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https://www.readbyqxmd.com/read/27922496/metabolic-myopathies
#1
Mark A Tarnopolsky
PURPOSE OF REVIEW: Metabolic myopathies are genetic disorders that impair intermediary metabolism in skeletal muscle. Impairments in glycolysis/glycogenolysis (glycogen-storage disease), fatty acid transport and oxidation (fatty acid oxidation defects), and the mitochondrial respiratory chain (mitochondrial myopathies) represent the majority of known defects. The purpose of this review is to develop a diagnostic and treatment algorithm for the metabolic myopathies. RECENT FINDINGS: The metabolic myopathies can present in the neonatal and infant period as part of more systemic involvement with hypotonia, hypoglycemia, and encephalopathy; however, most cases present in childhood or in adulthood with exercise intolerance (often with rhabdomyolysis) and weakness...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27921434/-actual-trends-in-diagnostics-and-treatment-of-congenital-hyperinsulinism
#2
Juraj Staník, Martina Škopková, Monika Rosoľanková, Iwar Klimeš, Daniela Gašperíková
Congenital hyperinsulinism (CHI) is the most common cause of severe persistent hypoglycemia in neonates and infants. Early diagnosis and effective treatment (based on the principles of pharmacogenetics) play the key role for the prognosis. The DNA anlysis, which can identify mutation in one of the 11 genes causing MODY, is crutial in the diagnostics. Moreover, The genotype determines also the optimal therapy approach (medicaments, diet or rarely surgery). There was a large progress of novel medicaments treating particularly most severe (diazoxide-resistant) forms of CHI...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27920549/management-of-hypoglycemia-in-nondiabetic-palliative-care-patients-a-prognosis-based-approach
#3
REVIEW
Victor C Kok, Ping-Hsueh Lee
Hypoglycemia due to underlying terminal illness in nondiabetic end-of-life patients receiving palliative care has not been fully studied. For example, we do not have adequate information on the frequency of spontaneous hypoglycemia in patients as occurs during the different stages of palliative care. Depending on the case-mix nature of the palliative care ward, at least 2% of palliative care patients may develop hypoglycemia near the end of life when the remaining life expectancy counts down in days. As many as 25%-60% of these patients will neither have autonomic response nor have neuroglycopenic symptoms during a hypoglycemic episode...
2016: Palliative Care
https://www.readbyqxmd.com/read/27918858/d10-in-the-treatment-of-prehospital-hypoglycemia-a-24-month-observational-cohort-study
#4
H Gene Hern, Matthew Kiefer, Derex Louie, Joseph Barger, Harrison J Alter
INTRODUCTION: Prehospital first responders historically have used an IV bolus of 50 mL of 50% dextrose solution (D50) for the treatment of hypoglycemia in the field. A local Emergency Medical Services (EMS) system recently approved a hypoglycemia treatment protocol of IV 10% dextrose solution (D10) due to occasional shortages and higher cost of D50. We use the experience of this EMS system to report the feasibility, safety, and efficacy of this approach. METHODS: Over the course of 104 weeks, paramedics treated 1,323 hypoglycemic patients with D10 and recorded patient demographics and clinical outcomes...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918639/evaluation-of-an-outpatient-protocol-in-the-treatment-of-canine-parvoviral-enteritis
#5
Emilee C Venn, Karolina Preisner, Pedro L Boscan, David C Twedt, Lauren A Sullivan
OBJECTIVE: To compare 2 treatment protocols (standard in-hospital versus modified outpatient) in affecting the duration of treatment or survival of dogs with parvoviral enteritis. DESIGN: Prospective, randomized study. SETTING: University teaching hospital. ANIMALS: Client-owned dogs with naturally acquired parvovirus were randomized to receive either an inpatient (n = 20) or outpatient (n = 20) treatment protocol. INTERVENTIONS: Both groups received intravenous (IV) fluid resuscitation and correction of hypoglycemia at hospital admission...
December 5, 2016: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/27914297/long-term-efficacy-and-safety-of-vildagliptin-add-on-therapy-in-type-2-diabetes-mellitus-with-insulin-treatment
#6
Ippei Kanazawa, Ken-Ichiro Tanaka, Masakazu Notsu, Sayuri Tanaka, Nobuaki Kiyohara, Sayo Koike, Yuko Yamane, Yuko Tada, Motofumi Sasaki, Mika Yamauchi, Toshitsugu Sugimoto
BACKGROUND: The use of dipeptidyl peptidase (DPP)-4 inhibitors in patients with type 2 diabetes treated with insulin may be beneficial. However, the long-term efficacy and safety of vildagliptin add-on therapy in these patients remains unclear. SUBJECTS AND METHODS: A total of 73 patients with type 2 diabetes treated with insulin were randomly assigned to receive either add-on therapy of vildagliptin (n=37) or conventional therapy without DPP-4 inhibitors (n=36) for glucose control...
November 20, 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/27905899/a-case-of-extragastrointestinal-stromal-tumor-complicated-by-severe-hypoglycemia-a-unique-presentation-of-a-rare-tumor
#7
Zeb Saeed, Solaema Taleb, Carmella Evans-Molina
BACKGROUND: Non-Islet Cell Tumor Hypoglycemia (NICTH) is a rare paraneoplastic cause of hypoglycemia arising from excess tumor production of insulin-like growth factor. The objective of this report is to describe an unusual case of Extragastrointestinal Stromal Tumor (EGIST) associated NICTH. CASE PRESENTATION: A 64 year-old African female was brought to the emergency room with a 1-month history of recurrent syncope, weight loss, and abdominal bloating. Serum blood glucose was discovered to 39 mg/dL, when insulin, proinsulin, and C-peptide were suppressed...
December 1, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27894787/safety-and-efficacy-of-liraglutide-treatment-in-japanese-type-2-diabetes-patients-after-acute-myocardial-infarction-a-non-randomized-interventional-pilot-trial
#8
Masataka Kajiwara, Atsushi Tanaka, Tomohiro Kawasaki, Koichi Nakao, Tomohiro Sakamoto, Shigeru Toyoda, Teruo Inoue, Nobuhiko Koga, Koichi Node
BACKGROUND: Glucagon-like peptide 1 analogs are expected to exert a cardio-protective action due to their effective glucose-lowering action and favorable potency on multifactorial metabolic pathways. However, the safety and tolerability of liraglutide treatment after a recent acute coronary syndrome (ACS) in Japanese patients with type 2 diabetes mellitus (T2DM) have yet to be fully established. METHODS: A total of eight T2DM patients were recruited within 2 weeks after the onset of a ST-elevation myocardial infarction (STEMI) followed by successful percutaneous coronary intervention (PCI)...
November 25, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27891268/a-case-report-describing-a-rare-presentation-of-simultaneous-occurrence-of-mpo-anca-associated-vasculitis-and-rheumatoid-arthritis
#9
Nathalie Foray, Tamer Hudali, Muralidhar Papireddy, John Gao
Background. Renal-limited myeloperoxidase vasculitis with simultaneous rheumatoid arthritis is reported as a rare occurrence. Review of literature suggests that most patients had a diagnosis of rheumatoid arthritis for several years prior to presenting with renal failure from myeloperoxidase vasculitis. Case Presentation. A 58-year-old Caucasian male presented to the hospital experiencing malaise, fevers, decreased oral intake, nausea, and vomiting for one week duration. His past medical history consisted of newly diagnosed but untreated rheumatoid arthritis, hypertension, and non-insulin-dependent diabetes mellitus...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27885968/possible-approaches-to-cyp2c9-guided-prescription-of-sulfonylureas-in-russia
#10
Anna Mosikian, Antonina Dolgorukova, Alsu Zalevskaya
AIM: To evaluate a possible role of CYP2C9 genotyping for sulfonylureas (SUs) prescription in Russia. MATERIALS & METHODS: We have collected the current data on correlation between SUs pharmacodynamics and CYP2C9 polymorphisms. We have evaluated the frequency of CYP2C9 polymorphisms in Russia by reviewing the literature published from 2004 to 2015 on Russian CYP2C9. RESULTS: The genotype *1/*1, which confers risk for treatment failure, has a higher frequency (81...
November 25, 2016: Pharmacogenomics
https://www.readbyqxmd.com/read/27882163/insulin-induced-autoimmune-syndrome-a-case-report
#11
Jian-Ping Chu, Xiao-Wei Zheng, Jie Lu, Jin-Yan Zhong, Jia-Lin Li, Miao Xu, Fang Lin
Insulin autoimmune syndrome (IAS) is a disease characterized by hyperinsulinemic hypoglycemia associated with autoantibodies against endogenous insulin. A 56-year-old man was admitted to Ningbo First Hospital for the treatment of spontaneous hypoglycemia. He was found to have elevated fasting insulin level (>1,000 mIU/l) and presence of insulin autoantibodies, and after appropriate workup, was diagnosed with IAS. After treating with prednisone for 2 months, his insulin level started decreasing. In patients with repeated hypoglycemia, IAS should be considered in the differential diagnosis...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27882107/effects-of-sitagliptin-as-initial-therapy-in-newly-diagnosed-elderly-type-2-diabetics-a-randomized-controlled-study
#12
Xiaoyan Xiao, Xiaopei Cui, Jianbo Zhang, Zhenxia Han, Yu Xiao, Nan Chen, Baoying Li, Mei Cheng, Haiqing Gao, Kuanxiao Tang
The objective of this study was to investigate the characteristics of blood glycemic excursion, incretins and pancreatic hormone secretion in elderly people with newly diagnosed type 2 diabetes mellitus (T2DM) and to study the effects of sitagliptin on glycemic excursion in these subjects. A total of 129 newly diagnosed T2DM patients were enrolled in the study from March 2012 to August 2013. Clinical data, serum incretin, pancreatic hormone and continuous glucose monitoring data were collected. Among these subjects, elderly patients (NEDM) randomly received metformin combined with sitagliptin phosphate or glimepiride for 24 weeks...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27879355/pregnancy-outcomes-in-women-with-diabetes-lessons-learned-from-clinical-research-the-2015-norbert-freinkel-award-lecture
#13
Elisabeth R Mathiesen
Among women with diabetes, the worst pregnancy outcome is seen in the subgroup of women with diabetic nephropathy. Development of severe preeclampsia that leads to early preterm delivery is frequent. Predictors and pathophysiological mechanisms for the development of preeclampsia among women with diabetes and observational studies that support antihypertension treatment for pregnant women with microalbuminuria or diabetic nephropathy preventing preeclampsia and early preterm delivery are presented here. Obtaining and maintaining strict glycemic control before and during pregnancy is paramount to prevent preterm delivery...
December 2016: Diabetes Care
https://www.readbyqxmd.com/read/27878914/severe-hypoglycemia-rates-are-not-associated-with-hba1c-a-cross-sectional-analysis-of-3-contemporary-pediatric-diabetes-registry-databases
#14
Aveni Haynes, Julia M Hermann, Kellee M Miller, Sabine E Hofer, Timothy W Jones, Roy W Beck, David M Maahs, Elizabeth A Davis, Reinhard W Holl
OBJECTIVE: To examine the association between glycated hemoglobin (HbA1c) and severe hypoglycemia rates in patients with type 1 diabetes receiving usual care, by analysing data from the US Type 1 Diabetes Exchange (T1DX), German/Austrian Diabetes Patienten Verlaufsdokumenation (DPV), and Western Australian Children Diabetes Database (WACDD) diabetes registries. METHODS: Data for patients with type 1 diabetes, aged <18 years with a minimum duration of diabetes of 2 years, were extracted from each registry for a 12-month observation period between 2011 and 2012 (7,102 T1DX, 18,887 DPV, and 865 WACDD)...
November 23, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27878271/estrogen-is-neuroprotective-against-hypoglycemic-injury-in-murine-n38-hypothalamic-cells
#15
Tandra R Chakraborty, Joshua Cohen, Darien Yohanan, Eilliut Alicea, Benjamin S Weeks, Sanjoy Chakraborty
Estrogen (E2) has been demonstrated to possess protective effects from hypoglycemic toxicity, particularly in the pancreas. In the central nervous system, several brain regions, such as the hypothalamus, are highly vulnerable to hypoglycemic injuries that may lead to seizures, coma, and mortality. The present study performed a novel in vitro assay of hypoglycemic injury to hypothalamic cells, and is the first study, to the best of our knowledge, to demonstrate that E2 protects hypothalamic cells from hypoglycemic toxicity...
November 18, 2016: Molecular Medicine Reports
https://www.readbyqxmd.com/read/27876337/beneficial-effect-of-carvone-a-dietary-monoterpene-ameliorates-hyperglycemia-by-regulating-the-key-enzymes-activities-of-carbohydrate-metabolism-in-streptozotocin-induced-diabetic-rats
#16
Udaiyar Muruganathan, Subramani Srinivasan
Diabetes mellitus is a common metabolic/endocrine disorder characterized by inadequate control of carbohydrate metabolism and causes serious health issues. This study evaluates the effect of carvone, a novel monoterpene ketone, on carbohydrate metabolic enzymes in the liver of normal and streptozotocin (STZ)-induced diabetic rats. Diabetes was induced by a single intraperitoneal injection of STZ (40mg/kg b.w). STZ intoxication led to a significant increase in the levels of plasma glucose, glycosylated hemoglobin (HbA1c) and decrease in the levels of insulin and hemoglobin (Hb)...
November 19, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/27875915/efficacy-and-safety-of-insulin-glp-1-receptor-agonists-combination-in-type-2-diabetes-mellitus-a-systematic-review
#17
D Cimmaruta, M I Maiorino, C Scavone, L Sportiello, F Rossi, D Giugliano, K Esposito, A Capuano
Attaining optimal glycemic targets in patients with type 2 diabetes is often hard and compromised by the shortcomings of the several treatments. Areas covered: When glycemic levels are not adequately controlled, an association of GLP-1 receptor agonists and insulin therapy can be adopted. In order to assess the benefit/risk profile of this combination therapy, a literature search of randomized clinical trials was performed.Eighteen trials matched the inclusion criteria. In 10 studies, GLP-1 receptor agonists were added on to an existing regimen, whereas insulin added to an existing GLP-1 receptor agonists regimen occurred in 2 studies...
December 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27875596/cost-effectiveness-of-saxagliptin-versus-acarbose-as-second-line-therapy-in-type-2-diabetes-in-china
#18
Shuyan Gu, Yuhang Zeng, Demin Yu, Xiaoqian Hu, Hengjin Dong
OBJECTIVE: This study assessed the long-term cost-effectiveness of saxagliptin+metformin (SAXA+MET) versus acarbose+metformin (ACAR+MET) in Chinese patients with type 2 diabetes mellitus (T2DM) inadequately controlled on MET alone. METHODS: Systematic literature reviews were performed to identify studies directly comparing SAXA+MET versus ACAR+MET, and to obtain diabetes-related events costs which were modified by hospital surveys. A Cardiff Diabetes Model was used to estimate the long-term economic and health treatment consequences in patients with T2DM...
2016: PloS One
https://www.readbyqxmd.com/read/27865808/postprandial-hyperinsulinemic-hypoglycemia-after-roux-en-y-gastric-bypass-an-update
#19
Caroline Christfort Øhrstrøm, Dorte Worm, Dorte Lindqvist Hansen
Roux-en-Y gastric bypass (RYGB) is an efficient treatment for morbid obesity and reduces obesity-related co-morbidities. With the growing number of patients undergoing gastric bypass, complications now demand further attention. Postprandial hyperinsulinemic hypoglycemia (PHH) after Roux-en-Y gastric bypass is a complex condition, characterized by increased glucose variability including both hyperglycemic and hypoglycemic values. PHH seems to be more prevalent than previously suggested and is highly dependent on the choice of diagnostic tool, which has not yet been standardized...
September 28, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27865017/isolated-thoughts-and-feelings-and-unsolved-concerns-adolescents-and-parents-perspectives-on-living-with-type-1-diabetes-a-qualitative-study-using-visual-storytelling
#20
Pernille Castensøe-Seidenfaden, Grete Teilmann, Finn Kensing, Eva Hommel, Birthe Susanne Olsen, Gitte Reventlov Husted
AIMS AND OBJECTIVES: To explore and describe the experiences of adolescents and their parents living with type 1 diabetes (T1DM), to identify their needs for support to improve adolescents' self-management skills in the transition from child- to adulthood. BACKGROUND: Adolescents with T1DM often experience deteriorating glycemic control and distress. Parents are important in adolescents' ability to self-manage T1DM, but they report anxiety and frustrations. A better understanding of the challenges adolescents and parents face, in relation to the daily self-management of T1DM, is important to improve clinical practice...
November 16, 2016: Journal of Clinical Nursing
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