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https://www.readbyqxmd.com/read/28544214/do-we-know-the-true-mechanism-of-action-of-the-dpp-4-inhibitors
#1
REVIEW
Emilie Skytte Andersen, Carolyn F Deacon, Jens Juul Holst
The prevalence of type 2 diabetes is increasing which is alarming because of its serious complications. Antidiabetic treatment aims to control glucose homeostasis as tightly as possible in order to reduce these complications. Dipeptidyl peptidase-4 (DPP-4) inhibitors are a recent addition to the antidiabetic treatment modalities, and have become widely accepted because of their good efficacy, their benign side effect profile and their low hypoglycaemia risk. The actions of DPP-4 inhibitors are not direct, but rather are mediated indirectly through preservation of the substrates they protect from degradation...
May 24, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28544081/direct-medical-costs-of-severe-hypoglycaemic-events-in-patients-with-type-2-diabetes-in-england-a-retrospective-database-study
#2
Tim Holbrook, Yuexin Tang, Romita Das, R Ravi Shankar, Kaan Tunceli, Jean Williams, Larry Radican, Sarah E Holden, Chris Ll Morgan, James Piercy, Craig J Currie
AIMS: Hypoglycaemia in patients with diabetes can be induced by insulins and sulfonylureas. We assessed the real-world impact of specific monotherapy and combination regimens on hypoglycaemic events requiring hospitalisation and related secondary costs to the English healthcare system. METHODS: This retrospective observational study used the Clinical Practice Research Datalink with linked hospital admission data during 2008-2012. Patients with type 2 diabetes mellitus (T2DM) using antihyperglycaemic agents (AHAs) were assigned to mutually exclusive subgroups (insulin- and non-insulin-containing regimens; treatment groups of interest; age group) based on treatment at index date (date of first AHA prescription)...
May 23, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28536206/dextrose-gel-treatment-does-not-impair-subsequent-feeding
#3
Philip J Weston, Deborah L Harris, Jane E Harding
BACKGROUND: Dextrose gel is increasingly used as first-line treatment for neonatal hypoglycaemia. Treatment with 400 mg/kg previously has been reported to impair subsequent feeding. We sought to determine if the recommended dose of 200 mg/kg altered feeding. METHODS: Hypoglycaemic babies were randomised to 200 mg/kg dextrose gel or placebo and fed. Prefeed alertness, quality and duration of breast feeding, and the volume of formula taken were assessed on the next feeding...
May 23, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28535809/safety-and-tolerability-of-adjunctive-rosiglitazone-treatment-for-children-with-uncomplicated-malaria
#4
Rosauro Varo, Valerie M Crowley, Antonio Sitoe, Lola Madrid, Lena Serghides, Rubao Bila, Helio Mucavele, Alfredo Mayor, Quique Bassat, Kevin C Kain
BACKGROUND: Despite the widespread use and availability of rapidly acting anti-malarials, the fatality rate of severe malaria in sub-Saharan Africa remains high. Adjunctive therapies that target the host response to malaria infection may further decrease mortality over that of anti-malarial agents alone. Peroxisome proliferator-activated receptor-gamma agonists (e.g. rosiglitazone) have been shown to act on several pathways implicated in the pathogenesis of severe malaria and may improve clinical outcome as an adjunctive intervention...
May 23, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28532504/vineland-adaptive-behavior-scales-to-identify-neurodevelopmental-problems-in-children-with-congenital-hyperinsulinism-chi
#5
Maria Salomon-Estebanez, Zainab Mohamed, Maria Michaelidou, Hannah Collins, Lindsey Rigby, Mars Skae, Raja Padidela, Stewart Rust, Mark Dunne, Karen Cosgrove, Indraneel Banerjee, Jacqueline Nicholson
BACKGROUND: Congenital Hyperinsulinism (CHI) is a disease of severe hypoglycaemia caused by excess insulin secretion and associated with adverse neurodevelopment in a third of children. The Vineland Adaptive Behavior Scales Second Edition (VABS-II) is a parent report measure of adaptive functioning that could be used as a developmental screening tool in patients with CHI. We have investigated the performance of VABS-II as a screening tool to identify developmental delay in a relatively large cohort of children with CHI...
May 22, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28527646/high-dose-amino-acid-administration-achieves-an-anabolic-response-in-type-2-diabetic-patients-that-is-independent-of-glycaemic-control-a-randomized-clinical-trial
#6
Chelsia Gillis, Patricia S Roque, Jürgen Bläss, Albert Urwyler, Harald Schepperle, Guido Kunz, Thomas Peters, Thomas Schricker, Linda Wykes, Andrea Kopp Lugli
BACKGROUND & AIMS: Surgical stress provokes protein catabolism and hyperglycaemia that is enhanced in patients with type 2 diabetes (T2DM), and increases perioperative morbidity. This study hypothesized that perioperative administration of high dose intravenous (IV) amino acids (AA) will augment protein balance in T2DM patients receiving tight plasma glucose control via continuous IV insulin compared to standard plasma glucose control via subcutaneous (SC) insulin sliding scale. METHODS: Eighteen patients with well-controlled T2DM (HbA1C% < 7...
May 3, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28526658/nonclinical-pharmacology-and-toxicology-of-the-first-biosimilar-insulin-glargine-drug-product-basaglar-%C3%A2-abasaglar-%C3%A2-approved-in-the-european-union
#7
Richard A Byrd, Rebecca A Owens, Jamie L Blackbourne, David E Coutant, Mark W Farmen, M Dodson Michael, Julie S Moyers, A Eric Schultze, Michael K Sievert, Niraj K Tripathi, John L Vahle
Basaglar(®)/Abasaglar(®) (Lilly insulin glargine [LY IGlar]) is a long-acting human insulin analogue drug product granted marketing authorisation as a biosimilar to Lantus(®) (Sanofi insulin glargine [SA IGlar]) by the European Medicines Agency. We assessed the similarity of LY IGlar to the reference drug product, European Union-sourced SA IGlar (EU-SA IGlar), using nonclinical in vitro and in vivo studies. No biologically relevant differences were observed for receptor binding affinity at either the insulin or insulin-like growth factor-1 (IGF-1) receptors, or in assays of functional or de novo lipogenic activity...
May 16, 2017: Regulatory Toxicology and Pharmacology: RTP
https://www.readbyqxmd.com/read/28511644/relationship-between-glycemic-levels-and-treatment-outcome-among-critically-ill-children-admitted-into-emergency-room-in-enugu
#8
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/28509408/insulin-associated-weight-gain-in-obese-type-2-diabetes-mellitus-patients-what-can-be-done
#9
REVIEW
Adrian Brown, Nicola Guess, Anne Dornhorst, Shahrad Taheri, Gary Frost
Insulin therapy (IT) is initiated for patients with type 2 diabetes mellitus when glycaemic targets are not met with diet and other hypoglycaemic agents. The initiation of IT improves glycaemic control and reduces the risk of microvascular complications. There is, however, an associated weight gain following IT, which may adversely affect diabetic and cardiovascular morbidity and mortality. A 3 to 9 kg insulin associated weight gain (IAWG) is reported to occur in the first year of initiating IT, consisting predominantly of adipose tissue...
May 16, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28505544/real-life-experience-of-patients-starting-insulin-degludec-a-multicenter-analysis-of-1064-subjects-from-the-german-austrian-dpv-registry
#10
Barbara Bohn, Artur Zimmermann, Christian Wagner, Sigrun Merger, Desirée Dunstheimer, Florian Kopp, Katja Gollisch, Volker Zindel, Reinhard W Holl
BACKGROUND: The long-acting insulin analogue degludec is a therapeutic option for patients with type 1 (T1D) or type 2 diabetes (T2D). Aim of this analysis was to investigate differences in clinical characteristics of patients before and after initiating degludec use in a cohort of German/Austrian patients. METHODS: 1064 subjects with T1D/T2D and documented degludec use from the Diabetes-Patient-Follow-Up (DPV) registry were included. The follow-up cohort (n=421) comprised patients with available data before and 3-15months after switching to degludec...
May 4, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28504776/insulin-mediated-hypoglycaemia-secondary-to-recurrent-clear-cell-renal-carcinoma
#11
G Gogna, N Patel, P Bilinski
Renal cell carcinoma has previously been associated with hypoglycaemia in the setting of non-islet cell tumours, caused by a paraneoplastic phenomenon relating to the production of insulin-like growth factor type II. We present a case of recurrent clear cell renal cell carcinoma, leading to an insulin-mediated paraneoplastic phenomenon causing severe recurrent hypoglycaemia. Hypoglycaemina was managed successfully using diazoxide therapy, in conjunction with pazopanib and radiotherapy to reduce tumour burden...
December 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28500918/experience-using-high-dose-glucose-insulin-potassium-gik-in-critically-ill-patients
#12
Elise M A Slob, Rob Shulman, Mervyn Singer
PURPOSE: To audit the use of GIK in terms of safety, haemodynamic effects, and impact on catecholamine dosage. MATERIALS AND METHODS: A retrospective, descriptive, evaluative audit of GIK use within the adult ICU of a London teaching hospital was conducted. Rescue therapy of GIK (up to 1.0Unitsinsulin/kg/h) was administered to improve cardiac function. Outcomes were ICU survival, change in cardiac index (CI) and blood lactate levels, events of hypoglycaemia, hyperglycaemia, hypokalaemia and hyperkalaemia, and discontinuation time of catecholamine inotropes...
April 26, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28498634/older-people-with-type-2-diabetes-including-those-with-chronic-kidney-disease-or-dementia-are-commonly-overtreated-with-sulfonylurea-or-insulin-therapies
#13
C E Hambling, Samuel Seidu, M J Davies, K Khunti
AIM: To evaluate potential overtreatment with sulfonylurea and insulin therapies amongst older people with Type 2 diabetes, including those with chronic kidney disease or dementia. METHODS: Using the ECLIPSE Live software tool, we developed a search to examine data on older people (age ≥ 70 years) with Type 2 diabetes, who were prescribed sulfonylurea or insulin therapies over the previous 90 days. Sixteen Norfolk general practices participated, representing a population of 24 661 older people, including 3862 (15...
May 12, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28497592/hypoglycaemia-seriousness-and-weight-gain-as-determinants-of-cardiovascular-disease-outcomes-among-sulfonylurea-users
#14
Anthony P Nunes, Kristy Iglay, Larry Radican, Samuel S Engel, Jing Yang, Michael C Doherty, David D Dore
AIMS: Certain treatments for type 2 diabetes mellitus cause hypoglycaemia and weight gain, and thus might counteract the benefits of intensive glucose control. We quantify the association of cardiovascular disease (CVD) outcomes with hypoglycaemia and weight gain among patients with type 2 diabetes treated with sulfonylureas. MATERIALS AND METHODS: This cohort study included patients from January 2009 through December 2014 identified within a deidentified nationwide electronic health records repository, including multiple provider networks and electronic medical records systems...
May 12, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28491431/hyperinsulinaemic-hypoglycaemic-syndrome-due-to-acquired-nesidioblastosis-in-a-cat
#15
Lydia E Hambrook, Amanda A Ciavarella, Judith S Nimmo, Julie Wayne
Case summary A 6-year-old, neutered female British Shorthair cat presented with acute-onset weakness and mental dullness. Initially the cat was mildly hyperglycaemic (9.9 mmol/l; reference interval [RI] 3.3-6.7 mmol/l). Over the following 12 h the cat developed central blindness, tremors, intermittent seizures and opisthotonus. Repeat blood sampling revealed a marked hypoglycaemia (0.8 mmol/l). Insulin level (performed on a serum sample collected while the cat was hypoglycaemic) was inappropriately elevated (1575 mIU/l; RI 10-80 mIU/l)...
July 2016: JFMS Open Rep
https://www.readbyqxmd.com/read/28477413/emergency-treatment-of-hypoglycaemia-a-guideline-and-evidence-review
#16
REVIEW
M Villani, B de Courten, S Zoungas
AIM: To examine the current treatment guidelines for the emergency management of hypoglycaemia and the evidence underpinning recommendations. METHODS: International diabetes agencies were searched for hypoglycaemia treatment guidelines. Guidelines were assessed using the Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument. An electronic database search was conducted for evidence regarding emergency treatment of hypoglycaemia in adults, and relevant articles were critically appraised...
May 6, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28476968/glucose-monitoring-system-using-nanopellets
#17
C Rajasekaran, Madian Nirmala, K B Jayanthi
The combination of the fields of software engineering, gadgets, and science has stood out among the most revolutionary future innovations. Health issues have been the focus of various engaging and explanatory studies. One such health-related dilemma is diabetes. Diabetes at its serious stage results in impaired vision. Increase in the glucose level is a critical parameter that could result in hyperglycaemia, hypoglycaemia, massive heart attack, strokes, and aneurysms. Monitoring the glucose level in blood is one of the control measures for diabetes in the affected population...
February 2017: IET Nanobiotechnology
https://www.readbyqxmd.com/read/28473681/pregnancy-and-dumping-syndrome-post-bariatric-surgery-a-case-report
#18
D E Edawati, J Abigail, K Mardiana, C Ming-Cheng, N S Harris
This case report discusses dumping syndrome in the postbariatric mother. Diagnostically a challenge, the symptoms of postprandial hypoglycaemia mimic common early gestation complaints and may go undiagnosed, thus requiring a high index of suspicion. As weight-loss surgery gains traction, it is pertinent to note at booking and followups. The pregnancy is at-risk and multidisciplinary team management is central. The mainstay of management remains diet modification. There have been case reports of successful medical treatment of dumping syndrome in pregnancy with good maternal and fetal outcomes...
April 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28472859/lifestyle-interventions-for-the-treatment-of-women-with-gestational-diabetes
#19
REVIEW
Julie Brown, Nisreen A Alwan, Jane West, Stephen Brown, Christopher Jd McKinlay, Diane Farrar, Caroline A Crowther
BACKGROUND: Gestational diabetes (GDM) is glucose intolerance, first recognised in pregnancy and usually resolving after birth. GDM is associated with both short- and long-term adverse effects for the mother and her infant. Lifestyle interventions are the primary therapeutic strategy for many women with GDM. OBJECTIVES: To evaluate the effects of combined lifestyle interventions with or without pharmacotherapy in treating women with gestational diabetes. SEARCH METHODS: We searched the Pregnancy and Childbirth Group's Trials Register (14 May 2016), ClinicalTrials...
May 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28472467/hypothalamic-regulation-of-liver-and-muscle-nutrient-partitioning-by-brain-specific-carnitine-palmitoyltransferase-1c-cpt1c-in-male-mice
#20
Macarena Pozo, Rosalía Rodríguez-Rodríguez, Sara Ramírez, Patricia Seoane-Collazo, Miguel López, Dolors Serra, Laura Herrero, Núria Casals
Carnitine palmitoyltransferase 1C (CPT1C), a brain-specific protein localized in the endoplasmic reticulum of neurons, is expressed in almost all brain regions. Based on global knockout (KO) models, CPT1C has demonstrated relevance in hippocampus-dependent spatial learning as well as in hypothalamic regulation of energy balance. Specifically, it has been shown that CPT1C is protective against high-fat diet-induced obesity (DIO), and that CPT1C KO mice show reduced peripheral fatty acid oxidation (FAO) both during fasting and DIO...
May 3, 2017: Endocrinology
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