scholarly journals The experience of a severe hypoglycemic event from the perspective of people with diabetes and their caregivers: “What am I going to do?”

2021 ◽  
Author(s):  
Heather Stuckey ◽  
Urvi Desai ◽  
Sarah B King ◽  
Lyuba Popadic ◽  
William Levinson ◽  
...  
Keyword(s):  
Hypoglycemic Event

Predictors of recurrent hypoglycemia following a severe hypoglycemic event among hospitalized patients

2015 ◽  
Vol 44 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Michael D’Netto ◽  
Claire V. Murphy ◽  
Antoinett Mitchell ◽  
Kathleen Dungan
Keyword(s):  
Hospitalized Patients ◽  
Hypoglycemic Event ◽  
Recurrent Hypoglycemia

scholarly journals Effectiveness of diabetes self-management education and support via a smartphone application in insulin-treated patients with type 2 diabetes: results of a randomized controlled trial (TRIGGER study)

2019 ◽  
Vol 7 (1) ◽  
pp. e000981 ◽  
Author(s):  
Anne Meike Boels ◽  
Rimke C Vos ◽  
Lioe-Ting Dijkhorst-Oei ◽  
Guy E H M Rutten
Keyword(s):  
Type 2 Diabetes ◽  
Dietary Habits ◽  
Management Education ◽  
Intervention Group ◽  
Self Management ◽  
Smartphone App ◽  
Control Group ◽  
Hypoglycemic Event ◽  
Randomized Controlled

ObjectiveTo investigate the effect of diabetes self-management education and support via a smartphone app in individuals with type 2 diabetes on insulin therapy.Research design and methodsOpen two-arm multicenter parallel randomized controlled superiority trial. The intervention group (n=115) received theory and evidence-based self-management education and support via a smartphone app (optionally two or six times per week, once daily at different times). The control group (n=115) received care as usual. Primary outcome: HbA1c at 6 months. Other outcomes included HbA1c ≤53 mmol/mol (≤7%) without any hypoglycemic event, body mass index, glycemic variability, dietary habits and quality of life. We performed multiple imputation and regression models adjusted for baseline value, age, sex, diabetes duration and insulin dose.ResultsSixty-six general practices and five hospital outpatient clinics recruited 230 participants. Baseline HbA1c was comparable between groups (8.1% and 8.3%, respectively). At 6 months, the HbA1c was 63.8 mmol/mol (8.0%) in the intervention vs 66.2 mmol/mol (8.2%) in the control group; adjusted difference −0.93 mmol/mol (−0.08%), 95% CI −4.02 to 2.17 mmol/mol (−0.37% to 0.20%), p=0.557. The odds for achieving an HbA1c level ≤7% without any hypoglycemic event was lower in the intervention group: OR 0.87, 95% CI 0.33 to 2.35. There was no effect on secondary outcomes. No adverse events were reported.ConclusionsThis smartphone app providing diabetes self-management education and support had small and clinically not relevant effects. Apps should be more personalized and target individuals who think the app will be useful for them.Trial registration numberNTR5515.

scholarly journals Efficacy and Safety of Vildagliptin Compared to Sulphonylurea in Patients with Type 2 Diabetes during Fasting in Ramadan

2016 ◽  
Vol 33 (3) ◽  
pp. 120-125 ◽  
Author(s):  
Md Faruque Pathan ◽  
Md Feroz Amin ◽  
Faria Afsana ◽  
Md Saghir Abdur Rahim ◽  
Md Jahangir Alam Sarker ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Treatment Adherence ◽  
Primary Outcome ◽  
Observational Cohort Study ◽  
Prospective Observational Cohort Study ◽  
Efficacy And Safety ◽  
Hypoglycemic Event ◽  
Observational Cohort ◽  
Safety Signals

The objective of this study is to evaluate the efficacy and safety of vildagliptin compared to sulphonylurea (SU) in Type 2 Diabetes during Fasting in Ramadan. This was a prospective, observational cohort study, which enrolledpatients from Bangladesh. Patients aged >18 years with T2DM and HbA1c <8.5% were treated with vildagliptin or SU as add-on to metformin or as monotherapy for 16 weeks.The primary outcome of interest was to compare the proportion of patients with >1 hypoglycemic event(s) (HE) during fasting between the vildagliptin and SU groups. Changes in HbA1c, body weight and treatment adherence were also measured. Of the 100 patients enrolled, 97completed the study and 3 patients discontinued prematurely. Patients experiencing >1 HE(s) were fewer in the vildagliptingroup compared with SU group (4.3% vs. 8.2%; p=0.678). The reduction in HbA1c was 0.1% with vildagliptin from a baseline of 7.1%,however, there was no changewith SU from a baseline of 7.2% (between-treatment difference: “0.1%; p=0.600). A gain of 0.35kg and 0.08 kg was seen with vildagliptinand SUs treatment, respectively. Overall, the incidence of adverse events was similar betweenthe vildagliptin and SU groups (23.4% vs. 20.4%) with no new safety signals. The treatment with vildagliptin was associated with fewer hypoglycemic events compared with SU and was well tolerated in Muslim T2DM patients fasting during Ramadan.J Bangladesh Coll Phys Surg 2015; 33(3): 120-125

scholarly journals Identifying Potential Intervention Points for Acute Hypoglycemic Events in Patients With Type 2 Diabetes Using Retrospective Clinical Data

2021 ◽  
Author(s):  
Mary E. Lacy ◽  
Rachel A. Whitmer ◽  
Sei J. Lee ◽  
Robert J. Rushakoff ◽  
Mark J. Pletcher
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Private Insurance ◽  
Emergency Department Visits ◽  
Hypoglycemic Event ◽  
Black Race ◽  
Factors Associated ◽  
Acute Hypoglycemia

This retrospective study examined changes in medication orders as a risk factor for future acute hypoglycemic events. The investigators identified factors associated with acute hypoglycemic events resulting in emergency department visits or inpatient admissions. Non-Hispanic Black race, chronic kidney disease, insulin at baseline, and non-private insurance were associated with higher risk of an acute hypoglycemic event, whereas age, sex, and A1C were not. After adjustment for other risk factors, changes in insulin orders after A1C measurement were associated with a 1.5 times higher risk of an acute hypoglycemia (adjusted hazard ratio 1.48, 95% CI 1.08–2.03). These results further understanding of risk factors and clinical processes relevant to predicting and preventing acute hypoglycemia.

Effect of telemedicine intervention on hypoglycaemia in diabetes patients: A systematic review and meta-analysis of randomised controlled trials

2018 ◽  
Vol 25 (7) ◽  
pp. 402-413 ◽  
Author(s):  
Yuli Hu ◽  
Xiaohong Wen ◽  
Feifei Wang ◽  
Dongliang Yang ◽  
Shanshan Liu ◽  
...  
Keyword(s):  
Usual Care ◽  
Positive Impact ◽  
Blood Glucose Concentration ◽  
Mean Difference ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Control Group ◽  
Diabetic Patients ◽  
Hypoglycemic Event ◽  
Significant Difference

Introduction Hypoglycaemia is a clinical syndrome from various causes, which happens when the blood glucose concentration is too low. Many studies show that telemedicine intervention can improve glycemic control and has a positive impact on the management of diabetic patients. The purpose of this study was to evaluate the effect of telemedicine intervention on hypoglycemic event occurrences and results on hemoglobin A1c (HbA1c) and body mass index (BMI). Methods We searched the Cochrane Library, PubMed, Web of Science, the EBSCO host, and OVID to identify relevant studies published from January 2006 to December 2017. The work of searching, selecting and assessing risk of bias was administrated by two independent reviewers. The primary outcomes were hypoglycemic event rate and HbA1c; the secondary outcome was BMI. Results From 1246 articles, we identified 14 eligible RCTs ( n = 1324). Compared to usual care, telemedicine was found to reduce the odds of hypoglycaemia (odds ratio ( OR) = 0.42; 95% confidence interval ( CI) = 0.29–0.59; I2 = 32%; p < 0.00001). We found that the clinical relevance declined in HbA1c level compared to control group (mean difference = −0.28; 95% CI = −0.45 to −0.12; I2 = 53%; p = 0.0005), but that telemedicine had no effect on BMI (mean difference = −0.27; 95% CI = −0.86–0.31; I2 = 40%; p = 0.35). Discussion Compared to usual care, the use of telemedicine was found to improve HbA1c and reduce the risk of moderate hypoglycaemia in diabetic patients, but without significant difference in BMI.

Abstract P074: Racial Differences in the Association Between Hemoglobin A1c and Hypoglycemic Events

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Mary E Lacy ◽  
Rachel A Whitmer ◽  
Mark J Pletcher
Keyword(s):  
African American ◽  
African Americans ◽  
Racial Differences ◽  
Statistical Power ◽  
Hemoglobin A1c ◽  
Severe Hypoglycemia ◽  
Mean Difference ◽  
Hypoglycemic Event ◽  
The Difference ◽  
Elevated Rate

Background: Rates of severe hypoglycemia are higher in African Americans than in whites. We hypothesize that the elevated rate of hypoglycemic events observed in African Americans is a result of treating African Americans and whites to the same target hemoglobin A1c (hbA1c) despite established racial differences in the association between hbA1c and glucose measures. Methods: Using de-identified patient clinical data from 2011- 2017 on 22,554 self-identified African American or white patients with type 2 diabetes from UCSF Health, we examined racial differences in the association between hbA1c and hypoglycemic events. Results: Of the 22,554 patients (17% African American; 54% male; mean age 59.6), 275 experienced a hypoglycemic event requiring medical care; 2.20% of African Americans experienced a hypoglycemic event compared to 1.02% of whites (p<0.001). Of the 275 patients experiencing a hypoglycemic event, 102 had a last recorded hbA1c value within 90 days prior to the event. The mean hbA1c value preceding a hypoglycemic event was 7.50% for African Americans compared to 6.91% in whites (mean difference= 0.59%, 95% confidence interval: -0.38%, 1.56%, p=0.24). In models adjusted for age, sex, and duration of diabetes, the difference in hbA1c was slightly attenuated (mean difference= 0.56%, 95%CI: -0.41%, 1.52%, p=0.26). Conclusion: In this population, African Americans were significantly more likely to experience a hypoglycemic event than whites. HbA1c values preceding the event were slightly higher in African Americans than whites; this finding was not statistically significant but statistical power was potentially limited by sample size.

scholarly journals The Association of Biochemical Hypoglycemia with the Subsequent Risk of a Severe Hypoglycemic Event: Analysis of the DCCT Data Set

2019 ◽  
Vol 21 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Roy W. Beck ◽  
Richard M. Bergenstal ◽  
Tonya D. Riddlesworth ◽  
Craig Kollman
Keyword(s):  
Event Analysis ◽  
Hypoglycemic Event ◽  
Data Set ◽  
Subsequent Risk

scholarly journals Big Insulin-like Growth Factor 2–Producing Tumor in a Hypoglycemic Dog

2020 ◽  
Vol 57 (3) ◽  
pp. 432-436 ◽  
Author(s):  
Syunya Noguchi ◽  
Yoshiaki Kubo ◽  
Mami Araki ◽  
Miki Koh ◽  
Yuji Hamamoto ◽  
...  
Keyword(s):  
Growth Factor ◽  
Islet Cell Tumor ◽  
Severe Hypoglycemia ◽  
Insulin Like Growth Factor ◽  
Chain Reaction ◽  
Hypoglycemic Event ◽  
Hypoglycemic Attack ◽  
Tumor Region ◽  
Polymerase Chain ◽  
The Right

A 10-year-old female Papillon dog that had previously developed a mammary tumor was admitted for treatment of a hypoglycemic attack. Blood examination showed severe hypoglycemia and decreased blood insulin concentration. Computed tomography indicated multiple tumors in the cranial and caudal lobes of the right lung. These tumors were resected surgically and diagnosed as pulmonary adenocarcinomas by histopathologic examination. Hypoglycemia was temporarily improved after the resection, but a hypoglycemic event occurred 2 months after the surgery. Immunohistochemistry of the tumor demonstrated the expression of insulin-like growth factor 2 in tumor cells. Western blot analysis revealed the expression of high-molecular-weight (big)–insulin-like growth factor 2 in the tumor region. Insulin-like growth factor 2 mRNA expression was also confirmed in the tumor using reverse transcription–polymerase chain reaction. These findings indicate the diagnosis of non–islet cell tumor-induced hypoglycemia caused by big-insulin-like growth factor 2 produced by the tumor in the dog. This report provides information on differentiating tumors that cause paraneoplastic hypoglycemia.

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