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Basal insulin dose

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https://www.readbyqxmd.com/read/28636047/decoding-the-regulatory-mechanism-of-glucose-and-insulin-induced-phosphatidylinositol-3-4-5-trisphosphate-dynamics-in-%C3%AE-cells
#1
Tagari Samanta, Peeyush Sharma, Dwijendra Kukri, Sandip Kar
In MIN6 pancreatic β-cells, glucose and insulin act in a synergistic manner to regulate the dynamics of Phosphatidylinositol (3,4,5)-trisphosphate (PIP3). However, the precise regulatory mechanism behind such an experimentally observed synergy is poorly understood. In this article, we propose a phenomenological mathematical model for studying the glucose and insulin driven PIP3 activation dynamics under various stimulatory conditions to unfold the mechanism responsible for the observed synergy. The modeling study reveals that the experimentally observed oscillation in PIP3 dynamics with disparate time scales for different external glucose doses is mainly orchestrated by the complex dynamic regulation of cytosolic Ca(2+) in β-cells...
June 21, 2017: Molecular BioSystems
https://www.readbyqxmd.com/read/28624930/basal-and-bolus-insulin-dose-changes-after-switching-basal-insulin-to-insulin-degludec-in-patients-with-type-1-diabetes%C3%A2-mellitus-a-pilot-study
#2
Yoshiyuki Hamamoto, Sachiko Honjo, Kanta Fujimoto, Shinsuke Tokumoto, Hiroki Ikeda, Yoshiharu Wada, Hiroyuki Koshiyama
BACKGROUND AND OBJECTIVES: Ultra-long-acting insulin degludec (DEG) has a longer duration of action and less daily variability relative to other basal insulin (BI), and thus may benefit patients with type 1 diabetes mellitus (T1DM). We examined the impact of switching BI to DEG on glycemic control and insulin dose in T1DM. METHODS: T1DM patients (n = 22; six male; mean age: 64.5 ± 12.6 years) receiving basal-bolus insulin therapy were included. Initially, the BI dose was replaced with DEG in a 1:1 ratio; 80-100% of the total dose was replaced with DEG for multiple basal insulin injections...
June 17, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28618984/glycemic-variability-and-insulin-needs-in-patients-with-type-1-diabetes-mellitus-supplemented-with-vitamin-d-a-pilot-study-using-continuous-glucose-monitoring-system
#3
Karem Miléo Felício, Ana Carolina Contente Braga de Souza, João Felício Abrahão Neto, Franciane Trindade Cunha de Melo, Carolina Tavares Carvalho, Thaís Pontes Arbage, Hana Andrade de Rider Brito, Amanda Soares Peixoto, Alana Ferreira de Oliveira, Fabricio de Souza Resende, Scarlatt Sousa Reis, Ana Regina Motta, Henrique da Costa Miranda, Luísa Corrêa Janaú, Elizabeth Sumi Yamada, João Soares Felício
BACKGROUND: Recent studies suggest that glycemic variability could influence the risk of complications in type 1 diabetes mellitus (T1DM). There are no data about the action of vitamin D (VD) on glycemic variability. Our pilot study aims to evaluate glycemic variability and insulin needs in patients with T1DM supplemented with VD. METHODS: 22 patients received doses of 4000 and 10000 IU/day of cholecalciferol for 12 weeks, according to the patient's baseline VD levels and underwent continuous glucose monitoring system...
June 15, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28604327/effects-of-exogenous-human-insulin-dose-adjustment-on-body-mass-index-in-adult-patients-with-type-1-diabetes-mellitus-at-kalafong-hospital-pretoria-south-africa-2009-2014
#4
Tohlang Solomon A Sehloho, Danie G Van Zyl
BACKGROUND: To maintain fasting blood glucose levels within near to the normal range in type 1 diabetes mellitus (DM), frequent insulin dose adjustments may be required with short-, intermediate- and long-acting insulin formulations. Patients on human insulin generally experience weight gain over time, regardless of the level of glycaemic control achieved. OBJECTIVES: To determine the effects of human insulin, adjusted quarterly to achieve glycaemic control, on body mass index (BMI), and establish dose regimens that achieve optimal glycaemic control without increasing BMI in patients with type 1 DM at the Kalafong Diabetes Clinic in Pretoria, South Africa...
May 24, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28574177/review-of-basal-plus-insulin-regimen-options-for-simpler-insulin-intensification-in-people-with-type-2-diabetes-mellitus
#5
REVIEW
D Raccah, D Huet, A Dib, F Joseph, B Landers, J Escalada, H Schmitt
AIMS: To identify simple insulin regimens for people with Type 2 diabetes mellitus that can be accepted and implemented earlier in primary and specialist care, taking into consideration each individual's needs and capabilities. METHODS: Using randomized clinical trials identified by a search of the PubMed database, as well as systematic reviews, meta-analyses and proof-of-concept studies, this review addresses topics of interest related to the progressive intensification of a basal insulin regimen to a basal-plus regimen (one basal insulin injection plus stepwise addition of one to three preprandial short-acting insulin injections/day) vs a basal-bolus regimen (basal insulin plus three short-acting insulin injections per day) in people with Type 2 diabetes...
June 2, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28571661/-evaluation-and-perioperative-management-of-patients-with-diabetes-mellitus-a-challenge-for-the-anesthesiologist
#6
REVIEW
João Paulo Jordão Pontes, Florentino Fernandes Mendes, Mateus Meira Vasconcelos, Nubia Rodrigues Batista
Diabetes mellitus (DM) is characterized by alteration in carbohydrate metabolism, leading to hyperglycemia and increased perioperative morbidity and mortality. It evolves with diverse and progressive physiological changes, and the anesthetic management requires attention regarding this pathology interference in multiple organ systems and their respective complications. Patient's history, physical examination, and complementary exams are important in the preoperative management, particularly glycosylated hemoglobin (HbA1c), which has a strong predictive value for complications associated with diabetes...
May 29, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28544548/assessment-of-factors-determining-an-hba1c-concentration%C3%A2-%C3%A2-%C3%A2-7-5-in-patients-with-type-1-diabetes
#7
Eijiro Yamada, Shuichi Okada, Yasuyo Nakajima, Claire Bastie, Yuko Tagaya, Aya Osaki, Yoko Shimoda, Ryo Shibusawa, Tsugumichi Saito, Atsushi Ozawa, Masanobu Yamada
BACKGROUND: Establishing an optimal insulin regimen is crucial for maintaining glycemic control in patients with type 1 diabetes. We aimed to determine the insulin dose required to achieve a hemoglobin A1c (HbA1c) concentration ≤ 7.5% in Japanese patients with type 1 diabetes. METHODS: This multi-centered cross-sectional study was performed at 3 institutions in Japan. Among 107 patients with type 1 diabetes, 92 had no detectable endogenous insulin secretion: 39 patients had HbA1c concentration ≤ 7...
May 22, 2017: Journal of Diabetes
https://www.readbyqxmd.com/read/28537449/understanding-how-pharmacokinetic-and-pharmacodynamic-differences-of-basal-analog-insulins-influence-clinical-practice
#8
Jennifer Goldman, Christoph Kapitza, Jeremy Pettus, Tim Heise
This article reviews pharmacokinetic (PK) and pharmacodynamic (PD) concepts relating to the pharmacology of basal insulin analogs. Understanding the pharmacology of currently available long-acting basal insulins and the techniques used to assess PK and PD parameters (e.g. the euglycemic clamp method) is important when considering the efficacy and safety of these agents, and can help in understanding the rationale for specific dosing strategies when tailoring therapy for a specific patient. Basal insulins such as insulin glargine 100 units (U)/mL and insulin detemir show improved PK/PD characteristics compared with the intermediate-acting NPH insulin, with a longer duration of action, a more consistent glucose-lowering effect and less prominent concentration peaks...
May 24, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28505544/real-life-experience-of-patients-starting-insulin-degludec-a-multicenter-analysis-of-1064-subjects-from-the-german-austrian-dpv-registry
#9
Barbara Bohn, Artur Zimmermann, Christian Wagner, Sigrun Merger, Desirée Dunstheimer, Florian Kopp, Katja Gollisch, Volker Zindel, Reinhard W Holl
BACKGROUND: The long-acting insulin analogue degludec is a therapeutic option for patients with type 1 (T1D) or type 2 diabetes (T2D). Aim of this analysis was to investigate differences in clinical characteristics of patients before and after initiating degludec use in a cohort of German/Austrian patients. METHODS: 1064 subjects with T1D/T2D and documented degludec use from the Diabetes-Patient-Follow-Up (DPV) registry were included. The follow-up cohort (n=421) comprised patients with available data before and 3-15months after switching to degludec...
July 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28494126/real-life-glycemic-control-in-patients-with-type-2-diabetes-treated-with-insulin-therapy-a-prospective-longitudinal-cohort-study-diabetes-distress-and-care-registry-at-tenri-ddcrt-9
#10
Naotaka Fujita, Yosuke Yamamoto, Yasuaki Hayashino, Hirohito Kuwata, Shintaro Okamura, Tadao Iburi, Miyuki Furuya, Masako Kitatani, Shin Yamazaki, Hitoshi Ishii, Satoru Tsujii, Nobuya Inagaki, Shunichi Fukuhara
AIMS/INTRODUCTION: We investigated the association between four insulin regimens and increase in HbA1c and insulin dose in a real-life clinical setting because there is no data about them among insulin regimens. MATERIALS AND METHODS: Subjects included 757 patients with type 2 diabetes having been treated with insulin therapy for more than 1 year. The four insulin regimens were regimen 1 (long-acting insulin, once daily), regimen 2 (biphasic insulin, twice daily), regimen 3 (biphasic insulin, three times daily), and regimen 4 (basal-bolus therapy)...
May 11, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28466661/dose-unit-establishment-for-a-new-basal-insulin-using-joint-modeling-of-insulin-dose-and-glycemic-response
#11
Yongming Qu, Junxiang Luo, Parag Garhyan, Caryl J Antalis, Annette M Chang, Scott J Jacober
BACKGROUND: For new insulin analogs with properties that vary from human insulin, defining activity in units of human insulin based on glycemic lowering efficacy may be challenging. Here we present a new method that can be used to quantify a unit dose of an experimental insulin when the traditional euglycemic clamp method is not adequate. METHODS: Joint modeling of insulin dose and the glycemic outcome variable hemoglobin A1c (HbA1c), where both were response variables, was used to evaluate insulin unit potency for basal insulin peglispro (BIL)...
May 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28465791/insulin-mimetic-compound-hexaquis-benzylammonium-decavanadate-is-antilipolytic-in-human-fat-cells
#12
Christian Carpéné, Silvia Garcia-Vicente, Marta Serrano, Luc Marti, Chloé Belles, Miriam Royo, Jean Galitzky, Antonio Zorzano, Xavier Testar
AIM: To assess in rodent and human adipocytes the antilipolytic capacity of hexaquis(benzylammonium) decavanadate (B6V10), previously shown to exert antidiabetic effects in rodent models, such as lowering free fatty acids (FFA) and glucose circulating levels. METHODS: Adipose tissue (AT) samples were obtained after informed consent from overweight women undergoing plastic surgery. Comparison of the effects of B6V10 and reference antilipolytic agents (insulin, benzylamine, vanadate) on the lipolytic activity was performed on adipocytes freshly isolated from rat, mouse and human AT...
April 15, 2017: World Journal of Diabetes
https://www.readbyqxmd.com/read/28465607/methods-for-quantifying-adipose-tissue-insulin-resistance-in-overweight-obese-humans
#13
K W Ter Horst, K A van Galen, P W Gilijamse, A V Hartstra, P F de Groot, F M van der Valk, M T Ackermans, M Nieuwdorp, J A Romijn, M J Serlie
BACKGROUND/OBJECTIVES: Insulin resistance of adipose tissue is an important feature of obesity-related metabolic disease. However, assessment of lipolysis in humans requires labor-intensive and expensive methods, and there is limited validation of simplified measurement methods. We aimed to validate simplified methods for the quantification of adipose tissue insulin resistance against the assessment of insulin sensitivity of lipolysis suppression during hyperinsulinemic-euglycemic clamp studies...
May 3, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28457028/consensus-on-insulin-dose-and-titration-algorithms-in-ambulatory-care-of-type-2-diabetes-in-india
#14
Rajiv Kovil, Manoj Chawla, Rajesh Rajput, A K Singh, Binayak Sinha, Samit Ghosal, Piya Ballani, Sunil Gupta, Snehal Tanna, S M Bandukwala, Tejas Shah, Vijay Negalur, Anil Bhoraskar, S R Aravind, Abdul H Zargar, Jothydev Kesavadev, Ashok Kumar Das
INSTRUCTION: Insulin is the oldest of the currently available treatment options in Type 2 diabetes mellitus (T2DM) and is considered as the most effective glucose lowering agent. Despite this, decision on starting insulin therapy is often delayed in India as well as worldwide due to various barriers at both patient and physician levels. Appropriate insulin dosing and titration is also critical to the successful achievement of tight glycaemic control. OBJECTIVE: To provide simple and easily implementable guidelines to primary care physicians on appropriate insulin dosing and titration of various insulin regimens for both initiation and intensification...
February 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28442823/insulin-degludec-200-units-ml-is-associated-with-lower-injection-frequency-and-improved-patient-reported-outcomes-compared-with-insulin-glargine-100-units-ml-in-patients-with-type-2-diabetes-requiring-high-dose-insulin
#15
Mark L Warren, Louis B Chaykin, Serge Jabbour, Mae Sheikh-Ali, Charlotte T Hansen, Thor S S Nielsen, Paul Norwood
IN BRIEF Many patients with type 2 diabetes require high basal insulin doses, necessitating multiple injections, increasing patient burden, and resulting in reduced treatment adherence. This randomized, controlled, crossover trial compared the efficacy, safety, and patient-reported outcomes for a concentrated formulation of insulin degludec (200 units/mL) to those of insulin glargine in patients requiring high doses of basal insulin. By offering equivalent glycemic control while reducing the rate of confirmed hypoglycemia and the number of injections required for administration, insulin degludec 200 units/mL may be preferred by patients with type 2 diabetes who require high basal insulin doses...
April 2017: Clinical Diabetes: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/28440768/clinical-and-metabolic-profile-of-patients-with-latent-autoimmune-diabetes-in-adults-in-specialized-care-in-madrid
#16
Alfonso Arranz Martín, Edurne Lecumberri Pascual, Miguel Ángel Brito Sanfiel, Víctor Andía Melero, Lia Nattero Chavez, Iván Sánchez López, Gloria Cánovas Molina, Francisco Arrieta Blanco, Noemí González Perez Del Villar
OBJECTIVE: To report the clinical characteristics of patients with latent autoimmune diabetes in adults (LADA), and to ascertain their metabolic control and associated chronic complications. METHODS: Patients with DM attending specialized medical care in Madrid who met the following criteria: age at diagnosis of DM >30years, initial insulin independence for at least 6months and positive GAD antibodies were enrolled. Clinical profiles, data on LADA diagnosis, associated autoimmunity, C-peptide levels, therapeutic regimen, metabolic control, and presence of chronic complications were analyzed...
January 2017: Endocrinol Diabetes Nutr
https://www.readbyqxmd.com/read/28438827/implementing-a-pharmacist-consultation-model-for-multimodal-insulin-therapy
#17
Angela Hodges, James Hall, Esther Castellanos, Edward Laue, Tammy Ellis, LaDonna Oelschlaeger
PURPOSE: The implementation of pharmacist-managed insulin dosing for selected hospitalized patients under a multimodal insulin protocol (MMIP) is described. SUMMARY: Hyperglycemia has been linked to increased thrombosis, decreased wound healing, and decreased immune response. Current recommendations support the use of multimodal (basal-bolus) insulin therapy in noncritically ill inpatients. As part of a systemwide quality-improvement initiative to improve glycemic management, the pharmacy department of a community hospital initiated a service to provide protocol-directed insulin dosing for selected patients under a pharmacist consultation model...
May 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28436541/pdx1-mody-and-dorsal-pancreatic-agenesis-new-phenotype-of-a-rare-disease
#18
L A Caetano, L S Santana, A D Costa-Riquetto, A M Lerario, M Nery, G F Nogueira, C D Ortega, M S Rocha, Aal Jorge, M G Teles
Maturity-Onset Diabetes of the Young (MODY) type 4 or PDX1-MODY is a rare form of monogenic diabetes caused by heterozygous variants in PDX1. Pancreatic developmental anomalies related to PDX1 are reported only in neonatal diabetes cases. Here, we describe dorsal pancreatic agenesis in two patients with PDX1-MODY. The proband presented with diabetes since 14 years of age and maintained regular glycemic control with low doses of basal insulin and detectable C-peptide levels after 30 years with diabetes. A diagnosis of MODY was suspected...
April 24, 2017: Clinical Genetics
https://www.readbyqxmd.com/read/28421968/chronic-toxicology-studies-of-basal-insulin-peglispro-in-rats-and-dogs-a-novel-pegylated-insulin-lispro-analog-with-a-prolonged-duration-of-action
#19
Richard A Byrd, Jamie L Blackbourne, Mary Pat Knadler, Albert E Schultze, John L Vahle
Basal insulin peglispro (BIL) consists of insulin lispro with a 20-kDa polyethylene glycol (PEG) moiety covalently attached to lysine B28. Because chronic parenteral administration of PEGylated proteins to animals has sometimes resulted in PEG vacuolation of tissue macrophages, renal tubular cells, and choroid plexus ependymal cells, we investigated whether chronic subcutaneous (sc) injection of BIL in rats (52 weeks) and dogs (39 weeks) was associated with systemic toxicities or other changes, including vacuolation of tissue macrophages, renal tubular cells, and ependymal cells...
April 2017: Toxicologic Pathology
https://www.readbyqxmd.com/read/28420259/seasonality-of-insulin-use-in-german-outpatients-with-diabetes-a-retrospective-analysis
#20
Karel Kostev, Sarah Gläser, Louis Jacob
BACKGROUND: Seasonality in insulin sensitivity has been the focus of controversial literature in the past decades. The aim of this study was to analyze seasonality of insulin use in patients with diabetes who were followed in German general practices. METHODS: This study included patients affected by type 1 (T1DM) or type 2 diabetes mellitus (T2DM) who received intensified conventional insulin therapy over a period of at least 12 months between 2013 and 2015. The main outcome was the median insulin dose per day (calculated daily insulin doses, CDDs) between June and August (summer) and between December and February (winter)...
April 1, 2017: Journal of Diabetes Science and Technology
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