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https://www.readbyqxmd.com/read/28226967/nonlinear-model-predictive-glycemic-control-of-critically-ill-patients-using-online-identification-of-insulin-sensitivity
#1
Sha Wu, Eiko Furutani, Sha Wu, Eiko Furutani, Eiko Furutani, Sha Wu
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
https://www.readbyqxmd.com/read/28225315/improving-glycemic-control-safely-in-critical-care-patients-a-collaborative-systems-approach-in-nine-hospitals
#2
Gregory A Maynard, Janet Holdych, Heather Kendall, Karen Harrison, Patricia A Montgomery, Kristen Kulasa
Objective Safely improve glycemic control in the critical care units of nine hospitals. Methods Critical care adult inpatients from nine hospitals with ≥ 4 point-of-care (POC) blood glucose (BG) readings over ≥ 2 days were targeted by collaborative improvement efforts to reduce hyper- and hypo-glycemia. Balanced glucometric goals for each hospital were set targeting improvement from baseline, or goals deemed desirable from Society of Hospital Medicine (SHM) benchmarking data. Collaborative interventions included standardized insulin infusion protocols, hypoglycemia prevention bundles, audit and feedback, education, and measure-vention (coupling measurement of patients "off protocol" with concurrent interventions to correct suboptimal care)...
February 22, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28225312/perspectives-on-learning-and-clinical-practice-improvement-for-diabetes-in-the-hospital-a-review-of-educational-interventions-for-providers
#3
Ariana Pichardo-Lowden, Paul Haidet, Guillermo E Umpierrez
BACKGROUND: The management inpatient hyperglycemia and diabetes requires expertise among many healthcare providers. There is limited evidence about how education for healthcare providers can result in optimization of clinical outcomes. The purpose of this critical review of the literature is to examine methods and outcomes related to educational interventions regarding the management of diabetes and dysglycemia in the hospital setting. This report provides recommendations to advance learning, curricular planning and clinical practice...
February 22, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28224109/timing-method-and-discontinuation-of-hydrocortisone-administration-for-septic-shock-patients
#4
Miguel A Ibarra-Estrada, Quetzalcóatl Chávez-Peña, Claudia I Reynoso-Estrella, Jorge Rios-Zermeño, Pável E Aguilera-González, Miguel A García-Soto, Guadalupe Aguirre-Avalos
AIM: To characterize the prescribing patterns for hydrocortisone for patients with septic shock and perform an exploratory analysis in order to identify the variables associated with better outcomes. METHODS: This prospective cohort study included 59 patients with septic shock who received stress-dose hydrocortisone. It was performed at 2 critical care units in academic hospitals from June 1(st), 2015, to July 31(st), 2016. Demographic data, comorbidities, medical management details, adverse effects related to corticosteroids, and outcomes were collected after the critical care physician indicated initiation of hydrocortisone...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28212470/-prediabetes-as-a-riskmarker-for-stress-induced-hyperglycemia-in-critically-ill-adults
#5
Diego Jesús García-Gallegos, Eliseo Luis-López
BACKGROUND: It is not known if patients with prediabetes, a subgroup of non-diabetic patients that usually present hyperinsulinemia, have higher risk to present stress-induced hyperglycemia. The objective was to determine if prediabetes is a risk marker to present stress-induced hyperglycemia. METHODS: Analytic, observational, prospective cohort study of non-diabetic critically ill patients of a third level hospital. We determined plasmatic glucose and glycated hemoglobin (HbA1c) at admission to diagnose stress-induced hyperglycemia (glucose ≥ 140 mg/dL) and prediabetes (HbA1c between 5...
2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28212343/oxyresveratrol-supplementation-to-c57bl-6-mice-fed-with-a-high-fat-diet-ameliorates-obesity-associated-symptoms
#6
Hui Yuan Tan, Iris Mei Ying Tse, Edmund Tsze Shing Li, Mingfu Wang
Oxyresveratrol has been proven effective in inhibiting adipogenesis in a 3T3-L1 cell model. We investigated the preventive effect of oxyresveratrol supplementation on obesity development in high-fat diet-fed mice. Male C57bl/6 mice were randomly subjected to control (5% fat by weight, LF), high-fat (30% fat by weight, HF), and high-fat supplemented with 0.25% and 0.5% oxyresveratrol (OXY1 and OXY2, respectively) diet groups for eight weeks. Oxyresveratrol supplementation effectively alleviated obesity-associated symptoms such as insulin resistance, hyperglycemia, and hepatic steatosis in high-fat diet-fed mice...
February 16, 2017: Nutrients
https://www.readbyqxmd.com/read/28207836/tmg-123-a-novel-glucokinase-activator-exerts-durable-effects-on-hyperglycemia-without-increasing-triglyceride-in-diabetic-animal-models
#7
Yoshinori Tsumura, Yu Tsushima, Azusa Tamura, Makiko Hasebe, Masanobu Kanou, Hirotsugu Kato, Tsunefumi Kobayashi
Glucokinase (GK) plays a critical role for maintaining glucose homeostasis with regulating glucose uptake in liver and insulin secretion in pancreas. GK activators have been reported to decrease blood glucose levels in patients with type 2 diabetes mellitus. However, clinical development of GK activators has failed due to the loss of glucose-lowering effects and increased plasma triglyceride levels after chronic treatment. Here, we generated a novel GK activator, TMG-123, examined its in vitro and in vivo pharmacological characteristics, and evaluated its risks of aforementioned clinical issues...
2017: PloS One
https://www.readbyqxmd.com/read/28183874/novel-insights-into-dna-methylation-and-its-critical-implications-in-diabetic-vascular-complications
#8
Jia Zheng, Jing Cheng, Qian Zhang, Xinhua Xiao
Recent epidemiological and clinical studies have shown that type 2 diabetic patients can develop diabetic vascular complications even after intensive glycemic control. It has been suggested that this phenomenon could be explained by the hypothesis of "metabolic memory". The underlying mechanisms between these enduring effects and the prior hyperglycemic state are still not well understood. Preliminary studies demonstrate that hyperglycemia can regulate gene expression by epigenetic modifications, such as DNA methylation, which can persistently exist even after glucose normalization...
February 9, 2017: Bioscience Reports
https://www.readbyqxmd.com/read/28164134/diabetes-induced-reactive-oxygen-species-mechanism-of-their-generation-and-role-in-renal-injury
#9
REVIEW
Selim Fakhruddin, Wael Alanazi, Keith E Jackson
Diabetes induces the onset and progression of renal injury through causing hemodynamic dysregulation along with abnormal morphological and functional nephron changes. The most important event that precedes renal injury is an increase in permeability of plasma proteins such as albumin through a damaged glomerular filtration barrier resulting in excessive urinary albumin excretion (UAE). Moreover, once enhanced UAE begins, it may advance renal injury from progression of abnormal renal hemodynamics, increased glomerular basement membrane (GBM) thickness, mesangial expansion, extracellular matrix accumulation, and glomerulosclerosis to eventual end-stage renal damage...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28149085/complications-in-mechanically-ventilated-patients-of-guillain-barre-syndrome-and-their-prognostic-value
#10
Archana Becket Netto, Arun B Taly, Girish B Kulkarni, G S Uma Maheshwara Rao, Shivaji Rao
INTRODUCTION: The spectrum of various complications in critically ill Guillain-Barre syndrome (GBS) and its effect on the prognosis is lacking in literature. This study aimed at enumerating the complications in such a cohort and their significance in the prognosis and mortality. MATERIALS AND METHODS: Retrospective case record analysis of all consecutive mechanically ventilated patients of GBS in neurology Intensive Care Unit (ICU) of a tertiary care institute for 10 years was done...
January 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28148567/critical-role-of-the-camp-pka-pathway-in-hyperglycemia-induced-epigenetic-activation-of-fibrogenic-program-in-the-kidney
#11
Dilip K Deb, Riyue Bao, Yan Chun Li
Hyperglycemia is a major pathogenic factor that promotes diabetic nephropathy, but the underlying mechanism remains incompletely understood. Here, we show that high glucose induced cAMP response element-binding protein (CREB)-binding protein (CBP)-mediated H3K9/14 hyperacetylation in approximately 5000 gene promoters in glomerular mesangial cells, including those of Tgfb1, Tgfb3, and Ctgf, the major profibrotic factors that are known to drive diabetic renal fibrogenesis. In these promoters, H3K9/14 hyperacetylation was closely associated with NF-κB or CREB motifs...
February 1, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28138002/high-fat-feeding-unmasks-variable-insulin-responses-in-male-c57bl-6-mouse-substrains
#12
Rebecca L Hull, Joshua R Willard, Matthias D Struck, Breanne M Barrow, Gurkirat S Brar, Sofianos Andrikopoulos, Sakeneh Zraika
Mouse models are widely used for elucidating mechanisms underlying type 2 diabetes. Genetic background profoundly affects metabolic phenotype; therefore, selecting the appropriate model is critical. Although variability in metabolic responses between mouse strains is now well recognized, it also occurs within C57BL/6 mice, of which several substrains exist. This within-strain variability is poorly understood and could emanate from genetic and/or environmental differences. To better define the within-strain variability, we performed the first comprehensive comparison of insulin secretion from C57BL/6 substrains 6J, 6JWehi, 6NJ, 6NHsd, 6NTac and 6NCrl...
April 2017: Journal of Endocrinology
https://www.readbyqxmd.com/read/28118549/tight-glycemic-control-in-critically-ill-children
#13
Michael S D Agus, David Wypij, Eliotte L Hirshberg, Vijay Srinivasan, E Vincent Faustino, Peter M Luckett, Jamin L Alexander, Lisa A Asaro, Martha A Q Curley, Garry M Steil, Vinay M Nadkarni
Background In multicenter studies, tight glycemic control targeting a normal blood glucose level has not been shown to improve outcomes in critically ill adults or children after cardiac surgery. Studies involving critically ill children who have not undergone cardiac surgery are lacking. Methods In a 35-center trial, we randomly assigned critically ill children with confirmed hyperglycemia (excluding patients who had undergone cardiac surgery) to one of two ranges of glycemic control: 80 to 110 mg per deciliter (4...
February 23, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28112704/evaluation-and-treatment-of-hyperglycemia-in-critically-ill-patients
#14
Andrea Balloni, Federico Lari, Fabrizio Giostra
The hyperglycemic reaction to stress is part of adaptive metabolic response to critical illness, especially hypoxia, hemorrhage and sepsis. It involves neuro-endocrine and immune pathways leading to the development of insulin resistance and hepatic glucose production by gluconeogenesis and glycogenolysis. Over the last years the concept of stress related hyperglycemia has been replaced by the concept of dysglycemia and its three domains: hyperglycemia, hypoglycemia and glycemic variability. Each of the three domains is independently associated with increased risk of mortality in patients admitted in intensive care unit and non critically ill patients, both medical and surgical...
January 16, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28111213/a-non-invasive-method-to-assess-hepatic-acetyl-coa-in%C3%A2-vivo
#15
Rachel J Perry, Liang Peng, Gary W Cline, Kitt Falk Petersen, Gerald I Shulman
Acetyl-coenzyme A (acetyl-CoA) is a critical metabolic signaling molecule that regulates gluconeogenesis, pyruvate oxidation, protein acetylation, and steroid and fatty acid biosynthesis; however, measurements of this metabolite using standard biochemical approaches are technically demanding, and there is currently no method to non-invasively assess hepatic acetyl-CoA content in vivo. To this end, we developed and validated a method to non-invasively detect differences in hepatic acetyl-CoA content in vivo across a 5-fold range of physiological acetyl-CoA concentrations by assessing the turnover of [(13)C4]β-hydroxybutyrate (β-OHB)...
January 18, 2017: Cell Metabolism
https://www.readbyqxmd.com/read/28109123/sodium-butyrate-protects-against-high-fat-diet-induced-cardiac-dysfunction-and-metabolic-disorders-in-type-ii-diabetic-mice
#16
Ling Zhang, Jianfeng Du, Naohiro Yano, Hao Wang, Yu Tina Zhao, Dubielecka-Szczerba Patricia, Shougang Zhuang, Eugene Y Chin, Gangjian Qin, Ting C Zhao
Histone deacetylases are recently identified to act as key regulators for cardiac pathophysiology and metabolic disorders. However, the function of histone deacetylase (HDAC) in controlling cardiac performance in type II diabetes and obesity remains unknown. Here we determine whether HDAC inhibition attenuates high fat diet (HFD)-induced cardiac dysfunction and improves metabolic features. Adult mice were fed with either HFD or standard chow food for 24 weeks. Starting at 12 weeks, mice were divided into four groups randomly, in which sodium butyrate (1%), a potent HDAC inhibitor, was provided to chow and HFD-fed mice in drinking water, respectively...
January 21, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28105734/calcium-calmodulin-dependent-protein-kinase-mediates-the-intracellular-signaling-pathways-of-cardiac-apoptosis-in-mice-with-impaired-glucose-tolerance
#17
Marilen Federico, Enrique L Portiansky, Leandro Sommese, Francisco J Alvarado, Paula G Blanco, Carolina N Zanuzzi, John Dedman, Marcia Kaetzel, Xander H T Wehrens, Alicia Mattiazzi, Julieta Palomeque
Background The impact of cardiac apoptosis in pre-diabetic stages of diabetic cardiomyopathy is unknown. We described that myocytes from fructose-rich diet (FRD) animals exhibit arrhythmias produced by exacerbated Ca(2+) /calmodulin-protein kinase (CaMKII) activity, ryanodine receptors (RyR2) phosphorylation and sarcoplasmic reticulum (SR) Ca(2+) leak. We tested the hypothesis that this mechanism also underlies cardiac apoptosis in pre-diabetes. Methods and Results We generated a pre-diabetic model in mice fed with FRD...
January 20, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28098719/regional-gray-matter-volumes-as-related-to-psychomotor-slowing-in-adults-with-type-1-diabetes
#18
Karen A Nunley, Christopher M Ryan, Howard J Aizenstein, Rebecca L MacCloud, Trevor J Orchard, Caterina Rosano
OBJECTIVE: Psychomotor slowing is a common cognitive complication in type 1 diabetes (T1D), but its neuroanatomical correlates and risk factors are unclear. In non-diabetic adults, smaller gray matter volume (GMV) and presence of white matter hyperintensities (WMH) are associated with psychomotor slowing. We hypothesize that smaller GMV in prefronto-parietal regions explains T1D-related psychomotor slowing. We also inspect the contribution of microvascular disease and hyperglycemia. METHODS: GMV, WMH, and glucose levels were measured concurrently with a test of psychomotor speed (Digit Symbol Substitution Test, DSST) in 95 adults with childhood-onset T1D (mean age/duration=49/41 years) and 135 similarly-aged non-T1D adults...
January 17, 2017: Psychosomatic Medicine
https://www.readbyqxmd.com/read/28093504/a-model-of-type-2-diabetes-in-the-guinea-pig-using-sequential-diet-induced-glucose-intolerance-and-streptozotocin-treatment
#19
Brendan K Podell, David F Ackart, Michael A Richardson, James E DiLisio, Bruce Pulford, Randall J Basaraba
Type 2 diabetes is a leading cause of morbidity and mortality among non-communicable diseases and additional animal models that more closely replicate the pathogenesis of human type 2 diabetes are needed. The goal of this study was to develop a model of type 2 diabetes in guinea pigs in which diet-induced glucose intolerance precedes β cell cytotoxicity, two processes that are critical to the development of human type 2 diabetes. Guinea pigs developed impaired glucose tolerance after eight weeks of feeding a high fat, high carbohydrate diet, as determined by oral glucose challenge...
January 12, 2017: Disease Models & Mechanisms
https://www.readbyqxmd.com/read/28089906/adenosine-signaling-in-diabetes-mellitus-and-associated-cardiovascular-and-renal-complications
#20
REVIEW
Maria Peleli, Mattias Carlstrom
Diabetes mellitus is characterized by abnormal glucose and lipid metabolism, and subsequent hyperglycemia and dyslipidemia, which results from defects in pancreatic islet beta-cells insulin secretion and/or decreased insulin sensitivity in metabolically active organs (i.e. liver, skeletal muscle and adipose tissue). Accumulating evidence highlights a critical role for the adenosine system in the regulation of insulin and glucose homeostasis and the pathophysiology of type 2 diabetes (T2D). Adenosine is a key diverse extracellular signaling molecule that regulates several aspects of tissue function by activating four G-protein-coupled receptors (i...
January 12, 2017: Molecular Aspects of Medicine
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