179 results match your criteria: "Metabolic Disease and Stroke - Hyperglycemia Hypoglycemia"
The association between the stress hyperglycaemia ratio and mortality in cardiovascular disease: a meta-analysis and systematic review.
Cardiovasc Diabetol
November 2024
Department of Cardiology, Imperial College Healthcare NHS Trust, London, UK.
Background: A raised stress hyperglycaemia ratio (SHR) has been associated with all-cause mortality and may better discriminate than an absolute glucose value. The aim of this meta analysis and systematic review is to synthesise the evidence assessing the relationship between the SHR and all-cause mortality across three common cardiovascular presentations.
Methods: We undertook a comprehensive search of Medline, Embase, Cochrane CENTRAL and Web of Science from the date of inception to 1st March 2024, and selected articles meeting the following criteria: studies of patients hospitalised for acute myocardial infarction, ischaemic stroke or acute heart failure reporting the risk (odds ratio or hazard ratio) for all-cause mortality associated with the SHR.
Effect of frailty on effectiveness and safety of GLP-1 receptor agonists versus SGLT2 inhibitors in people with type 2 diabetes in Taiwan: a retrospective, nationwide, longitudinal study.
Lancet Healthy Longev
September 2024
Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan. Electronic address:
Background: GLP-1 receptor agonists and SGLT2 inhibitors are increasingly being used in people with type 2 diabetes on the basis of findings from randomised clinical trials; however, little is known of whether clinical outcomes are affected by frailty in real-world settings. We aimed to compare the clinical effectiveness and safety of GLP-1 receptor agonists and SGLT2 inhibitors in managing type 2 diabetes, with a specific focus on stratifying people by their frailty status.
Methods: In this retrospective, nationwide, longitudinal study, we identified people (aged ≥20 years) with type 2 diabetes who newly initiated either a GLP-1 receptor agonist or an SGLT2 inhibitor during the period Jan 1, 2017 to Dec 31, 2019 from the Taiwan National Health Insurance database.
Glucose control during pregnancy in patients with type 1 diabetes correlates with fetal hemodynamics: a prospective longitudinal study.
BMC Pregnancy Childbirth
April 2024
Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
Article Synopsis
- - **Context**: Maternal diabetes negatively impacts the development of the fetal cardiovascular system, with an emphasis on the link between maternal glucose control and fetal heart structure/function.
- - **Study Design**: A case-control study with 62 pregnant women with type 1 diabetes and 30 healthy controls assessed fetal heart measures in the second and third trimesters using various ultrasound techniques, while analyzing maternal glucose management over three gestational periods.
- - **Findings**: Fetuses of diabetic mothers showed significant changes (e.g., increased heart dimensions and output) compared to controls, and certain fetal heart metrics were inversely related to poor glucose control and higher hemoglobin levels
Diabetic striatopathy and other acute onset de novo movement disorders in hyperglycemia.
Diabetes Metab Syndr
March 2024
Department of Endocrinology & Metabolism, Medical College & Hospital, Kolkata, India. Electronic address:
Article Synopsis
- Acute onset of movement disorders, particularly hemichorea-hemiballism, is a recognized but often underreported complication of diabetes, linked to episodes of hyperglycemia.* -
- A comprehensive literature review from 1950 to October 2023 was conducted, analyzing various case studies and research to understand diabetic striatopathy, including its risk factors and underlying mechanisms.* -
- Diabetic striatopathy, defined by specific imaging features, is influenced by multiple interconnected factors and may present with symptoms beyond movement disorders, although it generally has a favorable prognosis.*
Safety and efficacy of tight versus loose glycemic control in acute stroke patients: A meta-analysis of randomized controlled trials.
Int J Stroke
August 2024
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Article Synopsis
- Hyperglycemia negatively impacts stroke recovery, but it's unclear if strict glucose control improves outcomes during acute stroke periods; this study performed a meta-analysis to explore this relationship.
- The analysis included 15 randomized controlled trials with a focus on the effects of tight versus loose glycemic control on stroke patients within 24 hours after onset, measuring outcomes like 90-day mortality and disability scores.
- Results indicated no significant difference in 90-day mortality between those receiving tight glycemic control and those receiving loose control, suggesting that strict management may not confer additional benefits on survival following a stroke.
Disparities in Acute and Chronic Complications of Diabetes Along the U.S. Rural-Urban Continuum.
Diabetes Care
May 2024
Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
Article Synopsis
- The study aimed to evaluate the risks associated with acute and chronic complications of diabetes among people living in different areas of the U.S., from rural to urban settings.
- Using a large dataset from the OptumLabs Data Warehouse, researchers analyzed health records of over 2.9 million adults with diabetes from 2012 to 2021, comparing complication rates based on population density.
- Results indicated that while remote area residents faced higher risks for certain heart issues, those in small towns experienced greater overall diabetes complications, suggesting a need for further investigation into the factors contributing to these health disparities.
Knowledge of Complications of Diabetes Mellitus Among Patients Visiting the Diabetes Clinics: A Cross-Sectional Study in the Qassim Region.
Cureus
December 2023
Department of Family Medicine, University of Szeged Albert Szent-Györgyi Medical School, Szeged, HUN.
Article Synopsis
- Diabetes mellitus (DM) is a growing global health crisis, increasing the risk of serious complications like heart disease, stroke, and chronic kidney disease, affecting both wealthy and poorer populations.
- A study in Saudi Arabia assessed the knowledge and attitudes of diabetes patients regarding these complications, involving 368 participants at the Diabetes Clinics of King Fahad Specialist Hospital.
- Results showed that 75% of participants were aware of diabetic complications, with most having received information primarily from healthcare professionals, though social media also played a noticeable role.
Management of Poststroke Hyperglycemia: Results of the TEXAIS Randomized Clinical Trial.
Stroke
December 2023
Department of Neurology, Christchurch Hospital, New Zealand (T.W., J.F.).
Article Synopsis
- Hyperglycemia in acute ischemic stroke negatively impacts treatment effectiveness and outcomes, leading researchers to explore exenatide, a GLP-1 receptor agonist, as a potential alternative.
- The TEXAIS trial involved 350 patients, comparing the effects of exenatide versus standard care on stroke recovery over a 5-day period, focusing on improvements in the National Institutes of Health Stroke Scale (NIHSS) scores.
- Results showed slightly better recovery outcomes in the exenatide group, with no instances of hypoglycemia noted, though the differences were not statistically significant, and recruitment was halted early due to COVID-19 challenges.
Molecular and biochemical mechanisms of diabetic encephalopathy.
Acta Biochim Pol
November 2023
Department of Clinical Laboratory Diagnostics, Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine.
Article Synopsis
- * The review discusses the molecular mechanisms behind diabetic encephalopathy, addressing issues like oxidative stress, mitochondrial dysfunction, and changes in the thiol-disulfide system.
- * HSP70 is highlighted as an important neuroprotective protein that helps manage protein processes in cells and could be a potential therapeutic target for treating diabetes-related complications.
From diabetic hyperglycemia to cerebrovascular Damage: A narrative review.
Brain Res
December 2023
Laboratory of Neurobiology of Inflammatory and Metabolic Processes, Graduate Program in Health Sciences, Health Sciences Unit, University of South Santa Catarina, Tubarão, SC, Brazil.
Article Synopsis
- - Diabetes mellitus causes significant health issues, particularly vascular damage that can lead to serious conditions like heart disease and strokes.
- - High blood sugar levels harm blood vessels and can also affect the brain, leading to conditions like diabetic encephalopathy, which increases the risk of ischemic strokes.
- - Understanding the connection between diabetes and stroke is essential to create effective treatments that can reduce the overall health risks and complications associated with diabetes.
Role of GLP-1 Receptor Agonist in Diabetic Cardio-renal Disorder: Recent Updates of Clinical and Pre-clinical Evidence.
Curr Diabetes Rev
May 2024
Department of Pharmacology, ISF College of Pharmacy, GT Road, GhalKalan, Moga 142001, Punjab, India.
Cardiovascular complications and renal disease is the growing cause of mortality in patients with diabetes. The subversive complications of diabetes such as hyperglycemia, hyperlipidemia and insulin resistance lead to an increase in the risk of myocardial infarction (MI), stroke, heart failure (HF) as well as chronic kidney disease (CKD). Among the commercially available anti-hyperglycemic agents, incretin-based medications appear to be safe and effective in the treatment of type 2 diabetes mellitus (T2DM) and associated cardiovascular and renal disease.
View Article and Find Full Text PDFImproved postoperative blood glucose control through implementation of clinical pharmacist driven glycemic management model after colorectal surgery.
Am J Surg
June 2023
Mayo Clinic, 201 West Center Street, Rochester, MN, 55902, USA.
Article Synopsis
- Poor postoperative blood sugar control can lead to serious complications like increased mortality and longer hospital stays.
- A study comparing a pharmacist-managed approach to standard care in colorectal surgery patients with Type 2 Diabetes showed better blood sugar levels and fewer hyperglycemic events with the pharmacist model.
- Utilizing pharmacists in postoperative care improves glycemic control and may reduce negative outcomes for patients.
Admission glucose as a prognostic marker for all-cause mortality and cardiovascular disease.
Cardiovasc Diabetol
November 2022
Department of Clinical Science and Research, Karolinska Institutet, Stockholm, Sweden.
Article Synopsis
- - The study investigated whether patients with elevated blood glucose but no prior diabetes history face higher risks of mortality and cardiovascular events compared to those with normal glucose levels.
- - An analysis of 618,694 emergency department patients in Sweden showed that those with hypoglycemia had the highest mortality risk, followed by those with hyperglycemia and dysglycemia, while normal glucose tolerance represented the lowest risk group.
- - Results indicated that patients with hyperglycemia were at significant risk for cardiovascular issues, including myocardial infarction and stroke, demonstrating the importance of blood glucose levels in emergency settings.
Efficacy and Safety of Analog Insulin in Comparison With Human Insulin for Hyperglycemia in Hospitalized Patients With Acute Stroke: A Randomized, Open-Label, Single-Center Trial.
Endocr Pract
January 2023
Department of Neurology, National Institute of Neurosciences and Hospital, Sher-E-Bangla Nagar, Agargaon, Dhaka, Bangladesh.
Article Synopsis
- The study aimed to compare the effectiveness and safety of analog insulins versus human insulins for controlling high blood sugar in hospitalized patients with acute strokes.
- In a trial with 102 patients, there were no significant differences in average blood glucose levels or hypoglycemic events between the two insulin types, but severe hypoglycemia primarily occurred in those using human insulin.
- The results suggested that while both types of insulin had similar outcomes, analog insulins may lead to slightly lower insulin requirements and a lower risk of severe hypoglycemia in patients with acute stroke and hyperglycemia.
Pre-diabetes, Diabetes, Hyperglycemia, and Stroke: Bittersweet Therapeutic Opportunities.
Curr Neurol Neurosci Rep
November 2022
Department of Neurology, Medical College of Georgia at Augusta University, Augusta, GA, USA.
Article Synopsis
- The review discusses how chronic high blood sugar (hyperglycemia) in diabetes mellitus (DM) contributes to vascular complications and might worsen injuries during acute events like ischemic stroke.
- A recent study found that lowering hyperglycemia during acute ischemic stroke did not show significant benefits for patient outcomes, which helps refine clinical practices for treating these patients.
- Despite the lack of evidence supporting blood sugar reduction in acute stroke improving recovery, the review highlights the need for further research in specific scenarios.
Association between diabetes mellitus and post-stroke cognitive impairment.
J Diabetes Investig
January 2023
Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.
Article Synopsis
- Stroke survivors experience a range of physical, emotional, and cognitive impairments influenced by factors like underlying diseases, brain function, the stroke location, and inflammation.
- The text discusses how diabetes mellitus affects brain changes in stroke survivors that can lead to cognitive dysfunction, including the impact of blood sugar levels on cognitive outcomes.
- It further explores biomarkers for predicting post-stroke cognitive impairment and dementia, along with strategies for improving glycemic control to prevent these issues.
Characterising frailty, metrics of continuous glucose monitoring, and mortality hazards in older adults with type 2 diabetes on insulin therapy (HARE): a prospective, observational cohort study.
Lancet Healthy Longev
November 2021
Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; School of Public Health, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
Article Synopsis
- - The study investigated the connection between frailty, dysglycaemia, and mortality in older adults (70+) with type 2 diabetes on insulin therapy using continuous glucose monitors (CGMs), revealing a link between greater frailty and hypoglycaemia.
- - Conducted in Hong Kong, the HARE study included 225 participants (with 215 providing usable data) and examined factors like age, glycated hemoglobin (HbA), and renal function, finding that frailty levels increased with poorer health metrics.
- - Results showed that 8 out of 11 CGM metrics were significantly tied to frailty, particularly noting that decreased time in range (TIR) and increased time above range (TAR) were
Influence of Optimal Management of Hyperglycemia and Intensive Nursing on Blood Glucose Control Level and Complications in Patients with Postoperative Cerebral Hemorrhage.
Comput Math Methods Med
September 2022
Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
Article Synopsis
- Cerebral hemorrhage is a serious type of stroke, contributing to a significant portion of stroke cases and linked with high rates of complications and mortality.
- The study aimed to assess how effective optimized management of high blood sugar and intensive care nursing is on patients recovering from postoperative cerebral hemorrhage.
- Results showed that patients in the optimized care group had better blood glucose control and shorter times to achieve standard blood glucose levels compared to those receiving conventional care, although electrolyte levels were similar between the two groups.
Changes in glycaemic control of oral anti-diabetic medications assessed by continuous glucose monitors among patients with type 2 diabetes: a protocol of network meta-analysis.
Syst Rev
June 2022
School of Management, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China.
Article Synopsis
- * The review will analyze randomized clinical trials published between 2000 and 2021 using CGM data to measure key health outcomes, including HbA1c levels, time in hypo/hyperglycemic states, and changes in weight and cardiovascular health.
- * Study quality will be ensured through independent reviews and assessments using the GRADE tool, aiming to identify significant trends and impacts of oral anti-diabetic medications on glucose control and overall health in adults with type 2 diabetes.
Glycaemic Variability and Hyperglycaemia as Prognostic Markers of Major Cardiovascular Events in Diabetic Patients Hospitalised in Cardiology Intensive Care Unit for Acute Heart Failure.
J Clin Med
March 2022
Endocrinology-Metabolic Diseases, Hôpital Saint-André, Bordeaux University, 33000 Bordeaux, France.
Article Synopsis
- Hyperglycaemia and hypoglycaemia are significant risk factors for cardiovascular disease, but the impact of glycaemic variability (GV) on major cardiovascular events in diabetic patients with acute heart failure is not well understood.
- An observational study involving 392 diabetic patients with acute heart failure was conducted, where GV was measured and various major cardiovascular events (MACE) such as hospitalisation, myocardial infarction, and cardiac death were tracked over a median follow-up of 29 months.
- The study found that a GV greater than 50 mg/dL, along with factors like age over 75, low left ventricular ejection fraction, and female gender, were strong independent predictors of mid-term MACE in these patients.
Trends in the Incidence of Hospitalization for Major Diabetes-Related Complications in People With Type 1 and Type 2 Diabetes in Australia, 2010-2019.
Diabetes Care
April 2022
Baker Heart and Diabetes Institute, Melbourne, Australia.
Article Synopsis
- - The study analyzed hospitalization trends for major diabetes-related complications in over 1 million Australians with type 1 and type 2 diabetes from 2010 to 2019, revealing distinct patterns for each type.
- - In individuals with type 1 diabetes, complications were mostly stable, with exceptions for increased stroke and hyperglycemia rates, while type 2 diabetes showed a decline in myocardial infarction, heart failure, and hypoglycemia hospitalizations.
- - Overall, type 2 diabetes patients saw improvements in complication rates for older age groups, but rising hospitalization rates for lower-extremity amputation and hyperglycemia highlight ongoing challenges.
Preliminary results of effect of barley (Hordeum vulgare L.) extract on liver, pancreas, kidneys and cardiac tissues in streptozotocin induced diabetic rats.
Eur J Transl Myol
November 2021
School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran.
Diabetes mellitus (DM) and its complications impose a significant burden on patients and the health care system. In the Traditional Persian Medicine (TPM), barley is recommended for treatment of DM. This study sought to assess the effect of barley seed aqueous extract on hepatic, pancreatic, renal and cardiac tissues in normal (non-diabetic) and Streptozotocin-induced diabetic rats.
View Article and Find Full Text PDFNovel approaches to hypoglycemia and burnt-out diabetes in chronic kidney disease.
Curr Opin Nephrol Hypertens
January 2022
Providence Healthcare, Spokane.
Purpose Of Review: Diabetes mellitus is a leading cause of chronic kidney disease (CKD) that confers faster kidney disease progression, higher mortality, and various metabolic derangements including hypoglycemia.
Recent Findings: Even in the absence of diabetes mellitus, growing research demonstrates that CKD patients are at heightened risk for hypoglycemia via multiple pathways. In CKD patients transitioning to end-stage renal disease (ESRD), spontaneous resolution of hyperglycemia and frequent hypoglycemia resulting in reduction and/or cessation of glucose-lowering medications are frequently observed in a phenomenon described as 'burnt-out diabetes'.
A randomized trial to investigate the efficacy and safety of insulin glargine in hyperglycemic acute stroke patients receiving intensive care.
Sci Rep
June 2021
Stroke Center and Department of Neurology, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, 10055, Taiwan.
Article Synopsis
- The study compared two insulin regimens, insulin glargine (IG) and neutral protamine Hagedorn (NPH), in stroke patients with high blood sugar receiving intensive care.
- It involved 50 patients, with measurements taken over 72 hours to see how well each insulin type maintained blood glucose levels between 80-180 mg/dL.
- The results showed that both IG and NPH were similarly effective and safe, with no significant differences in blood sugar control or post-stroke outcomes.
GLP-1 receptor agonists in the treatment of type 2 diabetes - state-of-the-art.
Mol Metab
April 2021
Diabetes Division, Katholisches Klinikum Bochum, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany.
Background: GLP-1 receptor agonists (GLP-1 RAs) with exenatide b.i.d.
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