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Basal insulin dose

Yeoree Yang, Jeong Ah Shin, Hae Kyung Yang, Seung Hwan Lee, Seung Hyun Ko, Yu Bae Ahn, Kun Ho Yoon, Jae Hyoung Cho
BACKGROUND: There were a limited number of studies about β-cell function after insulin initiation in patients exposed to long durations of sulfonylurea treatment. In this study, we aimed to evaluate the recovery of β-cell function and the efficacy of concurrent sulfonylurea use after the start of long-acting insulin. METHODS: In this randomized controlled study, patients with type 2 diabetes mellitus (T2DM), receiving sulfonylurea for at least 2 years with glycosylated hemoglobin (HbA1c) >7%, were randomly assigned to two groups: sulfonylurea maintenance (SM) and sulfonylurea reduction (SR)...
October 11, 2016: Diabetes & Metabolism Journal
James Weatherall, Lisa Bloudek, Sarah Buchs
OBJECTIVE: To quantify the annual budget impact if all United States (US) commercially insured type 1 diabetes mellitus patients on basal-bolus therapy (T1DMBBT), type 2 diabetes mellitus patients on basal-oral therapy (T2DMBOT), and type 2 diabetes mellitus patients on basal-bolus therapy (T2DMBBT) switched from insulin glargine (IGlar) to insulin degludec (IDeg). METHODS: A short-term (1-year) budget impact model was developed to evaluate the costs of IDeg vs...
October 21, 2016: Current Medical Research and Opinion
Fumitaka Okajima, Tomoko Nagamine, Yuko Nakamura, Naomi Hattori, Hitoshi Sugihara, Naoya Emoto
The efficacy of the administration of sodium-glucose co-transporter 2 inhibitor (SGLT2I) or the co-administration of SGLT2I and dipeptidyl peptidase-4 inhibitor (DPP-4I) to insulin therapy is not well known. Fifty-eight patients with type 2 diabetes, admitted for glycemic control, were randomized to basal-bolus insulin therapy (BBT) alone or BBT plus 50 mg ipragliflozin and/or 20 mg teneligliptin. Insulin doses were adjusted to maintain normal blood glucose levels. Plasma glucose profiles were estimated by continuous glucose monitoring (CGM) before discharge...
October 20, 2016: Journal of Diabetes Investigation
Tatsuhiko Urakami, Yusuke Mine, Masako Aoki, Misako Okuno, Junichi Suzuki
This study implemented a randomized crossover design to evaluate the efficacy and safety of switching from insulin glargine (IGlar) to insulin degludec (IDeg) in 18 children (11 males, 7 females; age 11.0 ± 0.5 years) with type 1 diabetes. All subjects had previously used IGlar once daily at bedtime. We compared fasting plasma glucose (FPG) and HbA1c levels, frequencies of overall and nocturnal (2200 h - 0659 h) hypoglycemia, and basal insulin dose at the baseline with those measured during a 24-week period during which IGlar or IDeg was administered in combination with pre-meal rapid acting insulin analogues...
October 14, 2016: Endocrine Journal
S Mudaliar, R R Henry, T P Ciaraldi, D A Armstrong, P M Burke, J H Pettus, P Garhyan, S L Choi, M P Knadler, E C Q Lam, M J Prince, N Bose, N K Porksen, V P Sinha, H Linnebjerg, S J Jacober
AIMS: Basal insulin peglispro (BIL), a novel PEGylated basal insulin with a large hydrodynamic size, has a delayed absorption and reduced clearance that prolongs the duration of action. The current study compared the effects of BIL and insulin glargine (GL) on endogenous glucose production (EGP), glucose disposal rate (GDR) and lipolysis in patients with type 1 diabetes. MATERIALS AND METHODS: This was a randomized, open-label, four-period, crossover study. Patients received intravenous infusions of BIL and GL, each at two dose levels selected for partial and maximal suppression of EGP, during an 8 to 10 h euglycemic clamp procedure with d-[3-(3) H] glucose...
October 2016: Diabetes, Obesity & Metabolism
Kathryn M Hurren, Jessica L O'Neill
Glargine 300 units/ml (Gla-300) is a novel basal insulin formulation approved in 2015 for the treatment of diabetes. This more concentrated form of glargine causes delayed redissolution from the subcutaneous depot after injection and thus altered action profile. Areas covered: The pharmacokinetics, pharmacodynamics, efficacy, and safety of Gla-300 in patients with type 1 diabetes mellitus (T1DM) will be reviewed. Expert opinion: Gla-300 has a flatter and more prolonged pharmacokinetic profile compared to glargine 100 units/ml (Gla-100), but is less potent on a unit per unit basis...
October 6, 2016: Expert Opinion on Drug Metabolism & Toxicology
Tim Heise, Eric Zijlstra, Leszek Nosek, Tord Rikte, Hanne Haahr
AIMS: Continuous subcutaneous insulin infusion (CSII) is increasingly used in patients with diabetes. Faster-acting insulin aspart (faster aspart) is insulin aspart (IAsp) in a new formulation with a faster time-action profile. We evaluated the pharmacological characteristics of faster aspart versus IAsp> during CSII. MATERIALS AND METHODS: In this randomised, double-blind, crossover trial, 48 men and women aged 18-64 years with type 1 diabetes mellitus (T1DM) received faster aspart and IAsp as a 0...
October 6, 2016: Diabetes, Obesity & Metabolism
Hanne Haahr, Edmond G Fita, Tim Heise
Insulin degludec/insulin aspart (IDegAsp; 70 % IDeg and 30 % IAsp) is a soluble combination of two individual insulin analogues in one product, designed to provide mealtime glycaemic control due to the IAsp component and basal glucose-lowering effect from the IDeg component. The pharmacokinetic and pharmacodynamic characteristics of IDegAsp have been investigated in a series of clinical pharmacology studies with generally comparable designs, methodologies and patient inclusion/exclusion criteria. The glucose-lowering effect profile of IDegAsp during once-daily dosing at steady state shows distinct and clearly separated action from the prandial and basal components of IDegAsp...
October 1, 2016: Clinical Pharmacokinetics
Wenying Yang, Zhaojun Yang, Jing Zhao, Hai Lu, Tianhong Luo
BACKGROUND: A large proportion of patients with T2DM in China do not meet accepted HbA1c targets despite the availability of guidelines that describe a treatment pathway for achieving glycemic control. The aim of this study is to identify the fasting plasma glucose (FPG) target that will provide the highest control rate of HbA1c <7 % in Chinese patients with T2DM treated with an insulin glargine-based regimen as an adjunct to an established OAD regimen. This information will support improvements in diabetes care management in China...
September 26, 2016: Trials
Arturo Rojas, Georgina Sposetti, Jorge L Gross, Douglas Eugenio Barbieri, Ran Duan, Bruno Linetzky, Janaina Martins De Lana, Oded Stempa, Angel Rodriguez
BACKGROUND: This post hoc analysis examined the efficacy and safety of twice-daily insulin lispro low mixture (LM25) and once-daily basal insulin glargine plus once-daily prandial insulin lispro (IGL) in a Latin American subpopulation with type 2 diabetes mellitus (T2DM). METHODS: A phase 4, randomized, open-label, parallel-arm trial included participants aged 18-75 years with T2DM taking once-daily insulin glargine and stable doses of metformin and/or pioglitazone with glycated hemoglobin (HbA1c) 7...
2016: Diabetology & Metabolic Syndrome
Michelle Downie, Gary Kilov, Jencia Wong
: The progressive nature of type 2 diabetes (T2D) often results in the need for initiation and subsequent intensification of insulin treatment to achieve glycemic control. The aim of this review is to examine published clinical evidence that has directly compared two recommended treatment approaches in patients with T2D: (1) a 'basal plus' regimen, whereby 1-2 injections of prandial insulin are added to basal insulin; or (2) the use of once- or twice-daily premix insulin analogs, which contain both basal and prandial insulin in a single injection...
September 22, 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Sheng-Ping Wang, Dan Zhou, Zuliang Yao, Santhosh Satapati, Ying Chen, Natalie A Daurio, Aleksandr Petrov, Xiaolan Shen, Daniel Metzger, Wu Yin, Andrea R Nawrocki, George J Eiermann, Joyce Hwa, Craig Fancourt, Corey Miller, Kithsiri Herath, Thomas P Roddy, Deborah Slipetz, Mark D Erion, Stephen F Previs, David E Kelley
Aberrant regulation of glucose production makes a critical contribution to the impaired glycemic control that is observed in Type 2 diabetes. Although isotopic tracer methods have proven to be informative in quantifying the magnitude of such alterations, it is presumed that one must rely on venous access to administer glucose tracers which therein presents obstacles for the routine application of tracer methods in rodent models. Since intraperitoneal injections are readily used to deliver glucose challenges and/or dose potential therapeutics, we hypothesized that this route could also be used to administer a glucose tracer...
September 20, 2016: American Journal of Physiology. Endocrinology and Metabolism
Vanita R Aroda, Julio Rosenstock, Carol Wysham, Jeffrey Unger, Diego Bellido, Guillermo González-Gálvez, Akane Takami, Hailing Guo, Elisabeth Niemoeller, Elisabeth Souhami, Richard M Bergenstal
OBJECTIVE: This study was conducted to demonstrate the efficacy and safety of LixiLan (iGlarLixi), a novel, titratable, fixed-ratio combination of insulin glargine (iGlar) (100 units) and lixisenatide, compared with iGlar in patients with type 2 diabetes inadequately controlled on basal insulin with or without up to two oral glucose-lowering agents. RESEARCH DESIGN AND METHODS: After a 6-week run-in when iGlar was introduced and/or further titrated, and oral antidiabetic drugs other than metformin were stopped, 736 basal insulin-treated patients (mean diabetes duration 12 years, BMI 31 kg/m(2)) were randomized 1:1 to open-label, once-daily iGlarLixi or iGlar, both titrated to fasting plasma glucose <100 mg/dL (<5...
September 20, 2016: Diabetes Care
A Chico, L Herranz, R Corcoy, O Ramírez, M M Goya, J Bellart, S González-Romero, M Codina, P Sánchez, A Cortázar, D Acosta, M J Picón, J A Rubio, A Megía, M A Sancho, M Balsells, E Solá, N L González, J López-López
OBJECTIVE: To examine the potential role of the type of basal insulin on glycemic control and maternal and foetal outcomes in pregnant women with type 1 diabetes (T1DM). STUDY DESIGN: Retrospective cohort study of pregnancies attended at 18 Spanish tertiary hospitals. INCLUSION CRITERIA: T1DM, singleton pregnancies, delivery between 2002-2010, and use of the same basal and prandial insulin from before pregnancy until delivery. RESULTS: A total of 1534 pregnancies were included...
September 9, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
S R Ladyman, D R Grattan
Despite increased leptin concentrations during pregnancy, fat mass and food intake are increased. The satiety response to central leptin is suppressed indicating a state of leptin insensitivity in the hypothalamus. While the regulation of food intake is a major function of leptin, this hormone also influences a while range of functions within the body. These actions include regulation of glucose homeostasis, which undergoes major adaptation in the maternal body to generate optimal conditions for fetal development and growth...
September 13, 2016: Journal of Neuroendocrinology
S Galasso, A Facchinetti, B M Bonora, V Mariano, F Boscari, E Cipponeri, A Maran, A Avogaro, G P Fadini, D Bruttomesso
BACKGROUND AND AIMS: Degludec is an ultralong-acting insulin analogue with a flat and reproducible pharmacodynamic profile. As some patients with type 1 diabetes (T1D) fail to achieve 24-h coverage with glargine or detemir despite twice-daily injections, we studied the effect of switching T1D patients from twice-daily glargine or detemir to degludec. METHODS AND RESULTS: In this prospective observational study, T1D patients on twice-daily glargine or detemir were enrolled...
August 6, 2016: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
Mehul R Dalal, Michael Grabner, Nicole Bonine, Judith J Stephenson, Andres DiGenio, Nella Bieszk
AIMS: To investigate treatment patterns and achievement of glycemic targets in patients with type 2 diabetes mellitus treated with basal insulin in a real-world setting, and to determine physicians' beliefs and practices regarding these patients. METHODS: This study had two components; a retrospective analysis using a US claims database of patient and treatment data, and a survey of physicians' beliefs and practices. RESULTS: A total of 39,074 patients treated with basal insulin were included in this analysis...
August 24, 2016: Diabetes Research and Clinical Practice
Martin Tauschmann, Janet M Allen, Malgorzata E Wilinska, Hood Thabit, Carlo L Acerini, David B Dunger, Roman Hovorka
OBJECTIVE: This study evaluated the feasibility, safety, and efficacy of day-and-night hybrid closed-loop insulin delivery in adolescents with type 1 diabetes under free-living conditions. RESEARCH DESIGN AND METHODS: In an open-label randomized crossover study,12 suboptimally controlled adolescents on insulin pump therapy (mean ± SD age 14.6 ± 3.1 years; HbA1c 69 ± 8 mmol/mol [8.5 ± 0.7%]; duration of diabetes 7.8 ± 3.5 years) underwent two 21-day periods in which hybrid closed-loop insulin delivery was compared with sensor-augmented insulin pump therapy in random order...
September 9, 2016: Diabetes Care
Nandu Thalange, Abdullah Bereket, Lisbeth Bjerring Jensen, Line Conradsen Hiort, Valentina Peterkova
BACKGROUND: To study the long-term development (104 weeks) of insulin antibodies during treatment with insulin detemir (IDet) and insulin aspart (IAsp) in children with type 1 diabetes aged 2-16 years. METHODS: A 52-week, two-arm, randomized trial comparing IDet and neutral protamine Hagedorn insulin, both in combination with IAsp, was followed by a one-arm, 52-week extension trial of the IDet + IAsp arm. The present analysis was conducted in children who completed the randomized trial and entered into the extension trial...
September 6, 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Tim Heise, Chantal Mathieu
Manufacturers of insulin products for diabetes therapy have long sought ways to modify the absorption rate of exogenously administered insulins in an effort to better reproduce the naturally occurring pharmacokinetics of endogenous insulin secretion. Several mechanisms of protraction have been used in pursuit of a basal insulin for which a low injection frequency would provide tolerable and reproducible glucose control; these mechanisms have met with varying degrees of success. Before the advent of recombinant DNA technology, development focused on modifications to the formulation that increased insulin self-association, such as supplementation with zinc or the development of pre-formed precipitates using protamine...
September 4, 2016: Diabetes, Obesity & Metabolism
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