Of 12 studies comparing GBBIR with CSII, six found improved

glycemic control with CSII and six found no significant difference. These studies were often limited by small numbers of subjects and other study design parameters.

Methods: Selleckchem PARP inhibitor We reviewed hemoglobin (Hb) A1c data for youths with type 1 diabetes (n = 43) changing from conventional split mix insulin regimens (CSMIR) to GBBIR and subsequently to CSII at 3, 6 and 12 months after each transition. All subjects had a diabetes duration of at least 1 year before initiating GBBIR.

Results : HbA1c levels at 3 months, 6 months and 1 year were not significantly different for GBBIR and CSII regimens. HbA1c increased significantly during GBBIR (p = 0.036) and marginally during CSII (p = mTOR inhibitor 0.058) when 3-month and 1-year values were compared.

Conclusions : We found no significant difference in glycemic control, as reflected by HbA1c, in youths with type 1 diabetes treated with GBBIR and CSII for up to 1 year. Blood sugar control waned by 12 months in both the GBBIR (p = 0.036) and CSII (p = 0.058) groups,

which suggests that “”burn out”" qually affects those on each regimen. Additional investigation of glycemic variability and quality of life for those on GBBIR and CSII would be clinically relevant.”
“Severe liver disease in find more pregnancy is generally considered to have a favorable prognosis. The limited data available have not yielded disease-specific prognostic criteria or guidance on who should undergo liver transplantation (LT). We retrospectively evaluated 54 admissions with pregnancy-related liver disease to (1) evaluate if any admission parameters were associated with death and/or transplantation and (2) identify maternal complications. Eighteen had acute fatty liver of pregnancy and 32 had hypertension/eclampsia related disease. Seven patients (13%) died

and four (7%) underwent LT. Survival rates were 43/48 if not listed for LT and 4/6 if listed. Of the four transplanted, three survived. Patients who died and/or underwent LT were more likely to have encephalopathy (p = 0.04) and hyperlactaemia (p = 0.03). Serum lactate was the best discriminant (ROC AUC 0.84). An admission lactate greater than 2.8mg/dL had 73% sensitivity and 75% specificity for predicting death or LT. The addition of encephalopathy to this parameter increased sensitivity and specificity to 90% and 86%, respectively. The King’s College criteria were not effective in predicting outcome. This study confirms the overall favorable prognosis in pregnancy-related liver failure but indicates that elevated lactate levels in the presence of encephalopathy best identify patients at greatest risk of death or LT.