-health-in-diabetes-mellitus
#9
Gar Yee Koh, Matthew J Rowling
The worldwide prevalence of diabetes mellitus is expected to reach 439 million by 2030. Diabetes increases the risk for developing secondary complications such as nephropathy and cardiovascular disease, critical factors that dictate the survival rate of diabetes patients. Compelling evidence has indicated that the positive impact of fermentable carbohydrates in obesity-related diabetes is mediated by the production of short-chain fatty acids and the modulation of colonic microbiota. This review summarizes the potential implications of dietary resistant starch, a class of fermentable fiber, in glucose homeostasis and kidney health in obesity-associated diabetes and examines the mechanisms underlying the protective effect of resistant starch...
May 1, 2017: Nutrition Reviews
https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#10
Inge Hommel, Petra J van Gurp, Alfons A den Broeder, Hub Wollersheim, Femke Atsma, Marlies E J L Hulscher, Cees J Tack
As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care...
April 24, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28400681/blood-glucose-variability-and-outcomes-in-critically-ill-children
#11
Kirti Mahadeorao Naranje, Banani Poddar, Arpita Bhriguvanshi, Richa Lal, Afzal Azim, Ratender K Singh, Mohan Gurjar, Arvind K Baronia
OBJECTIVES: To find the incidence of hyperglycemia (blood glucose [BG] ≥150 mg/dl), hypoglycemia (BG ≤60 mg/dl), and variability (presence of hypoglycemia and hyperglycemia) in critically ill children in the 1(st) week of Intensive Care Unit (ICU) stay and their association with mortality, length of ICU stay, and organ dysfunction. MATERIALS AND METHODS: The design was a retrospective observational cohort study. Consecutive children ≤18 years of age admitted from March 2003 to April 2012 in a combined adult and pediatric closed ICU...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28344751/management-of-critically-ill-patients-with-diabetes
#12
REVIEW
Livier Josefina Silva-Perez, Mario Alberto Benitez-Lopez, Joseph Varon, Salim Surani
Disorders of glucose homeostasis, such as stress-induced hypoglycemia and hyperglycemia, are common complications in patients in the intensive care unit. Patients with preexisting diabetes mellitus (DM) are more susceptible to hyperglycemia, as well as a higher risk from glucose overcorrection, that may results in severe hypoglycemia. In critically ill patients with DM, it is recommended to maintain a blood glucose range between 140-180 mg/dL. In neurological patients and surgical patients, tighter glycemic control (i...
March 15, 2017: World Journal of Diabetes
https://www.readbyqxmd.com/read/28325206/improving-glycemic-control-safely-in-non-critical-care-patients-a-collaborative-systems-approach-in-nine-hospitals
#13
Gregory A Maynard, Diana Childers, Janet Holdych, Heather Kendall, Tom Hoag, Karen Harrison
BACKGROUND: Practice variations in insulin management and glycemic adverse events led nine Dignity Health hospitals to initiate a collaborative effort to improve hypoglycemia, uncontrolled hyperglycemia, and glycemic control. METHODS: Non-critical care adult inpatients with ≥4 point-of-care blood glucose (BG) readings in a ≥2-day period were included. Balanced glucometric goals for each hospital were individualized to improve performance by 10%-20% from baseline or achieve top performance derived from Society of Hospital Medicine (SHM) benchmarking studies...
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28323688/challenges-of-inpatient-glycemic-control
#14
Sally O Gerard, Josephine Ritchie
Hyperglycemia occurs in more than 30% of hospitalized patients. The condition has been associated with higher mortality and poor outcomes. Systems to effectively treat dysglycemia have been put into place, although many focus on critical care areas. The purpose of this article is to provide an overview of the challenges for glycemic control in non-critical care areas. Standardized order sets, critical pathways, professional education, and collaborative systems can support improved control.
July 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28319802/associations-between-home-insulin-dose-adjustments-and-glycemic-outcomes-at-hospital-admission
#15
Saira Khan, Sherita Hill Golden, Nestoras Mathioudakis
AIMS: To describe patterns of home insulin dose adjustments for non-surgical, non-critically ill patients at admission and to describe associations between these adjustments and inpatient glycemic control. METHODS: Hospital records of non-critically ill patients treated with basal insulin prior to admission were identified. After exclusion of records in which a confounding factor influencing insulin dosing was present, 258 patient-admissions over a 3-year time period were included...
May 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28302323/new-onset-diabetes-after-acute-and-critical-illness-a-systematic-review
#16
REVIEW
Chirag J Jivanji, Varsha M Asrani, John A Windsor, Maxim S Petrov
Hyperglycemia is commonly observed during acute and critical illness. Recent studies have investigated the risk of developing diabetes after acute and critical illness, but the relationship between degree of in-hospital hyperglycemia and new-onset diabetes has not been investigated. This study examines the evidence for the relationship between in-hospital hyperglycemia and prevalence of new-onset diabetes after acute and critical illness. A literature search was performed of the MEDLINE, EMBASE, and Scopus databases for relevant studies published from January 1, 2000, through August 4, 2016...
May 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28283030/impaired-osteogenesis-of-t1dm-bone-marrow-derived-stromal-cells-and-periosteum-derived-cells-and-their-differential-in-vitro-responses-to-growth-factor-rescue
#17
Tera M Filion, Jordan D Skelly, Henry Huang, Dale L Greiner, David C Ayers, Jie Song
BACKGROUND: Poor bone quality, increased fracture risks, and impaired bone healing are orthopedic comorbidities of type 1 diabetes (T1DM). Standard osteogenic growth factor treatments are inadequate in fully rescuing retarded healing of traumatic T1DM long bone injuries where both periosteal and bone marrow niches are disrupted. We test the hypotheses that osteogenesis of bone marrow-derived stromal cells (BMSCs) and periosteum-derived cells (PDCs), two critical skeletal progenitors in long bone healing, are both impaired in T1DM and that they respond differentially to osteogenic bone morphogenetic proteins (BMPs) and/or insulin-like growth factor-1 (IGF-1) rescue...
March 11, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28277831/dapagliflozin-potential-beneficial-effects-in-the-prevention-and-treatment-of-renal-and-cardiovascular-complications-in-patients-with-type-2-diabetes
#18
REVIEW
Paola Fioretto, Angelo Avogaro
Diabetic kidney disease is the leading cause of end-stage renal disease, a significant contributor to cardiovascular (CV) disease, responsible for much of the morbidity and mortality in patients with type 2 diabetes (T2DM). Strategies to slow or prevent the onset and progression of diabetic kidney disease are critical for effectively managing T2DM and reducing CV risk. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are effective antidiabetic agents, which may provide nephroprotective and CV protective effects...
April 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28273059/effect-of-admission-hyperglycemia-on-6-month-functional-outcome-in-patients-with-spontaneous-cerebellar-hemorrhage
#19
Chuanyuan Tao, Xin Hu, Jiajing Wang, Chao You
BACKGROUND Cerebellar hemorrhage (CH) has a quite different treatment strategy and prognostic factors compared with supratentorial intracerebral hemorrhage (ICH). The prognostic role of hyperglycemia has been discussed mainly in cases of supratentorial hemorrhage; it remains to be elucidated following CH. We aimed to determine the association of hyperglycemia on admission with 6-month functional outcome in CH patients. MATERIAL AND METHODS We retrospectively analyzed 77 patients with acute CH between September 2010 and April 2015 in West China Hospital...
March 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28268776/nonlinear-model-predictive-glycemic-control-of-critically-ill-patients-using-online-identification-of-insulin-sensitivity
#20
Sha Wu, Eiko Furutani
In critically ill patients suffering from hyperglycemia, it has been recently shown that mortality and morbidity can be reduced by keeping blood glucose within the range of 80-110 mg/dL. However, maintaining glycemia within such range is difficult due to the time variability in insulin sensitivity in critically ill patients. In this paper, we propose a novel glycometabolism model of critically ill patients with an insulin sensitivity parameter and develop a nonlinear model predictive glycemic control system with online identification of insulin sensitivity at one-hour intervals...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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