scholarly journals Early Correction of Post-Kidney Transplant Hyperglycaemia is Associated with Reduction of the Prevalence of Post-Transplant Diabetes Mellitus

2021 ◽  
Vol 75 (2) ◽  
pp. 99-105
Author(s):  
Klinta Suhecka ◽  
Aivars Lejnieks ◽  
Jānis Jušinskis ◽  
Aleksandrs Maļcevs ◽  
Vadims Suhorukovs ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Kidney Transplant ◽  
Glucose Level ◽  
Early Recognition ◽  
Insulin Dosage ◽  
Kidney Transplant Recipients ◽  
Post Transplantation ◽  
Post Transplant

Abstract Our study was focused on identification and correction of early hyperglycaemia, with the aim to reduce the risk of developing post-transplant diabetes mellitus (PTDM) and its associated complications. In a single centre, the prospective study included adult kidney transplant recipients without diabetes mellitus whose pre-transplant glucometabolic data did not show signs of diabetes mellitus. Starting from the first day after kidney transplantation, patients were closely monitored for hyperglycaemia; glucose level measurements were started to obtain pre-prandial levels. If the blood glucose level exceeded 11.1 mmol/l, hyperglycaemia was corrected with short-acting insulin. A total of 14 patients completed a three-month follow-up. During the first post-transplant week, the blood glucose level exceeded 11.1 mmol/l in nine patients (63.9%). From those patients five (55.5%) did not develop PTDM. None of the patients who did not need insulin treatment developed PTDM. Higher pre-lunch glucose levels increased the risk of developing PTDM (p = 0.006). Patients with diabetes required a two times higher insulin dosage than other patients during the first post-transplantation week. We found that hyperglycaemia is a common problem in the early post-transplant period. Early recognition and correction of inpatient hyperglycaemia was associated with reduction of the prevalence of PTDM in more than a half of the patients in the studied group at three months post transplant.

Glucose Levels and Outcome After Primary Intraventricular Hemorrhage

2019 ◽  
Vol 16 (1) ◽  
pp. 40-46
Author(s):  
Rui Guo ◽  
Ruiqi Chen ◽  
Chao You ◽  
Lu Ma ◽  
Hao Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Incidence Rate ◽  
Glucose Level ◽  
Intraventricular Hemorrhage ◽  
Laboratory Data ◽  
History Of ◽  
Poor Outcomes ◽  
The Impact

Background and Purpose: Hyperglycemia is reported to be associated with poor outcome in patients with spontaneous Intracerebral Hemorrhage (ICH), but the association between blood glucose level and outcomes in Primary Intraventricular Hemorrhage (PIVH) remains unclear. We sought to identify the parameters associated with admission hyperglycemia and analyze the impact of hyperglycemia on clinical outcome in patients with PIVH. Methods: Patients admitted to Department of Neurosurgery, West China Hospital with PIVH between 2010 and 2016 were retrospectively included in our study. Clinical, radiographic, and laboratory data were collected. Univariate and multivariate logistic regression analyses were used to identify independent predictors of poor outcomes. Results: One hundred and seventy patients were included in the analysis. Mean admission blood glucose level was 7.78±2.73 mmol/L and 10 patients (5.9%) had a history of diabetes mellitus. History of diabetes mellitus (P = 0.01; Odds Ratio [OR], 9.10; 95% Confidence Interval [CI], 1.64 to 50.54) was independent predictor of admission critical hyperglycemia defined at 8.17 mmol/L. Patients with admission critical hyperglycemia poorer outcome at discharge (P < 0.001) and 90 days (P < 0.001). After adjustment, admission blood glucose was significantly associated with discharge (P = 0.01; OR, 1.30; 95% CI, 1.06 to 1.59) and 90-day poor outcomes (P = 0.03; OR, 1.27; 95% CI, 1.03 to 1.58), as well as mortality at 90 days (P = 0.005; OR, 1.41; 95% CI, 1.11 to 1.78). In addition, admission critical hyperglycemia showed significantly increased the incidence rate of pneumonia in PIVH (P = 0.02; OR, 6.04; 95% CI 1.27 to 28.80) even after adjusting for the confounders. Conclusion: Admission blood glucose after PIVH is associated with discharge and 90-day poor outcomes, as well as mortality at 90 days. Admission hyperglycemia significantly increases the incidence rate of pneumonia in PIVH.

scholarly journals Current Pharmacological Intervention and Medical Management for Diabetic Kidney Transplant Recipients

Pharmaceutics ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 413
Author(s):  
Theerawut Klangjareonchai ◽  
Natsuki Eguchi ◽  
Ekamol Tantisattamo ◽  
Antoney J. Ferrey ◽  
Uttam Reddy ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Pharmacological Intervention ◽  
Diabetic Patients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Kidney Allograft ◽  
Post Transplant ◽  
Glucose Management

Hyperglycemia after kidney transplantation is common in both diabetic and non-diabetic patients. Both pretransplant and post-transplant diabetes mellitus are associated with increased kidney allograft failure and mortality. Glucose management may be challenging for kidney transplant recipients. The pathophysiology and pattern of hyperglycemia in patients following kidney transplantation is different from those with type 2 diabetes mellitus. In patients with pre-existing and post-transplant diabetes mellitus, there is limited data on the management of hyperglycemia after kidney transplantation. The following article discusses the nomenclature and diagnosis of pre- and post-transplant diabetes mellitus, the impact of transplant-related hyperglycemia on patient and kidney allograft outcomes, risk factors and potential pathogenic mechanisms of hyperglycemia after kidney transplantation, glucose management before and after transplantation, and modalities for prevention of post-transplant diabetes mellitus.

scholarly journals A vércukorértékek nem feltétlenül jellemzik megfelelően a sejtanyagcsere-állapotot

2017 ◽  
Vol 158 (11) ◽  
pp. 409-417
Author(s):  
Kornél Simon ◽  
István Wittmann
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Energy Production ◽  
Cellular Metabolism ◽  
Transport Parameter ◽  
Metabolic State ◽  
Cellular Energy ◽  
Acute And Chronic Stress

Abstract: In clinical recommendations the normalized blood glucose level is declared as the main target in therapy of diabetes mellitus, i.e. the achievement of euglycemia is the main therapeutic goal. This approach suggests, that the normal blood glucose value is the marker of the normal carbohydrate metabolism (eumetabolism), and vice versa: hyperglycemia is associated with abnormal metabolism (dysmetabolism). However the question arises, whether identical blood glucose values do reflect the same intracellular biochemical mechanisms? On the basis of data published in the literature authors try to answer these questions by studying the relations between the short/longterm blood glucose level and the cellular metabolism in different clinical settings characterized by divergent pathophysiological parameters. The correlations between blood glucose level and cellular metabolism in development of micro-, and macroangiopathy, in the breakthrough phenomenon, as well as during administration of metabolic promoters, the discrepancies of relation between blood glucose values and cellular metabolism in type 1, and type 2 diabetes mellitus, furthermore association between blood glucose value and myocardial metabolism in acute and chronic stress were analyzed. Authors conclude, that the actual blood glucose values reveal the actual cellular metabolism in a very variable manner: neither euglycemia does mandatorily indicate eumetabolism (balance of cellular energy production), nor hyperglycemia is necessarily a marker of abnormal metabolic state (dept of cellular energy production). Moreover, at the same actual blood glucose level both the metabolic efficacy of the same organ may sharply vary, and the intracellular biochemical machinery could also be very different. In case of the very same longterm blood glucose level the metabolic state of the different organs could be very variable: some organs show an energetically balanced metabolism, while others produce a significant deficit. These inconsistencies between blood glucose level and cellular metabolism can be explained by the fact, that blood glucose value is a transport parameter, reflecting the actual steady state of glucose transport from the carbohydrate pools into the blood, and that from the blood into the tissues. Without knowing the speed of these transports of opposite direction, the blood glucose value per se can not reveal the quantitative and qualitative characteristics of cellular metabolism. Orv. Hetil., 2017, 158(11), 409–417.

scholarly journals Experimental strategy of animal trial for the approval of anti-diabetic agents prior to their use in pre-human clinical trials

2015 ◽  
Vol 11 (1) ◽  
pp. 30
Author(s):  
Vivek K. Bajpai ◽  
Irfan A. Rather ◽  
Gyeong-Jun Nam
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Animal Experiments ◽  
New Drugs ◽  
Global Public Health ◽  
Animal Trial ◽  
Treatment Of Diabetes ◽  
Pass Through

<p>Although several naturally available drugs have been historically used for the treatment of diabetes mellitus throughout the world, few of them have been validated by scientific criteria. Before approval of any drug developed it should pass through animal trial prior to clinical human trial, which should followed by some standard ethical rules. Recently, a large diversity of animal models have been developed to better understand the pathogenesis of diabetes mellitus, and new drugs have been introduced in the market to treat this autoimmune disease. In the present article, we demonstrated some standard handling procedure of animal trial for the approval of anti-diabetic drug, which could be helpful for both academics and industrial scientific community to conduct the animal experiments. This research also contributes in the field of ethnopharmacology to design new strategies for the development of novel drugs to treat this serious condition of diabetes mellitus that constitutes a global public health.</p><p> </p><p><strong>VIDEO CLIPS</strong></p><p><a href="https://www.youtube.com/v/_Qz4opKbNuc">Handling and caring of mice:</a>                                              2 min 30 sec</p><p><a href="https://www.youtube.com/v/1ftT8ozWy-c">Inducing diabetes in mice and observing blood glucose level:</a>   1 min 47 sec</p><p><a href="https://www.youtube.com/v/u01ls9p6310">Drug administration and observation of blood glucose level:</a>    2 min 11 sec</p><p> </p>

scholarly journals Nutritional Therapy In Ischemic Stroke Patients With Type 2 Diabetes Mellitus : A Case Report

2020 ◽  
Vol 3 (1) ◽  
pp. 33
Author(s):  
Cipuk Muhaswitri ◽  
Diyah Eka Andayani ◽  
Taufik Mesiano
Keyword(s):  
Diabetes Mellitus ◽  
Ischemic Stroke ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Nutritional Therapy ◽  
Facial Nerve Paralysis ◽  
Stroke Patients ◽  
Nerve Paralysis

<p><strong>Introduction</strong>: The prevalence of stroke in Indonesia increased from 8.3 per 1000 population in 2007 to 12.1 per 1000 population in 2013, based on Riset Kesehatan Dasar (RISKESDAS) 2013. Diabetes mellitus (DM) is an independent risk factor and can be modified. Hyperglycemia that occurs in the acute phase of stroke is associated with an increase in mortality and poor clinical outcome after stroke. Moreover, stroke patients are at risk of developing hypoalbuminemia due to poor intake and the presence of a chronic inflammatory process.<br /><strong>Methods:</strong> A 66-year-old female patient with third recurrent ischemic stroke, history of uncontrolled DM, conciousness based on GCS is E3M5Vaphasia, Nasogastric tube (NGT) was inserted and there was a right facial nerve paralysis and bilateral hemiparesis . Nutritional status of patient is obese-1. During follow up period, the patient's blood glucose level ranged from 194 g/dl-345 g/dl. Nutrition therapy is given with a target of 1350 kcal (32 kcal/kg). Its composition consists of 15% protein, 25% fat and 60% carbohydrate (preferred complex carbohydrates), in the form of DM-specific formula containing inulin and monounsaturated fatty acid (MUFA). This nutritional therapy was administrated six times per day via enteral pathway, followed by the administration of micronutrients of vitamins C, B and folic acid.<br /><strong>Result:</strong> During follow up period, the patient tolerated well with the diet. After the 14 days hospitalization, there was improvement of blood glucose level (&lt;200 g/dL). Albumin level increases from 2.5 g/dL to 2.9 g/dl by the nutritional therapy containing protein more than 1.2 g/kg/day.<br /><strong>Conclusion:</strong> Administering a diet with the recommended composition and formula helps control hyperglycemia and improve hypoalbuminemia in patients that can improve the patient's clinical condition.</p>

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