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managment diabetes

Darshan Khangura, L Romayne Kurukulasuriya, Adam Whaley-Connell, James R Sowers
The presence of hypertension in individuals with type 2 diabetes augments the risk for cardiovascular morbidity and mortality. In this regard, data support that management of hypertension in this high-risk population is a critical risk reduction strategy. In recent years, a number of work groups have redefined hypertension, management strategies, and targets. In this context, there is still considerable discussion on an appropriate target for blood pressure in the diabetic population. However, despite this discussion on target blood pressure, it is widely recognized that there is considerable residual risk for heightened cardiovascular events in the hypertensive, diabetic population despite widespread awareness and treatment...
March 14, 2018: American Journal of Hypertension
Belén Pérez-Pevida, Daniela Stefania Trifu, Anna Kamocka, Julia Álvarez Hernández
CONTEXT: Bariatric surgery has beneficial effects on obesity and associated comorbidities such as glycaemic control in type 2 diabetes, dyslipidaemia, hypertension, and renal and hepatic function. Nevertheless, this surgery is not free of complications and possible side effects due to restrictive and/or malabsorptive related components. CASE DESCRIPTION: We report the case of a 60-year-old woman whose past medical history included morbid obesity, hypertension and Scopinaro biliopancreatic diversion (BPD) with duodenal switch in 1998...
March 1, 2018: International Journal of Surgery Case Reports
Soo Lim, Robert H Eckel, Kwang Kon Koh
The final goal in the management of patients with type 2 diabetes (T2D) is reduction in cardiovascular (CV) complications and total mortality. Various factors including hyperglycemia contribute to these complications and mortality directly and indirectly. In recent years, large-scale CV outcome trials with new antidiabetic medications, such as dipeptidyl peptidase-4 (DPP4) inhibitors, glucagon-like peptide-1 (GLP1) receptor agonists, and sodium glucose cotransporter-2 (SGLT2) inhibitors, have been completed...
March 8, 2018: Atherosclerosis
George Grunberger, Yehuda Handelsman, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, Richard A Haas, Victor L Roberts, Guillermo E Umpierrez
This document represents the official position of the American Association of Clinical Endocrinologists and American College of Endocrinology. Where there are no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician...
March 2018: Endocrine Practice
Carla D McArdle, Katie M Lagan, David A McDowell
BACKGROUND: This study investigated the resistance of bacteria isolated from diabetic foot ulcers (DFUs) to antibiotics frequently used in the management of the diabetic foot infections, at a range of pH values (pH 6.5, 7.5, and 8.5) known to exist in DFU wound fluid. This study aimed to determine whether changes (or atypical stasis) in wound fluid pH modulate the antibiotic resistance of DFU isolates, with potential implications in relation to the suppression/eradication of bacterial infections in DFUs...
January 2018: Journal of the American Podiatric Medical Association
Michaël R Laurent
An overview of selected papers related to bone published in 2017 is provided. PURPOSE: This paper accompanies a lecture at the 2018 Belgian Bone Club annual Clinical Update Symposium held in Brussels on January 20th, discussing the best papers (in the opinion of the author) published in the previous year. METHODS: A PubMed search using the keyword "bone" and articles published in 2017. RESULTS: Hot topics include screening for osteoporosis, novel anabolic drugs such as romosozumab and abaloparatide for osteoporosis and rare metabolic bone diseases, as well as long-term efficacy of denosumab and possible risk of multiple vertebral fractures following its discontinuation...
March 15, 2018: Archives of Osteoporosis
Przemyslaw Rys, Agnieszka H Ludwig-Słomczyńska, Katarzyna Cyganek, Maciej T Malecki
BACKGROUND: Randomised controlled trials (RCTs) have shown an advantage of continuous subcutaneous insulin infusion (CSII) over multiple daily injections (MDI) in the general type 1 diabetes mellitus (T1DM) population. RCT data on T1DM management in pregnancy remain limited. OBJECTIVE: We performed a systematic review of both RCTs and non-RCTs evaluating CSII versus MDI in T1DM-complicated pregnancy. STUDY DESIGN: Electronic databases were searched for studies comparing CSII with MDI in T1DM-complicated pregnancy...
March 15, 2018: European Journal of Endocrinology
Khaled Elshazly, Varun R Kshettry, Christopher J Farrell, Gurston Nyquist, Marc Rosen, James J Evans
BACKGROUND: Giant pituitary adenomas represent a surgical challenge. We present the results of the endoscopic endonasal approach (EEA) for giant pituitary adenomas. METHODS: We retrospectively reviewed medical records of 55 patients with giant pituitary adenomas (> 4 cm in maximum diameter) that underwent an EEA from 2008 - 2016. Factors affecting the extent of resection (EOR) were evaluated. RESULTS: Mean age was 55.5 years. All tumors were non-functional except in four patients (GH-secreting [2], ACTH-secreting [1], prolactinoma [1])...
March 12, 2018: World Neurosurgery
Holger Lörchner, Christian Widera, Yunlong Hou, Albrecht Elsässer, Henning Warnecke, Evangelos Giannitsis, Jean-Sebastien Hulot, Thomas Braun, Kai C Wollert, Jochen Pöling
BACKGROUND: Regenerating islet-derived protein 3 beta (Reg3β) is a cardiomyocyte-derived chemokine for macrophages that is upregulated after myocardial infarction (MI) in mice. Here, we hypothesized that monitoring Reg3β expression might provide specific information on the degree of cardiac inflammation, which is a key determinant in disease progression and prognosis of patients with acute coronary syndrome (ACS). METHODS AND RESULTS: The expression of Reg3β and other inflammatory markers including C-reactive protein (CRP) and myeloperoxidase (MPO) was measured by immunoblotting at serial time points in the hearts and serum of mice with acute MI...
May 1, 2018: International Journal of Cardiology
Brendan M Everett, Marc Y Donath, Aruna D Pradhan, Tom Thuren, Prem Pais, Jose C Nicolau, Robert J Glynn, Peter Libby, Paul M Ridker
BACKGROUND: Subclinical inflammation mediated in part by interleukin-1 beta (IL-1β) participates in peripheral insulin resistance and impaired pancreatic insulin secretion. OBJECTIVES: We tested the hypothesis that canakinumab, an IL-1β inhibitor, reduces incident diabetes. METHODS: The Canakinumab Antiinflammatory Thrombosis Outcomes Study (CANTOS) randomized 10,061 patients with prior MI and high-sensitivity C-reactive protein (hsCRP) ≥2 mg/L to placebo or canakinumab at doses of 50mg, 150mg, or 300mg subcutaneously once every three months...
March 3, 2018: Journal of the American College of Cardiology
Tinashe Mutize, Zibusiso Mkandla, Bongani B Nkambule
BACKGROUND: DNA methylation (global and gene-specific) has been reported as an epigenetic mechanism that could be involved in the pathogenesis of type 2 diabetes mellitus (T2DM). Furthermore, epigenetic therapy has been suggested as a future possibility for T2DM treatment. Epigenetic changes illustrate the environmental link of the disease. Since some of the epigenetic modifications can be reversed, they could be used as potential therapeutic targets. The aim of the systematic review will be to synthesise the available evidence pertaining to the link between DNA methylation and T2DM...
March 15, 2018: Systematic Reviews
Christina Schumann, Michael Faust
BACKGROUND:  Diabetic ketoacidosis and the hyperosmolar hyperglycemic state are the most serious diabetic emergencies. Before the discovery of insulin in 1921 by Banting and Best the diagnosis of type 1 diabetes was fatal ending in diabetic ketoacidosis equivalent to a torturous death. Today, mortality from diabetic ketoacidosis is low at approximately 2 %. But each death from these two acute metabolic complications of diabetes is potentially avoidable by improved patient and healthcare professional education...
March 2018: Deutsche Medizinische Wochenschrift
Fraser Magee, Michael Bailey, David V Pilcher, Johan Mårtensson, Rinaldo Bellomo
PURPOSE: To investigate the relationship between dysglycemia and hospital mortality in patients with and without a preadmission diagnosis of insulin treated diabetes mellitus (ITDM). MATERIALS AND METHODS: An observational multicentre cohort study using the ANZICS-APD database on adult patients admitted to ICU with sepsis between January 1st 2006 and December 31st 2015. Four domains of dysglycemia were investigated (highest, mean and lowest blood glucose levels and glycemic variability: the absolute difference between the highest and lowest level)...
March 3, 2018: Journal of Critical Care
Bernardo Costa-Pinel, Santiago Mestre-Miravet, Francisco Barrio-Torrell, Joan-Josep Cabré-Vila, Xavier Cos-Claramunt, Sofía Aguilar-Sanz, Claustre Solé-Brichs, Conxa Castell-Abat, Victoria Arija-Val, Jaana Lindström
BACKGROUND: The DE-PLAN-CAT project (Diabetes in Europe-Prevention using lifestyle, physical activity and nutritional intervention-Catalonia) has shown that an intensive lifestyle intervention is feasible in the primary care setting and substantially reduces the incidence of diabetes among high-risk Mediterranean participants. The DP-TRANSFERS project (Diabetes Prevention-Transferring findings from European research to society) is a large-scale national programme aimed at implementing this intervention in primary care centres whenever feasible...
2018: PloS One
Meda E Pavkov, Jessica L Harding, Nilka R Burrows
Acute kidney injury is a sudden decrease in kidney function with or without kidney damage, occurring over a few hours or days. Diabetes, hypertension, and advanced age are primary risk factors for acute kidney injury. It is increasingly recognized as an in-hospital complication of sepsis, heart conditions, and surgery (1,2). Its most severe stage requires treatment with dialysis. Acute kidney injury is also associated with higher likelihood of long-term care, incidence of chronic kidney disease and hospital mortality, and health care costs (1,2)...
March 16, 2018: MMWR. Morbidity and Mortality Weekly Report
Danika Martyn, Maryse Darch, Ashley Roberts, Han Youl Lee, Tina Yaqiong Tian, Naoko Kaburagi, Pablo Belmar
The current review examined published data on the intake of all major low-/no-calorie sweeteners-aspartame, acesulfame-K, saccharin, sucralose, cyclamate, thaumatin and steviol glycosides-globally over the last decade. The most detailed and complex exposure assessments were conducted in Europe, following a standardized approach. Japan and Korea similarly had up-to-date and regular intake data available. The data for other Asian countries, Latin America, Australia/New Zealand and global estimates, evaluated by the Joint FAO/WHO Expert Committee on Food Additives (JECFA), while available, were shown to be more limited in terms of design...
March 15, 2018: Nutrients
Yu-Ri Kang, Hwang-Yong Choi, Jung-Yun Lee, Soo In Jang, Hanna Kang, Jung-Bae Oh, Hae-Dong Jang, Young-In Kwon
Onion ( Allium cepa L.) is widely consumed as food or medicinal plant due to its well-defined health benefits. The antioxidant and antihyperlipidemic effects of onion and its extracts have been reported well. However, very limited information on anti-hyperglycemic effect is available in processed onion extracts. In our previous study, we reported that Amadori rearrangement compounds (ARCs) produced by heat-processing in Korean ginseng can reduce carbohydrate absorption by inhibiting intestinal carbohydrate hydrolyzing enzymes in both in vitro and in vivo animal models...
March 15, 2018: International Journal of Molecular Sciences
Kimberly L Savin, Emily R Hamburger, Alexandra D Monzon, Niral J Patel, Katia M Perez, Jadienne H Lord, Sarah S Jaser
Family conflict in adolescents with type 1 diabetes (T1D) has been linked to worse disease management (i.e., glycemic control, adherence to treatment regimen) and reduced quality of life. We sought to examine parental risk factors associated with increased levels of diabetes-specific family conflict and to investigate the discrepancies between parent and adolescent reports of conflict. Adolescents with T1D and their parents (N = 120 dyads) completed measures of diabetes-specific family conflict. Adolescents also reported on health-related quality of life, and parents reported on demographic information...
February 2018: Journal of Family Psychology: JFP
Ahmed A Aljohaney
OBJECTIVES: To determine the mortality rates and predictors among patients hospitalized with active tuberculosis (TB) at King Abdulaziz University Hospital (KAUH) in Jeddah. METHODS: A retrospective study was performed on 291 active TB patients hospitalized in KAUH, Jeddah, Saudi Arabia from December 2011 to December 2016. Medical records were collected and evaluated using a dedicated data extraction sheet. The records included demographics, clinical, radiological, laboratory, and drug resistance data...
March 2018: Saudi Medical Journal
Paola Cipriani, Vasiliky Liakouli, Francesco Carubbi, Onorina Berardicurti, Paola Di Benedetto, Francesco Ciccia, Giuliana Guggino, Saverio Alvaro, Giovanni Triolo, Roberto Giacomellia, Piero Ruscitti
BACKGROUND: Although in the past, prevention of the joint destruction and disability were strongly emphasised in rheumatoid arthritis (RA), at present, a growing body of evidence is focused at identifying the best management of associated comorbidities, such as type 2 diabetes (T2D). Recently, the hypothesis that blocking pro-inflammatory activity may be helpful in the treatment of some comorbidities has been proposed in RA patients. OBJECTIVE: We reviewed the role of IL-1β during RA and T2D, the efficacy of IL-1 blocking agents in controlling both diseases and, possible, decreasing the concomitant enhanced atherosclerotic process...
March 13, 2018: Reviews on Recent Clinical Trials
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