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Model-based glycaemic control

Christina Bächle, Anna Peneva, Werner Maier, Katty Castillo, Anna Stahl-Pehe, Oliver Kuß, Rolf Holle, Julia M Hermann, Reinhard W Holl, Joachim Rosenbauer
PURPOSE: To analyse the association of area-level deprivation (German Index of Multiple Deprivation, GIMD 2010) with health- and disease-related quality of life (QoL) and glycaemic control (HbA1c) jointly with individual-level socioeconomic status (SES) in young patients with preschool-onset type 1 diabetes. METHODS: A total of 425 male and 414 female patients aged 11-21 years from a Germany-wide population-based survey completed the generic KINDL-R, the DISABKIDS chronic-generic module (DCGM-12), and the DISABKIDS diabetes-specific module with impact and treatment scales (QoL indicators; range 0-100 with higher scores representing better QoL)...
August 11, 2018: Quality of Life Research
Marc Evans, Roopa Mehta, Jens Gundgaard, Barrie Chubb
BACKGROUND: Understanding which therapeutic innovations in diabetes represent the best value requires rigorous economic evaluation. Data from randomised controlled trials and observational studies indicate that insulin degludec has a hypoglycemia advantage versus insulin glargine 100 units/mL (glargine U100), the most widely prescribed basal insulin analogue in the UK. This analysis was done to more rigorously assess cost-effectiveness in a UK setting. METHODS: Data from two double-blinded, randomised, two-period crossover trials in type 1 (SWITCH 1) and type 2 (SWITCH 2) diabetes mellitus were used to assess the cost-effectiveness of degludec vs...
October 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Lindokuhle Patience Mabuza, Mlindeli Wilkinson Gamede, Sanam Maikoo, Irvin Noel Booysen, Phikelelani Siphosethu Ngubane, Andile Khathi
Pre-diabetes is a condition that precedes type 2 diabetes mellitus (T2DM) that is characterised by elevated glycated haemoglobin (HbA1c). The management of pre-diabetes includes the combination of dietary and pharmacological interventions to increase insulin sensitivity. However, poor patient compliance has been reported with regard to dietary interventions, therefore, new alternative drugs are required that can be effective even without the dietary intervention. In our laboratory, we have synthesised a novel ruthenium complex that has been shown to have elevated biological activity...
July 14, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
David G Bruce, Wendy A Davis, Timothy M E Davis
AIM: To investigate whether tight glycaemic control achieved with metformin, insulin or sulphonylurea-based pharmacotherapy increases all-cause mortality in older people with type 2 diabetes. MATERIALS AND METHODS: We conducted a prospective cohort study of individuals with known diabetes recruited between 2008 and 2011 and followed until 2016. The impact of baseline glycated haemoglobin (HbA1c) on mortality hazards was investigated in participants aged ≥75 years...
July 13, 2018: Diabetes, Obesity & Metabolism
Theresa J Allain, Grieves Mang'anda, Marrianne Kasiya, Patricia Khomani, Ndaziona P Banda, Andrew Gonani, Ingrid Peterson, Gavin Dreyer
The Malawian health sector has a strong tradition of systematic data collection for monitoring and evaluation of large-scale services. A highly successful adapted Directly Observed Treatment, Short course "DOTS" framework, based on patient registers and paper-based mastercards was introduced to facilitate the management and monitoring of the scale up of antiretroviral therapy. Subsequently, a simple, touch-screen based electronic medical record system (EMRs) was effectively introduced at high burden ART sites...
December 2017: Malawi Medical Journal: the Journal of Medical Association of Malawi
A Cabrera, M Vives, A Molina, M París, E Raga, A Sánchez, F Sabench, D Del Castillo
AIM: Laparoscopic gastric plication (LGP) is a bariatric surgical technique based on the anatomical principles of laparoscopic sleeve gastrectomy (LSG), but its effects on the metabolic profile are still uncertain. The aim of our study is to compare the changes in weight, metabolic parameters and gastric histology following intervention by gastric plication (GP) and sleeve gastrectomy (SG) in an experimental model of obesity. METHODS: To conduct the study, 32 8-week-old male Sprague-Dawley rats (Charles River®) were fattened by means of a cafeteria diet and randomly assigned to the following experimental groups: group 1: GP (n = 12); group 2: SG (n = 12) and group 3: sham (n = 8)...
October 2018: Obesity Surgery
Xin Liu, Wei Gan, Chuqi Gao, Xin Qi, Xia Liao, Jing Lin, Yaling Zhao
PURPOSE: High-protein diets were popular in weight control. However, the role of protein intake in adiposity and related metabolic conditions among general populations is not clear. We aimed to evaluate the associations of protein intake with adiposity and glycaemic control among adult Chinese in a nationwide population-based survey. METHODS: The data were from China Health and Nutrition Survey 2009. A total of 9360 men and women aged 18 years or older were included...
June 13, 2018: European Journal of Nutrition
Jennifer L Knopp, Adrienne M Lynn, Geoffrey M Shaw, J Geoffrey Chase
OBJECTIVE: Previous studies examine clinical outcomes of insulin therapy in neonatal intensive care units (NICUs), without first developing safe and effective control protocols. This research quantifies the safety and performance of a computerised model-based control algorithmSTAR-GRYPHON (Stochastic TARgeted Glucose Regulation sYstem to Prevent Hyper- and hypO-glycaemia in Neonates). DESIGN: Retrospective observational study of glycaemic control in very/extremely low birthweight infants treated with insulin from Christchurch Women's Hospital NICU between January 2013 and June 2017...
June 21, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
Rosie Dobson, Robyn Whittaker, Yannan Jiang, Ralph Maddison, Matthew Shepherd, Catherine McNamara, Richard Cutfield, Manish Khanolkar, Rinki Murphy
OBJECTIVE: To determine the effectiveness of a theoretically based and individually tailored, text message based, diabetes self management support intervention (SMS4BG) in adults with poorly controlled diabetes. DESIGN: Nine month, two arm, parallel randomised controlled trial. SETTING: Primary and secondary healthcare services in New Zealand. PARTICIPANTS: 366 participants aged 16 years and over with poorly controlled type 1 or type 2 diabetes (HbA1c ≥65 mmol/mol or 8%) randomised between June 2015 and November 2016 (n=183 intervention, n=183 control)...
May 17, 2018: BMJ: British Medical Journal
Angus Forbes, Trevor Murrells, Henrietta Mulnier, Alan J Sinclair
BACKGROUND: Glycaemic targets for older people have been revised in recent years because of concern that more stringent targets are associated with increased mortality. We aimed to investigate the association between glycaemic control (mean HbA1c ) and variability (variability of HbA1c over time) and mortality in older people with diabetes. METHODS: We did a 5-year retrospective cohort study using The Health Improvement Network database, which includes data from 587 UK primary care practices...
June 2018: Lancet Diabetes & Endocrinology
Anthony H Barnett, Simon Arnoldini, Barnaby Hunt, Gowri Subramanian, Christina Stentoft Hoxer
AIMS: The recent LIRA-SWITCH trial showed that switching from sitagliptin 100 mg to liraglutide 1.8 mg led to statistically significant and clinically relevant improvements in glycated haemoglobin (HbA1C) and body mass index (BMI). Based on these findings, the aim of the present study was to assess the long-term cost-effectiveness of switching from sitagliptin to liraglutide in patients with type 2 diabetes in the UK. MATERIALS AND METHODS: The IQVIA CORE Diabetes Model Version 8...
August 2018: Diabetes, Obesity & Metabolism
William G Herrington, Jesus Alegre-Díaz, Rachel Wade, Louisa Gnatiuc, Raúl Ramirez-Reyes, Michael Hill, Martha Solano-Sánchez, Colin Baigent, Sarah Lewington, Rory Collins, Roberto Tapia-Conyer, Richard Peto, Pablo Kuri-Morales, Jonathan R Emberson
BACKGROUND: Diabetes is a cause of at least a third of all deaths in Mexican adults aged 35-74 years, with the excess mortality due mainly to vascular disease, renal disease, infection, and acute diabetic crises. We aimed to analyse the effect of diabetes duration and glycaemic control on death rate ratios (RRs) for these causes and to assess the relevance to cause-specific mortality of undiagnosed diabetes. METHODS: About 100 000 women and 50 000 men aged 35 years or older from Mexico City were recruited into a blood-based prospective study between April 14, 1998, and Sept 28, 2004, and followed up until Jan 1, 2016, for cause-specific mortality...
June 2018: Lancet Diabetes & Endocrinology
Mohammed B Sarhan, Rula Ghandour, Niveen M E Abu Rmeileh
BACKGROUND: The burden of type 2 diabetes is increasing rapidly in the occupied Palestinian territory. Different counselling interventions have been applied worldwide to reduce HbA1c concentrations in patients with type 2 diabetes. Achieving good glycaemic control is important for prevention of complications of type 2 diabetes. The aim of this modelling study was to assess the effectiveness of different counselling interventions in improving glycaemic control in patients with type 2 diabetes...
February 21, 2018: Lancet
Z K Lum, K Y K Tsou, J Y-C Lee
AIMS: To investigate the effects of diabetes-related distress and perception of hyperglycaemia on self-reported medication adherence and glycaemic control, as measured by HbA1c , and to compare the cost outcomes in patients with sub-optimally vs uncontrolled Type 2 diabetes mellitus. METHODS: We conducted a retrospective cross-sectional study that involved the review of a chronic disease database in Singapore. Data on clinical characteristics, diabetes-related distress, perception of hyperglycaemia, self-reported medication adherence and costs were obtained from the database...
June 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Adam Martin, Rupert Payne, Edward Cf Wilson
BACKGROUND: The National Health Service (NHS) in England spends over £9 billion on prescription medicines dispensed in primary care, of which over two-thirds is accounted for by repeat prescriptions. Recently, GPs in England have been urged to limit the duration of repeat prescriptions, where clinically appropriate, to 28 days to reduce wastage and hence contain costs. However, shorter prescriptions will increase transaction costs and thus may not be cost saving. Furthermore, there is evidence to suggest that shorter prescriptions are associated with lower adherence, which would be expected to lead to lower clinical benefit...
June 2018: Applied Health Economics and Health Policy
D Canistro, F Vivarelli, S Cirillo, A Soleti, B Albertini, N Passerini, G Merizzi, M Paolini
PURPOSE: We previously showed the positive effects of the new antioxidant molecule bis(1-hydroxy-2,2,6,6-tetramethyl-4-piperidinyl)-decandioate (IAC) in reducing basal hyperglycaemia and relieving glucose intolerance in a diabetes model. However, the chemical properties of IAC did not allow an efficient oral administration, thus representing the main failing of that study. Here, we tested the effect of a new oral delivery system based on solid lipid microparticles (SLMs) in a diabetes mouse model...
October 2018: Journal of Endocrinological Investigation
Ying Wang, Hong Yang, Mark Nolan, Faraz Pathan, Kazuaki Negishi, Thomas H Marwick
AIMS: Patients with heart failure (HF) risk factors are described as being in Stage A of this condition (SAHF). Management is directed towards prevention of HF progression, but to date, no evidence has been described to align the intensity of this intervention to HF risk. We sought to what extent SAHF of Type 2 diabetes mellitus (T2DM) and other HF risks showed differences in subclinical left ventricular function, exercise capacity, and prognosis. METHODS AND RESULTS: We recruited 551 elder asymptomatic SAHF patients (age 71 ± 5 years, 49% men, 290 T2DM) with at least one risk factor from a community-based population with preserved ejection fraction...
June 2018: ESC Heart Failure
R Barua, A J Templeton, B Seruga, A Ocana, E Amir, J-L Ethier
AIMS: Diabetes is associated with adverse cancer outcomes. However, the effect of hyperglycaemia in non-diabetic cancer patients is unclear. MATERIALS AND METHODS: A systematic search of electronic databases identified publications exploring the effect of hyperglycaemia on overall survival, disease-free survival (DFS) or progression-free survival (PFS). Data from studies reporting a hazard ratio and 95% confidence interval and/or a P-value were pooled in a meta-analysis using generic inverse-variance and random effects modelling...
April 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
Susan Tran, Ravi Retnakaran, Bernard Zinman, Caroline K Kramer
AIMS: Glucagon-like peptide-1 (GLP-1) agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors are both incretin-based therapies for type 2 diabetes (T2DM) but have distinct efficacy and side effect profiles. We thus performed a systematic review and meta-analysis to compare the effects of GLP-1 agonists to DPP-4 inhibitors on glycaemic control, weight and incidence of adverse events in adults with T2DM. We also sought to determine whether there was any additional effect in switching from DPP-4 inhibitor to GLP-1 agonist...
February 2018: Diabetes, Obesity & Metabolism
Wanessa Costa Silva Faria, Morenna Alana Giordani, Ariadny da Silva Arcas, Daniela Fernanda Lima Carvalho Cavenaghi, Adriana Paiva de Oliveira, Jacqueline Fiuza Dos Santos, Wander Miguel Barros
This study assessed the effect of whey protein substitution with isolated soy protein in protein bar (PB) formulations at 25% (PB2), 50% (PB3), or 75% (PB1) weight/weight on the proximate and mineral composition, sensory, and antidiabetic properties. Sensory evaluation was conducted within diabetic (DB) and non-diabetic (NDB) consumers by preference ranking and acceptance test. The formulations were analysed in terms of moisture, ash, protein, lipid, carbohydrates, fibers and mineral content. The consumers did not distinguish the formulations by preference ranking test...
January 2018: Journal of Food Science and Technology
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