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    Vanishing 17-Hydroxyprogesterone Concentrations in 21-Hydroxylase Deficiency.
    Horm Res Paediatr 2018 Apr 25:1-7. Epub 2018 Apr 25.
    Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, University Hospital of Schleswig-Holstein, UKSH, Campus Kiel/Christian Albrecht University of Kiel, CAU, Kiel, Germany.
    We present a boy with a genetically proven congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. While massively elevated 17-hydroxyprogesterone (17-OHP) concentrations after birth led to the diagnosis, 17-OHP concentrations became immeasurable starting with the second year of life even though the dose of hydrocortisone was continuously decreased to ∼7 mg/m2/day. Furthermore, 17-OHP levels were immeasurable during the ACTH test and after withdrawing hydrocortisone medication. Read More

    Continuous Glucose Monitoring in Resource-Constrained Settings for Hypoglycaemia Detection: Looking at the Problem from the Other Side of the Coin.
    Biosensors (Basel) 2018 Apr 25;8(2). Epub 2018 Apr 25.
    Centro de Investigação em Saúde de Manhiça (CISM), CP1929 Maputo, Mozambique.
    The appearance, over a decade ago, of continuous glucose monitoring (CGM) devices has triggered a patient-centred revolution in the control and management of diabetes mellitus and other metabolic conditions, improving the patient’s glycaemic control and quality of life. Such devices, the use of which remains typically restricted to high-income countries on account of their elevated costs, at present show very limited implantation in resource-constrained settings, where many other urgent health priorities beyond diabetes prevention and management still need to be resolved. In this commentary, we argue that such devices could have an additional utility in low-income settings, whereby they could be selectively used among severely ill children admitted to hospital for closer monitoring of paediatric hypoglycaemia, a life-threatening condition often complicating severe cases of malaria, malnutrition, and other common paediatric conditions. Read More

    Transition to adult diabetes care in Germany - high risk for acute complications and declining metabolic control during the transition phase.
    Pediatr Diabetes 2018 Apr 25. Epub 2018 Apr 25.
    Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Germany.
    Objective: There is evidence that transition from pediatric to adult health care is frequently associated with deterioration of health in youths with type 1 diabetes (T1D). The aim of this study was to compare metabolic control, acute complications and microvascular complications in adolescents and young adults before and after transfer to an adult treatment center with respect to the time between first visit in the adult center and last visit in pediatric treatment.

    Methods: All data were collected during routine care and retrieved from the German/Austrian DPV database. Read More

    Decreasing the Time to Insulin Administration for Hospitalized Patients With Cystic Fibrosis-Related Diabetes.
    Hosp Pediatr 2018 Apr 24. Epub 2018 Apr 24.
    Divisions of Endocrinology.
    Objectives: Children with cystic fibrosis-related diabetes (CFRD) represent a commonly hospitalized pediatric population whose members require insulin for blood glucose (BG) control. The aim of this quality improvement initiative was to increase the proportion of hospitalized patients with CFRD receiving insulin within 30 minutes of a BG check while decreasing severe hypo- and hyperglycemia episodes.

    Methods: Quality improvement methodology (gathering a team of stakeholders, identifying metrics, implementing iterative plan-do-study-act cycles and analysis of data over time) was applied in the setting of a cystic fibrosis unit in a tertiary care children's hospital. Read More

    Role and prevalence of impaired awareness of hypoglycaemia in ambulance service attendances to people who have had a severe hypoglycaemic emergency: a mixed-methods study.
    BMJ Open 2018 Apr 24;8(4):e019522. Epub 2018 Apr 24.
    Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK.
    Objectives: (1) To compare the experiences of people who are affected by diabetes-related hypoglycaemia and either do or do not require an emergency attendance and (2) to measure the prevalence of impaired awareness of hypoglycaemia in patients who are attended by an ambulance service due to a severe hypoglycaemic event.

    Design: A sequential mixed-methods study.

    Setting: A qualitative interview study was undertaken with 31 people with diabetes (types 1 and 2) resident in the central belt of Scotland. Read More

    Clinical assessment and treatment of diabetes in patients with chronic kidney disease.
    Rev Clin Esp 2018 Apr 21. Epub 2018 Apr 21.
    Servicio de Medicina Interna, Hospital Comarcal de Zafra, Badajoz, España.
    Diabetes mellitus type 2 is the main cause of chronic kidney disease. Patients with this disease have higher morbidity and mortality and risk of hypoglycaemia than those without this disease. In 2010, type 2 diabetes was the reason for starting renal replacement therapy in 24. Read More

    Forebrain cellular bioenergetics in neonatal mice.
    J Neonatal Perinatal Med 2018 ;11(1):79-86
    Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates.
    Background: Hypoglycemia occurs frequently in the neonate and may result in neurologic dysfunction. Its impact on the kinetics of cellular respiration and bioenergetics in the neonatal brain remains to be explored.

    Aims: Develop murine model to investigate the effects of hypoglycemia on neonatal brain bioenergetics. Read More

    Experiences of young adults with type 1 diabetes while using alcohol and recreational drugs: An interpretative phenomenological analysis (IPA) of semi-structured interviews.
    Diabetes Res Clin Pract 2018 Apr 21. Epub 2018 Apr 21.
    Department of Addiction Medicine, St Vincent's Hospital Melbourne and Department of Medicine, University of Melbourne.
    Aims: Alcohol and recreational drug use is common in young adults with type 1 diabetes (T1DM) and may account for increased morbidity and mortality. This study explores the motivations and experiences unique to this population while using alcohol and recreational drugs.

    Methods: Semi-structured interviews focusing on substance use were performed with 16 young adults aged 18-35 with T1DM who drink alcohol (at least 50 grams, 5 Australian standard drinks, in a single session) and/or used recreational drugs. Read More

    Managing Diabetes in Patients Hospitalized in Internal Medicine Units.
    Rambam Maimonides Med J 2018 Apr 19;9(2). Epub 2018 Apr 19.
    Institute of Endocrinology, Diabetes and Metabolism, Rambam Health Care Campus, Haifa, Israel.
    Diabetes and hyperglycemia are present in over one-third of inpatients in internal medicine units and are associated with worse prognosis in multiple morbidities. Treatment of inpatient hyperglycemia is usually with basal bolus insulin in a dose calculated by the patient's weight, with lower doses recommended in patients who are at a higher risk for hypoglycemia. Other antihyperglycemic medications and insulin regimens can be used in selected patients. Read More

    Beyond HbA1c: Comparing Glycemic Variability and Glycemic Indices in Predicting Hypoglycemia in Type 1 and Type 2 Diabetes.
    Diabetes Technol Ther 2018 Apr 24. Epub 2018 Apr 24.
    1 Department of Endocrinology, Singapore General Hospital , Singapore .
    Background: Hypoglycemia is the major impediment to therapy intensification in diabetes. Although higher individualized HbA1c targets are perceived to reduce the risk of hypoglycemia in those at risk of hypoglycemia, HbA1c itself is a poor predictor of hypoglycemia. We assessed the use of glycemic variability (GV) and glycemic indices as independent predictors of hypoglycemia. Read More

    Severe lactic acidosis and hypoglycemia due to acute metformin intoxication in a dog.
    J Vet Emerg Crit Care (San Antonio) 2018 Apr 24. Epub 2018 Apr 24.
    William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, Davis, CA, 95616.
    Objective: To report a case of severe lactic acidosis and hypoglycemia due to acute metformin intoxication in a dog.

    Case Summary: A female neutered Rat Terrier was presented for an acute onset of seizure-like episodes, weakness, and vomiting approximately 14 hours after ingestion of 198 mg/kg of metformin. The dog was found to be laterally recumbent, paddling, and unresponsive shortly before presentation. Read More

    Semaglutide as a therapeutic option for elderly patients with type 2 diabetes: pooled analysis of the SUSTAIN 1-5 trials.
    Diabetes Obes Metab 2018 Apr 23. Epub 2018 Apr 23.
    L'Institut du Thorax, Department of Endocrinology, CHU de Nantes, Nantes, France.
    This pooled analysis evaluated the efficacy and safety of semaglutide vs comparators in non-elderly (<65 years) and elderly (≥65 years) patients with type 2 diabetes (T2D) across the SUSTAIN 1-5 trials. Patients were randomised to once-weekly subcutaneous semaglutide (0.5 or 1. Read More

    Young people's experiences of managing Type 1 diabetes at university: a national study of UK university students.
    Diabet Med 2018 Apr 23. Epub 2018 Apr 23.
    Diabetes and Endocrinology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.
    Aim: Little is known about the challenges of transitioning from school to university for young people with Type 1 diabetes. In a national survey, we investigated the impact of entering and attending university on diabetes self-care in students with Type 1 diabetes in all UK universities.

    Methods: Some 1865 current UK university students aged 18-24 years with Type 1 diabetes, were invited to complete a structured questionnaire. Read More

    Beating the urine drug test - a case report on niacin toxicity.
    J Community Hosp Intern Med Perspect 2018 17;8(2):73-75. Epub 2018 Apr 17.
    Internal Medicine, Greater Baltimore Medical Center, Towson, MD, USA.
    Niacin is a form of vitamin B3 which is used for the medical treatment of hyperlipidemia and niacin deficiency. However, within the last few years, it is being advertised on the Internet as a quick way to detoxify the human body in an attempt to evade urine drug tests. This claim is without any medical or scientific evidence and as a result, many cases have been reported where young adults have ended up with niacin toxicity. Read More

    Internal Experts Collaborate to Reduce Critical Hypoglycemia and Insulin Errors and Improve Insulin Administration Timing.
    Clin Diabetes 2018 Apr;36(2):191-197
    University of Pittsburgh Medical Center Passavant Hospital, Pittsburgh, PA.
    "Quality Improvement Success Stories" are published by the American Diabetes Association in collaboration with the American College of Physicians, Inc., and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions. Read More

    Diabetes Center of Excellence Hypoglycemia Emergency Preparedness Project.
    Clin Diabetes 2018 Apr;36(2):184-186
    Wilford Hall Ambulatory Surgical Center Diabetes Center of Excellence, Joint Base San Antonio Lackland AFB, TX.
    "Quality Improvement Success Stories" are published by the American Diabetes Association in collaboration with the American College of Physicians, Inc., and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions. Read More

    Initiating Titratable Fixed-Ratio Combinations of Basal Insulin Analogs and Glucagon-Like Peptide-1 Receptor Agonists: What You Need to Know.
    Clin Diabetes 2018 Apr;36(2):174-182
    Washington State University, Spokane, WA.
    Titratable fixed-ratio combinations (FRCs) of a basal insulin and a glucagon-like peptide-1 (GLP-1) receptor agonist are new therapeutic options for people with type 2 diabetes. Two FRCs-insulin degludec/liraglutide and insulin glargine/lixisenatide-have been approved for use in the United States. The two components in these FRCs target different aspects of diabetes pathophysiology, working in a complementary manner to decrease blood glucose while mitigating the side effects associated with each component (hypoglycemia and weight gain with insulin and gastrointestinal side effects with GLP-1 receptor agonists). Read More

    Using Shared Decision-Making to Address Possible Overtreatment in Patients at High Risk for Hypoglycemia: The Veterans Health Administration's Choosing Wisely Hypoglycemia Safety Initiative.
    Clin Diabetes 2018 Apr;36(2):120-127
    Veterans Health Administration Office of Specialty Care Services, Washington, DC.
    Successful management of patients with diabetes requires individualizing A1C and treatment goals in conjunction with identifying and managing hypoglycemia risk. This article describes the Veterans Health Administration's Choosing Wisely Hypoglycemia Safety Initiative (CW-HSI), a voluntary program that aims to reduce the occurrence of hypoglycemia through shared decision-making about deintensifying diabetes treatment in a dynamic cohort of patients identified as being at high risk for hypoglycemia and potentially overtreated. The CW-HSI incorporates education for patients and clinicians, as well as clinical decision support tools, and has shown decreases in the proportions of high-risk patients potentially overtreated and impacts on the frequency of reported hypoglycemia. Read More

    Indonesia Cohort of IO HAT Study to Evaluate Diabetes Management, Control, and Complications in Retrospective and Prospective Periods Among Insulin-Treated Patients with Type 1 and Type 2 Diabetes.
    Acta Med Indones 2018 Jan;50(1):26-37
    Department of Internal Medicine, Faculty of Medicine, Brawijaya University, Malang, Indonesia.
    Background: hypoglycemia is a major adverse event of insulin therapy for diabetes mellitus patients. The study was conducted to evaluate the incidence of hypoglycemia among insulin treated patients with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) in the Indonesian cohort.

    Methods: this Indonesian cohort study consisted of retrospective and prospective evaluation of hypoglycemic episodes, using International Operations Hypoglycemia Assessment Tool (IO HAT) in 374 patients with diabetes (T1DM; n=17 or T2DM; n=357). Read More

    Gestational diabetes mellitus: glycemic control during pregnancy and neonatal outcomes of twin and singleton pregnancies.
    Endocrinol Diabetes Nutr 2018 Apr 20. Epub 2018 Apr 20.
    Unidad de Diabetes, Departamento de Endocrinología y Nutrición, Hospital Universitario La Paz, Madrid, España.
    Objective: To assess the impact of glycemic control in gestational on neonatal weight and metabolic complications of twin and singleton pregnancies.

    Methods: An observational, retrospective study to monitor 120 twin and 240 singleton pregnancies in women with GDM. Maternal glycemic parameters during pregnancy (oral glucose tolerance test results, treatment, insulinization rate, mean HbA1c in the third trimester), and neonatal complications and weight were recorded. Read More

    Severe hypoglycaemia in diabetic patients in Pre-hospital and Emergency Department care: a cross-sectional survey.
    BMC Res Notes 2018 Apr 23;11(1):249. Epub 2018 Apr 23.
    Endocrinology, Diabetes and Metabolism Department, Centro Hospitalar São João, Alameda Prof. Hernani Monteiro, 4200-319, Porto, Portugal.
    Objective: We aimed to characterize hypoglycaemia episodes and patients examined by a Pre-hospital Medical Emergency Unit (PH) and in the Emergency Department (ED) of our hospital.

    Results: We identified 86 episodes of severe hypoglycaemia (PH: n 37; ED: n 49; both: n 12). Hypoglycaemia accounted for 4. Read More

    Role of inflammatory markers in Elderly Type 2 Diabetic Patients with Mild Cognitive Impairment.
    Curr Diabetes Rev 2018 Apr 22. Epub 2018 Apr 22.
    Department of Internal Medicine, and Endocrinology, Faculty of Medicine - Ain Shams University. Egypt.
    Background: Type 2 diabetes (T2DM) is a risk factor for Alzheimer's disease and mild cognitive impairment. The etiology of cognitive impairment in people with T2DM is uncertain but, chronic hyperglycemia, cerebral micro vascular disease, severe hypoglycemia, and increased prevalence of macro vascular disease are implicated.

    Objectives: to determine the serum levels of soluble vascular adhesion molecule (sVCAM-1) and highly sensitive C-reactive protein (hs-CRP) in elderly type 2 diabetics with mild cognitive impairment (MCI). Read More

    Salbutamol-induced electrophysiological changes show no correlation with electrophysiological changes during hyperinsulinaemic-hypoglycaemic clamp in young people with Type 1 diabetes.
    Diabet Med 2018 Apr 23. Epub 2018 Apr 23.
    Department of Oncology and Metabolism, University of Sheffield.
    Aims: Hypoglycaemia causes QT-interval prolongation and appears pro-arrhythmogenic. Salbutamol, a β -adrenoreceptor agonist also causes QT-interval prolongation. We hypothesized that the magnitude of electrophysiological changes induced by salbutamol and hypoglycaemia might relate to each other and that salbutamol could be used as a non-invasive screening tool for predicting an individual's electrophysiological response to hypoglycaemia. Read More

    Insulin therapy for type 2 diabetes - are we there yet? The d-Nav® story.
    Clin Diabetes Endocrinol 2018 10;4. Epub 2018 Apr 10.
    1Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan Medical Center, 1000 Wall St, Ann Arbor, MI 48105 USA.
    Insulin replacement therapy is mostly used by patients with type 2 diabetes who become insulin deficient and have failed other therapeutic options. They comprise about a quarter of those with diabetes, endures the majority of the complications and consumes the majority of the resources. Adequate insulin replacement therapy can prevent complications and reduce expenses, as long as therapy goals are achieved and maintained. Read More

    Amniocentesis compared with antenatal corticosteroids prior to early term scheduled cesarean delivery.
    J Matern Fetal Neonatal Med 2018 Apr 22:1-11. Epub 2018 Apr 22.
    b Department of Obstetrics, Gynecology and Reproductive Science , Icahn School of Medicine at Mount Sinai , New York , New York , USA.
    Objective: There are a variety of maternal or fetal conditions that require late preterm or early term delivery. In cases where early delivery is indicated, optimal management is not always clear. Historically, obstetricians used amniocentesis to document fetal lung maturity, but recently, many have transitioned to administration of antenatal corticosteroids (ACS). Read More

    Economic Value of Improved Accuracy for Self-Monitoring of Blood Glucose Devices for Type 1 and Type 2 Diabetes in England.
    J Diabetes Sci Technol 2018 Apr 1:1932296818769098. Epub 2018 Apr 1.
    1 Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
    Objective: The objective was to model clinical and economic outcomes of self-monitoring blood glucose (SMBG) devices with varying error ranges and strip prices for type 1 and insulin-treated type 2 diabetes patients in England.

    Methods: We programmed a simulation model that included separate risk and complication estimates by type of diabetes and evidence from in silico modeling validated by the Food and Drug Administration. Changes in SMBG error were associated with changes in hemoglobin A1c (HbA1c) and separately, changes in hypoglycemia. Read More

    Giant umbilical cord and hypoglycemia in an infant with Proteus syndrome.
    Am J Med Genet A 2018 May;176(5):1222-1224
    Department of Pediatrics, University of Yamanashi, Yamanashi, Japan.
    Proteus syndrome (PS) is characterized by the progressive, segmental, or patchy overgrowth of the skin, and other tissues. This is the first case report of recurrent severe insulin-independent hypoglycemia in an infant with PS. Somatic p. Read More

    Prevalence of hypoglycemia during oral glucose tolerance testing in adults with cystic fibrosis and risk of developing cystic fibrosis-related diabetes.
    J Cyst Fibros 2018 Apr 18. Epub 2018 Apr 18.
    Department of Respirology, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada; Keenan Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, 209 Victoria Street, Toronto, Ontario M5B 1T8, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M6, Canada.
    Background: Hypoglycemia in cystic fibrosis (CF) patients during the oral glucose tolerance test (OGTT) has been reported; however, these patients have not been well-characterized. Few studies have examined whether hypoglycemia during the OGTT increases the risk of developing CF-related diabetes (CFRD). Objectives of this study were to describe the characteristics of CF patients with hypoglycemia during the OGTT and to determine the incidence and time to development of CFRD in those with hypoglycemia. Read More

    Pharmacotherapy for Hyperglycemia in Pregnancy - Do Oral Agents have a Place?
    Diabetes Res Clin Pract 2018 Apr 18. Epub 2018 Apr 18.
    Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address:
    Diabetes is a frequent condition in pregnancy and achieving adequate glycemic control is of paramount importance. Insulin treatment is the gold standard, oral agents are more attractive, but their safety and efficiency should be a prerequisite for their use. We have more information regarding treatment of women with gestational diabetes mellitus where glyburide can induce a picture of fetal hyperinsulinism (higher birthweight and more neonatal hypoglycemia) whereas metformin requires supplemental insulin in a larger proportion of women but achieves satisfactory perinatal outcomes with the exception of preterm birth. Read More

    Metformin ameliorates TGF-β1-induced osteoblastic differentiation of human aortic valve interstitial cells by inhibiting β-catenin signaling.
    Biochem Biophys Res Commun 2018 Apr 21. Epub 2018 Apr 21.
    Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China. Electronic address:
    Osteoblastic differentiation of aortic valve interstitial cells (AVICs) is the central process in the development of calcific aortic valve disease (CAVD). Metformin is a widely used first-line antidiabetic drug, and recently, pleiotropic benefits of metformin beyond hypoglycemia have been reported in the cardiovascular system. Here, we examined the effect of metformin on the osteoblastic differentiation of human AVICs. Read More

    Stigma and Its Association With Glycemic Control and Hypoglycemia in Adolescents and Young Adults With Type 1 Diabetes: Cross-Sectional Study.
    J Med Internet Res 2018 Apr 20;20(4):e151. Epub 2018 Apr 20.
    Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Department of Medicine, McGill University, Montreal, QC, Canada.
    Background: Qualitative studies in type 1 diabetes indicate that visibility of diabetes supplies, self-care, and hypoglycemia symptoms are associated with stigma and suboptimal management. This may be particularly salient in youth who face concurrent challenges such as establishing autonomy and making vocational choices.

    Objective: The aim of the study was to estimate stigma prevalence in youth (aged 14-24 years) with type 1 diabetes and its associations with glycemic control. Read More

    Hypoglycemia in Type 2 DM patients: Review article.
    Diabetes Metab Syndr 2018 Apr 12. Epub 2018 Apr 12.
    Family and Community Medicine Department, Chronic Diseases Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
    Hypoglycemia is an essential issue for diabetic patients and considered a limiting factor in the glycemic management. Heterogeneity of the diseases in Type 2 Diabetes Mellitus can affect the frequency of hypoglycemia, especially when the patient has cardiovascular diseases. There are several factors lead to hypoglycemia sulfonylurea therapy, insulin therapy, delayed or missed a meal, physical exercise, or drug or alcohol consumption. Read More

    Association between BMI and risk of severe hypoglycaemia in type 2 diabetes.
    Diabetes Metab 2018 Apr 6. Epub 2018 Apr 6.
    Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea. Electronic address:
    Aim: This study aimed to assess the association between body mass index (BMI) and the development of severe hypoglycaemia in patients with type 2 diabetes (T2D), using nationwide data for the entire South Korean population.

    Methods: The association between BMI and severe hypoglycaemia was retrospectively examined from claims and National Health examination data registered between 2002 and 2015. A total of 1,366,692 subjects assigned clinical codes for T2D and prescribed antihypoglycaemic agents were included. Read More

    Growth hormone receptor-deficient pigs resemble the pathophysiology of human Laron syndrome and reveal altered activation of signaling cascades in the liver.
    Mol Metab 2018 Mar 15. Epub 2018 Mar 15.
    Chair for Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, LMU Munich, Feodor-Lynen-Str. 25, 81377 Munich, Germany; Center for Innovative Medical Models (CiMM), Department of Veterinary Sciences, LMU Munich, Hackerstr. 27, 85764 Oberschleißheim, Germany; Meiji University International Institute for Bio-Resource Research, 1-1-1 Higashimita, Tama, Kawasaki, 214-8571, Japan; German Center for Diabetes Research (DZD), Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany; Laboratory for Functional Genome Analysis (LAFUGA), Gene Center, LMU Munich, Feodor-Lynen-Str. 25, 81377 Munich, Germany. Electronic address:
    Objective: Laron syndrome (LS) is a rare, autosomal recessive disorder in humans caused by loss-of-function mutations of the growth hormone receptor (GHR) gene. To establish a large animal model for LS, pigs with GHR knockout (KO) mutations were generated and characterized.

    Methods: CRISPR/Cas9 technology was applied to mutate exon 3 of the GHR gene in porcine zygotes. Read More

    The incidence and risk factors associated with developing symptoms of hypoglycemia after bariatric surgery.
    Surg Obes Relat Dis 2018 Jan 31. Epub 2018 Jan 31.
    Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University, Baltimore, Maryland.
    Background: Hypoglycemia after bariatric surgery is an increasingly recognized metabolic complication associated with exaggerated secretion of insulin and gut hormones.

    Objective: We sought to determine the incidence of hypoglycemic symptoms (hypo-sx) after bariatric surgery and characteristics of those affected compared with those unaffected.

    Setting: University hospital. Read More

    Abnormally low Bispectral index and severe hypoglycemia during maintenance of and recovery from general anesthesia in diabetic retinopathy surgery: two case reports.
    BMC Anesthesiol 2018 Apr 20;18(1):45. Epub 2018 Apr 20.
    Department of Anesthesiology, Beijing Shijitan Hospital, Capital Medical University, Tieyilu 10, Yangfangdian, Haidian District, Beijing, 100038, China.
    Background: Hypoglycemia is one of the most fatal complications during the perioperative period. General anesthesia or sedation can mask a hypoglycemia-altered mental status. Acute hypoglycemia might result in permanent brain injury. Read More

    Association Between Use of Sodium-Glucose Cotransporter 2 Inhibitors, Glucagon-like Peptide 1 Agonists, and Dipeptidyl Peptidase 4 Inhibitors With All-Cause Mortality in Patients With Type 2 Diabetes: A Systematic Review and Meta-analysis.
    JAMA 2018 04;319(15):1580-1591
    Department of Endocrinology, Imperial College Healthcare NHS Foundation Trust, London, United Kingdom.
    Importance: The comparative clinical efficacy of sodium-glucose cotransporter 2 (SGLT-2) inhibitors, glucagon-like peptide 1 (GLP-1) agonists, and dipeptidyl peptidase 4 (DPP-4) inhibitors for treatment of type 2 diabetes is unknown.

    Objective: To compare the efficacies of SGLT-2 inhibitors, GLP-1 agonists, and DPP-4 inhibitors on mortality and cardiovascular end points using network meta-analysis.

    Data Sources: MEDLINE, Embase, Cochrane Library Central Register of Controlled Trials, and published meta-analyses from inception through October 11, 2017. Read More

    Near-Continuous Glucose Monitoring Makes Glycemic Control Safer in ICU Patients.
    Crit Care Med 2018 Apr 19. Epub 2018 Apr 19.
    Department of Intensive Care, Erasme University Hospital, Université libre de Bruxelles, Brussels, Belgium.
    Objectives: Tight glycemic control using intermittent blood glucose measurements is associated with a risk of hypoglycemia. Glucose concentrations can now be measured near continuously (every 5-15 min). We assessed the quality and safety of glycemic control guided by a near-continuous glucose monitoring system in ICU patients. Read More

    [Faster aspart insulin (FIASP®)].
    Rev Med Liege 2018 Apr;73(4):211-215
    Service de Diabétologie, Nutrition et Maladies métaboliques et Unité de Pharmacologie clinique, CHU Sart Tilman, Liège, Belgique.
    Fast-acting insulin aspart (faster aspart), commercialized under the trade name of Fiasp®, is insulin aspart in a new formulation aiming to mimic the physiologic prandial insulin release more closely than currently available rapid-acting insulin products. Fiasp® is insulin aspart (NovoRapid®) in which two excipients (L-arginine and niacinamide) have been added, L-arginine serving as a stabilising agent, while niacinamide being responsible for accelerated initial absorption after subcutaneous administration. The pharmacokinetic characteristics of insulin faster aspart have the potential to better reproduce the fast endogenous prandial insulin secretion and thereby to improve postprandial glucose control compared with insulin aspart. Read More

    Longitudinal assessment of hippocampus structure in children with Type 1 Diabetes.
    Pediatr Diabetes 2018 Apr 19. Epub 2018 Apr 19.
    Department of Pediatrics, Washington University in St. Louis and the St. Louis Children's Hospital, St. Louis, MO.
    The extant literature finds that children with type 1 diabetes (T1D) experience mild cognitive alterations compared to healthy age-matched controls. The neural basis of these cognitive differences is unclear but may relate in part to the effects of dysglycemia on the developing brain. We investigated longitudinal changes in hippocampus volume in young children with early-onset T1D. Read More

    Sodium Glucose Co-Transporter 2 Inhibitors: Beyond Glucose Lowering.
    Curr Drug Targets 2018 Apr 19. Epub 2018 Apr 19.
    Center for Cardiovascular Research and Alternative Medicine, University of Wyoming College of Health Sciences, Laramie, WY 82071. United States.
    Diabetes is an important cause of morbidity and mortality in worldwide. Management of blood glucose is critical for diabetic patients since diabetes carries risk for many diseases and disorders. Although there are several antidiabetic agents in the markets for a long time, some of the agents have dose-limiting side effects, such as hypoglycemia and weight gain which limits their ability to reduce cardiovascular complications. Read More

    Timing of diagnosis of gestational diabetes and pregnancy outcomes: A retrospective cohort.
    Aust N Z J Obstet Gynaecol 2018 Apr 19. Epub 2018 Apr 19.
    Mercy Perinatal Research Centre, Mercy Hospital for Women, Melbourne, Victoria, Australia.
    Background: Recent guidelines suggest screening high-risk women in early pregnancy for gestational diabetes (GDM); however, there is little evidence to support this.

    Aims: To compare pregnancy outcomes associated with diabetes for women with risk factors for GDM according to gestation of diagnosis. Early GDM was defined as a positive test before 20 weeks gestation, late GDM as a positive test at 20 or more weeks and no GDM when both tests were negative. Read More

    Glycemic control is related to cognitive dysfunction in Chinese children with type 1 diabetes mellitus.
    J Diabetes 2018 Apr 19. Epub 2018 Apr 19.
    Medical Psychological Center, The Second Xiangya Hospital,Central South University, Changsha, Hunan, 410011, China.
    Background: Type 1 diabetes mellitus (T1DM) type 1 diabetes is considered to be a risk factor for developing cognitive difficulties. The present study examined if Chinese children with T1DM differ in cognitive performance from healthy control (HC) children, and whether cognitive dysfunction is related to glycemic control.

    Methods: Using a cross-sectional design, we administered cognitive tests, including general intelligence tests, to pediatric T1DM patients (N = 105) and HC participants (N = 90). Read More

    Semen Cassiae Extract Improves Glucose Metabolism by Promoting GlUT4 Translocation in the Skeletal Muscle of Diabetic Rats.
    Front Pharmacol 2018 4;9:235. Epub 2018 Apr 4.
    Key Laboratory of Myocardial Ischemia Mechanism and Treatment, Ministry of Education, Harbin Medical University, Harbin, China.
    Diabetes mellitus is a clinical syndrome characterised by hyperglycaemia; its complications lead to disability and even death. Semen Cassiae is a traditional Chinese medicine, which has anti-hypertensive, anti-hyperlipidaemia, anti-oxidation, and anti-ageing properties. Our study was designed to evaluate the action of total anthraquinones of Semen Cassiae extract (SCE) on the improvement of glucose metabolism in diabetic rats and to elucidate the underlying mechanism. Read More

    Hydroxychloroquine-induced hypoglycaemia in non-diabetic renal patient on peritoneal dialysis.
    BMJ Case Rep 2018 Apr 18;2018. Epub 2018 Apr 18.
    Internal Medicine Department, Nephrology Division, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Dammam, Saudi Arabia.
    Hydroxychloroquine (HCQ) is a commonly used drug for the treatment of systemic lupus erythematosus (SLE). Renal involvement is common in SLE. We present a 25-year-old woman with lupus nephritis on peritoneal dialysis whose lupus was quite silent for almost three years, and secondary to HCQ she developed severe hypoglycaemic episodes, which were completely resolved after stopping HCQ. Read More

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