Link to this page

Your search term(s) "hypoglycemia" returned 234 results.

Page 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24    Display All

Home Blood Glucose Prediction: Validation, Safety, and Efficacy Testing in Clinical Diabetes. Diabetes Technology & Therapeutics. 7(3): 487-496. June 2005.

Patients with diabetes do daily self-monitoring of blood glucose (SMBG). For such patients, the authors devised a model that predicts not only the expected blood glucose level at the next meal but also the pending risks of hypoglycemia. This article reports on a study undertaken to validate the predictions based on this model and to provide evidence of the safety and effectiveness of using predicted data in dosing decision support for routine patient care. The prediction model is a computer program that access a central database into which daily records of SMBG are entered. Over the 6-month study period a total of 30,129 blood glucose levels were reported by the 54 study patients, and some 24,953 blood glucose predictions were made. Of these, 83 percent were in the clinically acceptable zones of the Clarke Error Grid. When these data were used for dosing decision support in the poor control group, glycated hemoglobin levels fell significantly from 9.7 percent (plus or minus 1.7 percent) to 7.9 percent (plus or minus 1.2 percent), and hypoglycemia dropped fourfold. Total daily insulin doses declined 22 percent, while body weight remained constant. In the parallel tight control group (n = 24), glycated hemoglobin also fell, but only slightly, while daily insulin doses, rates of hypoglycemia, and body weight remained constant. The authors conclude that the use of this computer model generated meaningful predictions of blood glucose levels and was helpful in decision support for managing medication doses safely and effectively. 1 figure. 3 tables. 30 references.

Full Record   Printer Friendly Version

Hospital Food Tips: Practical Advice for Eating Healthy When Hospitalized. Diabetes Forecast. 58(9): 59-60. September 2005.

This article provides nutrition tips for readers with diabetes who need to have hospital care. Readers are encouraged to take an active role in managing most or all aspects of their own diabetes care. Topics include the different meal plans that may be used in the hospital, the need to maintain caloric intake, how to avoid low blood glucose (hypoglycemia) in the hospital, working with the hospital dietitian, liquid diets (usually used just after surgery), adjusting insulin or other medications to manage times during the hospital stay when fasting is required, and how to manage a missed meal while hospitalized. The author tries to explain the various situations that patients may encounter regarding medications and food.

Full Record   Printer Friendly Version

How Good is Your Glucose Control?. Diabetes Technology & Therapeutics. 7(6): 863-875. December 2005.

Blood glucose control is the basis of the management of diabetes and maintenance of health. Blood glucose control is usually measured by self monitoring of blood glucose (SMBG), used to evaluate present glycemic status and response to therapy, and HbA1c (glycosylated hemoglobin), a measurement of blood glucose levels over time that is not sensitive to low blood glucose dips (hypoglycemia). This article reports on the use of an additional measure of performance in diabetes management in general and of glycemic control in particular. The authors adapted a graphical method of analysis from the statistician's toolbox (known as the lag plot) to form a visual measure of performance. The lag plot can use SMBG data sets from any source, including memory meters and registry databases in call centers. Data are retrieved, processed, formatted, and then plotted on a PC screen or printer. The resulting lag plots visually characterize the performance of glucose control achieved over periods ranging from days to months. The authors describe the clinical use of the lag plot in seven case studies ranging from a person without diabetes, through glucose intolerance, early onset type 2 diabetes, type 1 diabetes, intensified therapy, pump therapy, and finally islet call transplantation. The visual comparisons before and after action or referral show the impact of interventions, incidences of hypoglycemia, and changes in the polyglycemia of unstable diabetes. The authors conclude that the simple lag plot can empower patients and their providers to identify problems in glycemic control, seek proactive action, adopt beneficial strategies, evaluate outcomes, and, most importantly, rule out interventions with no benefit. 5 figures. 2 tables. 34 references.

Full Record   Printer Friendly Version

Hyperglycemia in the Hospital. Diabetes Spectrum. 18(1): 20-27. Winter 2005.

This article reviews the use of subcutaneous insulin for hospitalized patients with diabetes mellitus. The authors discuss the rationale for using insulin; scheduled insulin therapy to cover basal and nutritional needs; correction therapy; dose determination; establishment of timing of insulin action appropriate to the pattern of carbohydrate exposure; education of caregivers; and the design of hospital systems that will promote quality and help staff to manage complexity. The authors conclude with a brief discussion of how hospitals can move in the direction of intensifying treatment of hospital hyperglycemia, which will result in improved patient outcomes and cost reductions.. They focus on the importance of a multidisciplinary team of health caregivers and hospital administrators, working together to design and implement these initiatives. Recommended strategies include screening for hyperglycemia; knowledge of appropriate glycemic targets; spread of the use of intravenous insulin infusion; recognition of unsafe situations leading to hypoglycemia or ketosis; preservation of basal insulin regimens for type 1 diabetes; facilitation of inpatient diabetes self-management for experienced and competent patients; elimination of sliding scale monotherapy; creation of order sets and computerized clinical systems that facilitate regimen selection, intensification, and daily revision of insulin therapy; and appropriate patient education and discharge planning. 6 figures. 2 tables. 74 references.

Full Record   Printer Friendly Version

Hypoglycemia in Type 2 Diabetes: Pathophysiology, Frequency, and Effects of Different Treatment Modalities. Diabetes Care. 38(12): 2948-2961. December 2005.

This article reports on a literature review of hypoglycemia (low blood glucose levels) in type 2 diabetes, focusing on pathophysiology, frequency, and the effects of different treatment modalities. The authors used the bibliographic database PubMed to identify publications in English from 1984 until 2005 related to hypoglycemia associated with treatment of type 2 diabetes, and the bibliographies were searched for additional citations. Specific topics include normal physiological responses to hypoglycemia, the effects of aging on the responses to hypoglycemia, the effects of type 2 diabetes on the responses to hypoglycemia, morbidity of hypoglycemia in type 2 diabetes and in the elderly, epidemiological data from interventional trials and from observational studies, moderators of hypoglycemia in type 2 diabetes, oral antidiabetes agents, alternative insulin regimens, and new agents for the treatment of type 2 diabetes. The author concludes that in older people, effective self-treatment of hypoglycemia may be compromised by the juxtaposition of the glycemic thresholds for onset of symptoms and cognitive dysfunction, which occur almost simultaneously, and these age-related changes will be relevant to many people with type 2 diabetes. The author cautions that the lack of data from elderly people is of concern, as this age-group is at greatest risk from the morbidity of hypoglycemia. 5 figures. 2 tables. 151 references.

Full Record   Printer Friendly Version

Inhaled Insulin Improves Glycemic Control When Substituted for or Added to Oral Combination Therapy in Type 2 Diabetes: A Randomized, Controlled Trial. Annals of Internal Medicine. 143(8): 549-558. October 2005.

Patients with type 2 diabetes who do not achieve glycemic control with oral drug therapy eventually require insulin. This article reports on a study undertaken to determine the effect on glycemic control of inhaled insulin alone or added to dual oral therapy (insulin secretagogue and sensitizer) after failure of dual oral therapy. The open-label, randomized, controlled trial set in 48 outpatient centers in the United States and Canada included 309 patients with type 2 diabetes, no clinically significant respiratory disease, and HbA1c (glycosylated hemoglobin, a measure of blood glucose over time) level of 8 percent to 11 percent who were receiving dual oral therapy. The patients were given inhaled insulin (Exubera), titrated to blood glucose, administered alone (n = 104) or added to dual oral agents (n = 103) versus oral therapy alone (n = 99). Results showed that reductions in HbA1c level were greater with inhaled insulin. HbA1c level less than 7 percent was achieved by 32 percent of the patients using inhaled insulin plus oral agents and by 1 percent of patients on oral agent therapy. Hypoglycemia, mild weight gain, mild cough, and insulin antibodies were more frequent with inhaled insulin than with oral agent therapy alone. Pulmonary function was similar in all groups. The authors conclude that inhaled insulin improved overall glycemic control and HbA1c level when added to or substituted for dual oral agent therapy with an insulin secretagogue and sensitizer. Similar to other insulin therapies, hypoglycemia and mild weight gain occurred. 4 figures. 3 tables. 42 references.

Full Record   Printer Friendly Version

Insulin Pump Therapy in Preschool Children with Type 1 Diabetes Mellitus Improves Glycemic Control and Decreases Glucose Excursions and Risk of Hypoglycemia. Diabetes Technology & Therapeutics. 7(6): 876-884. December 2005.

Hypoglycemia (low blood glucose levels) in preschool children limits the effectiveness of insulin therapy. This article reports on a study of insulin pump therapy (continuous subcutaneous insulin infusion or CSII) in preschool children with type 1 diabetes. The authors test the hypothesis that, compared with twice-daily insulin injection, CSII decreases the standard deviation (SD) of the mean daily blood glucose (BG) and improves glycemic control. The study was also designed to evaluate the effect of CSII on parental anxiety using the Parental Stress Index (PSI) scale. The study included 10 subjects younger than 6 years of age and currently receiving insulin injections. Each underwent two 72-hour monitoring periods on an insulin pump and then was started on CSII and remonitored 3 and 6 months later. There was a 22 percent decrease in the BG variability and a 13 percent decreased in HbA1c (glycosylated hemoglobin, a measure of blood glucose over time) in children on CSII. There was a decrease in the 24-hour median number and duration of hypoglycemic episodes, as well as the median number and duration of nighttime episodes. There was no statistically significant change found in the PSI score. The authors conclude that CSII in preschool children is feasible and safe. 3 figures. 1 table. 20 references.

Full Record   Printer Friendly Version

Joslin's Diabetes Mellitus. 14th ed. Philadelphia, PA: Lippincott Williams and Wilkins. 2005. 1209 p.

The comprehensive diabetes textbook reflects the practice and experiences of the physicians of the Joslin Diabetes Center and updates the information presented in the last version of the text published 10 years ago. The text offers 70 chapters in eight sections: basic mechanisms of islet development and function; hormone action and the regulation of metabolism; the definition, genetics, and pathogenesis of diabetes; obesity and lipoprotein disorders; treatment of diabetes mellitus; biology of the complications of diabetes; clinical aspects of managing diabetic complications; and hypoglycemia and islet cell tumors. Specific topics include genetic regulation of islet function, insulin biosynthesis, insulinlike growth factors, glucagon and glucagonlike peptides, fat and protein metabolism in diabetes, maturity-onset diabetes of the young (MODY), syndromes of extreme insulin resistance, diabetes in minorities in the United States, lipid disorders in diabetes, medical nutrition therapy (MNT), psychological issues in diabetes, iatrogenic hypoglycemia, the economic and social costs of diabetes, diabetic neuropathy, diabetic nephropathy, diabetic retinopathy, cardiovascular disease in diabetes, erectile dysfunction, diabetes and wound healing, and endocrine tumors of the pancreas. Each chapter is illustrated with tables and figures and includes a list of references; a subject index concludes the volume.

Full Record   Printer Friendly Version

Living Your Life With Diabetes: A Self-Care Handbook. South Deerfield, MA: Channing Bete Company. 2005. 30 p.

This booklet helps readers recently diagnosed with diabetes understand the complexities of a basic diabetes care program. The booklet begins with a description of both type 1 and type 2 diabetes, as well as an overview of the three components of care: medications, including insulin; exercise; and meal planning. The booklet then covers each of these components in detail, including blood sugar monitoring (SMBG), using a food pyramid, carbohydrate counting, exchange lists, food labels, meal planning, exercise, insulin and diabetes pills, preparing and giving an insulin shot, coping with sick days, hypoglycemia, hyperglycemia, ketone testing, long term complications and how to prevent them, foot care, travel tips, and emotional health. The booklet focuses on practical tips and guidelines to help readers quickly learn about and undertake the care required for diabetes management. A tear-out card is provided, on which readers can record their medication schedule. The inside front cover also provides space to record health care providers' names and telephone numbers. 18 figures. 3 tables.

Full Record   Printer Friendly Version

Lows and Your Pregnancy. Diabetes Forecast. 58(4): 61-64. April 2005.

For women with gestational diabetes, tight control of blood glucose during pregnancy is good for both mother and child, but it may put the mother at risk for low blood glucose (hypoglycemia). This article reviews how to prevent hypoglycemia and how to handle episodes of low blood glucose. The author notes that the hormones produced in the placenta during pregnancy may boost the mother's blood glucose so much that the body needs three times the amount of insulin used before the pregnancy. The author briefly reviews the complications associated with hyperglycemia during pregnancy, target blood glucose levels, and the symptoms and treatment of hypoglycemia. One sidebar outlines a recommended plan for coping with a measured low blood glucose level. The author concludes that keeping tabs on blood glucose levels, maintaining tight control on diabetes, and knowing how and when to treat a low blood glucose level can help ensure that the pregnancy goes smoothly. 3 figures.

Full Record   Printer Friendly Version

Page 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24    Display All

Start a new search.