Background: Admission hyperglycemia is associated with increased morbidity and mortality in trauma patients. However, admission hyperglycemia is not only associated with stress-induced hyperglycemia (SIH) but also with diabetic hyperglycemia (DH); furthermore, patients with normoglycemia may not only have non-diabetic normoglycemia (NDN) but also have a possibility of diabetic normoglycemia (DN), with the diabetes under control. This study aimed to assess the effects of SIH and DH on the mortality outcomes of traumatic femoral fracture patients with NDN and DN. Methods: Admission hyperglycemia was diagnosed as a serum glucose ≥200 mg/dL upon arrival at the emergency department. Diabetes mellitus (DM) was determined by patient history and/or admission HbA1c ≥ 6.5%. DH and SIH were diagnosed by admission hyperglycemia in patients with and without DM. DN and NDN were determined by absence of admission hyperglycemia in patients with and without DM. These patients were allocated into four groups: SIH (n
Background: Admission hyperglycemia is associated with higher morbidity and mortality in patients with traumatic brain injury (TBI). Stress-induced hyperglycemia (SIH), a form of hyperglycemia induced by the stress response, is associated with increased patient mortality following TBI. However, admission hyperglycemia occurs not only in SIH but also in patients with diabetic hyperglycemia (DH). Current information regarding whether trauma patients with SIH represent a distinct group with differential outcomes compared to those with DH remains limited. Methods: Serum glucose concentration ≥200 mg/dL upon arrival at the emergency department was defined as hyperglycemia. Presence of diabetes mellitus (DM) was determined by patient history and/or admission glycated hemoglobin (HbA1c) level ≥6.5%. In the present study, the patient cohort included those with moderate and severe TBI, as defined by an Abbreviated Injury Scale (AIS) score ≥3 points in the head, and excluded those who had additional AIS
Neurovascular coupling (NVC) is the link between neural activity and the corresponding changes to regional cerebral blood flow. Chronic hyperglycemia associated with diabetes has deleterious effects on vascular function. However, the potential effects of acute hyperglycemia on NVC in healthy humans is unknown. We aimed to characterize the effects of acute hyperglycemia on NVC response magnitude in females and males, and hypothesized that acute hyperglycemia would reduce NVC response magnitude. 40 healthy participants (21.6±1.7 yrs; BMI 24.1±4.1 kg/m2; 20 females) were instrumented with electrocardiogram (ECG) to measure heart rate (HR), Finometer to measure mean arterial pressure (MAP), transcranial Doppler ultrasound (TCD) for measurement of posterior cerebral artery velocity (PCAv). Blood glucose was tested using a glucometer and capillary draw via sterile lancet. NVC responses were elicited using a standardized strobe light visual stimulus (VS; 6Hz, 360rpm; 5x30sec on/60sec off) before ...
Słowik, A.; Zwolińska, G.; Tomik, B.; Wyrwicz-Petkow, U.; Szczudlik, A., 1998: Prognostic significance of transient hyperglycemia in acute phase of ischemic stroke
Scarlett Law Group injury blog - Hyperglycemia can indicate traumatic brain injury. Contact a San Francisco Catastrophic Injury Lawyer today!
Hyperglycemia is associated with increased morbidity and mortality in hospitalized patients with a variety of medical conditions [1-3]. However, while the association between glucose concentration in hospital and mortality is strong in patients without known diabetes, paradoxically glucose concentration is not as strongly associated with mortality in patients with diabetes [2-6]. This suggests that background glycemia influences the relationship between glucose and mortality in patients admitted to hospital.. An elevated blood glucose in a hospitalized patient can occur because a patient has poor chronic glycemic control or if there is an acute increase in glucose, often termed stress hyperglycemia [7]. Stress hyperglycemia is the relative increase in glucose in response to an intercurrent illness. Our group has recently proposed a novel metric for relative glycemia termed the stress hyperglycemia ratio (SHR), whereby admission glucose concentration is corrected for background glycemia estimated ...
TY - JOUR. T1 - Relationship between vitamin D deficiency, post-challenge hyperglycemia, and endothelial function in healthy older adults. AU - Sokol, Seth I.. AU - Grushko, Michael. AU - Srinivas, Vankeepuram S.. AU - Crandall, Jill P.. PY - 2012/3/1. Y1 - 2012/3/1. KW - Endothelial function. KW - Glucose intolerance. KW - Vitamin D. UR - http://www.scopus.com/inward/record.url?scp=84857423787&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=84857423787&partnerID=8YFLogxK. U2 - 10.1111/j.1753-0407.2011.00158.x. DO - 10.1111/j.1753-0407.2011.00158.x. M3 - Letter. C2 - 21936883. AN - SCOPUS:84857423787. VL - 4. SP - 102. EP - 103. JO - Journal of Diabetes. JF - Journal of Diabetes. SN - 1753-0393. IS - 1. ER - ...
Perioperative hyperglycemia is associated with postoperative neurocognitive disorders after cardiac surgery Xiaopeng Zhang,1 Xiaowei Yan,2 Jennifer Gorman,2 Stuart N Hoffman,3 Li Zhang,1 Joseph A Boscarino2 1Department of Anesthesiology, Geisinger Medical Center, 2Center for Health Research, Geisinger Clinic, 3Department of Neurology, Geisinger Medical Center, Danville, PA, USA Objective: Neurocognitive disorders commonly occur following cardiac surgery. However, the underlying etiology of these disorders is not well understood. The current study examined the association between perioperative glucose levels and other risk factors and the onset of neurocognitive disorders in adult patients following coronary artery bypass and/or valvular surgery. Methods: Adult patients who underwent their first cardiac surgery at a large tertiary care medical center were identified and those with neurocognitive disorders prior to surgery were excluded. Demographic, perioperative, and postoperative neurocognitive
Chronic hyperglycemia contributes to beta-cell dysfunction in diabetes and with islet transplantation, but the mechanisms remain unclear. Recent studies demonstrate that the unfolded protein response (UPR) is critical for beta-cell function. Here, we assessed the influence of hyperglycemia on UPR gene expression in transplanted islets. Streptozotocin-induced diabetic or control nondiabetic mice were transplanted under the kidney capsule with syngeneic islets either sufficient or not to normalize hyperglycemia. Twenty-one days after transplantation, islet grafts were excised and RT-PCR was used to assess gene expression. In islet grafts from diabetic mice, expression levels of many UPR genes of the IRE1/ATF6 pathways, which are important for adaptation to endoplasmic reticulum stress, were markedly reduced compared with that in islet grafts from control mice. UPR genes of the PERK pathway were also downregulated. The normalization of glycemia restored the changes in mRNA expression, suggesting that
Stress hyperglycemia (also called stress diabetes or diabetes of injury) is a medical term referring to transient elevation of the blood glucose due to the stress of illness. It usually resolves spontaneously, but must be distinguished from various forms of diabetes mellitus. It is often discovered when routine blood chemistry measurements in an ill patient reveal an elevated blood glucose. Blood glucose can be assessed either by a bedside fingerstick glucose meter or plasma glucose as performed in a laboratory (the latter being more efficacious). A retrospective cohort study by the Mayo Clinic held that bedside glucometry was a reliable estimate of plasma glucose with a mean difference of 7.9 mg/dL, but still may not coincide with every individual. The glucose is typically in the range of 140-300 mg/dl (7.8-16.7 mM) but occasionally can exceed 500 mg/dl (28 mM), especially if amplified by drugs or intravenous glucose. The blood glucose usually returns to normal within hours unless ...
One of the most common causes is stress hyperglycemia.In a stressful situation, the body needs energy source.The adrenal glands are released into the blood hormones cortisol and adrenaline, which cause liver glycogen conversion to glucose.As a result, the blood sugar level increases dramatically, allowing the flow of energy.Therefore, even a common fear of taking a blood test can lead to incorrect results.The same situation occurs when emotional experiences, trauma, surgery, physical exercise.. Quite often diagnosed hyperglycemia and infectious diseases.Here, the role played by at least two factors.Needless effects of an infectious agent may affect glucose levels.On the other hand, the disease is any such organism to stress, which should be the standard cascade of reactions starting with the ejection mechanism of glucose in the blood.. Taking certain medications can cause hyperglycemia.This is observed in the use of thiazide diuretics, hormonal agents, as well as during chemotherapy.. reason for ...
1 - Diabetes: High Blood Sugar High Blood Sugar Although people usually think about the long-term complications when it comes to diabetes, short-term or …. Mar 4, 2010 … Hyperglycemia happens when there is excess sugar level in blood. … Non- diabetic people, postprandial or post meal glucose level rarely go …. Jan 1, 2012 … 1.0 Diagnosis and recognition of hyperglycemia and diabetes in the … 4.0 Management of hyperglycemia in the non-critical care setting.. Hyperglycemia Treatment ★★★ Hyperglycemia Treatment ★★★ Diabetes Diet Drinks ::The 3 Step Trick that Reverses Diabetes Permanently in As Little …. National Direct Diabetic Supply 26 Home Pharmacy Inc On a national scale, direct medical costs totaled over $175 billion, with indirect costs … referred to as patient-centered medical homes or PCMH. …. care, prescription medicine, diabetes supplies, and physician …. 15.12.2005 · Hyperglycemia Vs Diabetes Highlights ★★★ Hyperglycemia Vs Diabetes ★★★ ...
In type 1 diabetic patients, insulin supplementation can never mimic the exquisite control of glucose by pancreatic insulin seen in normal individuals. Multiple finger pricks and insulin injections (three to four per day) mean poor patient compliance, repeated exposure to bouts of inadequate glucose control (and a shift in cardiac metabolism), and cardiovascular disease in the long term. To imitate this poorly controlled type 1 diabetic patient exposed to acute hyperglycemia, we used DZ. Measurement of LPL protein expression in the heart revealed no change after acute hyperglycemia. However, the drawback with this measurement is that it does not distinguish active LPL from its inactive monomeric form. Using the heparin-sepharose column, our data for the first time show that acute hyperglycemia can indeed increase the amount of dimeric LPL in the heart. We are unaware of a similar increase in dimeric LPL in other physiology or pathology. In fact, the reverse is often seen with lipid metabolism ...
Without treatment, high blood sugar levels can lead to severe dehydration. If you have surgery, you may develop an infection in your surgery wound, or it may not heal well. You may get a blood clot in your leg or arm. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke. Hyperglycemia may cause pancreatitis. Hyperglycemia can also lead to diabetes. Hyperglycemia can damage your nerves, veins, arteries, and organs over time. Damage to arteries may increase your risk for a heart attack or stroke ...
Chronic hyperglycemia can lead to chronic activation of the nutrient-sensing serine/threonine protein kinase, mammalian Target of Rapamycin (mTOR) in β cells. Activated mTOR triggers serine/threonine phosphorylation of IRS-2 and its subsequent proteosomal degradation, leading to increased β-cell apoptosis (39). It should be noted, however, that chronic hyperglycemia can also trigger β-cell apoptosis by additional mechanisms, collectively referred to as "glucotoxicity." These mechanisms include the generation of potentially damaging reactive-oxygen species (ROS) as a consequence of chronically increased glucose metabolism in β cells (40); chronic elevation of intracellular [Ca2+] to cytotoxic levels (3); a marked up-regulation in the synthesis of β-cell secretory granule proteins, including pro-insulin and pro-Islet Amyloid Associated Peptide (proIAPP), which in turn could promote ER stress (3, 41); and a glucose-induced increase in local interleukin-1β (IL-1β) production (42). Some of ...
Its not always the case that its easy to forgive and forget, particularly when it comes to past memories. The concept of the legacy effect or hyperglycemic memory describes the deferred consequence of antecedent glycemic status on the development of diabetic complications. Anyone researching chronic hyperglycemia appreciates that glucose is still considered the major risk factor implicated in the development and progression of diabetic vascular complications. Now, the same can be concluded for transient hyperglycemia. Large clinical studies have demonstrated that prior glycemic control has a sustained benefit in reducing subsequent diabetic complications.1-4 The Diabetes Control and Complications Trial (DCCT) and the follow-up study, Epidemiology of Diabetes Interventions and Complications (EDIC) have determined that episodes of poor glycemic control can lead many years later to the long-term complications of diabetes.5,6 The DCCT study was designed to compare intensive versus conventional ...
Purpose: : Insulin resistance and altered insulin release are the pathogenetic mechanisms underlying the development of hyperglycemia in subjects with type 2 diabetes mellitus (T2DM). Microvascular complications, such as retinopathy, arise as a consequence of chronic hyperglycemia, eventually leading to blindness. Initially, the natural history of T2DM includes a period of normal or near-normal fasting plasma glucose levels and marked postprandial glycemic excursions. The impact of these glycemic spikes on retinal function is still matter of controversy. The aim of the present study was to develop a model of mild type 2 diabetes in rats (combining diet-induced insulin resistance and a slight β-cell secretory impairment) in order to study early retinopathic changes in rodents with slight fasting hyperglycemia and markedly elevated postprandial glucose levels. Methods: : Adult male Wistar rats received tap water and citrate buffer i.p. (Group 1), tap water with 30% w/v sucrose and citrate buffer ...
Krzeczkowski JE, Boylan K, Arbuckle TE, Dodds L, Muckle G, Fraser WD, Favotto LA, Van Lieshout RJ, on behalf of The MIREC Study Group. Early Human Development. 2018 Oct;125:8-16. doi: 10.1016/j.earlhumdev.2018.08.005.. Pre-pregnancy obesity (adiposity) or maternal high blood glucose (hyperglycemia) have been linked to altered brain development in infants. A babys brain is rapidly developing both during pregnancy and in early life. Thus, maternal adiposity or hyperglycemia during pregnancy may impact the childs cognition (IQ) and behavior. This study was designed to look at the associations between pre-pregnancy adiposity or hyperglycemia and child IQ and behavior at around 3 years of age.. Data from 808 mother-child pairs from the MIREC-CD Plus study were analysed. Pre-pregnancy adiposity was assessed by calculating the womans body mass index (BMI: weight in kg/height in m2). If the women had gestational diabetes or impaired glucose tolerance (measures of high blood glucose), they were ...
The current goal of diabetes therapy is to reduce time-averaged mean levels of glycemia, measured as HbA1c, to prevent diabetic complications. However, HbA1c only explains ,25% of the variation in risk of developing complications. Because HbA1c does not correlate with glycemic variability when adjusted for mean blood glucose, we hypothesized that transient spikes of hyperglycemia may be an HbA1c-independent risk factor for diabetic complications. We show that transient hyperglycemia induces long-lasting activating epigenetic changes in the promoter of the nuclear factor κB (NF-κB) subunit p65 in aortic endothelial cells both in vitro and in nondiabetic mice, which cause increased p65 gene expression. Both the epigenetic changes and the gene expression changes persist for at least 6 d of subsequent normal glycemia, as do NF-κB-induced increases in monocyte chemoattractant protein 1 and vascular cell adhesion molecule 1 expression. Hyperglycemia-induced epigenetic changes and increased p65 ...
Definition of hyperglycemia management in the Financial Dictionary - by Free online English dictionary and encyclopedia. What is hyperglycemia management? Meaning of hyperglycemia management as a finance term. What does hyperglycemia management mean in finance?
Definition of hyperglycemia management in the Legal Dictionary - by Free online English dictionary and encyclopedia. What is hyperglycemia management? Meaning of hyperglycemia management as a legal term. What does hyperglycemia management mean in law?
Our large, nationally representative study of elderly patients hospitalized with AMI indicates that the nature of the relationship between admission glucose and mortality is different in patients with and without recognized diabetes. Elevated glucose is common, infrequently treated, and associated with a steep, linear mortality increase in patients without recognized diabetes. In contrast, elevated glucose levels are not associated with an increased relative risk of mortality in patients with diabetes, except at severe levels of hyperglycemia. Surprisingly, elevated admission glucose confers at least as high or a higher risk of 30-day and 1-year mortality in patients without known diabetes as in those with diabetes.. Our study substantially expands the current understanding of the relationship between admission glucose values and adverse outcomes in patients with AMI. First, we directly compared the nature of the relationship between elevated glucose and mortality in patients with and without ...
Blood glucose is commonly considered too high if it is higher than 130 mg/dl before a meal or higher than 180 mg/dl two hours after the first bite of a meal. However, most of the signs and symptoms of high blood glucose dont appear until the blood glucose level is higher than 250 mg/dl. Some of the symptoms have a rapid onset, while others require a long period of high blood glucose to set in.Its important to note that individuals differ in their sensitivity to the effects of high blood glucose: Some people feel symptoms more quickly or more strongly than others. But each sign or symptom has a biological underpinning, or a specific cause behind the effect.Hyperglycemia can be acute or chronic. Acute hyperglycemialasts only briefly and is often the result of a high-carbohydrate meal, a missed dose of medicine, stress, or illness. Chronic hyperglycemia, on the other hand, is a state of long-term elevated blood glucose. It is often the result of undiagnosed diabetes or of an inadequate diabetes ...
The aim of diabetes treatment is to keep blood sugar levels as near to normal as possible. But if you have diabetes, no matter how careful you are, youre likely to experience hyperglycaemia at some point.. Its important to be able to recognise and treat hyperglycaemia, as it can lead to serious health problems if left untreated.. Occasional mild episodes are not usually a cause for concern and can be treated quite easily or may return to normal on their own. But hyperglycaemia can be potentially dangerous if blood sugar levels become very high or stay high for long periods.. Very high blood sugar levels can cause life-threatening complications, such as:. ...
When to Seek Medical Care for High Blood Sugar (Hyperglycemia) Questions to Ask Your Doctor about High Blood Sugar (Hyperglycemia) Self-Care at Home for High Blood Sugar (Hyperglycemia)
Journal of Diabetes Research is a peer-reviewed, Open Access journal that publishes research articles, review articles, and clinical studies related to type 1 and type 2 diabetes. The journal welcomes submissions focusing on the epidemiology, etiology, pathogenesis, management, and prevention of diabetes, as well as associated complications, such as diabetic retinopathy, neuropathy and nephropathy.
Influence of hyperinsulinaemia and/or hyperglycaemia on proinflammatory mRNA levels. Six subjects were studied on four separate occasions: during a lower insuli
Hyperglycemia commonly occurs in patients who are acutely ill, in a variety of clinical situations. Generally, moderate hyperglycemia in critically ill patients was thought to be beneficial; however, the degree of hyperglycemia on admission and the duration of hyperglycemia during critical illness are now recognized markers of adverse outcome. The use of insulin therapy to maintain normoglycemia for at least a few days improves survival and reduces morbidity in patients who are in a surgical intensive care unit (ICU), as shown by a large, randomized, controlled study. These results were recently confirmed by two studies--a randomized, controlled study of patients in a medical ICU, and a prospective, observational study of a heterogeneous patient population admitted to a mixed medical and surgical ICU. Results of multicenter trials that investigated tight blood-glucose control in critically ill patients are, however, still lacking. While we await those multicenter results, the current evidence ...
Abstract of Paper: THE EFFECT OF HYPERGLYCEMIA ON SERUM TRANSFORMING GROWTH FACTOR-B1 (TGF-B1) LEVEL AND THEIR RELATIONS TO DIABETIC NEPHROPATHY IN PATIENTS WITH CONTROLLED TYPE 2 DIABETES MELLITUS , Author: Medhat Abdel Monem*, Awad EI-Abd*, Mosad Odah*, Ashraf Talaat** and Inas Abdel Monem* , Year: 2005 , Faculty of Medicine, Benha University
Hyperglycemia is a driving force of late diabetic complications, making it necessary to understand not only indirect effects of glucose, such as the AGE-mediated cellular effects, but also direct effects of glucose. Several studies have shown that even an acute increase in blood glucose may impair the physiological homeostasis of many systems (2,3), such as the balance of free radicals/anti-oxidants. Furthermore, hyperglycemia increases adhe-sion molecules such as intracellular adhesion molecule (ICAM)-1 in type 2 diabetic patients (4), augments leukocyte-endothelial interaction (48), and suppresses flow-mediated endothelium-dependent vasodilation of brachial artery (6,7). This is explained by an overshoot of superoxide anions resulting in increased nitric oxide degradation. The mechanisms through which acute hyperglycemia exerts these effects may be the production of free radicals. As shown in the present study, the formation of free radicals can be detected on the molecular level by the ...
The PI3K/AKT pathway is constitutively active in many human malignancies. Signaling through this pathway plays a critical role in promoting cancer cell proliferation, survival, and chemoresistance; thus, intense efforts are under way to develop inhibitors of AKT as cancer therapy. The novel pan-AKT kinase inhibitor, GSK690693, is currently being evaluated in a phase I clinical trial for patients with solid tumors or lymphoma. The potential side effects of GSK690693 include transient hyperglycemia and hyperinsulinemia as observed in preclinical animal models (Figs. 1 and 2). As described previously, daily administration of GSK690693 (30 mg/kg intraperitoneally) for 21 days was well tolerated in mice (24) and there was no significant difference in the blood glucose elevation between days 1 and 21, suggesting that GSK690693-induced hyperglycemic effect remains transient with repeat dosing. Hyperglycemia was also observed in patients treated with perifosine and triciribine phosphate, both of which ...
The impact of hyperglycemia on mortality and discharge destination of community-dwelling older adults with staphylococcus aureus bacteremia Conference Paper ...
Kim, M S. and Urano, M, "The effect of hyperglycemia on the combined hyperthermia and chemotherpay (cyclophosphamide). Abstr." (1982). Subject Strain Bibliography 1982. 3890 ...
Reducing the burden of long-term complications in type 2 diabetic patients remains a major task, and represents a huge challenge. Whilst tight glycemic control has been shown to reduce the risk of microvascular complications, controversy remains regarding the benefit of intensive treatment in relation to the prevention of cardiovascular events. Recent large trials (including ACCORD, ADVANCE, and VADT) were unable to show a significant impact of glycemic control on cardiovascular events. Also, it has been argued that these trials included patients with a long duration of the disease, and with previous unsatisfactory glycemic control. Chronic exposure to hyperglycemia may cause a kind of negative metabolic memory, and thereby reduce the potential impact of good glycemic control. This concept has been corroborated by the UKPDS which recruited only subjects with newly diagnosed diabetes and without prior cardiovascular events. In these patients, early achievement of glycemic control translated into a long
Title: IGF-I Signaling in Response to Hyperglycemia and the Development of Diabetic Complications. VOLUME: 7 ISSUE: 4. Author(s):David Clemmons, Laura Maile, Gang Xi, Xinchun Shen and Yashwanth Radhakrishnan. Affiliation:CB &# 7170, 8025 Burnett Womack Division of Endocrinology, University of North Carolina, Chapel Hill, NC 27599-7170, USA.. Keywords:Mitogen, Vascular smooth muscle, Atherosclerosis, Retinopathy, Dedifferentiation, Hyperglycemia, Diabetic Complications, IGF-I Signaling, αVβ3 LIGANDS, Mitogen activated protein kinase. Abstract:IGF-I is structurally related to proinsulin and when administered to human subjects it enhances insulin sensitivity. However because of its growth promoting properties and its relationship to growth hormone, it has been proposed as a etiologic factor in the development of diabetic complications. This review discusses recently published data regarding the ability of hyperglycemia to sensitize cells that are capable of dedifferentiating to the growth ...
Diabetes Care in the Hospital Setting ADA Standards 2016. Hospital Discharge Algorithm 2014 Diabetes Care. Management of Hyperglycemia in Hospitalized Patients in the Non-Critical Care Setting: An Endocrine Society Clinical Practice Guideline 2012 » A consensus statement that provides evidence based guidelines on inpatient glucose management for the non critical setting.. Clinical Guidelines for the Management of Hyperglycemia in Hospitalized Patients in a Non-Critical Care Setting » Powerpoint Slide Presentation 2011. Management of Diabetes and Hyperglycemia in Hospitalized-Patients 2014 Endotext-ncbi-bookshelf. Creative Strategies to Improve Diabetes Care in the Inpatient Setting » this article is a guide to setting up an inpatient diabetes program with limited resources and staff. Authored by Beverly Thomassian and based on her experience setting up a diabetes program at Stanford Medical Center.. Consensus Statement on Inpatient Glycemic Control, 2009 » American Association of Clinical ...
The mention a concept of metabolic memory of renal cells and epigenomics in diabetes is new. The question of whether transient hyperglycemia ( leading to a memory of that in the renal cells) due to glycosolated end products or AGE, can induce epigenetic modifications of gene expression by affecting the methylation of particular parts of the genome is what is discussed in one of the articles. Metobolic memory is referred to as if the cells have seen prior hyperglycemia, they keep that memory and can later on return via epigenetic mechanism to lead to diabetic disease ...
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Sepsis, renal impairment with electrolyte imbalance, and low blood pressure were independent prognostic factors of mortality among patients with severe hyperglycemia in the emergency department.
The overriding goal of managing patients with T2DM is to safely maintain glycemic control and most patients will require combination therapy with multiple agents. Until recently, pharmacologic options for T2DM included oral antihyperglycemic agents (eg, metformin, sulfonylureas, thiazolidinediones) and insulin (basal, prandial). In the last decade, a new class of agents based on the incretin pathway has emerged as a safe and effective option for many patients with T2DM. The incretin therapeutics include the oral DPP-4 inhibitors, which have moderate glucose-lowering efficacy, and the injectable GLP-1 receptor agonists (RA), which have potent glucose-lowering efficacy and can be safely combined with other medications, including basal insulin. These agents effectively target both fasting and postprandial hyperglycemia, do not cause weight gain, and have low risk for hypoglycemia.. In this monograph, we will review the goals of therapy in T2DM, the frequent need for combination therapy, and the ...
Participants who experienced persistent hyperglycemia (high blood glucose) could have qualified for hyperglycemia rescue. The conditions for hyperglycemia rescue were as follows: FPG ,=280 milligrams/deciliter (mg/dL) between ,=Week 2 and ,Week 4; FPG ,=250 mg/dL between ,=Week 4 and ,Week 12; HbA1c ,=8.5% and a ,=0.5% reduction from Baseline between ,=Week 12 and ,Week 24; HbA1c ,=8.5% between ,=Week 24 and ,Week 48; HbA1c ,=8.0% between ,= Week 48 and ,Week 156. Participants could have been rescued at any time on or after Week 2. Time to hyperglycemia rescue is defined as the time between the date of the first dose of study medication and the date of hyperglycemia rescue plus 1 day, or the time between the date of the first dose of study medication and the date of the last visit during the active treatment period plus 1 day for participants not requiring rescue. This time was divided by 7 to express the result in weeks ...
The association between hyperglycemia and increased mortality associated with acute coronary syndrome (ACS) has been studied and affirmed. Although more studies are needed to explore how managing this hyperglycemia can affect ACS mortality, the need to educate regarding current data is urgent so that it can be clinically applied. Reviews, randomized controlled trials, and other studies were obtained by means of electronic search strategies, such as Medline and Cochrane Library, as well as hand selection. Sources selected were limited to those that discussed ACS and hyperglycemia, and specific emphasis was placed on sources that focused on ACS and hyperglycemia in conjunction with one another ...
Admission blood glucose predicts mortality and length of stay in patients admitted through the emergency department. Martin WG, Galligan J et al. Internal Medical Journal. Doi: 10.1111/imj.12841. The need to control blood glucose levels in patients with acute illness in hospital is well established and has lead to the development of guidelines for these patients especially the recognition that referral to the inpatient diabetes team is necessary. However, patients without a diagnosis of diabetes often present with hyperglycaemia, possibly due to unrecognised diabetes or stress hyperglycaemia. This retrospective observational study showed that an admission glucose ,11.5mmol/l was significantly associated with increased 90 day mortality in those patients without a diagnosis of diabetes. This was not the case in those patients with a diagnosis - although their length of stay was longer. There is a need to recognise the importance of glycaemic control in all patients, not just those with diabetes - ...
Cardiovascular disease (CVD) is the main cause of mortality in type 1 diabetes (T1D) patients. Chronic hyperglycemia has been linked to progression of coronary artery calcification and CVD events. Physical activity (PA) may improve hyperglycemia in T1D patients. The objective of this study was to analyze the relationship between PA and glucose parameters obtained from Continuous Glucose Monitoring (CGM).. This study included 43 women with T1D who were 33±9 (mean±SD) years of age from the Women, Insulin and Sex Hormones study. Subjects wore a CGM (Dexcom SEVEN PLUS) for an average of 14±12 days. Glycemic control was evaluated by the average mean glucose, percentage of values within target range (70-180mg/dL), hypoglycemic (,70mg/dL), hyperglycemic (,180mg/dL), and hemoglobin A1c (HbA1c). Participants were classified into two categories, met (n=8) or did not meet (n=34) the AHA guidelines for moderate PA of at least 150 minutes or vigorous PA of at least 60 minutes per week.. T1D women who met ...
Doctor answers on Symptoms, Diagnosis, Treatment, and More: Dr. Dowd on is hyperglycemia the same as diabetes: Hypergycemia is high blood sugar concentration in the blood. It can occur in diabetics but also in people with pre-diabetes so hyperglycemia alone does not give you the diagnosis of diabetes. for topic: Is Hyperglycemia The Same As Diabetes
Introduction: Over half of COPD patients hospitalised for exacerbations have elevated blood glucose. Acute hyperglycaemia is associated with increased risk of death and prolonged hospital stay [Baker et al Thorax;61:284-9]. We investigated the effect of acute hyperglycaemia and insulin therapy on systemic inflammation.. Methods: 8 stable COPD patients (4male, 66±8yrs, FEV1 44±16%predicted) and 8 volunteers (8male, 24±5yrs, FEV1 89±12%) with fasting glucose ,7mM received an octreotide infusion to inhibit pancreatic function. Glucose and insulin were infused for 4 consecutive 60min periods to achieve: Low glucose (fasting), low insulin (0.3mU.kg-1.min-1); high glucose (10mM above fasting levels), low insulin; high glucose, high insulin (1.5mU.kg-1.min-1); low glucose, high insulin. Cytokines were measured in blood sampled at the end of each 60min period using a Bio-Plex system (Bio-Rad).. Results: In COPD, high glucose, low insulin increased IP10 by 48 (12-181)% (median (interquartile range)), ...
RESEARCH DESIGN AND METHODS We evaluated 13,621 patient discharges with a primary diagnosis of PE from 185 acute care hospitals in Pennsylvania (from January 2000 to November 2002). Admission glucose levels were analyzed as a categorical variable (≤110, ,110-140, ,140-170, ,170-240, and ,240 mg/dL). The outcomes were 30-day all-cause mortality and hospital readmission. We used random-intercept logistic regression to assess the independent association between admission glucose levels and mortality and hospital readmission, adjusting for patient (age, sex, race, insurance, comorbid conditions, severity of illness, laboratory parameters, and thrombolysis) and hospital (region, size, and teaching status) factors. ...
What is Hyperglycemia? meaning and definition of Hyperglycemia on Cancer, Health terms. full Cancer, Health glossary and dictionary
Results The fasting hyperglycemic patients were significantly older and had significantly more in-hospital complications than the normal blood glucose group. Previously known diabetic subjects tended to be older and had more mechanical complications postinfarction than the group with normal blood glucose but the difference did not reach statistical significance. There was no significant difference between the diabetic subjects and patients with fasting hyperglycemia in mean age and in-hospital prognosis.. ...
Diabetes mellitus Diabetes mellitus is a metabolic abnormality in which there is a failure to utilise glucose and hence a state of hyperglycaemia can occur. If hyperglycaemia continues uncontrolled over time, it will lead to significant and widespread pathological changes, including involvement of the retina, brain and kidney. In industrialised countries, approximately 1% of the…