Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
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To summarize the novel evidence for maintaining normoglycemia with intensive insulin therapy during intensive care in critically ill patients, with or without diabetes, in the surgical intensive-care unit. ⋯ The available evidence favors targeting normoglycemia (blood glucose levels of less than 110 mg/dL or 6.1 mmol/L) by insulin infusion in all adult surgical intensive-care patients. Whether these findings are applicable to nonsurgical intensive-care or to pediatric patients in the intensive care unit remains unclear.
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Randomized Controlled Trial Clinical Trial
Role of insulin-glucose infusion in outcomes after acute myocardial infarction: the diabetes and insulin-glucose infusion in acute myocardial infarction (DIGAMI) study.
To review the Diabetes and Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) study for findings regarding effects on morbidity and mortality. ⋯ The DIGAMI study supports the theory that intensive metabolic care in patients with diabetes who have had an acute myocardial infarction improves the prognosis. The study, however, could not answer whether this result was due to the initial insulin-glucose infusion or to the long-term subcutaneous treatment with insulin. This question is currently being addressed in the DIGAMI-2 study.
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To describe a case of pituitary apoplexy complicated by diabetes insipidus and to review management of patients with pituitary apoplexy and water excretion disturbances associated with transsphenoidal surgery. ⋯ Pituitary apoplexy may be rarely associated with diabetes insipidus.
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To determine whether 1990 guidelines established by the National Institutes of Health (NIH) for the optimal management (surgical versus nonsurgical) of patients with asymptomatic primary hyperparathyroidism (PHPT) are known and followed by endocrinologists. ⋯ Suboptimal awareness of the 1990 NIH panel recommendations and the substantial variation in clinical management of PHPT indicate that newer NIH guidelines developed in 2002 must be more widely disseminated and strongly recommended if practice patterns are to be influenced and clinical outcomes improved.