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Hypoglycemia

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1. Intravenous Dextrose Drip versus Push for Adults Experiencing Hypoglycemia: Comparative Clinical Effectiveness

Intravenous Dextrose Drip versus Push for Adults Experiencing Hypoglycemia: Comparative Clinical Effectiveness Intravenous Dextrose Drip versus Push for Adults Experiencing Hypoglycemia: Comparative Clinical Effectiveness | CADTH.ca Find the information you need Intravenous Dextrose Drip versus Push for Adults Experiencing Hypoglycemia: Comparative Clinical Effectiveness Intravenous Dextrose Drip versus Push for Adults Experiencing Hypoglycemia: Comparative Clinical Effectiveness Last updated (...) : May 6, 2019 Project Number: RB1335-000 Product Line: Research Type: Drug Report Type: Summary of Abstracts Result type: Report Question What is the comparative clinical effectiveness and safety of dextrose 10% intravenous drip versus dextrose 50% intravenous push for adults experiencing acute hypoglycemia? Key Message No relevant literature was identified regarding the comparative clinical effectiveness and safety of dextrose 10% intravenous drip versus dextrose 50% intravenous push for adults

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

2. Oral Glucose Tablets versus Gel or Solution for the Treatment of Mild Hypoglycemia: Comparative Clinical Effectiveness

Oral Glucose Tablets versus Gel or Solution for the Treatment of Mild Hypoglycemia: Comparative Clinical Effectiveness Oral Glucose Tablets versus Gel or Solution for the Treatment of Mild Hypoglycemia: Comparative Clinical Effectiveness | CADTH.ca Find the information you need Oral Glucose Tablets versus Gel or Solution for the Treatment of Mild Hypoglycemia: Comparative Clinical Effectiveness Oral Glucose Tablets versus Gel or Solution for the Treatment of Mild Hypoglycemia: Comparative (...) Clinical Effectiveness Last updated: May 8, 2019 Project Number: RB1336-000 Product Line: Research Type: Drug Report Type: Summary of Abstracts Result type: Report Question What is the comparative clinical effectiveness of oral glucose tablets versus oral glucose gel or solution for the treatment of mild hypoglycemia in patients of any age? Key Message One systematic review was identified regarding oral glucose tablets versus gel or solution for the treatment of mild hypoglycemia. In addition, one

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

7. Oral Glucose Gel for Neonatal Hypoglycemia: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines

Oral Glucose Gel for Neonatal Hypoglycemia: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines Oral Glucose Gel for Neonatal Hypoglycemia: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines | CADTH.ca Find the information you need Oral Glucose Gel for Neonatal Hypoglycemia: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines Oral Glucose Gel for Neonatal Hypoglycemia: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines (...) from one systematic review suggested that oral glucose gel administered in a hospital setting was clinically effective in preventing neonatal hypoglycemia in at-risk neonates. Evidence of moderate quality from two systematic reviews was inconclusive for oral glucose gel reducing the risk of separation of birthing parent and infant due to reporting of opposite effects. Limited evidence of low quality from four non-randomized studies was also inconclusive for oral glucose gel reducing admissions

2018 Canadian Agency for Drugs and Technologies in Health - Rapid Review

8. A Randomized Clinical Trial of the Effect of Continuous Glucose Monitoring on Nocturnal Hypoglycemia, Daytime Hypoglycemia, Glycemic Variability, and Hypoglycemia Confidence in Persons with Type 1 Diabetes Treated with Multiple Daily Insulin Injections (G (PubMed)

A Randomized Clinical Trial of the Effect of Continuous Glucose Monitoring on Nocturnal Hypoglycemia, Daytime Hypoglycemia, Glycemic Variability, and Hypoglycemia Confidence in Persons with Type 1 Diabetes Treated with Multiple Daily Insulin Injections (G To evaluate the effects of continuous glucose monitoring (CGM) on nocturnal and daytime hypoglycemia in persons with type 1 diabetes treated with multiple daily insulin injections (MDI); we also evaluated factors related to differences (...) in hypoglycemia confidence in this population.Evaluations were performed from the GOLD randomized trial, an open-label multicenter crossover randomized clinical trial (n = 161) over 69 weeks comparing CGM to self-measurement of blood glucose (SMBG) in persons with type 1 diabetes treated with MDI. Masked CGM and the hypoglycemia confidence questionnaire were used for evaluations.Time with nocturnal hypoglycemia, glucose levels <70 mg/dL was reduced by 48% (10.2 vs. 19.6 min each night, P < 0.001) and glucose

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2018 Diabetes technology & therapeutics

9. Cognitions Associated With Hypoglycemia Awareness Status and Severe Hypoglycemia Experience in Adults With Type 1 Diabetes. (PubMed)

Cognitions Associated With Hypoglycemia Awareness Status and Severe Hypoglycemia Experience in Adults With Type 1 Diabetes. Impaired awareness of hypoglycemia (IAH) and recurrent severe hypoglycemia (RSH) remain problematic for people with type 1 diabetes (T1D), despite major therapeutic advances. We explored beliefs around hypo- and hyperglycemia in adults with T1D with, and without, IAH and RSH.A cross-sectional U.S. multicenter survey included Attitudes to Awareness of Hypoglycemia (A2A (...) ; a 19-item questionnaire concerning beliefs about hypoglycemia), the Gold score (single item: awareness of hypoglycemia), and a question about severe hypoglycemia over the preceding year. The survey was emailed to 6,200 adult participants of the annual T1D Exchange clinic registry data collection. A2A data were subjected to principal component analysis with varimax rotation.Among 1,978 respondents (response rate 32%), 61.7% were women, mean ± SD age was 39.6 ± 16.3 years, and T1D duration was 23.1

2019 Diabetes Care

10. Predictors of Recurrent Severe Hypoglycemia in Adults With Type 1 Diabetes and Impaired Awareness of Hypoglycemia During the HypoCOMPaSS Study. (PubMed)

Predictors of Recurrent Severe Hypoglycemia in Adults With Type 1 Diabetes and Impaired Awareness of Hypoglycemia During the HypoCOMPaSS Study. The HypoCOMPaSS study was designed to test the hypothesis that successful avoidance of biochemical hypoglycemia without compromising overall glycemic control would restore sufficient hypoglycemia awareness to prevent recurrent severe hypoglycemia in the majority of participants with established type 1 diabetes. Before starting the study, we planned (...) to investigate associations between baseline characteristics and recurrent severe hypoglycemia over 2 years' follow-up.A total of 96 adults with type 1 diabetes and impaired awareness of hypoglycemia participated in a 24-week 2 × 2 factorial randomized controlled trial comparing insulin delivery and glucose monitoring modalities, with the goal of rigorous biochemical hypoglycemia avoidance. The analysis included 71 participants who had experienced severe hypoglycemia in the 12-month prestudy with confirmed

2019 Diabetes Care

11. Self-Monitoring of Blood Glucose Frequency for Patients with Hypoglycemia Unawareness: A Review of Clinical Effectiveness and Guidelines

Self-Monitoring of Blood Glucose Frequency for Patients with Hypoglycemia Unawareness: A Review of Clinical Effectiveness and Guidelines Medical Cannabis in Residential Transition or Addiction Programs: A Review of Clinical and Cost-Effectiveness and Guidelines | CADTH.ca Find the information you need Medical Cannabis in Residential Transition or Addiction Programs: A Review of Clinical and Cost-Effectiveness and Guidelines Medical Cannabis in Residential Transition or Addiction Programs

2017 Canadian Agency for Drugs and Technologies in Health - Rapid Review

12. Self-Monitoring of Blood Glucose Frequency for Patients with Hypoglycemia Unawareness: A Review of Clinical Effectiveness and Guidelines

Self-Monitoring of Blood Glucose Frequency for Patients with Hypoglycemia Unawareness: A Review of Clinical Effectiveness and Guidelines Self-Monitoring of Blood Glucose Frequency for Patients with Hypoglycemia Unawareness: A Review of Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Self-Monitoring of Blood Glucose Frequency for Patients with Hypoglycemia Unawareness: A Review of Clinical Effectiveness and Guidelines Self-Monitoring of Blood Glucose Frequency (...) for Patients with Hypoglycemia Unawareness: A Review of Clinical Effectiveness and Guidelines Published on: April 5, 2017 Project Number: RC0869-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of various frequencies of self-monitoring of blood glucose with test strips for patients with type 1 diabetes mellitus and hypoglycemia unawareness? What are the evidence-based guidelines regarding

2017 Canadian Agency for Drugs and Technologies in Health - Rapid Review

13. A Transdermal Glucagon Patch for Severe Hypoglycemia

A Transdermal Glucagon Patch for Severe Hypoglycemia A Transdermal Glucagon Patch for Severe Hypoglycemia | CADTH.ca CADTH Document Viewer A Transdermal Glucagon Patch for Severe Hypoglycemia Table of Contents Search this document A Transdermal Glucagon Patch for Severe Hypoglycemia June 2017 Summary The ZP-Glucagon patch uses novel microneedle technology to deliver glucagon through the skin to people who are experiencing severe hypoglycemia (very low blood sugar). There is very limited (...) Hypoglycemia occurs when a person’s blood glucose (blood sugar) level is too low; it is a common problem in people living with diabetes who are on insulin or insulin secretagogues (drugs that increase insulin secretion by the pancreas). 1 Although the precise thresholds for hypoglycemia and severe hypoglycemia based on blood glucose levels continue to be debated, the severity of hypoglycemia is generally categorized by the clinical symptoms and the type of intervention required. 2,3 Common symptoms of mild

2017 CADTH - Issues in Emerging Health Technologies

14. A Transdermal Glucagon Patch for Severe Hypoglycemia

A Transdermal Glucagon Patch for Severe Hypoglycemia A Transdermal Glucagon Patch for Severe Hypoglycemia | CADTH.ca CADTH Document Viewer A Transdermal Glucagon Patch for Severe Hypoglycemia Table of Contents Search this document A Transdermal Glucagon Patch for Severe Hypoglycemia June 2017 Summary The ZP-Glucagon patch uses novel microneedle technology to deliver glucagon through the skin to people who are experiencing severe hypoglycemia (very low blood sugar). There is very limited (...) Hypoglycemia occurs when a person’s blood glucose (blood sugar) level is too low; it is a common problem in people living with diabetes who are on insulin or insulin secretagogues (drugs that increase insulin secretion by the pancreas). 1 Although the precise thresholds for hypoglycemia and severe hypoglycemia based on blood glucose levels continue to be debated, the severity of hypoglycemia is generally categorized by the clinical symptoms and the type of intervention required. 2,3 Common symptoms of mild

2017 CADTH - Issues in Emerging Health Technologies

15. The relation between HbA1c and hypoglycemia revisited; a secondary analysis from an intervention trial in patients with type 1 diabetes and impaired awareness of hypoglycemia. (PubMed)

The relation between HbA1c and hypoglycemia revisited; a secondary analysis from an intervention trial in patients with type 1 diabetes and impaired awareness of hypoglycemia. We aimed to re-assess the previously shown but recently disputed association between HbA1c and severe hypoglycemia.52 Patients with T1D and IAH participated in an earlier reported randomized, crossover trial with two 16-week intervention periods comparing continuous glucose monitoring (CGM) with self-monitoring of blood (...) glucose (SMBG). In this previous study, time spent in normoglycemia (the primary outcome), was improved by 9.6% (p<0.0001). We performed post-hoc analyses using a zero-inflated Poisson regression model to assess the relationship between severe hypoglycemia and HbA1c, glucose variability and duration of diabetes.During SMBG use, HbA1c and the number of severe hypoglycemic events were negatively associated (OR 0.20 [95% CI 0.09 to 0.44]). During CGM use, this relationship showed an odds ratio of 0.65

2018 Journal of diabetes and its complications

16. Sustained Reduction in Severe Hypoglycemia in Adults With Type 1 Diabetes Complicated by Impaired Awareness of Hypoglycemia: 2-Year Follow-up in the HypoCOMPaSS Randomized Clinical Trial. (PubMed)

Sustained Reduction in Severe Hypoglycemia in Adults With Type 1 Diabetes Complicated by Impaired Awareness of Hypoglycemia: 2-Year Follow-up in the HypoCOMPaSS Randomized Clinical Trial. Severe hypoglycemia is a feared complication of type 1 diabetes; yet, few trials have targeted prevention using optimized self-management (educational, therapeutic, and technological support). We aimed to investigate whether improved awareness and reduced severe hypoglycemia, achieved during an intensive (...) randomized clinical trial (RCT), were sustained after return to routine care.Ninety-six adults with type 1 diabetes (29 ± 12 years' duration) and impaired awareness of hypoglycemia at five U.K. tertiary referral diabetes centers were recruited into a 24-week 2 × 2 factorial RCT (HypoCOMPaSS). Participants were randomized to pump (continuous subcutaneous insulin infusion [CSII]) or multiple daily injections (MDIs) and real-time continuous glucose monitoring (RT-CGM) or self-monitoring of blood glucose

2018 Diabetes Care

17. An unusual presentation of post gastric bypass hypoglycemia with both postprandial and fasting hypoglycemia (PubMed)

An unusual presentation of post gastric bypass hypoglycemia with both postprandial and fasting hypoglycemia There has been an increasing awareness of post gastric bypass hypoglycemia (PGBH). Histopathologic findings from such patients who underwent partial/total pancreatomy, however, can vary widely from minimal changes to classic nesidioblastosis, making the pathologic diagnosis challenging. PGBH typically presents as postprandial hypoglycemia, as opposed to insulinoma, which presents (...) as fasting hypoglycemia. Herein, we describe an unusual case of a patient with PGBH who initially presented with postprandial hypoglycemia three years after surgery, but later developed fasting hyperinsulinemic hypoglycemia as the disease progressed. Our hypothesis for this phenomenon is that this disease is progressive, and later in its course, the insulin release becomes dissociated from food stimulation and is increased at baseline. Future studies are needed to investigate the prevalence as well

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2018 Endocrinology, diabetes & metabolism case reports

18. Switching from Flash Glucose Monitoring to Continuous Glucose Monitoring on Hypoglycemia in Adults with Type 1 Diabetes at High Hypoglycemia Risk: The Extension Phase of the I HART CGM Study (PubMed)

Switching from Flash Glucose Monitoring to Continuous Glucose Monitoring on Hypoglycemia in Adults with Type 1 Diabetes at High Hypoglycemia Risk: The Extension Phase of the I HART CGM Study The I HART CGM study showed that real-time continuous glucose monitoring (RT-CGM) has greater beneficial impact on hypoglycemia than intermittent flash glucose monitoring (flash) in adults with type 1 diabetes (T1D) at high risk. The impact of continuing RT-CGM or switching from flash to RT-CGM for another (...) 8 weeks was then evaluated.Prospective randomized parallel group study with an extension phase. After a 2-week run-in with blinded CGM, participants were randomized to either RT-CGM or flash for 8 weeks. All participants were then given the option to continue with RT-CGM for another 8 weeks. Glycemic outcomes at 8 weeks are compared with the 16-week endpoint.Forty adults with T1D on intensified multiple daily insulin injections and with impaired awareness of hypoglycemia or a recent episode

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2018 Diabetes technology & therapeutics

19. Hypoglycemia unawareness in type 1 diabetes suppresses brain responses to hypoglycemia (PubMed)

Hypoglycemia unawareness in type 1 diabetes suppresses brain responses to hypoglycemia Among nondiabetic individuals, mild glucose decrements alter brain activity in regions linked to reward, motivation, and executive control. Whether these effects differ in type 1 diabetes mellitus (T1DM) patients with and without hypoglycemia awareness remains unclear.Forty-two individuals (13 healthy control [HC] subjects, 16 T1DM individuals with hypoglycemia awareness [T1DM-Aware], and 13 T1DM individuals (...) with hypoglycemia unawareness [T1DM-Unaware]) underwent blood oxygen level-dependent functional MRI brain imaging during a 2-step hyperinsulinemic euglycemic (90 mg/dl)-hypoglycemic (60 mg/dl) clamp for assessment of neural responses to mild hypoglycemia.Mild hypoglycemia in HC subjects altered activity in the caudate, insula, prefrontal cortex, and angular gyrus, whereas T1DM-Aware subjects showed no caudate and insula changes, but showed altered activation patterns in the prefrontal cortex and angular gyrus

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2018 The Journal of clinical investigation

20. The current status of treatment‐related severe hypoglycemia in Japanese patients with diabetes mellitus: A report from the committee on a survey of severe hypoglycemia in the Japan Diabetes Society (PubMed)

The current status of treatment‐related severe hypoglycemia in Japanese patients with diabetes mellitus: A report from the committee on a survey of severe hypoglycemia in the Japan Diabetes Society Despite great strides in pharmacotherapy for diabetes, there is increasing concern over the risk of hypoglycemia in patients with diabetes receiving pharmacotherapy as they become increasingly older. This has prompted the Japan Diabetes Society (JDS) to initiate a survey on the current status (...) of severe hypoglycemia in clinical settings. In July 2015, following approval from the JDS Scientific Survey/Research Ethics Committee, the JDS extended an invitation to executive educators, who represented a total of 631 healthcare facilities accredited by the JDS for diabetes education, to participate in the proposed survey. Of these, those who expressed their willingness to participate in the survey were sent an application form required for obtaining ethical approval at these healthcare facilities

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2018 Journal of Diabetes Investigation

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