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Inpatient diabetes management

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https://www.readbyqxmd.com/read/28067472/efficacy-of-basal-bolus-insulin-regimens-in-the-inpatient-management-of-non-critically-ill-patients-with-type-2-diabetes-a-systematic-review-and-meta-analysis
#1
REVIEW
Merete B Christensen, Anders Gotfredsen, Kirsten Nørgaard
BACKGROUND: Hyperglycemia during hospitalization is associated with increased rates of complications and longer hospital stays. Various insulin regimens are used in the inpatient diabetes management of non-critically ill patients. We aimed to assess the efficacy and safety of basal-bolus insulin therapy (BBI) by summarizing evidence from studies of BBI versus sliding scale insulin therapy (SSI) in the management of hospitalized non-critically ill type 2 diabetes patients. METHODS: We searched MEDLINE, EMBASE, Scopus and the Cochrane Library for studies comparing BBI therapy with SSI therapy in hospitalized non-critically ill patients with type 2 diabetes...
January 9, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28034481/complications-following-outpatient-total-joint-arthroplasty-an-analysis-of-a-national-database
#2
P Maxwell Courtney, Anthony J Boniello, Richard A Berger
BACKGROUND: As outpatient total hip (THA) and knee arthroplasties (TKA) increase in popularity, concerns exist about the safety of discharging patients home the same day. The purpose of this study is to determine the complications associated with outpatient total joint arthroplasty (TJA) and to identify high-risk patients who should be excluded from these protocols. METHODS: We queried the American College of Surgeons-National Surgical Quality Improvement Program database for all patients who underwent primary TKA or THA from 2011 to 2014...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28031946/hyperglycemia-during-the-immediate-period-following-liver-transplantation
#3
K Tuesday Werner, Patricia A Mackey, Janna C Castro, Elizabeth J Carey, Harini A Chakkera, Curtiss B Cook
AIM: High blood glucose levels in the hospital are common among transplant recipients. METHODS: Retrospective analysis, stratified by diagnosis of pretransplant diabetes mellitus (DM). RESULTS: Of 346 patients, 96 had pretransplant DM (insulin, n = 60; no insulin, n = 36) and 250 did not. Patients with pretransplant DM had higher inpatient mean glucose levels and more hyperglycemia and hypoglycemia (all p < 0.01). For patients without pretransplant DM, the need for insulin at discharge increased 23% for every 5-year age increase (odds ratio: 1...
March 2016: Future Science OA
https://www.readbyqxmd.com/read/28017586/operative-variables-are-better-predictors-of-postdischarge-infections-and-unplanned-readmissions-in-vascular-surgery-patients-than-patient-characteristics
#4
Caitlin W Hicks, Michael Bronsert, Karl E Hammermeister, William G Henderson, Douglas R Gibula, James H Black, Natalia O Glebova
OBJECTIVE: Although postoperative readmissions are frequent in vascular surgery patients, the reasons for these readmissions are not well characterized, and effective approaches to their reduction are unknown. Our aim was to analyze the reasons for vascular surgery readmissions and to report potential areas for focused efforts aimed at readmission reduction. METHODS: The 2012 to 2013 American College of Surgeons National Quality Improvement Program (ACS NSQIP) data set was queried for vascular surgery patients...
December 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28012724/the-evaluation-of-comorbidities-relative-to-length-of-stay-for-total-joint-arthroplasty-patients
#5
Jakub Sikora-Klak, Andrew Gupta, Christopher Bergum, Bradley Zarling, David C Markel
BACKGROUND: The ability to identify those at risk for longer inpatient stay helps providers with postoperative planning and patient expectations. Decreasing length of stay (LOS) in the future will be determined by appropriate patient selection, risk stratification, and preoperative patient optimization. The purpose of this study was to identify factors that place patients at risk for extended postoperative LOSs. METHODS: The study cohort included 2009 primary total knee arthroplasty (TKA) patients and 905 total hip arthroplasty (THA) patients...
November 16, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27994438/comorbidity-and-health-care-visit-burden-in-working-age-commercially-insured-patients-with-diabetic-macular-edema
#6
Szilárd Kiss, Hitesh S Chandwani, Ashley L Cole, Vaishali D Patel, Orsolya E Lunacsek, Pravin U Dugel
PURPOSE: To examine the comorbidity profile and update estimates of health care resource utilization for commercially insured, working-age adults with diabetic macular edema (DME) relative to a matched comparison group of diabetic adults without DME. Additional comparisons were made in the subgroup of pseudophakic patients. PATIENTS AND METHODS: A retrospective matched-cohort study of commercially insured diabetic adults aged 18-63 years was conducted using medical and outpatient pharmacy claims (July 1, 2008-June 30, 2013)...
2016: Clinical Ophthalmology
https://www.readbyqxmd.com/read/27967230/pathophysiology-and-management-of-hypoglycemia-in-end-stage-renal-disease-patients-a-review
#7
Roma Y Gianchandani, Shristi Neupane, Jennifer J Iyengar, Michael Heung
OBJECTIVE: This review focuses on hypoglycemia in patients with end stage renal disease (ESRD). It discusses pathophysiology of glucose metabolism in the kidney, the impact of dialysis on glucose and insulin metabolism and the challenges of glucose monitoring in ESRD. The clinical relevance of these changes are reviewed in relation to altered blood glucose targets and modification of antidiabetes therapy to prevent hypoglycemia. Based on current data and guidelines, recommendations for the outpatient and inpatient setting are provided for diabetes management in ESRD...
December 14, 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27967226/use-of-a-computer-guided-glucose-management-system-to-improve-glycemic-control-and-address-national-quality-measures-a-7-year-retrospective-observational-study-at-a-tertiary-care-teaching-hospital
#8
Robert J Tanenberg, Sandra Hardee, Caitlin Rothermel, Almond J Drake
Objectives Inpatient hyperglycemia, hypoglycemia, and glucose variability are associated with increased mortality. The use of electronic Glucose Management Systems (eGMS) to guide intravenous (IV) insulin infusion have been found to significantly improve blood glucose (BG) control. This retrospective observational study evaluated the 7-year (1/2009-12/2015) impact of the EndoTool(®) eGMS in intensive and intermediate units at Vidant Medical Center, a 900-bed tertiary teaching hospital. Methods Patients assigned to eGMS had indications for IV insulin infusion, including uncontrolled diabetes, stress hyperglycemia, and/or post-operative BG levels >140 mg/dL...
December 14, 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27928991/mortality-in-patients-with-diabetes-mellitus-and-addison-s-disease-a-nationwide-matched-observational-cohort-study
#9
Dimitrios Chantzichristos, Anders Persson, Björn Eliasson, Mervete Miftaraj, Stefan Franzén, Ragnhildur Bergthorsdottir, Soffia Gudbjörnsdottir, Ann-Marie Svensson, Gudmundur Johannsson
OBJECTIVE: Our hypothesis was that patients with diabetes mellitus obtain an additional risk of death if they develop Addison's disease (AD). DESIGN AND METHODS: Nationwide, matched, observational cohort study cross-referencing the Swedish National Diabetes Register with Inpatient, Cancer and Cause of Death Registers in patients with diabetes (type 1 and 2) and AD and matched controls with diabetes. Clinical characteristics at baseline, overall, and cause-specific mortality were assessed...
January 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/27913984/basal-insulin-persistence-associated-factors-and-outcomes-after-treatment-initiation-a-retrospective-database-study-among-people-with-type-2-diabetes-mellitus-in-japan
#10
Irene Hadjiyianni, Urvi Desai, Shuichi Suzuki, Jasmina I Ivanova, Dachuang Cao, Noam Y Kirson, Dai Chida, Caroline Enloe, Howard G Birnbaum, Magaly Perez-Nieves
INTRODUCTION: The objective of this study was to assess basal insulin persistence, associated factors, and economic outcomes for insulin-naïve people with type 2 diabetes mellitus (T2DM) in Japan. METHODS: People aged at least 18 years with T2DM with first claim for basal insulin between May 2006 and April 2013 (index date), no insulin use before index date, and continuous insurance coverage for 6 months before (baseline) and 12 months after index date were selected from the Japan Medical Center Database...
December 2, 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/27903117/risk-factors-associated-with-the-surgical-management-of-craniopharyngiomas-in-pediatric-patients-analysis-of-1961-patients-from-a-national-registry-database
#11
Joshua Bakhsheshian, Diana L Jin, Ki-Eun Chang, Ben A Strickland, Dan A Donoho, Steven Cen, William J Mack, Frank Attenello, Eisha A Christian, Gabriel Zada
OBJECTIVE Patient demographic characteristics, hospital volume, and admission status have been shown to impact surgical outcomes of sellar region tumors in adults; however, the data available following the resection of craniopharyngiomas in the pediatric population remain limited. The authors sought to identify potential risk factors associated with outcomes following surgical management of pediatric craniopharyngiomas. METHODS The Nationwide Inpatient Sample database and Kids' Inpatient Database were analyzed to include admissions for pediatric patients (≤ 18 years) who underwent a transcranial or transsphenoidal craniotomy for resection of a craniopharyngioma...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27864954/prevalence-of-comorbidity-and-associated-risk-factors-in-adults-with-atopic-dermatitis
#12
A Egeberg, Y M F Andersen, G H Gislason, L Skov, J P Thyssen
BACKGROUND: Atopic dermatitis (AD) is a common chronic skin disorder, which may persist into adulthood; however, the prevalence of comorbidities in patients with AD is not well characterized. AD is considered a systemic disorder like psoriasis, which has raised a need for data on the comorbidity profile of patients with AD, to assess the potential risks, benefits, and complications in management of patients with AD. We described the occurrence of medical and psychiatric comorbidities and associated risk factors in adults with AD compared with psoriasis and the general population...
November 16, 2016: Allergy
https://www.readbyqxmd.com/read/27864238/outcomes-of-a-pharmacist-managed-glucose-collaborative-practice-agreement
#13
Vidya Pugazhenthi, Travis B Dick, Matthew Call
PURPOSE: The impact of a pharmacist-managed glucose collaborative practice agreement (CPA) on glycemic control at a tertiary medical center was investigated. METHODS: A retrospective data analysis was performed on hospitalized, noncritically ill patients admitted between December 2012 and June 2014 who received at least one dose of subcutaneous insulin and experienced at least one blood glucose concentration of 140 mg/dL or higher. The study population was divided into cohorts based on admittance before versus after implementation of the CPA, as well as glucose management by pharmacist versus nonpharmacist provider...
December 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27823609/inpatient-diabetes-management-in-the-twenty-first-century
#14
REVIEW
Natasha B Khazai, Osama Hamdy
In hospitalized patients, both hyperglycemia and hypoglycemia have been associated with poor outcomes. During the inpatient period, hyperglycemia has been associated with increased risk of infection, cardiovascular events, and mortality. It is also associated with longer length of hospital stay. Hypoglycemia has also been associated with an increased risk of mortality. Therefore, current evidence supports avoidance of both conditions among hospitalized patients whether they are admitted to critical care units or noncritical care units...
December 2016: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/27807908/home-based-vs-inpatient-education-for-children-newly-diagnosed-with-type-1-diabetes
#15
H Clapin, L Hop, E Ritchie, R Jayabalan, M Evans, K Browne-Cooper, S Peter, J Vine, T W Jones, E A Davis
BACKGROUND: Initial management of children diagnosed with type 1 diabetes (T1D) varies worldwide with sparse high quality evidence regarding the impact of different models of care. AIM: To compare the inpatient model of care with a hybrid home-based alternative, examining metabolic and psychosocial outcomes, diabetes knowledge, length of stay, and patient satisfaction. SUBJECTS AND METHODS: The study design was a randomized-controlled trial...
November 3, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27802864/glucokinase-mutation-a-rare-cause-of-recurrent-hypoglycemia-in-adults-a-case-report-and-literature-review
#16
Oluremi N Ajala, David M Huffman, Ibrahim I Ghobrial
BACKGROUND: Hypoglycemia occurs frequently in patients both in the inpatient and outpatient settings. While most hypoglycemia unrelated to diabetes treatment results from excessive endogenous insulin action, rare cases involve functional and congenital mutations in glycolytic enzymes of insulin regulation. CASE: A 21-year-old obese woman presented to the emergency department with complaints of repeated episodes of lethargy, syncope, dizziness, and sweating. She was referred from an outside facility on suspicion of insulinoma, with severe hypoglycemia unresponsive to repeated dextrose infusions...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27788459/the-prevalence-of-diabetes-mellitus-type-2-in-people-with-alcohol-use-disorders-a-systematic-review-and-large-scale-meta-analysis
#17
REVIEW
Davy Vancampfort, James Mugisha, Mats Hallgren, Marc De Hert, Michel Probst, Dirk Monsieur, Brendon Stubbs
Type 2 Diabetes Mellitus (T2DM) is highly predictive of cardiovascular diseases and is associated with worse quality of life and increased healthcare utilisation. The current meta-analysis aimed to (i) describe the pooled prevalence of T2DM in people with alcohol use disorders (AUDs), (ii) investigate the impact of demographic, clinical and treatment factors, and (iii) compare T2DM prevalences in AUDs versus the general population. The trim and fill adjusted pooled T2DM prevalence among 3998 people with AUDs (age range 34...
December 30, 2016: Psychiatry Research
https://www.readbyqxmd.com/read/27776013/chronic-health-conditions-in-medicare-beneficiaries-65-years-and-older-with-hiv-infection
#18
Eleanor E Friedman, Wayne A Duffus
OBJECTIVES: To examine sociodemographic factors and chronic health conditions of people living with HIV (PLWHIV/HIV+) at least 65 years old and compare their chronic disease prevalence with beneficiaries without HIV. DESIGN: National fee-for-service Medicare claims data (parts A and B) from 2006 to 2009 were used to create a retrospective cohort of beneficiaries at least 65 years old. METHODS: Beneficiaries with an inpatient or skilled nursing facility claim, or outpatient claims with HIV diagnosis codes were considered HIV+...
October 23, 2016: AIDS
https://www.readbyqxmd.com/read/27769219/advanced-practice-pharmacists-a-retrospective-evaluation-of-the-efficacy-and-cost-of-clinical-pharmacist-practitioners-managing-ambulatory-medicare-patients-in-north-carolina-apple-nc
#19
Michèle M Kislan, Adam T Bernstein, Loretta R Fearrington, Timothy J Ives
BACKGROUND: Clinical Pharmacist Practitioners are advanced practicing pharmacists in North Carolina that provide disease-specific management. The purpose of this retrospective cohort study was to compare the efficacy and charges from referrals to a Clinical Pharmacist Practitioner by the primary care provider, to those managed by a primary care provider alone. METHODS: Patients were separated into cohorts depending if they had at least two appointments with a Clinical Pharmacist Practitioner from November 2008 to November 2011...
October 21, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27743395/validation-of-administrative-and-clinical-case-definitions-for-gestational-diabetes-mellitus-against-laboratory-results
#20
S L Bowker, A Savu, L E Donovan, J A Johnson, P Kaul
AIM: To examine the validity of International Classification of Disease, version 10 (ICD-10) codes for gestational diabetes mellitus in administrative databases (outpatient and inpatient), and in a clinical perinatal database (Alberta Perinatal Health Program), using laboratory data as the 'gold standard'. METHODS: Women aged 12-54 years with in-hospital, singleton deliveries between 1 October 2008 and 31 March 2010 in Alberta, Canada were included in the study...
October 15, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
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