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

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Healthy Aging with Diabetes. Diabetes Self-Management. 23(1): 20-22. January February 2006.

This article explores issues that older people with diabetes may face as they age. The author discusses the effects of diabetes on aging and vice versa, offering recommendations for readers who want to stay healthy and full of vitality well into old age. Topics include the basal metabolic rate, aerobic capacity, glucose intolerance, changes in bone metabolism and strength, problems with joints (including arthritis), blood pressure, visual and hearing acuity, cognitive changes associated with aging, nonenzymatic glycation, advanced glycosylation endproducts (AGEs), the interplay of diabetes complications and aging, the impact of aging on blood glucose control strategies, coping with multiple medications (for comorbid conditions as well as for diabetes), and hypoglycemia. The article concludes with a list of suggestions to help counteract the effects of diabetes and aging, including pay attention to monitoring numbers (blood glucose, blood pressure, blood lipid), stay physically active, eat healthy foods, get adequate sleep, take medications carefully, get regular checkups, stay mentally active, and give up vices, especially smoking.

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Hypoglycaemia. IN: Katsilambros, N., et al. Diabetes in Clinical Practice: Questions and Answers From Case Studies. Somerset, NJ: John Wiley & Sons. 2006. pp 71-80.

This chapter on hypoglycemia is from a book that deals with various aspects of diabetes in clinical practice, presented in the form of questions concerning diabetes diagnosis, management, and therapy, all based on real-life case studies. The author notes that episodes of hypoglycemia are usually perceived and treated by the patients themselves. However, if not detected early enough, hypoglycemia can lead to serious problems, including coma. Topics covered include the effects of hypoglycemia in type 1 and type 2 diabetes, the causes of hypoglycemia in a person with diabetes, the symptoms of hypoglycemia, the indications for hospitalization for episodes of hypoglycemia, and posthospitalization patient care and follow-up. The chapter presents five case studies, which are individually discussed, and relevant questions are posed and answered. Readers are walked through the diagnostic and patient care management processes for the case studies presented. 3 references.

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Hypoglycemia in Newborns and Infants. Advances in Pediatrics. 53: 5-22. August 2006.

This article reviews the problem of hypoglycemia in newborns and infants. The authors first describe the changes that must occur at birth when the umbilical cord is cut and the infant goes from total dependence on maternal nutrient supply to independence from the mother and dependence on endogenous fuels. This change requires an immediate, coordinated, and integrated series of hormonal and enzymatic changes, including surges in glucagon and catecholamines, with decreases in insulin concentrations. The authors focus on the application of newer biochemical and molecular techniques that have been used to define hypoglycemic syndromes, particularly those that are due to hyperinsulinemia. Topics include the sensing of hypoglycemia by ATP-regulated potassium channels and the ventromedial hypothalamic nucleus for counter regulation, mechanisms of hypoglycemic central nervous system damage, the signs and symptoms of hypoglycemia, classification, and the management of hyperinsulinemic hypoglycemic of infancy. 2 figures. 3 tables. 66 references.

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Hypoglycemia in Type 1 and Type 2 Diabetes: Physiology, Pathophysiology and Management. Clinical Diabetes. 24(3): 115-121. Summer 2006.

This article reviews the physiology, pathophysiology and management of hypoglycemia in type 1 and type 2 diabetes. The authors note that the threat of hypoglycemia is the major limiting factor in intensive glycemic control for both types of diabetes. The authors focus on the physiology of the normal counter-regulatory responses to hypoglycemia and the deficient counter-regulatory defenses that occur in patients with diabetes. They contend that the combination of understanding the physiological reaction and monitoring glycemic therapy can help reduce the prevalence of iatrogenic hypoglycemia. Topics include the symptoms of hypoglycemia, hypoglycemia and glycemic thresholds, counter-regulatory hormone responses to hypoglycemia in older adults, and exercise-related hypoglycemia. The article concludes with a section of strategies to reduce the risk of iatrogenic hypoglycemia. 3 tables. 48 references.

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Inhalable Insulin is On the Way. Diabetes Forecast. 59(4): 15. April 2006.

This brief article alerts readers to the new, inhalable insulin called Exubera (Pfizer, Inc., and Nektar Therapeutics). Exubera is a mealtime insulin in powdered form that patients use not more than 10 minutes before eating. The insulin is delivered in a special inhaler that is used by drawing a regular breath. The inhaler does not require batteries or electricity, and weighs about 4 ounces. For patients with type 1 diabetes, Exubera may be used in place of mealtime injections of rapid-acting insulin, but patients would still need to take their regular injections of longer-acting insulin. For patients with type 2 diabetes, Exubera may be used as an alternative to diabetes pills or mealtime insulin injections, or in combination with pills or longer-acting injectable insulin. Side effects can include low blood glucose (hypoglycemia), dry mouth, chest discomfort, and decreased lung capacity. Readers are referred to the Pfizer education number for more information (800-398-2372 or www.exubera.com).

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Learning to Use Pramlintide. Practical Diabetology. 25(1): 42-46. March 2006.

Pramlintide (Symlin) was approved in 2005 for use together with insulin in patients with type 1 and type 2 diabetes. Pramlintide is a synthetically produced analog of the hormone amylin and reduces postprandial hyperglycemia, or high blood glucose levels after a meal, and glycosylated hemoglobin—HbA1c, a measure of blood glucose over time—while reducing body weight. This article reviews current knowledge about pramlintide, in terms of mechanism of action, effectiveness, and clinical use. Pramlintide is approved only for use by patients already taking both basal and mealtime insulin. It is administrated subcutaneously in the same manner as insulin and is given immediately before major meals. Clinical observations suggest that many patients feel better when taking pramlintide, even more so than would be expected by improvements in HbA1c or weight. Dosing strategies can be used to avoid the main adverse effect of pramlintide, which is insulin-induced hypoglycemia that can accompany the initiation of pramlintide. 3 tables. 5 references.

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Managing the Diabetic Patient in a Weight-Loss Program. Diabetes Spectrum. 25(4): 30-36. December 2006.

This review provides the strategies and guidelines necessary to manage overweight and obese individuals with diabetes in a weight-loss program. The author stresses that to safely improve blood glucose levels, blood pressure, and lipids, the optimal approach to weight management is close medical monitoring by an experienced health care professional in a structured program. The author describes the initial patient evaluation, establishing goals, medical monitoring, lifestyle change strategies, and medication management. Successful management of obesity can be particularly rewarding for the patient with diabetes, resulting in improved glycemic control and reduced medication needs. However, the interplay of reduced caloric intake and oral hypoglycemic agents is complex and must be closely monitored to avoid complications such as hypoglycemia. 1 figure. 3 tables. 19 references.

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Medical Treatment of the Obese Patient with Type 2 Diabetes. IN: Obesity and Diabetes. Totowa, NJ: Humana Press. 2006. pp. 471-486.

This chapter, from a comprehensive textbook on diabetes and obesity, focuses on the medical treatment of type 2 diabetes, with a special emphasis on the approach to the obese patient with this disease. Topics include the pathophysiology and natural history of type 2 diabetes, the goals of therapy and monitoring in type 2 diabetes, medical nutrition therapy (MNT) and exercise, oral antihyperglycemic agents, available insulin formulations, the approach to insulin use in obese patients with type 2 diabetes, and future therapies. The authors conclude that the goal of treatment is to achieve and maintain near-normal glycemic control without increasing the risk of hypoglycemia. MNT and exercise form the cornerstone of a comprehensive management program, but the vast majority of patients require drug therapy to achieve and maintain optimal blood glucose levels. For the obese patient with diabetes, insulin sensitizers are effective medications, and combination therapy with insulin secretagogues and sensitizers should be considered in patients with suboptimal control. Insulin remains an important component of the treatment regimens for patients not achieving target blood glucose goals with oral agents. 1 figure. 4 tables. 110 references.

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New Therapies in Diabetes. IN: Katsilambros, N., et al. Diabetes in Clinical Practice: Questions and Answers From Case Studies. . Somerset, NJ: John Wiley & Sons. 2006. pp 409-436.

This chapter on new therapies in diabetes is from a book that deals with various aspects of diabetes in clinical practice, presented in the form of questions concerning diabetes diagnosis, management, and therapy, all based on real-life case studies. Topics covered include the use of continuous subcutaneous insulin infusion pumps, the different types of insulin pumps available, the components of an insulin pump, how the basal rate is determined, how the boluses are determined, patient indications for the use of an insulin pump, the use of an insulin pump to help prevent hypoglycemia unawareness, complications associated with an insulin pump, patient care management and follow up for a patient using an insulin pump, the use of inhaled insulin, the metabolism of inhaled insulin, complications regarding the use of inhaled insulin, the use of inhaled insulin in patients who smoke, kidney and pancreas transplantation, transplantation of pancreatic islets, glucagon-like peptide (GLP-1) in patients with type 2 diabetes, amylin, pramlintide, and the artificial pancreas. The chapter presents one detailed case study, with relevant questions posed and answered. Readers are walked through the diagnostic and patient care management process for the case study presented. 1 figure. 28 references.

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Nutrition Support and Hyperglycemia. IN: Mechanick, J.; Brett, E., eds. Nutritional Strategies for the Diabetic and Prediabetic Patient. Boca Raton, FL: CRC Press. 2006. pp. 171-192.

This chapter on nutrition support and hyperglycemia is from a book written to advance physicians’ knowledge in nutrition as it relates to diabetes and to help them provide evidence-based recommendations to their patients with diabetes. Hyperglycemia in patients receiving nutrition support may be due to type 1 diabetes, type 2 diabetes, or stress hyperglycemia. Stress hyperglycemia is the presence of elevated glucose during an acute illness, in a patient without a prior diagnosis of diabetes, which normalizes after the illness. The author covers the causes of hyperglycemia, the rationale for glycemic control in hospitalized patients, clinical practice guidelines for glycemic control among hospitalized patients, nutrition support, parenteral nutrition, enteral nutrition, and hypoglycemia. The sections on parenteral and enteral nutrition discuss macronutrient requirements, insulinization, and micronutrient supplements. The author notes that the majority of patients who receive nutrition support are hospitalized patients with acute illnesses that require temporary nutrition support. 1 figure. 4 tables. 169 references.

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