scholarly journals Therapeutic Use of Intranasal Glucagon: Resolution of Hypoglycemia

2019 ◽  
Vol 20 (15) ◽  
pp. 3646 ◽  
Author(s):  
Antonio E. Pontiroli ◽  
Elena Tagliabue
Keyword(s):  
Severe Hypoglycemia ◽  
Well Being ◽  
Glucose Levels ◽  
Fear Of Hypoglycemia ◽  
Blood Glucose Levels ◽  
Increase Blood Glucose ◽  
Level Of Consciousness ◽  
Patients With Diabetes ◽  
Adults And Children ◽  
First Time

Episodes of hypoglycemia are frequent in patients with diabetes treated with insulin or sulphonylureas. Hypoglycemia can lead to severe acute complications, and, as such, both prevention and treatment of hypoglycemia are important for the well-being of patients with diabetes. The experience of hypoglycemia also leads to fear of hypoglycemia, that in turn can limit optimal glycemic control in patients, especially with type 1 diabetes. Treatment of hypoglycemia is still based on administration of carbohydrates (oral or parenteral according to the level of consciousness) or of glucagon (intramuscular or subcutaneous injection). In 1983, it was shown for the first time that intranasal (IN) glucagon drops (with sodium glycocholate as a promoter) increase blood glucose levels in healthy volunteers. During the following decade, several authors showed the efficacy of IN glucagon (drops, powders, and sprays) to resolve hypoglycemia in normal volunteers and in patients with diabetes, both adults and children. Only in 2010, based on evaluation of patients’ beliefs and patients’ expectations, a canadian pharmaceutical company (Locemia Solutions, Montreal, Canada) reinitiated efforts to develop glucagon for IN administration. The project has been continued by Eli Lilly, that is seeking to obtain registration in order to make IN glucagon available to insulin users (children and adolescents) worldwide. IN glucagon is as effective as injectable glucagon, and devoid of most of the technical difficulties associated with administration of injectable glucagon. IN glucagon appears to represent a major breakthrough in the treatment of severe hypoglycemia in insulin-treated patients with diabetes, both children and adults.

scholarly journals New Fast Acting Glucagon for Recovery from Hypoglycemia, a Life-Threatening Situation: Nasal Powder and Injected Stable Solutions

2021 ◽  
Vol 22 (19) ◽  
pp. 10643
Author(s):  
Lucia La Sala ◽  
Antonio E. Pontiroli
Keyword(s):  
Severe Hypoglycemia ◽  
Well Being ◽  
Nasal Administration ◽  
Diabetic Patients ◽  
Good Glycemic Control ◽  
Increased Risk ◽  
The Us ◽  
Patients With Diabetes ◽  
Adults And Children ◽  
Fast Acting

The goal of diabetes care is to achieve and maintain good glycemic control over time, so as to prevent or delay the development of micro- and macrovascular complications in type 1 (T1D) and type 2 diabetes (T2D). However, numerous barriers hinder the achievement of this goal, first of all the frequent episodes of hypoglycemia typical in patients treated with insulin as T1D patients, or sulphonylureas as T2D patients. The prevention strategy and treatment of hypoglycemia are important for the well-being of patients with diabetes. Hypoglycemia is strongly associated with an increased risk of cardiovascular disease in diabetic patients, due probably to the release of inflammatory markers and prothrombotic effects triggered by hypoglycemia. Treatment of hypoglycemia is traditionally based on administration of carbohydrates or of glucagon via intramuscular (IM) or subcutaneous injection (SC). The injection of traditional glucagon is cumbersome, such that glucagon is an under-utilized drug. In 1983, it was shown for the first time that intranasal (IN) glucagon increases blood glucose levels in healthy volunteers, and in 1989–1992 that IN glucagon is similar to IM glucagon in resolving hypoglycemia in normal volunteers and in patients with diabetes, both adults and children. IN glucagon was developed in 2010 and continued in 2015; in 2019 IN glucagon obtained approval in the US, Canada, and Europe for severe hypoglycemia in children and adults. In the 2010s, two ready-to-use injectable formulations, a stable non-aqueous glucagon solution and the glucagon analog dasiglucagon, were developed, showing an efficacy similar to traditional glucagon, and approved in the US in 2020 and in 2021, respectively, for severe hypoglycemia in adults and in children. Fast-acting glucagon (nasal administration and injected solutions) appears to represent a major breakthrough in the treatment of severe hypoglycemia in insulin-treated patients with diabetes, both adults and children. It is anticipated that the availability of fast-acting glucagon will expand the use of glucagon, improve overall metabolic control, and prevent hypoglycemia-related complications, in particular cardiovascular complications and cognitive impairment.

scholarly journals The screening and management of newborns at risk for low blood glucose

2019 ◽  
Vol 24 (8) ◽  
pp. 536-544 ◽  
Author(s):  
Michael R Narvey ◽  
Seth D Marks
Keyword(s):  
At Risk ◽  
Blood Glucose ◽  
Severe Hypoglycemia ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Group Experiences ◽  
Key Issues ◽  
Definition Of ◽  
First Time

Abstract Hypoglycemia in the first hours to days after birth remains one of the most common conditions facing practitioners across Canada who care for newborns. Many cases represent normal physiologic transition to extrauterine life, but another group experiences hypoglycemia of longer duration. This statement addresses key issues for providers of neonatal care, including the definition of hypoglycemia, risk factors, screening protocols, blood glucose levels requiring intervention, and managing care for this condition. Screening, monitoring, and intervention protocols have been revised to better identify, manage, and treat infants who are at risk for persistent, recurrent, or severe hypoglycemia. The role of dextrose gels in raising glucose levels or preventing more persistent hypoglycemia, and precautions to reduce risk for recurrence after leaving hospital, are also addressed. This statement differentiates between approaches to care for hypoglycemia during the ‘transitional’ phase—the first 72 hours post-birth—and persistent hypoglycemia, which occurs or presents for the first time past that point.

Pharmacology Update: Emergency Medications for Hypoglycemia in Diabetes

2021 ◽  
pp. 1942602X2098164
Author(s):  
Carol Schaumleffel
Keyword(s):  
Severe Hypoglycemia ◽  
Well Being ◽  
Healthcare Facility ◽  
Altered Mental Status ◽  
Physical Symptoms ◽  
Medical Emergency ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Life Threatening ◽  
Threatening Situation

Children and adults with Type 1 and Type 2 diabetes are at risk for severe hypoglycemia, an unpredictable and potentially life-threatening situation. Severe hypoglycemia creates low blood glucose levels in which a person has an altered mental status or physical symptoms that require assistance from another individual to treat the hypoglycemia. Treatment of severe hypoglycemia is a medical emergency and prompt treatment is important for the well-being of students with diabetes. If left untreated, severe hypoglycemia can lead to death. Glucagon is a medication used to treat severe hypoglycemia outside of a healthcare facility. Recently, more stable and easier to use formulations of glucagon have become available. The purpose of this pharmacology update is to describe two new formulations of ready to use glucagon: an intranasal and subcutaneous, autoinjector formulation.

PERBEDAAN PENGETAHUAN DAN SIKAP PASIEN DIABETES MELLITUS RAWAT INAP RUMAH SAKIT ISLAM SAMARINDA SEBELUM DAN SESUDAH KONSELING GIZI DENGAN MENGGUNAKAN MEDIA AUDIOVISUAL

2017 ◽  
Vol 2 (1) ◽  
pp. 8
Author(s):  
Siswanto Siswanto ◽  
Ismail Kamba ◽  
Siti Aminah
Keyword(s):  
Diabetes Mellitus ◽  
Public Health Problem ◽  
Visual Media ◽  
P Value ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Disease Mortality ◽  
Before And After ◽  
Patients With Diabetes

Diabetes mellitus is one of the communicable diseases that have become a public health problem, not only in Indonesia but also the world. Currently morbidity of diabetes mellitus is increasing every year, where in 2006 there were 14 million people in 2011 and ranks fourth with 773 cases. DM is also a cause of disease mortality by 5.8%. And Samarinda own particular Islamic Hospital years 2009, there were 449 patients with DM, and 2011 an increase in the 1931 patients with diabetes mellitus. To increase patients’ knowledge about diabetes and diabetic patients be directing attitudes that support or positive attitude towards keeping blood glucose levels to remain normal. Methode to use pra eksperiment with one group pretest posttest. individual conseling withAudiovisual media. There is increased knowledge about diabetes diabetic patients before and after intervention with increasing value of 3.77 (p value = 0.000) and increase in attitudes regarding diabetes mellitus diabetic patients with an increase in the value of 5,35 (p value = 0.003). There was an increase in knowledge and attitudes of patients hospitalized with diabetes mellitus hospital after islam samarinda given nutritional counseling using audio-visual media

scholarly journals PENGARUH JUS LIDAH BUAYA TERHADAP KADAR GLUKOSA DARAH PUASA DAN 2 JAM PP(Post Prandial) PADA PENDERITA DIABETES MELITUS

2019 ◽  
Vol 10 (1) ◽  
pp. 77
Author(s):  
Febria Syafyu Sari ◽  
Ridhyalla Afnuhazi
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Blood Sugar ◽  
Fasting Blood Glucose ◽  
Aloe Vera ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Patients With Diabetes ◽  
Paired T Test ◽  
Diabetes Melitus

ABSTRAK Diabetes Melitus merupakan penyakit yang paling menonjol yang disebabkan oleh gagalnya pengaturan gula darah. Lidah buaya berkhasiat untuk menurunkan kadar gula dalam darah bagi penderita diabetes dan dapat mengontrol tekanan darah. Tujuan penelitian untuk mengetahui pengaruh jus lidah buaya (AloeBarbadensis Miller) terhadap penurunan glukosa darah puasa GDP) dan 2 Jam PP (Post Prendial) pada penderita DM (Diabetes Melitus). Desain penelitian merupakan Quasi Eksperimental dengan pendekatan one group pretest – postest design. Sampel terbagi menjadi 14 responden. Data dianalisis dengan paired t-test. Hasil menunjukan rata-rata penurunan glukosa darah puasa pada intervensi (28,42 gr/dl) dan glukosa darah 2 jam pp pada intervensi (40,57 gr/dl). Untuk analisis bivariat terdapat perbedaan antara glukosa puasa dan 2 jam pp dengan glukosa darah puasa GDP) dan 2 Jam PP (Post Prendial) pada penderita DM (Diabetes Melitus). Kesimpulan didapatkanlidah buaya dapat menurunkan kadar glukosa darah.Berdasarkan hasil penelitian jus lidah buaya dapat menjadi salah satu alternatif keperawatan non farmakologi dalam penyakit diabetes melitus. Kata Kunci : Lidah Buaya ; Diabetes Mellitus THE EFFECT OF VEGETABLE VOCATIONAL JUICE ON FAST BLOOD GLUCOSE LEVELS AND 2 HOURS OF PP (Post Prandial) IN DIABETES MELLITUS  ABSTRACT Diabetes mellitus is the most prominent disease caused by the failure of blood sugar regulation. Aloe vera is efficacious can to  reduce blood sugar levels for diabetics and can control blood pressure. The purpose of this study was to determine the effect of Aloe Barbadensis Miller on the reduction of fasting blood glucose GDP and 2 hours of PP (post prendial) in patients with diabetes mellitus. The research design is Experimental Quasi with one group pretest - postest design approach. The sample is divided into 14 respondents. Data were analyzed by paired t-test. The results showed an average decrease in fasting blood glucose at intervention (28.42 gr / dl) and 2 hours pp blood glucose at intervention (40.57 gr / dl). For bivariate analysis there was a difference between fasting glucose and 2 hours pp with fasting blood glucose GDP) and 2 hours PP (Post Prendial) in patients with diabetes mellitus. The conclusion is that aloe vera can reduce blood glucose levels. Based on the results of research on aloe vera juice can be an alternative non-pharmacological nursing in diabetes mellitus. Keywords: Aloe Vera ; Diabetes Mellitus

scholarly journals Platelet Effects of Anti-diabetic Therapies: New Perspectives in the Management of Patients with Diabetes and Cardiovascular Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Annunziata Nusca ◽  
Dario Tuccinardi ◽  
Silvia Pieralice ◽  
Sara Giannone ◽  
Myriam Carpenito ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Large Population ◽  
Optimal Management ◽  
Direct And Indirect Effects ◽  
Thrombotic Risk ◽  
Glucose Lowering ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Patients With Diabetes

In type 2 diabetes, anti-thrombotic management is challenging, and current anti-platelet agents have demonstrated reduced efficacy. Old and new anti-diabetic drugs exhibited—besides lowering blood glucose levels—direct and indirect effects on platelet function and on thrombotic milieu, eventually conditioning cardiovascular outcomes. The present review summarizes existing evidence on the effects of glucose-lowering agents on platelet properties, addressing pre-clinical and clinical research, as well as drug–drug interactions with anti-platelet agents. We aimed at expanding clinicians’ understanding by highlighting new opportunities for an optimal management of patients with diabetes and cardiovascular disease. We suggest how an improvement of the thrombotic risk in this large population of patients may be achieved by a careful and tailored combination of anti-diabetic and anti-platelet therapies.

Glycemia under control

2021 ◽  
pp. 54-55
Author(s):  
Nadezhda Kalinina
Keyword(s):  
Mobile Application ◽  
Vascular Complications ◽  
Self Monitoring ◽  
Glucose Levels ◽  
Therapy Goals ◽  
Blood Glucose Levels ◽  
Number Of Patients ◽  
Patients With Diabetes ◽  
The Russian Federation ◽  
Do It Yourself

Diabetes mellitus (DM) has become a global and national menace. The number of patients with diabetes in the Russian Federation tallied roughly 5.1 million, according to the incidence of outpatient visits in 2020 [1]. “Do-it-yourself” regular measurements of blood glucose levels (self-monitoring) are one of the most important components in achieving the therapy goals for patients with diabetes and preventing severe vascular complications. Now that the technologies have caught on, new “smart” glucometers appeared, which enable remote control and significantly expand opportunities of DM monitoring due to free mobile application integration.

BECKWITH'S SYNDROME WITH EXTREME ORGAN HYPERPLASIA

PEDIATRICS ◽  
1973 ◽  
Vol 52 (3) ◽  
pp. 372-381
Author(s):  
Thomas F. Roe ◽  
Ann K. Kershnar ◽  
Jordan J. Weitzman ◽  
Luis Salinas Madrigal
Keyword(s):  
Adrenal Gland ◽  
Abdominal Mass ◽  
Severe Hypoglycemia ◽  
Immunoreactive Insulin ◽  
Left Adrenal Gland ◽  
Adrenal Steroid ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Pedunculated Tumor ◽  
The Right

A large newborn infant with hemihypertrophy, omphalocele, hepatomegaly, left upper quadrant abdominal mass, and zoster-like skin rash had severe hypoglycemia at 4 hours of age. Serum immunoreactive insulin levels were markedly elevated. Hypoglycemia was not controlled by vigorous medical therapy but blood glucose levels returned toward normal following subtotal excision of the markedly hyperplastic pancreas at 24 days of age. At 4½ months of age, a right upper quadrant abdominal mass was noted and urinary adrenal steroid levels were elevated. The right adrenal gland was found to be markedly hyperplastic and it was removed; the left adrenal gland was slightly hyperplastic. Between the ages of 5 and 8 months the umbilical stump enlarged progressively forming a large pedunculated tumor which was removed. This patient presents an unusually severe example of Beckwith's syndrome with both prenatal and postnatal organ overgrowth, severe hypoglycemia and hyperinsulinism.

TYPE 2 DIABETES MELLITUS;

2018 ◽  
Vol 21 (05) ◽  
pp. 1005-1014
Author(s):  
Jamil A. Malik ◽  
Tuba Mumtaz ◽  
Samsaam Ali Haider
Keyword(s):  
Blood Glucose ◽  
Emotional Problem ◽  
Emotional Problems ◽  
Treatment Modalities ◽  
Routine Practice ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Obese Class ◽  
Patients With Diabetes ◽  
Effective Instrument

Objectives: The study is aimed to assess emotional problem of patients with Type2diabetes by translating and validating PAID. Associations between PAID and blood glucoselevels, and differences in prevalence of emotional problems across treatment modalities andBMI. Data Sources: Data was collected from various outpatients of Rawalpindi and Islamabad.Sample and Procedure: The sample of study comprised of 300 patients with diabetes bothmale = 135 (45%) and female n=165 (55%). Formal approval was taken from authorities atrespective hospitals and after taking informed consent patients were interviewed. Period:Data collection was completed during Feb to April, 2013. Material and Method: Patients wereasked to fill in demographic sheet along with Translated PAID scale. Latest blood glucose levelswere collected from their medical records whereas BMI was calculated by measuring patients’weight and height. Results: Results showed that emotional problems as assessed by PAID arepositively correlated with blood glucose levels (r=.12 to r=.19, p<.05). Additionally, patientswith IV modality of treatment (i.e., taking insulin shots) suffered significantly high (MD=4.88,p=.01) from emotional problems and patients with normal BMI and Obese Class-II have are athigher risk of emotional problem. Finally, patients rated serious concerns on diabetes-relatedissues like lifelong maintenance, future complications, depression and anxiety, and satisfactionwith physician. Conclusions: PAID is a very effective instrument in identifying emotionalproblems of diabetes patients related to adherence and compliance to their treatment regimeand hence it shall be used by physicians and health professional in routine practice.

scholarly journals Prototypes of User Interfaces for Mobile Applications for Patients with Diabetes

Computers ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. 1 ◽  
Author(s):  
Jan Pavlas ◽  
Ondrej Krejcar ◽  
Petra Maresova ◽  
Ali Selamat
Keyword(s):  
Blood Glucose ◽  
User Interfaces ◽  
Mobile Applications ◽  
Eating Habits ◽  
Relevant Literature ◽  
Optimal Solution ◽  
Glucose Levels ◽  
Current State ◽  
Blood Glucose Levels ◽  
Patients With Diabetes

We live in a heavily technologized global society. It is therefore not surprising that efforts are being made to integrate current information technology into the treatment of diabetes mellitus. This paper is dedicated to improving the treatment of this disease through the use of well-designed mobile applications. Our analysis of relevant literature sources and existing solutions has revealed that the current state of mobile applications for diabetics is unsatisfactory. These limitations relate both to the content and the Graphical User Interface (GUI) of existing applications. Following the analysis of relevant studies, there are four key elements that a diabetes mobile application should contain. These elements are: (1) blood glucose levels monitoring; (2) effective treatment; (3) proper eating habits; and (4) physical activity. As the next step in this study, three prototypes of new mobile applications were designed. Each of the prototypes represents one group of applications according to a set of given rules. The most optimal solution based on the users’ preferences was determined by using a questionnaire survey conducted with a sample of 30 respondents participating in a questionnaire after providing their informed consent. The age of participants was from 15 until 30 years old, where gender was split to 13 males and 17 females. As a result of this study, the specifications of the proposed application were identified, which aims to respond to the findings discovered in the analytical part of the study, and to eliminate the limitations of the current solutions. All of the respondents expressed preference for an application that includes not only the key functions, but a number of additional functions, namely synchronization with one of the external devices for measuring blood glucose levels, while five-sixths of them found suggested additional functions as being sufficient.

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