Growth Hormone and Counterregulation in the Pathogenesis of Diabetes
AbstractPurpose of ReviewCanonical growth hormone (GH)-dependent signaling is essential for growth and counterregulatory responses to hypoglycemia, but also may contribute to glucose homeostasis (even in the absence of hypoglycemia) via its impact on metabolism of carbohydrates, lipids and proteins, body composition, and cardiovascular risk profile. The aim of this review is to summarize recent data implicating GH action in metabolic control, including both IGF-1-dependent and -independent pathways, and its potential role as target for T2D therapy.Recent FindingsExperimental blockade of the GHR can modulate glucose metabol...
Source: Current Diabetes Reports - August 24, 2022 Category: Endocrinology Source Type: research
Mindfulness-Based Interventions: Focus on Pediatric Type 1 and Type 2 Diabetes
AbstractPurpose of ReviewMindfulness-based interventions (MBIs) focus on promoting nonjudgmental, purposeful awareness of the present experience, and they include specific components such as body scan, meditation, and breathing techniques for healthier coping with stress and reduced negative affect. In adult populations with chronic illness (e.g., type 1 diabetes [T1D], type 2 diabetes [T2D], overweight), MBIs have been shown to improve psychosocial outcomes with some improvements in health outcomes as well. Youth with T1D/T2D frequently experience heightened depression as well as diabetes distress, which are associated wi...
Source: Current Diabetes Reports - August 19, 2022 Category: Endocrinology Source Type: research
Potential Clinical Applications for Continuous Ketone Monitoring in the Hospitalized Patient with Diabetes
AbstractPurpose of ReviewIn this review, the authors discuss potential clinical applications for continuous ketone monitoring (CKM) in a broad continuum of clinical settings from pre-hospital care and the emergency department to acute inpatient management and post-discharge follow-up.Recent FindingsThough in its early stages, the concept of a novel continuous ketone sensing technology exerts great potential for use in the detection and hospital management of DKA, namely to overcome diagnostic barriers associated with ketoacidosis in patients with diabetes and obtain real-time BOHB levels, which may be useful in understandi...
Source: Current Diabetes Reports - August 19, 2022 Category: Endocrinology Source Type: research
Electronic Health Record –Based Decision-Making Support in Inpatient Diabetes Management
AbstractPurpose of ReviewThis review discusses ways in which the electronic health record (EHR) can offer clinical decision support (CDS) tools for management of inpatient diabetes and hyperglycemia.Recent FindingsThe use of electronic order sets can help providers order comprehensive basal bolus insulin regimens that are consistent with current guidelines. Order sets have been shown to reduce insulin errors and hypoglycemia rates. They can also help set glycemic targets, give hemoglobin A1C reminders, guide weight-based dosing, and match insulin regimen to nutritional profile. Glycemic management dashboards allow multiple...
Source: Current Diabetes Reports - August 2, 2022 Category: Endocrinology Source Type: research
Evaluating Natural Experiments that Impact the Diabetes Epidemic: an Introduction to the NEXT-D3 Network
AbstractPurpose of ReviewDiabetes is an ongoing public health issue in the USA, and, despite progress, recent reports suggest acute and chronic diabetes complications are increasing.Recent FindingsThe Natural Experiments for Translation in Diabetes 3.0 (NEXT-D3) Network is a 5-year research collaboration involving six academic centers (Harvard University, Northwestern University, Oregon Health& Science University, Tulane University, University of California Los Angeles, and University of California San Francisco) and two funding agencies (Centers for Disease Control and Prevention and National Institutes of Health) to ...
Source: Current Diabetes Reports - July 22, 2022 Category: Endocrinology Source Type: research
Pharmacist Role in Providing Inpatient Diabetes Management
AbstractPurpose of ReviewGlycemic
management of hospitalized patients remains a growing burden in organizations across the country. Attainment of well-established glycemic targets has shown improved clinical outcomes. Empowered glucose management interdisciplinary teams are critical in organizations attaining improved outcomes. Pharmacists possess diverse knowledge and skills that uniquely position them to take a leadership role in healthcare organizations ’ efforts to achieve safe and effective glycemic outcomes in hospitalized patients.Recent FindingsVarious models of pharmacy care have demonstrated success in impro...
Source: Current Diabetes Reports - July 13, 2022 Category: Endocrinology Source Type: research
Lipodystrophy for the Diabetologist —What to Look For
AbstractPurpose of ReviewGenetic or acquired lipodystrophies are characterized by selective loss of body fat along with predisposition towards metabolic complications of insulin resistance, such as diabetes mellitus, hypertriglyceridemia, hepatic steatosis, polycystic ovarian syndrome, and acanthosis nigricans. In this review, we discuss the various subtypes and when to suspect and how to diagnose lipodystrophy.Recent FindingsThe four major subtypes are autosomal recessive, congenital generalized lipodystrophy (CGL); acquired generalized lipodystrophy (AGL), mostly an autoimmune disorder; autosomal dominant or recessive fa...
Source: Current Diabetes Reports - July 11, 2022 Category: Endocrinology Source Type: research
Content Validity of Patient-Reported Outcome Measures Developed for Assessing Health-Related Quality of Life in People with Type 2 Diabetes Mellitus: a Systematic Review
AbstractPurpose of reviewWe aimed to systematically evaluate the content validity of patient-reported outcome measures (PROMs) specifically developed to measure (aspects of) health-related quality of life (HRQOL) in people with type 2 diabetes. A systematic review was performed in PubMed and Embase of PROMs measuring perceived symptoms, physical function, mental function, social function/participation, and general health perceptions, and that were validated to at least some extent. Content validity (relevance, comprehensiveness, and comp rehensibility) was evaluated using COSMIN methodology.Recent findingsWe identified 5...
Source: Current Diabetes Reports - July 11, 2022 Category: Endocrinology Source Type: research
Telehealth for the Management of Diabetes in Pregnancy
AbstractPurpose of ReviewTelehealth initiatives are becoming ubiquitous in clinical practice and can be a useful tool in the management of diabetes in pregnancy. The purpose of this review is to summarize new techniques in telemedicine delivery and offer details on how to leverage telehealth in delivering care to pregnant women with diabetes.Recent FindingsUsing mobile phone technology to collect glucose values in women with gestational diabetes has been found to be beneficial by increasing the amount of glucose data available for interpretation. Remote patient monitoring in non-pregnant people with type 2 diabetes has sho...
Source: Current Diabetes Reports - July 9, 2022 Category: Endocrinology Source Type: research
CGM in the Hospital: Is It Ready for Prime Time?
AbstractPurpose of ReviewThe use of continuous glucose monitoring (CGM) in the hospital setting is growing with more patients using these devices at home and when admitted to the hospital, especially during the COVID-19 pandemic.Recent FindingsHistorically, most evidence for CGM use in the inpatient setting was limited to small studies utilizing outdated CGM technology and analyzing accuracy of sensor measurements. Previous studies have shown reduced sensor accuracy during extreme hypo- or hyperglycemia, rapid fluctuations of glucose, compression of the sensor itself, and in those who are critically ill. Studies that are m...
Source: Current Diabetes Reports - July 7, 2022 Category: Endocrinology Source Type: research
Diabetes Out-of-the-Box: Diabetes Mellitus and Impairment in Hearing and Vision
AbstractPurposeof ReviewThis review aims to provide an update on the etiologies of diabetes that are due to genetic disorders and that co-occur with impaired hearing or vision and to compare them. The potential mechanisms, including novel treatments, will be detailed.Recent FindingsWolfram syndrome, Kearns –Sayre syndrome, thiamine-responsive megaloblastic anemia, and maternally inherited diabetes and deafness are genetic disorders characterized by diabetes, impaired hearing, and vision. They differ in mode of inheritance, age at presentation, and the involvement of other organs; they are often misd iagnosed as type 1 or...
Source: Current Diabetes Reports - July 5, 2022 Category: Endocrinology Source Type: research
Risk of Type 2 Diabetes Among Individuals with Excess Weight: Weight Trajectory Effects
Abstract Purpose of ReviewIncreased risk of type 2 diabetes mellitus (T2D) among individuals with overweight or obesity is well-established; however, questions remain about the temporal dynamics of weight change (gain or loss) on the natural course of T2D in this at-risk population. Existing epidemiologic evidence is limited to studies that discretely sample and assess excess weight and T2D risk at different ages with limited follow-up, yet changes in weight may have time-varying and possibly non-linear effects on T2D risk. Predicting the impact of weight change on the risk of T2D is key to informing primary prevention. ...
Source: Current Diabetes Reports - July 4, 2022 Category: Endocrinology Source Type: research
Machine Learning Models for Inpatient Glucose Prediction
AbstractPurpose of ReviewGlucose management in the hospital is difficult due to non-static factors such as antihyperglycemic and steroid doses, renal function, infection, surgical status, and diet. Given these complex and dynamic factors, machine learning approaches can be leveraged for prediction of glucose trends in the hospital to mitigate and prevent suboptimal hypoglycemic and hyperglycemic outcomes. Our aim was to review the clinical evidence for the role of machine learning –based models in predicting hospitalized patients’ glucose trajectory.Recent FindingsThe published literature on machine learning algorithms...
Source: Current Diabetes Reports - June 27, 2022 Category: Endocrinology Source Type: research
Metabolic Syndrome and Vascular-Associated Cognitive Impairment: a Focus on Preclinical Investigations
AbstractPurpose of ReviewMetabolic syndrome is associated with an increased risk of vascular cognitive impairment or, in the more extreme, vascular dementia. Animal models are used to investigate the relationship between pathology and behaviour. This review summarizes the latest understanding of the role of the hippocampus and prefrontal cortex in vascular cognitive impairment, the influence of inflammation in this association while also commenting on some of the latest interventions proposed.Recent FindingsModels of vascular cognitive impairment and vascular dementia, whether they develop from an infarct or non-infarct ba...
Source: Current Diabetes Reports - June 23, 2022 Category: Endocrinology Source Type: research
Shift Work and Obesity Risk —Are There Sex Differences?
AbstractPurpose of review
Shift work is prevalent among the working population and is linked to an array of adverse health outcomes. This review summarizes current evidence on the relation between shift work and risk of obesity, with a particular emphasis on potential sex differences.Recent findingsObservational data strongly point towards an association between shift work and heightened risk of prevalent and incident obesity, and particularly abdominal obesity. Circadian misalignment and unhealthy lifestyle behaviors are the primary culprits mediating such association. As it pertains to sex differences in the impact of...
Source: Current Diabetes Reports - June 23, 2022 Category: Endocrinology Source Type: research
