O f the many publications in this field, the ones discussed hereunder seem to be most relevant for clinical practice. Intravenous thrombolysis with tissue plasminogen activa-tor (tPA) is the only therapy proven to improve outcome in ischemic stroke. Studies of intravenous thrombolysis show that response to therapy is time-dependent; the sooner the patients receive tPA, the better the chance of ...

BACKGROUND Studies have shown that, when implemented early in the course of type 2 diabetes mellitus, treatment with intensive insulin therapy for 2-3 weeks can induce a glycaemic remission, wherein patients are able to maintain normoglycaemia without any anti-diabetic medication. We thus did a systematic review and meta-analysis of interventional studies to assess the effect of short-term inte...

The intent of this review is to evaluate the literature with respect to increased risk for hypoglycemia for critically ill patients with acute kidney injury or chronic kidney disease who are given insulin therapy. The unique pathophysiology of insulin and glucose metabolism during renal failure that predisposes patients for hypoglycemia is reviewed. Studies that contribute to the understanding ...

BACKGROUND Optimal treatment for patients with both type 2 diabetes mellitus and stable ischemic heart disease has not been established. METHODS We randomly assigned 2368 patients with both type 2 diabetes and heart disease to undergo either prompt revascularization with intensive medical therapy or intensive medical therapy alone and to undergo either insulin-sensitization or insulin-provisi...

OBJECTIVES Excessive weight gain associated with valproate sodium (VPA) may predispose patients with epilepsy to other health problems such as insulin resistance. The purpose of this study was to examine the changes in body weight and several biochemical parameters in children receiving VPA treatment. The effects of behavior therapy for epileptic children with VPA-induced weight gain are discus...

M e t h o d s Design: Randomized controlled trial. Allocation: {Concealed}†.* Blinding: Blinded (primary outcome assessors and data analysts). Follow-up period: Until hospital discharge. Setting: A medical ICU in Leuven, Belgium. Patients: 1200 medical patients (mean age 64 y, 62% men) admitted to the medical ICU who were assumed to require at least 3 days of intensive care. Patients were exclu...

PURPOSE To report the progress (after 9-year follow-up) of a study designed to determine whether improved glucose control in patients with newly diagnosed non-insulin-dependent diabetes mellitus (NIDDM) is effective in reducing the incidence of clinical complications. DATA SOURCE A multicenter, randomized, controlled trial of different therapies for NIDDM. After initial diet therapy, 4209 asy...

BACKGROUND Hyperglycemia is frequent in the critically ill patient, and is a risk factor for unfavorable clinical outcomes, including mortality. During the recent years, intensive blood glucose control using intravenous insulin infusion has gained a prominent role in the critically ill patient management. There is important concern on insulin solution continued efficacy over the time, as little...