scholarly journals Perioperative Management of Patients with Diabetes

2017 ◽  
Vol 10 ◽  
pp. 117863291773507 ◽  
Author(s):  
Vivien Leung ◽  
Kristal Ragbir-Toolsie
Keyword(s):  
Glucose Control ◽  
Preoperative Evaluation ◽  
Glucose Monitoring ◽  
Perioperative Period ◽  
Blood Glucose Monitoring ◽  
Effective Strategies ◽  
Uncontrolled Diabetes ◽  
Patients With Diabetes ◽  
Management Recommendations ◽  
Frequent Blood Glucose Monitoring

Hyperglycemia has long been recognized to have detrimental effects on postoperative outcomes in patients undergoing surgery. The manifestations of uncontrolled diabetes are manifold and can include risk of hyperglycemic crises, postoperative infection, poor wound healing, and increased mortality. There is substantial literature supporting the role of diligent glucose control in the prevention of adverse surgical outcomes, but considerable debate remains as to the optimal glucose targets. Hence, most organizations advocate the avoidance of hypoglycemia while striving for adequate glucose control in the perioperative period. These objectives can be accomplished with careful preoperative evaluation, clear patient instructions the day of surgery, frequent blood glucose monitoring during the perioperative period, and use of effective strategies for insulin initiation and titration. This article highlights the major issues concerning patients with diabetes undergoing surgery and reviews the management recommendations put forth by general consensus guidelines and expert opinion.

scholarly journals Future Perspectives in Glucose Monitoring Sensors

2013 ◽  
Vol 09 (01) ◽  
pp. 21 ◽  
Author(s):  
Giulio Frontino ◽  
Franco Meschi ◽  
Riccardo Bonfanti ◽  
Andrea Rigamonti ◽  
Roseila Battaglino ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Patient Compliance ◽  
Glucose Control ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Severe Hypoglycemia ◽  
Blood Glucose Monitoring ◽  
Patients With Diabetes ◽  
Almost All ◽  
Monitoring Devices

The prevalence of diabetes is increasing. Improved glucose control is fundamental to reduce both long-term micro- and macrovascular complications and short-term complications, such as diabetic ketoacidosis and severe hypoglycemia. Frequent blood glucose monitoring is an essential part of diabetes management. However, almost all available blood glucose monitoring devices are invasive. This determines a reduced patient compliance, which in turn reflects negatively on glucose control. Therefore, there is a need to develop noninvasive glucose monitoring devices that will reduce the need of invasive procedures, thus increasing patient compliance and consequently improving quality of life and health of patients with diabetes.

scholarly journals Diabetes and COVID-19 Vaccination

2021 ◽  
Vol 22 (4) ◽  
pp. 221-224
Author(s):  
Hae Dong Choi ◽  
Jun Sung Moon
Keyword(s):  
Immune Response ◽  
Blood Glucose ◽  
Clinical Outcomes ◽  
Glucose Control ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Effective Strategy ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Patients With Diabetes

Diabetes is one of the major comorbidities associated with increased risk of mortality and severe clinical outcomes in coronavirus disease 19 (COVID-19) patients. Thus, timely and appropriate vaccination is the most effective strategy for mitigating the risk of COVID-19 infection in people with diabetes. Recent studies have shown that immune response after vaccination is significant in both diabetes and non-diabetes groups, but slightly lower in patients with diabetes. Inadequate glucose control might impair the immune response. Blood glucose monitoring is required more often than usual for several days after vaccination. If a patient’s blood glucose is not controlled adequately, appropriate management should be provided.

scholarly journals Future Perspectives in Glucose Monitoring Sensors

2010 ◽  
Vol 9 (1) ◽  
pp. 21 ◽  
Author(s):  
Giulio Frontino ◽  
Franco Meschi ◽  
Riccardo Bonfanti ◽  
Andrea Rigamonti ◽  
Roseila Battaglino ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Patient Compliance ◽  
Glucose Control ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Severe Hypoglycemia ◽  
Blood Glucose Monitoring ◽  
Patients With Diabetes ◽  
Almost All ◽  
Monitoring Devices

The prevalence of diabetes is increasing. Improved glucose control is fundamental to reduce both long-term micro- and macrovascular complications and short-term complications, such as diabetic ketoacidosis and severe hypoglycemia. Frequent blood glucose monitoring is an essential part of diabetes management. However, almost all available blood glucose monitoring devices are invasive. This determines a reduced patient compliance, which in turn reflects negatively on glucose control. Therefore, there is a need to develop noninvasive glucose monitoring devices that will reduce the need of invasive procedures, thus increasing patient compliance and consequently improving quality of life and health of patients with diabetes.

Self-monitoring Blood Glucose (SMBG): Now and the Future

2004 ◽  
Vol 17 (1) ◽  
pp. 29-38 ◽  
Author(s):  
Amber L. Briggs ◽  
Susan Cornell
Keyword(s):  
Blood Glucose ◽  
Glucose Control ◽  
Microvascular Complications ◽  
Blood Glucose Control ◽  
Glucose Monitoring ◽  
The United States ◽  
Blood Glucose Monitoring ◽  
Self Monitoring ◽  
State Management ◽  
Monitoring Devices

In 2002, the cost of diabetes in the United States reached $132 billion. There is a well-established relationship between blood glucose control and the risk of diabetes-related complications. Tight blood glucose control, through intensive diabetes therapy, reduces the risk and delays the onset of diabetesrelated microvascular complications. Regular and consistent self-monitoring of blood glucose (SMBG) is and should be a part of all diabetes disease state management programs. Pharmacists can truly increase the numbers of patients who use SMBG by being aware and familiar with the monitoring devices available to patients and identifying the physical and psychological issues surrounding SMBG. Results from SMBG and hemoglobin A1C are the basis formost of the medical decisions made for patients with diabetes. This review discusses the best time for patients to test their blood glucose, information regarding blood glucose monitoring devices, alternative site testing, and the newest technology available in glucose monitoring.

Management of diabetes during the last days of life: attitudes of consultant diabetologists and consultant palliative care physicians in the UK

2006 ◽  
Vol 20 (3) ◽  
pp. 197-203 ◽  
Author(s):  
S Ford-Dunn ◽  
A Smith ◽  
J Quin
Keyword(s):  
Palliative Care ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Terminal Phase ◽  
Diabetic Patients ◽  
Clinical Vignettes ◽  
Dying Patients ◽  
Co Morbidity ◽  
Patients With Diabetes ◽  
The Uk

Diabetes is an increasingly common condition and hence, managing dying patients with diabetes as a co-morbidity will become a frequent challenge. It is uncertain whether there is net beneficence in preventing hyperglycaemia in diabetic patients during the terminal phase or whether the distress involved in administering therapy and blood glucose monitoring may outweigh this ordeal. Since there is no available evidence upon which to base clinical decisions, a semi-structured questionnaire based around three clinical vignettes was sent to consultants in diabetes and palliative care in the UK. There was consensus of opinion from both groups of consultants that treatment and monitoring should be stopped in patients with type 2 diabetes, once in the terminal phase. There was less consensus regarding management of type 1 diabetes. Practical issues were raised by both groups of consultants and clinical guidelines are suggested.

scholarly journals Diabetic ketoacidosis following PEG-asparaginase therapy

2018 ◽  
Vol 2018 ◽  
Author(s):  
Miriam Hinaa Ahmad ◽  
Ismat Shafiq
Keyword(s):  
Diabetic Ketoacidosis ◽  
Pediatric Population ◽  
Lymphoblastic Leukemia ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Physician Education ◽  
List Type ◽  
African American Female ◽  
Treatment Protocols ◽  
Frequent Blood Glucose Monitoring

Summary We report a case of a 21-year-old African American female with history of pre-diabetes, and a diagnosis of a rare leukemia, blastic-plasmacytoid dendritic neoplasm (BPDCN), who developed diabetic ketoacidosis (DKA) after the third dose of PEG-asparaginase infusion. She was successfully treated with insulin. Asparaginase is a vital part of treatment protocols for acute lymphoblastic leukemia (ALL) in combination with other chemotherapeutic drugs. Asparaginase therapy has been reported to cause hyperglycemia especially when used in conjunction with glucocorticoids for the treatment of ALL in the pediatric population. Multiple mechanisms for hyperglycemia have been hypothesized which include decreased insulin secretion, impaired insulin receptor function and excess glucagon formation. Hyperglycemia is usually self-limiting but can deteriorate to diabetic ketoacidosis. DKA is a rare adverse effect with asparaginase therapy with an incidence rate of about 0.8%. Learning points: DKA is a rare finding following asparaginase therapy. Hyperglycemia is most commonly seen with asparaginase treatment when used along with glucocorticoid. Frequent blood glucose monitoring and prompt initiation of insulin treatment with hyperglycemia can prevent severe complications. Patients and physician education on this complication can reduce morbidity due to DKA.

scholarly journals Measures of Accuracy for Continuous Glucose Monitoring and Blood Glucose Monitoring Devices

2018 ◽  
Vol 13 (3) ◽  
pp. 575-583 ◽  
Author(s):  
Guido Freckmann ◽  
Stefan Pleus ◽  
Mike Grady ◽  
Steven Setford ◽  
Brian Levy
Keyword(s):  
Blood Glucose ◽  
Continuous Glucose Monitoring ◽  
Measurement Accuracy ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Glucose Measurement ◽  
Bias Analysis ◽  
Patients With Diabetes ◽  
Monitoring Devices ◽  
Error Grid

Currently, patients with diabetes may choose between two major types of system for glucose measurement: blood glucose monitoring (BGM) systems measuring glucose within capillary blood and continuous glucose monitoring (CGM) systems measuring glucose within interstitial fluid. Although BGM and CGM systems offer different functionality, both types of system are intended to help users achieve improved glucose control. Another area in which BGM and CGM systems differ is measurement accuracy. In the literature, BGM system accuracy is assessed mainly according to ISO 15197:2013 accuracy requirements, whereas CGM accuracy has hitherto mainly been assessed by MARD, although often results from additional analyses such as bias analysis or error grid analysis are provided. The intention of this review is to provide a comparison of different approaches used to determine the accuracy of BGM and CGM systems and factors that should be considered when using these different measures of accuracy to make comparisons between the analytical performance (ie, accuracy) of BGM and CGM systems. In addition, real-world implications of accuracy and its relevance are discussed.

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