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Type 2 diabetes and basal insulin

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https://www.readbyqxmd.com/read/28529547/basal-hyperinsulinemia-beyond-a-threshold-predicts-major-adverse-cardiac-events-at-1-year-after-coronary-angiogram-in-type-2-diabetes-mellitus-a-retrospective-cohort-study
#1
Mukund Srinivasan, Padmanabh Kamath, Narayan Bhat, Narasimha Pai, Rajesh Bhat, Tejas Shah, Poornima Manjrekar, Chakrapani Mahabala
BACKGROUND: There is a substantial reduction in cardiovascular related morbidity and mortality in the general population attributed to improved treatment of cardiac risk factors and disease, the same magnitude of benefit has not been observed in those with diabetes mellitus. The aim of the present study was to evaluate factors associated with the cardiac outcome at 1 year after coronary angiogram in patients with type 2 diabetes mellitus and to compare the outcomes with nondiabetics. METHODS: A retrospective cohort study was carried out in subjects who underwent coronary angiogram for an evaluation of CAD, with follow-up data available for period of 12 months...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28523483/modeling-the-long-term-cost-effectiveness-of-ideglira-in-patients-with-type-2-diabetes-who-are-failing-to-meet-glycemic-targets-on-basal-insulin-alone-in-the-netherlands
#2
Barnaby Hunt, Divina Glah, Maarten van der Vliet
INTRODUCTION: Insulin degludec/liraglutide (IDegLira) is the first basal insulin and glucagon-like peptide-1 receptor agonist (GLP-1 RA) in a single pen injection device, and a once-daily treatment option for patients with type 2 diabetes mellitus (T2DM) who are uncontrolled on basal insulin and require treatment intensification. The objective of this analysis was to evaluate the long-term cost-effectiveness of IDegLira versus basal-bolus therapy (insulin glargine U100 + 3× daily insulin aspart) for patients with T2DM uncontrolled on basal insulin [HbA1c >53 mmol/mol (>7%)] in the Netherlands...
May 18, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
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
#3
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...
May 4, 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
#4
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/28483786/faster-aspart-versus-insulin-aspart-as-part-of-a-basal-bolus-regimen-in-inadequately-controlled-type-2-diabetes-the-onset-2-trial
#5
Keith Bowering, Christopher Case, John Harvey, Michael Reeves, Michael Sampson, Robert Strzinek, Ditte-Marie Bretler, Rikke Beck Bang, Bruce W Bode
OBJECTIVE: This multicenter, double-blind, treat-to-target, phase 3 trial evaluated the efficacy and safety of fast-acting insulin aspart (faster aspart) versus insulin aspart (IAsp) in adults with type 2 diabetes receiving basal insulin and oral antidiabetic agents. RESEARCH DESIGN AND METHODS: The primary end point was HbA1c change from baseline after 26 weeks' treatment. After an 8-week run-in to optimize basal insulin, subjects were randomized (1:1) to mealtime faster aspart (n = 345) or IAsp (n = 344), titrated using a simple daily patient-driven algorithm, plus insulin glargine U100 and metformin...
May 8, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28480415/anti-diabetic-effects-of-zhuoduqing-formula-a-chinese-herbal-decoction-on-a-rat-model-of-type-2-diabetes
#6
Xiao-Tao Feng, Shu-Yan Tang, Yun-Xia Jiang, Wei Zhao
BACKGROUND: Zhuoduqing formula (ZDQ) is a Chinese herbal decoction and used to treat type 2 diabetes in clinical practice, but the potential evidence needs to be provided. MATERIALS AND METHODS: Type 2 diabetic model rats were induced by feeding high fat diet (HFD) and intraperitoneal injection of streptozotocin (STZ). The model rats were given ZDQ for 4 weeks. Insulin sensitivity was evaluated by homeostasis model assessment of basal insulin resistance (HOMA-IR) and intraperitoneal glucose tolerance test (IPGTT)...
2017: African Journal of Traditional, Complementary, and Alternative Medicines: AJTCAM
https://www.readbyqxmd.com/read/28477414/do-glycoalbumin-levels-preferentially-reflect-changes-in-postprandial-glucose-excursions
#7
S K Paul, R R Holman
AIMS: To evaluate whether plasma glycated albumin, which provides an integrated measure of plasma glucose levels over the preceding 2-4 weeks, better reflects changes in postprandial glucose excursions than HbA1c . METHODS: People with suboptimum glycaemic control on dual oral therapy were enrolled in the Treating-to-Target-in-Type 2 diabetes (4-T) trial, in which participants were randomized to the addition of once-daily basal insulin, twice-daily biphasic insulin or thrice-daily prandial insulin...
May 6, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28466661/dose-unit-establishment-for-a-new-basal-insulin-using-joint-modeling-of-insulin-dose-and-glycemic-response
#8
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/28458515/united-states-experience-of-insulin-degludec-alone-or-in-combination-for-type-1-and-type-2-diabetes
#9
REVIEW
Marc Rendell
Insulin degludec has been the product of a sophisticated and systematic biochemical engineering program which began with the release of insulin detemir. The goal was to produce a long-lasting basal insulin with low individual variability. Certainly, this goal has been achieved. Degludec has a duration of action approaching twice that of glargine. Another advantage of degludec is in its lack of unpredictable copolymerization of added aspart. In several studies, degludec has shown lower rates of nocturnal hypoglycemia than glargine...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28457028/consensus-on-insulin-dose-and-titration-algorithms-in-ambulatory-care-of-type-2-diabetes-in-india
#10
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/28453877/asymmetric-changes-in-circulating-insulin-levels-after-an-increase-compared-with-a-reduction-in-insulin-pump-basal-rate-in-people-with-type-1-diabetes
#11
S A McAuley, G M Ward, J C Horsburgh, J L Gooley, A J Jenkins, R J MacIsaac, D N O'Neal
AIMS: To investigate circulating insulin profiles after a clinically relevant insulin pump basal rate increase vs a reduction, and the associated glucose responses. METHODS: A cohort of 12 adults with Type 1 diabetes undertook this two-stage university hospital study using Accu-Chek pumps (Roche Diagnostics, Mannheim, Germany) and insulin aspart. An insulin basal rate change of 0.2 unit/h (increase in first stage, reduction in second stage) was implemented at ~09:30 h, after a single overnight basal rate (without bolus insulin), while fasting participants rested...
April 28, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
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
#12
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/28433618/evidence-based-recommendations-for-insulin-intensification-strategies-after-basal-insulin-in-type-2-diabetes
#13
Sujoy Ghosh, A G Unnikrishnan, Banshi Saboo, Jothydev Kesavadev, S R Aravind, Sarita Bajaj, Rajesh Rajput, Krishna Seshadri, Narsingh Verma, Arvind Gupta, Brij Mohan Makkar, Mihir Saikia, Shailaja Kale, Suresh Damodaran, Ashish Dengra, T K M Eashwar, Anuj Maheshwari, Sharad Pendsey, Sanjeev R Phatak, Surendra Kumar Sharma, Surya Kumar Singh, A Ramachandran, Abdul H Zargar, Shashank R Joshi, Shaukat M Sadikot
Over the time due to progressive nature of diabetes, proactive intensification of the existing insulin therapy becomes imminent as it minimizes patients' exposure to chronic hypo/hyperglycaemia and reduces weight gain while achieving individualized glycaemic targets. This review focuses on the strength of evidence behind various options for intensification, primarily the insulins as also the GLP-1 analogues. The recommendations presented here are meant to serve as a guide for the physician managing type 2 diabetes patients requiring insulin intensification upon failing of basal insulin therapy...
April 5, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28433560/glycaemic-control-and-hypoglycaemia-with-insulin-glargine-300-u-ml-compared-with-glargine-100-u-ml-in-japanese-adults-with-type-2-diabetes-using-basal-insulin-plus-oral-anti-hyperglycaemic-drugs-edition-jp-2-randomised-12-month-trial-including-6-month-extension
#14
Y Terauchi, M Koyama, X Cheng, M Sumi, M C Riddle, G B Bolli, T Hirose
AIMS: To compare insulin glargine 300 U/mL (Gla-300) with glargine 100 U/mL (Gla-100) in Japanese adults with uncontrolled type 2 diabetes on basal insulin and oral anti-hyperglycaemic drugs over 12 months. METHODS: EDITION JP 2 was a randomised, open-label, phase 3 study. Following a 6-month treatment period, participants continued receiving previously assigned once daily Gla-300 or Gla-100, plus oral anti-hyperglycaemic drugs, in a 6-month extension period. Glycaemic control, hypoglycaemia and adverse events were assessed...
April 19, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28432748/future-challenges-and-therapeutic-opportunities-in-type-2-diabetes-changing-the-paradigm-of-current-therapy
#15
REVIEW
D R Owens, L Monnier, A H Barnett
Most algorithms for type 2 diabetes mellitus (T2DM) do not recommend treatment escalation until glycated haemoglobin (HbA1c) fails to reach the recommended target of 7% (53 mmol/mol) within approximately 3 months on any treatment regimen ('treat to failure'). Clinical inertia and/or poor adherence to therapy contribute to patients not reaching glycaemic targets when managed according to this paradigm. Clinical inertia exists across the entire spectrum of anti-diabetes therapies, although it is most pronounced when initiating and optimizing insulin therapy...
April 21, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28431670/use-of-glp-1-receptor-agonists-for-type-2-diabetes-treatment-intensification-after-basal-insulin-failure
#16
M Joubert, Y Reznik
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are part of the armamentarium for the treatment of type 2 diabetes (T2D), although recent guidelines have mainly recommended their use on top of oral treatments when a single or combination of two or three oral hypoglycaemic agents has failed to lower HbA1c levels below the individualized target range. In such situations, the decision to use GLP-1RAs is mostly driven by their high level of efficacy, their effect on body weight balance and their safety considerations, such as low hypoglycaemic risk...
April 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28428368/erratum-efficacy-and-safety-of-lixilan-a-titratable-fixed-ratio-combination-of-insulin-glargine-plus-lixisenatide-in-type-2-diabetes-inadequately-controlled-on-basal-insulin-and-metformin-the-lixilan-l-randomized-trial-diabetes-care-2016-39-1972-1980
#17
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
No abstract text is available yet for this article.
April 20, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28420259/seasonality-of-insulin-use-in-german-outpatients-with-diabetes-a-retrospective-analysis
#18
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
https://www.readbyqxmd.com/read/28417532/non-alcoholic-fatty-liver-disease-nafld-prevalence-and-its-metabolic-associations-in-patients-with-type-1-diabetes-and-type-2-diabetes
#19
Kenneth Cusi, Arun J Sanyal, Shuyu Zhang, Mark L Hartman, Juliana M Bue-Valleskey, Byron J Hoogwerf, Axel Haupt
We investigated non-alcoholic fatty liver disease (NAFLD) prevalence and its metabolic associations in patients with type 1 diabetes (T1D), and in insulin-naïve and insulin-treated patients with type 2 diabetes (T2D). Baseline data from patients who had liver fat content (LFC) evaluated by magnetic resonance imaging in 4 phase 3 studies of basal insulin peglispro (BIL) were analyzed. Associations of NAFLD with clinical characteristics, glycemic control and diabetes therapy were evaluated. The prevalence of NAFLD (defined as LFC ≥6%) was low in T1D (8...
April 17, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28405346/safety-and-efficacy-of-saxagliptin-for-glycemic-control-in-non-critically-ill-hospitalized-patients
#20
Rajesh Garg, Brooke Schuman, Shelley Hurwitz, Cheyenne Metzger, Shreya Bhandari
OBJECTIVE: To evaluate whether saxagliptin is non-inferior to basal-bolus insulin therapy for glycemic control in patients with controlled type 2 diabetes mellitus (T2DM) admitted to hospital with non-critical illnesses. RESEARCH DESIGN AND METHODS: This was an open-label, randomized controlled clinical trial. Patients received either saxagliptin or basal-bolus insulin, both with correctional insulin doses. The main study outcome was the mean daily blood glucose (BG) after the first day of randomization...
2017: BMJ Open Diabetes Research & Care
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