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Hypoglycemia
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1. Flexible intensive insulin therapy in adults with type 1 diabetes and high risk for severe hypoglycemia and diabetic ketoacidosis.
Match Strength: 6.871

OBJECTIVE: Diabetes treatment and teaching programs (DTTPs) for type 1 diabetes, which teach flexible intensive insulin therapy to enable dietary freedom, have proven to be safe and effective in routine care. This study evaluates DTTP outcomes in patients at high risk for severe hypoglycemia and severe ketoacidosis. RESEARCH DESIGN AND METHODS: There were 96 diabetes centers that participated between 1992 and 2004. A total of 9,583 routine-care patients with type 1 diabetes were examined before and 1 year after a DTTP. History of repeated severe hypoglycemia/severe ketoacidosis was an ... Read More »
» Published in Diabetes Care. 2006 Oct;29(10):2196-9.

2. Prevention of hypoglycemia during exercise in children with type 1 diabetes by suspending basal insulin.
Match Strength: 6.659

OBJECTIVE: Strategies for preventing hypoglycemia during exercise in children with type 1 diabetes have not been well studied. The Diabetes Research in Children Network (DirecNet) Study Group conducted a study to determine whether stopping basal insulin could reduce the frequency of hypoglycemia occurring during exercise. RESEARCH DESIGN AND METHODS: Using a randomized crossover design, 49 children 8-17 years of age with type 1 diabetes on insulin pump therapy were studied during structured exercise sessions on 2 days. On day 1, basal insulin was stopped during exercise, and on day 2 it was ... Read More »
» Published in Diabetes Care. 2006 Oct;29(10):2200-4.

3. Type II glucocorticoid receptor involvement in habituated activation of lateral hypothalamic area orexin-A-immunopositive neurons during recurring insulin-induced hypoglycemia.
Match Strength: 5.210

Neurons that synthesize the potent orexigenic neuropeptide, orexin-A (ORX-A) are confined to the lateral hypothalamic area (LHA) and adjacent structures, and project throughout the central neuroaxis to structures that govern central nervous system responses to energy imbalance. Insulin-induced hypoglycemia (IIH) upregulates prepro-orexin mRNA and Fos immunostaining of LHA ORX-A neurons. These neurons apparently become desensitized to this metabolic challenge, since both responses are diminished by recurrent insulin-induced hypoglycemia (RIIH). Recent studies implicate central type II ... Read More »
» Published in Neurosci Res. 2006 Nov;56(3):309-13. Epub 2006 Sep 25.

4. Inpatient management of hyperglycemia: the Northwestern experience.
Match Strength: 4.836

OBJECTIVE: To describe a novel method of safe and effective intensive management of inpatient hyperglycemia with use of cost-effective protocols directed by a glucose management service (GMS). METHODS: An intravenous insulin protocol was designed to achieve a glycemic target of 80 to 110 mg/dL. When stable inpatients were transferred from the intravenous protocol to a subcutaneous insulin protocol, which consisted of basal long-acting and prandial and supplemental rapid-acting insulins, the blood glucose target was 80 to 150 mg/dL. Glucose levels were reviewed by the GMS at least daily for ... Read More »
» Published in Endocr Pract. 2006 Sep-Oct;12(5):491-505.

5. Capecitabine improves cancer cachexia and normalizes IL-6 and PTHrP levels in mouse cancer cachexia models.
Match Strength: 4.569

PURPOSE: To clarify the potential of parathyroid hormone-related protein (PTHrP) and interleukin-6 (IL-6) as cachectic factors in a colon 26 model and the effects of capecitabine on cancer cachexia as determined by plasma levels of IL-6 and PTHrP and body weight loss. METHODS: From two colon 26 sublines-cancer cachectic clone20 and non-cachectic clone5 plasma levels of PTHrP protein and mRNA expression levels in tumor tissues were compared. An IL-6 neutralizing antibody, a PTHrP neutralizing antibody, and capecitabine were administered into mice bearing clone20 and their anticachectic effects ... Read More »
» Published in Cancer Chemother Pharmacol. 2006 Sep 29;

6. Evaluation of the superiority of insulin glargine as basal insulin replacement by continuous glucose monitoring system.
Match Strength: 4.163

To evaluate the superiority of insulin glargine as basal insulin replacement by continuous glucose monitoring system (CGMS). Twenty-four patients with type 2 diabetes mellitus (T2DM) whose blood glucose was not well controlled with sulphanylureas were enrolled. At first, they were treated with extended-release glipizide (glucotrol XL) 5mg/d before breakfast for 2 weeks, then randomized to combination treatment with glargine (16 patients) or NPH (8 patients) and treated for 12 weeks. CGMS were carried in the second week after treatment with glucotrol XL, and in the 12th week after combination ... Read More »
» Published in Diabetes Res Clin Pract. 2006 Sep 13;

7. The dry plant extract of common bean seed (Phaseoli vulgari pericarpium) does not have an affect on postprandial glycemia in healthy human subject.
Match Strength: 4.089

The aim of present study was to assess the effects and safety of a dry Phaseoli vulgari pericarpium (PVP) extract on postprandial glycemia in healthy participants. A randomized crossover experiment where participants received either PVP extract or placebo. Chemical compounds in dry extract were assessed by established methods. Eighteen healthy participants (9 male and 9 female) aged 29+/-4,8 years, body mass index (BMI) 23+/-3,7 kg/m(2) were recruited among students and staff at the Faculty of Pharmacy, University of Belgrade. All participants were able to follow the study protocol without ... Read More »
» Published in Bosn J Basic Med Sci. 2006 Aug;6(3):28-33.

8. Glycemic control with continuous subcutaneous insulin infusion with use of U-500 insulin in a pregnant patient.
Match Strength: 3.855

OBJECTIVE: To demonstrate the benefits and to advocate the safety and efficacy of using an insulin pump with U-500 insulin in comparison with U-100 insulin for a pregnant patient with diabetes requiring massive doses of insulin. METHODS: We present a detailed case report about the use of continuous subcutaneous insulin infusion with U-500 insulin during pregnancy. Dose calculation is reviewed, and the benefits of insulin pump therapy in patients with diabetes are discussed. RESULTS: A 34-year-old white woman, with a history of type 2 diabetes for 7 years, was seen at 17 weeks of gestation ... Read More »
» Published in Endocr Pract. 2006 Sep-Oct;12(5):542-4.

9. Tight control of type 1 diabetes: recommendations for patients.
Match Strength: 3.085

Tight control of blood glucose levels and risk factors for cardiovascular disease (e.g., hypertension, hypercholesterolemia) can substantially reduce the incidence of microvascular and macrovascular complications from type 1 diabetes. Physicians play an important role in helping patients make essential lifestyle changes to reduce the risk of these complications. Key recommendations that family physicians can give patients to optimize their outcomes include: take control of daily decisions regarding your health, focus on preventing and controlling risk factors for cardiovascular disease, ... Read More »
» Published in Am Fam Physician. 2006 Sep 15;74(6):971-8.

10. Glyburide for the management of gestational diabetes: risk factors predictive of failure and associated pregnancy outcomes.
Match Strength: 2.892

OBJECTIVE: The purpose of this study was to identify characteristics that may predict failure of glyburide therapy for the management of A2 gestational diabetes, and to evaluate whether those that fail are at increased risk for adverse pregnancy outcomes. STUDY DESIGN: This was a retrospective cohort of gestational diabetics requiring medical therapy (A2DM) treated between January 2002 and July 2005. RESULTS: Of the 235 gestational diabetics identified, 79% of the 101 A2DMs were successfully treated with glyburide as first-line therapy. Those that failed had a higher mean glucose value on ... Read More »
» Published in Am J Obstet Gynecol. 2006 Oct;195(4):1090-4.

11. Reversible subclinical hypothyroidism in the presence of adrenal insufficiency.
Match Strength: 2.776

OBJECTIVE: To describe 3 different scenarios of reversible hypothyroidism in young patients with adrenal insufficiency. METHODS: We present 3 case reports of patients with adrenal insufficiency--one with delayed puberty, the second with type 1 diabetes and poor weight gain, and the third with hypoglycemia-related seizures and glucocorticoid deficiency--who had biochemical evidence of hypothyroidism. RESULTS: Our first patient (case 1) initially had a mildly elevated thyrotropin (thyroid-stimulating hormone or TSH) level and a normal free thyroxine (FT4) level that, on follow-up assessment, had ... Read More »
» Published in Endocr Pract. 2006 Sep-Oct;12(5):572.

12. Long- and short-haul travel by air: issues for people with diabetes on insulin.
Match Strength: 2.610

OBJECTIVE: To determine what problems are experienced by people with diabetes mellitus traveling abroad using insulin, whether appropriate and consistent advice is available to them, and if necessary, how this advice could be improved or enhanced. DESIGN: Census study by self-administered questionnaire of patients with diabetes who use insulin attending an outpatient clinic. SETTING: Grampian Diabetes Centre, Woolmanhill Hospital, Aberdeen. PARTICIPANTS: A total of 493 patients using insulin who attended the clinic in Aberdeen over a period of 3 months. MAIN OUTCOME MEASURES: Determination of ... Read More »
» Published in J Travel Med. 2006 Sep-Oct;13(5):255-60.

13. Taurine release in mouse brain stem slices under cell-damaging conditions.
Match Strength: 2.452

Taurine has been thought to be essential for the development and survival of neural cells and to protect them under cell-damaging conditions. In the brain stem taurine regulates many vital functions, including cardiovascular control and arterial blood pressure. We have recently characterized the release of taurine in the adult and developing brain stem under normal conditions. Now we studied the properties of preloaded [(3)H]taurine release under various cell-damaging conditions (hypoxia, hypoglycemia, ischemia, the presence of metabolic poisons and free radicals) in slices prepared from the ... Read More »
» Published in Amino Acids. 2006 Sep 27;

14. A double-blind, placebo-controlled trial assessing pramlintide treatment in the setting of intensive insulin therapy in type 1 diabetes.
Match Strength: 2.214

OBJECTIVE: To assess safety, efficacy, and tolerability of pramlintide dose escalation with proactive mealtime insulin reduction, followed by insulin optimization, in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS: This 29-week, double-blind, placebo-controlled study randomized 296 patients to pramlintide or placebo as an adjunct to insulin. During initiation, pramlintide was escalated from 15 to 60 microg/meal (15-microg increments) with recommended reductions (30-50%) in mealtime insulin. Insulin was subsequently adjusted to optimize glycemic control. End points included safety ... Read More »
» Published in Diabetes Care. 2006 Oct;29(10):2189-95.

15. Long-term safety of pioglitazone versus glyburide in patients with recently diagnosed type 2 diabetes mellitus.
Match Strength: 2.162

STUDY OBJECTIVE: To evaluate the long-term safety and efficacy of glyburide versus pioglitazone in patients with a recent diagnosis of type 2 diabetes mellitus. DESIGN: Prospective, randomized, multicenter, double-blind trial with a 16-week titration period and a 40-week maintenance period. SETTING: Sixty-five investigative sites in the United States and Puerto Rico. PATIENTS: Five hundred two subjects with a recent diagnosis of type 2 diabetes that was unsuccessfully treated with diet and exercise were randomly assigned to study treatment. Of the 251 patients in each treatment group, 128 (51 ... Read More »
» Published in Pharmacotherapy. 2006 Oct;26(10):1388-95.

16. A practical approach to hyperglycemia management in the intensive care unit: evaluation of an intensive insulin infusion protocol.
Match Strength: 2.031

STUDY OBJECTIVES: To evaluate the effectiveness and safety of maintaining a target blood glucose concentration of 91-130 mg/dl with a standardized, nurse-managed, intensive insulin infusion protocol outside a study setting, and to determine if a statistically significant favorable effect on morbidity and mortality was achieved. DESIGN: Retrospective, observational, chart review. SETTING: Medical and surgical intensive care units (ICUs) in a community teaching hospital. PATIENTS: One hundred forty-three adult patients who received insulin infusions managed at the discretion of the physician ... Read More »
» Published in Pharmacotherapy. 2006 Oct;26(10):1410-20.

17. Management of diabetes mellitus in hospitalized patients: efficiency and effectiveness of sliding-scale insulin therapy.
Match Strength: 2.010

STUDY OBJECTIVE: To determine the efficiency and effectiveness of current prescribing practices relative to short- and intermediate-acting insulins in the prevention or treatment of acute hyperglycemic episodes in hospitalized patients with diabetes mellitus or hyperglycemia, and to identify clinical findings that influence the effectiveness of insulin therapy in these patients. DESIGN: Retrospective observational study. SETTING: University-affiliated hospital. PATIENTS: Ninety consecutive adult inpatients who had orders placed for as-needed subcutaneous regular or lispro sliding-scale insulin ... Read More »
» Published in Pharmacotherapy. 2006 Oct;26(10):1421-32.

18. Exenatide: a new option for the treatment of type 2 diabetes.
Match Strength: 2.003

OBJECTIVE: To evaluate available literature characterizing the pharmacology, pharmacokinetics, drug interactions, efficacy, and safety of exenatide in patients with type 2 diabetes. DATA SOURCES: A PubMed database search (1966-May 2006) was conducted, using exenatide as the search term. The manufacturer's prescribing information was also used. STUDY SELECTION AND DATA EXTRACTION: English-language articles were selected and data were extracted with a focus on clinical outcomes associated with the treatment of patients with type 2 diabetes. DATA SYNTHESIS: Exenatide exerts a glucoregulatory ... Read More »
» Published in Ann Pharmacother. 2006 Oct;40(10):1777-84. Epub 2006 Sep 19.

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