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    A case report of methadone-associated hypoglycemia in an 11-month-old male.
    Clin Toxicol (Phila) 2017 Jun 26:1-3. Epub 2017 Jun 26.
    a Harvard Medical Toxicology Program , Boston Children's Hospital , Boston , MA , USA.
    Background: Methadone is a synthetic μ-opioid receptor agonist that is used in the management of pain, neonatal abstinence withdrawal syndrome, and opioid dependence. Overdose can cause miosis, respiratory depression, and central nervous system depression. Rarely, hypoglycemia has been reported. Read More

    An update on type 2 diabetes management in primary care.
    Nurse Pract 2017 Jun 22. Epub 2017 Jun 22.
    Jeffrey M. Waddell is a DNP student at Pittsburg State University, Pittsburg, Kan., and a family NP at Jefferson County Health Center, Fairfield, Iowa.
    Diabetes mellitus is a chronic disease impacting glucose metabolism. Type 2 diabetes mellitus (T2DM) stems from the inability of the body to utilize endogenous insulin properly. Approximately 90% to 95% of newly diagnosed cases of diabetes are T2DM. Read More

    A Novel Heterozygous IGF-1 Receptor Mutation Associated with Hypoglycemia.
    Endocr Connect 2017 Jun 25. Epub 2017 Jun 25.
    L de Vries, Institure for Endocrinology and Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, 49202, Israel
    Mutation in the insulin-like growth factor-1 receptor (IGF1R) gene is a rare cause for intrauterine and postnatal growth disorders. Patients identified with IGF1R mutations present with either normal or impaired glucose tolerance. None of the cases described so far showed hypoglycemia. Read More

    Presentations for hypoglycemia associated with diabetes mellitus to emergency departments in a Canadian province: A database and epidemiological analysis.
    Diabetes Res Clin Pract 2017 Mar 11;130:229-236. Epub 2017 Mar 11.
    Department of Emergency Medicine, University of Alberta, 790 University Terrace Building, 8303 - 112 Street, Edmonton, Alberta T6G 2T4, Canada; Emergency Strategic Clinical Network, Alberta Health Services, Alberta Health Services Corporate Office, Seventh Street Plaza, 14th Floor, North Tower, 10030 - 107 Street NW, Edmonton, Alberta T5J 3E4, Canada; School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405 - 87 Ave, Edmonton, Alberta T6G 1C9, Canada. Electronic address:
    Aims: The prevalence of diabetes mellitus was reportedly 9% in 2014, making it one of the most common global chronic conditions. Hypoglycemia is an important complication of diabetes treatment. The objective of this study was to quantify and characterize hypoglycemia presentations associated with type 1 or 2 diabetes made to emergency departments (EDs) by adults in a Canadian province. Read More

    HPI/AMF inhibition halts the development of the aggressive phenotype of breast cancer stem cells.
    Biochim Biophys Acta 2017 Jun 22. Epub 2017 Jun 22.
    Departamento de Bioquímica, Instituto Nacional de Cardiología, Tlalpan, México, DF 14080, Mexico.. Electronic address:
    Cancer stem cells are responsible for tumor recurrence and metastasis. A new highly reproducible procedure for human breast cancer MCF-7 stem cells (BCSC) isolation and selection was developed by using a combination of hypoxia/hypoglycemia plus taxol and adriamycin for 24h. The BCSC enriched fraction (i) expressed (2-15 times) the typical stemness protein markers CD44+, ALDH1A3 and Oct 3/4; (ii) increased its clonogenicity index (20-times), invasiveness profile (>70%), migration capacity (100%) and ability to form mammospheres, compared to its non-metastatic MCF-7 counterpart. Read More

    [Retrospective analysis of anesthetic and perioperative management in patients of acute fatty liver of pregnancy].
    Zhonghua Yi Xue Za Zhi 2017 Jun;97(24):1878-1882
    Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China.
    Objective: To retrospectively analyze the clinical characteristics of patients with acute fatty liver of pregnancy (AFLP), and to discuss perioperative and anesthetic management. Methods: A retrospective review was conducted on the records of pregnant patients with a diagnosis of acute fatty liver of pregnancy in Peking University Third Hospital from January 2007 to December 2015. 12 cases were identified. Read More

    Continuous Glucose Monitoring in Pediatrics: The Gap between Potential Benefits and the Reality of Utility.
    Pediatr Endocrinol Rev 2017 Jun;14(Suppl 2):435-440
    Diabetes Center for Children at The Children's Hospital of Philadelphia, 34th Street and Civic Center Blvd, Philadelphia, PA 19342, USA.
    Continuous Glucose Monitoring (CGM) is rapidly becoming a standard of care in the management of Type 1 diabetes (T1D). Today's devices are nearly as accurate as home glucose meters. They provide glucose data every 5 minutes, alert to high and low blood glucose levels, and allow for remote monitoring of a user's glucose data and patterns. Read More

    Treatments for gestational diabetes: a systematic review and meta-analysis.
    BMJ Open 2017 Jun 24;7(6):e015557. Epub 2017 Jun 24.
    MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK.
    Objective: To investigate the effectiveness of different treatments for gestational diabetes mellitus (GDM).

    Design: Systematic review, meta-analysis and network meta-analysis.

    Methods: Data sources were searched up to July 2016 and included MEDLINE and Embase. Read More

    Relationship between Measures of Neonatal Glycemia, Neonatal Illness, and 2-Year Outcomes in Very Preterm Infants.
    J Pediatr 2017 Jun 21. Epub 2017 Jun 21.
    Liggins Institute, University of Auckland, Auckland, New Zealand. Electronic address:
    Objectives: To investigate relationships between early neonatal glycemia, neonatal characteristics, neonatal illness, and developmental outcomes in very preterm infants.

    Study Design: A retrospective, observational cohort study of 443 infants born weighing <1500 g or <30 weeks of gestation, and admitted within 24 hours to National Women's Hospital, Auckland, New Zealand. Glucose variability was defined as the standard deviation around the mean after log transformation of all blood glucose concentrations. Read More

    Prenatal, perinatal and neonatal risk factors for perinatal arterial ischaemic stroke: a systematic review and meta-analysis.
    Eur J Neurol 2017 Jun 24. Epub 2017 Jun 24.
    Department of Neonatology, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.
    The aim of the present study was to perform a meta-analysis of published data to determine the significance of clinical factors and exposures to the risk of perinatal arterial ischaemic stroke (PAIS) and provide guidance for clinical diagnosis and treatment. A comprehensive literature search of the PubMed, Embase, MEDLINE and Cochrane Library databases for relevant observational studies (cohort/case-control) from March 1984 to March 2016 was undertaken. Two review authors independently examined the full text records to determine which studies met the inclusion criteria and evaluated risk factors for PAIS. Read More

    Glucose Control, Diabetes Status, and Mortality in Critically Ill Patients: The Continuum From Intensive Care Unit Admission to Hospital Discharge.
    Mayo Clin Proc 2017 Jun 7. Epub 2017 Jun 7.
    Department of Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, MA.
    Objective: To describe the relationships among glycemic control, diabetes mellitus (DM) status, and mortality in critically ill patients from intensive care unit (ICU) admission to hospital discharge.

    Patients And Methods: This is a retrospective investigation of 6387 ICU patients with 5 or more blood glucose (BG) tests and 4462 ICU survivors admitted to 2 academic medical centers from July 1, 2010, through December 31, 2014. We studied the relationships among mean BG level, hypoglycemia (BG level <70 mg/dL [to convert to mmol/L, multiply by 0. Read More

    iGlarLixi: A Fixed-Ratio Combination of Insulin Glargine 100 U/mL and Lixisenatide for the Treatment of Type 2 Diabetes.
    Ann Pharmacother 2017 Jun 1:1060028017717281. Epub 2017 Jun 1.
    2 University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.
    Objective: To review the safety and efficacy of iGlarLixi, a titratable fixed-ratio combination of insulin glargine 100 U/mL (iGlar) and lixisenatide, a glucagon-like peptide-1 receptor agonist.

    Data Sources: A literature search of MEDLINE for all English-language primary articles through June 2016, using the terms LixiLan, iGlarLixi and insulin glargine and lixisenatide, and a search of abstracts presented at the 2016 Scientific Sessions of the American Diabetes Association were performed.

    Study Selection And Data Extraction: All studies assessing the efficacy and/or safety of iGlarLixi were evaluated. Read More

    IDegLira was effective across a range of dysglycaemia and BMI categories in the DUAL V randomized trial.
    Diabetes Obes Metab 2017 Jun 23. Epub 2017 Jun 23.
    University Hospital Quiron Salud Madrid, Universidad Europea de Madrid, Madrid, Spain.
    This study assessed the efficacy of insulin degludec/liraglutide (IDegLira) versus insulin glargine U100 (IGlar) across categories of baseline HbA1c (≤7.5%, >7.5- ≤ 8. Read More

    [Why is a combination of basal insulin with a GLP-1 receptor agonist useful in many patients with type 2 diabetes?]
    MMW Fortschr Med 2017 Jun 22;159(Suppl 5):7-15. Epub 2017 Jun 22.
    Novo Nordisk Pharma GmbH, Mainz, Deutschland.
    Background: In 2015, the combination of basal insulin and GLP-1 receptor agonist (RA) was incorporated into the guideline recommendations for type 2 diabetes as an option for the last escalation step. The two antidiabetics to be injected subcutaneously are complementary regarding their respective main effects and limitations. Basal insulin is predominantly active between meals and in the fasting state, whereas the main action of GLP-1 RA consists in preventing an excessive postprandial blood glucose increase. Read More

    Empagliflozin Improves Left Ventricular Diastolic Dysfunction in a Genetic Model of Type 2 Diabetes.
    Cardiovasc Drugs Ther 2017 Jun 22. Epub 2017 Jun 22.
    Cardiovascular Research Institute, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
    Purpose: Cardiovascular (CV) diseases in type 2 diabetes (T2DM) represent an enormous burden with high mortality and morbidity. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have recently emerged as a new antidiabetic class that improves glucose control, as well as body weight and blood pressure with no increased risk of hypoglycemia. The first CV outcome study terminated with empagliflozin, a specific SGLT2 inhibitor, has shown a reduction in CV mortality and in heart failure hospitalization, suggesting a beneficial impact on cardiac function which remains to be demonstrated. Read More

    Development of Pulmonary Hypertension During Treatment with Diazoxide: A Case Series and Literature Review.
    Pediatr Cardiol 2017 Jun 22. Epub 2017 Jun 22.
    San Antonio Military Medical Center, San Antonio, USA.
    Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in infancy. The mainstay of medical management for CHI is diazoxide. Diazoxide inhibits insulin release from the pancreas, but also causes smooth muscle relaxation and fluid retention so it is typically given with chlorothiazide. Read More

    Diverse metabolic effects of O-GlcNAcylation in the pancreas but limited effects in insulin-sensitive organs in mice.
    Diabetologia 2017 Jun 22. Epub 2017 Jun 22.
    Department of Medicine, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan.
    Aims/hypothesis: O-GlcNAcylation is characterised by the addition of N-acetylglucosamine to various proteins by O-GlcNAc transferase (OGT) and serves in sensing intracellular nutrients by modulating various cellular processes. Although it has been speculated that O-GlcNAcylation is associated with glucose metabolism, its exact role in whole body glucose metabolism has not been fully elucidated. Here, we investigated whether loss of O-GlcNAcylation globally and in specific organs affected glucose metabolism in mammals under physiological conditions. Read More

    Hypoglycemia Patients and Transport by EMS in Alameda County, 2013-15.
    Prehosp Emerg Care 2017 Jun 22:1-6. Epub 2017 Jun 22.
    Objective: To estimate the rate, characteristics, and dispositions of hypoglycemia events among persons who received care from Alameda County, California, Emergency Medical Services (EMS).

    Methods: This study was based on data for 601,077 Alameda County EMS encounters during 2013-15. Subjects were defined as having hypoglycemia if EMS personnel recorded a primary impression of hypoglycemia or low blood glucose (<60 mg/dl or "unspecified low"). Read More

    Hospitalization with hypoglycemia in patients without diabetes mellitus: A retrospective study using a national inpatient database in Japan, 2008-2012.
    Medicine (Baltimore) 2017 Jun;96(25):e7271
    aDepartment of Internal Medicine, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba bDepartment of Clinical Epidemiology and Health Economics, School of Public Health, Graduate School of Medicine, The University of Tokyo cDepartment of Health Informatics and Policy, Tokyo Medical and Dental University Graduate School of Medicine dDepartment of Diabetes, Endocrinology, and Metabolism, Center Hospital, National Center for Global Health and Medicine eMetabolic Epidemiology Section, Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
    We aimed to examine prevalence, patient characteristics, etiology, and clinical outcomes of hospitalized patients who had hypoglycemia without a diagnosis of diabetes mellitus, using a Japanese nationwide database.This was a retrospective observational study using a national database of acute-care inpatients in Japan. Nondiabetic patients aged ≥15 years who were hospitalized for hypoglycemia were eligible. Read More

    [Euglycemic ketoacidosis : a complication of SGLT2 inhibitors].
    Rev Med Suisse 2017 May;13(565):1164-1167
    Unité de diabétologie, Hôpital de La Tour, Avenue J.-D. Maillard 3, 1217 Meyrin.
    Sodium-glucose cotransporter 2 (SGLT2) inhibitors constitute a new category of oral antidiabetics recently indicated for the treatment of type 2 diabetes. Their mechanism of action (inhibition of renal reabsorption of glucose) and the fact that they do not induce hypoglycemia (as monotherapy) make their clinical use interesting. Various adverse events have however been reported regarding these drugs with the euglycemic ketoacidosis being the most serious. Read More

    [Value of continuous glucose monitoring in type 2 diabetic patients].
    Rev Med Suisse 2017 May;13(565):1140-1144
    Service d'endocrinologie, diabétologie, hypertension et nutrition, HUG, 1211 Genève 14.
    Management of type 1 and type 2 diabetes mellitus is getting complex with the apparition of new treatments, but also new technologies. Among these, continuous glucose monitoring systems (CGMS) lead to a better glycemic control and less hypoglycemia in type 1 diabetic patients. Studies are scarce in type 2 diabetes but also seem to show a benefit, particularly in patients using insulin. Read More

    Exercise for pregnant women with gestational diabetes for improving maternal and fetal outcomes.
    Cochrane Database Syst Rev 2017 Jun 22;6:CD012202. Epub 2017 Jun 22.
    Liggins Institute, The University of Auckland, Park Rd, Grafton, Auckland, New Zealand, 1142.
    Background: Gestational diabetes mellitus (GDM) is associated with both short- and long-term complications for the mother and her baby. Exercise interventions may be useful in helping with glycaemic control and improve maternal and infant outcomes.The original review on Exercise for diabetic pregnant women has been split into two new review titles reflecting the role of exercise for pregnant women with gestational diabetes and for pregnant women with pre-existing diabetes. Read More

    Incidence of diabetes-related complications in Chinese patients with type 1 diabetes: a population-based longitudinal cohort study in Taiwan.
    BMJ Open 2017 Jun 21;7(6):e015117. Epub 2017 Jun 21.
    School of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
    Objective: To estimate the incidence densities and cumulative incidence of diabetes-related complications in patients with type 1 diabetes for a maximum of 15-year follow-up. The estimations were further stratified by gender and age at diagnosis (ie, early onset: 0-12 years, late onset:≥13 years).

    Design: A population-based retrospective longitudinal cohort study. Read More

    Comparative Simulation Study of Glucose Control Methods Designed for Use in the Intensive Care Unit Setting via a Novel Controller Scoring Metric.
    J Diabetes Sci Technol 2017 Jun 1:1932296817711297. Epub 2017 Jun 1.
    1 Ideal Medical Technologies Inc, Asheville, NC, USA.
    Background: Effective glucose control in the intensive care unit (ICU) setting has the potential to decrease morbidity and mortality rates and thereby decrease health care expenditures. To evaluate what constitutes effective glucose control, typically several metrics are reported, including time in range, time in mild and severe hypoglycemia, coefficient of variation, and others. To date, there is no one metric that combines all of these individual metrics to give a number indicative of overall performance. Read More

    Network meta-analysis of liraglutide versus DPP-4 inhibitors for the treatment of Type 2 diabetes in Japanese patients.
    Curr Med Res Opin 2017 Jun 21:1-19. Epub 2017 Jun 21.
    d Novo Nordisk A/S , Denmark.
    Aims: To determine the comparative efficacy and safety of liraglutide and dipeptidyl peptidiase-4 (DPP-4) inhibitors as antidiabetics for Japanese patients with uncontrolled type 2 diabetes (T2DM).

    Methods And Materials: We searched for randomized-controlled trials (RCTs) evaluating outcomes among Japanese adults with uncontrolled T2DM and including liraglutide or DPP-4 inhibitors up to August 2016. We extracted data on trial and patient characteristics, and the following outcomes: HbA1c, weight, patients meeting HbA1c <7%, patients experiencing hypoglycemic events, microalbuminuria, estimated glomerular filtration rate (eGFR) and creatinine. Read More

    Incidence of prolonged QTc and severe hypoglycemia in type 1 diabetes: the EURODIAB Prospective Complications Study.
    Acta Diabetol 2017 Jun 20. Epub 2017 Jun 20.
    Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy.
    Aims: To assess the independent role of severe hypoglycemia on 7-year cumulative incidence of prolonged QTc in a large cohort of patients with type 1 diabetes.

    Methods: People with type 1 diabetes recruited by the EURODIAB Prospective Complications Study who had normal QTc were examined at baseline and after 7 years with standardized methods (n = 1415; mean age ± SD 32.1 ± 9. Read More

    A study to evaluate the prevalence of impaired awareness of hypoglycaemia in adults with type 2 diabetes in outpatient clinic in a tertiary care centre in Singapore.
    Ther Adv Endocrinol Metab 2017 May 5;8(5):69-74. Epub 2017 May 5.
    Department of Endocrinology, Singapore General Hospital, Singapore.
    Background: Impaired awareness of hypoglycaemia (IAH) predisposes affected patients to severe hypoglycaemia. There are few data on prevalence of IAH in adults with insulin-treated type 2 diabetes in Asia. We aim to ascertain the prevalence of IAH among insulin-treated patients with type 2 diabetes in an outpatient clinic in a tertiary care centre in Singapore. Read More

    Oxidative stress and DNA damage in newborns born to mothers with hyperglycemia - a prospective cohort study.
    J Matern Fetal Neonatal Med 2017 Jun 20:1-11. Epub 2017 Jun 20.
    a Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) , Puducherry , India.
    Background: Hyperglycemic mothers have increased oxidative stress during pregnancy which can adversely affect the outcome in their neonates Objectives: To measure the oxidative stress and DNA damage in newborns born to mothers with hyperglycemia and correlate their immediate outcome with the amount of oxidative stress and DNA damage.

    Methods: This prospective cohort study conducted in a tertiary care teaching hospital, south India included 3 groups - newborns born to pregestational diabetic mothers (PGDM), gestational diabetic mothers (GDM) and euglycemic mothers with 24 newborns in each. Oxidative stress parameters - Malondialdehyde (MDA), Total antioxidant capacity (TAC) and DNA damage (comet assay) were assessed in umbilical cord blood. Read More

    Extensive Assessment of Blood Glucose Monitoring During Postprandial Period and Its Impact on Closed-Loop Performance.
    J Diabetes Sci Technol 2017 Jun 1:1932296817714272. Epub 2017 Jun 1.
    1 Institut d'Informàtica i Aplicacions, Universitat de Girona, Girona, Spain.
    Background: Closed-loop (CL) systems aims to outperform usual treatments in blood glucose control and continuous glucose monitors (CGM) are a key component in such systems. Meals represents one of the main disturbances in blood glucose control, and postprandial period (PP) is a challenging situation for both CL system and CGM accuracy.

    Methods: We performed an extensive analysis of sensor's performance by numerical accuracy and precision during PP, as well as its influence in blood glucose control under CL therapy. Read More

    Predicting inpatient hypoglycaemia in hospitalized patients with diabetes: a retrospective analysis of 9584 admissions with diabetes.
    Diabet Med 2017 Jun 20. Epub 2017 Jun 20.
    Institute of Applied Health Research, University of Birmingham, Birmingham.
    Aims: To explore whether a quantitative approach to identifying hospitalized patients with diabetes at risk of hypoglycaemia would be feasible through incorporation of routine biochemical, haematological and prescription data.

    Methods: A retrospective cross-sectional analysis of all diabetic admissions (n=9584) from 1 January 2014 to 31 December 2014 was performed. Hypoglycaemia was defined as a blood glucose level of <4 mmol/l. Read More

    Benefits of Islet Transplantation as an Alternative to Pancreas Transplantation: Retrospective Study of More Than 10 Ten Years of Experience in a Single Center.
    Rev Diabet Stud 2017 12;14(1):10-21. Epub 2017 Jun 12.
    Department of Diabetes, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
    Background: Pancreas transplantation (PTx) represents the method of choice in type 1 diabetic patients with conservatively intractable hypoglycemia unawareness syndrome. In 2005, the Institute for Clinical and Experimental Medicine (IKEM) launched a program to investigate the safety potential of islet transplantation (ITx) in comparison to PTx.

    Aim: This study aims to compare the results of PTx and ITx regarding severe hypoglycemia elimination, metabolic control, and complication rate. Read More

    Experiences of closed-loop insulin delivery among pregnant women with Type 1 diabetes.
    Diabet Med 2017 Jun 20. Epub 2017 Jun 20.
    Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge.
    Aims: To explore the experiences of pregnant women with Type 1 diabetes, and the relationships between perceptions of glucose control, attitudes to technology and glycaemic responses with regard to closed-loop insulin delivery.

    Methods: We recruited 16 pregnant women with Type 1 diabetes [mean ± sd age 34.1 ± 4. Read More

    [Safety and tolerability of oral hypoglycemic therapies in type 2 diabetes mellitus patients at high cardiovascular risk].
    G Ital Cardiol (Rome) 2017 Jun;18(6):485-495
    Dipartimento di Scienze Biomediche Avanzate, Università degli Studi "Federico II", Napoli.
    Oral hypoglycemic drugs for type 2 diabetes aim at preventing the metabolic effects of hyperglycemia and cardiovascular (CV) events. The evidence of the possible CV risk related to the prescription of some antidiabetic drugs prompted regulatory agencies to require safety studies. This review provides an updated analysis of CV safety profiles for antidiabetic drugs used for the treatment of patients with high CV risk. Read More

    Relationship Between Duration of Type 2 Diabetes and Effectiveness of DPP-4 Inhibitor Versus Sulfonylurea as Add-on Therapy: A Post Hoc Analysis.
    Diabetes Ther 2017 Jun 19. Epub 2017 Jun 19.
    Catholic University of Leuven, Leuven, Belgium.
    Introduction: To assess the impact of duration of type 2 diabetes on glucose-lowering effectiveness of the dipeptidyl peptidase-4 (DPP-4) inhibitor vildagliptin versus sulfonylureas (SUs) in a real-life setting.

    Methods: Data were extracted from the large 1-year, observational EDGE study (N = 45,868). Patients receiving either DPP-4 inhibitor or any SU as add-on to monotherapy were selected (N = 36,164). Read More

    Safety and Tolerability of Empagliflozin in Patients with Type 2 Diabetes: Pooled Analysis of Phase I-III Clinical Trials.
    Adv Ther 2017 Jun 19. Epub 2017 Jun 19.
    Boehringer Ingelheim Pharma GmbH & Co. KG, Binger Strasse 173, 55216, Ingelheim, Germany.
    Introduction: We characterized the safety and tolerability of empagliflozin in patients with type 2 diabetes (T2DM) randomized 1:1:1 to placebo, empagliflozin 10 mg, or empagliflozin 25 mg in clinical trials.

    Methods: Pooled data were analyzed from patients with T2DM treated with placebo (N = 4203), empagliflozin 10 mg (N = 4221), or empagliflozin 25 mg (N = 4196) in 15 randomized phase I-III trials plus four extension studies. Adverse events (AEs) were assessed descriptively in participants who took at least one dose of study drug. Read More

    Urinalysis and Clinical Correlations in Patients with P. vivax or P. falciparum Malaria from Colombia.
    J Trop Med 2017 24;2017:7868535. Epub 2017 May 24.
    Malaria Group, Faculty of Medicine, University of Antioquia, Calle 70, No. 52-21, Medellin, Colombia.
    Background: Urinalysis is a poorly reviewed diagnostic tool in malaria patients; its application can show the presence of severe malaria.

    Methods: Urinalysis was performed in a total of 620 patients diagnosed with malaria by thick blood smear; complications were classified according to WHO major criteria for severity and minor criteria according to the Colombian malaria guideline.

    Results: Severe or moderate clinical complications were diagnosed in 31. Read More

    Clinical practice points for diabetes management during RAMADAN fast.
    Diabetes Metab Syndr 2017 Jun 13. Epub 2017 Jun 13.
    Diabetes Care & Hormone Clinic, Ahmedabad, India.
    Diabetes management during Ramadan is very crucial from the patient perspective as it can present significant risk of hypoglycemia and death when proper care is not taken. Moreover, managing diabetes in fasting Ramadan patients require different mechanisms than the routine diabetes management and pose significant challenge to the health care practitioners. Here we set forth to review the available literature of various clinical trials and studies on different antidiabetic agents in the context of Ramadan. Read More

    The importance of declining insulin requirements during pregnancy in patients with pre-gestational gestational diabetes mellitus.
    Eur J Obstet Gynecol Reprod Biol 2017 Jun 3;215:148-152. Epub 2017 Jun 3.
    Department of Obstetrics and Gynecology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
    Objective: In patients with pre-gestational and gestational diabetes mellitus (GDM), insulin requirements often increase during the third trimester of pregnancy in order to maintain proper glycemic control. However, a fraction of patients demonstrate a significant decrease in insulin requirements in late gestation. We aimed to evaluate the clinical significance of decreasing insulin requirements in patients with pre-gestational diabetes and GDM with respect to fetal wellbeing and pregnancy outcome. Read More

    Characterization of the concurrent metabolic changes in brain and plasma during insulin-induced moderate hypoglycemia using (1)H NMR spectroscopy in juvenile rats.
    Neurosci Lett 2017 Jun 14;653:370-375. Epub 2017 Jun 14.
    Division of Neonatology, Department of Pediatrics, University of Minnesota, Mayo Mail Code 39, 420 Delaware Street, SE, Minneapolis, MN 55455, USA; Center for Neurobehavioral Development, University of Minnesota, Mayo Mail Code 39, 420 Delaware Street, SE, Minneapolis, MN 55455, USA. Electronic address:
    Treatment of hypoglycemia in children is currently based on plasma glucose measurements. This approach may not ensure neuroprotection since plasma glucose does not reflect the dynamic state of cerebral energy metabolism. To determine whether cerebral metabolic changes during hypoglycemia could be better characterized using plasma metabolomic analysis, insulin-induced acute hypoglycemia was induced in 4-week-old rats. Read More

    Hypoglycemia and Clinical Outcomes in Hospitalized Patients With Diabetes.
    J Diabetes Sci Technol 2017 Jan 1:1932296816688012. Epub 2017 Jan 1.
    1 Diabetes Centre, Gartnavel General Hospital, Glasgow, Scotland, UK.
    Background: Hypoglycemia is associated with increased length of stay in hospital patients, but previous studies have not considered the confounding effect of increased hypoglycemia detection associated with increased capillary blood glucose (CBG) measurement in prolonged admissions. We aimed to determine the effect of recorded hypoglycemia on length of stay of hospital inpatients (LOS) when this mathematical association is subtracted.

    Methods: CBG data were analyzed for inpatients within our health board area (01/2009-01/2015). Read More

    Hypoglycemic Coma Induced by the Use of Succinic Acid Cibenzoline in Frail Late-stage Elderly Subjects.
    Intern Med 2017 15;56(12):1527-1529. Epub 2017 Jun 15.
    Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan.
    Succinic acid cibenzoline (CZ) is an antiarrhythmic agent often used for the treatment of tachyarrhythmia. However, hypoglycemia should be avoided in the treatment of diabetes. We herein report two late-stage elderly subjects who experienced a severe and prolonged hypoglycemic coma after the usage of CZ. Read More

    Investigating the Relationship between Morning Glycemic Variability and Patient Characteristics Using Continuous Glucose Monitoring Data in Patients with Type 2 Diabetes.
    Intern Med 2017 15;56(12):1467-1473. Epub 2017 Jun 15.
    Department of Endocrinology and Diabetes, Ichinomiyanishi Hospital, Japan.
    Objective To investigate the relationship between patient characteristics and morning glycemic variability. Methods We retrospectively evaluated 106 patients with type 2 diabetes who underwent continuous glucose monitoring during admission. The highest postprandial glucose level (within 3 hours after breakfast; 'highest level'), the time from the start of breakfast to the highest postprandial glucose level ('highest time'), the difference between the pre-breakfast and highest postprandial breakfast glucose level ('increase'), the area under the curve (AUC; ≥180 mg/dL) for the glycemic variability within 3 hours after breakfast ('morning AUC'), and the post-breakfast glucose gradient ('gradient') were calculated. Read More

    Long-Term Cost-Effectiveness of Two GLP-1 Receptor Agonists for the Treatment of Type 2 Diabetes Mellitus in the Italian Setting: Liraglutide Versus Lixisenatide.
    Clin Ther 2017 Jun 15. Epub 2017 Jun 15.
    Novo Nordisk SpA, Rome, Italy.
    Purpose: Maintaining glycemic control is the key treatment target for patients with type 2 diabetes mellitus. In addition, the glucagon-like peptide-1 (GLP-1) receptor agonists may be associated with other favorable treatment characteristics, such as reduction in body weight and reduced risk of hypoglycemia compared with traditional diabetes interventions. The aim of the present analysis was to compare the long-term cost-effectiveness of 2 GLP-1 receptor agonists, liraglutide 1. Read More

    Basal and Bolus Insulin Dose Changes after Switching Basal Insulin to Insulin Degludec in Patients with Type 1 Diabetes Mellitus: A Pilot Study.
    Clin Drug Investig 2017 Jun 17. Epub 2017 Jun 17.
    Center for Diabetes and Endocrinology, The Tazuke Kofukai Foundation, Medical Research Institute, Kitano Hospital, Osaka, Japan.
    Background And Objectives: Ultra-long-acting insulin degludec (DEG) has a longer duration of action and less daily variability relative to other basal insulin (BI), and thus may benefit patients with type 1 diabetes mellitus (T1DM). We examined the impact of switching BI to DEG on glycemic control and insulin dose in T1DM.

    Methods: T1DM patients (n = 22; six male; mean age: 64. Read More

    The short- to mid-term symptom prevalence of dumping syndrome after primary gastric-bypass surgery and its impact on health-related quality of life.
    Surg Obes Relat Dis 2017 Apr 28. Epub 2017 Apr 28.
    Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
    Background: Early and late dumping are complications of gastric bypass surgery. Early dumping occurs within an hour after eating, when the emptying of food into the small intestine triggers rapid fluid shifts into the intestinal lumen and the release of gastrointestinal hormones, resulting in gastrointestinal and vasomotor symptoms. Late dumping occurs between 1 and 3 hours after carbohydrate ingestion and is caused by an exaggerated insulin release, resulting in hypoglycemia. Read More

    Neonatal hypoglycemia: A wide range of electroclinical manifestations and seizure outcomes.
    Eur J Paediatr Neurol 2017 Jun 1. Epub 2017 Jun 1.
    Gazi University, Faculty of Medicine, Department of Pediatric Neurology, Turkey.
    Purpose: We examined the various types of epilepsy in children with neonatal hypoglycemia in order to define electroclinical and prognostic features of these patients.

    Method: We retrospectively reviewed the medical records of patients with a history of symptomatic neonatal hypoglycaemia who have been followed at Gazi University Hospital Pediatric Neurology Department between 2006 and 2015. Patients with perinatal asphyxia were excluded. Read More

    Glycaemic control and hypoglycaemia with insulin glargine 300U/mL versus insulin glargine 100U/mL in insulin-naïve people with type 2 diabetes: 12-month results from the EDITION 3 trial.
    Diabetes Metab 2017 Jun 13. Epub 2017 Jun 13.
    Newcastle University, Newcastle upon Tyne, UK.
    Aim: To explore if efficacy and safety findings for insulin glargine 300U/mL (Gla-300) versus insulin glargine 100U/mL (Gla-100), observed over 6 months in insulin-naïve people with type 2 diabetes, are maintained after 12 months.

    Methods: EDITION 3 was a phase 3a, randomized, multicentre, open-label, parallel-group, treat-to-target study of once-daily Gla-300 versus Gla-100 (target fasting self-monitored plasma glucose, 4.4-5. Read More

    Metabolic Adaptation Establishes Disease Tolerance to Sepsis.
    Cell 2017 Jun;169(7):1263-1275.e14
    Instituto Gulbenkian de Ciência, 2780-156 Oeiras, Portugal. Electronic address:
    Sepsis is an often lethal syndrome resulting from maladaptive immune and metabolic responses to infection, compromising host homeostasis. Disease tolerance is a defense strategy against infection that preserves host homeostasis without exerting a direct negative impact on pathogens. Here, we demonstrate that induction of the iron-sequestering ferritin H chain (FTH) in response to polymicrobial infections is critical to establish disease tolerance to sepsis. Read More

    Administration of Exogenous Melatonin After the Onset of Systemic Inflammation Is Hardly Beneficial.
    Inflammation 2017 Jun 15. Epub 2017 Jun 15.
    Institute of Physiological Chemistry, University Hospital Essen, Essen, Germany.
    Melatonin improves survival and functional impairment including hemolysis, thrombocytopenia, and hypotension when administered in a prophylactic manner or early after initiation of sepsis or endotoxemia. In the present study, melatonin was given not before first symptoms of systemic inflammation became manifest. Lipopolysaccharide was infused at a rate of 0. Read More

    Postgastric bypass hypoglycaemia in a patient with end-stage renal disease: a diagnostic and management pitfall.
    BMJ Case Rep 2017 Jun 15;2017. Epub 2017 Jun 15.
    Department of Endocrinology, Florida Hospital, Orlando, Florida, USA.
    Roux-en-Y gastric bypass (RYGB) surgery is currently one of the most popular procedures to aid weight loss. Hypoglycaemia associated with gastric bypass surgery is an underdiagnosed but life-threatening potential consequence of the surgical procedure. We present a case of a 44-year-old woman with end-stage renal disease presenting with refractory hypoglycaemia after 10 years of RYGB. Read More

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