Diabetes Care at Summer Camps.

Attending summer camp can be a rewarding experience for children with type 1 diabetes and an opportunity for them to build their confidence and diabetes self-management skills. Diabetes camps are built to cater to the medical needs of children with diabetes. With proper communication, education, and resources, traditional summer camps can provide the same benefits.

Anatabine supplementation decreases thyroglobulin antibodies in patients with chronic lymphocytic autoimmune (Hashimoto's) thyroiditis: a randomized controlled clinical trial.

Context: Hashimoto's thyroiditis is less prevalent in tobacco smokers. Anatabine, an alkaloid found in Solanaceae plants including tobacco, has been reported to ameliorate a mouse model of Hashimoto's thyroiditis.

Objective: The effects of anatabine in patients with Hashimoto's thyroiditis were studied.

Glycemic management in the inpatient setting.

Hyperglycemia occurs frequently in hospitalized patients and affects patient outcomes, including mortality, inpatient complications, hospital length of stay, and overall hospital costs. Various degrees of glycemic control have been studied and consensus statements from the American Diabetes Association/American Association of Clinical Endocrinologists and The Endocrine Society recommend a target blood glucose range of 140 to 180 mg/dL in most hospitalized patients. Insulin is the preferred modality for treating all hospitalized patients with hyperglycemia, as it is adaptable to changing patient physiology over the course of hospitalization.

Safe insulin use in the hospital setting.

Inpatients have a high rate of diabetes (12%-26%) and hyperglycemia (~38%). All patients should have their glycosylated hemoglobin (A1C) checked on admission to help differentiate between long-term and new-onset hyperglycemia. Good glycemic control throughout the hospital stay is associated with decreases in short- and long-term risk of mortality, inpatient complications, length of hospital stay, and health care costs.

Insulin resistance following cardiothoracic surgery in patients with and without a preoperative diagnosis of type 2 diabetes during treatment with intravenous insulin therapy for postoperative hyperglycemia.

Objective: To assess insulin resistance postoperatively in patients with (DM) and without (nonDM) a prior diagnosis of diabetes.

Research Design And Methods: Following cardiac surgery, 122 nonDM and 33 DM were treated with insulin infusions to obtain glucose levels <110 mg dl(-1). Glucose levels, insulin infusion rates, and insulin infusion rate/glucose ratios were calculated to assess insulin resistance.

Metabolic syndrome management.

Overweight, obesity and the metabolic syndrome occur in genetically susceptible individuals with environmental influences, and may be further compounded by other disorders of metabolism or pharmacological therapy that increase insulin resistance or promotes weight gain. Treatment of the metabolic syndrome should focus on treatment on [corrected] each individual component, but first, lifestyle modification, including diet and exercise with weight reduction, should be [corrected] the foundation of any successful treatment regimen for the metabolic syndrome. Pharmacological therapy should be individualized and targeted to normalize blood pressure, HDL cholesterol, triglycerides and glucose values.

Reduction of surgical mortality and morbidity in diabetic patients undergoing cardiac surgery with a combined intravenous and subcutaneous insulin glucose management strategy.

Objective: To determine if glucose management in postcardiothoracic surgery patients with a combined intravenous (IV) and subcutaneous (SC) insulin regimen reduces mortality and morbidity in patients with diabetes and stress-induced hyperglycemia.

Research Design And Methods: Retrospective review of 614 consecutive patients who underwent cardiothoracic (CT) surgery in 2005 was performed to evaluate the incidence and treatment of postoperative hyperglycemia and operative morbidity and mortality. Hyperglycemic patients (glucose >6.

Conversion of intravenous insulin infusions to subcutaneously administered insulin glargine in patients with hyperglycemia.

Objective: To determine the optimal dose of insulin glargine needed to maintain glycemic control in patients undergoing conversion from intravenous regular insulin infusions to a subcutaneous insulin regimen.

Methods: Seventy-five hospitalized patients receiving continuous insulin infusions were randomized to receive 40%, 60%, or 80% of their total daily insulin requirement, calculated from the rate during the final 6 hours of the infusion, as insulin glargine at the time of conversion to a subcutaneous regimen. Prandial insulin aspart was added to the subcutaneous regimen when patients began oral intake, and the dosage was left to clinical judgment.

Inpatient management of hyperglycemia: the Northwestern experience.

Objective: To describe a novel method of safe and effective intensive management of inpatient hyperglycemia with use of cost-effective protocols directed by a glucose management service (GMS).

Methods: An intravenous insulin protocol was designed to achieve a glycemic target of 80 to 110 mg/dL. When stable inpatients were transferred from the intravenous protocol to a subcutaneous insulin protocol, which consisted of basal long-acting and prandial and supplemental rapid-acting insulins, the blood glucose target was 80 to 150 mg/dL.