Diabetes technology & therapeutics
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Diabetes Technol. Ther. · Aug 2010
ReviewResolution of type 2 diabetes following bariatric surgery: implications for adults and adolescents.
Bariatric surgery is now widely reported to ameliorate or resolve type 2 diabetes mellitus in adults. Some clinical investigators even suggest its use as an early therapeutic intervention for type 2 diabetes in patients not meeting standard criteria for bariatric surgery. ⋯ We outline current hypotheses regarding the mechanisms by which these surgical procedures affect diabetes and report on morbidity and mortality. Finally, we discuss the available data on bariatric surgery in adolescent patients, including special considerations in this potentially vulnerable population.
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Diabetes Technol. Ther. · Aug 2010
Comparative StudyIncidence of hypoglycemia with tight glycemic control protocols: a comparative study.
Comparison of hypoglycemia incidence among tight glycemic control (TGC) protocols is a crucial aspect that has not been done in previous trials. This study compared the incidence of hypoglycemia using three TGC protocols in critically ill patients. ⋯ TGC protocols vary in their risk of inducing hypoglycemia. Whether this translates into differences in clinical outcomes such as mortality and adverse effects is still to be determined by future studies.
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Diabetes Technol. Ther. · Jul 2010
The performance of a glucose-ketone meter in the diagnosis of diabetic ketoacidosis in patients with type 2 diabetes in the emergency room.
Diabetic ketoacidosis (DKA) is a serious metabolic complication. One of its precipitating causes is insulin omission. DKA requires early diagnosis and strict glucose control, which increases the use of glucose meters in the Emergency Room (ER). We aimed to determine the performance of a glucose-ketone meter in the diagnosis of DKA. ⋯ Implementation of measures such as home glucose and ketone monitoring can possibly decrease the number of hospital admissions due to DKA.
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Diabetes Technol. Ther. · Jun 2010
Randomized Controlled Trial Clinical TrialA diabetes-specific enteral formula improves glycemic variability in patients with type 2 diabetes.
Well-controlled studies have demonstrated that inpatient hyperglycemia is an indicator of poor clinical outcomes, but the use of diabetes-specific enteral formulas in hospitalized patients remains a topic of great debate. ⋯ Relative to the standard formula, the diabetes-specific formula reduced postprandial glycemia, mean glucose, glycemic variability, and short-acting insulin requirements. These results suggest potential clinical usefulness of a diabetes-specific enteral formula for minimizing glycemic excursions in hospitalized patients.
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Diabetes Technol. Ther. · Jun 2010
Effect of Veterans Administration use on indicators of diabetes care in a national sample of veterans.
Diabetes poses a serious health burden, of which veterans have a disproportionate share. Few data exist regarding differences in self-care behaviors and provider-based quality of care indicators among a large sample of veterans. The objective of this study was to determine the effect of Veterans Affairs (VA) use on diabetes quality of care indicators among veterans. ⋯ Key quality indicators for diabetes care were better among veterans getting some or all of their care from VA facilities, suggesting more effective care strategies. However, interventions should identify and perpetuate excellent self-care behaviors to more substantially impact adverse diabetes-related outcomes.