Research Topics
| I B HirschSummaryAffiliation: University of Washington Country: USA Publications
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Publications
Clinical review: Realistic expectations and practical use of continuous glucose monitoring for the endocrinologistIrl B Hirsch
University of Washington School of Medicine, Seattle, Washington 98105, USA
J Clin Endocrinol Metab 94:2232-8. 2009..Real-time continuous glucose monitoring (CGM) has been available for type 1 diabetes for several years. This paper is a status report on our early experiences with this next technology...
New insulin infusion protocol Improves blood glucose control in hospitalized patients without increasing hypoglycemiaSusanna Y Ku
University of Washington Medical Center, USA
Jt Comm J Qual Patient Saf 31:141-7. 2005..In addition, there was no increase in hypoglycemia despite the use of the protocol in non-critical care units with higher patient-to-nurse ratios, suggests that insulin infusion therapy can be safely used outside of critical care units...
Insulin Degludec/Insulin Aspart Administered Once Daily at Any Meal, With Insulin Aspart at Other Meals Versus a Standard Basal-Bolus Regimen in Patients With Type 1 Diabetes: A 26-week, phase 3, randomized, open-label, treat-to-target trialIrl B Hirsch
Corresponding author Irl B Hirsch
Diabetes Care 35:2174-81. 2012....
Hyperthyroidism from autoimmune thyroiditis in a man with type 1 diabetes mellitus: a case reportJohn K Amory
Division of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195, USA
J Med Case Reports 5:277. 2011..abstract:..
Surveillance for complications of diabetes: don't wait for symptoms before interveningI B Hirsch
Diabetes Care Center, University of Washington Medical Center, Seattle, 98195 6176, USA
Postgrad Med 99:147-55, 159-62. 1996..Early diagnosis and treatment often improve outcome and should dramatically decrease the burden of diabetes in our society...
Sensor-augmented insulin pump therapy: results of the first randomized treat-to-target studyIrl B Hirsch
University of Washington Medical Center Roosevelt, Seattle, Washington 98105, USA
Diabetes Technol Ther 10:377-83. 2008....
Clinical application of emerging sensor technologies in diabetes management: consensus guidelines for continuous glucose monitoring (CGM)Irl B Hirsch
Department of Medicine, University of Washington Medical Center Roosevelt, Seattle, Washington 98105, USA
Diabetes Technol Ther 10:232-44; quiz 245-6. 2008..Finally, researchers, manufacturers, payers, and advocacy groups must join forces on the policy level to create an environment conducive to managing continuous data, measuring outcomes, and formalizing best practices...
Piecing the puzzle together: ACCORDing to whom?Irl B Hirsch
University of Washington School of Medicine Roosevelt, 4225 Roosevelt Avenue Northeast, Suite 101, Seattle, Washington 98105, USA
J Clin Endocrinol Metab 93:1161-3. 2008
The changing faces of diabetesIrl B Hirsch
Department of Medicine, University of Washington, 1959 NE Pacific Street, Box 356176, Seattle, WA 98195 6176, USA
Prim Care 30:499-510. 2003..Clearly, new classifications will be required as we learn more about the different types of diabetes...
Arguments against the use of inhaled insulinIrl B Hirsch
University of Washington School of Medicine, Seattle, Washington 98105, USA
Diabetes Technol Ther 9:S111-4. 2007
Glycemic variability: it's not just about A1C anymore!Irl B Hirsch
University of Washington Medical Center, Seattle, Washington 98105, USA
Diabetes Technol Ther 7:780-3. 2005
Should minimal blood glucose variability become the gold standard of glycemic control?Irl B Hirsch
University of Washington Medical Center, Box 356176, 1959 NE Pacific Street, PO Seattle, WA 98105 6176, United States
J Diabetes Complications 19:178-81. 2005....
Intensifying insulin therapy in patients with type 2 diabetes mellitusIrl B Hirsch
Diabetes Care Center, Division of Endocrinology, University of Washington School of Medicine, Seattle, Washington 98195, USA
Am J Med 118:21S-6S. 2005....
Continuous subcutaneous insulin infusion (CSII) of insulin aspart versus multiple daily injection of insulin aspart/insulin glargine in type 1 diabetic patients previously treated with CSIIIrl B Hirsch
University of Washington, Seattle, WA, USA
Diabetes Care 28:533-8. 2005..Multiple daily injection (MDI) therapy of bolus insulin aspart and basal insulin glargine was compared with continuous subcutaneous insulin infusion (CSII) with aspart in type 1 diabetic patients previously treated with CSII...
The burden of diabetes (care)Irl B Hirsch
Department of Metabolism, Endocrinology and Nutrition, University of Washington, Seattle, USA
Diabetes Care 26:1613-4. 2003
Insulin analoguesIrl B Hirsch
Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195-6176, USA
N Engl J Med 352:174-83. 2005
Patient factors associated with glucagonlike peptide 1 receptor agonist use with and without insulinIrl B Hirsch
University of Washington School of Medicine, Seattle, Washington, USA
Endocr Pract 17:707-16. 2011..To evaluate both the patient factors associated with the initiation of exenatide and the real-world treatment patterns of exenatide use with and without insulin...
A multifaceted intervention in support of diabetes treatment guidelines: a cont trialIrl B Hirsch
Division of Metabolism, Endocrinology and Nutrition, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356176, Seattle, WA 98195, USA
Diabetes Res Clin Pract 58:27-36. 2002..Providers received didactic training and computerized compliance feedback to support staged diabetes management, an evidenced-based approach to diabetes care...
Practical pearls in insulin pump therapyIrl B Hirsch
University of Washington School of Medicine, Medical Center, 4225 Roosevelt Way NE, Seattle, WA 98101, USA
Diabetes Technol Ther 12:S23-7. 2010..Finally, the introduction of bolus calculators and software to download the pumps has provided technology that when used appropriately can further benefit glycemic control...
Impact of prandial plus basal vs basal insulin on glycemic variability in type 2 diabetic patientsIrl B Hirsch
University of Washington Medical Center Roosevelt, 4225 Roosevelt Way NE, Ste 101 Box 354691, Seattle, WA 98105, USA
Endocr Pract 15:343-8. 2009....
Web-based collaborative care for type 2 diabetes: a pilot randomized trialJames D Ralston
Center for Health Studies, Group Health Cooperative, Seattle, Washington, USA
Diabetes Care 32:234-9. 2009..To test Web-based care management of glycemic control using a shared electronic medical record with patients who have type 2 diabetes...
Outpatient insulin therapy in type 1 and type 2 diabetes mellitus: scientific reviewDawn E DeWitt
Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, USA
JAMA 289:2254-64. 2003..The key to effective insulin therapy is an understanding of principles that, when implemented, can result in improved diabetes control...
Individualizing care for the many: the evolving role of professional continuous glucose monitoring systems in clinical practiceElizabeth A Nardacci
Albany Medical Center, Division of Endocrinology, Albany, NY 12208, USA
Diabetes Educ 36:4S-19S; quiz 20S-21S. 2010..CONCLUSION: Strategic implementation of professional CGM may improve the time- and cost-effectiveness of diabetes care while advancing more personalized treatment in the course of everyday practice...
Islet cell antibodies and glutamic acid decarboxylase antibodies, but not the clinical phenotype, help to identify type 1(1/2) diabetes in patients presenting with type 2 diabetesR Juneja
Department of Medicine, University of Washington, Seattle, WA 98108, USA
Metabolism 50:1008-13. 2001..We therefore conclude that screening with antibodies, mainly ICA and GAD, but not age, BMI, or clinical presentation should be used to identify type 1(1/2) diabetes...
Less hypoglycemia with insulin glargine in intensive insulin therapy for type 1 diabetes. U.S. Study Group of Insulin Glargine in Type 1 DiabetesR E Ratner
MedStar Clinical Research Center, Washington, DC, USA
Diabetes Care 23:639-43. 2000..This study compared insulin glargine with NPH human insulin in subjects with type 1 diabetes who had been previously treated with multiple daily injections of NPH insulin and regular insulin...
Improving the quality of outpatient care for older patients with diabetes: lessons from a comparison of rural and urban communitiesR A Rosenblatt
University of Washington, Department of Family Medicine, Box 354696, Seattle, WA 98195 4696, USA
J Fam Pract 50:676-80. 2001..Our goal was to compare the quality of diabetic care received by patients in rural and urban communities...
A path model of chronic stress, the metabolic syndrome, and coronary heart diseasePeter P Vitaliano
Departments of Psychiatry and Behavioral Sciences and Medicine, University of Washington, Seattle, Washington 98195 6560, USA
Psychosom Med 64:418-35. 2002....
Interpersonal predictors of HbA(1c) in patients with type 1 diabetesPaul S Ciechanowski
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington 98195, USA
Diabetes Care 25:731-6. 2002....
Inpatient diabetes: review of data from the cardiac care unitIrl B Hirsch
Department of Medicine, Division of Metabolism, Endocrinology and Nutrition, University of Washington School of Medicine, Seattle, Washington, USA
Endocr Pract 12:27-34. 2006..While we improve our understanding of the basic roles of glucose and insulin in modulating inflammation, we must aggressively treat hyperglycemia to the national goals for this population, which would substantially improve outcomes...
The relationship of depressive symptoms to symptom reporting, self-care and glucose control in diabetesPaul S Ciechanowski
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195, USA
Gen Hosp Psychiatry 25:246-52. 2003..Because of their association with clinical aspects of diabetes care such as diabetes symptom reporting and adherence to diabetes self-care, depressive symptoms are important to recognize in treating patients with diabetes...
Designing mobile support for glycemic control in patients with diabetesLynne T Harris
Department of Health Services, University of Washington, Magnuson Health Sciences Center, Room H 664, Seattle, WA 98195 7660, USA
J Biomed Inform 43:S37-40. 2010..Participants saw value in the mobile system as an adjunct to the Web-based program and traditional office-based care. Mobile diabetes management systems may represent one strategy to improve the quality of diabetes care...
Practical aspects of real-time continuous glucose monitoringLisa K Gilliam
University of Washington Medical Center, Seattle, Washington 98195 7710, USA
Diabetes Technol Ther 11:S75-82. 2009..In this review, we will discuss the practical benefits and challenges of rt-CGM use, in order to better educate care providers as to which of their patients might actually benefit from this technology...
Web-based collaborative care for type 1 diabetes: a pilot randomized trialKelly P McCarrier
Department of Health Services, University of Washington, Seattle, Washington 98195, USA
Diabetes Technol Ther 11:211-7. 2009....
Assessment of therapy with continuous subcutaneous insulin infusion in an academic diabetes clinicJusten W Rudolph
Department of Medicine, Division of Metabolism, Endocrinology, and Nutrition, University of Washington School of Medicine, Seattle, Washington, USA
Endocr Pract 8:401-5. 2002..CSII therapy, when provided in conjunction with a standard educational program, should continue to be an important treatment option in appropriately selected patients with type 1 diabetes...
Using an Internet comanagement module to improve the quality of chronic disease careHarold I Goldberg
University of Washington, Seattle, USA
Jt Comm J Qual Saf 29:443-51. 2003..At the University of Washington, a diabetes care module was developed, and the feasibility of allowing patients with type 2 diabetes to comanage their disease from home was pilot tested...
Blood glucose monitoring technology: translating data into practiceIrl B Hirsch
The University of Washington Medical Center, Seattle, Washington, USA
Endocr Pract 10:67-76. 2004..CONCLUSION: Data downloaded from glucose meters can be used in conjunction with written records in logbooks to evaluate glucose patterns and formulate more precise and efficacious therapeutic regimens...
Evidence-based management: using serial firm trials to improve diabetes care qualityHarold I Goldberg
University of Washington, Seattle, USA
Jt Comm J Qual Improv 28:155-66. 2002..The effectiveness of the "computerized firm system" approach to chronic disease CQI was examined, with diabetes as the focus of a 5-year case study...
Self-Monitoring of Blood Glucose (SMBG) in insulin- and non-insulin-using adults with diabetes: consensus recommendations for improving SMBG accuracy, utilization, and researchIrl B Hirsch
Department of Medicine, University of Washington Medical Center Roosevelt, Seattle, Washington 98105, USA
Diabetes Technol Ther 10:419-39. 2008..The panel also made suggestions for designing future studies that increase the ability to discern optimal models of SMBG utilization for individuals with diabetes who may, or may not, use insulin...
The rationale and management of hyperglycemia for in-patients with cardiovascular disease: time for changeDace L Trence
Division of Metabolism, Endocrinology, and Nutrition, University of Washington School of Medicine, Seattle, Washington 98195-6176, USA
J Clin Endocrinol Metab 88:2430-7. 2003..v. and s.c. insulin. Although there are several appropriate options for both of these routes of administration, it is critical that all caregivers involved in this population's care are knowledgeable about insulin strategies...
Use of serum and plasma glucose measurements as a benchmark for improved hospital-wide glycemic controlAndrew N Hoofnagle
Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
Endocr Pract 14:556-63. 2008..To demonstrate the benefit of an institutionally implemented glucose control intervention based on serum and plasma glucose values in the acute inpatient setting...
Animal insulin therapy induces a biased insulin antibody response that persists for years after introduction of human insulinShilpa Oak
Department of Medicine, University of Washington, Seattle, WA, USA
Acta Diabetol 47:131-5. 2010..0001). We conclude that IA binding level and epitope specificity are biased by treatment with animal insulin. This bias remains for over 20 years after animal insulin treatment is terminated...
Sepsis and glycemia: read the fine print!Irl B Hirsch
Division of Metabolism, Endocrinology and Nutrition, University of Washington School of Medicine, Seattle, Washington 98195-4691, USA
Endocr Pract 14:389-90. 2008
Implementing an intravenous insulin protocol in your practice: practical advice to overcome clinical, administrative, and financial barriersJanet L Kelly
University of Washington Medical Center, School of Pharmacy, Division of Metabolism, Endocrinology, and Nutrition, University of Washington, Seattle, WA, USA
Semin Thorac Cardiovasc Surg 18:346-58. 2006....
Optimal initiation of insulin in type 2 diabetesIrl B Hirsch
University of Washington, University of Washington Medical Center, Seattle, Washington, USA
MedGenMed 7:49. 2005..In addition to A1C, a patient's age, lifestyle, competence, personal preferences, and comorbidities can be used to help determine the choice of insulin therapy...
Treatment of patients with severe insulin deficiency; what we have learned over the past 2 yearsIrl B Hirsch
Diabetes Care Center and the Department of Medicine, University of Washington School of Medicine, 1959 NE Pacific, UW Mailbox 356176, Seattle, WA 98195-6176, USA
Am J Med 116:17S-22S. 2004..Newer insulin analogues, improved devices for home glucose monitoring, and pulmonary inhaled insulin are other innovations that promise improvement of hemoglobin A(1c) levels...
Hyperglycemic crises in diabetes mellitus type 2D L Trence
Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
Endocrinol Metab Clin North Am 30:817-31. 2001..Medications such as the protease inhibitors may in the future lead to a better understanding of the pathophysiology of the metabolic derangements seen in the development of type 2 diabetes mellitus...
The contribution of malglycemia to mortality among allogeneic hematopoietic cell transplant recipientsMarilyn J Hammer
Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, Washington, USA
Biol Blood Marrow Transplant 15:344-51. 2009..The applicability of these findings to other situations and whether correcting malglycemia in HCT can lead to reductions in mortality remain to be determined...
Relationship of family history of type 2 diabetes, hypoglycemia, and autoantibodies to weight gain and lipids with intensive and conventional therapy in the Diabetes Control and Complications TrialJonathan Q Purnell
Division of Endocrinology, Diabetes, and Clinical Nutrition, Oregon Health and Science University, Portland, Oregon 97201, USA
Diabetes 52:2623-9. 2003..These data support the hypothesis that increased weight gain with intensive therapy might be explained, in part, by genetic traits...
Inpatient management of adults and children with type 1 diabetesDavid M Tridgell
Division of Metabolism, Endocrinology and Nutrition, University of Washington, 1959 NE Pacific Street, Box 356426, Seattle, WA 98195, USA
Endocrinol Metab Clin North Am 39:595-608. 2010..This article focuses on inpatient and perioperative insulin management of stable, nonketotic, nonpregnant adults and children with type 1 diabetes. These principles can also be applied to patients with steroid-induced hyperglycemia...
Isn't this just bedtime snacking? The potential adverse effects of night-eating symptoms on treatment adherence and outcomes in patients with diabetesShereen A Morse
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195 6560, USA
Diabetes Care 29:1800-4. 2006..Psychosocial variables and emotional triggers may be associated with these behaviors. In patients with diabetes, such behaviors may lead to glucose dysregulation and contribute to obesity and complications...
Effect of insulin therapy on nonglycemic variables during acute illnessIrl B Hirsch
University of Washington School of Medicine, Seattle, Washington, USA
Endocr Pract 10:63-70. 2004....
American College of Endocrinology position statement on inpatient diabetes and metabolic controlAlan J Garber
Endocr Pract 10:4-9. 2004
Visceral obesity, hepatic lipase activity, and dyslipidemia in type 1 diabetesShalamar D Sibley
Division of Endocrinology and Diabetes, University of Minnesota, Minneapolis, Minnesota 55455, USA
J Clin Endocrinol Metab 88:3379-84. 2003..DCCT-related weight gain positively correlated with subsequent IAF...
Intensive insulin therapy in critically ill patientsIrl B Hirsch
N Engl J Med 346:1586-8; author reply 1586-8. 2002
Depression-related hyperglycemia in type 1 diabetes: a mediational approachPatrick J Lustman
Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO 63110, USA
Psychosom Med 67:195-9. 2005..In this study, we applied mediational analysis methods to determine whether the hyperglycemic effect of depression could be mediated by poor diabetes self-care...
American College of Endocrinology position statement on inpatient diabetes and metabolic controlAlan J Garber
Endocr Pract 10:77-82. 2004
Hospital management of diabetesEtie S Moghissi
Inpatient Diabetes and Metabolic Control Task Force, American Association of Clinical Endocrinologists, 501 East Hardy Street, Suite 110, Inglewood, CA 90301, USA
Endocrinol Metab Clin North Am 34:99-116. 2005..We believe that we can already state with confidence that the preliminary evidence shows that, like outpatient diabetes management,metabolic control matters during acute illness...
Novel insulins and strict glycemic control. Analogues approximate normal insulin secretory responseJohn R White
Department of Pharmacotherapy, Washington State University College of Pharmacy, Spokane, WA 99210 1495, USA
Postgrad Med 113:30-6. 2003..In this article, the authors review the development of insulin formulations and the pharmacology of currently available insulin molecules and those soon to be on the market...
Frequency of blood glucose monitoring in relation to glycemic control in patients with type 2 diabetesLawrence Blonde
Diabetes Care 25:245-6. 2002
Continuous glucose monitoring and intensive treatment of type 1 diabetesWilliam V Tamborlane
N Engl J Med 359:1464-76. 2008..Further work is needed to identify barriers to effectiveness of continuous monitoring in children and adolescents. (ClinicalTrials.gov number, NCT00406133.)..
The accuracy and efficacy of real-time continuous glucose monitoring sensor in patients with type 1 diabetesJohn Mastrototaro
Medtronic Diabetes, Northridge, California 91325 1219, USA
Diabetes Technol Ther 10:385-90. 2008..The accuracy and efficacy of the Medtronic Diabetes (Northridge, CA) Real-Time (RT)-Continuous Glucose Monitoring (CGM) sensor were analyzed in 72 subjects with type 1 diabetes...
Insulin therapy for type 2 diabetes. Getting startedChristin Snyder
Diabetes Self Manag 25:30, 32-3, 35-6. 2008
Fighting diabetic kidney disease. The best defense is a good offense--take action now to prevent kidney diseaseIrl B Hirsch
Diabetes Forecast 55:68-70. 2002
Evidence-based primingIrl B Hirsch
Diabetes Technol Ther 8:521-2. 2006
Efficacy of sertraline in prevention of depression recurrence in older versus younger adults with diabetesMonique M Williams
Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri 63110, USA
Diabetes Care 30:801-6. 2007..A secondary analysis was performed to assess this effect in younger and older subsets of patients...
Glycemic variability: a hemoglobin A1c-independent risk factor for diabetic complicationsMichael Brownlee
JAMA 295:1707-8. 2006
Pharmacotherapies for diabetes management: an update for the practicing clinicianLuigi Meneghini
University of Miami Miller School of Medicine, Diabetes Research Institute, Miami, Florida 33136, USA
Semin Thorac Cardiovasc Surg 18:379-89. 2006....
Insulin therapy: evolution and practiceIrl B Hirsch
Endocrinol Metab Clin North Am 36:7-8. 2007
Self-monitoring of blood glucose cannot compensate for ineffective diabetes managementChristopher G Parkin
Am J Med 118:1448; author reply 1448-9. 2005
Continuous subcutaneous insulin infusion and multiple daily injection therapy are equally effective in type 2 diabetes: a randomized, parallel-group, 24-week studyPhilip Raskin
University of Texas, Southwestern Medical Center, Dallas, Texas 75390 8858, USA
Diabetes Care 26:2598-603. 2003..Compare the efficacy, safety, and patient satisfaction of continuous subcutaneous insulin infusion (CSII) therapy with multiple daily injection (MDI) therapy for patients with type 2 diabetes...
Type 2 diabetes: the role of basal insulin therapyDerek LeRoith
J Fam Pract 53:215-22. 2004
Management of diabetes and hyperglycemia in hospitalsStephen Clement
Department of Endocrinology, Georgetown University Hospital, Washington, DC 20007, USA
Diabetes Care 27:553-91. 2004
Diabetes and heart failure: is insulin therapy the answer?Wayne C Levy
J Am Coll Cardiol 42:1051-3. 2003
In-patient hyperglycemia--are we ready to treat it yet?Irl B Hirsch
J Clin Endocrinol Metab 87:975-7. 2002
The effect of glucose variability on the risk of microvascular complications in type 1 diabetesIrl B Hirsch
Diabetes Care 30:186-7; author reply 188-9. 2007
What's in a name: latent autoimmune diabetes of adults, type 1.5, adult-onset, and type 1 diabetesJerry P Palmer
Diabetes Care 26:536-8. 2003
Sertraline for prevention of depression recurrence in diabetes mellitus: a randomized, double-blind, placebo-controlled trialPatrick J Lustman
Department of Veterans Affairs Medical Center, St Louis, MO, USA
Arch Gen Psychiatry 63:521-9. 2006..In patients with diabetes mellitus, depression is a prevalent and recurrent problem that adversely affects the medical prognosis...
