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Type 2 diabetes and basal insulin

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https://www.readbyqxmd.com/read/27913984/basal-insulin-persistence-associated-factors-and-outcomes-after-treatment-initiation-a-retrospective-database-study-among-people-with-type-2-diabetes-mellitus-in-japan
#1
Irene Hadjiyianni, Urvi Desai, Shuichi Suzuki, Jasmina I Ivanova, Dachuang Cao, Noam Y Kirson, Dai Chida, Caroline Enloe, Howard G Birnbaum, Magaly Perez-Nieves
INTRODUCTION: The objective of this study was to assess basal insulin persistence, associated factors, and economic outcomes for insulin-naïve people with type 2 diabetes mellitus (T2DM) in Japan. METHODS: People aged at least 18 years with T2DM with first claim for basal insulin between May 2006 and April 2013 (index date), no insulin use before index date, and continuous insurance coverage for 6 months before (baseline) and 12 months after index date were selected from the Japan Medical Center Database...
December 2, 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/27913575/lowest-glucose-variability-and-hypoglycemia-are-observed-with-the-combination-of-a-glp-1-receptor-agonist-and-basal-insulin-variation-study
#2
Harpreet S Bajaj, Karri Venn, Chenglin Ye, Avril Patrick, Shivani Kalra, Hasnain Khandwala, Nadeem Aslam, David Twum-Barima, Ronnie Aronson
OBJECTIVE: There is a dearth of published literature comparing glucose variability (GV) between different insulin regimens in type 2 diabetes. This cohort study compares GV using continuous glucose monitoring (CGM) in patients with well-controlled type 2 diabetes using four common insulin regimens: basal insulin + oral drugs (BO), basal insulin + glucagon-like peptide 1 receptor agonist (GLP-1 RA) (BGLP), premixed insulin (PM), and basal-bolus insulin (BB). RESEARCH DESIGN AND METHODS: Consecutive patients from three endocrinology clinics who met study criteria-type 2 diabetes, age 18 to 80 years, BMI ≤ 45 kg/m(2), stable insulin regimen for a minimum of 6 months, and stable A1C value ≤7...
December 2, 2016: Diabetes Care
https://www.readbyqxmd.com/read/27909699/aav-mediated-sirt1-overexpression-in-skeletal-muscle-activates-oxidative-capacity-but-does-not-prevent-insulin-resistance
#3
Laia Vilà, Carles Roca, Ivet Elias, Alba Casellas, Ricardo Lage, Sylvie Franckhauser, Fatima Bosch
Type 2 diabetes is characterized by triglyceride accumulation and reduced lipid oxidation capacity in skeletal muscle. SIRT1 is a key protein in the regulation of lipid oxidation and its expression is reduced in the skeletal muscle of insulin resistant mice. In this tissue, Sirt1 up-regulates the expression of genes involved in oxidative metabolism and improves mitochondrial function mainly through PPARGC1 deacetylation. Here we examined whether Sirt1 overexpression mediated by adeno-associated viral vectors of serotype 1 (AAV1) specifically in skeletal muscle can counteract the development of insulin resistance induced by a high fat diet in mice...
2016: Molecular Therapy. Methods & Clinical Development
https://www.readbyqxmd.com/read/27896568/how-can-a-good-idea-fail-basal-insulin-peglispro-ly2605541-for-the-treatment-of-type-2-diabetes
#4
REVIEW
Araceli Muñoz-Garach, María Molina-Vega, Francisco J Tinahones
INTRODUCTION: Lack of control in diabetic patients has stimulated the development of new insulin analogues. One of these was basal insulin peglispro (BIL) or LY2605541; it had a large hydrodynamic size, flat pharmacokinetic profile, half life of 2-3 days and acted preferably in the liver. METHODS: We reviewed the recent literature examining the pharmacokinetics, pharmacodynamics, efficacy and safety of BIL treatment in type 2 diabetes patients. RESULTS: The pharmacodynamic and pharmacokinetic outline of BIL seemed to have an advantage over neutral protamine Hagedorn and glargine insulins...
November 28, 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/27888561/novel-hepato-preferential-basal-insulin-peglispro-bil-does-not-differentially-affect-insulin-sensitivity-compared-with-insulin-glargine-in-patients-with-type-1-and-type-2-diabetes
#5
Niels Porksen, Helle Linnebjerg, Parag Garhyan, Eric Chen Quin Lam, Mary Pat Knadler, Scott J Jacober, Ulrike Hoevelmann, Leona Plum-Moerschel, Elaine Watkins, Amalia Gastaldelli, Tim Heise
AIMS: Basal insulin peglispro (BIL) is a novel PEGylated basal insulin with a flat pharmacokinetic and glucodynamic profile and reduced peripheral effects, which results in a hepato-preferential action. In Phase 3 trials, patients with T1DM treated with BIL had lower prandial insulin requirements, yet improved prandial glucose control, relative to insulin glargine (GL). We hypothesized that this may be due to an enhanced sensitivity to prandial insulin with BIL resulting from lower chronic peripheral insulin action...
November 26, 2016: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/27875915/efficacy-and-safety-of-insulin-glp-1-receptor-agonists-combination-in-type-2-diabetes-mellitus-a-systematic-review
#6
D Cimmaruta, M I Maiorino, C Scavone, L Sportiello, F Rossi, D Giugliano, K Esposito, A Capuano
Attaining optimal glycemic targets in patients with type 2 diabetes is often hard and compromised by the shortcomings of the several treatments. Areas covered: When glycemic levels are not adequately controlled, an association of GLP-1 receptor agonists and insulin therapy can be adopted. In order to assess the benefit/risk profile of this combination therapy, a literature search of randomized clinical trials was performed.Eighteen trials matched the inclusion criteria. In 10 studies, GLP-1 receptor agonists were added on to an existing regimen, whereas insulin added to an existing GLP-1 receptor agonists regimen occurred in 2 studies...
December 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27871838/chronic-insulin-infusion-induces-reversible-glucose-intolerance-in-lean-rats-yet-ameliorates-glucose-intolerance-in-obese-rats
#7
Shereen M Hamza, Miranda M Sung, Fei Gao, Carrie-Lynn Soltys, Nancy P Smith, Patrick E MacDonald, Peter E Light, Jason R B Dyck
: Background Although insulin resistance (IR) is a key factor in the pathogenesis of type 2 diabetes (T2D), the precise role of insulin in the development of IR remains unclear. Therefore, we investigated whether chronic basal insulin infusion is causative in the development of glucose intolerance. Methods Normoglycemic lean rats surgically instrumented with i.v. catheters were infused with insulin (3mU/kg/min) or physiological saline for 6weeks. At infusion-end, plasma insulin levels along with glucose tolerance were assessed Results 6weeks of insulin infusion induced glucose intolerance and impaired insulin response in healthy rats...
November 18, 2016: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/27871780/type-2-diabetes-hypoglycemia-and-basal-insulins-ongoing-challenges
#8
REVIEW
Ian Blumer, Maureen Clement
Hypoglycemia in people with insulin-treated type 2 diabetes can be a limiting factor for management and a barrier to optimizing glycemic control. Even mild episodes of hypoglycemia can affect an individual's quality of life, and fear of hypoglycemia can lead to underinsulinization. This article explores the prevalence and consequences of hypoglycemia in people with type 2 diabetes with a focus on those who use basal insulins, offering strategies for prevention and management. It also discusses the benefits and challenges associated with new basal insulins, and their potential role in reducing hypoglycemia risk...
November 18, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27863088/the-relationship-of-hba1c-fasting-and-postprandial-hyperglycemia-in-subjects-with-type-2-diabetes-mellitus-in-malaysia
#9
Lee Ling Lim, Alan Jm Brnabic, Siew Pheng Chan, Luqman Ibrahim, Sharmila Sunita Paramasivam, Jeyakantha Ratnasingam, Shireene Ratna Vethakkan, Alexander Tong Boon Tan
AIMS/INTRODUCTION: Studies on the relative contributions of fasting and postprandial hyperglycemia (FH and PPH) to HbA1c in type 2 diabetes (T2D) subjects have yielded inconsistent results. We aimed to assess the relationship by using continuous glucose monitoring (CGM) in a multi-ethnic cohort. MATERIALS AND METHODS: 100 T2D adults were assessed with 6-day CGM and HbA1c . Area under the curve (AUC) ≥5.6 mmol/L was defined as AUCTOTAL . AUC ≥ each pre-prandial glucose for 4 hours was defined as AUCPPH ...
November 14, 2016: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/27862873/the-sustained-influence-of-metformin-therapy-on-circulating-glp-1-levels-in-individuals-with-and-without-type-2-diabetes
#10
David Preiss, Adem Dawed, Paul Welsh, Alison Heggie, Angus G Jones, Jacqueline Dekker, Robert Koivula, Tue H Hansen, Ms Caitlin Stewart, Rury R Holman, Paul W Franks, Mark Walker, Ewan R Pearson, Naveed Sattar
AIMS: Small, short studies suggest metformin influences the glucagon-like peptide (GLP)-1 axis in individuals with and without type 2 diabetes (T2DM). In the Carotid Atherosclerosis: Metformin for insulin ResistAnce (CAMERA) trial (NCT00723307) we investigated whether this effect is sustained and related to changes in glycaemia or weight. In the cross-sectional DIabetes REsearCh on patient straTification (DIRECT) study, we investigated basal and post-meal GLP-1 levels in diabetic patients...
November 13, 2016: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/27860499/premixed-insulin-analogue-compared-with-basal-plus-regimen-for-inpatient-glycemic-control
#11
Abraham Edgar Gracia-Ramos, María Del Pilar Cruz-Domínguez, Eduardo Osiris Madrigal-Santillán, José Antonio Morales-González, Eduardo Madrigal-Bujaidar, José Leopoldo Aguilar-Faisal
BACKGROUND: No previous studies have investigated the use of a premixed insulin analogue in a hospital setting. OBJECTIVE: To compare the efficacy and safety of treatment with premixed insulin analogue (insulin lispro mix 75/25, LM75/25) with the basal-plus regimen with insulin glargine in hospitalized patients with type 2 diabetes (T2D). MATERIALS AND METHODS: A randomized clinical trial in hospitalized patients with T2D and glucose >140 mg/dL on admission was performed...
November 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27860496/predicting-insulin-treatment-scenarios-with-the-net-effect-method-domain-of-validity
#12
Martina Vettoretti, Andrea Facchinetti, Giovanni Sparacino, Claudio Cobelli
BACKGROUND: A simulation methodology based on the net effect, a signal estimated from continuous glucose monitoring (CGM) and insulin data accounting for sources of glucose variability, for example, meals and exercise, has been proposed. This method has been recently used to "replay" real-life treatment scenarios and determine the minimal level of CGM sensor accuracy required for nonadjunctive use. Given the potential of the net effect method, it is important to assess its domain of validity...
November 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27853981/intensification-of-idegasp-twice-daily-adding-insulin-aspart-vs-switching-to-basal-bolus-exploratory-randomized-trial-in-type-2-diabetes
#13
Wan Mohamaed Wan Bebakar, Louis Chaykin, Malene Lundgren Hersløv, Søren Rasmussen
INTRODUCTION: In a preceding trial comparing two different titration schemes, insulin degludec/insulin aspart (IDegAsp) showed good efficacy for achieving HbA1c <7% when administered twice daily (BID) in patients with uncontrolled type 2 diabetes (T2D). However, poor glycemic control persisted in a minority of patients. The current exploratory trial investigated the efficacy and safety of intensifying IDegAsp BID treatment in these patients by either adding a once-daily (OD) bolus injection of insulin aspart (IAsp) or by switching to a basal-bolus regimen of insulin degludec (IDeg) plus IAsp taken three times a day (TID)...
November 16, 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/27845180/methodological-challenges-and-time-to-event-techniques-in-register-based-health-services-research
#14
Tobias Bluhmki, Peter Bramlage, Michael Volk, Matthias Kaltheuner, Thomas Danne, Wolfgang Rathmann, Jan Beyersmann
OBJECTIVE: Complex longitudinal sampling and the observational structure of patient registers in health services research are associated with methodological challenges regarding data management and statistical evaluation. We exemplify common pitfalls and want to stimulate discussions on the design, development, and deployment of future longitudinal patient registers and register-based studies. STUDY DESIGN AND SETTING: For illustrative purposes, we employ data from the prospective, observational, German DIabetes Versorgungs-Evaluation (DIVE) register...
November 11, 2016: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/27810995/a-mobile-computerized-decision-support-system-to-prevent-hypoglycemia-in-hospitalized-patients-with-type-2-diabetes-mellitus-lessons-learned-from-a-clinical-feasibility-study
#15
Stephan Spat, Klaus Donsa, Peter Beck, Bernhard Höll, Julia K Mader, Lukas Schaupp, Thomas Augustin, Franco Chiarugi, Katharina M Lichtenegger, Johannes Plank, Thomas R Pieber
BACKGROUND: Diabetes management requires complex and interdisciplinary cooperation of health care professionals (HCPs). To support this complex process, IT-support is recommended by clinical guidelines. The aim of this article is to report on results from a clinical feasibility study testing the prototype of a mobile, tablet-based client-server system for computerized decision and workflow support (GlucoTab®) and to discuss its impact on hypoglycemia prevention. METHODS: The system was tested in a monocentric, open, noncontrolled intervention study in 30 patients with type 2 diabetes mellitus (T2DM)...
November 2, 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/27810685/attitudes-towards-insulin-initiation-in-type-2-diabetes-patients-among-healthcare-providers-a-survey-research
#16
Javier Escalada, Domingo Orozco-Beltran, Carlos Morillas, Fernando Alvarez-Guisasola, Fernando Gomez-Peralta, Manel Mata-Cases, Rafael Palomares, Rosario Iglesias, Concepción Carratalá-Munuera
AIMS: To describe the views of healthcare providers about starting insulin in patients with type 2 diabetes and to determine the specific factors that contribute to delay insulin initiation. METHODS: Two-phases observational descriptive study. In the quantitative phase we conducted a cross-sectional survey of a sample of 380 healthcare professionals (general practitioners (GPs), endocrinologists, internists and nurses). In the qualitative phase, a discussion group reviewed the results of the survey to propose solutions...
October 14, 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/27807935/type-2-diabetes-in-a-5-year-old-and-single-center-experience-of-type-2-diabetes-in-youth-under-10
#17
Jessica Hutchins, Rose Ann Barajas, Daniel Hale, Elia Escaname, Jane Lynch
The worrisome rise in pediatric type 2 diabetes (T2DM) is most prevalent among minority ethnic/racial populations. Typically, T2DM occurs during puberty in high risk obese adolescents with evidence of insulin resistance. Screening for T2DM in obese youth can be a daunting task for pediatricians and differentiating between pediatric T1DM and T2DM in obese youth can be challenging for pediatric endocrinologists. There is very limited data regarding the prevalence of T2DM among youth < 10 years of age...
November 3, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27801414/-incretin-secretion-and-glucose-metabolism-in-morbidly-obese-patients-in-the-early-and-late-periods-after-biliopancreatic-diversion
#18
I I Dedov, G A Mel'nichenko, E A Troshina, E V Ershova, N V Mazurina, N A Ogneva, Yu I Yashkov, A V Il'in
AIM: To estimate the parameters of glucose metabolism and to assess the secretion of incretins in patients after biliopancreatic diversion (BPD) for morbid obesity (MO) in the early and late postoperative periods. SUBJECTS AND METHODS: The prospective part of the investigation included 22 patients with a body mass index of 35.8 to 68.4 kg/m2 and type 2 diabetes mellitus (T2DM). All the patients were examined before, 3 weeks and 3 months after BPD. The retrospective part covered 23 patients who were examined after BPD for MO; the postoperative period was 4...
2016: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/27799746/insulin-glargine-300-u-ml-in-the-management-of-diabetes-clinical-utility-and-patient-perspectives
#19
REVIEW
Bastiaan E de Galan
There is ongoing interest in optimizing basal insulin treatment by developing insulins with a flat pharmacological profile, a long duration of action (typically beyond 24 hours) and minimum day-to-day variation. Glargine-300 is a modified form of the long-acting insulin analog glargine in that it has been concentrated at 300 units/mL rather than the conventional 100 units/mL. Glargine-300 has a longer duration of action and a flatter pharmacological profile than original glargine-100. This property allows for more flexibility around the timing of administration, when injected once per day...
2016: Patient Preference and Adherence
https://www.readbyqxmd.com/read/27796906/basal-bolus-therapy-in-patients-with-type-2-diabetes-mellitus-in-the-uk-patient-characteristics-treatment-patterns-and-the-effect-of-switching-to-premixed-insulin
#20
Kate van Brunt, Bradley Curtis, Tibor Ivanyi, Elemer Balogh, Corina Chalkiadaki, Sharon MacLachlan, David Neasham, Mireia Raluy-Callado
INTRODUCTION: Increasing emphasis is being placed on insulin use among patients with type 2 diabetes mellitus (T2DM). Basal-bolus (BB) therapy is regarded as the gold standard, but a high frequency of injections and the general complexity of this therapy are seen as barriers in real-world practice. Here we describe the characteristics and treatment patterns of patients with T2DM receiving BB in the UK, with specific focus on those switching to a simplified regimen of premixed insulin...
October 31, 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
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