Search results for "glycemia"

¿De qué nos sirve evaluar las tendencias del perfil glucémico ambulatorio?

2014

The ambulatory glucose profile is an instrument used to detect blood glucose patterns from patient results by recording blood glucose results or, more usually, by continuous glucose monitoring. This instrument analyzes the changes in glucose levels obtained over a number of days, and expresses the data, depending on the time of the day, using the median and the 10th, 25th, 75th and 90th percentiles. It is very useful for identifying glycemic patterns over the day, to quantify blood glucose variability, and to classify hypoglycemia risk according to time. This should be complemented with the analysis of individual blood glucose data, diet, and exercise, to detect potential causes of variabil…

A Decision Support Tool for Appropriate Glucose-Lowering Therapy in Patients with Type 2 Diabetes

2015

Contains fulltext : 152084.pdf (Publisher’s version ) (Open Access) BACKGROUND: Optimal glucose-lowering therapy in type 2 diabetes mellitus requires a patient-specific approach. Although a good framework, current guidelines are insufficiently detailed to address the different phenotypes and individual needs of patients seen in daily practice. We developed a patient-specific decision support tool based on a systematic analysis of expert opinion. MATERIALS AND METHODS: Based on the American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) 2012 position statement, a panel of 12 European experts rated the appropriateness (RAND/UCLA Appropriateness Method) of tre…

Diabetes Mellitus and Ramadan: Physiopathological, Clinical and Therapeutic Aspects

2017

Fasting from dawn to sunset during Ramadan is one of the five pillars of Islam. A significant number of diabetic patients insist on fasting during Ramadan against the recommendations of their physicians. Fasting in diabetic subjects may be associated with increased risk of hypoglycemia and hyperglycemia, diabetic ketoacidosis, dehydration and thrombosis. Patients with uncontrolled diabetes mellitus are predisposed to major metabolic risks. Another problem is the reluctance of diabetic patients in taking their medications during the fast; therefore the timing and the dosage of anti-diabetic drugs must be adapted for each patient. It is important for diabetic patients who wish to fast during …

Transient chylomicronemia preceding the onset of insulin-dependent diabetes in a young girl with no humoral markers of islet autoimmunity

2004

OBJECTIVE: We investigated the possible causes of diabetes in a young child who presented with hyperglycemia associated with severe hypertriglyceridemia (>166 mmol/l), hypercholesterolemia (>38 mmol/l) and fasting chilomicrons. RESULTS: The patient did not have any of the HLA and autoantibody markers typically associated with type 1 diabetes. A glucose clamp failed to demonstrate insulin resistance (peripheral glucose utilization rate (M)=4.3 mg/kg per min) and there was no family history of type 2 diabetes or maturity onset diabetes in youth. Both fasting and stimulated C-peptide levels, including those in response to i.v. glucagon, were below the limit of detection. This is consiste…

Development of a fuzzy expert system for the control of glycemia in type 1 diabetic patients

2011

Abstract The paper describes the structure and the characteristics of an expert system that allows the optimization of postprandial glycemia in type 1 diabetic patients. The expert system is able to provide patients with the number of rapid insulin units that must be taken in order to keep the blood glucose level close to the omeostatic condition in the hours following a meal.

Management of Diabetes in Candidates for Liver Transplantation and in Transplant Recipients.

2021

Diabetes is common in patients wait-listed for liver transplantation due to end-stage liver disease or to hepatocellular cancer as well as in post-transplant phase (post-transplantation diabetes mellitus-PTDM). In both conditions the presence of diabetes severely affects disease burden and long-term clinical outcomes; careful monitoring and appropriate treatment are pivotal to reduce cardiovascular events and graft and recipients' death. We thoroughly reviewed the epidemiology of diabetes in the transplant setting and the different therapeutic options, from lifestyle intervention to antidiabetic drug use - including the most recent drug classes available - and to the inclusion of bariatric …

Seven-day subcutaneous continuous glucose monitoring demonstrates that treatment with acarbose attenuates late dumping syndrome in a woman with gastr…

2013

Direct antiviral agents in hepatitis C virus related liver disease: Don’t count the chickens before they’re hatched

2021

Since molecules with direct-acting antiviral (DAA) became available, the landscape of the treatment of hepatitis C virus (HCV) infection has completely changed. The new drugs are extremely effective in eradicating infection, and treatment is very well tolerated with a duration of 8-12 wk. This review aims to report the outstanding clinical benefits of DAA and to highlight their critical disadvantages, identifying some clinically relevant hot topics. First, do the rates of virological response remain as high when patients with more advanced cirrhosis are considered? Large studies have shown slightly lower but still satisfactory rates of response in these patients. Nevertheless, modified sche…

GLP-1 Receptor agonists and diabetic kidney disease: A call of attention to nephrologists

2020

Type 2 diabetes mellitus (T2DM) represents the main cause of chronic kidney disease (CKD) and end-stage renal disease (ESKD), and diabetic kidney disease (DKD) is a major cause of morbidity and mortality in diabetes. Despite advances in the nephroprotective treatment of T2DM, DKD remains the most common complication, driving the need for renal replacement therapies (RRT) worldwide, and its incidence is increasing. Until recently, prevention of DKD progression was based around strict blood pressure (BP) control, using renin–angiotensin system blockers that simultaneously reduce BP and proteinuria, adequate glycemic control and control of cardiovascular risk factors. Glucagon-like peptide-1 r…

Age-related changes in cholesterol metabolism in macrosomic offspring of rats with streptozotocin-induced diabetes.

2001

The aim of this study was to determine the impact of diabetic macrosomia on cholesterol and lipoprotein metabolism. Age-related changes in the activities of serum LCAT, hepatic HMG-CoA reductase, cholesterol 7α-hydroxylase, and ACAT, the major enzymes involved in cholesterol metabolism, were determined in macrosomic offspring of streptozotocin-induced diabetic rats. Hepatic, serum, and lipoprotein cholesterol contents were also examined. Mild hyperglycemia in pregnant rats was induced by intraperitoneal injection of streptozotocin (40 mg/kg body weight) on day 5 of gestation. Control pregnant rats were injected with citrate buffer. At birth, macrosomic pups had higher serum, LDL-HDL1, and H…