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https://www.readbyqxmd.com/read/28328534/clinical-presentation-and-treatment-response-to-diazoxide-in-two-siblings-with-congenital-hyperinsulinism-as-a-result-of-a-novel-compound-heterozygous-abcc8-missense-mutation
#1
Sonya Galcheva, Violeta Iotova, Sian Ellard, Sarah E Flanagan, Irina Halvadzhiyan, Chayka Petrova, Khalid Hussain
BACKGROUND: Congenital hyperinsulinism (CHI) can present with considerable clinical heterogeneity which may be due to differences in the underlying genetic etiology. We present two siblings with hyperinsulinaemic hypoglycaemia (HH) and marked clinical heterogeneity caused by compound heterozygosity for the same two novel ABCC8 mutations. CASE PRESENTATION: The index patient is a 3-year-old boy with hypoglycaemic episodes presenting on the first day of life. HH was diagnosed and treatment with intravenous glucose and diazoxide was initiated...
March 22, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28328262/haemodialysis-nutritional-disorders-and-hypoglycaemia-in-critical-care
#2
Jeiel Carlos Lamonica Crespo, Vanessa Rossato Gomes, Ricardo Luís Barbosa, Katia Grillo Padilha, Silvia Regina Secoli
This study aimed to determine hypoglycemia incidence and associated factors in critically ill patients. It looked at a retrospective cohort with 106 critically ill adult patients with 48 hours of glycaemic control and 72 hours of follow up. The dependent variable, hypoglycaemia (≤70 mg/dl), was assessed with respect to independent variables: age, diet, insulin, catecholamines, haemodialysis, nursing workload and the Simplified Acute Physiology Score. Statistical analysis was performed using Student's t-test, Fisher's exact test and logistic regression at 5% significance level...
March 9, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28326603/response-to-early-view-an-opportunity-for-enhanced-peer-review
#3
Tonja Nansel, Aiyi Liu, Benjamin Gee
We welcome the anonymous readers' interest in our advance-access manuscript, and appreciate the opportunity to respond to the Editor's comments on our article as it reaches the Journal's pages in print. First, the Editor suggests 'it may be incorrect to state that the intervention led to a reduction in hypoglycaemia rates' because the study did not report the change in hypoglycaemia rates from baseline. The aim of our study was to compare rates of adverse events between intervention and control groups during the course of the trial...
March 22, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28318952/glycaemic-variability-in-patients-with-severe-sepsis-or-septic-shock-admitted-to-an-intensive-care-unit
#4
L M Silveira, A Basile-Filho, E A Nicolini, C A M Dessotte, G C S Aguiar, A M Stabile
BACKGROUND: Sepsis is associated with morbidity and mortality, which implies high costs to the global health system. Metabolic alterations that increase glycaemia and glycaemic variability occur during sepsis. OBJECTIVE: To verify mean body glucose levels and glycaemic variability in Intensive Care Unit (ICU) patients with severe sepsis or septic shock. METHOD: Retrospective and exploratory study that involved collection of patients' sociodemographic and clinical data and calculation of severity scores...
March 15, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28318089/a-cacna1d-mutation-in-a-patient-with-persistent-hyperinsulinaemic-hypoglycaemia-heart-defects-and-severe-hypotonia
#5
S E Flanagan, F Vairo, M B Johnson, R Caswell, T W Laver, H Lango Allen, K Hussain, S Ellard
Congenital hyperinsulinaemic hypoglycaemia (HH) can occur in isolation or it may present as part of a wider syndrome. For approximately 40%-50% of individuals with this condition, sequence analysis of the known HH genes identifies a causative mutation. Identifying the underlying genetic aetiology in the remaining cases is important as a genetic diagnosis will inform on recurrence risk, may guide medical management and will provide valuable insights into β-cell physiology. We sequenced the exome of a child with persistent diazoxide-responsive HH, mild aortic insufficiency, severe hypotonia, and developmental delay as well as the unaffected parents...
March 20, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28317897/identification-of-mangiferin-as-a-potential-glucokinase-activator-by-structure-based-virtual-ligand-screening
#6
Qiuxia Min, Xinpei Cai, Weiguang Sun, Fei Gao, Zhimei Li, Qian Zhang, Luo-Sheng Wan, Hua Li, Jiachun Chen
The natural product mangiferin (compound 7) has been identified as a potential glucokinase activator by structure-based virtual ligand screening. It was proved by enzyme activation experiment and cell-based assays in vitro, with potency in micromolar range. Meanwhile, this compound showed good antihyperglycemic activity in db/db mice without obvious side effects such as excessive hypoglycaemia.
March 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28317891/hepatic-mitochondrial-dysfunction-is-a-feature-of-glycogen-storage-disease-type-ia-gsdia
#7
Benjamin L Farah, Rohit A Sinha, Yajun Wu, Brijesh K Singh, Andrea Lim, Masahiro Hirayama, Dustin J Landau, Boon Huat Bay, Dwight D Koeberl, Paul M Yen
Glycogen storage disease type Ia (GSDIa, von Gierke disease) is the most common glycogen storage disorder. It is caused by the deficiency of glucose-6-phosphatase, an enzyme which catalyses the final step of gluconeogenesis and glycogenolysis. Clinically, GSDIa is characterized by fasting hypoglycaemia and hepatic glycogen and triglyceride overaccumulation. The latter leads to steatohepatitis, cirrhosis, and the formation of hepatic adenomas and carcinomas. Currently, little is known about the function of various organelles and their impact on metabolism in GSDIa...
March 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28316020/%C3%AE-hydroxybutyrate-boosts-mitochondrial-and-neuronal-metabolism-but-is-not-preferred-over-glucose-under-activated-conditions
#8
Lavanya B Achanta, Benjamin D Rowlands, Donald S Thomas, Gary D Housley, Caroline D Rae
The ketone body, β-hydroxybutyrate (βOHB), is metabolised by the brain alongside the mandatory brain fuel glucose. To examine the extent and circumstances by which βOHB can supplement glucose metabolism, we studied guinea pig cortical brain slices using increasing concentrations of [U-(13)C]D-βOHB in conjunction with [1-(13)C]D-glucose under conditions of normo- and hypoglycaemia, as well as under high potassium (40 mmol/L K(+)) depolarization in normo- and hypoglycaemic conditions. The contribution of βOHB to synthesis of GABA was also probed by inhibiting the synthesis of glutamine, a GABA precursor, with methionine sulfoximine (MSO)...
March 18, 2017: Neurochemical Research
https://www.readbyqxmd.com/read/28314943/predicting-hospital-stay-mortality-and-readmission-in-people-admitted-for-hypoglycaemia-prognostic-models-derivation-and-validation
#9
Francesco Zaccardi, David R Webb, Melanie J Davies, Nafeesa N Dhalwani, Laura J Gray, Sudesna Chatterjee, Gemma Housley, Dominick Shaw, James W Hatton, Kamlesh Khunti
AIMS/HYPOTHESIS: Hospital admissions for hypoglycaemia represent a significant burden on individuals with diabetes and have a substantial economic impact on healthcare systems. To date, no prognostic models have been developed to predict outcomes following admission for hypoglycaemia. We aimed to develop and validate prediction models to estimate risk of inpatient death, 24 h discharge and one month readmission in people admitted to hospital for hypoglycaemia. METHODS: We used the Hospital Episode Statistics database, which includes data on all hospital admission to National Health Service hospital trusts in England, to extract admissions for hypoglycaemia between 2010 and 2014...
March 17, 2017: Diabetologia
https://www.readbyqxmd.com/read/28314656/safety-and-efficacy-of-a-basal-plus-regimen-with-insulin-glargine-and-insulin-glulisine-for-elderly-patients-with-high-cardiovascular-risk-and-type-2-diabetes-mellitus
#10
R Gómez-Huelgas, J Sabán-Ruiz, F J García-Román, N Quintela-Fernández, J M Seguí-Ripoll, M V Bonilla-Hernández, G Romero-Meliá
OBJECTIVES: To assess the safety and efficacy of a basal-plus (BP) regimen with insulin glargine (as basal insulin) and insulin glulisine (as prandial insulin) with the main meal for elderly patients with type 2 diabetes mellitus (DM2) and high cardiovascular risk, following standard clinical practice. PATIENTS AND METHODS: An observational, retrospective study was conducted in 21 centres of internal medicine in Spain. The study included patients aged 65 years or older with DM2, undergoing treatment with a BP regimen for 4 to 12 months before inclusion in the study and a diagnosis of cardiovascular disease or high cardiovascular risk...
March 14, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28304392/metrics-for-glycaemic-control-from-hba1c-to-continuous-glucose-monitoring
#11
REVIEW
Boris P Kovatchev
As intensive treatment to lower levels of HbA1c characteristically results in an increased risk of hypoglycaemia, patients with diabetes mellitus face a life-long optimization problem to reduce average levels of glycaemia and postprandial hyperglycaemia while simultaneously avoiding hypoglycaemia. This optimization can only be achieved in the context of lowering glucose variability. In this Review, I discuss topics that are related to the assessment, quantification and optimal control of glucose fluctuations in diabetes mellitus...
March 17, 2017: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/28302661/severe-co-trimoxazole-induced-hypoglycaemia-in-a-patient-with-microscopic-polyangiitis
#12
Thomas Edward Conley, Atif Mohiuddin, Noshaba Naz
A 69-year-old man presented to the emergency department with lower respiratory tract infection and febrile neutropaenia. He was recently discharged following a 50-day hospital stay with newly diagnosed microscopic polyangiitis, complicated by pulmonary haemorrhage and severe renal dysfunction requiring renal replacement therapy, plasma exchange and immunosuppression (cyclophosphamide and methylprednisolone). High risk of pneumocystis pneumonia (PCP) led to an escalation in treatment from prophylactic to therapeutic oral co-trimoxazole, alongside broad-spectrum antibiotics...
March 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28295974/risk-factors-and-outcome-differences-in-hypoglycaemia-related-hospital-admissions-a-case-control-study-in-england
#13
Francesco Zaccardi, David R Webb, Melanie J Davies, Nafeesa N Dhalwani, Gemma Housley, Dominic Shaw, James W Hatton, Kamlesh Khunti
AIMS: To evaluate risk factors for hospital admissions for hypoglycaemia and compare length of hospitalisation, inpatient mortality, and hospital readmission between hypoglycaemia and non-hypoglycaemia-related admissions. MATERIALS AND METHODS: We used all admissions for hypoglycaemia in people with diabetes to English NHS hospital trusts between 2005 and 2014 (101,475 case admissions) and three random admissions per case in people with diabetes without hypoglycaemia (304,425 control admissions)...
March 14, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28295934/insulin-degludec-lower-day-to-day-and-within-day-variability-in-pharmacodynamic-response-compared-to-insulin-glargine-u300-in-type-1-diabetes
#14
Tim Heise, Marianne Nørskov, Leszek Nosek, Kadriye Kaplan, Susanne Famulla, Hanne L Haahr
AIM: To compare day-to-day and within-day variability in glucose-lowering effect between insulin degludec (IDeg) and insulin glargine 300 U/mL (IGlar-U300) in type 1 diabetes. MATERIALS AND METHODS: In this double-blind, crossover study, patients were randomly assigned to 0.4 U/kg of IDeg or IGlar-U300 once-daily for two treatment periods lasting 12 days each. Pharmacodynamic parameters were assessed at steady state from glucose infusion rate profiles of three 24h euglycaemic glucose clamps (Days 6, 9 and 12) during each treatment period...
March 14, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28294499/a-placebo-controlled-randomised-trial-of-the-addition-of-once-weekly-glp-1-receptor-agonist-dulaglutide-to-titrated-daily-insulin-glargine-in-patients-with-type-2-diabetes-award-9
#15
Paolo Pozzilli, Paul Norwood, Esteban Jodar, Melanie J Davies, Tibor Ivanyi, Honghua Jiang, Brad Woodward, Zvonko Milicevic
AIMS: Compare the addition of weekly dulaglutide versus the addition of placebo to titrated glargine in patients with type 2 diabetes (T2D) with sub-optimal HbA1c . METHODS: Patients (N = 300) from this Phase 3, double-blind, parallel-arm, placebo-controlled study were randomised to weekly subcutaneous injections of dulaglutide 1.5 mg or placebo with titrated daily glargine (mean ± SD baseline dose: 39 ± 22 U), with or without metformin (≥1,500 mg/day)...
March 14, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28294488/the-efficacy-and-safety-of-sitagliptin-as-compared-with-glimepiride-in-japanese-patients-aged-60-years-or-older-with-type-2-diabetes-mellitus-start-j-trial
#16
Yasuo Terauchi, Yuichiro Yamada, Hitoshi Ishida, Mitsuru Ohsugi, Masafumi Kitaoka, Jo Satoh, Daisuke Yabe, Nobuyuki Shihara, Yutaka Seino
Non structured abstract To evaluate the efficacy and safety of sitagliptin administered to elderly patients with type 2 diabetes mellitus (T2DM) for one year as compared with glimepiride. Patients aged ≥ 60 years with T2DM and inadequately controlled blood glucose were randomly assigned to sitagliptin 50 mg qd or glimepiride 0.5 mg qd for 52 weeks. The primary efficacy endpoint was the change in HbA1c from baseline to Week 52. Secondary efficacy endpoints included self-monitored blood glucose (SMBG) and weight...
March 9, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28288434/uk-lipohypertrophy-interventional-study
#17
Mike Smith, Linda Clapham, Kenneth Strauss
INTRODUCTION: Lipohypertrophy (LH) is one of the most common complications of insulin therapy. We conducted a prospective study in 18 UK centres to assess the impact of a targeted LH intervention on a range of clinical, biological and socio-economic parameters. METHODS: Seventy-five insulin-injecting patients were recruited randomly and were followed prospectively for 3-6months, with results compared to baseline values. Interventions included the use of an intensive education program and a switch to a 4mm pen needle...
March 2, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28284167/albiglutide-for-the-treatment-of-type-2-diabetes-mellitus-an-integrated-safety-analysis-of-the-harmony-phase-3-trials
#18
Bo Ahrén, Molly C Carr, Karen Murphy, Christopher Perkins, Marc Rendell, Jason Mallory, Timothy Wilson, Susan Johnson
AIMS: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) stimulate the incretin system and lower glycaemic parameters in type 2 diabetes mellitus (T2DM). This analysis of clinical studies of up to 3years evaluated the safety of albiglutide, a GLP-1 RA, in people with T2DM. METHODS: Integrated safety analysis included seven phase-3 T2DM studies of albiglutide compared with placebo and/or active comparators (a dipeptidyl peptidase-4 inhibitor, GLP-1 RA, insulin, sulphonylurea, and thiazolidinedione)...
February 20, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28283260/-methodological-aspects-of-integrated-care-pathways
#19
R Gomis, M Mata Cases, D Mauricio Puente, S Artola Menéndez, J Ena Muñoz, J J Mediavilla Bravo, C Miranda Fernández-Santos, D Orozco Beltrán, L Rodríguez Mañas, C Sánchez Villalba, J A Martínez
An Integrated Healthcare Pathway (PAI) is a tool which has as its aim to increase the effectiveness of clinical performance through greater coordination and to ensure continuity of care. PAI places the patient as the central focus of the organisation of health services. It is defined as the set of activities carried out by the health care providers in order to increase the level of health and satisfaction of the population receiving services. The development of a PAI requires the analysis of the flow of activities, the inter-relationships between professionals and care teams, and patient expectations...
March 7, 2017: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
https://www.readbyqxmd.com/read/28280899/cognitive-deficits-associated-with-impaired-awareness-of-hypoglycaemia-in-type-1-diabetes
#20
Tor I Hansen, Sandra E Olsen, Elise C D Haferstrom, Trond Sand, Brian M Frier, Asta K Håberg, Marit R Bjørgaas
AIMS/HYPOTHESIS: The aim of this study was to compare cognitive function in adults with type 1 diabetes who have impaired awareness of hypoglycaemia with those who have normal awareness of hypoglycaemia. A putative association was sought between cognitive test scores and a history of severe hypoglycaemia. METHODS: A total of 68 adults with type 1 diabetes were included: 33 had impaired and 35 had normal awareness of hypoglycaemia, as confirmed by formal testing...
March 9, 2017: Diabetologia
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