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A Akirov, A Grossman, T Shochat, I Shimon
CONTEXT: Hypoglycemia is common among hospitalized patients with and without diabetes mellitus (DM) but the prognostic implications may differ with spontaneous versus insulin-related hypoglycemia. OBJECTIVE: Investigate the association between spontaneous or insulin-related hypoglycemia and mortality in hospitalized patients. DESIGN: Hypoglycemia was defined as blood glucose <70mg/dl (3.9 mmol/l), including moderate hypoglycemia (40-70mg/dl, 2...
November 17, 2016: Journal of Clinical Endocrinology and Metabolism
Steven P Marso, Stephen C Bain, Agostino Consoli, Freddy G Eliaschewitz, Esteban Jódar, Lawrence A Leiter, Ildiko Lingvay, Julio Rosenstock, Jochen Seufert, Mark L Warren, Vincent Woo, Oluf Hansen, Anders G Holst, Jonas Pettersson, Tina Vilsbøll
Background Regulatory guidance specifies the need to establish cardiovascular safety of new diabetes therapies in patients with type 2 diabetes in order to rule out excess cardiovascular risk. The cardiovascular effects of semaglutide, a glucagon-like peptide 1 analogue with an extended half-life of approximately 1 week, in type 2 diabetes are unknown. Methods We randomly assigned 3297 patients with type 2 diabetes who were on a standard-care regimen to receive once-weekly semaglutide (0.5 mg or 1.0 mg) or placebo for 104 weeks...
September 15, 2016: New England Journal of Medicine
Devina Willard, Jagriti Upadhyay, Chan Kim, Devin Steenkamp
CONTEXT: Type B insulin resistance syndrome is a rare disease which occurs due to the development of autoantibodies to the insulin receptor and can result in either severe insulin resistance and hyperglycemia or conversely hypoglycemia. Diabetes mellitus is often severe, usually transient and poorly responsive to exogenous insulin. Diabetic ketoacidosis is an unusual consequence of this most severe form of transient diabetes mellitus. CASE DESCRIPTION: A 39 year old Nigerian woman presented with significant weight loss, severe diabetic ketoacidosis and severe insulin resistance requiring massive doses of exogenous insulin...
September 16, 2016: Journal of Clinical Endocrinology and Metabolism
Seol-Jung Kang, Kwang-Jun Ko, Un-Hyo Baek
[Purpose] This study evaluated the effects of 12 weeks combined aerobic and resistance exercise on heart rate variability in patients with Type 2 diabetes mellitus. [Subjects and Methods] The subjects were 16 female patients with Type 2 diabetes mellitus selected among the participants of a chronic disease management exercise class at C Region Public Health Center in South Korea. Subjects were randomly assigned to the exercise group (n=8; age, 55.97 ± 7.37) or the control group (n=8; age, 57.53 ± 4.63) The exercise group performed aerobic and resistance exercises for 60 minutes per day, 3 times per week for 12 weeks...
July 2016: Journal of Physical Therapy Science
Lennart Tonneijck, Mark M Smits, Marcel H A Muskiet, Trynke Hoekstra, Mark H H Kramer, A H Jan Danser, Piet M Ter Wee, Michaela Diamant, Jaap A Joles, Daniël H van Raalte
OBJECTIVE: To investigate effects of dipeptidyl peptidase-4 inhibitor (DPP-4I) sitagliptin or glucagon-like peptide 1 (GLP-1) receptor agonist liraglutide treatment on renal hemodynamics, tubular functions, and markers of renal damage in overweight patients with type 2 diabetes without chronic kidney disease (CKD). RESEARCH DESIGN AND METHODS: In this 12-week, randomized, double-blind trial, 55 insulin-naïve patients with type 2 diabetes (mean ± SEM: age 63 ± 7 years, BMI 31...
September 1, 2016: Diabetes Care
William T Cefalu, Andrew J M Boulton, William V Tamborlane, Robert G Moses, Derek LeRoith, Eddie L Greene, Frank B Hu, George Bakris, Judith Wylie-Rosett, Julio Rosenstock, Katie Weinger, Lawrence Blonde, Mary de Groot, Matthew C Riddle, Sherita Hill Golden, Stephen S Rich, David D'Alessio, Lyn Reynolds
No abstract text is available yet for this article.
January 2016: Diabetes Care
Anne L Peters, Andrew J Ahmann, Tadej Battelino, Alison Evert, Irl B Hirsch, M Hassan Murad, William E Winter, Howard Wolpert
OBJECTIVE: To formulate clinical practice guidelines for the use of continuous glucose monitoring and continuous subcutaneous insulin infusion in adults with diabetes. PARTICIPANTS: The participants include an Endocrine Society-appointed Task Force of seven experts, a methodologist, and a medical writer. The American Association for Clinical Chemistry, the American Association of Diabetes Educators, and the European Society of Endocrinology co-sponsored this guideline...
September 2, 2016: Journal of Clinical Endocrinology and Metabolism
(no author information available yet)
BACKGROUND: One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes. METHODS: We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers...
April 9, 2016: Lancet
Bruna Babic, Xavier Keutgen, Pavel Nockel, Markke Miettinen, Corina Millo, Peter Herscovitch, Dhaval Patel, Naris Nilubol, Craig Cochran, Phillip Gorden, Electron Kebebew
CONTEXT: Insulinomas are usually due to a solitary tumor, but they can be challenging to localize. CASE DESCRIPTION: A 66-year-old woman presented with a 1-year history of episodic neuroglycopenic hypoglycemia and was suspected of having an insulinoma. On a supervised fast, she was found to be hypoglycemic at 39 mg/dL, with an insulin of 40 μU/mL 26 hours into the fast and a proinsulin of 35 pmol/L. Contrast-enhanced computed tomography and magnetic resonance imaging did not localize a pancreatic lesion...
October 2016: Journal of Clinical Endocrinology and Metabolism
David R Repaske
Epidemiological studies and case reports have demonstrated an increased rate of development of diabetes mellitus consequent to taking diverse types of medication. This review explores this evidence linking these medications and development of diabetes and presents postulated mechanisms by which the medications might cause diabetes. Some medications are associated with a reduction in insulin production, some with reduction in insulin sensitivity, and some appear to be associated with both reduction in insulin production and insulin sensitivity...
September 2016: Pediatric Diabetes
Anna Z Feldman, Florence M Brown
Women with type 1 diabetes (T1DM) have unique needs during the preconception, pregnancy, and postpartum periods. Preconception counseling is essential for women with T1DM to minimize pregnancy risks. The goals of preconception care should be tight glycemic control with a hemoglobin A1c (A1C) < 7 % and as close to 6 % as possible, without significant hypoglycemia. This will lower risks of congenital malformations, preeclampsia, and perinatal mortality. The safety of medications should be assessed prior to conception...
August 2016: Current Diabetes Reports
J C Hannukainen, R Lautamäki, A Mari, J P Pärkkä, M Bucci, M A Guzzardi, S Kajander, T Tuokkola, J Knuuti, P Iozzo
BACKGROUND: Insulin resistance, β-cell dysfunction, and ectopic fat deposition have been implicated in the pathogenesis of coronary artery disease (CAD) and type 2 diabetes, which is common in CAD patients. We investigated whether CAD is an independent predictor of these metabolic abnormalities and whether this interaction is influenced by superimposed myocardial ischemia. METHODS AND RESULTS: We studied CAD patients with (n = 8) and without (n = 14) myocardial ischemia and eight non-CAD controls...
July 2016: Journal of Clinical Endocrinology and Metabolism
J Michael Gonzalez-Campoy
CKD = chronic kidney disease DM = diabetes mellitus eGFR = estimated glomerular filtration rate FDA = Food & Drug Administration.
August 2016: Endocrine Practice
Abeer Anabtawi, John M Miles
Metformin is the most commonly prescribed drug for the treatment of type 2 diabetes because of its apparent robust effects in reducing cardiovascular risk. The United Kingdom Prospective Diabetes Study suggests that metformin reduces the risk of myocardial infarction, and more recent retrospective studies have shown an association between metformin and a reduction in stroke, atrial fibrillation and all-cause mortality. The mechanism(s) explaining these putative benefits are not clear but may involve decreased energy intake (with attendant weight loss), improvement in lipids, and lowering of blood pressure; a review of selected literature suggests that metformin lowers blood pressure when it is elevated, but not when it is normal...
May 23, 2016: Endocrine Practice
Peter P Swoboda, Adam K McDiarmid, Bara Erhayiem, Philip Haaf, Ananth Kidambi, Graham J Fent, Laura E Dobson, Tarique A Musa, Pankaj Garg, Graham R Law, Mark T Kearney, Julian H Barth, Ramzi Ajjan, John P Greenwood, Sven Plein
OBJECTIVE: Silent myocardial infarction (MI) is a prevalent finding in patients with type 2 diabetes and is associated with significant mortality and morbidity. Late gadolinium enhancement (LGE) by cardiovascular magnetic resonance (CMR) is the most validated technique for detection of silent MI, but is time-consuming, costly, and requires administration of intravenous contrast. We therefore planned to develop a simple and low-cost population screening tool to identify those at highest risk of silent MI validated against the CMR reference standard...
September 2016: Journal of Clinical Endocrinology and Metabolism
Christoph Wanner, Silvio E Inzucchi, John M Lachin, David Fitchett, Maximilian von Eynatten, Michaela Mattheus, Odd Erik Johansen, Hans J Woerle, Uli C Broedl, Bernard Zinman
BACKGROUND: Diabetes confers an increased risk of adverse cardiovascular and renal events. In the EMPA-REG OUTCOME trial, empagliflozin, a sodium-glucose cotransporter 2 inhibitor, reduced the risk of major adverse cardiovascular events in patients with type 2 diabetes at high risk for cardiovascular events. We wanted to determine the long-term renal effects of empagliflozin, an analysis that was a prespecified component of the secondary microvascular outcome of that trial. METHODS: We randomly assigned patients with type 2 diabetes and an estimated glomerular filtration rate of at least 30 ml per minute per 1...
July 28, 2016: New England Journal of Medicine
Jong Chul Won, Tae Sun Park
Diabetes is an increasing epidemic in Korea, and associated diabetic peripheral neuropathy (DPN) is its most common and disabling complication. DPN has an insidious onset and heterogeneous clinical manifestations, making it difficult to detect high-risk patients of DPN. Early diagnosis is recommended and is the key factor for a better prognosis and preventing diabetic foot ulcers, amputation, or disability. However, diagnostic tests for DPN are not clearly established because of the various pathophysiology developing from the nerve injury to clinical manifestations, differences in mechanisms according to the type of diabetes, comorbidities, and the unclear natural history of DPN...
June 2016: Endocrinology and Metabolism
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