Search Our Scientific Publications & Authors

World Neurosurg 2020 Apr 16;136:e514-e534. Epub 2020 Jan 16.

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address:

Objective: The role of tight glycemic control in the management of acute ischemic stroke remains uncertain. Our goal is to evaluate the effects of tight glucose control with insulin therapy after acute ischemic stroke.

Methods: We searched PubMed, CENTRAL, and Embase for randomized controlled trials (RCTs) that evaluated the effects of tight glycemic control (70-135 mg/dL) in acute ischemic stroke. Read More

World Neurosurg 2020 Apr 16;136:e487-e495. Epub 2020 Jan 16.

Department of Neurology, Jining First People's Hospital, Jining, China. Electronic address:

Background: Hyperglycemia is common in patients with ischemic stroke (IS) and has been proven to be associated with worse clinical outcomes. However, it is controversial whether intensive glucose control (IGC) is superior to standard glucose control (SGC). Therefore, we carried out this meta-analysis based on randomized controlled trials (RCTs). Read More

J Stroke Cerebrovasc Dis 2019 Dec 21;28(12):104346. Epub 2019 Sep 21.

Department of Internal Medicine, Division of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan.

Background: In patients with acute ischemic stroke, current guidelines recommend maintaining blood glucose levels in a range of 140-180 mg/dL and closely monitoring to prevent hypoglycemia (<60 mg/dL). We aimed to assess glucose variability by continuous glucose monitoring (CGM) and to demonstrate the risk of acute ischemic stroke patients with glucose levels outside of the glucose management recommendations.

Methods: Patients with ischemic stroke admitted within 7 days after onset were prospectively enrolled, and their blood glucose levels were monitored every 15 minutes for 72-hour period using the FreeStyle Libre Pro. Read More

Acta Neurol Scand 2019 Dec 2;140(6):443-448. Epub 2019 Oct 2.

Department of Clinical Science and Education at Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.

Objectives: Hyperglycemia is a predictor for poor stroke outcome. Hyperglycemic stroke patients treated with thrombolysis have an increased risk of intracranial hemorrhage. Insulin is the gold standard for treating hyperglycemia but comes with a risk of hypoglycemia. Read More

Postgrad Med 2019 Sep 12;131(7):423-437. Epub 2019 Aug 12.

Second Department of Neurology, "Attikon" University Hospital, National and Kapodistrian University of Athens , Athens , Greece.

Hyperglycemia on hospital admission is a common phenomenon in acute ischemic stroke patients and represents an independent predictor of poor clinical outcome with or without acute recanalization therapies (systemic thrombolysis or mechanical thrombectomy). Effective restoration of normoglycemia is considered to be beneficial, but conclusive evidence from randomized controlled clinical trials and specific recommendations are lacking. In addition, aggressive glucose control can be complicated by hypoglycemia leading to early neurological deterioration. Read More

Medicine (Baltimore) 2019 Aug;98(31):e16723

Fasting hyperglycemia is associated with poor neurologic outcome in acute ischemic stroke (AIS), but its relationship with in-hospital outcome in elderly patients remains largely unknown. To assess the association of in-hospital outcome with fasting plasma glucose (FPG) levels at admission in individuals with AIS.This retrospective propensity score-matched case-control study included patients aged over 60 years suffering from AIS and who were admitted to the emergency department from November 2013 to October 2016. Read More

JAMA 2019 07;322(4):326-335

Department of Public Health Sciences, Medical University of South Carolina, Charleston.

Importance: Hyperglycemia during acute ischemic stroke is common and is associated with worse outcomes. The efficacy of intensive treatment of hyperglycemia in this setting remains unknown.

Objectives: To determine the efficacy of intensive treatment of hyperglycemia during acute ischemic stroke. Read More

Diabetes Metab Res Rev 2019 11 28;35(8):e3191. Epub 2019 Jun 28.

Department of Diabetes, King's College Hospital NHS Foundation Trust, London, UK.

In the outpatient setting, glucagon-like peptide-1 (GLP-1) receptor agonists have proved to be highly efficacious drugs that provide glycaemic control with a low risk of hypoglycaemia. These characteristics make GLP-1 receptor agonists attractive agents to treat dysglycaemia in perioperative or high-dependency hospital settings, where glycaemic variability and hyperglycaemia are associated with poor prognosis. GLP-1 also has a direct action on the myocardium and vasculature-which may be advantageous in the immediate aftermath of a vascular insult. Read More

J Clin Endocrinol Metab 2019 06;104(6):2239-2249

Department of Hypertension and Diabetology, Medical University of Gdańsk, Faculty of Medicine, Gdańsk, Poland.

Context: We have summarized key studies assessing the epidemiology, mechanisms, and consequences of cognitive dysfunction (CD) in type 1 diabetes.

Evidence Synthesis: In a number of studies, the severity of CD in type 1 diabetes was affected by the age of onset and duration, and the presence of proliferative retinopathy and autonomic neuropathy. Diabetes-related CD has been observed, not only in adults, but also in children and adolescents. Read More

BMC Endocr Disord 2019 Jan 5;19(1). Epub 2019 Jan 5.

Institute of Population Health Sciences, National Health Research Institutes, No.35, Keyan Road, Zhunan Township, Miaoli County, 35053, Taiwan.

Background: Dipeptidyl peptidase-4 (DPP-4) inhibitors could effectively reduce HbA and postprandial hyperglycemia and could incur only minimal danger of hypoglycemia. Patients with uncontrolled diabetes might be treated by the complementary action of insulin plus DPP-4 inhibitors. Here, we compared the all-cause mortality risk between DPP-4 inhibitor users and nonusers with underlying insulin therapy. Read More

J Stroke Cerebrovasc Dis 2019 Jan 24;28(1):213-219. Epub 2018 Oct 24.

Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China. Electronic address:

Background And Purpose: The impacts of stress hyperglycemia and hypoglycemia on mortality of acute ischemic stroke patients treated with mechanical thrombectomy (MT) are largely unclear. This study aimed to use stress hyperglycemia ratio (SHR) to evaluate the influence of pretreatment relative blood glucose changes on mortality risk after MT.

Methods: The study retrospectively enrolled 321 acute ischemic stroke patients treated with MT. Read More

Kardiologiia 2018 Oct(10):80-87

Scientific Institute of Clinical and Experimental Lymphology.

A growing body of evidences indicates the role of increased glucose variability (GV) as an independent cardiovascular risk factor in diabetes. It has been shown that high GV is associated with coronary and carotid atherosclerosis in diabetic subjects. The impact of enhanced glycemic fluctuations on vascular wall is mediated through non-enzymatic glycation, oxidative stress, activation of inflammatory pathways, and endothelial dysfunction. Read More

J Pediatr 2018 12 6;203:137-143. Epub 2018 Sep 6.

Division of Neonatology, Children's National Health System, Washington, DC; Fetal Medicine Institute, Children's National Health System, Washington, DC. Electronic address:

Objective: To investigate whether the early glycemic profile in infants with hypoxic ischemic encephalopathy is associated with distinct patterns of brain injury on magnetic resonance imaging (MRI).

Study Design: We performed a secondary analysis of 178 prospectively enrolled infants who received therapeutic hypothermia for hypoxic ischemic encephalopathy. Glycemic profiles were identified by glucose concentrations within 24 hours after birth: normoglycemia (all glucose concentrations of >47 to ≤150 mg/dL; n = 62); hypoglycemia (≥1 concentration ≤47 mg/dL; n = 17); hyperglycemia (≥1 concentration >150 mg/dL; n = 76); and labile glucose (both hypoglycemia and hyperglycemia; n = 23). Read More

Int J Stroke 2018 10 18;13(8):857-862. Epub 2018 Jul 18.

1 Monash University Eastern Health Clinical School, Melbourne, VIC, Australia.

Rationale Post-stroke hyperglycemia occurs in up to 50% of patients presenting with acute ischemic stroke. It reduces the efficacy of thrombolysis, increases infarct size, and worsens clinical outcomes. Insulin-based therapies have generally not been beneficial in treating post-stroke hyperglycemia as they are difficult to implement, may cause hypoglycaemia, possibly increase mortality and worsen clinical outcomes. Read More

Curr Diab Rep 2018 06 16;18(8):49. Epub 2018 Jun 16.

Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins University School of Medicine, 1830 E. Monument Street, Suite 333, Baltimore, MD, 21287, USA.

Purpose Of Review: Hyperglycemia occurs frequently in hospitalized patients with stroke and peripheral vascular disease (PVD). Guidelines for inpatient glycemic management are not well established for this patient population. We will review the clinical impact of hyperglycemia in this acute setting and review the evidence for glycemic control. Read More

J Am Heart Assoc 2018 04 12;7(8). Epub 2018 Apr 12.

Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.

Background: The purpose of this study was to examine the relationships between glucose parameters obtained by continuous glucose monitoring and clinical outcomes in acute stroke patients.

Methods And Results: Consecutive patients with acute ischemic stroke or intracerebral hemorrhage within 24 hours after onset were included. A continuous glucose monitoring device (iPro2) was attached for the initial 72 hours after emergent admission. Read More

Pol Arch Intern Med 2018 03 26;128(3):178-186. Epub 2018 Mar 26.

Diabetes increases the risk of cardiovascular diseases, which are the leading cause of mortality among diabetic patients. Although hyperglycemia is a major determinant of macrovascular and microvascular complications in diabetes, hypoglycemia and glycemic variability have also a strong influence on the cardiovascular system. This overview presents the current state of knowledge on the impact of type 2 diabetes on the cardiovascular system and new therapeutic strategies that have been recently developed to correct gluco-metabolic disturbances in patients with high cardiovascular risk, such as glucagon-like peptide-1 (GLP-1) receptor agonists, dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium-glucose cotransporter 2 (SGLT2) inhibitors. Read More

J Chin Med Assoc 2018 03 13;81(3):189-222. Epub 2018 Feb 13.

Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC. Electronic address:

The global incidence and prevalence of type 2 diabetes have been escalating in recent decades. Patients with type 2 diabetes have an increased risk of atherosclerotic cardiovascular disease (ASCVD). About two-thirds of death in type 2 diabetes are due to ASCVD, including 40% from coronary heart disease (CHD), 15% from heart failure (HF), and 10% from stroke. Read More

Diabetologia 2018 07 7;61(7):1503-1516. Epub 2018 Feb 7.

Clinical Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel, 18-20 1090, Vienna, Austria.

Owing to the worldwide increase in life expectancy, the high incidence of diabetes in older individuals and the improved survival of people with diabetes, about one-third of all individuals with diabetes are now older than 65 years. Evidence is accumulating that type 2 diabetes is associated with cognitive impairment, dementia and frailty. Older people with diabetes have significantly more comorbidities, such as myocardial infarction, stroke, peripheral arterial disease and renal impairment, compared with those without diabetes. Read More

Biomed Res Int 2017 7;2017:7839101. Epub 2017 Nov 7.

Department of Medicine and Genetic Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar.

Diabetes is a significant health problem worldwide, and its association with cardiovascular disease (CVD) was reported in several studies. Hyperglycemia and insulin resistance seen in diabetes and prediabetes lead to an increase in reactive oxygen species, which triggers intracellular molecular signaling. The resulting prothrombotic state and increase in inflammatory mediators expedite atherosclerotic changes and the development of macrovascular complications. Read More

Cochrane Database Syst Rev 2017 12 4;12:CD003054. Epub 2017 Dec 4.

Department of Internal Medicine, Herlev University Hospital, Herlev Ringvej 75, Herlev, Denmark, DK-2730.

Background: The projected rise in the incidence of type 2 diabetes mellitus (T2DM) could develop into a substantial health problem worldwide. Whether diet, physical activity or both can prevent or delay T2DM and its associated complications in at-risk people is unknown.

Objectives: To assess the effects of diet, physical activity or both on the prevention or delay of T2DM and its associated complications in people at increased risk of developing T2DM. Read More

PLoS One 2017 16;12(10):e0186486. Epub 2017 Oct 16.

Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.

To determine the feasibility of using a real-time continuous glucose monitoring system (RTGMS) in intensive care units, our study focus on preterm infants with diabetic mothers owing to their high risk of blood sugar abnormalities. Thirty preterm babies (M = 15 and F = 15; ≤ 36 week gestation age) were studied from within 72 hours of delivery. These babies were admitted to the newborn intensive care and were further categorized into groups based on whether their mothers with or without diabetic mellitus. Read More

Diabetes Obes Metab 2018 02 8;20(2):344-351. Epub 2017 Sep 8.

Oslo University Hospital, Oslo, Norway.

Aims: To compare the sodium-glucose-cotransporter-2 (SGLT-2) inhibitor dapagliflozin with dipeptidyl peptidase-4 (DPP-4) inhibitors with regard to risk associations with major adverse cardiovascular (CV) events (MACE; non-fatal myocardial infarction, non-fatal stroke or cardiovascular mortality), hospitalization for heart failure (HHF), atrial fibrillation and severe hypoglycaemia in patients with type 2 diabetes (T2D) in a real-world setting.

Methods: All patients with T2D prescribed glucose-lowering drugs (GLDs) during 2012 to 2015 were identified in nationwide registries in Denmark, Norway and Sweden. Patients were divided into two groups: new users of dapagliflozin and new users of DPP-4 inhibitors, matched 1:3 by propensity score, calculated by patient characteristics, comorbidities and drug treatment. Read More

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

J Neuroinflammation 2017 01 23;14(1):21. Epub 2017 Jan 23.

Cerebral Vascular Disease Research Laboratories, University of Miami School of Medicine, Miami, FL, 33136, USA.

Stroke is one of the leading causes of death worldwide. A strong inflammatory response characterized by activation and release of cytokines, chemokines, adhesion molecules, and proteolytic enzymes contributes to brain damage following stroke. Stroke outcomes are worse among diabetics, resulting in increased mortality and disabilities. Read More

Diabetes Obes Metab 2017 05 27;19(5):664-671. Epub 2017 Feb 27.

Harvard Clinical Research Institute, Boston, Massachusetts.

Aims: To investigate relationships between glycated haemoglobin (HbA1c) and reported hypoglycaemia and risk of major adverse cardiovascular events (MACE).

Methods: The EXAMINE trial randomized 5380 patients with type 2 diabetes (T2DM) and a recent acute coronary syndrome (ACS) event, in 49 countries, to double-blind treatment with alogliptin or placebo in addition to standard of care. We used Cox proportional hazards models to analyse relationships among MACE, HbA1c levels and hypoglycaemic events. Read More

Diabetes Obes Metab 2017 05 23;19(5):644-653. Epub 2017 Feb 23.

Foundation for Diabetes Research in Older People, Diabetes Frail Ltd, Worcester, UK.

Aims: To describe the relative health and economic outcomes associated with different second-line therapeutic approaches to manage glycaemia in older type 2 diabetes patients requiring escalation from metformin monotherapy.

Materials And Methods: The Clinical Practice Research Datalink database was used to inform a retrospective observational cohort study of patients with type 2 diabetes treated with metformin monotherapy requiring escalation (addition or switch) to a second-line oral regimen from January 1, 2008 to December 31, 2014. Primary outcomes included time to first event (any event, myocardial infarction [MI], stroke, or composite of MI/stroke [major adverse cardiovascular event; MACE]) and total event rate. Read More

J Diabetes Complications 2017 Feb 5;31(2):390-394. Epub 2016 Dec 5.

Departments of Neurology, Soonchunhyang University School of Medicine, Seoul, Republic of Korea. Electronic address:

Background And Purpose: The association between blood glucose fluctuation and poststroke cardiovascular outcome has been largely unknown. This study attempted to evaluate whether initial glycemic variability increases cardiovascular events and mortality in diabetic patients with acute ischemic stroke.

Methods: We recruited consecutive patients with acute ischemic stroke or transient ischemic attack from March 2005 to December 2014. Read More

Br J Surg 2017 Jan 30;104(2):e95-e105. Epub 2016 Nov 30.

Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands.

Background: There is a clear association between hyperglycaemia and surgical-site infection (SSI). Intensive glucose control may involve a risk of hypoglycaemia, which in turn results in potentially severe complications. A systematic review was undertaken of studies comparing intensive versus conventional glucose control protocols in relation to reduction of SSI and other outcomes, including hypoglycaemia, mortality and stroke. Read More

J Endocrinol Invest 2017 May 21;40(5):457-462. Epub 2016 Nov 21.

1st Propedeutic Department of Internal Medicine, Medical School, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloníki, Greece.

Introduction: Close monitoring of blood glucose levels during the immediate post-acute stroke phase is of great clinical value, as there is evidence that the risk of neurological deterioration is associated with both hyper- and hypoglycaemia. The aim of this review paper is to summarise the evidence on post-stroke blood glucose management and its impact on clinical outcomes, during the early post-acute stage.

Findings: Post-stroke hyperglycaemia has been associated with increased cerebral oedema, haemorrhagic transformation, lower likelihood of recanalisation and deteriorating neurological state. Read More

Endocrine 2017 Sep 9;57(3):464-473. Epub 2016 Nov 9.

Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Policlinico "Mater Domini", Campus Universitario, Viale Europa, 88100,, Catanzaro, Italy.

Purpose: To compare the effect of liraglutide, sitagliptin and insulin glargine added to standard therapy on left ventricular function in post-ischemic type-2 diabetes mellitus patients.

Methods: We evaluated 32 type-2 diabetes mellitus Caucasians with history of post-ischemic chronic heart failure NYHA class II/III and/or left ventricular ejection fraction ≤45 %. Participants underwent laboratory determinations, electrocardiogram, echocardiogram, Minnesota Living with Heart Failure questionnaire and 6 min walking test at baseline and following 52 weeks treatment. Read More

Rinsho Byori 2016 Oct;64(10):1171-1177

The maintenance of the QOL by preventing the onset and progression of arteriosclerosis-related complica- tions such as a stroke and myocardial infarction is very important in the treatment of diabetes. However, recent large clinical trials reported that aggressively reducing the HbAlc level by the use of insulin or oral antidiabetic agents increased severe hypoglycemia, resulting in cardiovascular events and deaths. A "good quality of glycemic control" that improves postprandial hyperglycemia without hypoglycemia is required for the treatment of diabetes, and confirmation of the fluctuations in blood glucose for 24 hours using CGM (continuous glucose-monitoring) is now attracting marked attention. Read More

J Cereb Blood Flow Metab 2017 Jul 1;37(7):2577-2583. Epub 2016 Jan 1.

2 Division of Neurocritical Care and Emergency Neurology, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA.

Hyperglycemia is a common complication after ischemic stroke, but its link to worse outcome is not well understood. We hypothesized that hyperglycemia may reflect an impaired metabolic response that is associated with worse cytotoxic brain injury. We performed retrospective analysis of magnetic resonance imaging from a cohort of acute ischemic stroke patients prospectively collected from 2006 to 2010 with baseline demographic and laboratory data as well as three-month outcomes. Read More

Am J Emerg Med 2016 Dec 27;34(12):2343-2350. Epub 2016 Aug 27.

National Cancer Control Institute, National Cancer Center, Goyang-si, Kyunggi-do, Republic of Korea.

Background: Hyperglycemia and hyperosmolality are associated with poor outcomes among acute ischemic stroke (AIS) patients.

Objectives: We evaluated the association between hyperglycemia and hyperosmolality, as a combination measure, with poor outcome among AIS patients.

Methods: We conducted a retrospective study of AIS patients admitted to the study hospital emergency department between January and December 2014. Read More

Ann Thorac Surg 2017 Feb 25;103(2):526-532. Epub 2016 Aug 25.

Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York. Electronic address:

Background: Hypoglycemia is a known risk of intensive postoperative glucose control in patients undergoing cardiac operations. However, neither the consequences of hypoglycemia relative to hyperglycemia, nor the possible interaction effects, have been well described. We examined the effects of postoperative hypoglycemia, hyperglycemia, and their interaction on short-term morbidity and mortality. Read More

Clin Transplant 2016 10 24;30(10):1242-1249. Epub 2016 Sep 24.

Division of Transplantation, Department of Surgery, University of California San Francisco, San Francisco, CA, USA.

Recipient diabetes accounts for ~34% of end-stage renal disease in patients awaiting renal transplantation and has been linked to poor graft function. We conducted a single-center, open-label, randomized controlled trial to determine whether moderately intense glucose control during allograft reperfusion would reduce the incidence of poor graft function. Adult diabetics undergoing deceased donor renal transplant were randomized to moderately intense glucose control (n=30) or standard control (n=30). Read More

Parkinsonism Relat Disord 2016 09 21;30:29-35. Epub 2016 Jun 21.

Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea. Electronic address:

Background: The putamen is frequently involved in cases of secondary choreoballism (CB). To date, no study has investigated clinical features of secondary CB such as vascular CB (vCB) and glycemic CB (gCB) in view of putaminal involvement.

Objectives: Cases of CB with putaminal lesions from our hospital were identified in hospital records. Read More

Tohoku J Exp Med 2016 06;239(2):89-94

Department of Diabetes and Endocrinology, Osaka Red Cross Hospital.

Mitochondrial diabetes mellitus is a subtype of diabetes linked to mutations in mitochondrial DNA. In patients with mitochondrial diabetes mellitus, the effect of glycemic control on the serum concentrations of fibroblast growth factor 21 (FGF21) and growth differentiation factor 15 (GDF15) has not been evaluated. FGF21 and GDF15 have been reported to be useful biomarkers for the diagnosis and severity assessment of mitochondrial diseases like mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). Read More

BMJ Open 2016 Feb 24;6(2):e008203. Epub 2016 Feb 24.

Department of Diabetes, Endocrinology and Metabolism, Royal North Shore Hospital, Sydney, New South Wales, Australia University of Sydney, Northern Clinical School, Sydney, New South Wales, Australia.

Introduction: Both hyperglycaemia and hypoglycaemia in acute ischaemic stroke (AIS) are associated with increased infarct size and worse functional outcomes. Thus, therapies that can maintain normoglycaemia during stroke are clinically important. Glucagon-like peptide 1 (GLP-1) analogues, including exenatide, are routinely used in the treatment of hyperglycaemia in type 2 diabetes, but data on the usefulness of this class of agents in the management of elevated glucose levels in AIS are limited. Read More

Diabetes Obes Metab 2016 Feb 23;18(2):152-8. Epub 2015 Dec 23.

Institute of Cellular Medicine-Diabetes, Newcastle University, Newcastle upon Tyne, UK.

Aims: To examine the relationships between glycated haemoglobin (HbA1c) and cardiovascular (CV) events in people beginning insulin in routine clinical practice in Europe, North America and Asia in a non-interventional study, the Cardiovascular Risk Evaluation in people with Type 2 Diabetes on Insulin Therapy (CREDIT) study.

Methods: Data on 2999 people were collected prospectively over 4 years from physician reports. The primary outcome was the composite of stroke or myocardial infarction (MI) or CV-specific death. Read More

Drugs Today (Barc) 2015 Sep;51(9):519-35

Scripps Clinic and Scripps Whittier Diabetes Institute, La Jolla, California, USA.

Empagliflozin is an oral sodium-glucose cotransporter 2 (SGLT2) inhibitor that reduces hyperglycemia in type 2 diabetes mellitus (T2DM) by decreasing renal glucose reabsorption and promoting urinary glucose excretion. In clinical trials, empagliflozin demonstrated significant improvements in glycemic control, as monotherapy and in combination regimens. In addition, empagliflozin was associated with weight loss and moderate reductions in blood pressure. Read More

Can J Diabetes 2016 Feb 21;40(1):50-7. Epub 2015 Oct 21.

Boehringer Ingelheim Norway KS, Asker, Norway.

Objective: With the expanding armamentarium of noninsulin therapies for type 2 diabetes mellitus, the use of insulin with various oral agents is becoming more common. In this study, we assessed the efficacy and cardiovascular (CV) safety of the dipeptidyl peptidase-4 inhibitor linagliptin as add-on to insulin in patients with type 2 diabetes.

Methods: In this post hoc analysis, data for patients receiving basal or basal-bolus insulin were pooled from 4 randomized, double-blind, phase 3 clinical trials of linagliptin 5 mg once daily or placebo given as add-on to background glucose-lowering treatment. Read More

Zh Nevrol Psikhiatr Im S S Korsakova 2015 ;115(8):79-82

Endocrinology Researh Center, Moscow; Sechenov First Moscow State Medical University, Moscow.

A review of the Russian and international publications on the frequency, risk factors and characteristics of ischemic stroke in patients with type 2 diabetes mellitus (DM-2) is presented. We present a detailed description of specific risk factors for DM-2 (chronic and acute hyperglycemia, recurrent hypoglycemia, insulin resistance and hyperinsulinemia). Current demands to targeted glucose control in patients who survived vascular events are presented. Read More

Congenit Heart Dis 2015 Nov-Dec;10(6):E250-7. Epub 2015 Jul 29.

Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Ill, USA.

Objective: The objective of this study was to characterize the natural history of metabolic uncoupling (type B hyperlactemia and hyperglycemia) following cardiopulmonary bypass (CPB), and to determine the impact of insulin therapy on time to lactate normalization in patients without low cardiac output.

Design: The design used was a retrospective cohort study.

Setting: The study was set in a pediatric cardiac intensive care unit in a tertiary-care urban children's hospital. Read More

J Emerg Med 2015 Aug 20;49(2):244-52. Epub 2015 Mar 20.

Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee.

Background: Intravenous tissue-plasminogen activator remains the only U.S. Food and Drug Administration-approved treatment for acute ischemic stroke. Read More

Expert Opin Drug Saf 2015 Apr 29;14(4):505-24. Epub 2015 Jan 29.

University of Liège, CHU Sart Tilman, Division of Diabetes, Nutrition and Metabolic Disorders, Department of Medicine , (B35), B-4000 Liege 1 , Belgium +32 4 3667238 ; +32 4 3667068 ; andre.scheen @ chu.ulg.ac.be.

Introduction: Dipeptidyl peptidase-4 (DPP-4) inhibitors (gliptins) occupy a growing place in the armamentarium of drugs used for the management of hyperglycemia in type 2 diabetes, although some safety concerns have been raised in recent years.

Areas Covered: An updated review providing an analysis of available safety data (meta-analyses, randomized controlled trials, observational cohort and case-control studies and pharmacovigilance reports) with five commercialized DPP-4 inhibitors (sitagliptin, vildagliptin, saxagliptin, alogliptin, linagliptin). A special focus is given to overall safety profile; pancreatic adverse events (AEs) (acute pancreatitis, pancreatic cancer); overall cardiovascular safety (myocardial infarction and stroke); congestive heart failure concern and finally, safety in special populations (elderly, renal impairment). Read More

Neuroscience 2014 Dec 9;283:202-9. Epub 2014 May 9.

Division of Psychoneurobiology, Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany.

Hyperglycemia is a common phenomenon in the early phase of brain injury (BI). The management of blood glucose levels after BI, however, is subject of a growing debate. The occurrence of elevated blood glucose concentrations is linked to increased mortality and worse neurologic outcomes indicating the necessity for therapeutic glucose-lowering. Read More

Stroke 2014 Jun 17;45(6):1881-6. Epub 2014 Apr 17.

From the Department of Neurology, University of California at San Francisco (N.M.R., R.A.S.); and Neurology Service, San Francisco Veterans Affairs Medical Center, CA (R.A.S.).

Endocrine 2014 Nov 7;47(2):360-71. Epub 2014 Mar 7.

Department of Medicine IV, Eberhard-Karls-University, Otfried-Müller-Str. 10, 72076, Tübingen, Germany,

Glucagon-like peptide-1 (GLP-1) stimulates insulin secretion and inhibits glucagon secretion in the pancreatic islets of Langerhans under hyperglycaemia. In type 2 diabetes (T2DM), GLP-1 improves glycaemic control without a hypoglycaemia risk. GLP-1 receptors have also been found in extra-pancreatic tissues, e. Read More