Hypoglycemia is a common problem in hospitalized patients, particularly the elderly, frail, and severely ill. Hypoglycemia has been implicated in the development of adverse clinical outcomes, including increased mortality. Fear of iatrogenic hypoglycemia remains an obstacle to adequate inpatient glycemic control. However, evidence from large clinical trials is mixed: several intensive care unit studies have shown either reduced or no change in mortality with intensive glycemic control, despite high rates of iatrogenic hypoglycemia, and only 1 large study showed higher mortality. In the general ward setting, the association of hypoglycemia with worse outcomes and mortality has been frequently reported, but after multivariate adjustment for comorbidities this association disappears. Spontaneous hypoglycemia, rather than iatrogenic hypoglycemia, is strongly associated with mortality suggesting that hypoglycemia behaves as a biomarker rather than a causative factor of adverse outcomes. Inpatient glycemic management should be patient-centered, follow the current guidelines, and aimed at preventing hypoglycemia.
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http://dx.doi.org/10.1007/s11892-012-0336-x | DOI Listing |
JTCVS Open
December 2024
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Md.
Objective: Previous retrospective studies have established a relationship between postoperative hypoglycemia and adverse outcomes after cardiac surgery, but none have accounted for the cause of hypoglycemia.
Methods: A retrospective review was performed of patients who underwent cardiac surgery at a single institution between 2016 and 2021. Patients were categorized as hypoglycemic if they had 1 or more postoperative blood glucose measurement less than 70 mg/dL and normoglycemic otherwise.
World J Clin Pediatr
December 2024
Department of Pediatrics, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Institute, Milan 20132, Lombardy, Italy.
Background: Diazoxide is the sole approved drug for congenital hyperinsulinism; however, diuretic administration and vigilant monitoring are crucial to prevent and promptly identify potentially life-threatening adverse effects. This report aims to highlight a seldom-considered rare side effect of diazoxide. We believe that this brief report is of general interest to readership and increase the physicians' awareness of the guideline importance.
View Article and Find Full Text PDFJ Pak Med Assoc
October 2024
Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India; Non-communicable disease unit, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
Diabetes can present with multiple manifestations and subjective symptoms. One of these is headache. Headache can be a clinical presentation of diabetes per se, its complications or its comorbidities.
View Article and Find Full Text PDFJ Am Geriatr Soc
October 2024
Charles E. Schmidt College of Medicine, Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA.
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