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Ultra-rapid insulin

Roberto Luís Zagury, Melanie Rodacki, Larissa Mello de Oliveira, Claudia Saunders, Patricia de Carvalho Padilha, Lenita Zajdenverg
BACKGROUND/AIMS: Carbohydrate counting (CC) is a helpful strategy for the treatment of type 1 diabetes mellitus (T1DM) and the main parameters used in this method are the insulin to carbohydrate ratio (ICR) and the sensitivity factor (SF). Throughout pregnancy, a state of insulin resistance develops. Therefore, we hypothesized that ICR and SF change and our aim was to describe the pattern of modification of these parameters in pregnant women with T1DM on CC. METHODS: This study followed 21 women with T1DM throughout pregnancy...
2017: Annals of Nutrition & Metabolism
Soichi Takeishi, Hiroki Tsuboi, Shodo Takekoshi
INTRODUCTION: We compared the effects of morning administration of insulin glulisine + insulin glargine 300 U/mL (G + G300) with that of insulin lispro + insulin glargine biosimilar (L + GB). MATERIALS AND METHODS: A total of 30 patients with type 2 diabetes who wore a continuous glucose monitoring device on admission after glucose levels were stabilized by morning long-acting and ultra-rapid-acting insulins were randomly allocated to groups who received G + G300 on days 1 and 2, and the same dose L + GB on days 3 and 4, or vice versa...
March 28, 2017: Journal of Diabetes Investigation
Sanjay Kalra, Zafar A Latif, Abdurrahman Comlekci, Guillermo Gonzalez Galvez, Rached Malik, Md Faruque Pathan, Ajay Kumar
Insulin degludec/insulin aspart (IDegAsp) is a modern coformulation of ultra-long-acting basal insulin degludec, with rapid-acting insulin aspart. IDegAsp provides effective, safe, well-tolerated glycemic control, with a low risk of hypoglycemia while allowing flexibility in meal patterns and timing of administration. This consensus statement describes a pragmatic framework to identify patients who may benefit from IDegAsp therapy. It highlights the utility of IDegAsp in type 2 diabetic patients who are insulin-naive, suboptimally controlled on basal or premixed insulin, or dissatisfied with basal-bolus regimens...
July 2016: Indian Journal of Endocrinology and Metabolism
Edyta Cichocka, Anna Wietchy, Katarzyna Nabrdalik, Janusz Gumprecht
Insulin therapy is the most effective method of lowering blood glucose. Over 100 years have passed the studies for the optimisation of insulin action. To date, subcutaneous insulin administration has been the basic route of insulin delivery. The search for insulin therapy is simultaneously conducted in the following directions: the optimisation of insulin action, automatisation, and the decrease in the invasiveness of insulin delivery methods. The optimisation of insulin action has led to the discovery of ultra-rapid-acting human insulin analogues, ultra-long-acting human insulin analogues, and biosimilar insulin...
2016: Endokrynologia Polska
Sebastián Dubó, David Gallegos, Lissette Cabrera, Luis Sobrevia, Leandro Zúñiga, Marcelo González
Impairment of insulin signaling on diabetes mellitus has been related to cardiovascular dysfunction, heart failure, and sudden death. In human endothelium, cationic amino acid transporter 1 (hCAT-1) is related to the synthesis of nitric oxide (NO) and insulin has a vascular effect in endothelial cells through a signaling pathway that involves increases in hCAT-1 expression and L-arginine transport. This mechanism is disrupted in diabetes, a phenomenon potentiated by excessive accumulation of reactive oxygen species (ROS), which contribute to lower availability of NO and endothelial dysfunction...
2016: Frontiers in Physiology
Dick B S Brashier, Anjan Khadka, Tejus Anantharamu, Ashok Kumar Sharma, A K Gupta, Sushil Sharma, N Dahiya
Diabetes is a metabolic disorder characterized by relative or absolute deficiency of insulin, resulting in hyperglycemia. The main treatment of diabetes relies on subcutaneous insulin administration by injection or continuous infusion to control glucose levels, besides oral hypoglycemic agents for type 2 diabetes. Novel routes of insulin administration are an area of research in the diabetes field as insulin injection therapy is burdensome and painful for many patients. Inhalational insulin is a potential alternative to subcutaneous insulin in the management of diabetes...
July 2015: Journal of Pharmacology & Pharmacotherapeutics
Łukasz Kaska, Monika Proczko, Piotr Wiśniewski, Marta Stankiewicz, Derek Gill, Zbigniew Śledziński
INTRODUCTION: Insulin resistance (IR), the essential step in development of type 2 diabetes mellitus (T2DM), resolves quickly after bariatric surgery, but the effectiveness depends on the type of the procedure. Although the long-term influence on IR improvement is well documented, the mechanisms of the ultra-fast response after restrictive and bypass procedures require explanation. AIM: To determine IR evolution from the initial preparative period to 6 months after the operation, exposing the rapid postoperative response while comparing the 3 bariatric methods, with the belief that the metabolic effect may be correlated with anatomical combinations...
July 2015: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Moawia M Al-Tabakha
The current review was designed to compare between the insulin inhalation systems Exubera and Afrezza and to investigate the reasons why Exubera was unsuccessful, when Afrezza maker is expecting their product to be felicitous. In January 2006, Pfizer secured FDA and EC approval for the first of its kind, regular insulin through Exubera inhaler device for the management of types 1 and 2 diabetes mellitus (DM) in adults. The product was no longer available to the market after less than two years from its approval triggering a setback for competitive new inhalable insulins that were already in various clinical development phases...
October 10, 2015: Journal of Controlled Release: Official Journal of the Controlled Release Society
T Heise, L Nosek, O Klein, H Coester, A L Svendsen, H Haahr
AIMS: To evaluate the pharmacodynamic dose-response relationship of insulin degludec/insulin aspart (IDegAsp), a novel, soluble co-formulation of the ultra-long-acting basal insulin, insulin degludec (IDeg), with the rapid-acting prandial insulin (IAsp), across different doses in patients with type 1 diabetes (T1DM). METHODS: This was a randomized, single-centre, double-blind, four-period, incomplete block, crossover trial. A cohort of 33 people with T1DM received single doses (0...
July 2015: Diabetes, Obesity & Metabolism
M G Burt, S M Drake, N R Aguilar-Loza, A Esterman, S N Stranks, G W Roberts
BACKGROUND/AIM: Few studies have specifically investigated treatment of prednisolone-induced hyperglycaemia. AIM: To determine if a basal bolus insulin (BBI) protocol for inpatient hyperglycaemia is effective in patients prescribed acute prednisolone for an inflammatory disease. METHODS: In a cross-sectional study, 66 patients with type 2 diabetes admitted to a general medical ward and treated with BBI for up to 5 days were studied. Twenty-four patients were taking prednisolone ≥10 mg/day to treat an acute inflammatory disease...
March 2015: Internal Medicine Journal
Hyuck Hoon Kwon, Ji Young Yoon, Seon Yong Park, Seonguk Min, Dae Hun Suh
BACKGROUND: Screening of natural compounds for the development of anti-acne therapeutic agents has been steadily required considering various side effects of acne medications. However, previous studies have mainly focused on experimental tests without clinical trials and histopathological analysis. OBJECTIVES: To compare the clinical efficacy, safety and histopathological changes between Lactobacillus-fermented Chamaecyparis obtusa (LFCO) and existing tea tree oil (TTO)...
2014: Dermatology: International Journal for Clinical and Investigative Dermatology
Angela Dardano, Cristina Bianchi, Stefano Del Prato, Roberto Miccoli
Glycemic control remains the major therapeutic objective to prevent or delay the onset and progression of complications related to diabetes mellitus. Insulin therapy represents a cornerstone in the treatment of diabetes and has been used widely for achieving glycemic goals. Nevertheless, a large portion of the population with diabetes does not meet the internationally agreed glycemic targets. Moreover, insulin treatment, especially if intensive, may be associated with emergency room visits and hospitalization due to hypoglycemic events...
2014: Vascular Health and Risk Management
Viral N Shah, Aaron Shoskes, Beshoy Tawfik, Satish K Garg
Intensive insulin therapy (IIT) has been shown to reduce micro- and macrovascular complications in patients with type 1 diabetes mellitus (T1DM). However, IIT is associated with a significant increase in severe hypoglycemic events, resulting in increased morbidity and mortality. Optimization of glycemic control without hypoglycemia (especially nocturnal) should be the next major goal for subjects on insulin treatment. The use of insulin pumps along with continuous glucose monitors (CGMs) has made it easier but requires significant resources and patient education...
August 2014: Diabetes Technology & Therapeutics
Sanjay Kalra, Yashdeep Gupta
Insulin analogues are a major improvement in diabetes pharmacotherapy. Rapid acting insulins have certain advantages over regular insulin, but there is a need to develop even faster acting insulin preparations, which mimic physiological insulin release in a better manner. This review discusses recent developments and patents in the field of Ultra- fast acting insulins. It classifies various approaches towards creation of an Ultra-fast acting insulin profile based upon the method used to achieve a faster onset of action...
2014: Recent Patents on Endocrine, Metabolic & Immune Drug Discovery
Tim Heise, Leszek Nosek, Carsten Roepstorff, Suresh Chenji, Oliver Klein, Hanne Haahr
INTRODUCTION/AIM: Insulin degludec/insulin aspart (IDegAsp) is a soluble co-formulation of long-acting and short-acting insulin analogs. The primary objective of this study was to investigate the pharmacodynamic response of once-daily IDegAsp dosing in patients with type 1 diabetes. Pharmacokinetic response, as well as safety and tolerability, were assessed as secondary objectives. METHODOLOGY: This was a single-center, open-label, single-arm study. Twenty-two subjects received once-daily insulin degludec (IDeg) (0...
June 2014: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Xiuli Chu, Yuwu Zhao, Fang Liu, Yajing Mi, Jie Shen, Xiyun Wang, Jianzhi Liu, Weilin Jin
Hypoglycemia can cause rapid and severe brain damage. We studied the impact of hypoglycemic brain damage in the insulin-induced hypoglycemic rats. Thirty male rats were divided into normal blood sugar control group (group A), the blank group (group B), and the experimental group which was further divided into four groups according to the level of blood glucose reperfusion i.e., blood glucose ≤ 3 mmol/L (Group C), ≤ 6 mmol/L (Group D), ≤ 9 mmol/L (Group E), and >9 mmol/L (Group F). Each groups had five rats...
May 2014: Cell Biochemistry and Biophysics
E Cengiz
Mimicking physiologic insulin action has been the main goal of diabetes therapy since the discovery of insulin. The evolution of insulin therapy from animal insulin to recombinant insulin analogs has improved diabetes treatment significantly over the course of years. Nevertheless, the rapid-acting insulin analog pharmacokinetics and pharmacodynamics are still far from replicating physiologic insulin action resulting in poorly controlled after meal blood glucose levels. The slow action of insulin analogs has been a stumbling block for the development artificial pancreas systems that require a fast responding insulin to blood glucose changes...
September 2013: Panminerva Medica
Gillian M Keating
Insulin degludec (Tresiba(®)) is an ultra-long-acting insulin analogue that is also available as a coformulation with rapid-acting insulin aspart (insulin degludec/insulin aspart) [Ryzodeg(®)]. Insulin degludec has a flat, stable glucose-lowering profile with a duration of action of >42 h, and less within-patient day-to-day variability in glucose-lowering effect than the long-acting insulin analogue insulin glargine. In clinical trials, insulin degludec achieved similar glycaemic control to that seen with insulin glargine in patients with type 1 or 2 diabetes, but with a lower risk of nocturnal hypoglycaemia...
May 2013: Drugs
A J Garber
Most physicians are comfortable with initiating basal insulin replacement therapy in their patients with type 2 diabetes who are no longer meeting treatment goals with oral antidiabetic agents. What is more challenging is what to do when treatment goals are no longer being met despite adequate titration of basal insulin. Both fasting plasma glucose and postprandial glucose contribute to hemoglobin A1C levels. Addressing postprandial glucose levels can be accomplished by several approaches. Traditionally this has meant moving to basal bolus insulin, which is considered the gold standard...
March 2013: Diabetes, Obesity & Metabolism
Linda Morrow, Douglas B Muchmore, Marcus Hompesch, Elizabeth A Ludington, Daniel E Vaughn
OBJECTIVE: To compare the pharmacokinetics and glucodynamics of three rapid-acting insulin analogs (aspart, glulisine, and lispro) injected subcutaneously with or without recombinant human hyaluronidase (rHuPH20). RESEARCH DESIGN AND METHODS: This double-blind six-way crossover euglycemic glucose clamp study was conducted in 14 healthy volunteers. Each analog was injected subcutaneously (0.15 units/kg) with or without rHuPH20. RESULTS: The commercial formulations had comparable insulin time-exposure and time-action profiles as follows: 50% exposure at 123-131 min and 50% total glucose infused at 183-186 min...
February 2013: Diabetes Care
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