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Glycemic Variablity

Graham R Law, Alia Alnaji, Lina Alrefaii, Del Endersby, Sarah J Cartland, Stephen G Gilbey, Paul E Jennings, Helen R Murphy, Eleanor M Scott
OBJECTIVE: Continuous glucose monitoring (CGM) provides far greater detail about fetal exposure to maternal glucose across the 24-h day. Our aim was to examine the role of temporal glucose variation on the development of large for gestational age (LGA) infants in women with treated gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS: We performed a prospective observational study of 162 pregnant women with GDM in specialist multidisciplinary antenatal diabetes clinics...
February 14, 2019: Diabetes Care
Charrise M Ramkissoon, Athur Bertachi, Aleix Beneyto, Jorge Bondia, Josep Vehi
The purpose of this study was to develop an algorithm that detects aerobic exercise and triggers disturbance rejection actions to prevent exercise-induced hypoglycemia. This approach can provide a solution to poor glycemic control during and after aerobic exercise, a major hindrance in the participation of exercise by patients with type 1 diabetes. This novel exercise-induced hypoglycemia reduction algorithm (EHRA) detects exercise using a threshold on a disturbance term, a parameter estimated from an augmented minimal model using an Unscented Kalman Filter...
February 11, 2019: IEEE Journal of Biomedical and Health Informatics
Remi Kodera, Yuko Chiba, Yoshiaki Tamura, Rieko Miyazawa, Ryoji Tanei, Seijiro Mori, Hideki Ito, Atsushi Araki
AIM: Bullous pemphigoid (BP) is an autoimmune skin disorder characterized by the production of autoantibodies. Several recent reports have described the occurrence of BP in diabetic patients treated with dipeptidyl peptidase-4 (DPP-4) inhibitors. However, the clinical features of BP in diabetic patients, particularly in those treated with DPP-4 inhibitors, have not yet been examined. The aim of this study was to clarify clinical characteristics of BP in elderly type 2 diabetic patients...
2019: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Angelo Maria Patti, Dragana Nikolic, Antonio Magan-Fernandez, Rosaria Vincenza Giglio, Giuseppa Castellino, Roberta Chianetta, Roberto Citarrella, Egle Corrado, Francesca Provenzano, Vincenzo Provenzano, Giuseppe Montalto, Ali A Rizvi, Manfredi Rizzo
AIM: To evaluate the effect of exenatide long acting release (LAR) on carotid intima-media thickness (IMT) and endothelial function in patients with type 2 diabetes mellitus. METHODS: Sixty subjects with type 2 diabetes mellitus were treated with exenatide LAR as add-on to stable doses of metformin for 8 months in an open label study. Anthropometric variables, lipid profile and glycemic parameters were assessed by routine analysis. Carotid IMT by Doppler ultrasound and endothelial function by flow-mediated dilation of the brachial artery were also assessed...
February 10, 2019: Diabetes Research and Clinical Practice
Rachel L Usala, Stephen J Fernandez, Mihriye Mete, Nawar M Shara, Joseph G Verbalis
Context: Patients with diabetes mellitus are at increased risk for bone fragility fracture secondary to multiple mechanisms. Hyperglycemia can induce true dilutional hyponatremia. Hyponatremia is associated with gait instability, osteoporosis, and increased falls and bone fractures, and studies suggest that compromised bone quality with hyponatremia may be independent of plasma osmolality. We performed a case-control study of patients with diabetes mellitus matched by median glycated hemoglobin (HbA1c) to assess whether hyponatremia was associated with increased risk of osteoporosis and/or fragility fracture...
February 1, 2019: Journal of the Endocrine Society
Yaozhong Lv, Liming Zhang, Mengnan Li, Xihong He, Limin Hao, Yujie Dai
Native potato starch (NPS) with tea polyphenols (TPs) was treated in a planetary ball mill, and the effects of co-grinding on properties and digestibility of starch were studied. The X-ray diffraction (XRD) results showed that the crystal structure of starch granules was destroyed after 7 h of ball grinding, and their crystallinity degree reduced from 38.1% to 8.3%. The scanning electron microscopy (SEM) analyses indicated that the damaged starch granules and TPs displayed agglomerates after 7 h of milling...
February 6, 2019: International Journal of Biological Macromolecules
Helena Mendes-Soares, Tali Raveh-Sadka, Shahar Azulay, Kim Edens, Yatir Ben-Shlomo, Yossi Cohen, Tal Ofek, Davidi Bachrach, Josh Stevens, Dorin Colibaseanu, Lihi Segal, Purna Kashyap, Heidi Nelson
Importance: Emerging evidence suggests that postprandial glycemic responses (PPGRs) to food may be influenced by and predicted according to characteristics unique to each individual, including anthropometric and microbiome variables. Interindividual diversity in PPGRs to food requires a personalized approach for the maintenance of healthy glycemic levels. Objectives: To describe and predict the glycemic responses of individuals to a diverse array of foods using a model that considers the physiology and microbiome of the individual in addition to the characteristics of the foods consumed...
February 1, 2019: JAMA network open
Simone Pappacena, Michael Bailey, Luca Cabrini, Giovanni Landoni, Andrew Udy, David V Pilcher, Paul Young, Rinaldo Bellomo
BACKGROUND: Traumatic Brain Injury (TBI) and Sub-Arachnoid Hemorrhage (SAH) are the most common causes of severe acute brain injury in younger Intensive Care Unit (ICU) patients. Dysglycemia (abnormal peak glycemia, glycemic variability, mean glycemia, nadir glycemia) is common in these patients but its comparative outcome associations are unclear. METHODS: In a retrospective, cross-sectional, study of adults admitted to Australian and New Zealand ICUs with TBI and SAH (TBI&SAH) from 2005 to 2015, we studied the relationship between multiple aspects of early (first 24 hours) dysglycemia and mortality and compared TBI and SAH patients with the general ICU population and with each other...
February 7, 2019: Minerva Anestesiologica
Ji-Yong Jang, Shinje Moon, Sungsoo Cho, Kyoo Ho Cho, Chang-Myung Oh
This study evaluate association between glycemic variability and adverse vascular events in nondiabetic middle-aged adults. From 10,020 Ansung-Ansan cohort, Korean Genome, and Epidemiology Study (KoGES) data. 6,462 nondiabetic adults aged <65 years was analyzed. The mean and coefficient of variation (CV) of all biannually recorded HbA1c, fasting blood glucose(FBG), and post 2 hr blood glucose (PBG) were calculated and divided into 3 groups based on tertile of CV at each measurement, respectively. Primary endpoint was composite of Macro (composite of Coronary artery disease, Myocardial infarction, Congestive heart failure or Stroke) and Microvascular event (Creatine Clearance <60 ml/min/1...
February 4, 2019: Scientific Reports
Jenna Sopfe, Laura Pyle, Amy K Keating, Kristen Campbell, Arthur K Liu, R Paul Wadwa, Michael R Verneris, Roger H Giller, Gregory P Forlenza
Malglycemia (hypoglycemia, hyperglycemia, and/or glycemic variability) in adult hematopoietic stem cell transplant (HSCT) recipients is associated with increased infection, graft-versus-host disease, organ dysfunction, delayed engraftment, and mortality. Malglycemia has not been studied in pediatric HSCT recipients. This study aimed to characterize the incidence and consequences of malglycemia in this population. Medical records for a cohort of 344 patients, age 0 to 30 years, who underwent first HSCT from 2007 to 2016 at Children's Hospital Colorado were retrospectively reviewed...
February 12, 2019: Blood Advances
Huafeng Cheng, Xu Wan, Jing Ma, Bin Wu
PURPOSE: The goal of this study was to investigate the long-term economic outcomes of insulin degludec versus insulin glargine use in Chinese patients with type 2 diabetes mellitus (T2DM) whose oral antidiabetic drugs did not provide sufficient glycemic control. METHODS: A published and validated Chinese diabetes health policy model, which reflects Chinese T2DM epidemiologic profiles, was used to assess the lifetime economic outcomes of microvascular and macrovascular complications and mortality...
January 31, 2019: Clinical Therapeutics
Djeniffer Elias da Silva, Antônio José Grande, Leonardo Roever, Gary Tse, Tong Liu, Giuseppe Biondi-Zoccai, Joni Márcio de Farias
PURPOSE OF REVIEW: High-intensity exercise may beneficially impact on insulin sensitivity. However, there is still uncertainty on the actual impact of high-intensity interval training (HIIT) on chronic physiologic adaptations among patients with type 2 diabetes mellitus (T2DM). We aimed to systematically search and appraise the evidence base on the effects of HIIT in comparison to mild- or moderate-intensity interval training (MMIIT) on glycemic control inT2DM. RECENT FINDINGS: A total of 5 RCT met the inclusion criteria...
February 2, 2019: Current Atherosclerosis Reports
Tsuyoshi Ito, Taku Ichihashi, Hiroshi Fujita, Tomonori Sugiura, Junki Yamamoto, Shuichi Kitada, Kosuke Nakasuka, Yu Kawada, Nobuyuki Ohte
Impaired glucose metabolism is associated with an increased risk of cardiovascular complications, and coronary artery spasm is thought to underlie the development of coronary artery disease. Intraday glucose variability (GV) accelerates oxidative stress and inflammatory cytokine release, but its impact on coronary artery spasm remains unclear. This study investigated the relationship between intraday GV and coronary artery spasm. The study included 50 patients with dysglycemia and suspected coronary spastic angina...
February 2, 2019: Heart and Vessels
Svetlana V Doubova, Claudia Infante, Georgina Lizeth Villagrana-Gutiérrez, Ingrid Patricia Martínez-Vega, Ricardo Pérez-Cuevas
This study evaluates the health literacy of people with type 2 diabetes and its association with health outcomes. We conducted a cross-sectional survey in two family medicine clinics of the Mexican Institute of Social Security that included 778 diabetic patients >19 years of age. The Spanish version of the European Health Literacy questionnaire served to measure health literacy. Multiple logistic regressions were performed to determine the association between the independent variable (health literacy) and dependent variables (good self-rated health, glycemic control, and diabetes-related hospitalizations) after controlling for conceptually relevant patient's characteristics...
February 1, 2019: Psychology, Health & Medicine
Günay Demir, Samim Özen, Hafize Çetin, Şükran Darcan, Damla Gökşen
Objective: The aim of this study was to determine the prevalence of impaired hypoglycemia awareness (IHA) in children and adolescents with type 1 diabetes mellitus with professional continuous glucose monitoring system and to show the effect of structured education on glycemic variability (GV) in children and adolescents with IHA. Methods: Fourty type 1 diabetic children and adolescents with a diabetes duration of at least 5 years were eligible for inclusion in this prospective, quantitative study...
January 31, 2019: Journal of Clinical Research in Pediatric Endocrinology
Molla Abebe, Tiruneh Adane, Kassa Kefyalew, Tesfahun Munduno, Alebachew Fasil, Belete Biadgo, Sintayehu Ambachew, Saira Shahnawaz
Background: Diabetic kidney disease is a common and severe microvascular complication of diabetes mellitus (DM). There are limited data regarding alteration of urine parameters other than proteinuria among DM patients. Methods: Institution based cross-sectional study was conducted from February to May 2017 to assess alteration of urine parameters among DM patients at the University of Gondar Hospital, Northwest Ethiopia. A Systematic random sampling technique was used to recruit adult (≥18 years) diabetic participants...
January 2019: Ethiopian Journal of Health Sciences
Carlos Alberto Velasco-Benítez, Ángeles Ruíz-Extremera, Audrey Mary Matallana-Rhoades, Sandra Carolina Giraldo-Lora, Claudia Jimena Ortíz-Rivera
Introduction: Although the association between diabetes mellitus type 1 (T1DM) and celiac disease (CD) is well established; there are only a few studies that focus on South American children, haplotypes and their possible associations. Objective: To determine the prevalence of CD markers in a group of children with T1DM and to analyze the associated clinical, immunological and genetic manifestations. Methods: A prevalence study focusing on children with T1DM who were assessed based on variables including sociodemographics, anthropometric information, disease characteristics, laboratory results and family medical history...
December 30, 2018: Colombia Médica: CM
Maja Krhač, Marijana Vučić Lovrenčić
Attaining and maintaining good glycemic control is a cornerstone of diabetes care. The monitoring of glycemic control is currently based on the self-monitoring of blood glucose (SMBG) and laboratory testing for hemoglobin A1c (HbA1c), which is a surrogate biochemical marker of the average glycemia level over the previous 2-3 mo period. Although hyperglycemia is a key biochemical feature of diabetes, both the level of and exposure to high glucose, as well as glycemic variability, contribute to the pathogenesis of diabetic complications and follow different patterns in type 1 and type 2 diabetes...
January 15, 2019: World Journal of Diabetes
Archana Sarda, Suresh Munuswamy, Shubhankar Sarda, Vinod Subramanian
BACKGROUND: Research studies are establishing the use of smartphone sensing to measure mental well-being. Smartphone sensor information captures behavioral patterns, and its analysis helps reveal well-being changes. Depression in diabetes goes highly underdiagnosed and underreported. The comorbidity has been associated with increased mortality and worse clinical outcomes, including poor glycemic control and self-management. Clinical-only intervention has been found to have a very modest effect on diabetes management among people with depression...
January 29, 2019: JMIR MHealth and UHealth
Boris Kovatchev
Glycemic variability (GV) a well-established risk factor for hypoglycemia and a suspected risk factor for diabetes complications. GV is also a marker of the instability of a person's metabolic system, expressed as frequent high and low glucose excursions and overall volatile glycemic control. In this review, the author discusses topics related to the assessment, quantification, and optimal control of diabetes, including (1) the notion that optimal control of diabetes, that is, lowering of HbA1c-the commonly accepted gold-standard outcome-can be achieved only if accompanied by simultaneous reduction of GV; (2) assessment and visualization of the two principal dimensions of GV, amplitude and time, which is now possible via continuous glucose monitoring (CGM) and various metrics quantifying GV and the risks associated with hypo- and hyperglycemic excursions; and (3) the evolution of diabetes science and technology beyond quantifying GV and into the realm of GV control via pharmacological agents, for example, GLP-1 receptor agonists and DPP-4 inhibitors, which have pronounced variability-reducing effect, or real-time automated closed-loop systems commonly referred to as the "artificial pancreas...
January 29, 2019: Journal of Diabetes Science and Technology
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