scholarly journals Adjunctive Sitagliptin Therapy in Postoperative Cardiac Surgery Patients: A Pilot Study

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Marcia L. Brackbill ◽  
Ateequr Rahman ◽  
Jeffrey S. Sandy ◽  
M. Denton Stam ◽  
Arthur F. Harralson
Keyword(s):  
Cardiac Surgery ◽  
Blood Glucose ◽  
Pilot Study ◽  
Repeated Measures ◽  
Management Practices ◽  
Blood Glucose Control ◽  
Control Group ◽  
Diabetic Patients ◽  
Significant Difference ◽  
Mean Blood Glucose

Aim. We aimed to determine if sitagliptin added to standard postoperative standardized sliding-scale insulin regimens improved blood glucose.Methods. A prospective, randomized, double-blind, placebo-controlled pilot study was conducted in diabetic cardiac surgery patients. Patients received sitagliptin or placebo after surgery for 4 days. The primary endpoint was to estimate the effect of adjunctive sitagliptin versus placebo on overall mean blood glucose in the 4-day period after surgery.Results. Sixty-two patients participated. Repeated measures tests indicated no significant difference between the groups in the overall mean blood glucose level with a mean of147.2±4.8 mg/dL and153.0±4.6 mg/dL for the test and the control group, respectively (P=0.388).Conclusions. Sitagliptin added to normal postoperative glucose management practices did not improve overall mean blood glucose control in diabetic patients in the postoperative setting.

scholarly journals Assessment of Blood Glucose and Electrolytes during Cardiopulmonary Bypass in Diabetic and Non-Diabetic Patients of Pakistan

2016 ◽  
Vol 8 (9) ◽  
pp. 159
Author(s):  
Muhammad Bilal ◽  
Abdul Haseeb ◽  
Mohammad Hassaan Khan ◽  
Akash Khetpal ◽  
Muhammad Saad ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Cardiopulmonary Bypass ◽  
Repeated Measures ◽  
Artery Bypass ◽  
The Body ◽  
Diabetic Patients ◽  
Blood Electrolytes ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Significant Difference

<p><strong>INTRODUCTION: </strong>Perioperative hyperglycemia has been shown to be related to higher levels of morbidity and mortality in patients on cardiopulmonary bypass (CPB) undergoing coronary artery bypass grafting (CABG), both diabetic and non-diabetic. Blood electrolytes, like sodium, potassium, calcium, and chloride play a very important role in the normal functioning of the body and can lead to a variety of clinical disorders if they become deficient. A minimal number of studies have been conducted on the simultaneous perioperative changes in both blood glucose and electrolyte levels during CPB in Pakistan. Therefore, our aim is to record and compare the changes in blood glucose and electrolyte levels during CPB in diabetic and non-diabetic patients.</p><p><strong>MATERIALS &amp; METHODS: </strong>This was a prospective, observational study conducted on 200 patients who underwent CABG with CPB, from October 2014 to March 2015. The patients were recruited from the Cardiac Surgery Ward, Civil Hospital Karachi after they complied with the inclusion criteria. Repeated-measures analysis of variance (ANOVA) was used to compare the trend of the changes perioperatively for the two groups.</p><p><strong>RESULTS: </strong>There was no significant difference in changes in blood glucose between the two groups (<em>P</em> = 0.62). The only significant difference detected between the two groups was for PaCO<sub>2</sub> (<em>P</em> = 0.001). Besides, further analysis revealed insignificant group differences for the trend changes in other blood electrolytes (<em>P</em> &gt; 0.05).</p><p><strong>CONCLUSION: </strong>Our findings highlighted that there is no significant difference in blood electrolytes changes and the increase in blood glucose levels between diabetic and non-diabetic patients.</p>

scholarly journals Intraoperative Hyperglycemia May be Associated with an Increased Risk of Myocardial Injury After Non-Cardiac Surgery in Diabetic Patients

2021 ◽  
Author(s):  
Sojin Kim ◽  
Jungchan Park ◽  
Kwangmo Yang ◽  
Jin-ho Choi ◽  
Kyunga Kim ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Myocardial Injury ◽  
Blood Glucose Control ◽  
Postoperative Mortality ◽  
Normal Group ◽  
Diabetic Patients ◽  
Increased Risk

Abstract Background: Hyperglycemia in surgical candidates is associated with increased mortality and morbidity. We aimed to evaluate the effect of intraoperative blood glucose level on the incidence of myocardial injury after non-cardiac surgery (MINS) in diabetic patients.Methods: Diabetic patients with available intraoperative blood glucose measurement during non-cardiac surgery were enrolled in this study. Based on the highest intraoperative blood glucose level, patients were stratified into two groups; the normal group (intraoperative peak glucose < 180mg/dL) and the hyperglycemia group (intraoperative peak glucose ≥ 180mg/dL). The primary outcome was the incidence of MINS, and secondary outcomes were in-hospital and 30-day mortalities.Results: Of the 11,302 diabetic patients, 8,337 patients were in the normal group (73.8%), and 2,965 patients were in the hyperglycemia group (26.2%). After inverse probability weighting adjustment, MINS was significantly higher in the hyperglycemia group (24.0% vs 17.2%; odds ratio [OR], 1.26; 95% confidence interval [CI], 1.14 – 1.40; p < 0.001). In addition, in-hospital and 30-day mortalities were also higher in the hyperglycemia group compared to the normal group (4.2% vs 2.3%, hazard ratio [HR], 1.39; 95% CI, 1.07 - 1.81; p=0.01, and 3.1% vs 1.8%; HR, 1.76; 95% CI, 1.31 - 2.36; p < 0.001, respectively). Receiver-operating characteristic plots showed that the threshold of glucose level related to MINS was 149mg/dL.Conclusion: Intraoperative hyperglycemia was associated with an increased MINS incidence and postoperative mortality in diabetic patients. Intraoperative blood glucose control may be helpful in preventing MINS.

scholarly journals Selfcare in Type I Diabetes with Continuous Glucose Monitoring

2019 ◽  
Vol 8 (1) ◽  
pp. 5
Author(s):  
Elham Nazari ◽  
Somaye Nazari
Keyword(s):  
Blood Glucose ◽  
Type I Diabetes ◽  
Blood Glucose Control ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Control Group ◽  
Diabetic Patients ◽  
Type I ◽  
Online Data ◽  
Data Set

Introduction: The number of diabetes patients are increasing. If the blood glucose is not controlled in diabetics, patients will face with complications. Self-care is important to control the blood glucose of diabetic patients and prevention of complications such as neurological complications, heart, eye disease, amputations and so on. Therefore aim of this study is to identify the effect of Continuous blood Glucose Monitoring or CGM on the blood glucose control in type I diabetes.Materials and methods: The study was done on 20 patients chosen from an online data set available in http://www.jaeb-diabetes.net/ . These patients used CGM to test blood glucose and the result of three month test was measured. To analyze the data, the software SPSS 21, independent Mann- Whitney test was used.Results: The results showed that blood glucose in patients of the experimental group reduced significantly rather than patient of the control group in the second and third month. Also, HbA1C of the patients has reduced.Conclusion: The CGM has an effective role in controlling blood glucose and prevention of complications. Therefore it is recommended that educational programs on the use of monitoring blood glucose, such as CGM as a requirement to be developed.

scholarly journals Glycemic Status of Type 2 Diabetic Patients Treated with Different Single Anti-diabetic Agents

2016 ◽  
Vol 5 (2) ◽  
pp. 92-97
Author(s):  
Sultana Marufa Shefin ◽  
Nazmul Kabir Qureshi ◽  
Sazzad Hossain Khandker ◽  
Faria Afsana ◽  
Omar Faruque ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Control ◽  
Age Groups ◽  
Diabetic Patients ◽  
Glycemic Status ◽  
Type 2 Diabetic Patients ◽  
Significant Difference ◽  
Glucose Profiles ◽  
Type 2 Diabetic

Objective: The study was aimed to describe the patterns of single anti-diabetic agents used by type 2 diabetic patients and their glycemic status during hospital admission.Study design and methods: This cross-sectional study was carried out in BIRDEM among hospitalized type 2 adult diabetic patients of different ages and both sexes. Data were collected during admission that included detailed history, medical records review, clinical examination and laboratory investigations.Results: Subjects (n=253; 174 female, 79 male) had age (years) as mean ± SD: 55.28 ±13.45 (15- 90 years), BMI (kg/m2) as mean ±SD: 24.67±4.97 and HbA1c (%) as mean ±SD: 10.56±2.98. Use of pre-mixed insulin 90 (35.57%) and split-mixed insulin 70 (27.66%) were more common than other drugs. Glycaemic control was poor in all age groups as evidenced by raised HbA1c, significantly higher in patients <40 years age group. Blood glucose profiles were also high among the all age groups. HbA1c and blood glucose profiles both were high irrespective of type of anti-diabetic agents used during admission. It was also found that patients with increasing age groups were using insulin more frequently. BMI categorization had no significance within treatment groups. (p=0.453).Conclusion: There was no significant difference in blood glucose control among the different single anti-diabetic drug users, that might be due to treatment of diabetes includes medical nutrition therapy with judicious and individualized dietary plan, lifestyle modification, effective exercise plan, and individualized target oriented use of anti-diabetic agents. Along with proper selection of anti-diabetic agents, patient’s self-management education and disease-specific awareness is essential to achieve good glycemic control.Birdem Med J 2015; 5(2): 92-97

scholarly journals Risk Assessment of Perioperative Infection about 263 Diabetic Patients Undergoing Small Bowel Lateral-lateral Anastomos(intestinal bypass)

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Haolin Xie ◽  
Hongliang Lv ◽  
Hongyi Zhang ◽  
Hu Jin
Keyword(s):  
Risk Assessment ◽  
Blood Glucose ◽  
Small Bowel ◽  
Antimicrobial Agents ◽  
Blood Glucose Control ◽  
Control Group ◽  
Diabetic Patients ◽  
Intestinal Bypass ◽  
Observation Group ◽  
The Difference

Objective: Analyze and summarize the risk assessment of perioperative infection of 263 diabetic patients undergoing small bowel lateral-lateral anastomos(intestinal bypass )in the small intestine's side ,discuss the managerial methods of antimicrobial agents during the perioperative period. Methods: Retrospectively analyze the clinical data of patients who underwent laparoscopic small bowel lateral anastomosis (intestinal bypass) from January 2018 to December 2018. The patients with HBA1c ?9.0% were selected as the observation group and patients with HBA1c < 9.0% as the control group. Results: The decling range of the average value about blood glucose in the observation group was greater than that in the control group. The difference was statistically significant (P<0.05). The average postoperative neutrophil ratio of the observation group was higher than that of the control group; and the difference was statistically significant(P<0.05). The proportion of patients with postoperative body temperature over 37 degrees in the observation group was higher than that in the control group. Conclusion: Laparoscopic lateral anastomosis (intestinal bypass surgery) may cause intestinal fluid overflow and intestinal flora ectopic, for the diabetic patients with poor blood glucose control, perioperative risk of infection increased, we should consider strengthening the grade of antimicrobial agents in preventive application, better cover gram-negative bacteria and anaerobic bacteria.

Poor Intraoperative Blood Glucose Control Is Associated with a Worsened Hospital Outcome after Cardiac Surgery in Diabetic Patients

2005 ◽  
Vol 103 (4) ◽  
pp. 687-694 ◽  
Author(s):  
Alexandre Ouattara ◽  
Patrick Lecomte ◽  
Yannick Le Manach ◽  
Marc Landi ◽  
Sophie Jacqueminet ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Postoperative Morbidity ◽  
Heart Surgery ◽  
Blood Glucose Control ◽  
Diabetic Patients ◽  
Hospital Outcome ◽  
Blood Glucose Concentrations

Background Tight perioperative control of blood glucose improves the outcome of diabetic patients undergoing cardiac surgery. Because stress response and cardiopulmonary bypass can induce profound hyperglycemia, intraoperative glycemic control may become difficult. The authors undertook a prospective cohort study to determine whether poor intraoperative glycemic control is associated with increased intrahospital morbidity. Methods Two hundred consecutive diabetic patients undergoing on-pump heart surgery were enrolled. A standard insulin protocol based on subcutaneous intermediary insulin was given the morning of the surgery. Intravenous insulin therapy was initiated intraoperatively from blood glucose concentrations of 180 mg/dl or greater and titrated according to a predefined protocol. Poor intraoperative glycemic control was defined as four consecutive blood glucose concentrations greater than 200 mg/dl without any decrease in despite insulin therapy. Postoperative blood glucose concentrations were maintained below 140 mg/dl by using aggressive insulin therapy. The main endpoints were severe cardiovascular, respiratory, infectious, neurologic, and renal in-hospital morbidity. Results Insulin therapy was required intraoperatively in 36% of patients, and poor intraoperative glycemic control was observed in 18% of patients. Poor intraoperative glycemic control was significantly more frequent in patients with severe postoperative morbidity (37% vs. 10%; P &lt; 0.001). The adjusted odds ratio for severe postoperative morbidity among patients with a poor intraoperative glycemic control as compared with patients without was 7.2 (95% confidence interval, 2.7-19.0). Conclusion Poor intraoperative control of blood glucose concentrations in diabetic patients undergoing cardiac surgery is associated with a worsened hospital outcome after surgery.

Effect of Coenzyme Q10 on Oxidative Stress, Glycemic Control and Inflammation in Diabetic Neuropathy: A Double Blind Randomized Clinical Trial

2014 ◽  
Vol 84 (5-6) ◽  
pp. 252-260 ◽  
Author(s):  
Maryam Akbari Fakhrabadi ◽  
Ahmad Zeinali Ghotrom ◽  
Hassan Mozaffari-Khosravi ◽  
Hossein Hadi Nodoushan ◽  
Azadeh Nadjarzadeh
Keyword(s):  
Oxidative Stress ◽  
Clinical Trial ◽  
Blood Glucose ◽  
Insulin Sensitivity ◽  
Diabetic Neuropathy ◽  
Lipid Profile ◽  
Coenzyme Q10 ◽  
Control Group ◽  
Diabetic Patients ◽  
Significant Difference

Abstract. Objective: This 12-week randomized placebo controlled clinical trial investigated the effect of Coenzyme Q10 (CoQ10) on diabetic neuropathy, oxidative stress, blood glucose and lipid profile of patients with type 2 diabetes. Methods: Diabetic patients with neuropathic signs (n = 70) were randomly assigned to CoQ10 (200 mg/d) or placebo for 12 weeks. Blood samples were collected for biochemical analysis and neuropathy tests before and after the trial. Results: There were no significant differences between the two groups in terms of mean fasting blood glucose, HbA1c and the lipid profile after the trial. The mean insulin sensitivity and total antioxidant capacity (TAC) concentration significantly increased in the Q10 group compared to the placebo after the trial (P < 0.05). C-reactive protein (hsCRP) significantly decreased in the intervention group compared to placebo after the trial (P < 0.05). In the control group, insulin sensitivity decreased and HOMA-IR increased, which revealed a significant difference between groups after the trial. Neuropathic symptoms and electromyography measurements did not differ between two groups after the trial. Conclusions: According to the present study, CoQ10, when given at a dose of 200 mg/d for 12 weeks to a group of neuropathic diabetic patients, did not improve the neuropathy signs compared to placebo, although it had some beneficial effects on TAC and hsCRP and probably a protective effect on insulin resistance.

Introducing the Cardibra: A Randomised Pilot Study of a Purpose Designed Support Bra for Women Having Cardiac Surgery

2005 ◽  
Vol 4 (3) ◽  
pp. 220-226 ◽  
Author(s):  
Carolyn Naismith ◽  
Annette Street
Keyword(s):  
Wound Healing ◽  
Cardiac Surgery ◽  
Pilot Study ◽  
Repeated Measures ◽  
Control Group ◽  
Therapeutic Effects ◽  
Post Surgery ◽  
Therapeutic Benefits ◽  
Lateral Tension ◽  
Reduction Of Pain

Background: Cardiac nurses instruct women to wear a brassiere (bra) after a sternotomy for cardiac surgery to reduce lateral tension on the wound. However this practice is rarely implemented because regular bras impede nursing care in the immediate postoperative period. The Cardibra was developed to address the inadequacies of the regular bra and provide an alternate method of breast support. Aim: To develop a purpose designed support bra (the Cardibra) and evaluate its effectiveness on sternal wound healing and the reduction of pain for women who had a sternotomy for cardiac surgery. Methods: The study consisted of two stages. Stage 1 described the development of the Cardibra. Stage 2 was a pilot study of a clinical trial, prospective, randomised two-group design. The treatment group consisted of 10 women using the Cardibra immediately following surgery and the control group of 10 who wore a regular bra 3 days post surgery. Repeated measures at six time points assessed pain levels and wound healing. Results: This study indicated that the Cardibra might have beneficial therapeutic effects on pain levels and wound healing up to day 14 after cardiac surgery. Conclusion: This innovative device may offer therapeutic benefits to women following cardiac surgery.

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