72 results on '"Toledano Y"'
Search Results
2. Acquired prolactin deficiency in patients with disorders of the hypothalamic-pituitary axis
- Author
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Toledano, Y., Lubetsky, A., and Shimon, I.
- Published
- 2007
- Full Text
- View/download PDF
3. Improved glycaemic control with reduced hypoglycaemic episodes and without weight gain using long-term modern premixed insulins in type 2 diabetes
- Author
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Levit, S., Toledano, Y., and Wainstein, J.
- Published
- 2011
- Full Text
- View/download PDF
4. OC23.02: Fetal anogenital distance is longer in polycystic ovary syndrome mothers
- Author
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Perlman, S., primary, Toledano, Y., additional, Halevy, N., additional, Kivilevitch, Z., additional, and Gilboa, Y., additional
- Published
- 2019
- Full Text
- View/download PDF
5. PDB78 - ECONOMIC EVALUATION OF DAPAGLIFLOZIN AS ADD-ON TO METFORMIN FOR T2DM TREATMENT IN THE ISRAELI HEALTHCARE SETTING
- Author
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Moshel, S., primary, Hirsch Vexberg, M., additional, Shavit, O., additional, and Toledano, Y., additional
- Published
- 2018
- Full Text
- View/download PDF
6. Correction: Androgen Receptor CAG Repeat Length in Relation to Phenotype Among Females with Nonclassical 21-Hydroxylase Deficiency
- Author
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Ben-Shachar, S., primary, Ayalon, I., primary, Reznik-Wolf, H., additional, Tenenbaum-Rakover, Y., additional, Zuckerman-Levin, N., additional, Cohen, O., additional, Lifshitz, A., additional, Fraenkel, M., additional, Toledano, Y., additional, Rouach, V., additional, Koren, I., additional, Modan-Moses, D., additional, Hirsch, D., additional, Schachter-Davidov, A., additional, Israel, S., additional, Eyal, O., additional, and Weintrob, N., additional
- Published
- 2015
- Full Text
- View/download PDF
7. Androgen Receptor CAG Repeat Length in Relation to Phenotype Among Females with Nonclassical 21-Hydroxylase Deficiency
- Author
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Ben-Shachar, S., additional, Ayalon, I., additional, Reznik-Wolf, H., additional, Tenenbaum-Rakover, Y., additional, Zuckerman-Levin, N., additional, Cohen, O., additional, Lifshitz, A., additional, Fraenkel, M., additional, Toledano, Y., additional, Roash, V., additional, Koren, I., additional, Modan-Moses, D., additional, Hirsch, D., additional, Schachter-Davidov, A., additional, Israel, S., additional, Eyal, O., additional, and Weintrob, N., additional
- Published
- 2014
- Full Text
- View/download PDF
8. Actualizacion de informacion financiera con tasas variables de interes : aplicacion en el boletin B-10 y en la evaluacion de proyectos de inversion
- Author
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Toledano y Castillo, Mario Alfonso and Cardiel Hurtado, Jorge
- Subjects
Ciencias Sociales - Published
- 2002
9. Radiothérapie des gliomes de haut grade chez les patients de plus de 70ans : étude rétrospective sur 80 patients, résultats et facteurs pronostiques
- Author
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Dalloz, P., primary, Biau, J., additional, Dillies, A.-F., additional, Durando, X., additional, Kemeny, J.-L., additional, Khalil, T., additional, Kwiatkowski, F., additional, Toledano, Y., additional, and Verrelle, P., additional
- Published
- 2012
- Full Text
- View/download PDF
10. Improved glycaemic control with reduced hypoglycaemic episodes and without weight gain using long-term modern premixed insulins in type 2 diabetes
- Author
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Levit, S., primary, Toledano, Y., additional, and Wainstein, J., additional
- Published
- 2010
- Full Text
- View/download PDF
11. Androgen Receptor CAG Repeat Length in Relation to Phenotype Among Females with Nonclassical 21-Hydroxylase Deficiency.
- Author
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Ben-Shachar, S., Ayalon, I., Reznik-Wolf, H., Tenenbaum-Rakover, Y., Zuckerman-Levin, N., Cohen, O., Lifshitz, A., Fraenkel, M., Toledano, Y., Roash, V., Koren, I., Modan-Moses, D., Hirsch, D., Schachter-Davidov, A., Israel, S., Eyal, O., and Weintrob, N.
- Subjects
ANDROGEN receptors ,PHENOTYPES ,HYDROXYLASES ,PRECOCIOUS puberty ,MENARCHE ,HUMAN genes ,VIRILISM - Abstract
Nonclassical 21-hydroxylase deficiency ( NC21O HD) manifests with various degrees of post natal virilization. The length of CAG repeats of the androgen receptor gene (AR) is inversely correlated to activity of the human androgen receptor (AR) and affects phenotype of several androgendependent disorders. The aim of the study was to investigate the associations between CAG repeat length and the phenotype of females with NC21OHD. CAG repeat length and AR inactivation were assessed in females with NC21OHD, and related to their clinical presentation. CAG repeat length and AR inactivation were assessed in 119 females with NC21OHD. Biallelic mean (BAM) of the CAG repeat length and the weighted BAM (WBAM) were related to various clinical parameters. Age at diagnosis and age of menarche positively correlated with BAM (r = 0.22, p = 0.02, and r = 0.23, p = 0.01, respectively). A shorter ( < 25) BAM was associated with younger age at diagnosis (14.8 vs. 21.4 years, p < 0.01), at adrenarche (8.1 vs. 10.2 years, p < 0.01) and gonadarche (9.9 vs. 11.2 years, p < 0.01), and higher corrected height standard deviation score at diagnosis (0.77 vs. 0.15, p = 0.01). Precocious pubarche and precocious puberty were more frequent in these with the shorter BAM. Results of WBAM were similar. The CAG repeat length of the AR gene contributes to the clinical diversity of the phenotype in females with NC21OHD. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
12. Radiothérapie des gliomes de haut grade chez les patients de plus de 70 ans : étude rétrospective sur 80 patients, résultats et facteurs pronostiques
- Author
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Dalloz, P., Biau, J., Dillies, A.-F., Durando, X., Kemeny, J.-L., Khalil, T., Kwiatkowski, F., Toledano, Y., and Verrelle, P.
- Published
- 2012
- Full Text
- View/download PDF
13. Invasive pneumococcal infections. A comparison between adults and children.
- Author
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Rahav, G, Toledano, Y, Engelhard, D, Simhon, A, Moses, A E, Sacks, T, and Shapiro, M
- Published
- 1997
- Full Text
- View/download PDF
14. 40 EASD Annual Meeting of the European Association for the Study of Diabetes : Munich, Germany, 5-9 September 2004
- Author
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Veitenhansl, M., Stegner, K., Hierl, F-X, Dieterle, C., Feldmeier, H., Gutt, B., Landgraf, R., Garrow, A. P., Vileikyte, L., Findlow, A., Waterman, C., Boulton, A. J. M., Shankhdhar, K., Shankhdhar, L., Shankhdhar, U., Petrova, N. L., Foster, A. V. M., Edmonds, M. E., Ferraresi, R., Caravaggi, C., Giglio, R., Cavaiani, P., Pogliaghi, I., Sommariva, E., Katz, I. A., Harlan, A., Miranda-Palma, B., Prieto-Sanchez, L., Armstrong, D. G., Bowker, J. H., Mizel, M. S., Cernea, S., Wohlgelernter, J., Kidron, M., Modi, P., Raz, I., Arbit, E., Nosek, L., Kapitza, C., Beckett, P., Gelfand, R., Goldberg, M., Heise, T., Testa, M. A., Turner, R. R., Hayes, J. F., Scranton, R. E., Simonson, D. C., Yang, Y-W, Hsu, Y-J, Naujok, O., Francini, F., Jorns, A., Tiedge, M., Lenzen, S., Abdel-Wahab, Y. H. A., Marenah, L., Orr, D. F., Shaw, C., Flatt, P. R., Chokkalingam, K., Mansell, P. I., Clausen, P., Ekbom, P., Damm, P., Feldt-Rasmussen, U., Nielsen, B., Mathiesen, E. R., Feldt-Rasmussen, B., Dewan, S., Da Silva, N., Ternan, P. Mc, Leong, K. S., Wilding, J. P. H., Asatiani, N., Kurashvili, R., Dundua, M., Shelestova, E., Pagava, K., Ramazashvili, M., Hod, M., Smirnov, S., Petersen, J. L. A., Justesen, T. I., Ringholm Nielsen, L., Muller, C., Hojlund, K., Wensaas, A., Kase, E. T., Aas, V., Rustan, A. C., Thoresen, G. H., Levin, K., Beck-Nielsen, H., Gaster, M., Im, S-S, Kang, S-Y, Kim, S-Y, Ahn, Y-H, Lihn, A. S., Schmoll, D., Werner, T., Kienitz, A., Meyer, M., Barthel, A., Ailett, F., Sutherland, C., Walther, R., Grempler, R., Sasson, S., Reich, R., Tenenbaum, T., Alpert, E., Anfossi, G., Russo, I., Traversa, M., Massucco, P., Mattiello, L., Doronzo, G., Trovati, M., Lally, S., Tan, C. Y., Owens, D., Tomkin, G. H., Porchay, I., Pean, F., Bellili, N., Betoulle, D., Balkau, B., Tichet, J., Marre, M., Fumeron, F., Group D.E.S.I.R., Chatellier, G., Alhenc-Gelas, F., Diabhycar, Study Group, Nichols, G. A., Brown, J. B., Hayes, R. P., Bowman, L., Drexel, H., Saely, C. H., Marte, T., Benzer, W., Langer, P., Hoefle, G., Moll, W., Aczel, S., Karagiannis, E., Lubben, G., Urquhart, R., Edwards, G., Bruce, S., Howlett, H. S. C., Cugnardey, N., Turner, K. C., Park, J-S, Fiedorek, F. T., Avogaro, A., Gallo, A., Pinton, P., Rizzuto, R., Murphy, E., Ceolotto, G., Caterson, I., Guy-Grand, B., Hill, J., Barone, M., Aiello, A., Allochis, G., Borzi, V., Cannata, F., Caronna, S., D Avanzo, A., Elli, R., Formoso, G., Paroli, A., Scardapane, R., Sorichetti, P., Tatti, P., Viviani, G., Santeusanio, F., Italian Repaglinide Study Group, Manzella, D., Grella, R., Abbatecola, A. M., Paolisso, G., Sondergaard, L. G., Monster, T. B. M., Johnsen, S. P., Olsen, M. L., Mclaughlin, J. K., Sorensen, H. T., Lervang, H. H., Rungby, J., Lyssenko, V., Fredriksson, J., Almgren, P., Anevski, D., Orho-Melander, M., Sjogren, M., Tuomi, T., Groop, L., Jaziri, R., Aubert, R., Tuomilehto, J., Hu, G., Jousilahti, P., Peltonen, M., Lindstrom, J., Laina, A., Alevizaki, M., Philippou, G., Souvatzoglou, A., Anastasiou, E., Alba, S., Metcalf, B. S., Voss, L. D., Jeffery, A. N., Wilkin, T. J., Gluimer, C., Colagiuri, S., Vistisen, D., Borch-Johnsen, K., Haynes, A., Bower, C., Bulsara, M. K., Jones, T. W., Davis, E. A., Mortensen, H. B., Hougaard, P., Holl, R., Swift, P., Pociot, F., Knip, M., Hansen, L., Szadkowska, A., Pietrzak, I., Zmyslowska, A., Wyka, K., Bodalski, J., Holl, R. W., Swift, R., Hougaard, R., Gerstl, E-M, Engelsberger, I., Rabl, W., Rosenbauer, J., Grobe, H., Hofer, S. E., Krause, U., DPV-Wiss-Study Group, Dabelea, D., Morgan, T., Pettitt, D. J., Dolan, L., Mayer-Davis, E. J., Pihoker, C., Hillier, T. A., Imperatore, G., Ruggiero, A., Hamman, R. E., Stylianou, A., Tentolouris, N., Perrea, D., Tselepis, A. D., Lourida, E., Kitsou, E., Katsilambros, N., Vedovato, M., Dodesini, A. R., Lepore, G., Tiengo, A., Trevisan, R., Penno, G., Miccoli, R., Pucci, L., Lucchesi, D., Bandinelli, S., Fotino, C., Triscornia, S., Baldassari, E., Del Prato, S., Reboldi, P., Santeusanio, E., Fuller, J., Langham, R. G., Gow, R. M., Zhang, Y., Kelly, D. J., Christensen, P. K., Parving, H-H, Gilbert, R. E., Chibalin, A. V., Zhong, Z., Kotova, O., Davidescu, A., Ehren, I., Ekberg, K., Wahren, J., Wassef, L., Buckley, A. J., Rooney, K. B., Briody, J., Thompson, M., Ozanne, S. E., Thompson, C. H., Chamson-Reig, A., Summers, K., Arany, E. J. R., Hill, D. J., Solerte, S. B., Gazzaruso, C., Locatelli, E., Precerutti, S., Schifino, N., Ferrari, E., Fioravanti, M., Phenekos, C. V., Ginis, A., Fragaki, I., Chalkiadaki, M., Tzioras, C., Powell, L. A., Mcguire, G. M., Jewhurst, V., Trimble, E. R., Rasmussen, B. M., Vessby, B., Uusitupa, M., Berglund, L., Pedersen, E., Riccardi, G., Rivellese, A. A., Tapsell, L., Hermansen, K., Kanwu, Study Group, Da Silva Xavier, G., Rutter, J., Rutter, G. A., Briaud, I. M., Lingohr, M. K., Dickson, L. M., Mccuaig, J. R., Lawrence, J. C., Rhodes, C. J., Wikstrom, J. D., Katzman, S. M., Shirihai, O. S., Yang, J., Deng, S., Wang, X., Hessner, M. J., Wu, J., Wong, R. K., Sukumvanich, S., Markman, J. F., Naji, A., Wolf, B. A., Gao, Z., Rubi, B., Del Arco, A., Satrustegui, J., Maechler, P., Del Guerra, S., Lupi, R., Bugliani, M., Sbrana, S., Torri, S., Boggi, U., Vistoli, F., Mosca, F., Marchetti, P., Rennings, A. J. M., Smits, P., Stewart, M. W., Tack, C. J. J., Li, L., Nystrom, T., Gutniak, M., Ahren, B., Holst, J., Sjoholm, A., Gomes, M. B., Cailleaux, S., Tibirica, E., Albertini, J-P, Chen, H., Mather, R., Valensi, P. E., Chisalita, S. I., Arnqvist, H. J., Kraenkel, N., Adams, V., Linke, A., Gielen, S., Schuler, G., Humbrecht, R., Cipollone, F., Iezzi, A., Fazia, M., Pini, B., Cucurullo, C., Cesare, D., Schmidt, A. M., Mazurek, T., Zang, L. F., Mannion, J., Diehl, J., Martin, J., Martella, A., Zalewski, A., Shi, Y., Otter, W., Winter, M., Doering, W., Standi, E., Schnell, O., Kragelund, C., Kober, L., Faber, J., Hildebrandt, P., Steffensen, R., Pankowska, E., Szypowska, A., Lipka, M., Herwig, J., Scholl-Schilling, G., Bohles, H., Robertson, K. J., Schonle, E., Gucev, Z., Mordhorst, L., Tamer, S. C., Gall, M-A, Ludvigsson, J., Hoogma, R. P. L., Hammond, P. J., Gomis, R., Kerr, D., Bruttomesso, D., Bouter, P., Wiefels, K. J., La Calle, H., Schweitzer, D. H., Pfohl, M., Torlone, E., Krinelke, L. G., 205-Nations Study Group, Conget, I., Storms, F., Rodriguez, J., Leperlier, C., Davies, M., At Lantus, Study Group, Peter, R., Luzio, S. D., Dunseath, G., Miles, A., Hare, B., Backx, K., Pauvaday, V., Owens, D. R., Caselli, A., Marfia, G. A., Battista, C., Veves, A., Spallone, V., Uccioli, L., Gonzalez, J. S., Peyrot, M. F., Rubin, R. R., Leventhal, H., Scheffler, N., Ulbrecht, J. S., Cavanagh, P. R., Boulton, A. J., Perrin, N. A., Oglesby, A., Bastyr, E. J., Ziegler, D., Siekierka-Kleiser, E., Meyer, B., Schweers, M., Selvarajah, D., Wilkinson, I. D., Emery, C. J., Shaw, P. J., Griffiths, P. D., Tesfaye, S., Obrosova, I. G., Arezzo, J., Phillips, K., Fidarestat Study Group, Gribble, F. M., Williams, L., Reimann, F., Iakoubov, R., Whiteside, C., Brubaker, P. L., Acitores, A., Gonzalez, N., Sancho, V., Valverde, I., Villanueva-Penacarrillo, M. L., Martin-Duce, A., Trigo, M. V., Arnes, L., Burkart, V., Ichino, N., Ohashi, A., Klein, B. S., Paxian, S., Schmid, R., Karlsen, A. E., Heding, P. E., Frobose, H., Ronn, S. G., Kruhoffer, M., Orntoft, T. F., Nerup, J., Mandrup-Poulsen, T., Billestrup, N., Cardozo, A. K., Ortis, F., Feng, Y-M, Rasschaert, J., Eylen, F., Storling, J., Herchuelz, A., Eizirik, D. L., Wang, H., Kouri, G., Wollheim, C. B., Ribaux, P., Hammar, E., Parnaud, G., Rouiller, D., Bosco, D., Halban, P., Midthjell, K., Carlsson, S., Grill, V., Lau, C., Farch, K., Glumer, C., Tetens, I., Jorgensen, T., Tillin, T., Forouhi, N., Mckeigue, P., Chaturvedi, N., Zethelius, B., Hales, C. N., Berne, C., Coleman, R. L., Stevens, R. J., Holman, R. R., Christensen, J. O., Sandbak, A., Lauritzen, T., Irwin, N., Gault, V. A., Green, B. D., Harriott, P., O Harte, F. P. M., Bouman, S. D., Urso, B., Brand, C. L., Rolin, B., Ribel, U., Schaffer, L., Maggs, D. G., Ceriello, A., Frias, J. P., Wang, Y., Ruggles, J. A., Kolterman, O. G., Piconi, L., Weyer, C., Want, L. L., Ratner, R. E., Uwaifo, G. I., Thornberry, N. A., Eiermann, G., Kim, D., Lankas, G., Leiting, B., Li, Z., Lyons, K., Petrov, A., Sinha Roy, R., Woods, A., Woods, J., Zhang, B. B., Fisher, M., Moller, D. E., Weber, A. E., Dreyer, M., Bellin, C., Schmitz, V., Roesen, R., Nescheret, A. P., Bose, A. K., Mocanu, M. M., Carr, R. D., Yellon, D. M., Manolopoulos, K., Born, S., Wagner, A., Jeziorska, M., Ben Drief, A., Bashir, M., Tomlinson, D., Malik, R. A., Zeymer, U., Schwarzmaier-D Assie, A., Petzinna, D., Chiasson, J-L, Stratton, I. M., Af Bjorkesten, C-G, Fagerudd, J., Rosengard-Barlund, M., Forsblom, C., Pettersson-Fernholm, K., Waden, J., Saraheimo, M., Ronnback, M., Thorn, L., Groop, P-H, Mollsten, A., Svensson, M., Kockum, I., Rudberg, S., Brismar, K., Dahlquist, G., Hovind, P., Hansen, T. K., Tarnow, L., Thiel, S., Jensen, B. R., Flyvbjerg, A., Kankova, K., Hertlova, M., Krusova, D., Schwenke, S., Ott, J., Thom, S. A. M., Mistry, P., Sjolie, A., Larsen, B., Witt, N., Hughes, A. D., Samira, H. H., Lahiry, S., Howlader, S. R., Parveen, S., Azad Khan, A. K., Clarke, P. M., Gray, A., Stevens, R., Holman, R., Phillips, L., Phillips, P. J., Chittleborough, C., Baldock, K., Taylor, A., North West Adelaide Health Study Team, Davis, W. A., Davis, T. M. E., Knuiman, M. W., Hendrie, D., Worthley, D., Nicolucci, A., Pellegrini, F., Berardis, G., Franciosi, M., Belfiglio, M., Rossi, M. C. E., Sacco, M., Valentini, M., Richardson, C. C., Jones, P., Persaud, S., Hussain, K., Clark, A., Christie, M. R., Gniuli, D., Hribal, M. L., Accili, D., Khan, M., Zervou, S., Cheung, L., Abouna, S., Ifandi, V., Pelengaris, S., Luco, R. F., Ferrer, J., Ma, D., Shield, J. P. H., Dean, W., Leclerc, I., Knauf, C., Burcelin, R., Kelsey, G., Powers, A. C., Shostak, A., Ferrara, N., Poffenberger, G., Jerome, W. G., Brissova, M., Geloneze, S. R., Tambascia, M. A., Pareja, J. C., Chaim, E., Silveira, H. V., Geloneze, B., Ravikumar, B., Carey, P. E., Snaar, J. E., Dheelchand, D., Cook, D. B., Neely, D., Taylor, G., Morris, P. G., Taylor, R., Stears, A. J., Masding, M. G., Wootton, S. A., Sandeman, D. D., Klimes, I., Wein, S., Gasperikova, D., Ukropec, J., Wiernsperger, N., Sebokova, E., Manco, M., Mingrone, G., Granato, L., Greco, A. V., Nanni, G., Castagneto, M., Vidal, H., Calvani, M., Ferrannini, E., Alvarsson, M., Sundkvist, G., Lager, I., Henricsson, M., Berntorp, K., Fernqvist-Forbes, E., Steen, L., Orn, T., Shutler, S., Bianchi-Biscay, M., Rosenstock, J., Sugimoto, D., Strange, P., Stewart, J., Soltes Rak, E., Dailey, G., Kloos, C., Muller, U., Samann, A., Femerling, M., Risse, A., Jecht, M., Haak, T., Garg, R., Lawrence, I. G., Akinsola, M. O., Davies, M. J., Mcnally, P. G., Garber, A. J., Kim, H., Draeger, E., Aydin, L., Sengul, A., Kurklu, A., Ucak, S., Basat, O., Seber, S., Altuntas, Y., Jin, J., Yu, Y., Yu, H., Zhang, X., Mattoo, V., Eckland, D., Widel, M., Duran, S., Fajardo, C., Strand, J., Knight, D., Oakley, D., Tan, M., Sato, A., Nagao, M., Aki, N., Nakagami, T., Iwamoto, Y., Zhou, Z., Li, X., Huang, G., Yan, X., Yang, L., Peng, J., Wang, J., Tan, S., Tang, W., Furnsinn, C., Brunmair, B., Wagner, L., Gras, F., Artwohl, M., Zierhut, B., Waldhausl, W., Shine, B. L., Hopkins, D., Anand, V., Lim, E., Raval, U., Sharp, P., Corder, R., Lipkin, D., Lahiri, A., Bartnik, M., Ryden, L., Ferrari, R., Malmberg, K., Pyorala, K., Simoons, M. L., Standl, E., Soler-Soler, J., Ohrvik, J., Euro Heart Survey Investigators, Bruce, D. G., Starkstein, S. E., Schauer, U. J. W., Astrup, A. S., Pietraszek, L., Nielsen, F. S., Rossing, P., Ali, S., Smidt, U. M., Yokoyama, H., Pavkov, M. E., Knowler, W. C., Bennett, P. H., Nelson, R. G., Lopez-Alba, A., Morcillo, L., Caballero, A., Montoya, L., Jimenez, A., Maceira, B., Lewis, J. B., Ravid, M., Wajman, A., Tadgell, C., Remuzzi, G., Hunsicker, L. G., Wessman, M., Taskinen, M-R, FinnDiane Study Group, Pugliese, G., Amadio, L., Menini, S., Oddi, G., Ricci, C., Iacobini, C., Pricci, F., Sorcini, M., Pesce, C., Migliaccio, E., Giorgio, M., Pelicci, P., Di Mario, U., Lassila, M., Jandeleit-Dahm, K., Seah, K. K., Calkin, A. C., Allen, T. J., Cooper, M. E., Lopes Faria, J. M., Cavakcanti, T. C., Silva, K. C., Ferrari, A. L., Lopes Faria, J. B., Cellek, S., Foxwell, N. A., Cotter, M. A., Cameron, N. E., Tennagels, N., Jordan, H., Stahl, P., Voss, M. D., Welte, S., Werner, U., Lehmann, R., Moeschel, K., Baumgartner, F., Oeckinghaus, A., Beck, A., Weigert, C., Hennige, A., Schleicher, E. D., Haring, H. U., Mussig, K., Staiger, H., Haring, H-U, Natalicchio, A., Laviola, L., Tullio, C., Renna, L., Giorgino, R., Giorgino, F., Falasca, M., Maffucci, T., Park, D., Kang, S., Song, J., Lee, D., Lee, Y., Hariharan, N., Kunselman, L., Gu, L., Sasseville, V., Harrity, T., Cheng, P. T. W., Pratley, R. E., Schweizer, A., Mills, D., Kim, T-H, Song, X-L, Poelje, P. D., Potter, S. C., Dang, Q., Fujitaki, J. M., Linemeyer, D. L., Landau, B. R., Erion, M. D., Pankop, M., Golay, A., Despres, J., Sjostrom, L., Lawlor, D. L., Legg, K. T., Ur, E., Houweling, S. T., Kleefstra, N., Meyboom-De Jong, B., Bilo, H. J. G., Schlomer, G. 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M., Fonollosa, A., Berrone, E., Beltramo, E., Solimine, C., Ubertalli, A., Islam, N., Esteve, E., Fernandez, M., Recas, I., Mauri, S., Biarnes, F., Junca, E., Fernadez-Real, J., Rossner, S., Stenlof, K., Levy, B., Perry, B., Fitchet, M., Chrysos, G., Kamaratos, A., Lepeniotis, G., Kokkoris, S., Varytimiadis, K., Stasini, F., Mikros, S., Gianneli, D., Tryfinopoulou, K., Melidonis, A., Nikolopoulou, C., Harley, K., Ryder, R., De, P, Vannieuwenhoven, F. A., Rossing, K., Oliver, N., Goldschmeding, R., Jacobsen, P. K., Tan, F., Liew, S., Mukherjee, J. J., Lim, P., Frojdo, S., Sjolind, L., Parkkonen, M., Makinen, V., Tikellis, C., Nieuwenhoven, F. A. V., Macisaac, R. J., Tsalamandris, C., Mcneil, K. J., Panaiotopoulos, S., Smith, T. J., Ho, M., Matthews, P. G., Jerums, G., Hut, H., Den Meiracker, A. H., Nakhjavani, M., Behjati, J., Esteghamati, A., Esfahanian, F., Aghamohamadzadeh, N., Abbasi, M., Kohnert, K-D, Zander, E., Krabbe, S., Stehouwer, C. D., Schalkwijk, C. G., Saraheimo, M. T., Krarup Hansen, T., Teppo, A-M, Ebeling, P., Hansen, B. V., Abdella, N. A., Mojiminiyi, O. A., Al Dahi, W. A., Al Mohammedi, H., Al Jebely, S., Neugebauer-Baba, S., Baba, T., Ohashi, H., Nakajima, S., Hesselmann, C., Watanabe, T., Nargis, M., Zaid, R. B., Voronko, O. E., Shestakova, M. V., Shamkhalova, M. S., Tchugunova, L. A., Vikulova, O. K., Nosikov, V. V., Liu, L., Zheng, T., Li, M., Zhang, R., Xiang, K., Hadjadj, S., Jeunemaitre, X., Vervoort, G., Veldman, B., Berden, J., Wetzels, J., Singh, B. M., Holland, M. R., Baskar, V., Oh, J., Seo, J., Choi, K., Baik, S., Choi, D., Kim, N., Matsumoto, S., Suetsugu, M., Matsutomo, R., Pisarczyk-Wiza, D., Banaszak, A., Wysocki, H., Usui, H., Shikata, K., Okada, S., Ogawa, D., Yozai, K., Kido, Y., Nagase, R., Ohga, S., Tone, A., Sasaki, M., Wada, J., Unno, Y., Horiuchi, S., Mclennan, S. V., Kamarinos, M., Kelly, D., Waltham, M., Dy, V., Yue, D., Langham, R., Gilbert, R., Zdychova, J., Komers, R., Cresci, B., Giannini, S., Manuelli, C., Giunti, S., Pinach, S., Ianni Palarchio, A., Arnaldi, L., Vittone, F., Camussi, G., Cavallo Perin, P., Gruden, G., Marshall, S. M., Jones, S. E., White, K. E., Brizzi, M., Dentelli, P., Rosso, A., Calvi, C., Gambino, R., Cassader, M., Salvidio, G., Deferrari, G., Pegoraro, L., Pagano, G., Cavallo-Perin, P., Oates, R., Ellery, C., Beebe, D., Coutcher, J., Qian, Y-Z, Lowe, V., Appleton, T., Raunig, D., O Neil, S., Mylari, B., Amazonas, R. B., Fujita, A., Doi, A., Matsuno, S., Okamoto, K., Matsumoto, E., Furuta, H., Nishi, M., Tsuno, T., Taniguchi, H., Bessho, H., Wasen, E., Isoaho, R., Mattila, K., Vahlberg, T., Kivela, S-L, Irjala, K., Rigalleau, V., Lasseur, C., Perlemoine, C., Barthes, N., Raffaitin, C., Chauveau, P., Combe, C., Baillet-Blanco, L., Beauvieux, M-C, Gin, H., Heinrich, S., Steiner, T., Ott, U., Holdass, H., Fellstrom, B., Jardine, A., Staffler, B., Logan, J. O., Gimpelewicz, C., Stanciu, C. C., Pena, C. M., Serafinceanu, C. C., Gonzalez-Posada, J. M., Hernandez, D., Perez-Tamajo, L., Lo, A. J., Herna Alarco, M., Meneses, M., Barsotti, M., Rizzo, G., Schmauss, S., Havrdova, T., Saudek, F., Boucek, P., Adamec, M., Invitti, C., Gilardini, L., Parati, G., Mazzilli, G., Pontiggia, B., Sartorio, A., Lutgers, H. L., Groenier, K. H., Zasadzinska, G., Saryusz-Wolska, M., Temelkova-Kurktschiev, T. S., Kurktschiev, D. P., Majdrakova, I., Varbanova, T., Todorova, B., Bajo-Martinez, A., Bernal, E., Sanchez, O., Ugalde-Canitrot, A., Sanchez-Largo, E., Coca-Robinot, D., Fabregate, R., Calbacho, M., Marquez, J., Saban-Ruiz, J., Penesova, A., Cizmarova, E., Blazicek, P., Jongh, R. T., Serne, E. H., Ijzerman, R. G., Vries, G., Stehouwer, C. D. A., Poulsen, P. L., Andersen, N. H., Knudsen, S. T., Helleberg, K., Mogensen, C. E., Walus, M., Idzior-Walus, B., Sztefko, K., Cieslik, G., Fedak, D., Wozniakiewicz, E., Lin, S. D., Guo, M. Y., Lin, C. J., Liu, X. C., Francisco, M-M J., Rodriguez-Rosas, H., Peiro-Martinez, I., Macias-Batista, A., Harte, A. L., Rodriguez-Cuenca, S., Valsamakis, G., Chetty, R., Anderson, L. A., Roca, P., Matyka, K., Lasalle, J., Hershon, K., Berman, L., Gibson, E., Gillen, D., Maroni, J., Simmons, D., Hiukka, A., Forder, P., Leinonen, E., Hilden, H., Fruchart, J., Fruchart, J-C, Keech, A., Farnier, M., Freeman, M., Macdonell, G., Perevozskaya, I., Mitchel, Y., Gumbiner, B., Didangelos, T. P., Athyros, V. G., Mikhailidis, D. P., Papageorgiou, A. A., Bouloukos, V. I., Pehlivanidis, A. N., Symeonidis, A. N., Elisaf, M., Mckenney, J., Insull, W. Jr, Lewin, A., Maccubbin, D., Lee, M., Kush, D., Schuster, H., Barter, P. J., Stender, S., Cheung, R. C., Bonnet, J., Morrell, J. M., Watkins, C., Kallend, D., Stalenhoef, A. F. H., Ballantyne, C. M., Murin, J., Tonstad, S., Rose, H., Wilpshaar, W., Jenkins, A., Karschimkus, C., Dragicevic, G., Rowley, K., Wolthers, T., Best, J. D., Voet, B., Murdoch, S. J., Marcovina, S. M., Chen, H. C., Brunzell, J. D., Caparevic, Z. V., Kostic, N. D., Ilic, S. M., Sartore, G., Piarulli, F., Cantaro, S., Reitano, R., Fiore, C., Marin, R., Bassan, S., Manzato, E., Fedele, D., Solini, A., Santini, E., Thornalley, P. J., Babaei-Jadidi, R., Karachalias, N., Kupich, C., Ahmed, N., Fowler, A. E., Baker, A. R., Starczynski, J., O Hare, P., Szepietowska, B., Szelachowska, M., Puch, U., Glebocka, A., Quinn, D. W., Da Silva, N. F., Mcternan, C. L., Bonser, R. S., Mcternan, P., Dimitriou, K., Apostolou, O., Kontela, E., Devangelio, E., Gould, E. M., Serri, O., Roussin, A., Buithieu, J., Mamputu, J-C, Renier, G., Giordanetti, S., Amici, E., Poggi, G., Turpini, C., Fratino, P., Garzaniti, A., Yin, D., Banu, I., Roman, G., Negrean, M., Bala, C. G., Nita, C., Kistorp, C., Gustafsson, F., Chong, A., Lip, G., Galatius, S., Shearer, A. 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M., Baranova, L. Y., Ikeda, Y., Suehiro, T., Osaki, F., Ota, K., Arii, K., Kumon, Y., Hashimoto, K., Doney, A. S. F., Fischer, B., Morris, A. D., Palmer, C. N. A., Ahn, Y-M, Lee, B-C, Kim, S-I, Byun, S-H, Ahn, S-Y, Doo, H-K, Pagnin, E., Calo, L. A., Fadini, G., Kubaszek, A., Chai, S., Chai, Q., Rasmussen, L., Ledet, T., Wogensen, L., Lengyel, C., Varro, A., Virag, L., Magyar, J., Biro, T., Jost, N., Skoumal, R., Nanasi, P., Toth, M., Horkay, F., Papp, J. G., Zacharopoulou, O., Athanaselis, S., Tsokos, N., Doupis, J., Psallas, M., Cokkinos, D., Pavlatos, S., Liatis, S., Akhobadze, T., Dzneladze, L., Samarguliani, I., Taskiran, M., Rasmussen, V., Rasmussen, B., Jensen, G. B., Fisher, A. A., Petrovsky, N., Davis, M. W., Srikusalanukul, W., Budge, M. M., Trifunovic-Zamaklar, D. D., Zivkovic, M., Jelic, V., Vukomanovic, G., Ristic, A. D., Seferovic, P. M., Costa, J. V., Duarte, S., Manley, S. E., Sailesh, S., Venkataraman, A., Haider, Y., Groza, I., Oprean, M., Ardelean, A., Morosanu, A., Darkow, T., Vanderplas, A., Mamas, M. A., Mcelduff, P., Burns, J., Edwards, R., Fitchet, A., Young, R. J., Gibson, J. M., New, J. P., Lichiardopol, R., Niculescu, N., Totora, A., Pencea, C., Tomescu, I., Cinteza, M., Manicardi, V., Coscelli, C., Navazio, A., Catellani, E., Michelini, M., Dall Asta, D., Guberti, A., Piazza, A., Gasparini, E., Pantaleoni, M., Guiducci, U., Manari, A., Sejil, S., Janand-Delenne, B., Avierinos, J-F, Habib, G., Labastie, N., Vague, P., Lassmann-Vague, V., Luzniak, P., Wojciechowska Luzniak, A., Zairis, M., Lyras, A., Patsourakos, N., Tsirimbis, V., Foussas, S., Lupon, J., Urrutia, A., Herreros, J., Gonzalez, B., Coll, R., Altimir, S., Prats, M., Valle, V., Abreu-Padi, C., Rabago, G., Ivanova, L. A., Brasacchio, D., Calkin, A., Jandeleit-Dahm, K. A., Harno, E., Keenan, A. K., Li, H. L., Yu, Y. R., Lu, Z. M., Zhang, X. E., Ke, L., Liu, H., Zhang, X. X., Jeong, I-K, Chae, M-K, Choi, M-H, Yoo, H-J, Kim, C. D., Yun, M. R., Na, M. A., Kang, Y. H., Kong, O. N., Son, S. M., Kim, I. J., Kim, Y. K., Tanaka, N., Hosoi, M., Matsuyama, Y., Fukumoto, M., Yamakita, T., Yoshioka, K., Ishii, T., Sato, T., Fujii, S., Aoki, T., Shibata, T., Mizutani, N., Suzuki, J-Y, Fowelin, J. H. R., Samuelsson, P., Brandrup-Wogsen, G., Okumura, K., Tokmakova, A. Y., Staroverova, D. N., Antcieferov, M. B., Shutichina, I. V., Kuntchevich, G. I., Vriesendorp, T. M., Morelis, Q. J., Legemate, D. A., Schaper, F., Mainas, E. I., Gkioulmpasanis, I., Panagiotou, I., Vassilikos, G., Skorda, L., Sidira, M., Christoforidou, M., Alaveras, A., Artikis, V., Evdemon, E., Lechleitner, M., Koch, T., Ebenbichler, C., Sturm, W., Moretti, L., Moruzzo, D., Boldrini, E., Pandolfo, C., Kameyama, M., Iwasa, R., Cho, M-H, Nam, J-Y, Kim, C-S, Kim, D-M, Ahn, C-W, Cha, B-S, Lim, S-K, Kim, K-R, Lee, H-C, Huh, K-B, Kaplar, M., Paragh, G., Erdei, A., Csongradi, E., Garai, I., Varga, J., Galuska, L., Udvardy, M., Higa, M., Kaneko, Y., Hiroi, N., Koziarska, D., Nowacki, P., Majkowska, L., Wojciechowska-Luzniak, A., Tushuizen, M. E., Nieuwland, R., Snoeck, D. P., Sturk, A., Diamant, M., Aguiar, L. G. K., Bahia, L., Villela, N., Laflor, C., Conde, C., Bottino, D., Dorigo, D., Bouskela, E., Pu, S., Yu, H. L., Luo, Z. T., Lam, K. S. L., Dan, Q., Xu, A., Shen, J., Cheng, K., Xu, J. Y. U., Thamer, C., Stefan, N., Haap, M., Heller, E., Tschritter, O., Prado, A., Ortiz, A., Ybarra, J., Gich, I., Pou, J. M., Ehren, M., Meyer, M. F., Roggenland, D., Reinsen, B., Klein, H. H., Rittig, K., Stock, J., Kocher, B., Balletshofer, B., Lee, J., Shon, H. S., Chung, D. S., Nakatani, Y., Matsuhisa, M., Kaneto, H., Hatazaki, M., Yoshiuchi, K., Katakami, N., Kawamori, D., Ohtoshi, K., Sakamoto, K., Matsuoka, T-A, Ozawa, K., Ogawa, S., Hori, M., Yamasaki, Y., Zitouni, K., Harry, D., Nourooz-Zadeh, J., Betteridge, J. D., Earle, K. A., Rasmussen, L. M., Olesen, P., Franco, L., Corvaja, C., Semplicini, A., Rosen, P., Lee, I-K, Kim, M-J, Park, K-G, Jung, E-D, Shin, D-W, Jo, S-R, Obuobie, K., Prakash, P. K., Hanna, F. W., Evans, M., Lazarus, J., Varadhan, L., Gurushankar, J., James, D., Sheikh, S., Gaede, P., Li, H., Zou, D., Lee, S. J., Choi, M. G., Kim, D. S., Kim, T. W., Vilarrasa, N., Perez-Maraver, M., Mena, E., Perez, D., Setti, G., Buckingham, R., Urbancic, V., Stefanovska, A., Bernjak, A., Azman-Juvan, K., Kocijancic, A., Glowania, A., Filters, T. S., Fosmark, D. S., Torjesen, P. A., Kilhovd, B., Berg, T. J., Sandvik, L., Hanssen, K. F., Mentink, C. J. A., Kilhovd, B. K., Kuchmerovska, T. M., Shymanskyy, I. O., Donchenko, G. V., Stepanenko, S. P., Klimenko, A. P., Park, J., Maingrette, F., Deng, H. C., Lindenmair, A., Waldhausl, W. K., Freudenthaler, A., Baumgartner-Parzer, S. M., Nizheradze, K., Khoruzhenko, A., Tronko, N., Sheu, W. H. H., Ou, H-C, Shen, H-M, Lin, T-M, Wu, H-S, Yang, C-H, Mogylnytska, L., Mankovsky, B., Schmoelzer, I., Davies, J. I., Band, M., Morris, A., Struthers, A. D., Prazny, M., Skrha, J., Kasalova, Z., Neelotpol, S., Jahan, P., Kauschke, S. G., Harrop, C. A., Schafer, A., Widder, J., Eigenthaler, M., Walter, U., Uchimura, I., Ikebukuro, M., Kaibara, M., Hirata, M., Helal, R., Pervin, F., Khan, A. K. A., Yang, X., Jansson, P-A, Nagaev, I., Jack, M. M., Carvalho, E., Sunnerhagen, K. Stibrant, Cam, M. C., Cushman, S. W., Smith, U., Creely, S. J., Farmer, J., Creely, S., Gustafson, B., Kusminski, C. M., Krusinova, E., Wohl, P., Klementova, M., Lanska, V., Mcdougall, C., Thomas, S. J., Kelly, I., Abbas, Z. G., Lutale, J. K., Archibald, L. K., Karunajeewa, H., Stingemore, N., Stuccio, G., Mcgechie, D., Muller, L. M. A., Hak, E., Goudzwaard, W. L., Montorsi, F., Homering, M., Sprenger, K., Goldstein, I., Asnaghi, V., Ferrari, G., Rastaldi, M., Gabellini, D., Antonio, G., Maestroni, A., Ruggieri, D., Luzi, L., Piemonti, L., Zerbini, G., Anafaroglu, I., Tutuncu, N. B., Sultana, M., Siddiqua, N., Iwasaki, T., Nakajima, A., Yoneda, M., Mukasa, K., Tanaka, S., and Sekihara, H.
15. Discursos leídos ante el claustro de la Universidad de Barcelona en el acto solemne de la recepción del catedrático de Instituciones de Hacienda Pública de España, Dr. D. Eustaquio Toledano, el día 27 de enero de 1861
- Author
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Toledano y Hernansaiz, Eustaquio, Anglasell, Ramón 1820-1863, Toledano y Hernansaiz, Eustaquio, and Anglasell, Ramón 1820-1863
- Abstract
Recoge los discursos de Eustaquio Toledano y Hernansaiz y Ramón Anglasell
16. 40(th) EASD Annual Meeting of the European Association for the Study of Diabetes : Munich, Germany, 5-9 September 2004
- Author
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S. Artigas, A V Dreval, Mark I. McCarthy, C Watson, Peter H. Bennett, M Quint, Y Ikeda, E Alpert, F Schiele, H Sekihara, Erik Gylfe, P Lowe, J Kuhlmann, Alain Golay, V Longo, Shahidul Alam Khan Akm., L G Mantovani, M Zawodniak-Szalapska, G Winkler, T Harrity, L Virág, U Johne, Kuo S-W., Linda C Tapsell, J Rodriguez, Michel Komajda, K Kankova, Carole A. Cull, M Sporna, E Estilles, U Ribel, M C Spruce, E Buzzigoli, T Prazak, J K McLaughlin, M K Lingohr, M Lim, F Calara, A Siebenhofer, G Meregalli, Roberto Anichini, A D Baron, R Kurashvili, P C Butler, G I Fantus, T. E. De Gooyer, Park Y-M., R. Walther, S Heinrich, Agnieszka Zawiejska, S Mukherjee, Nikolaos Papanas, G Wong, Ian D. Caterson, David M. Maahs, Shuichi Kaneko, Alexandra E. Butler, Francisco Javier Ampudia-Blasco, O N Kong, Attali J-R., C A Hedman, K Oshinyemi, Nicolle Müller, I C Cranston, N Okumus, M V Vlaiculescu, Balasubramanian Ravikumar, W W Cheatham, K Mukasa, K B Biswas, Annunziata Lapolla, Phil McEwan, G Mader, Gilles Chassot, Dragi Anevski, Werner A. Scherbaum, M Donath, C Hesselmann, R A Gandhi, David E. Moller, Ezio Bonifacio, C Garcia, V Ifandi, P Hornnes, Nieuwenhoven Fav., C Puech, S Pérez-Del-Pulgar, Kim S-R., G Hines, C Rubio Terrés, Michael Gaster, N. Hosszufalusi, A Scholze, Andrew A. Young, Stavros Liatis, F Hariri, S Tan, Paul Valensi, Allan E. Karlsen, J Kim, E. Moberg, J Kaiser, L Berman, G Nelson, A Altkrüger, P Kothare, D B Cook, S Doran, G. van Dijk, Shahnaz Shahinfar, Kim C-S., P Stahl, M Manousaki, S Sigrist, S K Lim, M. P. Stern, A Guberti, C Rezzani, J McKenney, Karl Thomaseth, Sofia Carlsson, M Julia, R Brillante, I Rubesova, T Darkow, E Matsumoto, Wendy M. Macfarlane, M Di Martino, G Bardini, Rossella Menghini, D Duhot, E Farcasiu, Annalisa Natalicchio, I Lindner, J Buvat, Christian L. Brand, Harry Dorchy, Iwona Pietrzak, Z T Luo, P Home, M Ekelund, Jesper Gromada, Kristine Færch, F Piarulli, H Kim, R Mentel, Zsuzsanna K. Zsengellér, Dullaart Rpf., Anton Luger, Thomas A. Pearson, V Manicardi, P Rösen, Feng Y-M., R Morganti, Lars Hansen, Demuth H-U., Haruo Kasai, A Shostak, Rudi Steffensen, G Taylor, Markolf Hanefeld, C Santini, E Hamaguchi, Roberto Miccoli, F Storms, M Cooper, Y Lee, Allison E. Aiello, P Smith, T Suehiro, K Treece, M Waluś, Timothy A Welborn, Simone Baltrusch, E Kontela, S Chai, J Crean, H Yokoyama, Johan G. Eriksson, Rafael Hernández Hernández, J Rodríguez-Saldaña, M P Tornero, G Formoso, D. Lovell, E Bingham, A Mylonakis, M Manteghetti, D Fedele, Antonio Martín-Duce, Ralph A. DeFronzo, D Salcedo, Kurt Højlund, Antonio Petrone, Sheu Whh., C Gutierrez, Flavia Pricci, S Kurita, Z G Abbas, M M Benedetti, Philippe A. Halban, Daniel J. Cox, O Ljungkvist, Justine Davies, J Palsgaard, Lars Sjöström, E Bosi, L Janin-Manificat, W. F. Kelly, M. Fernandez, E Colak, O V Mulyarchik, B Kronshage, F Lang, M Erfurth, Takashi Kadowaki, N Jendrike, U Walter, J Wishart, Y. Neye, D Kim, N Furuhashi, M Barsotti, D Florow, L Ke, L Borgquist, N C Jackson, Ffolliott M. Fisher, V Baskar, K Yoshioka, Bryan A. Wolf, G Chabrier, R Skoumal, Livio Luzi, H Kose, I Pharisien, B. Klein, H Winiarska, M C Johnson, L Griffiths, Nonna Kravchun, C Combe, Baptist Gallwitz, J Zdychova, L Skorda, Jorma Ilonen, W Gao, I N Steen, A Terrinoni, P D Ambery, W Kern, C M Kusminski, Cho M-H., Paolo Pozzilli, Louise G. Grunnet, E Schönle, David R Matthews, Robert W. Taylor, Y Cohen, Kim H-S., M P Eccles, N B Tutuncu, D McDowell, Richard M. Bergenstal, K Takamatsu, T Steiner, Jaan Palgi, Valdemar Grill, N Niculescu, G Federici, S Lehto, P. M. McKeigue, M Barone, Michael E. 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Dell'Antonio, G, Maestroni, A, Ruggieri, D, Luzi, L, Piemonti, L, Zerbini, G, Anafaroglu, I, Tutuncu, N, Sultana, M, Siddiqua, N, Iwasaki, T, Nakajima, A, Yoneda, M, Mukasa, K, Tanaka, S, and Sekihara, H
- Subjects
0303 health sciences ,medicine.medical_specialty ,business.industry ,EASD ,Endocrinology, Diabetes and Metabolism ,Human physiology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Family medicine ,Internal Medicine ,Medicine ,business ,030217 neurology & neurosurgery ,030304 developmental biology - Published
- 2004
17. First-trimester fasting plasma glucose levels and progression to type 2 diabetes: A 5-year cohort study.
- Author
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Maor-Sagie E, Hallak M, Twig G, Toledano Y, and Gabbay-Benziv R
- Subjects
- Humans, Female, Pregnancy, Adult, Retrospective Studies, Risk Factors, Prediabetic State blood, Prediabetic State epidemiology, Incidence, Diabetes Mellitus, Type 2 blood, Pregnancy Trimester, First blood, Blood Glucose analysis, Diabetes, Gestational blood, Diabetes, Gestational epidemiology, Disease Progression, Fasting blood
- Abstract
Objective: Impaired fasting glucose is a prediabetic condition defined as glucose levels of 100-125 mg/dL and is considered a risk factor for type 2 diabetes. However, this definition does not confer to pregnancy. The significance of first-trimester fasting glucose and future progression to diabetes is not well defined. Therefore, we aimed to evaluate the progression to type 2 diabetes according to first- trimester fasting plasma glucose levels, as compared with gestational diabetes, a well-established risk factor for diabetes, in up to 5-year follow-up postpartum., Methods: A retrospective analysis of 69 001 parturients, evaluating fasting plasma glucose levels measured during the first trimester. The primary outcome was the incidence of type 2 diabetes within 5 years post-delivery. Fasting plasma glucose levels were categorized in 10 mg/dL increments. Receiver operating characteristic-area under the curve (ROC-AUC) statistics and the Youden index were employed to identify the optimal fasting plasma glucose cutoff for progression to type 2 diabetes. Survival analysis was applied to calculate the adjusted hazard ratios (aHRs) for type 2 diabetes progression with further stratification to maternal obesity status., Results: The identified fasting plasma glucose cutoff for progression to type 2 diabetes was 86.5 mg/dL. This cut-off demonstrated superior performance compared with gestational diabetes diagnosis. Stratification by maternal obesity revealed enhanced predictive capabilities for type 2 diabetes, particularly among patients without obesity., Conclusions: Increased first-trimester fasting plasma glucose levels are associated with progression to type 2 diabetes, at least as gestational diabetes. For patients without obesity, first-trimester fasting plasma glucose has a more pronounced impact on progression to diabetes., (© 2024 International Federation of Gynecology and Obstetrics.)
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- 2024
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18. Timing of gestational diabetes diagnosis and progression to type 2 Diabetes: A comparative analysis.
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Maor-Sagie E, Hallak M, Haggiag N, Naeh A, Toledano Y, and Gabbay-Benziv R
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- Humans, Female, Pregnancy, Adult, Retrospective Studies, Israel epidemiology, Time Factors, Risk Factors, Blood Glucose analysis, Obesity epidemiology, Obesity diagnosis, Obesity complications, Diabetes, Gestational diagnosis, Diabetes, Gestational epidemiology, Diabetes, Gestational blood, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 epidemiology, Disease Progression
- Abstract
Aim: To evaluate and compare the risk of progressing to type 2 diabetes (T2DM) based on the timing of gestational diabetes (GDM) diagnosis during pregnancy., Methods: Retrospective analysis of pregnant individuals with gestational diabetes and post-pregnancy follow up. Data sourced from Meuhedet HMO's computerized laboratory system, cross-tabulated with the Israeli National Diabetes Registry. The cohort was divided into normoglycemic, early GDM (diagnosed by fasting plasma glucose 92-125 mg/dL (5.1-6.9 mM) at < 15 weeks), 2nd trimester GDM (diagnosed at 24-28 weeks), and late GDM (diagnosed after 29 weeks). Statistics included univariate analysis followed by survival analysis. Risk was further analyzed for individuals by obesity status., Results: 75,459 entered the analysis: 90 % normoglycemic, 7.9 % early GDM, 1.4 % 2nd trimester GDM, and 0.7 % late GDM. Median post-pregnancy follow-up time was 4.3 (IQR 3.3-5.1). 2nd trimester GDM showed the highest T2DM risk annually after pregnancy. Cox regression analysis, adjusted for confounders, revealed a significantly higher T2DM risk for 2nd-trimester GDM compared to early and late GDM. Late GDM did not confer additional significant T2DM risk. Stratification by obesity status highlighted that early GDM increased the risk of T2DM only in individuals without obesity., Conclusions: GDM diagnosis timing significantly impacts T2DM risk. 2nd trimester GDM carries the highest T2DM risk., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)
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- 2024
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19. Greater risk of type 2 diabetes progression in multifetal gestations with gestational diabetes: the impact of obesity.
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Naeh A, Maor-Sagie E, Hallak M, Toledano Y, and Gabbay-Benziv R
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- Humans, Female, Pregnancy, Adult, Retrospective Studies, Risk Factors, Body Mass Index, Proportional Hazards Models, Israel epidemiology, Diabetes, Gestational epidemiology, Diabetes Mellitus, Type 2 epidemiology, Disease Progression, Obesity complications, Obesity epidemiology, Pregnancy, Multiple statistics & numerical data
- Abstract
Background: The relationship between gestational diabetes mellitus and adverse outcomes in multifetal pregnancies is complex and controversial. Moreover, limited research has focused on the risk of gestational diabetes mellitus progression to type 2 diabetes mellitus specifically in multifetal pregnancies, resulting in conflicting results from existing studies., Objective: This study aimed to assess the risk of gestational diabetes mellitus progression to type 2 diabetes mellitus between singleton and multifetal pregnancies in a large cohort of parturients with a 5-year follow-up., Study Design: A retrospective study was conducted on a prospective cohort of pregnant individuals with pregnancies between January 1, 2017, and December 31, 2020, followed up to 5 years after delivery. Glucose levels during pregnancy were obtained from the Meuhedet Health Maintenance Organization laboratory system and cross-linked with the Israeli National Diabetes Registry. The cohort was divided into 4 groups: singleton pregnancy without gestational diabetes mellitus, singleton pregnancy with gestational diabetes mellitus, multifetal pregnancy without gestational diabetes mellitus, and multifetal pregnancy with gestational diabetes mellitus. Gestational diabetes mellitus was defined according to the American Diabetes Association criteria using the 2-step strategy. Univariate analyses, followed by survival analysis that included Kaplan-Meier hazard curves and Cox proportional-hazards models, were used to assess differences between groups and calculate the adjusted hazard ratios with 95% confidence intervals for progression to type 2 diabetes mellitus., Results: Among 88,611 parturients, 61,891 cases met the inclusion criteria. The prevalence of type 2 diabetes mellitus was 6.5% in the singleton pregnancy with gestational diabetes mellitus group and 9.4% in the multifetal pregnancy with gestational diabetes mellitus group. Parturients with gestational diabetes mellitus, regardless of plurality, were older and had higher fasting plasma glucose levels in the first trimester of pregnancy. The rates of increased body mass index, hypertension, and earlier gestational age at delivery were significantly higher in the gestational diabetes mellitus group among patients with singleton pregnancies but not among patients with multifetal pregnancies. Survival analysis demonstrated that gestational diabetes mellitus was associated with adjusted hazard ratios of type 2 diabetes mellitus of 4.62 (95% confidence interval, 3.69-5.78) in singleton pregnancies and 9.26 (95% confidence interval, 2.67-32.01) in multifetal pregnancies (P<.001 for both). Stratified analysis based on obesity status revealed that, in parturients without obesity, gestational diabetes mellitus in singleton pregnancies increased the risk of type 2 diabetes mellitus by 10.24 (95% confidence interval, 6.79-15.44; P<.001) compared with a nonsignificant risk in multifetal pregnancies (adjusted hazard ratio, 9.15; 95% confidence interval, 0.92-90.22; P=.059). Among parturients with obesity, gestational diabetes mellitus was associated with an increased risk of type 2 diabetes mellitus for both singleton and multifetal pregnancies (adjusted hazard ratio, 3.66; [95% confidence interval, 2.81-4.67; P<.001] and 9.31 [95% confidence interval, 2.12-40.76; P=.003], respectively)., Conclusion: Compared with gestational diabetes mellitus in singleton pregnancies, gestational diabetes mellitus in multifetal pregnancies doubles the risk of progression to type 2 diabetes mellitus. This effect is primarily observed in patients with obesity. Our findings underscore the importance of providing special attention and postpartum follow-up for patients with multifetal pregnancies and gestational diabetes mellitus, especially those with obesity, to enable early diagnosis and intervention for type 2 diabetes mellitus., (Copyright © 2023 Elsevier Inc. All rights reserved.)
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- 2024
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20. Hypoglycemia in Oral Glucose Tolerance Test during Pregnancy and Risk for Type 2 Diabetes-A Five-Year Cohort Study.
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Haggiag N, Rotman M, Hallak M, Toledano Y, Gabbay-Benziv R, and Maor-Sagie E
- Abstract
Objective : To evaluate the risk of progression to type 2 diabetes (T2D) following reactive hypoglycemia in 100 g oral glucose tolerance test (oGTT) . Methods : A retrospective analysis of parturients with up to 5-year follow-up postpartum. Data were extracted from the computerized laboratory system of Meuhedet, an Israeli HMO and cross-linked with the Israeli National Registry of Diabetes. Included were parturients with no prior diabetesand available oGTT values during pregnancy. Reactive hypoglycemia was defined as glucose levels lower than 60 mg/dL in at least one of 3 post-glucose load values in oGTT. The cohort was divided into 3 groups: normal glucose status, reactive hypoglycemia, and GDM. Maternal characteristics, laboratory data, and progression to T2D over 5 years were compared. Univariate and survival analyses assessed the adjusted hazard ratio for T2D, stratified by obesity Results: Among 14,122 parturients, 16.8% had reactive hypoglycemia, 71% had normal glucose status, and 12.2% had GDM. Adjusted for age, obesity, and hypertension, Parturients with reactive hypoglycemia had similar T2D risk compared to normal glucose status and a lower risk compared to GDM patients, regardless of obesity status. Conclusions: Reactive hypoglycemia during oGTT does not increase the risk of progressing to T2D.
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- 2024
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21. One abnormal value in oral glucose tolerance test during pregnancy and type 2 diabetes risk: Insights from a 5-Year Follow-Up study.
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Hussein-Aro R, Maor-Sagie E, Toledano Y, Hallak M, and Gabbay-Benziv R
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- Humans, Female, Pregnancy, Adult, Follow-Up Studies, Retrospective Studies, Risk Factors, Obesity complications, Obesity epidemiology, Obesity blood, Israel epidemiology, Diabetes Mellitus, Type 2 epidemiology, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 diagnosis, Glucose Tolerance Test, Diabetes, Gestational epidemiology, Diabetes, Gestational blood, Diabetes, Gestational diagnosis, Blood Glucose analysis, Blood Glucose metabolism
- Abstract
Objectives: To evaluate the risk of type 2 diabetes(T2D) following one abnormal value(OAbV) in an oral glucose tolerance test(oGTT) performed during pregnancy., Study Design: A retrospective analysis of parturients between 01.01.2017 and 31.12.2020 with 5 years of follow-up after delivery. Glucose levels during pregnancy were extracted from the computerized laboratory system of Meuhedet HMO and cross-tabulated with the Israeli National Registry of Diabetes. Women with multiple gestations or pregestational diabetes were excluded. Maternal characteristics and risk of T2D were stratified and compared between 3 groups: normal glucose status, OAbV in oGTT, and gestational diabetes. Statistical analysis included univariate analysis followed by survival analysis. Further analysis was stratified to women with and without obesity., Results: 58,693 women entered the analysis. Following an adjustment to maternal age, obesity, hypertension, and hyperlipidemia, OAbV in oGTT was associated with a 1.8-fold increased risk of T2D in a 5-year follow-up compared to normal glucose status. When stratified by obesity, OAbV was associated with a 3.7-fold increase in T2D in women without obesity, however, was no longer a statistically significant predictor of T2D among women with obesity., Conclusions: Women with OAbV oGTT during pregnancy are at increased risk for developing T2D over 5 years of follow-up., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)
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- 2024
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22. [Transitional care from hospital to home: how to target the right population?]
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Michalski-Monnerat C, Jacquot-Pegeot ML, Rochat S, Schmid MC, Maillat Roth S, Chevrey N, Toledano Y, Jeannot JG, Donzé J, Bryant-Lukosius D, and Mabire C
- Subjects
- Humans, Hospital to Home Transition, Hospitals, Consensus, Transitional Care, Home Care Services
- Abstract
When patients are discharged from the hospital and return home, they are at risk of adverse events if the continuity of care is broken. So far, the evidence for transitional care models to reduce readmission rates has focused mainly on patients with a single condition. Based on this observation, we identified the population that may benefit the most from the development of a new transitional care model, as part of the INSTEAD project, by consensus between patients and professionals in hospitals and the community. To ensure continuity of care, it is necessary to consider the patients' perception, their understanding of the care plan and changes impacting the home care plan. Interprofessional collaboration is essential to achieve this., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article. Tous les auteurs font partie du comité de pilotage du projet INSTEAD.
- Published
- 2023
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23. Oral Glucose Tolerance Test Performed after 28 Gestational Weeks and Risk for Future Diabetes-A 5-Year Cohort Study.
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Maor-Sagie E, Hallak M, Toledano Y, and Gabbay-Benziv R
- Abstract
Gestational diabetes mellitus (GDM) is diagnosed by an oral glucose tolerance test (oGTT), preferably performed at 24 + 0-28 + 6 gestational weeks, and is considered a risk factor for type 2 diabetes (T2DM). In this study, we aimed to evaluate the risk of T2DM associated with abnormal oGTT performed after 28 weeks. We conducted a retrospective cohort study that included parturients with available glucose levels during pregnancy and up to 5 years of follow-up after pregnancy. Data were extracted from the computerized laboratory system of Meuhedet HMO and cross-tabulated with the Israeli National Registry of Diabetes (INRD). The women were stratified into two groups: late oGTT (performed after 28 + 6 weeks) and on-time oGTT (performed at 24 + 0-28 + 6 weeks). The incidence of T2DM was evaluated and compared using univariate analysis followed by survival analysis adjusted to confounders. Overall, 78,326 parturients entered the analysis. Of them, 6195 (7.9%) performed on-time oGTT and 5288 (6.8%) performed late oGTT. The rest-66,846 (85.3%)-had normal glucose tolerance. Women who performed late oGTT had lower rates of GDM and T2DM. However, once GDM was diagnosed, regardless of oGTT timing, the risk of T2DM was increased (2.93 (1.69-5.1) vs. 3.64 (2.44-5.44), aHR (95% CI), late vs. on-time oGTT, p < 0.001 for both). Unlike in oGTT performed on time, one single abnormal value in late oGTT was not associated with an increased risk for T2DM.
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- 2023
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24. Flat maternal glucose response curve and adverse pregnancy outcome.
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Navon I, Romano A, Pardo A, Matot R, Toledano Y, Barbash Hazan S, and Hadar E
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- Infant, Newborn, Pregnancy, Female, Humans, Birth Weight, Glucose, Retrospective Studies, Infant, Small for Gestational Age, Fetal Growth Retardation etiology, Pregnancy Outcome epidemiology, Infant, Newborn, Diseases
- Abstract
Objective: The significance of a flat oral glucose tolerance test (OGTT) response curve in pregnancy remains unclear. We investigated the association of a flat curve with pregnancy outcomes., Study Design: Retrospective cohort study. Flat OGTT curve was defined by an area under the curve below the 10th percentile. Pregnancy outcomes were compared between flat and normal curve., Results: Of the 2673 eligible women, 269 had a flat response curve. Compared with the normal-response group, the flat-curve group had a lower mean birthweight (3363 ± 547 g vs. 3459 ± 519 g, p < 0.005), higher probability of small for gestational age (SGA) (19% vs. 12%, p < 0.005, aOR = 1.75, 95% CI 1.24-2.47), and 5-min Apgar score < 7 (1.12% vs. 0.29%, p < 0.05, aOR = 3.95, 95% CI 1.01-15.5). There were no differences in obstetric or maternal outcomes., Conclusions: Flat OGTT is associated with lower birthweight, higher rates of SGA, and low Apgar scores. Detecting this previously unrecognized risk group, could potentially reduce these complications., (© 2023. The Author(s), under exclusive licence to Springer Nature America, Inc.)
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- 2023
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25. Does Iodine Intake Modify the Effect of Maternal Dysglycemia on Birth Weight in Mild-to-Moderate Iodine-Deficient Populations? A Mother-Newborn Prospective Cohort Study.
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Ovadia YS, Gefel D, Toledano Y, Rosen SR, Avrahami-Benyounes Y, Groisman L, Rorman E, Hen L, Fytlovich S, Katz LS, Anteby EY, and Shenhav S
- Subjects
- Infant, Newborn, Humans, Female, Pregnancy, Birth Weight, Mothers, Prospective Studies, Glucose, Thyrotropin, Thyroxine, Iodine, Endocrine System Diseases
- Abstract
It is unclear how maternal glycemic status and maternal iodine status influence birth weight among individuals with mild-to-moderate iodine deficiency (ID). We studied the association between birth weight and both maternal glucose levels and iodine intake among pregnant women with mild-to-moderate ID. Glucose values were assessed using a glucose challenge test (GCT) and non-fasting glucose levels that were determined before delivery; individuals' iodine statuses were assessed using an iodine food frequency questionnaire; and serum thyroglobulin (Tg) and urinary iodine concentrations (UIC) were used to assess each group's iodine status. Thyroid antibodies and free thyroxine (FT4) levels were measured. Obstetric and anthropometric data were also collected. Large-for-gestational age (LGA) status was predicted using a Cox proportional hazards model with multiple confounders. Tg > 13 g/L was independently associated with LGA (adjusted hazard ratio = 3.4, 95% CI: 1.4-10.2, p = 0.001). Estimated iodine intake correlated with FT4 among participants who reported consuming iodine-containing supplements (ICS) after adjusting for confounders (β = 0.4, 95% CI: 0.0002-0.0008, p = 0.001). Newborn weight percentiles were inversely correlated with maternal FT4 values (β = -0.2 95% CI:-0.08--56.49, p = 0.049). We conclude that in mild-to-moderate ID regions, insufficient maternal iodine status may increase LGA risk. Iodine status and ICS intake may modify the effect that maternal dysglycemia has on offspring weight.
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- 2023
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26. Autoimmune thyroid diseases as a cost of physiological autoimmune surveillance.
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Milo T, Korem Kohanim Y, Toledano Y, and Alon U
- Subjects
- Humans, Thyroiditis, Autoimmune, Hashimoto Disease, Graves Disease, Autoimmune Diseases
- Abstract
Graves' disease (GD) and Hashimoto's thyroiditis (HT) are common autoimmune diseases of the thyroid gland, causing hyperthyroidism and hypothyroidism, respectively. Despite their opposing clinical manifestation, they have several enigmatic links. Here, we propose that GD and HT have the same fundamental origin: both diseases are the cost of a beneficial physiological process called autoimmune surveillance of hypersecreting mutants. Autoreactive T cells selectively eliminate mutant cells that hypersecrete the hormones and threaten to become toxic nodules. These T cells can trigger a humoral response in susceptible individuals, leading to the production of antibodies against thyroid antigens. This shared origin can explain similarities in incidence and risk factors between HT and GD, despite their opposite clinical phenotypes., Competing Interests: Declaration of interests None declared by authors., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2023
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27. Pharmacological therapy in gestational diabetes - a comparison between insulin and oral therapy.
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Shmuel E, Krispin E, Toledano Y, Chen R, Wiznitzer A, and Hadar E
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- Infant, Newborn, Female, Pregnancy, Humans, Insulin therapeutic use, Glyburide adverse effects, Hypoglycemic Agents therapeutic use, Retrospective Studies, Blood Glucose, Diabetes, Gestational drug therapy, Diabetes, Gestational diagnosis, Hypoglycemia
- Abstract
Background: The appropriate medical treatment for gestational diabetes mellitus (GDM) is controversial and recommendations vary between different organizations., Objective: To compare the safety and efficacy of glyburide and insulin as treatments for GDM., Methods: Retrospective analysis of all pregnant women diagnosed with GDM and treated with either glyburide or insulin. Demographic features, clinical characteristics, maternal and neonatal outcomes were compared according to type of pharmacological treatment., Results: Included in the study were 323 women, of whom 269 (83.28%) were treated with glyburide and 54 (16.72%) with insulin. There were no significant differences between the groups, apart from a higher one-hour oral glucose tolerance test (OGTT) value (191.80 mg/dl in the glyburide group, 204.33 in the insulin group, p = .01). Optimal glucose control was achieved in 130 women in the glyburide group (48.32%) and 15 in the insulin group (27.77%), p = .007. This difference remained significant after adjustment for age, BMI, and fasting glucose during OGTT (aOR = 2.22). Mean gestational weight gain was lower in the glyburide group vs. insulin group (10.01 vs. 11.99 kg, p = .048). Apart from higher maternal hypoglycemia rate (12.64% in glyburide group vs. 1.85% in insulin group, p = .016), there were no other differences in maternal and neonatal outcomes between the groups. Glyburide failure rate was 13.38%, and associated with higher fasting OGTT value (100.70 mg/dl in glyburide failure group vs. 94.67 mg/dl in the glyburide treatment until delivery group, p = .041)., Conclusions: Glyburide is at least as safe and effective as insulin except for higher rates of maternal hypoglycemia. Considering its advantages compared to insulin (ease of use and storage, increased patient responsiveness, and lower cost), it may be considered as first line treatment in GDM, especially when fasting OGTT value is not high.
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- 2022
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28. Erratum to Relationship among chrononutrition, sleep, and glycemic control in women with gestational diabetes mellitus: a randomized controlled trial. American Journal of Obstetrics & Gynecology MFM. Volume 4, Issue 5, September 2022, 100660.
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Messika A, Toledano Y, Hadar E, Shmuel E, Tauman R, Shamir R, and Froy O
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- 2022
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29. Relationship among chrononutrition, sleep, and glycemic control in women with gestational diabetes mellitus: a randomized controlled trial.
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Messika A, Toledano Y, Hadar E, Shmuel E, Tauman R, Shamir R, and Froy O
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- Body Mass Index, Female, Glycemic Control, Humans, Infant, Newborn, Obesity complications, Pregnancy, Sleep, Diabetes, Gestational diagnosis, Diabetes, Gestational epidemiology, Diabetes, Gestational prevention & control
- Abstract
Background: Gestational diabetes mellitus is associated with an increased risk of maternal, fetal, and neonatal morbidities. Chronobiological disorders have recently been identified as risk factors for those morbidities. The disorders include chrononutritional disorders related to meal frequency and content according to the sleep-wake cycle, sleep disorders related to sleep quality, and chrono-obesity disorders, such as abnormal weight gain because of sleep deprivation and time of eating., Objective: This study aimed to assess whether a chrononutritional and sleep hygiene intervention can improve maternal glycemic control and reduce the proportion of large-for-gestational-age newborns among women with gestational diabetes mellitus., Study Design: This randomized controlled trial included 103 women with gestational diabetes mellitus who were carrying a singleton fetus and assigned to either the intervention group (n=33) or the control group (n=70). The intervention group was assigned to a chrononutrition and sleep hygiene program, in addition to the usual care for gestational diabetes mellitus, from the time of diabetes mellitus diagnosis to birth, whereas the control group received the usual gestational diabetes mellitus care., Results: The chrononutritional and sleep hygiene intervention significantly reduced the proportion of women with suboptimal glycemic control (<80% of the plasma glucose values at target), after adjustment for maternal age, prepregnancy body mass index, gravidity, history of gestational diabetes mellitus, and large for gestational age (relative risk, 0.28; 95% confidence interval, 0.18-0.81). The effect of the intervention on balancing maternal glycemic control was mainly because of the decreased carbohydrate intake in the evening interval of the day (relative risk, 0.8; 95% confidence interval, 0.64-0.99). However, the intervention had no effect on the proportion of large-for-gestational-age newborns., Conclusion: The chrononutritional and sleep hygiene intervention can improve maternal glycemic control., (Copyright © 2022 Elsevier Inc. All rights reserved.)
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- 2022
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30. Dynamics of thyroid diseases and thyroid-axis gland masses.
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Korem Kohanim Y, Milo T, Raz M, Karin O, Bar A, Mayo A, Mendelson Cohen N, Toledano Y, and Alon U
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- Humans, Thyroid Hormones, Thyrotropin, Graves Disease, Thyroid Diseases
- Abstract
Thyroid disorders are common and often require lifelong hormone replacement. Treating thyroid disorders involves a fascinating and troublesome delay, in which it takes many weeks for serum thyroid-stimulating hormone (TSH) concentration to normalize after thyroid hormones return to normal. This delay challenges attempts to stabilize thyroid hormones in millions of patients. Despite its importance, the physiological mechanism for the delay is unclear. Here, we present data on hormone delays from Israeli medical records spanning 46 million life-years and develop a mathematical model for dynamic compensation in the thyroid axis, which explains the delays. The delays are due to a feedback mechanism in which peripheral thyroid hormones and TSH control the growth of the thyroid and pituitary glands; enlarged or atrophied glands take many weeks to recover upon treatment due to the slow turnover of the tissues. The model explains why thyroid disorders such as Hashimoto's thyroiditis and Graves' disease have both subclinical and clinical states and explains the complex inverse relation between TSH and thyroid hormones. The present model may guide approaches to dynamically adjust the treatment of thyroid disorders., (© 2022 The Authors. Published under the terms of the CC BY 4.0 license.)
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- 2022
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31. Flash Glucose Monitoring in Israel: Understanding Real-World Associations between Self-Monitoring Frequency and Metrics of Glycemic Control.
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Eldor R, Roitman E, Merzon E, Toledano Y, Alves C, and Tsur A
- Subjects
- Benchmarking, Blood Glucose, Blood Glucose Self-Monitoring, Glucose, Humans, Israel, Diabetes Mellitus, Type 1 drug therapy, Glycemic Control
- Abstract
Objective: Flash glucose monitoring has been widely used in Israel for diabetes treatment and since 2018, the cost is reimbursed for all people with type 1 diabetes nationally. In the current study, we present the daily scanning behavior for FreeStyle Libre users in Israel and how this was associated with a range of metrics for glycemic assessment., Methods: Deidentified data from FreeStyle Libre readers were collected between September 2014 and October 2020. Scan-rate data from Israel was extracted and sorted into 10 equal-sized groups based on scan frequency. The glucose parameters derived for each group were: estimated HbA1c (eA1c), time in range (TIR) between 70 and 180 mg/dL, and time with glucose levels of <70 mg/dL, <54 mg/dL, and >180 mg/dL., Results: The data set for Israel included 12 370 readers, with data from 131 639 separate glucose sensors representing 152 million automatically recorded individual glucose readings. Users performed an average of 15 daily glucose scans, ranging from a mean of 4.1 scans per day (lowest, 10%), rising to a mean of 38.7 scans/day (highest, 10%) (median, 12; IQR, 8-18 for all readers). As the scan rates increased, the eA1c decreased from 7.6% to 6.7% (P < .001). Mean TIR increased from 56.9% to 70.0% with increasing scan rates (P < .001). Concordantly, time with glucose levels of >180 mg/dL and <54 mg/dL decreased from 37.2% to 23.6% (P < .001) and from 2.23% to 1.99%, respectively, as scan frequency increased., Conclusion: In Israel, people with diabetes under real-world conditions record higher rates of FreeStyle Libre scanning. These are associated with improvements in TIR, eA1c, and reduced time with glucose levels of >180 mg/dL or <54 mg/dL., (Copyright © 2022 AACE. Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
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32. Not All Patients with Type 2 Diabetes Are Equal.
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Toledano Y and Knobler H
- Subjects
- Age Factors, Diabetes Mellitus, Type 2 physiopathology, Humans, Insulin Resistance, Diabetes Mellitus, Type 2 classification
- Published
- 2021
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33. Characterization of women with gestational diabetes who failed to achieve glycemic control by lifestyle modifications.
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Krispin E, Ashkenazi Katz A, Shmuel E, Toledano Y, and Hadar E
- Subjects
- Adult, Blood Glucose analysis, Body Mass Index, Diabetes, Gestational blood, Diabetes, Gestational diagnosis, Female, Glucose Tolerance Test, Glycemic Control, Humans, Pregnancy, Retrospective Studies, Treatment Outcome, Diabetes, Gestational therapy, Glyburide therapeutic use, Hypoglycemic Agents therapeutic use, Insulin therapeutic use, Life Style, Metformin therapeutic use
- Abstract
Purpose: To identify specific characteristics of women diagnosed with gestational diabetes who failed to achieve good glycemic control by lifestyle modifications only., Methods: Retrospective analysis of women carrying a singleton pregnancy diagnosed with gestational diabetes. The cohort included 314 women who achieved good glycemic control by lifestyle modifications and 328 women who required anti-diabetic medications. Lifestyle modifications included medical nutrition therapy and physical exercise recommendations. Anti-diabetic medications included either oral treatment with metformin or glyburide and\or insulin., Results: Women in the lifestyle modifications group were younger (32.87 vs. 33.79 years, p = 0.012) and had lower pre-pregnancy body-mass-index (25.86 vs. 27.93 kg/m
2 , p < 0.001). Glucose challenge test (GCT) was significantly lower in the lifestyle modifications group (158.31 vs. 171.04 mg/dL in the anti-diabetic treatment group, p < 0.001). Moreover, fasting oral-glucose-tolerance-test (fOGTT) results were significantly lower in the lifestyle modifications group (88.22 vs. 96.34 mg/dL in the anti-diabetic treatment group, p < 0.001). In a receiver-operator-curve analysis, GCT + 4*fOGTT, was the best model to predict lifestyle modifications failure with an area under the curve of 0.7419. Higher rates of vaginal delivery and lower rates of maternal hypoglycemia in the lifestyle modifications group were observed., Conclusions: Maternal baseline characteristics and diabetes diagnostic parameters may predict which women will fail to achieve good glycemic control solely by lifestyle modifications.- Published
- 2021
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34. Letter to the Editor from Knobler and Toledano: "Validation of the Swedish Diabetes Regrouping Scheme in Adult-Onset Diabetes in China".
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Knobler H and Toledano Y
- Subjects
- Adult, China epidemiology, Feeding Behavior, Humans, Sweden epidemiology, Diabetes Mellitus, Type 2 epidemiology
- Published
- 2021
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35. Hypoglycaemia and its management in primary care setting.
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Ibrahim M, Baker J, Cahn A, Eckel RH, El Sayed NA, Fischl AH, Gaede P, Leslie RD, Pieralice S, Tuccinardi D, Pozzilli P, Richelsen B, Roitman E, Standl E, Toledano Y, Tuomilehto J, Weber SL, and Umpierrez GE
- Subjects
- Diabetes Mellitus, Type 1 pathology, Diabetes Mellitus, Type 2 pathology, Disease Management, Humans, Hypoglycemia chemically induced, Hypoglycemia pathology, Hypoglycemic Agents adverse effects, Diabetes Mellitus, Type 1 drug therapy, Diabetes Mellitus, Type 2 drug therapy, Hypoglycemia prevention & control, Hypoglycemic Agents administration & dosage, Primary Health Care methods
- Abstract
Hypoglycaemia is common in patients with type 1 diabetes and type 2 diabetes and constitutes a major limiting factor in achieving glycaemic control among people with diabetes. While hypoglycaemia is defined as a blood glucose level under 70 mg/dL (3.9 mmol/L), symptoms may occur at higher blood glucose levels in individuals with poor glycaemic control. Severe hypoglycaemia is defined as an episode requiring the assistance of another person to actively administer carbohydrate, glucagon, or take other corrective actions to assure neurologic recovery. Hypoglycaemia is the most important safety outcome in clinical studies of glucose lowering agents. The American Diabetes Association Standards of Medical Care recommends that a management protocol for hypoglycaemia should be designed and implemented by every hospital, along with a clear prevention and treatment plan. A tailored approach, using clinical and pathophysiologic disease stratification, can help individualize glycaemic goals and promote new therapies to improve quality of life of patients. Data from recent large clinical trials reported low risk of hypoglycaemic events with the use of newer anti-diabetic drugs. Increased hypoglycaemia risk is observed with the use of insulin and/or sulphonylureas. Vulnerable patients with T2D at dual risk of severe hypoglycaemia and cardiovascular outcomes show features of "frailty." Many of such patients may be better treated by the use of GLP-1 receptor agonists or SGLT2 inhibitors rather than insulin. Continuous glucose monitoring (CGM) should be considered for all individuals with increased risk for hypoglycaemia, impaired hypoglycaemia awareness, frequent nocturnal hypoglycaemia and with history of severe hypoglycaemia. Patients with impaired awareness of hypoglycaemia benefit from real-time CGM. The diabetes educator is an invaluable resource and can devote the time needed to thoroughly educate the individual to reduce the risk of hypoglycaemia and integrate the information within the entire construct of diabetes self-management. Conversations about hypoglycaemia facilitated by a healthcare professional may reduce the burden and fear of hypoglycaemia among patients with diabetes and their family members. Optimizing insulin doses and carbohydrate intake, in addition to a short warm up before or after the physical activity sessions may help avoiding hypoglycaemia. Several therapeutic considerations are important to reduce hypoglycaemia risk during pregnancy including administration of rapid-acting insulin analogues rather than human insulin, pre-conception initiation of insulin analogues, and immediate postpartum insulin dose reduction., (© 2020 John Wiley & Sons Ltd.)
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- 2020
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36. Foetal Sonographic Anogenital Distance Is Longer in Polycystic Ovary Syndrome Mothers.
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Perlman S, Toledano Y, Kivilevitch Z, Halevy N, Rubin E, and Gilboa Y
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Anogenital distance (AGD) is a biomarker for the prenatal hormonal environment. Androgen excess is a key element in polycystic ovary syndrome (PCOS). The aim of this study was to assess the sonographic foetal AGD in a population of PCOS mothers in comparison to the general population. Foetal AGD was measured prospectively by 2D ultrasound in PCOS mothers and compared to prenatal AGD nomograms. The results were interpreted regarding maternal and foetal characteristics. The mean sonographic foetal AGD centile measurement in PCOS mothers was significantly longer in comparison to the general population (86.04% ± 18.22; p < 0.001). Estimated foetal weight and birthweight were appropriate for gestational age and did not correlate with AGD. Sonographic foetal AGD was significantly longer in PCOS diabetic mothers and in those who conceived following assisted reproduction treatments when compared to the general population ( p < 0.001). Our results support the role of AGD as a biomarker of the prenatal hormonal environment and provide evidence for the hyperandrogenic effect in PCOS pregnancies on foetal androgenic status and genitalia development.
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- 2020
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37. Noninvasive, continuous, real-time glucose measurements compared to reference laboratory venous plasma glucose values.
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Hadar E, Chen R, Toledano Y, Tenenbaum-Gavish K, Atzmon Y, and Hod M
- Subjects
- Adult, Blood Chemical Analysis adverse effects, Blood Chemical Analysis methods, Blood Chemical Analysis standards, Blood Glucose Self-Monitoring adverse effects, Blood Glucose Self-Monitoring instrumentation, Blood Glucose Self-Monitoring methods, Clinical Laboratory Techniques instrumentation, Clinical Laboratory Techniques standards, Diabetes Mellitus, Type 1 blood, Diabetes Mellitus, Type 2 blood, Diabetes, Gestational blood, Female, Glucose Tolerance Test, Humans, Pregnancy, Pregnancy in Diabetics blood, Reference Standards, Reproducibility of Results, Sensitivity and Specificity, Veins chemistry, Wearable Electronic Devices adverse effects, Wearable Electronic Devices standards, Blood Chemical Analysis instrumentation, Blood Glucose analysis, Clinical Laboratory Techniques methods, Equipment and Supplies adverse effects, Equipment and Supplies standards
- Abstract
Purpose: Current modalities for glucose monitoring are invasive and inconvenient. The search for a noninvasive technique is still ongoing, without a clinically viable product. The aim of our study was to evaluate the safety and accuracy of a novel non-invasive continuous glucometer - the Wizmi™ device. Methods: Prospective, observational, controlled clinical trial. We included healthy pregnant women designated to undergo a 3-hour oral glucose tolerance test. Each participant underwent synchronous and simultaneous glucose measurement by venous sampling of plasma glucose and non-invasive glucose by Wizmi device. Primary outcome was the accuracy of the Wizmi device as assessed by comparing between paired measurements, i.e. non-invasive glucose measurements by Wizmi versus standard plasma glucose levels, which were taken at the exact same time. Results: Thirty-two women underwent oral glucose tolerance test (OGTT), contributing 224 paired glucose measurements. Of the 224 paired measurements, all were within the clinically appropriate zones of the Clarke error grid analysis zones -208 (93%) in Zone A and 16 (7%) in zone B. Mean absolute relative difference of the Wizmi non-invasive glucose versus plasma glucose laboratory reference was 7.23% or 9.66 mg/dl. Overall, for all 224 paired measurements, across all Wizmi glucose ranges, the agreement was 86.6, 92.0, 97.8 and 99.5% for deviations within ±15, 20, 30, 40% (if glucose >80 mg/dl) or mg/dl (if glucose ≤80 mg/dl). Conclusions: Wizmi device is novel non-invasive continuous glucose monitor, safe to use, with overall high accuracy compared to a gold standard reference of plasma glucose.
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- 2019
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38. Perinatal outcome in gestational diabetes according to different diagnostic criteria.
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Salman L, Pardo A, Krispin E, Oron G, Toledano Y, and Hadar E
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- Adult, Diabetes, Gestational therapy, Female, Humans, Middle Aged, Pregnancy, Retrospective Studies, Young Adult, Diabetes, Gestational diagnosis, Pregnancy Outcome
- Abstract
Objectives To evaluate whether gestational diabetes mellitus (GDM) diagnosed by different criteria impacts perinatal outcome. Methods This was a retrospective study of deliveries with a diagnosis of GDM (2014-2016). Perinatal outcomes were compared between patients with: (1) GDM diagnosed according to a single abnormal value on the 100-g oral glucose tolerance test (OGTT); (2) two or more abnormal OGTT values; and (3) a 50-g glucose challenge test (GCT) value ≥200 mg/dL. Results A total of 1163 women met the inclusion criteria, of whom 441 (37.9%) were diagnosed according to a single abnormal OGTT value, 627 (53.9%) had two or more abnormal OGTT values and 95 (8.17%) had a GCT value ≥200 mg/dL. Diet-only treatment was significantly higher in the single abnormal value group (70.3% vs. 65.1% vs. 50.5%) and rates of medical treatment were significantly higher in the GCT ≥ 200 mg/dL group (P < 0.05). Women in the GCT ≥ 200 mg/dL group had higher rates of neonatal intensive care unit (NICU) admission (10.5% vs. 2.7% vs. 2.8%, P < 0.001) and neonatal hypoglycemia (5.3% vs. 0.5% vs. 0.8%, P < 0.001). On multivariate logistic regression, GCT ≥ 200 mg/dL was no longer associated with higher rates of NICU admission and neonatal hypoglycemia (P > 0.05). Conclusion No difference was noted in the perinatal outcome amongst the different methods used for diagnosing GDM.
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- 2019
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39. First trimester glycosylated hemoglobin as a predictor of gestational diabetes mellitus.
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Arbib N, Shmueli A, Salman L, Krispin E, Toledano Y, and Hadar E
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- Adult, Biomarkers blood, Birth Weight, Diabetes, Gestational diagnosis, Female, Gestational Age, Humans, Infant, Newborn, Predictive Value of Tests, Pregnancy, Pregnancy Outcome, Pregnancy Trimester, First blood, ROC Curve, Retrospective Studies, Diabetes, Gestational blood, Glycated Hemoglobin analysis
- Abstract
Objective: To evaluate the potential role of glycosylated haemoglobin (HbA1C) as an early biomarker for gestational diabetes., Methods: In a retrospective analysis, healthy women who went on to give birth to a singleton newborn in a tertiary medical center in Petach Tikva, Israel, underwent measurement of HbA1C in the first trimester (up to 12 weeks of pregnancy) between August 1, 2007, and December 31, 2014. Women with type 1 or type 2 diabetes, HbA1C ≥6.5%, and/or fasting plasma glucose ≥126 mg/dL were excluded, as were women whose glucose levels had already been tested before 24 weeks of pregnancy. Data were extracted from a maternal and neonatal database. The primary outcome measure was the association between first trimester HbA1C and adverse pregnancy outcome, primarily, gestational diabetes., Results: The cohort included 142 women. HbA1C concentration was linearly and inversely correlated to length of gestation (r=-0.317, P<0.001). Higher HbA1C was associated with gestational diabetes. An HbA1C concentration of ≥5.45% predicted gestational diabetes with 83.3% sensitivity, 69% specificity, and gave positive and negative predictive values of 53% and 90.8%, respectively., Conclusion: Early pregnancy HbA1C could serve as a predictor of gestational diabetes. Ideally, HbA1C should be considered in multi-parameter prediction models to enhance accuracy., (© 2019 International Federation of Gynecology and Obstetrics.)
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- 2019
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40. Pharmacotherapy for hyperglycemia in pregnancy - The new insulins.
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Toledano Y, Hadar E, and Hod M
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- Female, Humans, Hypoglycemic Agents chemistry, Insulins chemistry, Pregnancy, Pregnancy Outcome, Hyperglycemia drug therapy, Hypoglycemic Agents therapeutic use, Insulins therapeutic use
- Abstract
Hyperglycemia in pregnancy may lead to adverse maternal, fetal and neonatal outcomes. Tight glycemic control is prudent in order to reduce pregnancy complications. For many years, the gold standard pharmacological therapy during pregnancy was human insulin. Recently, insulin analogues were also introduced to clinical use in pregnancy. This brief review aims to summarize the information on the efficacy and safety of insulin analogue therapy during gestation. The strengths and pitfalls of insulin analogue administration during gestation, compared with human insulin, are presented. According to studies in pregnant women with type 1 diabetes, insulins lispro, aspart and detemir are efficacious and safe. Correspondingly, the FDA has reclassified them for the treatment of pregnant women with diabetes from category C to category B. Although large and prospective data on insulin glargine in gestation are still lacking, no major safety concerns were documented. No controlled trials with insulins glulisine and degludec were conducted in pregnancy. In sum, insulin analogues are practical therapeutic options for hyperglycemia in pregnancy, mainly due to their hypoglycemia risk reduction. More research for their use in pregnant women with gestational diabetes or type 2 diabetes should be conducted. Overall, their efficacy and safety is possibly comparable to human insulin., (Copyright © 2018 Elsevier B.V. All rights reserved.)
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- 2018
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41. Effect of prandial treatment timing adjustment, based on continuous glucose monitoring, in patients with type 2 diabetes uncontrolled with once-daily basal insulin: A randomized, phase IV study.
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Ilany J, Bhandari H, Nabriski D, Toledano Y, Konvalina N, and Cohen O
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- Aged, Blood Glucose analysis, Diabetes Mellitus, Type 2 blood, Drug Administration Schedule, Drug Monitoring, Drug Therapy, Combination adverse effects, Female, Humans, Hypoglycemia chemically induced, Hypoglycemic Agents adverse effects, Hypoglycemic Agents therapeutic use, Insulin administration & dosage, Insulin adverse effects, Insulin therapeutic use, Insulin Glargine adverse effects, Insulin Glargine therapeutic use, Insulin Resistance, Intention to Treat Analysis, Lost to Follow-Up, Male, Meals, Middle Aged, Monitoring, Ambulatory, Patient Dropouts, Pilot Projects, Diabetes Mellitus, Type 2 drug therapy, Hyperglycemia prevention & control, Hypoglycemia prevention & control, Hypoglycemic Agents administration & dosage, Insulin analogs & derivatives, Insulin Glargine administration & dosage
- Abstract
Aims: To evaluate the glycaemic control achieved by prandial once-daily insulin glulisine injection timing adjustment, based on a continuous glucose monitoring sensor, in comparison to once-daily insulin glulisine injection before breakfast in patients with type 2 diabetes who are uncontrolled with once-daily basal insulin glargine., Materials and Methods: This was a 24-week open-label, randomized, controlled, multicentre trial. At the end of an 8-week period of basal insulin optimization, patients with HbA1c ≥ 7.5% and FPG < 130 mg/dL were randomized (1:1) to either arm A (no sensor) or arm B (sensor) to receive 16-week intensified prandial glulisine treatment. Patients in arm A received pre-breakfast glulisine, and patients in arm B received glulisine before the meal with the highest glucose elevation based on sensor data. The primary outcome was mean HbA1c at week 24 and secondary outcomes included rates of hypoglycaemic events and insulin dosage., Results: A total of 121 patients were randomized to arm A (n = 61) or arm B (n = 60). There was no difference in mean HbA1c at week 24 between arms A and B (8.5% ± 1.2% vs 8.4% ± 1.0%; P = .66). The prandial insulin glulisine dosage for arm A and arm B was 9.3 and 10.1 units, respectively (P = .39). The frequency of hypoglycaemic events did not differ between study arms (36.1% vs 51.7%; P = .08)., Conclusion: Using a CGM sensor to identify the meal with the highest glucose excursion and adjusting the timing of prandial insulin treatment did not show any advantage in terms of glycaemic control or safety in our patients., (© 2018 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.)
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- 2018
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42. Admission blood glucose and 10-year mortality among patients with or without pre-existing diabetes mellitus hospitalized with heart failure.
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Itzhaki Ben Zadok O, Kornowski R, Goldenberg I, Klempfner R, Toledano Y, Biton Y, Fisman EZ, Tenenbaum A, Golovchiner G, Kadmon E, Omelchenko A, Gal TB, and Barsheshet A
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- Aged, Aged, 80 and over, Female, Follow-Up Studies, Hospital Mortality trends, Hospitalization trends, Humans, Male, Prospective Studies, Time Factors, Blood Glucose metabolism, Diabetes Mellitus blood, Diabetes Mellitus mortality, Heart Failure blood, Heart Failure mortality, Patient Admission trends
- Abstract
Background: High admission blood glucose (ABG) level has been associated with a poor short-term outcome among non-diabetic patients with heart failure (HF). We aimed to investigate the association between ABG levels and long-term (10 years) mortality in patients with or without pre-existing diabetes mellitus (DM) admitted with HF., Methods: We analyzed data on 1811 patients with DM and 2182 patients without pre-existing DM who were hospitalized with HF during a prospective national survey. The relationship between ABG and 10-year mortality was assessed using the Cox proportional hazard model adjusting for multiple variables. ABG was analyzed both as a categorical (<110, 110-140, 140-200, and >200 mg/dL) and as a continuous variable., Results: At 10 years of follow-up the cumulative probability of mortality was 85 and 78% among patients with DM and patients with no pre-existing DM (p < 0.001), respectively. Among patients with no pre-existing DM, glucose levels of 110-140, 140-200 and ≥200 mg/dL were associated with 9% (p = 0.140), 16% (p = 0.031) and 53% (p < 0.001) increased mortality risk compared to ABG < 110 mg/dL. Each 18-mg/dL (1-mmol/L) increase in glucose level was associated with a 5% increased risk of mortality (p < 0.001) among patients with no-pre-existing DM. In contrast, among patients with DM, only those with glucose levels >200 mg/dL had an increased mortality risk (>200 mg/dL versus <110 mg/dL; HR = 1.20, p = 0.032)., Conclusion: Among hospitalized HF patients with no pre-existing DM there is a linear relationship between ABG level and long-term mortality, whereas among patients with DM only ABG level >200 mg/dL is associated with increased mortality risk.
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- 2017
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43. Pharmacological Management of Gestational Diabetes Mellitus.
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Bergel R, Hadar E, Toledano Y, and Hod M
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- Female, Glyburide administration & dosage, Humans, Insulin therapeutic use, Metformin therapeutic use, Pregnancy, Diabetes, Gestational drug therapy, Hypoglycemic Agents therapeutic use
- Abstract
Gestational diabetes mellitus (GDM) is one of the most common morbidities complicating pregnancy, with short- and long-term consequences to the mothers, fetuses, and newborns. Management and treatment are aimed to achieve best possible glycemic control, while avoiding hypoglycemia and ensuring maternal and fetal safety. It involves behavioral modifications, nutrition and medications, if needed; concurrent with maternal and fetal surveillance for possible adverse outcomes. This review aims to elaborate on the pharmacological options for GDM therapy. We performed an extensive literature review of different available studies, published during the last 50 years, concerning pharmacological therapy for GDM, dealing with safety and efficacy, for both fetal and maternal morbidity consequences; as well as failure and success in establishing appropriate metabolic and glucose control. Oral medication therapy is a safe and effective treatment modality for GDM and in some circumstances may serve as first-line therapy when nutritional modifications fail. When oral agents fail to establish glucose control then insulin injections should be added. Determining the best oral therapy in inconclusive, although it seems that metformin is slightly superior to glyburide, in some aspects. As for parenteral therapy, all insulins listed in this article are considered both safe and effective for treatment of hyperglycemia during pregnancy. Importantly, a better safety profile, with similar efficacy is documented for most analogues. As GDM prevalence rises, there is a need for successful monitoring and treatment for patients. Caregivers should know the possible and available therapeutic options.
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- 2016
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44. Insulin detemir versus glyburide in women with gestational diabetes mellitus.
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Koren R, Ashwal E, Hod M, and Toledano Y
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- Adult, Female, Glyburide administration & dosage, Glyburide adverse effects, Humans, Hypoglycemic Agents administration & dosage, Hypoglycemic Agents adverse effects, Insulin Detemir administration & dosage, Insulin Detemir adverse effects, Pregnancy, Retrospective Studies, Diabetes, Gestational drug therapy, Glyburide pharmacology, Hypoglycemic Agents pharmacology, Insulin Detemir pharmacology, Outcome Assessment, Health Care, Pregnancy Outcome
- Abstract
Aim: To evaluate the safety, efficacy and pregnancy outcomes of insulin detemir (IDet) versus glyburide treatment in women with gestational diabetes mellitus (GDM)., Methods: We conducted a retrospective cohort study of women with GDM who were treated with either glyburide or IDet for GDM in a university-affiliated tertiary hospital., Results: Ninety-one patients with GDM were enrolled, 62 were administered glyburide and 29 IDet. Maternal age, pregestational body mass index (BMI) and rate of abnormal oral glucose tolerance test (OGTT) blood glucose values were not significantly different between groups. Good glycemic control rates were comparable. Hypoglycemic episodes were reported only in the glyburide group (19.4% versus 0%, p = 0.01). Maternal weight gain during pregnancy was significantly higher among women in the glyburide group (8.8 ± 5.1 kg, p < 0.001) compared to those in the IDet group (2.1 ± 19.9 kg, p = 0.71)., Conclusions: To the best of our knowledge, this is the first study on IDet treatment in patients with GDM. By our preliminary results, IDet is a viable treatment option in women with GDM. Further large prospective studies are needed to determine the efficacy and safety of IDet in GDM patients.
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- 2016
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45. IGF-I levels reflect hypopituitarism severity in adults with pituitary dysfunction.
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Tirosh A, Toledano Y, Masri-Iraqi H, Eizenberg Y, Tzvetov G, Hirsch D, Benbassat C, Robenshtok E, and Shimon I
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- Adenoma complications, Adenoma therapy, Adrenocorticotropic Hormone deficiency, Adrenocorticotropic Hormone metabolism, Adult, Aged, Cranial Irradiation, Female, Follicle Stimulating Hormone deficiency, Follicle Stimulating Hormone metabolism, Gonadotropins, Pituitary deficiency, Gonadotropins, Pituitary metabolism, Humans, Hypopituitarism etiology, Luteinizing Hormone deficiency, Luteinizing Hormone metabolism, Male, Middle Aged, Pituitary Diseases complications, Pituitary Diseases metabolism, Pituitary Gland surgery, Pituitary Neoplasms complications, Pituitary Neoplasms therapy, Prolactin deficiency, Prolactin metabolism, Retrospective Studies, Severity of Illness Index, Testosterone metabolism, Thyrotropin deficiency, Thyrotropin metabolism, Thyroxine metabolism, Adenoma metabolism, Hypopituitarism metabolism, Insulin-Like Growth Factor I metabolism, Pituitary Neoplasms metabolism
- Abstract
Purpose: To evaluate the utility of Insulin-like growth factor I (IGF-I) standard deviation score (SDS) as a surrogate marker of severity of hypopituitarism in adults with pituitary pathology., Methods: We performed a retrospective data analysis, including 269 consecutive patients with pituitary disease attending a tertiary endocrine clinic in 1990-2015. The medical files were reviewed for the complete pituitary hormone profile, including IGF-I, and clinical data. Age-adjusted assay reference ranges of IGF-I were used to calculate IGF-I SDS for each patient. The main outcome measures were positive and negative predictive values of low and high IGF-I SDS, respectively, for the various pituitary hormone deficiencies., Results: IGF-I SDS correlated negatively with the number of altered pituitary axes (p < 0.001). Gonadotropin was affected in 76.6 % of cases, followed by thyrotropin (58.4 %), corticotropin (49.1 %), and prolactin (22.7 %). Positive and negative predictive values yielded a clear trend for the probability of low/high IGF-I SDS for all affected pituitary axes. Rates of diabetes insipidus correlated with IGF-I SDS values both for the full study population, and specifically for patients with non-functioning pituitary adenomas., Conclusions: IGF-I SDS can be used to evaluate the somatotroph function, as a valid substitute to absolute IGF-I levels. Moreover, IGF-I SDS predicted the extent of hypopituitarism in adults with pituitary disease, and thus can serve as a marker of hypopituitarism severity.
- Published
- 2016
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46. Safety of insulin analogues as compared with human insulin in pregnancy.
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Toledano Y, Hadar E, and Hod M
- Subjects
- Diabetes Mellitus, Type 1 complications, Diabetes Mellitus, Type 1 drug therapy, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 drug therapy, Female, Humans, Hypoglycemia chemically induced, Hypoglycemic Agents adverse effects, Hypoglycemic Agents classification, Infant, Newborn, Insulin, Regular, Human administration & dosage, Insulin, Regular, Human adverse effects, Insulin, Regular, Human classification, Insulins adverse effects, Insulins classification, Pregnancy, Diabetes, Gestational drug therapy, Hypoglycemic Agents administration & dosage, Insulins administration & dosage
- Abstract
Introduction: Diabetes during pregnancy may lead to maternal, fetal and neonatal complications. In order to limit unwarranted outcomes, strict glycemic control is essential. In the past, human insulin was the only insulin formulation administered in pregnancy. However, insulin analogues have also been used for this indication in recent years., Areas Covered: This article reviews the published data regarding the safety of insulin analogue use during pregnancy. We present the qualities, advantages and pitfalls of insulin analogue use in pregnancy compared with human insulin. Insulins lispro, aspart and detemir are safe in pregnant women with type 1 diabetes. Correspondingly, they were reclassified for the treatment of pregnant women with diabetes from category C to category B. For insulin glargine use in pregnancy, most studies are small and retrospective. Yet, no major safety concerns were reported. Insulin glulisine and degludec have not been studied in pregnancy., Expert Opinion: Insulin analogues are viable therapeutic options for diabetes in pregnancy, specifically lispro, aspart and detemir. Though data in limited, their safety and efficacy are comparable with human insulin. Remarkably, the analogues are superior to human insulin regarding hypoglycaemia risk. More data, specifically for their use in pregnancies complicated by gestational diabetes or type 2 diabetes, is needed.
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- 2016
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47. Solution structure and antiparasitic activity of scorpine-like peptides from Hoffmannihadrurus gertschi.
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Flores-Solis D, Toledano Y, Rodríguez-Lima O, Cano-Sánchez P, Ramírez-Cordero BE, Landa A, Rodríguez de la Vega RC, and Del Rio-Portilla F
- Subjects
- Animals, Antiparasitic Agents pharmacology, Arthropod Proteins pharmacology, Peptides pharmacology, Protein Structure, Secondary, Scorpion Venoms pharmacology, Taenia growth & development, Antiparasitic Agents chemistry, Arthropod Proteins chemistry, Peptides chemistry, Scorpion Venoms chemistry, Scorpions chemistry
- Abstract
Scorpine-like peptides are two domain peptides found in different scorpion venoms displaying various antimicrobial, cytolytic, and potassium channel-blocking activities. The relative contribution of each domain to their different activities remains to be elucidated. Here, we report the recombinant production, solution structure, and antiparasitic activity of Hge36, first identified as a naturally occurring truncated form of a Scorpine-like peptide from the venom of Hoffmannihadrurus gertschi. We also show that removing the first four residues from Hge36 renders a molecule with enhanced potassium channel-blocking and antiparasitic activities. Our results are important to rationalize the structure-function relationships of a pharmacologically versatile molecular scaffold., (© 2016 Federation of European Biochemical Societies.)
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- 2016
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48. VARIATIONS IN CLINICAL AND IMAGING FINDINGS BY TIME OF DIAGNOSIS IN FEMALES WITH HYPOPITUITARISM ATTRIBUTED TO LYMPHOCYTIC HYPOPHYSITIS.
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Tirosh A, Hirsch D, Robenshtok E, Masri-Iraqi H, Yoel U, Toledano Y, Twito O, Tsvetov G, and Shimon I
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- Adult, Autoimmune Hypophysitis epidemiology, Female, Humans, Hypopituitarism epidemiology, Magnetic Resonance Imaging, Middle Aged, Observer Variation, Postpartum Period, Pregnancy, Pregnancy Complications epidemiology, Pregnancy Complications etiology, Retrospective Studies, Time Factors, Young Adult, Autoimmune Hypophysitis complications, Autoimmune Hypophysitis diagnosis, Hypopituitarism diagnosis, Hypopituitarism etiology, Pregnancy Complications diagnosis
- Abstract
Objective: To describe the various patterns of presentation, including assisting analyses, associated with the timing of diagnosis of females with hypopituitarism and suspected clinical diagnosis of lymphocytic hypophysitis., Methods: A retrospective study of 9 consecutive females with pituitary dysfunction developed during or after pregnancy. All subjects were treated in our clinics between 2008 and 2014. Data were collected on clinical characteristics, pituitary hormone levels, and imaging findings., Results: The study group included 9 patients with a mean age 33.7 ± 7.8 years at delivery. The probable cause of disease was lymphocytic hypophysitis. Headache or specific symptoms/signs of hypopituitarism appeared within 1 year of delivery. Five patients had headache, and 8 had difficulty breastfeeding or amenorrhea. Laboratory findings included central hypocortisolism (8/9 patients), hypogonadotropic hypogonadism (8/9), and central hypothyroidism (6/7). Insulin-like growth factor-1 (IGF-1) levels were low in 8/8 patients. Prolactin levels were low in 3/9 patients, and 1 patient had diabetes insipidus. Seven patients were diagnosed less than 1 year from symptom onset; 4 (57%) complained of headaches, and 5 (71%) had panhypopituitarism. Two patients were diagnosed later. Both had difficulty breastfeeding and amenorrhea, and one also had headaches. Both had panhypopituitarism and reduced pituitary volume. None of the patients fully recovered pituitary function. Normalization of the thyrotroph axis occurred in 3 patients, gonadotroph function in 3, the corticotroph axis in 2, and IGF-1 normalized in 1 subject., Conclusion: Hypopituitarism attributed to lymphocytic hypophysitis may present during pregnancy or early postpartum period with a clear clinical picture, or later, with indolent and nonspecific symptoms and signs.
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- 2016
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49. Pituitary imaging findings in male patients with hypogonadotrophic hypogonadism.
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Hirsch D, Benbassat C, Toledano Y, S'chigol I, Tsvetov G, Shraga-Slutzky I, Eizenberg Y, and Shimon I
- Subjects
- Adenoma diagnostic imaging, Adult, Aged, Cohort Studies, Empty Sella Syndrome diagnostic imaging, Humans, Hypogonadism diagnostic imaging, Magnetic Resonance Imaging, Male, Middle Aged, Pituitary Gland diagnostic imaging, Pituitary Neoplasms diagnostic imaging, Retrospective Studies, Tomography, X-Ray Computed, Adenoma pathology, Empty Sella Syndrome pathology, Hypogonadism pathology, Pituitary Gland pathology, Pituitary Neoplasms pathology
- Abstract
Context: Data on pituitary imaging in adult male patients presenting with hypogonadotrophic hypogonadism (HH) and no known pituitary disease are scarce., Objective: To assess the usefulness of pituitary imaging in the evaluation of men presenting with HH after excluding known pituitary disorders and hyperprolactinemia., Design: A historical prospective cohort of males with HH., Patients: Men who presented for endocrine evaluation from 2011 to 2014 with testosterone levels <10.4 nmol/L (300 ng/mL), normal LH and FSH levels and no known pituitary disease., Results: Seventy-five men were included in the analysis. Their mean age and BMI were 53.4 ± 14.8 years and 30.7 ± 5.2 kg/m2, respectively. Mean total testosterone, LH, and FSH were 6.2 ± 1.7 nmol/L, 3.4 ± 2 and 4.7 ± 3.1 mIU/L, respectively. Prolactin level within the normal range was obtained in all men (mean 161 ± 61, range 41-347 mIU/L). Sixty-two men had pituitary MRI and 13 performed CT. In 61 (81.3%) men pituitary imaging was normal. Microadenoma was found in 8 (10.7%), empty sella and thickened pituitary stalk in one patient (1.3%) each. In other four patients (5.3%) a small or mildly asymmetric pituitary gland was noted. No correlation was found between testosterone level and the presence of pituitary anomalies., Conclusions: This study suggests that the use of routine hypothalamic-pituitary imaging in the evaluation of IHH, in the absence of clinical characteristics of other hormonal loss or sellar compression symptoms, will not increase the diagnostic yield of sellar structural abnormalities over that reported in the general population.
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- 2015
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50. Pregnancy outcomes in women with primary hyperparathyroidism.
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Hirsch D, Kopel V, Nadler V, Levy S, Toledano Y, and Tsvetov G
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- Adult, Calcium blood, Delivery, Obstetric, Female, Humans, Hyperparathyroidism, Primary blood, Infant, Newborn, Male, Pregnancy, Pregnancy Complications blood, Pregnancy Outcome, Retrospective Studies, Young Adult, Hyperparathyroidism, Primary diagnosis, Pregnancy Complications diagnosis
- Abstract
Objective: Primary hyperparathyroidism (PHPT) during pregnancy may pose considerable risks to mother and fetus. This study examined pregnancy outcomes in women with gestational PHPT in relation to clinical and laboratory parameters., Design: This study was designed as a retrospective case series., Methods: The study group included 74 women aged 20-40 years who were diagnosed with PHPT after a finding of serum calcium ≥ 10.5 mg/dL on routine screening at a health maintenance organization (2005-2013) and who became pregnant during the time of hypercalcemia (124 pregnancies). Clinical and laboratory data were collected from the files. Pregnancy outcomes were compared with 175 normocalcemic pregnant women (431 pregnancies) tested during the same period., Results: The cohort represented 0.03% of all women of reproductive age tested for serum calcium during the study period. Abortion occurred in 12 of 124 pregnancies (9.7%), and other complications occurred in 19 (15.3%) with no statistically significant differences from controls. Hypercalcemia was first detected during pregnancy in 14 of 74 women (18.9%) and before pregnancy (mean, 33.4 ± 29 mo) in 60. Serum calcium was measured antenatally in 57 of 124 pregnancies (46%); the mean level was 10.7 ± 0.6 mg/dL (median, 10.6 mg/dL). Measurement of the serum PTH level (with consequent diagnosis of PHPT) was performed during the first studied pregnancy in 17 of 74 women (23%), before pregnancy (mean, 37.8 ± 25.5 mo; median, 34 mo) in 23 (31.1%), and after delivery (mean, 54.7 ± 45.7 mo; median, 35 mo) in 34 (45.9%). Forty-three women (58.1%) underwent parathyroidectomy, six during pregnancy, without maternal or fetal complications. No difference was found in abortion or any pregnancy-related complication between patients who subsequently underwent parathyroidectomy and those who did not. No significant correlation was found between calcium level during pregnancy and pregnancy outcomes., Conclusions: Serum calcium levels are usually only mildly elevated during pregnancy in women with PHPT. A significant proportion of cases go undiagnosed. Mild hypercalcemia in gestational PHPT is generally not associated with an increased risk of obstetrical complications.
- Published
- 2015
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