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Diabetic coma

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https://www.readbyqxmd.com/read/29218766/risk-of-recurrent-severe-hypoglycemia-remains-associated-with-a-past-history-of-severe-hypoglycemia-up-to-4%C3%A2-years-results-from-a-large-prospective-contemporary-pediatric-cohort-of-the-dpv-initiative
#1
D Pacaud, J M Hermann, B Karges, J Rosenbauer, T Danne, R Dürr, A Herbst, S Lindauer, S Müther, S Pötzsch, K Raile, M Witsch, R W Holl
OBJECTIVES: In a contemporary cohort of youth with type 1 diabetes, we examined the interval between episodes of severe hypoglycemia (SH) as a risk factor for recurrent SH or hypoglycemic coma (HC). METHODS: This was a large longitudinal observational study. Using the DPV Diabetes Prospective follow-up data, we analyzed frequency and timing of recurrent SH (defined as requiring assistance from another person) and HC (loss of consciousness or seizures) in 14 177 youths with type 1 diabetes aged <20 years and at least 5 years of follow-up...
December 8, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/29181767/frailty-diabetes-and-the-convergence-of-chronic-disease-in-an-age-related-condition-a-population-based-nationwide-cross-sectional-analysis-of-the-mexican-nutrition-and-health-survey
#2
Roberto C Castrejón-Pérez, Carlos A Aguilar-Salinas, Luis M Gutiérrez-Robledo, Matteo Cesari, Mario U Pérez-Zepeda
AIMS: To describe the associations of frailty with diabetes mellitus and related conditions in older adults. METHODS: We conducted a cross-sectional analysis of a representative sample of older adults (n = 5379). We generated a 35-item frailty index (FI) and obtained information on diabetes and related conditions (peripheral neuropathy, lower limb amputation, diabetic coma, number of physician visits due to diabetes-related conditions, all-cause hospitalizations in the past year, years since diabetes diagnosis, and type of treatment)...
November 27, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29180613/analysis-of-risk-factors-for-hypoglycemic-coma-in-194-patients-with-type-2-diabetes
#3
Zefen Lu, Jianfeng Liu, Qing He, Anindita Chakraborty, Tiehong Zhu
BACKGROUND The present study was conducted to analyze possible risk factors in patients with type 2 diabetes who are in hypoglycemic coma. MATERIAL AND METHODS A total of 194 patients with type 2 diabetic hypoglycemic coma who were admitted to our hospital between January 2010 and January 2016 were included. The patients were all in coma on admission, and their blood glucose levels were lower than 2.8 mmol/L. None of the patients had type I diabetes, specific types of diabetes, or gestational diabetes. Multiple linear regression analysis was used to determine possible factors associated with hypoglycemic coma...
November 28, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29170119/adult-patients-with-pneumococcal-meningitis-at-a-neurosurgical-neurological-center-different-predisposing-conditions
#4
Lucero de María Ugalde-Mejía, Veronica Angeles Morales, Graciela Cárdenas, Jose Luis Soto-Hernández
BACKGROUND: In previous studies of pneumococcal meningitis in adults within general hospitals or national cohorts, the most common predisposing conditions are otitis media, sinusitis, pneumonia, immunosuppression, alcoholism, and diabetes. The epidemiology of pneumococcal meningitis is changing due to the use of vaccines in childhood, and antibiotic resistance has increased. METHODS: We retrospectively reviewed the cases of patients with diagnosis of pneumococcal meningitis proved by an inflammatory CSF with a positive culture, treated during a period of 14 years at an adult neurosurgical neurological reference center...
November 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29088954/morbidity-and-mortality-associated-with-hypernatremia-in-patients-with-severe-traumatic-brain-injury
#5
Aditya Vedantam, Claudia S Robertson, Shankar P Gopinath
OBJECTIVE Hypernatremia is independently associated with increased mortality in critically ill patients. Few studies have evaluated the impact of hypernatremia on early mortality in patients with severe traumatic brain injury (TBI) treated in a neurocritical care unit. METHODS A retrospective review of patients with severe TBI (admission Glasgow Coma Scale score ≤ 8) treated in a single neurocritical care unit between 1986 and 2012 was performed. Patients with at least 3 serum sodium values were selected for the study...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29079281/association-of-classic-cardiovascular-risk-factors-and-lifestyles-with-the-cardio-ankle-vascular-index-in-a-general-mediterranean-population
#6
Marc Elosua-Bayés, Ruth Martí-Lluch, María Del Mar García-Gil, Lourdes Camós, Marc Comas-Cufí, Jordi Blanch, Anna Ponjoan, Lia Alves-Cabratosa, Roberto Elosua, María Grau, Jaume Marrugat, Rafel Ramos
INTRODUCTION AND OBJECTIVES: The cardio-ankle vascular index (CAVI) assesses arterial stiffness. We aimed to describe the distribution of CAVI in a Mediterranean population, to determine the proportion of CAVI ≥ 9 by sex and coronary risk level, and to assess the association of CAVI with classic cardiovascular risk factors and lifestyle patterns. METHODS: This cross-sectional study was based on the population of Girona province. The CAVI was measured using the VaSera VS-1500...
October 25, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29047291/recurrent-moderate-hypoglycemia-exacerbates-oxidative-damage-and-neuronal-death-leading-to-cognitive-dysfunction-after-the-hypoglycemic-coma
#7
Gabriela Languren, Teresa Montiel, Leticia Ramírez-Lugo, Israela Balderas, Gustavo Sánchez-Chávez, Francisco Sotres-Bayón, Federico Bermúdez-Rattoni, Lourdes Massieu
Moderate recurrent hypoglycemia (RH) is frequent in Type 1 diabetes mellitus (TIDM) patients who are under intensive insulin therapy increasing the risk for severe hypoglycemia (SH). The consequences of RH are not well understood and its repercussions on neuronal damage and cognitive function after a subsequent episode of SH have been poorly investigated. In the current study, we have addressed this question and observed that previous RH during seven consecutive days exacerbated oxidative damage and neuronal death induced by a subsequent episode of SH accompanied by a short period of coma, in the parietal cortex, the striatum and mainly in the hippocampus...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28934363/sex-related-differences-in-the-risk-factors-for-in-hospital-mortality-and-outcomes-of-ischemic-stroke-patients-in-rural-areas-of-taiwan
#8
Cheung-Ter Ong, Yi-Sin Wong, Sheng-Feng Sung, Chi-Shun Wu, Yung-Chu Hsu, Yu-Hsiang Su, Ling-Chien Hung
BACKGROUND AND PURPOSE: Sex-related differences in the clinical presentation and outcomes of stroke patients are issues that have attracted increased interest from the scientific community. The present study aimed to investigate sex-related differences in the risk factors for in-hospital mortality and outcome in ischemic stroke patients. METHODS: A total of 4278 acute ischemic stroke patients admitted to a stroke unit between January 1, 2007 and December 31, 2014 were included in the study...
2017: PloS One
https://www.readbyqxmd.com/read/28918089/urinary-incontinence-and-indwelling-urinary-catheters-as-predictors-of-death-after-new-onset-stroke-a-report-of-the-south-london-stroke-register
#9
Gregor John, Steve Primmaz, Siobhan Crichton, Charles Wolfe
OBJECTIVE: To explore the relationship between indwelling urinary catheters (IUCs), urinary incontinence (UI), and death in the poststroke period and to determine when, after the neurological event, UI has the best ability to predict 1-year mortality. METHODS: In a prospective observational study, 4477 patients were followed up for 1 year after a first-ever stroke. The impact of UI or urinary catheters on time to death was adjusted in a Cox model for age, sex, Glasgow Coma Scale, prestroke and poststroke Barthel Index, swallow test, motor deficit, diabetes, and year of inclusion...
September 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28888993/the-risks-of-nocturnal-hypoglycaemia-in-insulin-treated-diabetes
#10
REVIEW
Alex J Graveling, Brian M Frier
Over half of all episodes of severe hypoglycaemia (requiring external help) occur during sleep, but nocturnal hypoglycaemia is often asymptomatic and unrecognised. The precise incidence of nocturnal hypoglycaemia is difficult to determine with no agreed definition, but continuous glucose monitoring has shown that it occurs frequently in people taking insulin. Attenuation of the counter-regulatory responses to hypoglycaemia during sleep may explain why some episodes are undetected and more prolonged, and modifies cardiovascular responses...
August 23, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28877108/prevention-of-heel-pressure-injuries-and-plantar-flexion-contractures-with-use-of-a-heel-protector-in-high-risk-neurotrauma-medical-and-surgical-intensive-care-units-a-randomized-controlled-trial
#11
RANDOMIZED CONTROLLED TRIAL
Tina Meyers
PURPOSE: The purpose of this study was to compare the use of a heel protector to standard of care (pillows) in the prevention of hospital-acquired pressure injuries (HAPI) of the heels and prevention of plantar flexion contractures. DESIGN: Randomized controlled trial. SUBJECTS AND SETTING: The study took place on a surgical intensive care unit, medical intensive care unit, and neurotrauma intensive care unit. Inclusion criteria were a minimum of 5 days of sedation related to care for a critical illness, immobility for 6 to 8 hours before study initiation, a Braden Scale for Pressure Sore Risk score 18 or less, and a mobility subscale score 2 or less...
September 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28821639/amyloid-induced-%C3%AE-cell-dysfunction-and-islet-inflammation-are-ameliorated-by-4-phenylbutyrate-pba-treatment
#12
Joel Montane, Sara de Pablo, Carlos Castaño, Júlia Rodríguez-Comas, Lisa Cadavez, Mercè Obach, Montse Visa, Gema Alcarraz-Vizán, Melchor Sanchez-Martinez, Alfons Nonell-Canals, Marcelina Parrizas, Joan-Marc Servitja, Anna Novials
Human islet amyloid polypeptide (hIAPP) aggregation is associated with β-cell dysfunction and death in type 2 diabetes (T2D). we aimed to determine whether in vivo treatment with chemical chaperone 4-phenylbutyrate (PBA) ameliorates hIAPP-induced β-cell dysfunction and islet amyloid formation. Oral administration of PBA in hIAPP transgenic (hIAPP Tg) mice expressing hIAPP in pancreatic β cells counteracted impaired glucose homeostasis and restored glucose-stimulated insulin secretion. Moreover, PBA treatment almost completely prevented the transcriptomic alterations observed in hIAPP Tg islets, including the induction of genes related to inflammation...
August 15, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28800866/five-year-trends-of-critical-care-practice-and-outcomes
#13
Craig M Lilly, Sunil Swami, Xinggang Liu, Richard R Riker, Omar Badawi
BACKGROUND: Longitudinal analyses of large, detailed adult critical care datasets provide insights into practice trends and generate useful outcome and process benchmarks. METHODS: Data representing 991,571 consecutive critical care visits to 160 US adult ICUs from 2009 to 2013 from the eICU Research Institute clinical practice database were used to quantitate patient characteristics, APACHE IV-based acuity predictions, treatments, and outcomes. Analyses for changes over time were performed for patient characteristics, entry and discharge locations, primary admission diagnosis, treatments, adherence to consensus ICU best practices, length of stay (LOS), and inpatient mortality...
October 2017: Chest
https://www.readbyqxmd.com/read/28720342/severe-hypoglycaemia-is-a-major-predictor-of-incident-diabetic-retinopathy-in-japanese-patients-with-type-2-diabetes
#14
S Tanaka, R Kawasaki, S Tanaka-Mizuno, S Iimuro, S Matsunaga, T Moriya, S Ishibashi, S Katayama, Y Ohashi, Y Akanuma, H Sone, H Yamashita
AIM: Hypoglycaemia is a common complication in diabetes patients. However, its relationship with retinopathy has not been well documented in patients with type 2 diabetes (T2D). This study aimed to investigate the associations between hypoglycaemia and the incidence and progression of diabetic retinopathy (DR). METHODS: In this longitudinal cohort study, which was part of the Japan Diabetes Complications Study (JDCS), adult patients with T2D were recruited at 59 diabetes clinics across Japan...
July 15, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28678332/effect-of-different-blood-glucose-intervention-plans-on-elderly-people-with-type-2-diabetes-mellitus-combined-with-dementia
#15
Y Chen, J Wang, L-J Wang, H Lin, P-J Huang
OBJECTIVE: We analyzed the effects of intensive and mitigatory blood glucose control strategy on elderly people with type 2 diabetes mellitus (T2DM) combined with Alzheimer disease (AD). PATIENTS AND METHODS: We enrolled 90 elderly patients with T2DM combined with AD to participate in this study. They were randomly divided into 3 groups: the control group, the strength group and the mitigation group with 30 cases in each group. In the control group, patients were only treated with diet and exercise while in the strength group patients were treated with oral hypoglycemic medications, subcutaneous insulin infusion or continuous infusion by micropump...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28672316/effect-of-insulin-degludec-vs-insulin-glargine-u100-on-hypoglycemia-in-patients-with-type-1-diabetes-the-switch-1-randomized-clinical-trial
#16
RANDOMIZED CONTROLLED TRIAL
Wendy Lane, Timothy S Bailey, Gregg Gerety, Janusz Gumprecht, Athena Philis-Tsimikas, Charlotte Thim Hansen, Thor S S Nielsen, Mark Warren
Importance: Hypoglycemia, common in patients with type 1 diabetes, is a major barrier to achieving good glycemic control. Severe hypoglycemia can lead to coma or death. Objective: To determine whether insulin degludec is noninferior or superior to insulin glargine U100 in reducing the rate of symptomatic hypoglycemic episodes. Design, Setting, and Participants: Double-blind, randomized, crossover noninferiority trial involving 501 adults with at least 1 hypoglycemia risk factor treated at 84 US and 6 Polish centers (January 2014-January 12, 2016) for two 32-week treatment periods, each with a 16-week titration and a 16-week maintenance period...
July 4, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28640135/hospitalization-with-hypoglycemia-in-patients-without-diabetes-mellitus-a-retrospective-study-using-a-national-inpatient-database-in-japan-2008-2012
#17
Akahito Sako, Hideo Yasunaga, Hiroki Matsui, Kiyohide Fushimi, Hidetaka Hamasaki, Hisayuki Katsuyama, Tetsuro Tsujimoto, Atsushi Goto, Hidekatsu Yanai
We aimed to examine prevalence, patient characteristics, etiology, and clinical outcomes of hospitalized patients who had hypoglycemia without a diagnosis of diabetes mellitus, using a Japanese nationwide database.This was a retrospective observational study using a national database of acute-care inpatients in Japan. Nondiabetic patients aged ≥15 years who were hospitalized for hypoglycemia were eligible. We estimated the annual numbers of hospitalized cases in Japan. We also investigated the patient characteristics, and risk factors of in-hospital mortality...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28626178/hypoglycemic-coma-induced-by-the-use-of-succinic-acid-cibenzoline-in-frail-late-stage-elderly-subjects
#18
Yurie Hirata, Shinji Kamei, Fuminori Tatsumi, Masashi Shimoda, Akihito Tanabe, Junpei Sanada, Yoshiro Fushimi, Shintaro Irie, Tomoatsu Mune, Kohei Kaku, Hideaki Kaneto
Succinic acid cibenzoline (CZ) is an antiarrhythmic agent often used for the treatment of tachyarrhythmia. However, hypoglycemia should be avoided in the treatment of diabetes. We herein report two late-stage elderly subjects who experienced a severe and prolonged hypoglycemic coma after the usage of CZ. These cases suggest that, when CZ is administered to elderly subjects with renal dysfunction and/or frailty, we should be aware of the possibility that this medicine may induce hypoglycemia and should adjust the dose as appropriate and monitor the concentration of CZ to avoid severe hypoglycemia...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28623943/does-metabolic-syndrome-predict-surgical-complications-a-protocol-for-a-systematic-review-and-meta-analysis
#19
Philip Norris, Nicholas Ralph, Clint Moloney
BACKGROUND: Metabolic syndrome (MetS) is defined by an accumulation of risk factors that include cardiovascular disease, diabetes, chronic high blood pressure, obesity, and hypercholesterolaemia which results in an increased risk of developing serious chronic diseases. MetS is widespread as it is estimated to affect up to 30% of the global population. For people with MetS who undergo surgery, an emerging body of literature points to significantly poorer postoperative outcomes compared with non-affected populations...
June 17, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28622071/survival-in-out-of-hospital-rapid-sequence-intubation-of-non-traumatic-brain-pathologies
#20
Pieter Francsois Fouche, Paul Andrew Jennings, Karen Smith, Malcolm Boyle, Gabriel Blecher, Jonathan Knott, Mani Raji, Pamela Rosengarten, Michael Roberto Augello, Stephen Bernard
INTRODUCTION: Rapid sequence intubation (RSI) is not only used in traumatic brain injuries in the out-of-hospital setting, but also for non-traumatic brain pathologies (NTBP) such as brain tumors, meningitis, encephalitis, hypoxic/anoxic brain injury, stroke, arteriovenous malformations, tumors, aneurysms, brain hemorrhage, as well as brain injury due to diabetes, seizures and toxicity, metabolic conditions, and alcohol and drug overdose. Previous research suggests that RSI is common in non-traumatic coma, but with an unknown prevalence of NTBP in those that receive RSI...
November 2017: Prehospital Emergency Care
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