Materiały źródłowe

• #1 Prevention of Hyperglycemia | IntechOpen

  https://www.intechopen.com/chapters/78058

  Hyperglycemia is the elevation of blood glucose concentrations above the normal range. […] Prolonged uncontrolled hyperglycemia is associated with serious life-threatening complications. […] Metformin is therefore recommended for use in the prevention of hyperglycemia, including drug-induced hyperglycemia, in at risk patients. […] The development of diabetes can be delayed or prevented by targeting the early prevention and/or reversal of hyperglycemia, as well as by inhibiting the development of hyperinsulinemia-induced insulin resistance. […] Metformin can rightfully be considered for hyperglycemia prevention and treatment in cases of insulin resistance. […] Recent studies have shown it confers a greater benefit to patients than the other oral diabetic agents, which has led to its recommendation for use in the prevention of hyperglycemia and prediabetes in at risk patients.

• #2 Hyperglycemia and diabetes: Connection, symptoms, treatments

  https://www.medicalnewstoday.com/articles/311204

  Hyperglycemia (high blood sugar) is the main sign of diabetes. Insufficient insulin production, resistance to the action of insulin, or both can cause diabetes to develop. […] People with prediabetes are still at risk of developing diabetes. […] Diabetes causes high blood sugar levels through two possible mechanisms: insufficient insulin production in the pancreas and resistance to the action of insulin elsewhere in the body. […] All people with diabetes, regardless of type, should monitor their blood sugar levels to make sure they stay within a safe range. […] People with diabetes may need to take extra medication to keep their blood sugar levels stable during times of illness or stress. […] In addition to talking with a doctor about managing their blood sugar levels, people can take the following steps to avoid hyperglycemia: Staying active: Regular exercise is an effective way to manage blood sugar.

• #3 Hyperglycemia (High Blood Sugar): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9815-hyperglycemia-high-blood-sugar

  Hyperglycemia usually means you have diabetes, and people with diabetes can experience hyperglycemia episodes frequently. […] If hyperglycemia is left untreated, it can develop into diabetes-related ketoacidosis (DKA), in which a lack of insulin and a high amount of ketones cause your blood to become acidic. DKA can also affect people who have undiagnosed Type 1 diabetes. This condition is an emergency situation that can lead to coma or death. […] If you take insulin to manage diabetes, injected insulin is the main way to treat hyperglycemia episodes. Everyone requires different insulin doses. You and your healthcare provider will determine which dose is best for you to treat and prevent high blood sugar. Dietary changes and exercise plans can also help manage your blood sugar to prevent hyperglycemia.

• #4 Hyperglycemia in diabetes – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hyperglycemia/symptoms-causes/syc-20373631

  High blood sugar, also called hyperglycemia, affects people who have diabetes. […] It’s important to treat hyperglycemia. If it’s not treated, hyperglycemia can become severe and cause serious health problems that require emergency care, including a diabetic coma. […] In people who have diabetes, glucose tends to build up in the bloodstream. This condition is called hyperglycemia. It may reach dangerously high levels if it is not treated properly. Insulin and other drugs are used to lower blood sugar levels. […] Keeping blood sugar in a healthy range can help prevent many diabetes-related complications. Long-term complications of hyperglycemia that isn’t treated include: […] To help keep your blood sugar within a healthy range: […] Follow your diabetes meal plan. If you take insulin or oral diabetes medication, be consistent about the amount and timing of your meals and snacks. The food you eat must be in balance with the insulin working in your body.

• #5 Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2606813/

  The epidemic of type 2 diabetes and the recognition that achieving specific glycemic goals can substantially reduce morbidity have made the effective treatment of hyperglycemia a top priority (13). […] Maintaining glycemic levels as close to the nondiabetic range as possible has been demonstrated to have a powerful beneficial effect on diabetes-specific microvascular complications, including retinopathy, nephropathy, and neuropathy, in the setting of type 1 diabetes (4,5); in type 2 diabetes, more intensive treatment strategies have likewise been demonstrated to reduce microvascular complications (68). […] Our consensus is that an A1C level of 7% should serve as a call to action to initiate or change therapy with the goal of achieving an A1C level of 7%. […] Assiduous attention to abnormalities other than hyperglycemia that accompany type 2 diabetes, such as hypertension and dyslipidaemia, has been shown to improve microvascular and cardiovascular complications.

• #6 Type 2 Diabetes Mellitus: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/117853-overview

  Type 2 diabetes mellitus consists of an array of dysfunctions characterized by hyperglycemia and resulting from the combination of resistance to insulin action, inadequate insulin secretion, and excessive or inappropriate glucagon secretion. […] Diabetes mellitus is a chronic disease that requires long-term medical attention to limit the development of its devastating complications and to manage them when they do occur. […] Hyperglycemia appears to be the determinant of microvascular and metabolic complications. […] Chronic hyperglycemia is associated with an increased risk of microvascular complications, as shown in the Diabetes Control and Complications Trial (DCCT) in individuals with type 1 diabetes and the United Kingdom Prospective Diabetes Study (UKPDS) in people with type 2 diabetes.

• #7 Hyperglycemia (High Blood Glucose) | American Diabetes Association

  https://diabetes.org/living-with-diabetes/treatment-care/hyperglycemia

  Your best bet is to practice good diabetes management and learn to detect hyperglycemia so you can treat it early before it gets worse. […] Part of managing your diabetes is checking your blood glucose often. Ask your doctor how often you should check and what your glucose sugar levels should be. Checking your blood and then treating high blood glucose early will help you avoid problems associated with hyperglycemia.

• #8 Hyperglycemia in diabetes – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hyperglycemia/diagnosis-treatment/drc-20373635

  Your health care provider sets your target blood sugar range. For many people who have diabetes, Mayo Clinic generally recommends the following target blood sugar levels before meals: […] For many people who have diabetes, the American Diabetes Association generally recommends the following target blood sugar levels: […] Your target blood sugar range may differ, especially if you’re pregnant or you have other health problems that are caused by diabetes. […] Routine blood sugar monitoring with a blood glucose meter is the best way to be sure that your treatment plan is keeping your blood sugar within your target range. […] If you have any symptoms of severe hyperglycemia even if they seem minor check your blood sugar level right away. […] If your blood sugar level is 240 mg/dL (13.3 mmol/L) or above, use an over-the-counter urine ketones test kit.

• #9 Hyperglycemia in diabetes – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hyperglycemia/diagnosis-treatment/drc-20373635

  If you have trouble keeping your blood sugar within your target range, schedule an appointment to see your health care provider. […] Your health care provider can help you make changes to better manage your diabetes. […] Create a record of metered glucose values. […] Using the record, your health care provider can recognize trends and offer advice on how to prevent hyperglycemia or adjust your medication to treat hyperglycemia. […] Illness or infections can cause your blood sugar to rise, so it’s important to plan for these situations.

• #10 Hyperglycemia in diabetes – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hyperglycemia/symptoms-causes/syc-20373631

  High blood sugar, also called hyperglycemia, affects people who have diabetes. […] It’s important to treat hyperglycemia. If it’s not treated, hyperglycemia can become severe and cause serious health problems that require emergency care, including a diabetic coma. […] In people who have diabetes, glucose tends to build up in the bloodstream. This condition is called hyperglycemia. It may reach dangerously high levels if it is not treated properly. Insulin and other drugs are used to lower blood sugar levels. […] Keeping blood sugar in a healthy range can help prevent many diabetes-related complications. Long-term complications of hyperglycemia that isn’t treated include: […] To help keep your blood sugar within a healthy range: […] Follow your diabetes meal plan. If you take insulin or oral diabetes medication, be consistent about the amount and timing of your meals and snacks. The food you eat must be in balance with the insulin working in your body.

• #11 Hyperglycaemia – symptoms, risks and management | Diabetes Australia

  https://www.diabetesaustralia.com.au/blog/hyperglycaemia/

  Hyperglycaemia cannot be avoided completely when you live with diabetes. The following tips may help you to keep your blood glucose levels in range: […] Follow a healthy meal plan for diabetes. An Accredited Practising Dietitian can help you to understand what to eat, and how much to eat for your body and lifestyle. […] Take your medication as prescribed by your doctor. […] Monitor your blood glucose regularly if it is outside of range, and have your doctor review it. Your doctor may need to modify the dose or change medications if hyperglycaemia persists. […] Move more. Regular, consistent physical activity will help your body to use glucose as well as making your body more sensitive to insulin. An Accredited Exercise Physiologist can help you to formulate a personal physical activity plan. […] Prevent weight gain. […] Have a current sick day plan to follow when you are well […] Manage stress.

• #12 How to Control Hyperglycemia With Diet

  https://www.verywellhealth.com/type-2-diabetes-with-hyperglycemia-6665456

  Hyperglycemia (high blood glucose) is a condition that occurs when the glucose levels in your blood rise too high. Hyperglycemia is commonly a symptom and complication of diabetes and can cause vomiting, excessive hunger and thirst, rapid heartbeat, vision problems, and other symptoms. […] People with type 1 or type 2 diabetes can manage or prevent hyperglycemia by: Managing stress, Exercising, Maintaining a healthy weight, Taking oral medications. […] Additionally, with the right dietary changes, you can sometimes keep hyperglycemia in check without medication. […] People with hyperglycemia must pay close attention to what and how much they eat to ensure they don’t trigger spikes in blood sugar. […] With this in mind, choosing low-glycemic foods with the help of the GI is ideal to help prevent blood sugar irregularities.

• #13 How to Control Hyperglycemia With Diet

  https://www.verywellhealth.com/type-2-diabetes-with-hyperglycemia-6665456

  Drinking plenty of water is an important component of managing and preventing hyperglycemia. […] A 2016 study showed that among other benefits, increasing the amount and regularly eating foods rich in soluble fiber significantly lowers fasting blood glucose and triglyceride levels, and improves insulin resistance. […] Legumes, including beans, chickpeas, and lentils, are among the lowest glycemic index foods. […] A 2012 study showed that a low-GI legume diet lowered A1C levels and cardiovascular risk in people with type 2 diabetes. […] With smart and careful planning, hyperglycemia can be managed with the help of the foods you eat.

• #14 Hyperglycemia in diabetes – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hyperglycemia/diagnosis-treatment/drc-20373635

  Talk to your health care provider about managing your blood sugar. Understand how different treatments can help keep your glucose levels within your target range. […] Regular exercise is often an effective way to control blood sugar. […] If you develop hyperglycemia often, your health care provider may adjust the dosage or timing of your medication. […] It helps to eat smaller portions and avoid sugary beverages and frequent snacking. […] Monitor your blood glucose as directed by your health care provider. […] Changes to your insulin program or a supplement of short-acting insulin can help control hyperglycemia. […] If you have signs and symptoms of diabetic ketoacidosis or hyperosmolar hyperglycemic state, you may be treated in the emergency room or admitted to the hospital. […] Emergency treatment can lower your blood sugar to a normal range.

• #15 Hyperglycemia and diabetes: Connection, symptoms, treatments

  https://www.medicalnewstoday.com/articles/311204

  Hyperglycemia (high blood sugar) is the main sign of diabetes. Insufficient insulin production, resistance to the action of insulin, or both can cause diabetes to develop. […] People with prediabetes are still at risk of developing diabetes. […] Diabetes causes high blood sugar levels through two possible mechanisms: insufficient insulin production in the pancreas and resistance to the action of insulin elsewhere in the body. […] All people with diabetes, regardless of type, should monitor their blood sugar levels to make sure they stay within a safe range. […] People with diabetes may need to take extra medication to keep their blood sugar levels stable during times of illness or stress. […] In addition to talking with a doctor about managing their blood sugar levels, people can take the following steps to avoid hyperglycemia: Staying active: Regular exercise is an effective way to manage blood sugar.

• #16 Hypo/Hyperglycemia | Korey Stringer Institute

  https://koreystringer.institute.uconn.edu/hypo-hyperglycemia/

  Type II Diabetes may be prevented or delayed by maintaining a healthy, active lifestyle. […] Athletes should wear medical identification bracelets at all times. […] Establish and follow diabetes care plan. […] Check blood glucose before activity. […] Consult physician on altering insulin dosages before activity. […] Adjust medication before activity. […] Check blood glucose during and after activity. […] Type I diabetic athletes can experience late hypoglycemia after exercise. These athletes should consume carbohydrate before bed to prevent hypoglycemia while sleeping. […] Hyperglycemia, (high blood glucose, 180 mg/dL), does not typically have an acute risk of death, however it does carry long term consequences. […] Athletes with moderate hyperglycemia (250 mg/dL) may continue with activity as long as no ketones are present in the urine and signs and symptoms do not increase.

• #17 Prevention of Hyperglycemia | IntechOpen

  https://www.intechopen.com/chapters/78058

  Hyperglycemia is the elevation of blood glucose concentrations above the normal range. […] Prolonged uncontrolled hyperglycemia is associated with serious life-threatening complications. […] Metformin is therefore recommended for use in the prevention of hyperglycemia, including drug-induced hyperglycemia, in at risk patients. […] The development of diabetes can be delayed or prevented by targeting the early prevention and/or reversal of hyperglycemia, as well as by inhibiting the development of hyperinsulinemia-induced insulin resistance. […] Metformin can rightfully be considered for hyperglycemia prevention and treatment in cases of insulin resistance. […] Recent studies have shown it confers a greater benefit to patients than the other oral diabetic agents, which has led to its recommendation for use in the prevention of hyperglycemia and prediabetes in at risk patients.

• #18 Prevention of Hyperglycemia | IntechOpen

  https://www.intechopen.com/chapters/78058

  Metformin prevents hyperglycemia by hastening the clearance of glucose. […] Metformin has been identified as a first line agent in treatment of type 2 diabetes mellitus. […] The benefits of metformin in the prevention of hyperglycemia are unmatched despite its list of contraindications. […] This has facilitated its expanded use based on its well-founded glycemic effects as well as numerous benefits conferred such as the beneficial effect on reduction of development of cardiovascular risk factors. […] Metformin has been shown to reduce the incidence of hyperglycemia-related complications such as diabetes and risk factors for cardiovascular disease in patients with impaired glucose tolerance and fasting blood sugar.

• #19 Inpatient Hyperglycemia Guideline Resources | Endocrine Society

  https://www.endocrine.org/clinical-practice-guidelines/inpatient-hyperglycemia-guideline-resources

  The 2022 guideline on management of hyperglycemia in hospitalized adult patients in non-critical care settings: […] Focuses on the treatment of hyperglycemia in non-critically ill hospitalized adult patients with diabetes and/or with newly recognized or stress-induced hyperglycemia. […] Emphasizes the use of emerging diabetes technology and insulin therapy for glycemic management and inpatient diabetes self-management education. […] Diabetes self-management education to hospitalized patients can promote improved glycemic control with reductions in the risk for hospital readmission. […] Patients with newly recognized hyperglycemia or well-managed diabetes on non-insulin therapy may be treated with correctional insulin alone as initial therapy at hospital admission. […] Scheduled insulin therapy is preferred for patients experiencing persistent blood glucose values 180 mg/dL.

• #20 Inpatient Hyperglycemia Guideline Resources | Endocrine Society

  https://www.endocrine.org/clinical-practice-guidelines/inpatient-hyperglycemia-guideline-resources

  In adult patients with diabetes who are hospitalized for non-critical illness, we suggest providing inpatient diabetes education as part of a comprehensive diabetes discharge-planning process, rather than not providing inpatient diabetes education. […] For adult patients with diabetes undergoing elective surgical procedures, we suggest targeting preoperative hemoglobin A1c (HbA1c) levels 8% (63.9 mmol/mol) and BG concentrations 100-180 mg/dL (5.6-10 mmol/L). […] In adult patients hospitalized for non-critical illness who are receiving enteral nutrition with diabetes-specific and non-specific formulations, we suggest using NPH-based or basal bolus regimens. […] In most adult patients with hyperglycemia (with or without known type 2 diabetes [T2D]) hospitalized for a non-critical illness, we suggest that scheduled insulin therapy be used instead of non-insulin therapies for glycemic management.

• #21 Individualizing Treatment of Hyperglycemia in Type 2 Diabetes | MDedge

  https://www.mdedge.com/jcomjournal/article/145784/diabetes/individualizing-treatment-hyperglycemia-type-2-diabetes

  Objective: To summarize key issues relevant to managing hyperglycemia in patients with type 2 diabetes mellitus (T2DM) and review a strategy for initiating and intensifying therapy. […] The goal of diabetes treatment is to prevent acute complications and reduce the risk of long-term complications. Interventions that have been shown to improve diabetes outcomes include medications for glycemic control and treatment of cardiovascular risk factors, nutrition and physical activity counseling, smoking cessation, immunizations, psychosocial care, and ongoing surveillance and early treatment for eye, kidney, and foot problems. […] A one-size-fits-all glycemic goal is no longer recommended. Personalization is necessary, balancing the potential benefits and risks of treatments required to achieve that goal. […] There is strong consensus that metformin is the preferred drug for monotherapy due to its long proven safety record, low cost, weight-reduction benefit, and potential cardiovascular advantages.

• #22 Type 2 Diabetes Mellitus: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/117853-overview

  Reversion to normal glucose regulation during attempts to prevent progression of prediabetes to frank diabetes is a good indicator of slowing disease progression, and it is associated with a better prognosis. […] The benefits of intensive intervention were indicated in the Steno-2 study in Denmark, which included 160 patients with type 2 diabetes and persistent microalbuminuria; the mean treatment period was 7.8 years, followed by an observational period for a mean of 5.5 years. Intensive therapy was associated with a lower risk of cardiovascular events, death from cardiovascular causes, progression to end-stage renal disease, and need for retinal photocoagulation. […] Overall, these studies suggest that tight glycemic control (HbA1c 7% or lower) is valuable for microvascular and macrovascular disease risk reduction in patients with recent-onset disease, no known cardiovascular diseases, and a longer life expectancy.

• #23 Type 2 Diabetes Mellitus: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/117853-overview

  In patients with known cardiovascular disease, a longer duration of diabetes (15 or more years), and a shorter life expectancy, however, tighter glycemic control is not as beneficial, particularly with regard to cardiovascular disease risk. […] These benefits are weighed against the risk of hypoglycemia and the short-term costs of providing high-quality preventive care. Studies have shown cost savings due to a reduction in acute diabetes-related complications within 1-3 years after starting effective preventive care.

• #24 Diabetes

  https://www.nhs.uk/conditions/diabetes/

  Many people have blood sugar levels above the normal range, but not high enough to be diagnosed as having diabetes. This is known as non-diabetic hyperglycaemia, or pre-diabetes. […] People with non-diabetic hyperglycaemia are at greater risk of developing type 2 diabetes, but the risk can be reduced through lifestyle changes. […] If you have non-diabetic hyperglycaemia, you may be eligible for the NHS Diabetes Prevention Programme. The programme helps people make lasting lifestyle changes and has been shown to help prevent type 2 diabetes. […] You can reduce the risk of type 2 diabetes through healthy eating, regular exercise and achieving a healthy body weight. […] However, some people can put their type 2 diabetes into remission by losing weight, where their blood sugar is reduced below the diabetes range. Some people are able to do this through a low-calorie diet, but this is not suitable for everyone, so it’s important to get medical advice first.

• #25 Pre-Diabetes: Causes, Symptoms, and Treatment

  https://patient.info/diabetes/pre-diabetes-impaired-glucose-tolerance

  In non-diabetic hyperglycaemia (NDH, previously known as impaired glucose tolerance or pre-diabetes), your blood sugar (glucose) is raised beyond the normal range. Whilst this raised glucose level is not so high that you have type 2 diabetes, you are at increased risk of developing type 2 diabetes when you have NDH. […] Up to 6 in every 10 people with NDH will develop diabetes within ten years. […] NDH develops for the same reasons as type 2 diabetes. They include: Being overweight or obese (most people with pre-diabetes are overweight or obese). […] There is increasing evidence that if NDH is treated, it becomes much easier to prevent or delay it progressing to type 2 diabetes. […] The same things that can help in preventing type 2 diabetes can help prevent NDH. These include: Eating a healthy balanced diet.

• #26 Therapeutics Initiative | [140] What to do about borderline hyperglycemia?

  https://www.ti.ubc.ca/2023/02/07/140-what-to-do-about-borderline-hyperglycemia/

  People characterized as borderline hyperglycemic by laboratory tests are at higher risk of progressing to confirmed type 2 diabetes (T2DM) than those who are normoglycemic. […] A 2020 summary of available evidence suggests that about two-thirds of people characterized as prediabetic do not develop diabetes when followed for up to 12 years, and a 2010 systematic review reached similar findings. […] The most important clinical issue is to reduce or delay long-term outcomes, primarily cardiovascular (CV) disease, in people who progress to T2DM. […] Hyperglycemia in prediabetes is not independently associated with CV disease, but is associated with co-existing non-glycemic risk factors such as smoking, hypertension, inactivity, or obesity. […] The US Diabetes Prevention Program trial (DPP) compared metformin 850 mg twice/day (plus standard lifestyle recommendations) with intensive lifestyle intervention alone, or standard lifestyle recommendations (control).

• #27 Dysglycemia: When Blood Sugar Is Too Low or Too High

  https://www.webmd.com/diabetes/what-is-dysglycemia

  Hyperglycemia and diabetes are much greater problems than hypoglycemia. […] Those with diabetes can prevent hyperglycemia by following their doctor’s instructions about diet and medication. […] Letting your blood sugar get too high has serious consequences. […] Hyperglycemia is a risk factor for these problems even if blood sugar is not high enough to be considered diabetes. […] Because diabetes is a serious health issue, some public health agencies have programs designed to reduce it. […] The National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) runs studies about preventing diabetes. […] After three years, participants in the lifestyle program lowered their risk of diabetes by 58%. […] The National DPP lifestyle program focuses on healthy eating and physical activity.

• #28 Prediabetes | Hyperglycemia | MedlinePlus

  https://medlineplus.gov/prediabetes.html

  If you have prediabetes, you are more likely to develop type 2 diabetes, heart disease, and stroke. But if you make some lifestyle changes now, you may be able to delay or prevent type 2 diabetes. […] If you are at risk for prediabetes, those same lifestyle changes (losing weight, regular physical activity, and a healthy eating plan) may prevent you from getting it. […] If you have prediabetes, you may be able to delay or prevent type 2 diabetes through lifestyle changes: Losing weight, if you are overweight, Getting regular physical activity, Following a healthy, reduced-calorie eating plan.

• #29 9.3 Hypoglycemia and Hyperglycemia – Clinical Procedures for Safer Patient Care

  https://opentextbc.ca/clinicalskills/chapter/hypoglycemia-protocol/

  Hyperglycemia occurs when blood glucose values are greater than 7 mmol/L in a fasting state or greater than 10 mmol/L two hours after eating a meal (Pardalis, 2005). Hyperglycemia is a serious complication of diabetes that can result from eating too much food or simple sugar; insufficient insulin dosages; infection, illness, or surgery; and emotional stress. Surgical patients are particularly at risk for developing hyperglycemia due to the surgical stress response (Dagogo-Jack Alberti, 2002; Mertin, Sawatzky, Diehl-Jones, Lee, 2007). Classic symptoms of hyperglycemia include the three Ps: polydipsia, polyuria, and polyphagia. […] Potential causes of hyperglycemia in a hospitalized patient include: Infection, Stress, Increased intake of calories (IV or diet), Decreased exercise, New medications or dose adjustments.

• #30

  https://link.springer.com/article/10.1007/s11892-017-0839-6

  An increasing number of orthopedic operations are being carried out in an older population in whom the prevalence of diabetes is dramatically increasing. […] People having surgery with diabetes and hyperglycemia are at increased risk of post-operative complications. […] This paper considers the issues surrounding orthopaedic surgery in patients with diabetes and the significance and management of hyperglycemia in the peri-operative period. […] Dysglycemia, which encompasses hyperglycemia, hypoglycemia, stress-induced hyperglycemia, and excessive glucose variability, is increasingly observed and associated with poorer post-operative outcomes even in those without a prior diagnosis of diabetes. […] Hyperglycemia impairs leucocyte function causing immunocompromise with consequences for superficial and deep tissue infection as well as overall mortality.

• #31

  https://link.springer.com/article/10.1007/s11892-017-0839-6

  The detrimental effects of suboptimal glycemic control on surgical outcomes and post-operative complications have been demonstrated across surgical specialities. […] Rates of surgical site infection are significantly increased in patients with diabetes, most notably in those with suboptimal glycemic control. […] Preoperative HbA1c levels above 7.0% have been found to be associated with higher rates of surgical site infection for thoracic and lumbar spinal instrumentation surgery. […] The incidence of surgical site infections has also been linked to peri-operative hyperglycemia in people without a prior diagnosis of diabetes. […] Following trauma, a 7-fold increase in peri-operative infections has been seen with peri-operative hyperglycemia. […] Despite the above associations, the key question is whether treating hyperglycemia reduces complications and improves these outcomes.

• #32

  https://link.springer.com/article/10.1007/s11892-017-0839-6

  There are no randomised studies in orthopedic surgery; however, one observational study by Agos et al. demonstrated that implementation of an evidence-based standard to control hyperglycemia reduced the rate of surgical site infection in people undergoing hip and knee replacement surgery. […] Treating hyperglycemia in the peri-operative period has been shown to reduce complications in other surgical disciplines. […] The American Association of Clinical Endocrinologists (AACE) and American Diabetes Association (ADA) guidelines, the Joint British Diabetes Society (JBDS) guidelines, and others all advocating treatment of hyperglycemia for hospitalized patients peri-operatively. […] The condition of diabetes, in a recent meta-analysis, has shown an increased surgical site infection rate from pooled US data with OR 1.26 for arthroplasty and 1.6 for spinal surgery after accounting for impact of hyperglycemia and adjusting for BMI.

• #33

  https://link.springer.com/article/10.1007/s13300-024-01628-0

  With the increasing global incidence of diabetes mellitus, physicians may encounter more patients with acute and chronic complications of medication-induced hyperglycemia and diabetes. […] It has long been recognized that multiple classes of medications are associated with hyperglycemia through various mechanisms, and the ability to foresee this and implement adequate management strategies are important. […] Assessment of underlying patient risk factors, dose and duration of a medication that can cause hyperglycemia or diabetes, and pre-existing comorbidities (e.g., cardiovascular disease, renal disease) are key factors to evaluate risk of medication-induced hyperglycemia and diabetes, and a frank discussion with the patient regarding these risks is warranted. […] Management of medication-induced hyperglycemia generally includes lifestyle measures and if required, pharmacologic treatment (with metformin generally first line).

• #34

  https://link.springer.com/article/10.1007/s13300-024-01628-0

  The importance of monitoring for and recognizing medication-induced hyperglycemia is significant. […] Successful management of steroid-induced hyperglycemia begins with appropriate monitoring of blood glucose. […] Prevention of antipsychotic-induced diabetes mellitus should first be considered, if possible, given the above evidence that certain agents may confer much less risk. […] Lifestyle changes and education should be implemented in all patients, especially considering the weight gain seen with beta blocker use. […] Diuretic-induced hyperglycemia is also dose dependent, so using the lowest effective dose or combining with other first-line antihypertensives such as calcium channel blockers, ACE inhibitors, or ARBs should also be considered. […] Overall, the potential of a drug to cause hyperglycemia and diabetes needs to be known and balanced with the patients underlying risk factors.

• #35

  https://link.springer.com/article/10.1007/s13300-024-01628-0

  Instituting measures to assess glycemic status prior to initiation of a diabetogenic medication and ongoing monitoring during treatment is critical, as most medications are duration and dose dependent. […] In general, treatment of medication-induced hyperglycemia and diabetes is similar to standard treatment with lifestyle measures including balanced diet and exercise applying to almost all cases. […] Medication-induced hyperglycemia requires recognition, screening, monitoring, and proper management to prevent acute and chronic complications.

• #36 The Effects of Vitamin D on Preventing Hyperglycemia and a Novel Approach to Its Treatment

  https://www.mdpi.com/2813-2998/2/4/46

  The dietary reference levels for vitamin D were established with an emphasis on its role in bone health; however, with the identification of vitamin D receptors in all body tissues novel associations with other metabolic disorders, such as diabetes, are being researched. […] A deficiency of vitamin D causes glucose intolerance and affects insulin secretion. […] It has been proven that vitamin D supplementation lowers the risk of type 1 and type 2 diabetes and its associated problems. […] The objective of this review was to summarize the need for studying the role of vitamin D in type 1 diabetes (T1DM) and type 2 diabetes (T2DM) and to examine the data from case studies that evaluated the effects of vitamin D supplementation in this setting. […] Vitamin D may help regulate immune responses, reduce inflammation, and modulate the immune system’s attack on pancreatic beta cells, which produce insulin.

• #37 The Effects of Vitamin D on Preventing Hyperglycemia and a Novel Approach to Its Treatment

  https://www.mdpi.com/2813-2998/2/4/46

  Maintaining adequate vitamin D levels could potentially preserve beta cell function and protect against the progression of type 1 diabetes. […] In individuals already diagnosed with type 1 diabetes, vitamin D supplementation may have beneficial effects on glycemic control. […] Vitamin D shows its effects majorly in two ways: by directly increasing intracellular calcium concentration via non-selective voltage-dependent calcium channels, vitamin-D causes beta cell insulin secretion, and it involves the activation of beta cell calcium-dependent endopeptidases that results in the conversion of proinsulin to insulin. […] Vitamin D is known to have anti-inflammatory properties and chronic inflammation is believed to play a role in the development and progression of type 2 diabetes. […] Vitamin D may help protect beta cells in the pancreas that produce insulin, and thus preserve their function.

• #38 The Effects of Vitamin D on Preventing Hyperglycemia and a Novel Approach to Its Treatment

  https://www.mdpi.com/2813-2998/2/4/46

  Gestational diabetes is significantly reduced when high-risk pregnant women take vitamin D supplements in the first and second trimesters. […] Studies have shown that maintaining adequate levels of vitamin D through supplementation or exposure to sunlight may help improve glycemic control in individuals with hyperglycemia or diabetes. […] It is essential for healthcare professionals to consider monitoring and addressing vitamin D status in patients with hyperglycemia as part of comprehensive diabetes management strategies.

• #39 Long-term reduction in hyperglycemia in advanced type 1 diabetes: the value of induced aerobic glycolysis with BCG vaccinations | npj Vaccines

  https://www.nature.com/articles/s41541-018-0062-8

  BCG also shows promise as treatment for numerous inflammatory and autoimmune diseases. […] After year 3, BCG lowered hemoglobin A1c to near normal levels for the next 5 years. […] These findings set the stage for further testing of a known safe vaccine therapy for improved blood sugar control through changes in metabolism and durability with epigenetic changes even in advanced Type 1 diabetes. […] In type 1 diabetes (T1D), three BCG vaccines administered in childhood lowered the incidence of T1D by age 12. […] The rational of this study was to investigate in established T1D subjects (average disease duration of 19 years), the possible long term immune, metabolic and clinical benefits of two doses of BCG vaccine as the Connaught strain (given two times, 4 weeks apart). […] The lowering of blood sugars to a range near normal was maintained for the next 5 years of monitoring.

• #40 Long-term reduction in hyperglycemia in advanced type 1 diabetes: the value of induced aerobic glycolysis with BCG vaccinations | npj Vaccines

  https://www.nature.com/articles/s41541-018-0062-8

  BCG appears to switch the immune system of T1Ds from high oxidative phosphorylation to augmented early aerobic glycolysis, a systemic metabolic shift that occurs gradually and allows cells to consume in a regulated fashion large amounts of glucose to safely lower hyperglycemia to near normal levels. […] The findings suggest a novel way to regulate blood sugars levels using attenuated Mycobacterium bovis. […] The data presented above suggests a novel way to systemically regulate blood sugars, independent of insulin. […] This novel approach for blood sugar regulation appears to hinge on a systemic switch from primarily oxidative phosphorylation to early aerobic glycolysis resulting in the acceleration of glucose uptake. […] BCG can thus significantly lower blood sugars without underlying autoimmunity, and BCG has no deleterious effect by lowering blood sugars lower than normal.

• #41 Hyperglycemia Management (Ambulatory)

  https://elsevier.health/en-US/preview/hyperglycemia-management-ambulatory

  Untreated hyperglycemia can lead to diabetic coma caused by ketoacidosis, a life-threatening condition that requires immediate treatment. […] Hyperglycemia is associated with diabetes and may be further complicated by certain medications or infectious processes. Successful management of hyperglycemia begins with comprehensive education about the disease process, potential complications, and methods to control blood glucose levels. […] Teach the patient that avoiding hypoglycemia is important because it may affect cardiovascular or cognitive function. […] Educate the patient about adopting a low glycemic index diet by reducing the consumption of carbohydrates. […] Educate the patient about weight reduction if the patient is overweight or obese. Provide an individualized weight loss goal and teach the patient that a reduction of 5% of body weight can improve glucose tolerance.

• #42 Hyperglycemia Management (Ambulatory)

  https://elsevier.health/en-US/preview/hyperglycemia-management-ambulatory

  Teach the patient that improved glucose control lowers the incidence of cardiovascular events, thereby reducing morbidity. […] Evaluate the patient’s knowledge about how to prevent hyperglycemia and provide education as needed. […] Older adult patients should avoid tightly controlling blood glucose because of the potential for hypoglycemia.

• #43 Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2606813/

  The major environmental factors that increase the risk of type 2 diabetes are overnutrition and a sedentary lifestyle, with consequent overweight and obesity (39,40). Not surprisingly, interventions that reverse or improve these factors have been demonstrated to have a beneficial effect on control of glycemia in established type 2 diabetes (41). […] Given these beneficial effects, which are usually seen rapidly within weeks to months and often before there has been substantial weight loss (47), a lifestyle intervention program to promote weight loss and increase activity levels should, with rare exceptions, be included as part of diabetes management. […] The glucose-lowering effectiveness of individual therapies and combinations demonstrated in clinical trials is predicated not only on the intrinsic characteristics of the intervention but also on the duration of diabetes, baseline glycemia, previous therapy, and other factors.

• #44

  https://www.who.int/news-room/fact-sheets/detail/diabetes

  A healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use are ways to prevent or delay the onset of type 2 diabetes. […] Lifestyle changes are the best way to prevent or delay the onset of type 2 diabetes. […] To help prevent type 2 diabetes and its complications, people should: reach and keep a health body weight, stay physically active with at least 150 minutes of moderate exercise each week, eat a healthy diet and avoid sugar and saturated fat, not smoke tobacco.

• #45 Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2606813/

  The epidemic of type 2 diabetes and the recognition that achieving specific glycemic goals can substantially reduce morbidity have made the effective treatment of hyperglycemia a top priority (13). […] Maintaining glycemic levels as close to the nondiabetic range as possible has been demonstrated to have a powerful beneficial effect on diabetes-specific microvascular complications, including retinopathy, nephropathy, and neuropathy, in the setting of type 1 diabetes (4,5); in type 2 diabetes, more intensive treatment strategies have likewise been demonstrated to reduce microvascular complications (68). […] Our consensus is that an A1C level of 7% should serve as a call to action to initiate or change therapy with the goal of achieving an A1C level of 7%. […] Assiduous attention to abnormalities other than hyperglycemia that accompany type 2 diabetes, such as hypertension and dyslipidaemia, has been shown to improve microvascular and cardiovascular complications.

• #46 Paradigm shift from glucocentric to organ protection for the management of hyperglycemia in patients with type 2 diabetes

  https://www.e-jcpp.org/journal/view.php?number=96

  The UK Prospective Diabetes Study was the first study to investigate the effectiveness of glycemic control in patients with type 2 diabetes. […] This has emphasized the need for comprehensive management of other risk factors (hypertension, dyslipidemia, renal failure, etc.) in addition to hyperglycemia to prevent atherosclerotic cardiovascular diseases and end-stage renal disease in type 2 diabetes. […] Recently, major societies around the world including the Korean Diabetes Association, have shifted the goals of diabetes management from the typical glucocentric view to cardiorenal outcome-oriented (organ protection) care, which has been widely accepted and is gradually applied to primary care. […] The primary goal of diabetes treatment is to alleviate wasting symptoms by regulating blood glucose levels and to prevent diabetes-specific chronic complications, such as microvascular complications, thereby maintaining a normal life expectancy.

• #47 Paradigm shift from glucocentric to organ protection for the management of hyperglycemia in patients with type 2 diabetes

  https://www.e-jcpp.org/journal/view.php?number=96

  Therefore, an ideal antidiabetic drug should not only provide hypoglycemic effects but also fundamentally reduce mortality associated with diabetes. […] This article explores the „paradigm shift in diabetes management,” moving from the traditional „glucocentric” approach in managing type 2 diabetes to the recently emphasized concept of „organ protection,” and examines how this shift has evolved over time. […] The importance of comprehensive management of CVD risk factors through blood pressure control, management of dyslipidemia, and antiplatelet medications rather than strict glycemic control alone has been recognized. […] The Korean Diabetes Associations guidelines recommend selecting antidiabetic drugs based on the level of hyperglycemia, categorized by A1c levels: 8.0%, 8.0%10.0%, and 10%.

• #48 Paradigm shift from glucocentric to organ protection for the management of hyperglycemia in patients with type 2 diabetes

  https://www.e-jcpp.org/journal/view.php?number=96

  Therefore, the focus has shifted from solely emphasizing the hypoglycemic effects of antidiabetic drugs to selecting a drug that does not increase the risk of CVDs and side effects such as weight gain or hypoglycemia. […] This approach is reflected in the latest treatment guidelines from the Korean Diabetes Association. Metformin is recommended as the initial treatment, accompanied by diet and exercise, for patients with type 2 diabetes. […] It is recommended that individual agents from these two classes should be selected for their confirmed CVD benefits and that other classes should be considered as combination therapy for glycemic control based on the clinical characteristics of the individual patient. […] Current management strategies for type 2 diabetes require a holistic approach that not only addresses hyperglycemia but also considers the risks associated with CVDs and DKD.

• #49

  https://www.who.int/health-topics/diabetes

  Type 1 diabetes cannot currently be prevented. […] Effective approaches are available to prevent type 2 diabetes and to prevent the complications and premature death that can result from all types of diabetes. […] A series of cost-effective interventions can improve patient outcomes, regardless of what type of diabetes they may have. […] These interventions include blood glucose control through a combination of diet, physical activity and, if necessary, medication; control of blood pressure and lipids to reduce cardiovascular risk and other complications; and regular screening for damage to the eyes, kidneys and feet to facilitate early treatment.

• #50 Hyperglycemia (High Blood Sugar): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/9815-hyperglycemia-high-blood-sugar

  Unfortunately, it can be difficult to totally prevent high blood sugar when you have diabetes. But you can adjust your diabetes management plan to try to reduce the number of hyperglycemia episodes you experience. […] The following steps can help prevent high blood sugar: Take all your medications as prescribed. Follow your healthcare providers instructions about food and exercise. Check your blood sugar regularly. […] Studies have shown that people with diabetes may be able to reduce the risk of complications by consistently keeping their A1C levels below 7%.

• #51 Diabetes: What It Is, Causes, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/7104-diabetes

  You cant prevent autoimmune and genetic forms of diabetes. But there are some steps you can take to lower your risk for developing prediabetes, Type 2 diabetes and gestational diabetes, including: […] Studies show that people with diabetes may be able to reduce their risk of complications by consistently keeping their A1c levels below 7%.

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