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Mol Metab 2021 Jun 8:101269. Epub 2021 Jun 8.

Division of Molecular Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA; Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN, USA; Bioinformatics and Computational Biology Program, University of Minnesota, Minneapolis, MN, USA. Electronic address:

Objective: Throughout the last decade, interest has intensified in intermittent fasting, ketogenic diets, and exogenous ketone therapies as prospective health-promoting, therapeutic, and performance-enhancing agents. However, the regulatory roles of ketogenesis and ketone metabolism on liver homeostasis remain unclear. Therefore, we sought to develop a better understanding of the metabolic consequences of hepatic ketone body metabolism by focusing on the redox-dependent interconversion of acetoacetate (AcAc) and D-β-hydroxybutyrate (D-βOHB). Read More

Eur J Pharmacol 2021 Jun 8:174244. Epub 2021 Jun 8.

Facultad de Farmacia, Universidad Autónoma Del Estado de Morelos, Cuernavaca, Morelos, 62209, México.

The current manuscript describes two molecules that were designed against PPARγ and GPR40 receptors. The preparation of the compounds was carried out following a synthetic route of multiple steps. Then, the mRNA expression levels of PPARγ, GLUT4, and GPR40 induced by compounds were measured and quantified in adipocyte and β-pancreatic cell cultures. Read More

Diabetes Technol Ther 2021 Jun 11. Epub 2021 Jun 11.

University of Virginia, Psychiatry and Neurobehavioral Sciences, Charlottesville, Virginia, United States;

Background: Closed-Loop Control (CLC) has been shown to improve glucose time in range and other glucose metrics; however, randomized trials longer than 3 months comparing CLC with sensor-augmented pump (SAP) therapy are limited. We recently reported glucose control outcomes from the 6-month international Diabetes Closed Loop (iDCL) trial; we now report patient-reported outcomes (PROs) in this iDCL trial.

Methods: Participants were randomized 2:1 to CLC (N=112) versus SAP (N=56) and completed questionnaires including Hypoglycemia Fear Survey, Diabetes Distress Scale (DDS), Hypoglycemia Awareness, Hypoglycemia Confidence, Hyperglycemia Avoidance, and Positive Expectancies of CLC (INSPIRE) at baseline, 3, and 6 months. Read More

PLoS One 2021 11;16(6):e0253078. Epub 2021 Jun 11.

Department of Radiology, University Hospital Basel, Basel, Switzerland.

Introduction: Pancreatic islet-cell tumors (PICT) often present with atypical signal-characteristics and are often missed on preoperative imaging. The aim of this study is to provide a multiparametric PICT characterization and investigate factors impeding PICT detection.

Material And Methods: This is a detailed MRI analysis of a prospective, monocenter study, including 49 consecutive patients (37 female, 12 male; median age 50) with symptoms due to endogenous hyperinsulinemic hypoglycemia (EHH) and mostly negative prior-imaging. Read More

Sci Rep 2021 Jun 10;11(1):12253. Epub 2021 Jun 10.

Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.

Loss-of-function (LoF) mutations in KCNQ1, encoding the voltage-gated K channel K7.1, lead to long QT syndrome 1 (LQT1). LQT1 patients also present with post-prandial hyperinsulinemia and hypoglycaemia. Read More

BMC Vet Res 2021 Jun 10;17(1):214. Epub 2021 Jun 10.

Institute of Animal Science, University of Hohenheim, Garbenstrasse 30, 70593, Stuttgart, Germany.

Background: Mycoplasma suis (M. suis) belongs to the group of haemotrophic mycoplasmas and is known as the causative agent of infectious anaemia in pigs. In the last few years valuable insights into the mechanism of adhesion and invasion, shedding patterns and cell tropism of M. Read More

Int J Pharm 2021 Jun 7:120784. Epub 2021 Jun 7.

Fujian Provincial Key Laboratory of Cancer Metastasis Chemoprevention and Chemotherapy, College of Chemistry, Fuzhou University, Fuzhou 350116, China. Electronic address:

Diabetes is a metabolic disease caused by insufficient insulin secretion, action or resistance, in which insulin plays an irreplaceable role in the its treatment. However, traditional administration of insulin requires continuous subcutaneous injections, which is accompanied by inevitable pain, local tissue necrosis and hypoglycemia. Herein, a green and safe nanoformulation with unique permeability composed of insulin and ginsenosides is developed for transdermal delivery to reduce above-mentioned side effects. Read More

JMIR Diabetes 2021 Jun 6. Epub 2021 Jun 6.

NOVI Health, Singapore, SG.

Background: With increasing type 2 diabetes mellitus (T2DM) prevalence, there is a need for effective programs that support diabetes management and improve T2DM outcomes. Mobile health (mHealth) interventions have shown promising results. With advances in wearable sensors and improved integration, mHealth programs could become more accessible and personalized. Read More

J Diabetes Investig 2021 Jun 10. Epub 2021 Jun 10.

Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, Korea.

2021 marks the 100-year anniversary of the discovery of insulin, an historic breakthrough in the treatment of type 1 diabetes. Insulin has helped save millions of lives. However, as Frederik G. Read More

BMJ Open 2021 Jun 9;11(6):e050919. Epub 2021 Jun 9.

Wessex Institute, University of Southampton, Southampton, Hampshire, UK.

Introduction: Cardiothoracic surgical outcomes are poorer in people with diabetes compared with those without diabetes. There are two important uncertainties in the management of people with diabetes undergoing major surgery: (1) how to improve diabetes management in the weeks leading up to an elective procedure and (2) whether that improved management leads to better postoperative outcomes. We previously demonstrated the feasibility of delivering the Optimising Cardiac Surgery ouTcOmes in People with diabeteS (OCTOPuS) intervention, an outpatient intervention delivered by diabetes healthcare professionals for people with suboptimally managed diabetes over 8-12 weeks before elective cardiac surgery. Read More

Medicine (Baltimore) 2021 May;100(19):e25843

Department of Paediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan.

Abstract: Pituitary stalk interruption syndrome (PSIS) is a rare disease associated with either isolated growth hormone deficiency (GHD) or combined pituitary hormone deficiency (CPHD). In older children and adults, most patients experience short stature or hypogonadism. Neonatal PSIS is extremely rare and is difficult to recognize due to absence of dwarfism. Read More

Forensic Sci Med Pathol 2021 Jun 9. Epub 2021 Jun 9.

Department of Forensic Medicine, School of Medicine, University of Occupational and Environmental Health Japan, Iseigaoka 1-1, Yahatanishi, Kitakyushu, Japan.

An 86-year-old female was found unconscious the day after taking a prescribed tablet containing a combination of tramadol and acetaminophen. At admission to the hospital, marked hypoglycemia (blood glucose: 4 mg/dL) was confirmed, but serum insulin and C-peptide were within the normal range, which suggested that neither endogenous hyperinsulinemia nor exogenous insulin administration was responsible for the hypoglycemia. Despite resuscitation efforts, the woman subsequently died. Read More

Artif Organs 2021 Jun 9. Epub 2021 Jun 9.

Departments of Surgery, Kochi Medical School, Kochi University, Kochi, Japan.

The development of a closed-loop artificial pancreas (AP) in the Western countries and Japan is different. In Western countries, wearable AP with a closed-loop glycemic control system has been developed as a treatment for patients with type 1 and type 2 diabetes. On the contrary, in Japan, bedside closed-loop AP explored by a Japanese company (Nikkiso, Tokyo, Japan) has developed as perioperative glycemic control device in surgical patients and acute care patients with emergency. Read More

Am J Physiol Lung Cell Mol Physiol 2021 06 9. Epub 2021 Jun 9.

Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Duke University Medical Center, Durham, NC.

Background: Bacterial pneumonia is a major cause of morbidity and mortality worldwide despite the use of antibiotics, and novel therapies are urgently needed. Building on previous work, we aimed to 1) develop a baboon model of severe pneumococcal pneumonia and sepsis with organ dysfunction; and 2) test the safety and efficacy of a novel extracorporeal blood filter to remove pro-inflammatory molecules and improve organ function.

Methods: After a dose-finding pilot study, twelve animals were inoculated with S. Read More

Diabetes Obes Metab 2021 Jun 9. Epub 2021 Jun 9.

Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.

We performed a systematic review and meta-analysis of randomized controlled trials to assess the efficacy and safety of the novel, ultra-rapid acting insulins aspart and lispro in adults with type 1 or type 2 diabetes. Our primary outcome was change in HbA1c from baseline. We additionally assessed eight efficacy and six safety endpoints. Read More

Case Rep Endocrinol 2021 19;2021:9919321. Epub 2021 May 19.

Department of Endocrinology, Department of Medicine, West Virginia University, Morgantown, WV, USA.

Objective: We present a case of refractory hypoglycemia, weight loss, and retroperitoneal solitary fibrous tumor. . A 68-year-old female presented with symptomatic hypoglycemia, weight loss, and abdominal mass identified on CT scan of the abdomen. Read More

Digit Health 2020 Jan-Dec;6:2055207620983120. Epub 2020 Dec 26.

Oncoendocrinology service of Instituto do Cancer do Estado de Sao Paulo Octávio Frias de Oliveira, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

Background: In-hospital hyperglycemia (HH) is frequent and related to higher morbidity and mortality. Despite the benefits of HH treatment, glycemic control is often poor and neglected. The use of health applications to support diagnosis and therapy is now incorporated into medical practice. Read More

J Cardiothorac Vasc Anesth 2021 May 12. Epub 2021 May 12.

Department of Anesthesiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Objectives: Perioperative hyperglycemia is associated with poor postoperative recovery, including compromised immune function and increased risk of infection. A closed-loop glycemic control system (artificial pancreas) has demonstrated strict safe perioperative glycemic control without hypoglycemia risk. The authors hypothesized that the artificial pancreas would reduce surgical site infections (SSIs) and postoperative inflammatory reactions. Read More

J Emerg Med 2021 Jun 5. Epub 2021 Jun 5.

Hypoglycemia Clinic, Joslin Diabetes Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.

Zhonghua Er Ke Za Zhi 2021 Jun;59(6):452-458

Department of Pediatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.

Continuous glucose monitoring (CGM) were performed in children with hepatic glycogen storage disease (GSD) to accurately understand the situation of glucose levels during their treatment, and to provide support for optimizing their nutritional management. In this retrospective research, 42 patients with hepatic GSD who under went 72 h CGM were collected from Department of Pediatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology from October 2019 to January 2020. According to the genetic test results, they were divided into 5 groups: type Ⅰa, type Ⅰb, type Ⅲa, type Ⅵ and type Ⅸa. Read More

Diabetes Res Clin Pract 2021 Jun 5:108904. Epub 2021 Jun 5.

Department of Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China; Department of Pharmacy, Peking University People's Hospital, Beijing, China. Electronic address:

Aims: To inform clinical practice by comparing and ranking the lowing blood glucose and weight-loss abilities of 8 glucagon-like peptide-1 receptor agonists (GLP-1RAs) in patients with type 2 diabetes (T2D).

Methods: We searched PubMed, EMBASE, and CENTRAL from database inception to April 13, 2021. The outcomes were Δ HbA, Δ weight, adverse events [AE] withdrawals, and incidence of hypoglycemia. Read More

Med Care 2021 Jul;59(7):612-615

Louis Stokes Department of Veterans Affairs Medical Center.

Background: Reducing serious hypoglycemic events is a Federal-wide objective. Despite studies of trends for rates of serious hypoglycemia in existing literature, rigorous evaluation of links between the observed trends and changes in professional guidelines or performance measures for glycemic control is lacking.

Objective: To evaluate whether changes in professional society guidelines and performance measures for glycemic control correspond to changes in rates of serous hypoglycemia. Read More

AEM Educ Train 2021 Jul 5;5(3):e10537. Epub 2020 Nov 5.

Department of Pediatrics Section of Pediatric Emergency Medicine University of Colorado School of Medicine Aurora CO USA.

Objective: Emergency medical services (EMS) professionals infrequently transport children leading to difficulty in recognition and management of pediatric critical illness. Simulation provides an opportunity to train EMS professionals on pediatric emergencies. The objective of this study was to examine the effect of serial simulation training over 6 months on EMS psychomotor and cognitive performance during team-based care. Read More

Diabetes Care 2021 Jun 7. Epub 2021 Jun 7.

Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, CA.

Objective: Advances in diabetes technology have transformed the treatment paradigm for type 1 diabetes, yet the burden of disease is significant. We report on a pivotal safety study of the first tubeless, on-body automated insulin delivery system with customizable glycemic targets.

Research Design And Methods: This single-arm, multicenter, prospective study enrolled 112 children (age 6-13. Read More

Diabetes Care 2021 Jun 7. Epub 2021 Jun 7.

Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA

Objective: Advances in continuous glucose monitoring (CGM) have transformed ambulatory diabetes management. Until recently, inpatient use of CGM has remained investigational, with limited data on its accuracy in the hospital setting.

Research Design And Methods: To analyze the accuracy of Dexcom G6, we compared retrospective matched-pair CGM and capillary point-of-care (POC) glucose data from three inpatient CGM studies (two interventional and one observational) in general medicine and surgery patients with diabetes treated with insulin. Read More

J Med Econ 2021 Jun 7. Epub 2021 Jun 7.

Medtronic International Trading Sàrl, Tolochenaz, Switzerland.

Aims: The MiniMed™ 670G insulin pump system is the first commercially available hybrid closed-loop (HCL) insulin delivery system and clinical studies have shown that this device is associated with incremental benefits in glycemic control relative to continuous subcutaneous insulin infusion (CSII) with or without continuous glucose monitoring (CGM). The aim was to evaluate the long-term cost-effectiveness of the MiniMed™ 670G system versus CSII alone in people with type 1 diabetes (T1D) in the UK.

Materials And Methods: Cost-effectiveness analysis was performed using the IQVIA CORE Diabetes Model. Read More

Diabetes Res Clin Pract 2021 Jun 4:108897. Epub 2021 Jun 4.

University of Groningen, University Medical Center Groningen, Department of Endocrinology, Groningen, The Netherlands; Isala, Diabetes Research Center, Zwolle, The Netherlands. Electronic address:

Aims: To evaluate the association between flash glucose monitoring (FLASH) frequency and glycemic parameters during real-life circumstances in the Netherlands.

Methods: Obtained glucose readings were de-identified and uploaded to a dedicated database when FLASH reading devices were connected to internet. Data between September 2014 and March 2020, comprising 16,331 analyzable readers (163,762 sensors) were analyzed. Read More

Diabetes Res Clin Pract 2021 Jun 4:108898. Epub 2021 Jun 4.

Department of Endocrinology and Nutrition, Hospital de Santa Creu i Sant Pau, Barcelona, Spain; Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain; CIBER-Bioengineering, Biomaterials and Nanotechnology (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain. Electronic address:

Aim: To determine if there are differences in terms of neurophysiology and neurocognitive functioning a group of type 1 diabetes (T1D) patients in terms of hypoglycaemia awareness.

Methods: 27 patients with T1D were classified according to Clarke score as having impaired awareness of hypoglycaemia (IAH; n=11) or normal awareness to hypoglycaemia (NAH; n=16). We measured several clinical and sociodemographic variables and cognitive performance using neuropsychological tests. Read More

J Med Internet Res 2021 Jun 7;23(6):e25409. Epub 2021 Jun 7.

Diabetes Management Research, Steno Diabetes Center Copenhagen, Copenhagen, Denmark.

Background: Automated insulin delivery (AID) systems have been shown to be safe and effective in reducing hyperglycemia and hypoglycemia but are not universally available, accessible, or affordable. Therefore, user-driven open-source AID systems are becoming increasingly popular.

Objective: This study aims to investigate the motivations for which people with diabetes (types 1, 2, and other) or their caregivers decide to build and use a personalized open-source AID. Read More

Health Technol Assess 2021 Jun;25(36):1-106

Neonatal Medicine, School of Public Health, Faculty of Medicine, Imperial College London, London, UK.

Background: Therapeutic hypothermia is standard of care for babies with moderate to severe hypoxic-ischaemic encephalopathy. There is limited evidence to inform provision of nutrition during hypothermia.

Objectives: To assess the association during therapeutic hypothermia between (1) enteral feeding and outcomes, such as necrotising enterocolitis and (2) parenteral nutrition and outcomes, such as late-onset bloodstream infection. Read More