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Hyperglycemia in hospital

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https://www.readbyqxmd.com/read/29028123/impact-of-insulin-detemir-administration-time-on-hypoglycemia-rates-in-hospitalized-patients
#1
Jennifer L Grelle, Sydney N Kutter, Megan E Giruzzi, John C Tawwater
STUDY OBJECTIVE: To determine if insulin detemir administration time affects the frequency of hypoglycemia (blood glucose level <70 mg/dL) in hospitalized patients. DESIGN: Retrospective cohort study. PATIENTS: A total of 357 adults (aged 18-89 yrs) who received insulin detemir for at least 48 hours while hospitalized between January 1, 2014, and December 31, 2015, were included. Patients were categorized into one of three groups according to insulin detemir administration time: detemir given once daily between 7 A...
October 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29019269/the-burden-of-severe-hypoglycemia-in-type-1-diabetes
#2
Jieruo Liu, Rosa Wang, Michael L Ganz, Yurek Paprocki, Doron Schneider, James Weatherall
AIMS: Approximately 1.25 million people in the United States have type 1 diabetes mellitus (T1DM), a chronic metabolic disease that develops from the body's inability to produce insulin, and requires life-long insulin therapy. Poor insulin adherence may cause severe hypoglycemia (SHO), leading to hospitalization and long-term complications; these, in turn, drive up costs of SHO and T1DM overall. This study's objective was to estimate the prevalence and costs of SHO-related hospitalizations and their additional longer-term impacts on patients with T1DM using basal-bolus insulin...
October 11, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29017368/the-burden-of-severe-hypoglycemia-in-type-2-diabetes
#3
Jieruo Liu, Rosa Wang, Michael L Ganz, Yurek Paprocki, Doron Schneider, James Weatherall
AIMS: More than 29 million people in the United States have type 2 diabetes mellitus (T2DM), a chronic metabolic disorder characterised by a progressive deterioration of glucose control, which eventually requires insulin. Abnormally low levels of blood glucose, a feared side effect of insulin treatment, may cause severe hypoglycemia (SHO), leading to emergency department (ED) admission, hospitalization, and long-term complications; these, in turn, drive up the costs of T2DM. This study's objective was to estimate the prevalence and costs of SHO-related hospitalizations and their additional longer-term impact on patients with T2DM using insulin...
October 11, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29017173/insulin-regimens-to-treat-hyperglycemia-in-hospitalized-patients-on-nutritional-support-systematic-review-and-meta-analyses
#4
Marina Verçoza Viana, Luciana Verçoza Viana, Ana Laura Tavares, Mirela Jobim de Azevedo
BACKGROUND: The best insulin regimen to treat hyperglycemia in hospitalized patients on nutritional support (NS) is unclear. METHODS: We searched electronic databases to identify cohort studies or randomized clinical trials in order to evaluate the efficacy of different insulin regimens used to treat hyperglycemia in hospitalized patients on NS on diverse outcomes: mean blood glucose (MBG), hypoglycemia, length of stay in hospital, and mortality. RESULTS: Seventeen studies from a total of 5,030 were included...
October 6, 2017: Annals of Nutrition & Metabolism
https://www.readbyqxmd.com/read/28993802/glycemia-is-related-to-impaired-cerebrovascular-autoregulation-after-severe-pediatric-traumatic-brain-injury-a-retrospective-observational-study
#5
Adam M H Young, Hadie Adams, Joseph Donnelly, Mathew R Guilfoyle, Helen Fernandes, Mathew R Garnett, Marek Czosnyka, Peter Smielewski, Mark Plummer, Shruti Agrawal, Peter J Hutchinson
INTRODUCTION: A strong association exists between hyperglycemia and outcome in pediatric traumatic brain injury (TBI). Herein, we describe observations of serum markers of glucose metabolism in a cohort of pediatric TBI patients and how these variables are related to parameters of intracranial pathophysiology. METHODS: A retrospective analysis was performed on pediatric severe TBI patients admitted to Addenbrookes Hospital Paediatric Intensive Care Unit (PICU) between January 2001 and December 2013...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28993227/adverse-glycaemic-effects-of-cancer-therapy-indications-for-a-rational-approach-to-cancer-patients-with-diabetes
#6
REVIEW
Marco Gallo, Giovanna Muscogiuri, Francesco Felicetti, Antongiulio Faggiano, Francesco Trimarchi, Emanuela Arvat, Riccardo Vigneri, Annamaria Colao
Diabetes and cancer are common, chronic, and potentially fatal diseases that frequently co-exist. Observational studies have reported an increased risk of cancer in patients with diabetes. Furthermore, many patients with cancer already have diabetes, or develop hyperglycemia as a consequence of the tumor or of cancer therapies, and coexisting diabetes confers a greater risk of mortality for many malignancies. Managing oncologic patients with diabetes is often complicated, since the co-existence of diabetes and cancer poses several complex clinical questions: what level of glycemic control to achieve, which therapy to use, how to deal with glucocorticoid therapies and artificial nutrition, how diabetes complications can affect cancer management, which drug-drug interactions should be taken into account, or even how to manage diabetes at the end of life...
October 6, 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28989869/-riding-high-on-low-fuel-our-experience-with-endogenous-hyperinsulinemic-hypoglycemia
#7
P R Manjunath, Belinda George, Vivek Mathew, Ganapathi Bantwal, Vageesh Ayyar
INTRODUCTION: Endogenous hyperinsulinemic hypoglycemia (EHH) is a condition in which the insulin levels are inappropriately high in the presence of low plasma glucose. MATERIALS AND METHODS: We did a retrospective analysis of case records of those patients admitted and evaluated for EHH from June 2004 to June 2016 in our center, excluding those that were diagnosed with reactive hypoglycemia. We collected data regarding demographics, clinical presentation, laboratory results, localization techniques, and treatment administered...
September 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28974329/long-term-outcomes-in-older-patients-with-hyperglycemia-on-admission-for-ischemic-stroke
#8
Alexander Gorshtein, Ilan Shimon, Tzipora Shochat, Oren Amitai, Amit Akirov
AIMS: Evaluate the association between admission blood glucose (ABG) and mortality in older patients with or without diabetes mellitus (DM) hospitalized for acute ischemic stroke (AIS). METHODS: Observational data of patients ≥65years, admitted for AIS between January 2011 and December 2013. ABG levels were classified to categories: ≤70 (low), 70-110 (normal), 111-140 (mildly elevated), 141-180mg/dl (moderately elevated) and >180mg/dl (markedly elevated)...
September 30, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28974008/higher-mortality-in-trauma-patients-is-associated-with-stress-induced-hyperglycemia-but-not-diabetic-hyperglycemia-a-cross-sectional-analysis-based-on-a-propensity-score-matching-approach
#9
Cheng-Shyuan Rau, Shao-Chun Wu, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Pao-Jen Kuo, Ching-Hua Hsieh
Background: Stress-induced hyperglycemia (SIH) is a form of hyperglycemia secondary to stress and commonly occurs in patients with trauma. Trauma patients with SIH have been reported to have an increased risk of mortality. However, information regarding whether these trauma patients with SIH represent a distinct group with differential outcomes when compared to those with diabetic hyperglycemia (DH) remains limited. Methods: Diabetes mellitus (DM) was determined by patient history and/or admission glycated hemoglobin (HbA1c) ≥6...
September 30, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28970655/liraglutide-as-an-alternative-to-insulin-for-glycemic-control-in-intensive-care-unit-a-randomized-open-label-clinical-study
#10
Vishesh Verma, Narendra Kotwal, Vimal Upreti, Monish Nakra, Yashpal Singh, K Anand Shankar, Amit Nachankar, K V S Hari Kumar
BACKGROUND: Intravenous insulin is the cornerstone in the management of hyperglycemia in the Intensive Care Unit (ICU). We studied the efficacy of liraglutide compared with insulin in the ICU. MATERIALS AND METHODS: In this prospective, open-labeled, randomized study, we included 120 patients (15-65 years, either sex) admitted to ICU with capillary blood glucose (CBG) between 181 and 300 mg/dl. We excluded patients with secondary diabetes and APACHE score >24...
September 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28970434/comparison-of-insulin-detemir-and-insulin-glargine-for-hospitalized-patients-on-a-basal-bolus-protocol
#11
Sondra Davis, Chad Friece, Nicki Roderman, Darrell Newcomer, Evangelina Castaneda
BACKGROUND: The primary purpose of this study is to determine whether insulin detemir is equivalent to insulin glargine in controlling hyperglycemia for the adult hospitalized patient on a basal-bolus treatment regimen. METHODS: A retrospective study was conducted at two acute care hospitals within the same health system. Patients from both facilities who were initiated on a basal-bolus subcutaneous insulin regimen were included in the study. The basal-bolus regimen consisted of three components: basal, bolus, and corrective insulin with only the data from the first seven days analyzed...
April 23, 2017: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/28935429/glycemic-control-in-patients-undergoing-coronary-artery-bypass-graft-surgery-clinical-features-predictors-and-outcomes
#12
Judson B Williams, Eric D Peterson, Álvaro S Albrecht, Shuang Li, Sameer A Hirji, T Ferguson, Peter K Smith, Renato D Lopes
PURPOSE: Critically ill patients with hyperglycemia have worse prognosis. The degree to which glycemic control is achieved following CABG surgery and the association with clinical outcomes is not well understood. MATERIALS AND METHODS: We studied patients undergoing higher risk CABG surgery at 55 US hospitals. Good glycemic control was defined as 70-180mg/dL in the first 24h postoperatively. Generalized estimating equations logistic regression models were used to assess the relationship between glycemic control and clinical outcomes after adjusting for baseline characteristics...
September 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28923612/deceased-organ-donation-from-pediatric-donors-does-the-literature-really-help-us-implication-for-more-powerful-guidelines
#13
M Mojtabaee, F Sadegh Beigee, F Ghorbani
BACKGROUND: Brain-dead pediatric donors have always been the focus of attention because of the higher quality, utility, and possibility of their organ donation. However, donors under the age of 5 years always necessitate making more challenging management efforts, which are not clearly implied in most parts of the guidelines. METHODS: The data obtained from 79 brain-dead pediatric donors of the Organ Procurement Unit of Masih Daneshvari Hospital, Tehran, Iran, were assessed...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28918911/mortality-of-severe-septic-patients-between-physician-s-high-and-low-care-volumes
#14
Chun-Yao Lin, Jo-Chi Tseng, Chih-Yu Huang, Chien-Ming Chu, Huang-Pin Wu
BACKGROUND: Patients with severe sepsis frequently require intensive care unit (ICU) admission and different ICU care models may influence their outcomes. The mortality of severe septic patients between physician's high and low care volume remains unclear. METHODS: We analyzed the data from a three-year prospective observation study, which was performed in an adult medical ICU of Chung Gung Memorial Hospital, Keelung. The data included initial bundle therapies based on the Surviving Sepsis Campaign (SSC) guidelines for patients with severe sepsis...
August 2017: Biomedical Journal
https://www.readbyqxmd.com/read/28913745/management-of-type-1-diabetes-in-the-hospital-setting
#15
REVIEW
Carlos E Mendez, Guillermo E Umpierrez
PURPOSE OF REVIEW: The purpose of this article was to review recent guideline recommendations on glycemic target, glucose monitoring, and therapeutic strategies, while providing practical recommendations for the management of medical and surgical patients with type 1 diabetes (T1D) admitted to critical and non-critical care settings. RECENT FINDINGS: Studies evaluating safety and efficacy of insulin pump therapy, continuous glucose monitoring, electronic glucose management systems, and closed loop systems for the inpatient management of hyperglycemia are described...
September 14, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28912863/a-novel-mutation-in-the-hepatocyte-nuclear-factor-1%C3%AE-gene-in-maturity-onset-diabetes-of-the-young-5-with-multiple-renal-cysts-and-pancreas-hypogenesis-a-case-report
#16
You Lv, Zhuo Li, Kan He, Ying Gao, Xianchao Xiao, Yujia Liu, Guixia Wang
A 17-year-old Chinese male was hospitalized exhibiting hyperglycemia and increased serum urea nitrogen and creatinine levels in addition to weight loss. The patient was treated with gliclazide. The patient was 150 cm tall, weighed 35 kg and had no family history of diabetes or kidney disease. Physical examination revealed cephalus quadratus, rachitic rosary and a visible toe-out gait. Laboratory examinations revealed that the patient's fasting plasma glucose and glycosylated hemoglobin levels were markedly increased, fasting plasma C-peptide level was slightly increased and no peak 2 h postprandial was observed...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28898432/hyperglycemia-on-admission-and-hospitalization-outcomes-in-patients-with-atrial-fibrillation
#17
Amit Akirov, Alon Grossman, Tzipora Shochat, Ilan Shimon
BACKGROUND: We evaluated the association of admission blood glucose (ABG) and mortality in patients with and without diabetes mellitus (DM) hospitalized for atrial fibrillation (AF). HYPOTHESIS: Hyperglycemia on admission is a bad prognostic marker in patients with AF. METHODS: Observational data were collected from electronic records of patients age ≥ 18 years hospitalized for AF in 2011-2013. Twelve-month data were available in all cases...
September 12, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28882417/derivation-and-validation-model-for-hospital-hypoglycemia
#18
Javier Ena, Antonio Zapatero Gaviria, Marta Romero-Sánchez, Juana Carretero-Gómez, Francisco Javier Carrasco-Sánchez, José Vicente Segura-Heras, Ana Belkis Porto-Perez, Patricia Vázquez-Rodriguez, Concepción González-Becerra, Ricardo Gómez-Huelgas
BACKGROUND: An objective and simple prognostic model for hospitalized patients with hypoglycemia could be helpful in guiding initial intensity of treatment. METHODS: We carried out a derivation rule for hypoglycemia using data from a nationwide retrospective cohort study of patients with diabetes or hyperglycemia carried out in 2014 (n=839 patients). The rule for hypoglycemia was validated using a second data set from a nationwide retrospective cohort study carried out in 2016 (n=561 patients)...
September 4, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28856166/ketoacidosis-with-canagliflozin-prescribed-for-phosphoinositide-3-kinase-inhibitor-induced-hyperglycemia-a-case-report
#19
Christopher Bowman, Vandana Abramson, Melissa Wellons
Context. Many phosphoinositide-3-kinase (PI3K) inhibitors are under trial for cancer treatment. We present a patient taking taselisib who developed ketoacidosis within 1 week of starting canagliflozin. Case Description. A 69-year-old female patient with no previous history of diabetes mellitus was enrolled in a clinical trial for taselisib therapy in stage IV breast cancer. Hyperglycemia treatment with metformin was insufficient and not tolerated. The addition of canagliflozin daily resulted in ketoacidosis and hospitalization within 1 week...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28854717/maternal-hyperglycemia-in-singleton-pregnancies-conceived-by-ivf-may-be-modified-by-first-trimester-bmi
#20
S Cai, P Natarajan, J K Y Chan, P C Wong, K H Tan, K M Godfrey, P D Gluckman, L P C Shek, F Yap, M S Kramer, S Y Chan, Y S Chong
STUDY QUESTION: Does IVF independently increase the risk of gestational diabetes mellitus (GDM) and is this increase in risk modified by maternal body mass index? SUMMARY ANSWER: IVF appears to be an independent risk factor for GDM and elevated blood glucose levels in overweight women (BMI > 25 kg/m2). WHAT IS KNOWN ALREADY: IVF has been associated with increased risk of GDM, but most previous studies did not adequately assess confounding or effect modification by other risk factors...
September 1, 2017: Human Reproduction
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