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https://www.readbyqxmd.com/read/28210868/cognitive-impairment-and-dementia-a-new-emerging-complication-of-type-2-diabetes-the-diabetologist-s-perspective
#1
Rafael Simó, Andreea Ciudin, Olga Simó-Servat, Cristina Hernández
Type 2 diabetes mellitus (T2D) and Alzheimer's disease (AD) are two of the most common diseases of aging around the world. Given the frequency with which T2D and AD occur, the notion that people with T2D may be at increased risk for AD has large societal consequences, and understanding the mechanistic links between these diseases is imperative for the development of effective AD prevention and treatment strategies. Apart from being an accelerator of AD, T2D is associated with a progressive cognitive decline...
February 16, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/28207728/discharge-outcomes-of-patients-referred-to-specialist-eye-clinic-from-diabetic-retinopathy-screening-in-northland-2014-15
#2
Pragnya Jagadish, David Dalziel
AIMS: To determine the discharge outcomes of patients seen in specialist eye clinic after referral from diabetic retinopathy screening (DRS). METHODS: Retrospective analysis of outcomes of a sample of 98 patients referred from DRS to specialist eye clinic. RESULTS: A sample of 98 patients were analysed following referral by DRS to specialist eye clinic from 16/4/14 to 16/4/15. Age at screening ranged from 13-88 years, with the main ethnic groups being Māori (57...
February 17, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28201967/dipeptidyl-peptidase-4-inhibitor-induced-angioedema-an-overlooked-and-potentially-lethal-adverse-drug-reaction
#3
Susanne Irene Scott, Michelle Fog Andersen, Lise Aagaard, Christian Von Buchwald, Eva Rye Rasmussen
Introduction Angioedema is a potentially fatal adverse drug reaction of some medications, as swellings of the upper airways can cause death by asphyxiation. Angiotensin converting enzyme-inhibitors are widely known to cause angioedema but less is known about the association between dipeptidyl peptidase-4 inhibitors (gliptins) and angioedema. Dipeptidyl peptidase-4 inhibitors are anti-diabetic drugs used to improve glycaemic control. They, as a class effect, inadvertently affect the degradation of the vasoactive kinins bradykinin and substance P, both of which can cause angioedema due to vasodilatation and increase in vascular permeability in the capillaries...
February 14, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28132967/kidney-cadmium-toxicity-diabetes-and-high-blood-pressure-the-perfect-storm
#4
Soisungwan Satarug, David A Vesey, Glenda C Gobe
Cadmium (Cd) is an environmental toxicant of widespread exposure and pervasive toxicity. Absorption, systemic transport and uptake of Cd are mediated by metal transporters that the body uses for acquisition of physiologically-essential elements, notably of iron, zinc and calcium. Currently, human exposure to Cd is known to damage the kidneys, especially the proximal tubular cells that actively reabsorb Cd along with zinc, glucose and amino acids in the glomerular filtrate. Severe kidney damage, glycosuria and proteinuria are known outcomes after high dietary Cd intake (> 200 µg/day)...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28118838/the-cost-effectiveness-of-changes-to-the-care-pathway-used-to-identify-depression-and-provide-treatment-amongst-people-with-diabetes-in-england-a-model-based-economic-evaluation
#5
Ben Kearns, R Rafia, J Leaviss, L Preston, J E Brazier, S Palmer, R Ara
BACKGROUND: Diabetes is associated with premature death and a number of serious complications. The presence of comorbid depression makes these outcomes more likely and results in increased healthcare costs. The aim of this work was to assess the health economic outcomes associated with having both diabetes and depression, and assess the cost-effectiveness of potential policy changes to improve the care pathway: improved opportunistic screening for depression, collaborative care for depression treatment, and the combination of both...
January 24, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28112704/evaluation-and-treatment-of-hyperglycemia-in-critically-ill-patients
#6
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/28105778/psychosocial-screening-and-management-of-young-people-aged-18-25-years-with-diabetes
#7
Helen d'Emden, Brett McDermott, Neisha D'Silva, Tom Dover, Tatjana Ewais, Kristen Gibbons, Trisha O'Moore-Sullivan
BACKGROUND: Routine psychosocial screening and management of people with diabetes is recommended. AIMS: To profile demographic, medical and psychosocial characteristics of young people with diabetes, and to develop a screening tool and care pathway for routine use. METHODS: Indices of diabetes control and recorded diabetes complications were complimented by psychosocial screening tools assessing psychological, diabetes specific, and perceived stress (K10, PAID, PSS), well-being (WHO-5), disordered eating ((EDI-3RC), compensatory behaviour questionnaire, social support (MSPSS), resilience (CD-2) and financial concerns...
January 20, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28086826/offering-patients-therapy-options-in-unplanned-start-options-implementation-of-an-educational-program-is-feasible-and-effective
#8
Anna Machowska, Mark Dominik Alscher, Satyanarayana Reddy Vanga, Michael Koch, Michael Aarup, Abdul Rashid Qureshi, Bengt Lindholm, Peter Rutherford
BACKGROUND: Patients with unplanned dialysis start (UPS) have worse clinical outcomes than non-UPS patients, and receive peritoneal dialysis (PD) less frequently. In the OPTiONS study of UPS patients, an educational programme (UPS-EP) aiming at improving care of UPS patients by facilitating care pathways and enabling informed choice of dialysis modality was implemented. We here report on impact of UPS-EP on modality choice and clinical outcomes in UPS patients. METHODS: This non-interventional, prospective, multi-center, observational study included 270 UPS patients from 26 centers in 6 European countries (Austria, Germany, Denmark, France, United Kingdom and Sweden) who prior to inclusion presented acutely, or were being followed by nephrologists but required urgent dialysis commencement by an acutely placed CVC or PD catheter...
January 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28050358/to-study-brain-stem-auditory-evoked-potential-in-patients-with-type-2-diabetes-mellitus-a-cross-sectional-comparative-study
#9
Mishra Indira Sushil, J N Muneshwar, Sayeeda Afroz
INTRODUCTION: Neuropathy is one of the commonest complications of Diabetes Mellitus (DM). Apart from having peripheral and autonomic neuropathy patients with type 2 DM may also suffer from sensory neural hearing loss, which is more severe at higher frequencies. However, few studies have done detailed evaluation of sensory pathway in these patients. In this study brain stem auditory evoked potential is used to detect the acoustic and central neuropathy in a group of patients with type 2 DM with controlled and uncontrolled blood sugar...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28024825/automated-diabetic-retinopathy-image-assessment-software-diagnostic-accuracy-and-cost-effectiveness-compared-with-human-graders
#10
Adnan Tufail, Caroline Rudisill, Catherine Egan, Venediktos V Kapetanakis, Sebastian Salas-Vega, Christopher G Owen, Aaron Lee, Vern Louw, John Anderson, Gerald Liew, Louis Bolter, Sowmya Srinivas, Muneeswar Nittala, SriniVas Sadda, Paul Taylor, Alicja R Rudnicka
OBJECTIVE: With the increasing prevalence of diabetes, annual screening for diabetic retinopathy (DR) by expert human grading of retinal images is challenging. Automated DR image assessment systems (ARIAS) may provide clinically effective and cost-effective detection of retinopathy. We aimed to determine whether ARIAS can be safely introduced into DR screening pathways to replace human graders. DESIGN: Observational measurement comparison study of human graders following a national screening program for DR versus ARIAS...
December 23, 2016: Ophthalmology
https://www.readbyqxmd.com/read/28004335/self-determination-theory-and-weight-loss-in-a-diabetes-prevention-program-translation-trial
#11
Paula M Trief, Donald Cibula, Linda M Delahanty, Ruth S Weinstock
We examined self-determination theory (SDT) and weight loss, and hypothesized that the Diabetes Prevention Program's (DPP) intervention would result in an increase in autonomous regulation of motivation (AR) in participants. Further, that those with higher AR, and those who perceived educators as supporting SDT-defined needs, would lose more weight. Support, Health Information, Nutrition and Exercise (SHINE) Study data (N = 257) were analyzed. SHINE was a randomized, controlled DPP translation trial (2-years, telephonic, primary care staff)...
December 21, 2016: Journal of Behavioral Medicine
https://www.readbyqxmd.com/read/27982668/data-driven-clinical-and-cost-pathways-for-chronic-care-delivery
#12
Yiye Zhang, Rema Padman
OBJECTIVES: This study illustrates a systematic methodology to embed medical costs into the exact flow of clinical events associated with chronic care delivery. We summarized and visualized the results using clinical and cost data, with the goal of empowering patients and care providers with actionable information as they navigate through a multitude of clinical events and medical expenses. STUDY DESIGN: We analyzed the electronic health records (EHRs) and medication cost data of 288 patients from 2009 to 2011, whose initial diagnoses included chronic kidney disease stage 3, hypertension, and diabetes...
December 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27965881/development-and-feasibility-testing-of-an-intervention-to-support-active-lifestyles-in-youths-with-type-1-diabetes-the-activpals-programme-a-study-protocol
#13
Fiona Mitchell, Alison Kirk, Kenneth Robertson, John J Reilly
BACKGROUND: The global incidence of type 1 diabetes is rising, and youths with type 1 diabetes continue to suffer poorer health than peers without diabetes. Evidence suggests youths with type 1 diabetes have physical activity (PA) levels well below the recommendations for health and have high levels of sedentary behaviour. An active lifestyle is therefore recommended to improve health. There is limited research showing effective lifestyle behaviour change in this population; therefore, an evidence gap exists between the need to promote physical activity in type 1 diabetes care and lack of understanding on how to do this...
2016: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/27920091/interferon-gamma-limits-diabetogenic-cd8-t-cell-effector-responses-in-type-1-diabetes
#14
John P Driver, Jeremy J Racine, Cheng Ye, Deanna J Lamont, Brittney N Newby, Caroline G McPhee-Leeth, Harold D Chapman, Todd M Brusko, Yi-Guang Chen, Clayton E Mathews, David V Serreze
Type 1 diabetes development in the NOD mouse model is widely reported to be dependent on high-level production by autoreactive CD4(+) and CD8(+) T-cells of IFNγ, generally considered a pro-inflammatory cytokine. However, IFNγ can also participate in tolerance induction pathways, indicating it is not solely pro-inflammatory. This study addresses how IFNγ can suppress activation of diabetogenic CD8(+) T-cells. CD8(+) T-cells transgenically expressing the diabetogenic AI4 T-cell receptor (TCR) adoptively transferred disease to otherwise unmanipulated NOD...
December 5, 2016: Diabetes
https://www.readbyqxmd.com/read/27910201/meal-insulin-cycle-a-visual-summary-of-the-biochemical-events-between-meals
#15
Stavros Kalogiannis
In the present article, a scheme that summarizes the biochemical events occurring in the human body after the consumption of a meal is proposed. The scheme illustrates the metabolic sequence as a series of counteracting components occupying opposite positions in a cycle, indicating their opposite actions or physiological states, such as meal versus energy consumption, increase versus decrease of blood glucose levels, and excretion of insulin versus excretion of glucagon. Furthermore, the cycle is complemented by a table indicating the acceleration or inhibition of selected metabolic pathways and actions...
December 2, 2016: Biochemistry and Molecular Biology Education
https://www.readbyqxmd.com/read/27903154/type-2-diabetes-mellitus-and-cancer-the-role-of-pharmacotherapy
#16
Gadi Shlomai, Brian Neel, Derek LeRoith, Emily Jane Gallagher
Purpose Type 2 diabetes mellitus (T2DM) is becoming increasingly prevalent worldwide. Epidemiologic data suggest that T2DM is associated with an increased incidence and mortality from many cancers. The purpose of this review is to discuss the links between diabetes and cancer, the effects of various antidiabetic medications on cancer incidence and mortality, and the effects of anticancer therapies on diabetes. Design This study is a review of preclinical and clinical data regarding the effects of antidiabetic medications on cancer incidence and mortality and the effects of anticancer therapies on glucose homeostasis...
December 10, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27884168/ataxia-telangiectasia-a-review
#17
REVIEW
Cynthia Rothblum-Oviatt, Jennifer Wright, Maureen A Lefton-Greif, Sharon A McGrath-Morrow, Thomas O Crawford, Howard M Lederman
DEFINITION OF THE DISEASE: Ataxia telangiectasia (A-T) is an autosomal recessive disorder primarily characterized by cerebellar degeneration, telangiectasia, immunodeficiency, cancer susceptibility and radiation sensitivity. A-T is often referred to as a genome instability or DNA damage response syndrome. EPIDEMIOLOGY: The world-wide prevalence of A-T is estimated to be between 1 in 40,000 and 1 in 100,000 live births. CLINICAL DESCRIPTION: A-T is a complex disorder with substantial variability in the severity of features between affected individuals, and at different ages...
November 25, 2016: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/27870424/sex-dependent-differences-in-voluntary-physical-activity
#18
REVIEW
Cheryl S Rosenfeld
Numbers of overweight and obese individuals are increasing in the United States and globally, and, correspondingly, the associated health care costs are rising dramatically. More than one-third of children are currently considered obese with a predisposition to type 2 diabetes, and it is likely that their metabolic conditions will worsen with age. Physical inactivity has also risen to be the leading cause of many chronic, noncommunicable diseases (NCD). Children are more physically inactive now than they were in past decades, which may be due to intrinsic and extrinsic factors...
January 2, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/27846404/local-release-of-dexamethasone-from-macroporous-scaffolds-accelerates-islet-transplant-engraftment-by-promotion-of-anti-inflammatory-m2-macrophages
#19
Kaiyuan Jiang, Jessica D Weaver, Yangjunyi Li, Xiongjian Chen, Jiapu Liang, Cherie L Stabler
Transplant-associated inflammatory responses generate an unfavorable microenvironment for tissue engraftment, particularly for cells susceptible to inflammatory stress, such as pancreatic islets. The localized delivery of anti-inflammatory agents, such as glucocorticoids, offers a promising approach to minimize the detrimental side effects associated with systemic delivery; however, the dosage must be carefully tailored to avoid deleterious responses, such as poor engraftment. Herein, we employed a polydimethylsiloxane (PDMS)-based three-dimensional scaffold platform for the local and controlled delivery of dexamethasone (Dex)...
November 5, 2016: Biomaterials
https://www.readbyqxmd.com/read/27843332/trends-in-medication-use-in-patients-with-type-2-diabetes-mellitus-a-long-term-view-of-real-world-treatment-between-2000-and-2015
#20
Victoria Higgins, James Piercy, Adam Roughley, Gary Milligan, Andrea Leith, James Siddall, Mike Benford
BACKGROUND: Despite the availability of a variety of treatments, many patients with type 2 diabetes mellitus (T2DM) are not achieving glucose control. We analyzed successive waves of the Adelphi Real World Diabetes Disease Specific Programmes (DSPs) to assess treatment patterns reported by primary care physicians (PCPs) and specialists and the effect of treatment on levels of glucose control. METHODS: Data were collected between 2000 and 2015 in the US and EU5 (France, Germany, Italy, Spain, and the UK)...
2016: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
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