Targeted Glycemic Control for Adult Patients With Type 2 Diabetes Mellitus in the Acute Care Setting

Pourmand, Ali; Mazer‐Amirshahi, Maryann; Caggiula, Amy; Nawab, Aria; Payette, Christopher; Johnson, Samuel G.

doi:10.1016/j.jcjd.2018.01.015

Cited by 4 publications

(3 citation statements)

References 68 publications

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“…Diabetes mellitus (DM), characterized by elevated levels of blood glucose, is a complex and heterogeneous, chronic metabolic disease [ 14 ]. DM is the leading cause of morbidity and mortality worldwide and is a major global health problem [ 15 , 16 ]. DM is divided into four different etiological categories: type 1 DM (T1DM), type 2 DM (T2DM), other specific types, and gestational DM.…”

Section: Introductionmentioning

confidence: 99%

Relationship between transforming growth factor-β1 and type 2 diabetic nephropathy risk in Chinese population

Zhou

Zhong

et al. 2018

BMC Med Genet

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BackgroundDiabetes mellitus (DM) is divided into four different etiological categories: type 1 DM (T1DM), type 2 DM (T2DM), other specific types, and gestational DM. One severe complication of T2DM is type 2 diabetic nephropathy (T2DN). The possible association of serum transforming growth factor-β1 (TGF-β1) levels and the TGF-β1 T869C gene polymorphism with patient susceptibility to T2DN in Chinese population is unclear at present. This study was conducted to assess these relationships in Chinese population by a meta-analysis.MethodsAssociation reports were searched and pulled from the Cochrane Library, the China Biological Medicine Database (CBM), and PubMed on March 1, 2018, and eligible studies were selected and used for calculations. The results were expressed as weighted mean differences (MD) for continuous data. Odds ratios (OR) were used to express the results for dichotomous data. Additionally, 95% confidence intervals (CI) were calculated.ResultsForty-eight reports for the relationship between serum TGF-β1 levels and the risk of T2DN and 13 studies on the association of the TGF-β1 T869C gene polymorphism with susceptibility to T2DN in Chinese population were retrieved from this study. Serum TGF-β1 levels in the T2DM group were higher than those in the normal control group (MD = 17.30, 95% CI: 12.69–21.92, P < 0.00001). The serum TGF-β1 level in the T2DN group was significantly higher than that in the normal control group (MD = 70.03, 95% CI: 60.81–79.26, P < 0.00001;). The serum TGF-β1 level in the T2DN group was significantly higher than that in the T2DM group (MD = 56.18, 95% CI: 46.96–65.39, P < 0.00001). Serum TGF-β1 levels in T2DM patients with microalbuminuria were increased when compared with those in T2DM patients with normoalbuminuria. Furthermore, serum TGF-β1 levels in T2DM patients with macroalbuminuria were increased when compared with those in T2DM patients with microalbuminuria. The TGF-β1 T allele, TT allele and CC genotype were associated with T2DN susceptibility in Chinese population (T: OR = 0.74, 95% CI: 0.59–0.92, P = 0.007; TT: OR = 0.55, 95% CI: 0.31–0.96, P = 0.04; CC: OR = 1.38, 95% CI: 1.14–1.67, P = 0.001).ConclusionsHigh levels of TGF-β1 are associated with susceptibility to T2DM, T2DN and the progression of proteinuria in T2DN patients in Chinese population. Further, the TGF-β1 T allele, and TT genotype were protective factors against the onset of T2DN and CC genotype was a risk factor for the susceptibility of T2DN in Chinese populations.

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Section: Introductionmentioning

confidence: 99%

Relationship between transforming growth factor-β1 and type 2 diabetic nephropathy risk in Chinese population

Zhou

Zhong

et al. 2018

BMC Med Genet

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“…These hormones increase gluconeogenesis, inhibit β-cell insulin release, and decrease glucose uptake which can impact disease severity and overall mortality. [2][3][4] Left untreated, elevated blood glucose levels can lead to detrimental patient outcomes including infection, stroke, venous thromboembolism, increased hospital length of stay and increased mortality. 5 Patients without a known diagnosis of diabetes are at highest risk of these adverse outcomes.…”

Section: Introductionmentioning

confidence: 99%

“… 7 Hyperglycemia produces the previously mentioned outcomes through altered tissue metabolism, increased oxidative stress, immunosuppression, impaired wound healing and thickening of capillary basement membranes which contributes to hypercoaguability. 2 , 3 The current 2020 American Diabetes Association guidelines recommend that for patients who are hospitalized, blood glucose should be maintained between 140-180 mg/dL. 1 This recommendation is supported by evidence of an increased risk of death seen from hypoglycemia (blood glucose ≤70 mg/dL).…”

Section: Introductionmentioning

confidence: 99%

Effect of Average Blood Glucose Greater Than 140 mg/dL on Adverse Patient Outcomes in Adult Medical/Surgical Patients

Wynes

Boyle

2021

Innov Pharm

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Background: In hospitalized patients, hyperglycemia is defined as blood glucose greater than 140 mg/dL. Hyperglycemia can lead to the development of nosocomial infections as well as cardiovascular events. Despite these risks, current guidelines recommend blood glucose be maintained between 140-180 mg/dL. Previous studies have shown that elevated blood glucose levels are associated with increased patient mortality. However, these studies assessed blood glucose at a single point in time. Objective: The primary objective of this study is to determine the impact of average blood glucose >140 mg/dL on a composite outcome of intensive care unit transfer, death, length of stay > 4 days, development of nosocomial infection, or new cardiovascular event (myocardial infarction [MI], ischemic stroke, deep vein thrombosis [DVT], pulmonary embolism [PE], or new onset heart failure) occurring during patient admission. Methods: This single centered, randomized, case-control, retrospective chart review sorted adult medical/surgical patients into two groups, average blood glucose ≤140 mg/dL or >140 mg/dL, of 120 patients each. Results: Forty-seven (39.2%) patients in the >140 mg/dL group experienced the primary composite outcome versus 27 (22.5%) patients in the ≤140 mg/dL group (p=0.005). Secondary outcomes found that patients with diabetes in the >140 mg/dL group were more likely to experience the primary outcome than those in the ≤140 mg/dL group (41 (48.8%) vs 3 (13.6%) p=0.003). Conclusions: This study found that medical/surgical patients with an average blood glucose >140 mg/dL may be at an increased risk of developing adverse patient outcomes.

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Comparison of two glycemic discharge goals in ED patients with hyperglycemia, a randomized trial

Klein

Cole

Prekker

et al. 2019

The American Journal of Emergency Medicine

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Targeted Glycemic Control for Adult Patients With Type 2 Diabetes Mellitus in the Acute Care Setting

Cited by 4 publications

References 68 publications

Relationship between transforming growth factor-β1 and type 2 diabetic nephropathy risk in Chinese population

Relationship between transforming growth factor-β1 and type 2 diabetic nephropathy risk in Chinese population

Effect of Average Blood Glucose Greater Than 140 mg/dL on Adverse Patient Outcomes in Adult Medical/Surgical Patients

Comparison of two glycemic discharge goals in ED patients with hyperglycemia, a randomized trial

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