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Diabetes Mellitus HELP
Based on 100,000 articles published since 2008
|||| 36 

These are the 100000 published articles about Diabetes Mellitus that originated from Worldwide during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline [Consensus statement of the Chilean endocrinological society on the role of bariatric surgery in type 2 diabetes]. 2018

Sapunar, Jorge / Escalona, Alex / Araya, A Verónica / Aylwin, Carmen Gloria / Bastías, María Juliana / Boza, Camilo / Cárcamo, Carlos / Csendes A, Attila / Davidof F, Patricio / Funke, Ricardo / Gómez, Patricia / González, María Isabel / Lahsen, Rodolfo / Lanzarini, Enrique / Maíz, Alberto / Mujica, Verónica / Muñoz, Rodrigo / Pérez, Gustavo / Raimann, Félix / Salman, Patricio / Sepúlveda, Matías / Soto, Néstor / Villagrán, Rodrigo. ·Departamento de Medicina Interna y Centro EPICYN, Facultad de Medicina, Universidad de la Frontera, Temuco, Chile. · Clínica Universidad de los Andes, Facultad de Medicina, Universidad de los Andes, Santiago, Chile. · Hospital Clínico, Universidad de Chile, Santiago, Chile. · Sección Endocrinología, Diabetes y Nutrición, Departamento de Medicina Interna, Hospital Naval Almirante Nef, Viña del Mar, Chile. · Clínica Las Condes, Santiago, Chile. · Instituto de Cirugía, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile. · Hospital FACH, Santiago, Chile. · Clínica Sanatorio Alemán, Concepción, Chile. · Departamento. Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. · Facultad de Medicina, Universidad Católica del Maule, Talca, Chile. · Departamento de Cirugía Digestiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. · Centro Integral de Obesidad y Diabetes, Servicio de Cirugía y Endoscopía, Clínica Puerto Varas, Puerto Varas, Chile. · Unidad de Endocrinología, Departamento de Medicina Interna, Facultad de Medicina. universidad de Concepción. Concepción, Chile. · Hospital de la Dirección de Previsión de Carabineros de Chile (DIPRECA). Santiago, Chile. · Unidad de Endocrinología y Diabetes, Servicio de Medicina Interna, Hospital San Borja Arriarán. Santiago, Chile. · Departamento de Cirugía Bariátrica Metabólica, Clínica Bupa Antofagasta. Antofagasta, Chile. ·Rev Med Chil · Pubmed #30724982.

ABSTRACT: Diabetes Mellitus (DM) and obesity are a public health problem in Chile. Bariatric surgery is the most effective treatment alternative to achieve a significant and sustained weight reduction in patients with morbid obesity. The results of controlled clinical trials indicate that, compared to medical treatment, surgery for obese patients with DM2 allows a better control of blood glucose and cardiovascular risk factors, reduces the need for medications and increases the likelihood for remission. Consensus conferences and clinical practice guidelines support bariatric surgery as an option to treat DM2 in Class III Obesity (Body Mass Index (BMI) > 40) regardless of the glycemic control and the complexity of pharmacological treatment and in Class II Obesity (BMI 35-39,9) with inadequate glycemic control despite optimal pharmacological treatment and lifestyle. However, surgical indication for patients with DM2 and BMI between 30-34.9, the most prevalent sub-group, is only suggested. The Chilean Societies of Endocrinology and Diabetes and of Bariatric and Metabolic Surgery decided to generate a consensus regarding the importance of other factors related to DM2 that would allow a better selection of candidates for surgery, particularly when weight does not constitute an indication. Considering the national reality, we also need a statement regarding the selection and characteristics of the surgical procedure as well as the role of the diabetologist in the multidisciplinary team.

2 Guideline Recommendations of the Polish Society of Gynecologists and Obstetricians regarding caesarean sections. 2018

Wielgos, Miroslaw / Bomba-Opoń, Dorota / Breborowicz, Grzegorz H / Czajkowski, Krzysztof / Debski, Romuald / Leszczynska-Gorzelak, Bozena / Oszukowski, Przemyslaw / Radowicki, Stanislaw / Zimmer, Mariusz. ·1st Chair and Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland. dbomba@wum.edu.pl. ·Ginekol Pol · Pubmed #30508218.

ABSTRACT: -- No abstract --

3 Guideline Clinical and Investigative Endocrinology and Diabetes. 2018

Anonymous3541075. · ·Endocr Pract · Pubmed #30430841.

ABSTRACT: -- No abstract --

4 Guideline [Definition, epidemiology and risk factors of obstetric anal sphincter injuries: CNGOF Perineal Prevention and Protection in Obstetrics Guidelines]. 2018

Thubert, T / Cardaillac, C / Fritel, X / Winer, N / Dochez, V. ·Service de gynécologie-obstétrique, hôpitaux de Nantes, CHU Hôtel-Dieu, 38, boulevard Jean-Monnet, 44000 Nantes, France; Université de Nantes, 1, rue Gaston-Veil, 44000 Nantes, France; GMC-UPMC 01, GREEN (Groupe de recherche clinique en neurourologie), 4, rue de la Chine, 75020 Paris, France. Electronic address: thibault.thubert@chu-nantes.fr. · Service de gynécologie-obstétrique, hôpitaux de Nantes, CHU Hôtel-Dieu, 38, boulevard Jean-Monnet, 44000 Nantes, France; Université de Nantes, 1, rue Gaston-Veil, 44000 Nantes, France. · Service de gynécologie-obstétrique, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France. ·Gynecol Obstet Fertil Senol · Pubmed #30385355.

ABSTRACT: OBJECTIVES: The aim of this review was to agree on a definition of the obstetric anal sphincter injuries (OASIS), to determine the prevalence and risk factors. METHODS: A comprehensive review of the literature on the obstetric anal sphincter injuries (OASIS), establishment of levels of evidence (NP), and grades of recommendation according to the methodology of the recommendations for clinical practice. RESULTS: To classify obstetric anal sphincter injuries (OASIS), we have used the WHO-RCOG classification, which lists 4 degrees of severity. To designate obstetric anal sphincter injuries, we have used the acronym OASIS, rather than the standard French terms of "complete perineum" and "complicated complete perineum". OASIS with only isolated involvement of the EAS (3a and 3b) appears to have a better functional prognosis than OASIS affecting the IAS or the anorectal mucosa (3c and 4) (LE3). The prevalence of women with ano-rectal symptoms increases with the severity of the OASIS (LE3). In the long term, 35-60% of women who had an OASIS have anal or fecal incontinence (LE3). The prevalence of an OASI in the general population is between 0.25 to 6%. The prevalence of OASIS in primiparous women is between 1.4 and 16% and thus, should be considered more important than among the multiparous women (0.4 to 2.7%). In women with a history of previous OASIS, the risk of occurrence is higher and varies between 5.1 and 10.7% following childbirth. The priority in this context remains the training of childbirth professionals (midwives and obstetricians) to detect these injuries in the delivery room, immediately after the birth. The training and awareness of these practitioners of OASIS diagnosis improves its detection in the delivery room (LE2). Professional experience is associated with better detection of OASIS (LE3) (4). Continuing professional education of obstetrics professionals in the diagnosis and repair of OASIS must be encouraged (Grade C). In the case of second-degree perineal tear, the use of ultrasound in the delivery room improves the diagnosis of OASIS (LE2). Ultrasound decreases the prevalence of symptoms of severe anal incontinence at 1 year (LE2). The diagnosis of OASIS is improved by the use of endo-anal ultrasonography in post-partum (72h-6weeks) (LE2). The principal factors associated with OASIS are nulliparity and instrumental (vaginal operative) delivery; the others are advanced maternal age, history of OASIS, macrosomia, midline episiotomy, posterior cephalic positions, and long labour (LE2). The presence of a perianal lesion (perianal fissure, or anorectal or rectovaginal fistula) is associated with an increased risk of 4th degree lacerations (LE3). Crohn's disease without perianal involvement is not associated with an excess risk of OASIS (LE3). For women with type III genital mutilation, deinfibulation before delivery is associated with a reduction in the risk of OASIS (LE3); in this situation, deinfibulation is recommended before delivery (grade C). CONCLUSION: It is necessary to use a consensus definition of the OASIS to be able to better detect and treat them.

5 Guideline 2019 Canadian guideline for physical activity throughout pregnancy. 2018

Mottola, Michelle F / Davenport, Margie H / Ruchat, Stephanie-May / Davies, Gregory A / Poitras, Veronica J / Gray, Casey E / Jaramillo Garcia, Alejandra / Barrowman, Nick / Adamo, Kristi B / Duggan, Mary / Barakat, Ruben / Chilibeck, Phil / Fleming, Karen / Forte, Milena / Korolnek, Jillian / Nagpal, Taniya / Slater, Linda G / Stirling, Deanna / Zehr, Lori. ·R Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, Children's Health Research Institute, The University of Western Ontario, London, Ontario, Canada. · Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada. · Department of Human Kinetics, Universite du Quebec a Trois-Rivieres, Trois-Rivieres, Quebec, Canada. · Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada. · Independent Researcher, Ottawa, Ontario, Canada. · Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. · Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. · School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada. · Canadian Society for Exercise Physiology, Ottawa, Ontario, Canada. · Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain. · College of Kinesiology, University of Saskatchewan, Saskatoon, Canada. · Department of Family and Community Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. · Department of Family and Community Medicine, University of Toronto, Granovsky Gluskin Family Medicine Centre, Sinai Health System, Sinai Health System, Toronto, Ontario, Canada. · Canadian Association of Midwives, Toronto, Canada. · John W Scott Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada. · Middlesex-London Health Unit, London, Ontario, Canada. · School of Health and Human Services, Camosun College, Victoria, Canada. ·Br J Sports Med · Pubmed #30337460.

ABSTRACT: The objective is to provide guidance for pregnant women and obstetric care and exercise professionals on prenatal physical activity. The outcomes evaluated were maternal, fetal or neonatal morbidity, or fetal mortality during and following pregnancy. Literature was retrieved through searches of MEDLINE, EMBASE, PsycINFO, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Scopus and Web of Science Core Collection, CINAHL Plus with Full Text, Child Development & Adolescent Studies, Education Resources Information Center, SPORTDiscus, ClinicalTrials.gov and the Trip Database from inception up to 6 January 2017. Primary studies of any design were eligible, except case studies. Results were limited to English-language, Spanish-language or French-language materials. Articles related to maternal physical activity during pregnancy reporting on maternal, fetal or neonatal morbidity, or fetal mortality were eligible for inclusion. The quality of evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation methodology. The Guidelines Consensus Panel solicited feedback from end users (obstetric care providers, exercise professionals, researchers, policy organisations, and pregnant and postpartum women). The development of these guidelines followed the Appraisal of Guidelines for Research and Evaluation II instrument. The benefits of prenatal physical activity are moderate and no harms were identified; therefore, the difference between desirable and undesirable consequences (net benefit) is expected to be moderate. The majority of stakeholders and end users indicated that following these recommendations would be feasible, acceptable and equitable. Following these recommendations is likely to require minimal resources from both individual and health systems perspectives.

6 Guideline Behavioral Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults: US Preventive Services Task Force Recommendation Statement. 2018

Anonymous2781080 / Curry, Susan J / Krist, Alex H / Owens, Douglas K / Barry, Michael J / Caughey, Aaron B / Davidson, Karina W / Doubeni, Chyke A / Epling, John W / Grossman, David C / Kemper, Alex R / Kubik, Martha / Landefeld, C Seth / Mangione, Carol M / Phipps, Maureen G / Silverstein, Michael / Simon, Melissa A / Tseng, Chien-Wen / Wong, John B. ·University of Iowa, Iowa City. · Fairfax Family Practice Residency, Fairfax, Virginia. · Virginia Commonwealth University, Richmond. · Veterans Affairs Palo Alto Health Care System, Palo Alto, California. · Stanford University, Stanford, California. · Harvard Medical School, Boston, Massachusetts. · Oregon Health & Science University, Portland. · Columbia University, New York, New York. · University of Pennsylvania, Philadelphia. · Virginia Tech Carilion School of Medicine, Roanoke. · Kaiser Permanente Washington Health Research Institute, Seattle. · Nationwide Children's Hospital, Columbus, Ohio. · Temple University, Philadelphia, Pennsylvania. · University of Alabama at Birmingham. · University of California, Los Angeles. · Brown University, Providence, Rhode Island. · Boston University, Boston, Massachusetts. · Northwestern University, Evanston, Illinois. · University of Hawaii, Honolulu. · Pacific Health Research and Education Institute, Honolulu, Hawaii. · Tufts University, Medford, Massachusetts. ·JAMA · Pubmed #30326502.

ABSTRACT: Importance: More than 35% of men and 40% of women in the United States are obese. Obesity is associated with health problems such as increased risk for coronary heart disease, type 2 diabetes, various types of cancer, gallstones, and disability. Obesity is also associated with an increased risk for death, particularly among adults younger than 65 years. Objective: To update the US Preventive Services Task Force (USPSTF) 2012 recommendation on screening for obesity in adults. Evidence Review: The USPSTF reviewed the evidence on interventions (behavioral and pharmacotherapy) for weight loss or weight loss maintenance that can be provided in or referred from a primary care setting. Surgical weight loss interventions and nonsurgical weight loss devices (eg, gastric balloons) are considered to be outside the scope of the primary care setting. Findings: The USPSTF found adequate evidence that intensive, multicomponent behavioral interventions in adults with obesity can lead to clinically significant improvements in weight status and reduce the incidence of type 2 diabetes among adults with obesity and elevated plasma glucose levels; these interventions are of moderate benefit. The USPSTF found adequate evidence that behavior-based weight loss maintenance interventions are of moderate benefit. The USPSTF found adequate evidence that the harms of intensive, multicomponent behavioral interventions (including weight loss maintenance interventions) in adults with obesity are small to none. Therefore, the USPSTF concludes with moderate certainty that offering or referring adults with obesity to intensive behavioral interventions or behavior-based weight loss maintenance interventions has a moderate net benefit. Conclusions and Recommendation: The USPSTF recommends that clinicians offer or refer adults with a body mass index of 30 or higher to intensive, multicomponent behavioral interventions. (B recommendation).

7 Guideline Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). 2018

Davies, Melanie J / D'Alessio, David A / Fradkin, Judith / Kernan, Walter N / Mathieu, Chantal / Mingrone, Geltrude / Rossing, Peter / Tsapas, Apostolos / Wexler, Deborah J / Buse, John B. ·Diabetes Research Centre, University of Leicester, Leicester, U.K. · Leicester Diabetes Centre, Leicester General Hospital, Leicester, U.K. · Department of Medicine, Duke University School of Medicine, Durham, NC. · National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. · Department of Medicine, Yale School of Medicine, New Haven, CT. · Clinical and Experimental Endocrinology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium. · Department of Internal Medicine, Catholic University, Rome, Italy. · Diabetes and Nutritional Sciences, King's College London, London, U.K. · Steno Diabetes Center Copenhagen, Gentofte, Denmark. · University of Copenhagen, Copenhagen, Denmark. · Second Medical Department, Aristotle University Thessaloniki, Thessaloniki, Greece. · Department of Medicine and Diabetes Unit, Massachusetts General Hospital, Boston, MA. · Harvard Medical School, Boston, MA. · Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC jbuse@med.unc.edu. ·Diabetes Care · Pubmed #30291106.

ABSTRACT: The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the prior position statements, published in 2012 and 2015, on the management of type 2 diabetes in adults. A systematic evaluation of the literature since 2014 informed new recommendations. These include additional focus on lifestyle management and diabetes self-management education and support. For those with obesity, efforts targeting weight loss, including lifestyle, medication, and surgical interventions, are recommended. With regards to medication management, for patients with clinical cardiovascular disease, a sodium-glucose cotransporter 2 (SGLT2) inhibitor or a glucagon-like peptide 1 (GLP-1) receptor agonist with proven cardiovascular benefit is recommended. For patients with chronic kidney disease or clinical heart failure and atherosclerotic cardiovascular disease, an SGLT2 inhibitor with proven benefit is recommended. GLP-1 receptor agonists are generally recommended as the first injectable medication.

8 Guideline Glycaemic management during the inpatient enteral feeding of people with stroke and diabetes. 2018

Roberts, A W / Penfold, S / Anonymous3251013. ·Cardiff and Vale University Health Board, Cardiff, UK. · Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth, UK. ·Diabet Med · Pubmed #30152589.

ABSTRACT: This paper is an abridged and modified version of guidelines produced by the Joint British Diabetes Societies for inpatient care on glycaemic management during the enteral feeding of people with stroke and diabetes. These were revised in 2017 and have been adapted specifically for Diabetic Medicine. The full version can be found at: www.diabetes.org.uk/joint-british-diabetes-society or https://abcd.care/joint-british-diabetes-societies-jbds-inpatient-care-group. Many people have both diabetes and an acute stroke, and a stanv dard approach to the management of people with stroke is the provision of adequate nutrition. Frequently, this involves a period of enteral feeding if there is impaired ability to swallow food safely. There is currently considerable variability in the management of people with diabetes fed enterally after a stroke, and the evidence base guiding diabetes management in this clinical situation is very weak, although poor glycaemic outcomes in people receiving enteral feeding after stroke may worsen recovery and cause harm. The aim of this document is to provide sensible clinical guidance in this area, written by a multidisciplinary team; this guideline had input from diabetes specialist nurses, diabetologists, dietitians, stroke physicians and pharmacists with expertise in this area, and from UK professional organizations. It is aimed at multidisciplinary teams managing people with stroke and diabetes who require enteral feeding. We recognize that there is limited clinical evidence in this area.

9 Guideline Managing hyperglycaemia during antenatal steroid administration, labour and birth in pregnant women with diabetes. 2018

Dashora, U / Murphy, H R / Temple, R C / Stanley, K P / Castro, E / George, S / Dhatariya, K / Haq, M / Sampson, M / Anonymous3241013. ·Conquest Hospital, St Leonards on Sea, UK. · Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. · Norwich Medical School, University of East Anglia, Norwich, UK. · Norfolk and Norwich University Hospital, Norwich, UK. · East Sussex Healthcare NHS Trust, St Leonards on Sea, UK. · East and North Hertfordshire NHS Trust, Stevenage, UK. · Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells, UK. ·Diabet Med · Pubmed #30152588.

ABSTRACT: Optimal glycaemic control before and during pregnancy improves both maternal and fetal outcomes. This article summarizes the recently published guidelines on the management of glycaemic control in pregnant women with diabetes on obstetric wards and delivery units produced by the Joint British Diabetes Societies for Inpatient Care and available in full at www.diabetes.org.uk/joint-british-diabetes-society and https://abcd.care/joint-british-diabetes-societies-jbds-inpatient-care-group. Hyperglycaemia following steroid administration can be managed by variable rate intravenous insulin infusion (VRIII) or continuous subcutaneous insulin infusion (CSII) in women who are willing and able to safely self-manage insulin dose adjustment. All women with diabetes should have capillary blood glucose (CBG) measured hourly once they are in established labour. Those who are found to be higher than 7 mmol/l on two consecutive occasions should be started on VRIII. If general anaesthesia is used, CBG should be monitored every 30 min in the theatre. Both the VRIII and CSII rate should be reduced by at least 50% once the placenta is delivered. The insulin dose needed after delivery in insulin-treated Type 2 and Type 1 diabetes is usually 25% less than the doses needed at the end of first trimester. Additional snacks may be needed after delivery especially if breastfeeding. Stop all anti-diabetes medications after delivery in gestational diabetes. Continue to monitor CBG before and 1 h after meals for up to 24 h after delivery to pick up any pre-existing diabetes or new-onset diabetes in pregnancy. Women with Type 2 diabetes on oral treatment can continue to take metformin after birth.

10 Guideline Management of hyperglycaemia and steroid (glucocorticoid) therapy: a guideline from the Joint British Diabetes Societies (JBDS) for Inpatient Care group. 2018

Roberts, A / James, J / Dhatariya, K / Anonymous3221013. ·Cardiff and Vale University Local Health Board, Cardiff, UK. · University Hospitals Leicester NHS Trust, Leicester, UK. · Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK. ·Diabet Med · Pubmed #30152586.

ABSTRACT: Glucocorticoids (steroids) are widely used across many medical specialities for their anti-inflammatory and immunosuppressive properties. However, one of their major side effects is the development of hyperglycaemia. It is well recognized that high glucose levels in people with diabetes in hospital are associated with harm and increased lengths of hospital stay. The use of glucocorticoid (steroid) treatment in people with pre-existing diabetes will undoubtedly result in worsening glucose control, and this may be termed 'steroid-induced hyperglycaemia', and will warrant temporary additional, and more active, glycaemic management. A rise in glucose may occur in people without a known diagnosis of diabetes, and this may be termed 'steroid-induced diabetes'. There is a lack of evidence to guide how people with hyperglycaemia should be managed, and much of the guidance given here is a consensus based on best practice collated from around the United Kingdom. Where evidence is available, this is referenced. These guidelines on the management of people with diabetes treated with steroids has been adapted specifically for Diabetic Medicine. The full version of the guidelines can be found on line at: www.diabetes.org.uk/joint-british-diabetes-society or https://abcd.care/joint-british-diabetes-societies-jbds-inpatient-care-group.

11 Guideline Management of adults with diabetes on the haemodialysis unit: summary of guidance from the Joint British Diabetes Societies and the Renal Association. 2018

Frankel, A H / Kazempour-Ardebili, S / Bedi, R / Chowdhury, T A / De, P / El-Sherbini, Nevine / Game, F / Gray, S / Hardy, D / James, J / Kong, M-F / Ramlan, G / Southcott, E / Winocour, P. ·Imperial College Healthcare NHS Trust, London, UK. · Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Iran. · Royal London Hospital, Whitechapel, London, UK. · Birmingham City Hospital (Sandwell and West Birmingham Hospitals NHS Trust), Birmingham, UK. · Derby Teaching Hospitals NHS Foundation Trust and University of Nottingham, UK. · East and North Herts NHS Trust, UK. · University Hospitals of Leicester NHS Trust, UK. · North Middlesex University Hospital NHS Trust, UK. · St James University Hospital, Leeds, UK. · Queen Elizabeth II Hospital, Welwyn Garden City, UK. ·Diabet Med · Pubmed #30152585.

ABSTRACT: Diabetic nephropathy remains the principal cause of end-stage renal failure in the UK and its prevalence is set to increase. People with diabetes and end-stage renal failure on maintenance haemodialysis are highly vulnerable, with complex comorbidities, and are at high risk of adverse cardiovascular outcomes, the leading cause of mortality in this population. The management of people with diabetes receiving maintenance haemodialysis is shared between diabetes and renal specialist teams and the primary care team, with input from additional healthcare professionals providing foot care, dietary support and other aspects of multidisciplinary care. In this setting, one specialty may assume that key aspects of care are being provided elsewhere, which can lead to important components of care being overlooked. People with diabetes and end-stage renal failure require improved delivery of care to overcome organizational difficulties and barriers to communication between healthcare teams. No comprehensive guidance on the management of this population has previously been produced. These national guidelines, the first in this area, bring together in one document the disparate needs of people with diabetes on maintenance haemodialysis. The guidelines are based on the best available evidence, or on expert opinion where there is no clear evidence to inform practice. We aim to provide clear advice to clinicians caring for this vulnerable population and to encourage and improve education for clinicians and people with diabetes to promote empowerment and self-management.

12 Guideline Royal College of Psychiatrists Liaison Faculty & Joint British Diabetes Societies (JBDS): guidelines for the management of diabetes in adults and children with psychiatric disorders in inpatient settings. 2018

Price, H C / Ismail, K / Anonymous3211013. ·Southern Health NHS Foundation Trust, Southampton, UK. · Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK. ·Diabet Med · Pubmed #30152583.

ABSTRACT: The Royal College of Psychiatrists Liaison Faculty & Joint British Diabetes Societies (JBDS) for Inpatient Care guidelines for the management of diabetes in adults and children with psychiatric disorders in inpatient settings are available in full at: www.diabetes.org.uk/joint-british-diabetes-society and https://abcd.care/joint-british-diabetes-societies-jbds-inpatient-care-group. This article summarizes the guidelines and recommendations. Commissioners are urged to ensure that the needs of people with diabetes and severe mental illness are specifically addressed in contracts with providers of inpatient care, and to avoid financial or other barriers to cross-organizational working and to ensure that patient-structured education is commissioned to meets the complex needs of people with diabetes and severe mental illness. Acute trusts are asked to develop joint pathways with mental health providers and facilitate multidisciplinary working and to screen for mental ill health in those admitted with acute complications of diabetes whose aetiology is unclear or not medically explained. Mental health trusts should create a diabetes register, screen for diabetes, particularly in those prescribed second-generation antipsychotics and ensure that staff are trained in managing and avoiding hypoglycaemia, and the safe use of insulin. Finally, clinical teams should ensure that all staff can access training in diabetes and mental health to support them to care for people with both diabetes and severe mental illness, develop local pathways for joint working and ensure best practice tariff criteria are met for diabetic ketoacidosis and hypoglycaemia, and for children and young people with diabetes.

13 Guideline Updates to the 2018

Anonymous4960959. · ·Diabetes Care · Pubmed #30135199.

ABSTRACT: -- No abstract --

14 Guideline Type 1 Diabetes in Children and Adolescents: A Position Statement by the American Diabetes Association. 2018

Chiang, Jane L / Maahs, David M / Garvey, Katharine C / Hood, Korey K / Laffel, Lori M / Weinzimer, Stuart A / Wolfsdorf, Joseph I / Schatz, Desmond. ·McKinsey & Company and Diasome Pharmaceuticals, Inc., Palo Alto, CA. · Department of Pediatrics, Stanford University School of Medicine, Stanford, CA. · Division of Endocrinology, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, MA. · Joslin Diabetes Center, Harvard Medical School, Boston, MA. · Pediatric Endocrinology & Diabetes, Yale School of Medicine, New Haven, CT. · Division of Endocrinology, Department of Pediatrics, University of Florida, Gainesville, FL schatz@ufl.edu. ·Diabetes Care · Pubmed #30093549.

ABSTRACT: -- No abstract --

15 Guideline Consensus document of the Spanish Society of Arteriosclerosis (SEA) for the prevention and treatment of cardiovascular disease in type 2 diabetes mellitus. 2018

Ruiz-García, Antonio / Arranz-Martínez, Ezequiel / Morón-Merchante, Ignacio / Pascual-Fuster, Vicente / Tamarit, Juan J / Trias-Villagut, Ferran / Pintó-Sala, Xavier / Ascaso, Juan F / Anonymous3610974. ·Centro de Salud Universitario Pinto, Unidad de Lípidos y Prevención Cardiovascular, Universidad Europea de Madrid, Pinto, Madrid, España. · Centro de Salud San Blas, Parla, Madrid, España. · Centro de Salud Universitario Goya, Universidad Autónoma de Madrid, Madrid, España. · Centro de Salud Palleter, Universidad CEU-Cardenal Herrera, Castellón, España. Electronic address: pascual_vic@gva.es. · Consorcio Hospital General Universitario, Valencia, España. · Hospital de Bellvitge, Universitat de Barcelona, Barcelona, España. · Hospital Clínico-Universitat de València, INCLIVA Research Institute, CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), ISCIII, Valencia, España. ·Clin Investig Arterioscler · Pubmed #30053980.

ABSTRACT: A consensus document of the Diabetes working group of the Spanish Society of Arteriosclerosis (SEA) is presented, based on the latest studies and conceptual changes that have appeared. It presents the cardiovascular risk in type 2 diabetes mellitus (T2DM) and the action guidelines for the prevention and treatment of cardiovascular disease (CVD) associated with T2DM. The importance of lipid control, based on the objective of LDL-C and non-HDL-C when there is hypertriglyceridemia, and the blood pressure control in the prevention and treatment of CVD is evaluated. The new hypoglycemic drugs and their effects on CVD are reviewed, as well as the treatment and control guidelines of hyperglycemia. Likewise, the use of antiplatelet agents is considered. Emphasis is placed on the importance of global and simultaneous action on all risk factors to achieve a significant reduction in cardiovascular events. This supplement is sponsored by Laboratorios Esteve, S.A.

16 Guideline Practical Recommendations for Glucose Measurement, Glucose Monitoring and Glucose Control in Patients with Type 1 or Type 2 Diabetes in Germany. 2018

Heinemann, Lutz / Deiss, Dorothee / Siegmund, Thorsten / Schlüter, Sandra / Naudorf, Michael / von Sengbusch, Simone / Lange, Karin / Freckmann, Guido. ·Arbeitsgemeinschaft Diabetes & Technologie der Deutschen Diabetes Gesellschaft e.V., Ulm (Diabetes & Technology Working Group of the German Diabetes Association). · Arbeitsgemeinschaft für Pädiatrische Diabetologie e. V., Münster (Paediatric Diabetology Working Group). ·Exp Clin Endocrinol Diabetes · Pubmed #29975980.

ABSTRACT: -- No abstract --

17 Guideline Definition, Classification and Diagnosis of Diabetes Mellitus. 2018

Petersmann, Astrid / Nauck, Matthias / Müller-Wieland, Dirk / Kerner, Wolfgang / Müller, Ulrich A / Landgraf, Rüdiger / Freckmann, Guido / Heinemann, Lutz. ·Kommission für Labordiagnostik der Diabetologie der Deutschen Diabetes Gesellschaft (DDG) und der Deutschen Gesellschaft für Klinische Chemie und Laboratoriumsmedizin (DGKL) (Commission for Laboratory Diagnostics in Diabetology of the German Diabetes Association (DDG) and the German Association for Clinical Chemistry and Laboratory Medicine). ·Exp Clin Endocrinol Diabetes · Pubmed #29975979.

ABSTRACT: Aim of recommendations like this one issued by the German Diabetes Association is to provide the GP and diabetologist and his team with information he needs for his daily practice. These recommendations are updated annually. They are written by a group of experts, but they are not evidence based guidelines. This specific recommendation for diabetes diagnosis briefly describes the diabetes types and the different options for diagnosis. Also the caveats and the practical procedure are presented.

18 Guideline Self-management of diabetes in hospital: a guideline from the Joint British Diabetes Societies (JBDS) for Inpatient Care group. 2018

Flanagan, D / Dhatariya, K / Kilvert, A / Anonymous2961013. ·Plymouth Hospitals NHS Trust, Plymouth. · Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK. · Northampton General Hospital NHS Trust, Northampton, UK. ·Diabet Med · Pubmed #29923215.

ABSTRACT: The aims of these guidelines are to improve the inpatient experience and safety for people with diabetes through effective self-management. The guidelines are aimed primarily at healthcare professionals working in hospitals, although some aspects are relevant to staff involved in pre-admission preparation. The guidelines suggest an approach to providing patient information, the circumstances in which self-management is appropriate, the development of care plans and the elements needed for effective self-management. This document is an abridged and modified version of 'Self-management of diabetes in hospital' adapted specifically for Diabetic Medicine. The full version can be found online at: www.diabetes.org.uk/joint-british-diabetes-society or https://abcd.care/joint-british-diabetes-societies-jbds-inpatient-care-group.

19 Guideline Language matters. Addressing the use of language in the care of people with diabetes: position statement of the English Advisory Group. 2018

Cooper, A / Kanumilli, N / Hill, J / Holt, R I G / Howarth, D / Lloyd, C E / Kar, P / Nagi, D / Naik, S / Nash, J / Nelson, H / Owen, K / Swindell, B / Walker, R / Whicher, C / Wilmot, E. ·Person with Type 1 diabetes, UK. · Greater Manchester Strategic Clinical Network, UK. · TREND-UK, UK. · University of Southampton, UK. · Diabetes UK, UK. · Open University, UK. · NHS England, UK. · Association of British Clinical Diabetologists, UK. · University College Hospital, UK. · Positive Diabetes, UK. · JDRF, the Type 1 diabetes Charity, UK. · Oxford Centre for Diabetes, Endocrinology and Metabolism, UK. · Diabetes UK and Parkrun Outreach (Diabetes), UK. · Successful Diabetes, UK. · Young Diabetes and Endocrinologists Forum representative, UK. · Diabetes Technology Network UK, Derby Teaching Hospitals NHS Foundation Trust, UK. ·Diabet Med · Pubmed #29888553.

ABSTRACT: The language used by healthcare professionals can have a profound impact on how people living with diabetes, and those who care for them, experience their condition and feel about living with it day-to-day. At its best, good use of language, both verbal and written, can lower anxiety, build confidence, educate and help to improve self-care. Conversely, poor communication can be stigmatizing, hurtful and undermining of self-care and can have a detrimental effect on clinical outcomes. The language used in the care of those with diabetes has the power to reinforce negative stereotypes, but it also has the power to promote positive ones. The use of language is controversial and has many perspectives. The development of this position statement aimed to take account of these as well as the current evidence base. A working group, representing people with diabetes and key organizations with an interest in the care of people with diabetes, was established to review the use of language. The work of this group has culminated in this position statement for England. It follows the contribution of Australia and the USA to this important international debate. The group has set out practical examples of language that will encourage positive interactions with those living with diabetes and subsequently promote positive outcomes. These examples are based on a review of the evidence and are supported by a simple set of principles.

20 Guideline [A consensual therapeutic recommendation for type 2 diabetes mellitus by the Slovak Diabetes Society (2018)]. 2018

Martinka, Emil / Uličiansky, Vladimír / Mokáň, Marián / Tkáč, Ivan / Galajda, Peter / Dókušová, Silvia / Schroner, Zbynek. · ·Vnitr Lek · Pubmed #29791176.

ABSTRACT: Type 2 diabetes mellitus is a heterogeneous medical condition involving multiple pathophysiological mechanisms. Its successful treatment requires an individualized approach and frequently combined therapy with utilizing its effect on multiple levels. Current possibilities enable the employment of such procedures to an incomparably greater extent than before. The effects of different classes of oral antidiabetic drugs on the reduction of glycemia and HbA1c is mutually comparable. However differences are observed in the proportions of patients who met the required criteria, regarding the increase in weight, incidence of hypoglycemia as well as the effect on cardiovascular, renal or oncologic morbidity and mortality, and severity of specific adverse effects, potential risks and contraindications. The presented text provides the reader with the information about the Consensual therapeutic algorithm for the treatment of type 2 diabetes mellitus in compliance with SPC, the ADA/EASD amended indicative limitations and recommendations, formulated by the Committee of the Slovak Diabetes Society.Key words: biguanides - gliflozins - gliptins - glitazones - GLP-1-receptor agonists - insulin - sulfonylurea.

21 Guideline Diabetes mellitus and cardiovascular risk: Update of the recommendations of the Diabetes and Cardiovascular Disease working group of the Spanish Diabetes Society (SED, 2018). 2018

Arrieta, Francisco / Iglesias, Pedro / Pedro-Botet, Juan / Becerra, Antonio / Ortega, Emilio / Obaya, Juan Carlos / Nubiola, Andreu / Maldonado, Gonzalo Fernando / Campos, Maria Del Mar / Petrecca, Romina / Pardo, José Luis / Sánchez-Margalet, Víctor / Alemán, José Juan / Navarro, Jorge / Duran, Santiago / Tébar, Francisco Javier / Aguilar, Manuel / Escobar, Fernando / Anonymous200947. ·Hospital Universitario Ramón y Cajal, CIBEROBN, IRYCIS, Madrid, España. Electronic address: arri68@hotmail.com. · Hospital Universitario Puerta de Hierro-Mjadahonda, Madrid, España. · Parc de Salut Mar, Barcelona, España. · Hospital Universitario Ramón y Cajal, Madrid, España. · Hospital Universitario Araba, Vitoria-Gasteiz, España. · Hospital Clínic i Universitari, CIBEROBN, IDIBAPS, Barcelona, España. · Centro de Salud Chopera, Alcobendas, Madrid, España. · Hospital de l'Esperit Sant, Santa Coloma de Gramenet, Barcelona, España. · Hospital Universitario San Cecilio, Granada, España. · Hospital Universitario Princesa, Madrid, España. · Centro de Salud Orihuela, Orihuela, Alicante, España. · Hospital Universitario Virgen Macarena, Sevilla, España. · Centro de Salud Tacoronte, Tacoronte, Santa Cruz de Tenerife, España. · Hospital Universitario Nuestra Señora de Valme, Sevilla, España. · Dirección de Atención Primaria, IIS INCLIVA, CIBERESP, Valencia, España. · Hospital Universitario Virgen de la Arrixaca, Murcia, España. · Hospital Puerta del Mar, Cádiz, España. ·Clin Investig Arterioscler · Pubmed #29754804.

ABSTRACT: This document is an update to the clinical practice recommendations for the management of cardiovascular risk factors in diabetes mellitus. The consensus is made by members of the Cardiovascular Risk Group of the Spanish Diabetes Society. We have proposed and updated interventions on lifestyle, pharmacological treatment indicated to achieve therapeutic objectives according to the levels of HbA1c, degree of obesity, hypertension, hyperlipidemia, heart failure, platelet antiagregation, renal insufficiency, and diabetes in the elderly, as well as new biomarkers of interest in the evaluation of cardiovascular risk in individuals with diabetes mellitus. The work is an update of the interventions and therapeutic objectives in addition, it is noted the need for the inclusion of specialists in Endocrinology, Metabolism and Nutrition in Cardiac Rehabilitation Units for the control and monitoring of this population.

22 Guideline Insulin Access and Affordability Working Group: Conclusions and Recommendations. 2018

Cefalu, William T / Dawes, Daniel E / Gavlak, Gina / Goldman, Dana / Herman, William H / Van Nuys, Karen / Powers, Alvin C / Taylor, Simeon I / Yatvin, Alan L / Anonymous4010946. ·American Diabetes Association, Arlington, VA wcefalu@diabetes.org. · Morehouse School of Medicine, Atlanta, GA. · North Coast Health, Lakewood, OH. · USC Schaeffer Center for Health Policy & Economics, Los Angeles, CA. · University of Michigan, Ann Arbor, MI. · Vanderbilt University Medical Center, Nashville, TN. · University of Maryland School of Medicine, Baltimore, MD. · Popper & Yatvin, Philadelphia, PA. ·Diabetes Care · Pubmed #29739814.

ABSTRACT: -- No abstract --

23 Guideline The Berlin Declaration: A call to action to improve early actions related to type 2 diabetes. How can specialist care help? 2018

Ceriello, Antonio / Gavin, James R / Boulton, Andrew J M / Blickstead, Rick / McGill, Margaret / Raz, Itamar / Sadikot, Shaukat / Wood, David A / Cos, Xavier / Khunti, Kamlesh / Kalra, Sanjay / Das, Ashok Kumar / López, Cutberto Espinosa / Anonymous12590941. ·Department of Cardiovascular and Metabolic Diseases, IRCCS Multimedica, Milan, Italy; Insititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain. Electronic address: aceriell@clinic.ub.es. · Emory University School of Medicine, Atlanta, GA, USA. · Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK. · Diabetes Canada, Toronto, Canada. · Central Clinical School, The University of Sydney, Sydney, Australia; The Diabetes Centre, Royal Prince Alfred Hospital, Sydney, Australia. · Hadassah Ein Kerem Hospital, Jerusalem, Israel. · Department of Endocrinology/Diabetology, Jaslok Hospital and Research Centre, Mumbai, India. · International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, UK. · Sant Marti de Provençals Primary Care Centres, Institut Català de la Salut, Barcelona, Spain; University Research Institute in Primary Care (IDIAP Jordi Gol), Barcelona, Spain. · Diabetes Research Centre, University of Leicester, Leicester, United Kingdom. · Bharti Hospital and B.R.I.D.E., Karnal, India. · Pondicherry Institute of Medical Sciences, Pondicherry, Puducherry, India. · CENAPRECE "National Center for Preventive Programs and Disease Control", Mexico City, Mexico. ·Diabetes Res Clin Pract · Pubmed #29596943.

ABSTRACT: Diabetes is a major global epidemic and places a huge burden on healthcare systems worldwide. The complications of type 2 diabetes (T2D) and related hospitalizations are major contributors to this burden, and there is strong evidence that the risk for these can be reduced by early action to identify and prevent progression of people at high risk of T2D and ensure tight glycemic control in those with established disease. In response to this, the Berlin Declaration was developed by four working groups of experts and ratified by healthcare professionals from 38 countries. Its aim is to act as a global call to action for early intervention in diabetes, in addition to providing short-, medium- and long-term targets that should be relevant to all nations. The Berlin Declaration focuses on four aspects of early action, and proposes actionable policies relating to each aspect: early detection, prevention, early control and early access to the right interventions. In addition, a number of treatment targets are proposed to provide goals for these policies. To ensure that the suggested policies are enacted in the most effective manner, the support of specialist care professionals is considered essential.

24 Guideline AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY 2018 POSITION STATEMENT ON INTEGRATION OF INSULIN PUMPS AND CONTINUOUS GLUCOSE MONITORING IN PATIENTS WITH DIABETES MELLITUS. 2018

Grunberger, George / Handelsman, Yehuda / Bloomgarden, Zachary T / Fonseca, Vivian A / Garber, Alan J / Haas, Richard A / Roberts, Victor L / Umpierrez, Guillermo E. · ·Endocr Pract · Pubmed #29547046.

ABSTRACT: This document represents the official position of the American Association of Clinical Endocrinologists and American College of Endocrinology. Where there are no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician. AACE/ACE Task Force on Integration of Insulin Pumps and Continuous Glucose Monitoring in the Management of Patients With Diabetes Mellitus Chair George Grunberger, MD, FACP, FACE Task Force Members Yehuda Handelsman, MD, FACP, FNLA, MACE Zachary T. Bloomgarden, MD, MACE Vivian A. Fonseca, MD, FACE Alan J. Garber, MD, PhD, FACE Richard A. Haas, MD, FACE Victor L. Roberts, MD, MBA, FACP, FACE Guillermo E. Umpierrez, MD, CDE, FACP, FACE Abbreviations: AACE = American Association of Clinical Endocrinologists ACE = American College of Endocrinology A1C = glycated hemoglobin BGM = blood glucose monitoring CGM = continuous glucose monitoring CSII = continuous subcutaneous insulin infusion DM = diabetes mellitus FDA = Food & Drug Administration MDI = multiple daily injections T1DM = type 1 diabetes mellitus T2DM = type 2 diabetes mellitus SAP = sensor-augmented pump SMBG = self-monitoring of blood glucose STAR 3 = Sensor-Augmented Pump Therapy for A1C Reduction phase 3 trial.

25 Guideline Defining Outcomes for β-cell Replacement Therapy in the Treatment of Diabetes: A Consensus Report on the Igls Criteria From the IPITA/EPITA Opinion Leaders Workshop. 2018

Rickels, Michael R / Stock, Peter G / de Koning, Eelco J P / Piemonti, Lorenzo / Pratschke, Johann / Alejandro, Rodolfo / Bellin, Melena D / Berney, Thierry / Choudhary, Pratik / Johnson, Paul R / Kandaswamy, Raja / Kay, Thomas W H / Keymeulen, Bart / Kudva, Yogish C / Latres, Esther / Langer, Robert M / Lehmann, Roger / Ludwig, Barbara / Markmann, James F / Marinac, Marjana / Odorico, Jon S / Pattou, François / Senior, Peter A / Shaw, James A M / Vantyghem, Marie-Christine / White, Steven. ·Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, and Institute for Diabetes, Obesity and Metabolism, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. · Division of Transplantation, Department of Surgery, University of California at San Francisco, San Francisco, CA. · Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands. · Diabetes Research Institute, San Raffaele Scientific Institute, Milan, Italy. · Department of Surgery, Charité Medical School Berlin, Berlin, Germany. · Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, and Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL. · Division of Endocrinology, Department of Pediatrics, and the Schulze Diabetes Institute, University of Minnesota, Minneapolis, MN. · Division of Transplantation and Visceral Surgery, Department of Surgery, Geneva University Hospital, Geneva, Switzerland. · Diabetes Research Group, King's College London, London, United Kingdom. · Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom. · Division of Transplantation, Department of Surgery, and the Schulze Diabetes Institute, University of Minnesota, Minneapolis, MN. · Department of Medicine, St. Vincent's Hospital, and St. Vincent's Institute of Medical Research, University of Melbourne, Melbourne, Victoria, Australia. · Diabetes Research Center, Vrije Universiteit Brussel, Brussels, Belgium. · Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, Mayo Clinic, Rochester, MN. · Juvenile Diabetes Research Foundation International, New York, NY. · Ordensklinikum Elisabethinin Hospital, Linz, Austria. · Department of Endocrinology and Diabetology, University Hospital Zurich, Zurich, Switzerland. · Division of Endocrinology and Diabetes, Department of Medicine III, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany. · Division of Transplantation, Department of Surgery, Massachusetts General Hospital, Boston, MA. · Division of Transplantation, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI. · Department of General and Endocrine Surgery, Centre Hospitalier Universitaire de Lille, and Inserm, Université de Lille, Lille, France. · Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. · Institute of Transplantation, The Freeman Hospital and Newcastle University, Newcastle upon Tyne, United Kingdom. · Department of Endocrinology, Diabetology and Metabolism, Centre Hospitalier Universitaire de Lille, and Inserm, Université de Lille, Lille, France. ·Transplantation · Pubmed #29528967.

ABSTRACT: β-cell replacement therapy, available currently as pancreas or islet transplantation, has developed without a clear definition of graft functional and clinical outcomes. The International Pancreas and Islet Transplant Association and European Pancreas and Islet Transplantation Association held a workshop to develop consensus for an International Pancreas and Islet Transplant Association and European Pancreas and Islet Transplant Association Statement on the definition of function and failure of current and future forms of β-cell replacement therapy. There was consensus that β-cell replacement therapy could be considered as a treatment for β-cell failure, regardless of etiology and without requiring undetectable C-peptide, accompanied by glycemic instability with either problematic hypoglycemia or hyperglycemia. Glycemic control should be assessed at a minimum by glycated hemoglobin (HbA1c) and the occurrence of severe hypoglycemia. Optimal β-cell graft function is defined by near-normal glycemic control (HbA1c ≤6.5% [48 mmol/mol]) without severe hypoglycemia or requirement for insulin or other antihyperglycemic therapy, and with an increase over pretransplant measurement of C-peptide. Good β-cell graft function requires HbA1c less than 7.0% (53 mmol/mol) without severe hypoglycemia and with a significant (>50%) reduction in insulin requirements and restoration of clinically significant C-peptide production. Marginal β-cell graft function is defined by failure to achieve HbA1c less than 7.0% (53 mmol/mol), the occurrence of any severe hypoglycemia, or less than 50% reduction in insulin requirements when there is restoration of clinically significant C-peptide production documented by improvement in hypoglycemia awareness/severity, or glycemic variability/lability. A failed β-cell graft is defined by the absence of any evidence for clinically significant C-peptide production. Optimal and good function are considered successful clinical outcomes.

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