New-onset type 1 diabetes complicated by diabetic ketoacidosis and severe sepsis requiring extracorporeal membrane oxygenation and kidney replacement therapy.

Diabetic ketoacidosis (DKA) accounts for up to a third of all new presentations of Type 1 Diabetes Mellitus (T1DM) in children and adolescents. While most cases are relatively uncomplicated new onset presentations, if DKA is compounded with an additional underlying severe illness, such as appendicitis or severe infection, diagnostic delays may be experienced, and treatment response and outcomes may be compromised. We report an atypical case of new onset diabetes with severe DKA and underlying severe sepsis, which responded poorly to traditional therapy resulting in maximal intensive care management including mechanical ventilation, inotropes, extracorporeal membrane oxygenation (ECMO) for cardiorespiratory support, and kidney replacement therapy.

Treatments for women with gestational diabetes mellitus: an overview of Cochrane systematic reviews.

Background: Successful treatments for gestational diabetes mellitus (GDM) have the potential to improve health outcomes for women with GDM and their babies.

Objectives: To provide a comprehensive synthesis of evidence from Cochrane systematic reviews of the benefits and harms associated with interventions for treating GDM on women and their babies.

Methods: We searched the Cochrane Database of Systematic Reviews (5 January 2018) for reviews of treatment/management for women with GDM.

Insulin for the treatment of women with gestational diabetes.

Background: Gestational diabetes mellitus (GDM) is associated with short- and long-term complications for the mother and her infant. Women who are unable to maintain their blood glucose concentration within pre-specified treatment targets with diet and lifestyle interventions will require anti-diabetic pharmacological therapies. This review explores the safety and effectiveness of insulin compared with oral anti-diabetic pharmacological therapies, non-pharmacological interventions and insulin regimens.

How Satisfied Are Patients When Their Choice of Funded Glucose Meter Is Restricted to a Single Brand?

Background: Many governments and insurers are driving down the cost of medical devices, including glucose meters, by the central management of purchasing decisions. We report patients' responses to an "enforced" change in brand of glucose meter, one year after the introduction of a national sole supplier arrangement for funded glucose meters and strips.

Method: Specialist diabetes clinic attendees from two geographical locations completed a questionnaire one year after the final meter changeover date.

Initiation and Intensification Strategies in Type 2 Diabetes Management: A Comparison of Basal Plus and Premix Regimens.

Unlabelled: The progressive nature of type 2 diabetes (T2D) often results in the need for initiation and subsequent intensification of insulin treatment to achieve glycemic control. The aim of this review is to examine published clinical evidence that has directly compared two recommended treatment approaches in patients with T2D: (1) a 'basal plus' regimen, whereby 1-2 injections of prandial insulin are added to basal insulin; or (2) the use of once- or twice-daily premix insulin analogs, which contain both basal and prandial insulin in a single injection. Broadly, the available evidence suggests that both basal plus and premix regimens are comparable in terms of efficacy and safety when used for insulin initiation in insulin-naïve patients and intensification in patients who have failed on basal insulin; instances of greater glycemic control are observed with premix insulin; however, these are often accompanied by increases in hypoglycemia and/or weight relative to basal plus treatment, and results should be interpreted within the context of total insulin doses used.

Practical Guidance on the Use of Premix Insulin Analogs in Initiating, Intensifying, or Switching Insulin Regimens in Type 2 Diabetes.

Introduction: Premix insulin analogs are a well-established treatment for type 2 diabetes (T2D). However, there is a lack of simple, clear guidance on some aspects of their use. These include choosing a regimen for insulin initiation, recognizing when patients need intensification of therapy, and switching from basal-bolus to a premix insulin analog when appropriate.

A cross-over study of the acute effects of espresso coffee on glucose tolerance and insulin sensitivity in people with type 2 diabetes mellitus.

The objective was to determine the effect of a single dose of espresso caffeinated coffee, decaffeinated coffee, or water on glucose tolerance and insulin sensitivity in people with type 2 diabetes mellitus. Eighteen participants who were habitual coffee drinkers, were studied using a random-order cross-over design. After a fasting blood sample participants consumed either a double-shot black espresso coffee, decaffeinated coffee, or hot water.

What makes for a pleasant social interaction? Motivational dynamics of interpersonal relations.

The authors used an event-contingent daily recording strategy, the Rochester Interaction Record (RIR), to examine the motivational dynamics of interpersonal relations. Using hierarchical linear modeling, the authors demonstrated that social interactions were more pleasant when participants felt autonomous, competent, and related. Autonomy, competence, and relatedness consistently predicted interaction quality, regardless of (a) the length of the interaction; (b) whether it was dyadic or in a group; and (c) whether it was an interaction with family, friends, or acquaintances.

The relations of parental autonomy support to cultural internalization and well-being of immigrants and sojourners.

Previous research has demonstrated that autonomy support is one particularly effective means of promoting internalization and fostering well-being. The present study sought to determine if this would also be the case with regards to culture by testing the relation of perceived parental autonomy support to the cultural internalization and well-being of multicultural students. In Study 1, 105 multicultural participants living in Canada were more likely to have fully internalized their host and heritage cultures and to have higher self-reported well-being when they reported that their parents were autonomy supportive.

Exploring the relation of independent and interdependent self-construals to why and how people pursue personal goals.

The authors examined whether independent or interdependent self-construals were associated with the way in which individuals pursued personal goals. Individuals with an independent self-construal orient toward personal-goal pursuit, whereas individuals with interdependent self-construal prioritize in-group goals above personal ones. The authors used a 1-week, prospective goal-setting paradigm.

On the risk of being a cultural chameleon: variations in collective self-esteem across social interactions.

In the present study the authors used an event-contingent daily recording strategy, the Rochester Interaction Record, to examine the relation of perceived evaluations of a multicultural person's heritage group to the nature and quality of his or her social interactions. Hierarchical linear modeling showed that having an interaction partner who positively evaluated one's heritage culture was associated with significantly enhanced interaction intimacy, disclosure, and quality, as well as with feelings of personal acceptance. Moderator analyses revealed that individuals who possessed a chameleon-like cultural identity and those who had low public collective self-esteem were particularly reactive to how their heritage group was being evaluated.

The impact of cultural internalization and integration on well-being among tricultural individuals.

The cultural internalization and competence of a diverse sample of tricultural university students was assessed. Based on recent research on the internalization of cultural norms, it was predicted that (a) having a heritage culture that embraced egalitarian values would be conducive to autonomous internalization and cultural competence, (b) competence and internalization would be associated with positive affect in heritage cultural contexts, and (c) the same positive relations between competence, internalization, and affect would be evident in English Canadian and French Canadian contexts. The study included 113 participants representing more than 35 distinct ethnicities.