Hypoglycemia in Diabetics on Dialysis with Poor Glycemic Control: Hemodialysis versus Continuous Ambulatory Peritoneal Dialysis

1992 ◽  
Vol 15 (7) ◽  
pp. 390-392 ◽  
Author(s):  
A.H. Tzamaloukas ◽  
G.H. Murata ◽  
B. Eisenberg ◽  
G. Murphy ◽  
P.S. Avasthi
Keyword(s):  
Heart Failure ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Glucose Concentration ◽  
Blood Glucose Concentration ◽  
Glycosylated Hemoglobin ◽  
Insulin Dose ◽  
Severe Congestive Heart Failure ◽  
Poor Glycemic Control ◽  
Mean Blood Glucose

Eight diabetic men with poor glycemic control, probably worsened by severe congestive heart failure and gastroparesis, were sequentially dialyzed by CAPD and hemodialysis. Mean blood glucose concentration, blood glycosylated hemoglobin, and insulin dose were higher during CAPD than during hemodialysis. Among blood glucose determinations, however, the frequency of hypoglycemia (glucose <3.3 mmol/L) was higher during hemodialysis (13.2 ± 8.9%) than during CAPD (2.8 ± 2.1% p = 0.012), whereas the frequencies of hyperglycemia (glucose >11.1 mmol/L) and euglycemia (glucose between 3.5 and 11.1 mmol/L) did not differ between the two dialysis modalities. Furthermore, hypoglycemia was severe during hemodialysis and was associated with two deaths. There were no deaths linked to abnormalities in blood glucose concentration during CAPD. When hypoglycemia is frequent in diabetics with poor glycemic control, CAPD is preferable to hemodialysis.

The evaluation of the ability of closed-loop glycemic control device to maintain the blood glucose concentration in intensive care unit patients*

2011 ◽  
Vol 39 (3) ◽  
pp. 575-578 ◽  
Author(s):  
Tomoaki Yatabe ◽  
Rie Yamazaki ◽  
Hiroyuki Kitagawa ◽  
Takehiro Okabayashi ◽  
Koichi Yamashita ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Glucose Concentration ◽  
Closed Loop ◽  
Blood Glucose Concentration ◽  
Control Device

scholarly journals Update on insulin treatment of dogs and cats with non-complicated diabetes mellitus

2018 ◽  
Vol 67 (2) ◽  
pp. 83
Author(s):  
M. N. SARIDOMICHELAKIS ◽  
M. K. CHATZIS
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Glucose Concentration ◽  
Insulin Treatment ◽  
Blood Glucose Concentration ◽  
Insulin Dose ◽  
Glucose Monitoring ◽  
Insulin Administration ◽  
Tight Control ◽  
Insulin Glargin

Diabetes mellitus is a common endocrine disease of dogs and cats. Treatment is mainly based on insulin administration and dietary modifications. The aim of this review is to provide updated information on insulin treatment of dogs and cats with non-complicated diabetes mellitus. During the last years, there has been significant progress in the management of this disease, thanks to the use of long-acting insulin preparations that do not cause pronounced fluctuations of blood glucose concentrations (insulin glargin and detemir) and because of the widespread use of home glucose monitoring by the owners of diabetic pets. Home glucose monitoring is based on capillary blood sampling from the ear pinnae or the foot pad and measurement of blood glucose concentration with a portable blood glucose meter. This can be done periodically (e.g. every week) to replace the traditional in-clinic blood glucose curve; in this case, blood glucose concentration is measured just before the morning insulin administration and then every 1-2 hours until the next dose (usually for 12 hours). Furthermore, especially for the cat, home glucose monitoring can be performed 3-5 times per day, on a daily basis, in order to safely adjust insulin dose and achieve tight control of hyperglycemia (i.e. blood glucose concentration between 50 and 200 mg dl-1 throughout the day). The combination of dietary management, of insulin glargine or detemir administration and of the tight control of hyperglycemia has substantially increased the proportion of cats that enter into temporal or permanent diabetic remission and can be further managed without insulin. Another important achievement is the use of continuous glucose monitoring systems to monitor interstitial fluid glucose concentrations. These devices can be used in the clinic and at home and they can measure glucose concentration every 5 minutes for up to 72 consecutive hours, thus facilitating optimal adjustment of insulin treatment.

scholarly journals Evaluation and follow up patients with diabetes mellitus who attended Sabratha diabetic center

2020 ◽  
Vol 8 (2) ◽  
pp. 340-343
Author(s):  
Khaled Ali ALawaini ◽  
Hanen Daw Sweed ◽  
Khalod Mohamed Sawesi ◽  
Fatma Abdusalam Kamoka ◽  
Sara Abugalel Alakrme ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Blood Glucose Concentration ◽  
Microvascular Disease ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Diabetes Incidence ◽  
Patients With Diabetes ◽  
Public Health Challenge ◽  
The Mean ◽  
Mean Blood Glucose

Background: Diabetes is a public health challenge facing the world. Awareness and long term diabetes have an enormous effect, including cardiovascular disease and microvascular disease. Objective: This study aimed to estimate diabetes incidence and it is complications. Methods: A hundred diabetic patients who attended Galil diabetic center in Sabratha city had participated in this study in May 2013. Results: The mean age was 56 years old. Diabetes was more prevalent in females than in males (62%vs38%). The mean blood glucose concentration was 168 mg/dl, reflecting poor glycemic control, as 16% of diabetic patients moved to treatment with insulin. Conclusion: Poor glycemic control means of fasting plasma glucose was 168 mg/dl, and 16% started to use insulin therapy, along with 15% had hypertension.

scholarly journals Pre-Exercise Blood Glucose Levels Determine the Amount of Orally Administered Carbohydrates during Physical Exercise in Individuals with Type 1 Diabetes—A Randomized Cross-Over Trial

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1287 ◽  
Author(s):  
Othmar Moser ◽  
Max L. Eckstein ◽  
Alexander Mueller ◽  
Philipp Birnbaumer ◽  
Felix Aberer ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glucose Concentration ◽  
Basal Insulin ◽  
Blood Glucose Concentration ◽  
Insulin Dose ◽  
Moderate Intensity ◽  
Rank Test ◽  
The Impact

The aim of the study was to assess the amount of orally administered carbohydrates needed to maintain euglycemia during moderate-intensity exercise in individuals with type 1 diabetes. Nine participants with type 1 diabetes (four women, age 32.1 ± 9.0 years, BMI 25.5 ± 3.9 kg/m2, HbA1c 55 ± 7 mmol/mol (7.2 ± 0.6%)) on insulin Degludec were randomized to cycle for 55 min at moderate intensity (63 ± 7% VO2peak) for five consecutive days on either 75% or 100% of their regular basal insulin dose. The impact of pre-exercise blood glucose concentration on the carbohydrate requirement was analyzed by one-way ANOVA stratified for pre-exercise blood glucose quartiles. The effect of the basal insulin dose on the amount of orally administered carbohydrates was evaluated by Wilcoxon matched-pairs signed-rank test. The amount of orally administered carbohydrates during the continuous exercise sessions was similar for both trial arms (75% or 100% basal insulin) with median [IQR] of 36 g (9–62 g) and 36 g (9–66 g) (p = 0.78). The amount of orally administered carbohydrates was determined by pre-exercise blood glucose concentration for both trial arms (p = 0.03). Our study elucidated the importance of pre-exercise glucose concentration related orally administered carbohydrates to maintain euglycemia during exercise in individuals with type 1 diabetes.

Characteristics of monitored diabetic patients by glycated haemoglobin (HbA1c)

2016 ◽  
Vol 5 (05) ◽  
pp. 4563
Author(s):  
Tariq A. Zafar
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Glycated Haemoglobin ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Age Group ◽  
Hba1c Test ◽  
Significant Difference ◽  
Tract Infections ◽  
The Impact

Glycated haemoglobin (HbA1c) test indicates the blood glucose levels for the previous two to three months. Using HbA1c test may overcome many of the practical issues and prevent infections such as urinary tract infections (UTIs). The study aimed to evaluate the impact of glycemic control using HbA1c test to understand patient characteristics and UTIs prevalence. Glycemic control was evaluated by measuring HbA1c for a total of 208 diabetes patients who were regularly attending diabetes center in Al-Noor specialist hospital in Makkah.  The results showed that good and moderate glycemic controlled patients were 14.9% and 16.9% respectively while the poor glycemic patients were 68.3%. Among the good improved glycemic control, 83.9% were females, 48.4% were from age group (15-44y). Among the moderately improved glycemic control, 68.4% were females, 54.3% were from age group (45-64 y) with no significant difference. The total number of the patients with positive UTIs was 55 (26.4%) while the total number of patients with negative was UTIs 153 (73.6%). Among the positive UTIs, 76.3% were with poor glycemic control while only 12.3% and 11% were moderate and good improved glycemic control respectively. Among the negative UTIs, 65.3% were with poor glycemic control while only 19% and 15.7% were with moderate and good improved glycemic control respectively.  Prevalence of UTIs among diabetic patients was not significant (p > 0.05). It was concluded that HbA1c was useful monitoring tool for diabetes mellitus and may lead to improved outcomes. Using a HbA1c test may overcome many of the practical issues that affect the blood glucose tests.

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