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Basal insulin

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https://www.readbyqxmd.com/read/28345792/adding-fast-acting-insulin-aspart-to-basal-insulin-significantly-improved-glycaemic-control-in-patients-with-type-2-diabetes-a-randomised-18-week-open-label-phase-3-trial-onset-3
#1
Helena W Rodbard, Devjit Tripathy, Maricela Vidrio Velázquez, Marek Demissie, Søren Can Tamer, Milivoj Piletič
AIM: To confirm glycaemic control superiority of mealtime fast-acting insulin aspart (faster aspart) in a basal-bolus (BB) regimen versus basal-only insulin. MATERIALS AND METHODS: In this open-label, randomised, 18-week trial (51 sites; 6 countries) adults (n = 236) with inadequately controlled type 2 diabetes (T2D; mean glycosylated haemoglobin [HbA1c ] ±SD: 7.9 ± 0.7% [63.1 ± 7.5 mmol/mol) receiving basal insulin and oral antidiabetic drugs underwent 8-week optimisation of prior once-daily basal insulins followed by randomisation 1:1 to a BB regimen with faster aspart (n = 116) or continuation of once-daily basal insulin (n = 120), both with metformin...
March 27, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28345162/reduction-of-postprandial-glucose-by-lixisenatide-versus-sitagliptin-in-japanese-patients-with-type-2-diabetes-on-background-insulin-glargine-a-randomised-phase-4-study
#2
Yuichiro Yamada, Masayuki Senda, Yusuke Naito, Masahiro Tamura, Daisuke Watanabe, Yujin Shuto, Yoshihisa Urita
AIM: To evaluate the pharmacodynamics of adjunctive lixisenatide once daily versus sitagliptin once daily in Japanese patients with type 2 diabetes receiving insulin glargine U100. METHODS: This multicentre, open-label, phase 4 study (NCT02200991) randomly assigned 136 patients to either lixisenatide once-daily subcutaneous injection (10 µg initially increased weekly by 5 µg up to 20 µg) or once-daily oral sitagliptin (50 mg dose). The primary endpoint was the change in postprandial glucose (PPG) exposure 4 hours after a standardized breakfast (PPG area under the plasma glucose concentration-time curve [AUC0:00-4:00h ]) from baseline to Day 29...
March 26, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28343792/liberating-a1c-goals-in-older-adults-may-not-protect-against-the-risk-of-hypoglycemia
#3
Medha N Munshi, Christine Slyne, Alissa R Segal, Nora Saul, Courtney Lyons, Katie Weinger
AIMS: Hemoglobin A1C is universally used as a marker for glycemic control and to establish glycemic goals in patients with diabetes. In the older population, experts recommend liberating A1C goals to decrease the risk of hypoglycemia. However, it's not clear which A1C level is optimal for this purpose. This study's aim was to understand the relationship between A1C levels and risk of hypoglycemia. METHODS: In a prospective study, we performed continuous glucose monitoring (CGM) on older adults on insulin...
March 14, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28335560/serum-amyloid-a-production-is-triggered-by-sleep-deprivation-in-mice-and-humans-is-that-the-link-between-sleep-loss-and-associated-comorbidities
#4
Edson M de Oliveira, Bruna Visniauskas, Sergio Tufik, Monica L Andersen, Jair R Chagas, Ana Campa
Serum amyloid A (SAA) was recently associated with metabolic endotoxemia, obesity and insulin resistance. Concurrently, insufficient sleep adversely affects metabolic health and is an independent predisposing factor for obesity and insulin resistance. In this study we investigated whether sleep loss modulates SAA production. The serum SAA concentration increased in C57BL/6 mice subjected to sleep restriction (SR) for 15 days or to paradoxical sleep deprivation (PSD) for 72 h. Sleep restriction also induced the upregulation of Saa1...
March 21, 2017: Nutrients
https://www.readbyqxmd.com/read/28332144/efficacy-and-safety-of-ideglira-in-participants-with-type-2-diabetes-in-india-uncontrolled-on-oral-antidiabetic-drugs-and-basal-insulin-data-from-the-dual-clinical-trial-program
#5
Kamlesh Khunti, Viswanathan Mohan, Sunil M Jain, Trine Welløv Boesgaard, Kamilla Begtrup, Bipin Sethi
INTRODUCTION: The efficacy and safety of insulin degludec/liraglutide (IDegLira) has been evaluated in the Dual Action of Liraglutide and Insulin Degludec in Type 2 Diabetes (DUAL) phase 3 clinical trial program. In this post hoc analysis, we compared the efficacy and safety of IDegLira in the Indian subpopulation with the results from the global trial population of DUAL trials. The analysis includes participants uncontrolled on oral antidiabetic drugs (OADs) in DUAL I and DUAL IV and participants uncontrolled on basal insulin and OADs in DUAL II...
March 22, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28331986/renal-function-preservation-with-pioglitazone-or-with-basal-insulin-as-an-add-on-therapy-for-patients-with-type-2-diabetes-mellitus
#6
Yu-Hung Chang, Der-Wei Hwu, Dao-Ming Chang, Ling-Wang An, Chang-Hsun Hsieh, Yau-Jiunn Lee
AIMS: Clinical outcome may differ owing to the distinct pharmacological characteristics of insulin sensitizers and insulin. This study was performed to compare the metabolic and renal function changes with add-on pioglitazone treatment versus basal insulin in patients with type 2 diabetes mellitus (DM) in whom sulfonylurea and metformin regimens failed. METHODS: Patients who were consecutively managed in the diabetes comprehensive program with add-on pioglitazone or detemir/glargine treatment for at least 2 years following sulfonylurea and metformin treatment failure were included...
March 22, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/28331351/long-term-management-of-type-2-diabetes-with-glucagon-like-peptide-1-receptor-agonists
#7
REVIEW
Hamish Courtney, Rahul Nayar, Chinnadorai Rajeswaran, Ravi Jandhyala
Continuously reducing excess blood glucose is a primary goal for the management of type 2 diabetes (T2D). Most patients with T2D require glucose-lowering medications to achieve and maintain adequate glycemic control; however, treatment failure may occur, limiting treatment options. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are an emerging therapeutic class that can be prescribed for patients instead of basal insulin after the failure of oral therapies. Recent studies have focused on the durability and tolerability of long-term GLP-1RA therapy...
2017: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
https://www.readbyqxmd.com/read/28328234/quantification-of-basal-insulin-peglispro-and-human-insulin-in-adipose-tissue-interstitial-fluid-by-open-flow-microperfusion
#8
Katrin Tiffner, Beate Boulgaropoulos, Christian Höfferer, Thomas Birngruber, Niels Porksen, Helle Linnebjerg, Parag Garhyan, Eric Chen Quin Lam, Mary Pat Knadler, Thomas R Pieber, Frank Sinner
BACKGROUND: Restoration of the physiologic hepatic-to-peripheral insulin gradient may be achieved by either portal vein administration or altering insulin structure to increase hepatic specificity or restrict peripheral access. Basal insulin peglispro (BIL) is a novel, PEGylated basal insulin with a flat pharmacokinetic and glucodynamic profile and altered hepatic-to-peripheral action gradient. We hypothesized reduced BIL exposure in peripheral tissues explains the latter, and in this study assessed the adipose tissue interstitial fluid (ISF) concentrations of BIL compared with human insulin (HI)...
March 22, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28325801/insulin-and-glucagon-like-peptide-1-receptor-agonist-combination-therapy-in-type-2-diabetes-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#9
REVIEW
Maria Ida Maiorino, Paolo Chiodini, Giuseppe Bellastella, Annalisa Capuano, Katherine Esposito, Dario Giugliano
OBJECTIVE: The combination of basal insulin plus a glucagon-like peptide 1 receptor agonist (GLP-1RA) has been proposed as a treatment option to intensify insulin therapy in type 2 diabetes. We performed a meta-analysis of randomized controlled trials (RCTs) comparing this combination strategy to other injectable antidiabetes treatments on metabolic control in adult patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: We conducted an electronic search until November 2016 on many electronic databases to identify RCTs assessing changes in HbA1c, proportion of patients at HbA1c target ≤7% (53 mmol/mol), hypoglycemia, and weight change...
April 2017: Diabetes Care
https://www.readbyqxmd.com/read/28325798/management-of-inpatient-hyperglycemia-and-diabetes-in-older-adults
#10
Guillermo E Umpierrez, Francisco J Pasquel
Adults aged 65 years and older are the fastest growing segment of the U.S. population, and their number is expected to double to 89 million between 2010 and 2050. The prevalence of diabetes in hospitalized adults aged 65-75 years and over 80 years of age has been estimated to be 20% and 40%, respectively. Similar to general populations, the presence of hyperglycemia and diabetes in elderly patients is associated with increased risk of hospital complications, longer length of stay, and increased mortality compared with subjects with normoglycemia...
April 2017: Diabetes Care
https://www.readbyqxmd.com/read/28324109/sex-specific-life-course-changes-in-the-neuro-metabolic-phenotype-of-glut3-null-heterozygous-mice-ketogenic-diet-ameliorates-electroencephalographic-seizures-and-improves-sociability
#11
Yun Dai, Yuanzi Zhao, Masatoshi Tomi, Bo-Chul Shin, Shanthie Thamotharan, Andrey Mazarati, Raman Sankar, Elizabeth A Wang, Carlos Cepeda, Michael S Levine, Jingjing Zhang, Andrew Frew, Jeffry R Alger, Peter Clark, Monica Sondhi, Sudatip Kositamongkol, Leah Leibovitch, Sherin U Devaskar
We tested the hypothesis that exposure of glut3+/- mice to a ketogenic diet ameliorates autism-like features which includes aberrant behavior and electrographic seizures. We first investigated the life course sex-specific changes in basal plasma-CSF-brain metabolic profile, brain glucose transport/uptake, glucose and monocarboxylate transporter proteins, and ATP in the presence or absence of systemic insulin administration. Glut3+/- male but not female mice (5m of age) displayed reduced CSF glucose/lactate concentrations with no change in brain Glut1, Mct2, glucose uptake or ATP...
January 24, 2017: Endocrinology
https://www.readbyqxmd.com/read/28324067/gestational-protein-restriction-impairs-glucose-disposal-in-the-gastrocnemius-muscles-of-female-rats
#12
C S Blesson, V Chinnathambi, S Kumar, C Yallampalli
Gestational low protein (LP) diet causes hyperglycemia and insulin resistance in adult offspring but the mechanism is not clearly understood. In this study, we explored the role of insulin signaling in gastrocnemius muscles of gestational LP exposed female offspring. Pregnant rats were fed control (20% protein) or isocaloric LP (6%) diet from gestational day 4 until delivery. Normal diet was given to mothers after delivery and to pups after weaning until necropsy. Offspring were euthanized at 4 months and gastrocnemius muscles were treated with insulin ex vivo for 30 min...
January 30, 2017: Endocrinology
https://www.readbyqxmd.com/read/28324055/substrate-metabolism-and-insulin-sensitivity-during-fasting-in-obese-human-subjects-impact-of-gh-blockade
#13
Morten Høgild Pedersen, Mads Vandsted Svart, Janne Lebeck, Martin Bidlingmaier, Hans Stødkilde-Jørgensen, Steen Bønløkke Pedersen, Niels Møller, Niels Jessen, Jens O L Jørgensen
Context: Insulin resistance and metabolic inflexibility are features of obesity and are amplified by fasting. GH secretion increases during fasting and GH causes insulin resistance. Objective: To study the metabolic effects of GH blockade during fasting in obese subjects. Subjects and Methods: Nine obese males were studied thrice in a randomized design: 1) After an overnight fast (Control), 2) After 72 h fasting (Fasting) and 3) After 72 h fasting with GH blockade (pegvisomant) (Fasting + GHA)...
January 18, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28324038/efficacy-of-exenatide-plus-pioglitazone-versus-basal-bolus-insulin-in-t2dm-patients-with-very-high-hba1c
#14
Muhammad Abdul-Ghani, Osama Mujahid, Ayman Mujahid, Ralph A DeFronzo, Mahmoud Zirie, Amin Jayyousi
Aim: To examine the efficacy and safety of combination therapy with exenatide plus pioglitazone versus basal-bolus insulin in poorly controlled type 2 diabetic patients with very high HbA1c (HbA1c>10%) on metformin plus sulfonylurea and long duration of disease. Research Design and Methods: 101 participants in Qatar Study with very poor glycemic control (HbA1c > 10%) and long duration of diabetes (10.9 years) on maximum/near-maximum doses of sulfonylurea plus metformin were randomized to receive: (i) pioglitazone plus weekly exenatide (Combination Therapy), or (ii) basal plus prandial insulin (Insulin Therapy) to maintain HbA1c <7...
February 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28323959/insulin-and-glucagon-partners-for-life
#15
Jens Juul Holst, William Holland, Jesper Gromada, Young Lee, Roger H Unger, Hai Yan, Kyle W Sloop, Timothy J Kieffer, Nicolas Damond, Pedro L Herrera
In August 2016, several leaders in glucagon biology gathered for the European Association for the Study of Diabetes Hagedorn Workshop in Oxford, England. A key point of discussion focused around the need for basal insulin to allow for the therapeutic benefit of glucagon blockade in the treatment of diabetes. Among the most enlightening experimental results presented were findings from studies where glucagon receptor-deficient mice were administered streptozotocin to destroy pancreatic beta cells or had undergone diphtheria toxin-induced beta cell ablation...
January 31, 2017: Endocrinology
https://www.readbyqxmd.com/read/28319890/one-year-follow-up-of-clinical-metabolic-and-oxidative-stress-profile-of-morbid-obese-patients-after-laparoscopic-sleeve-gastrectomy-8-oxo-dg-as-a-clinical-marker
#16
Lidia Monzo-Beltran, Antonio Vazquez-Tarragón, Concha Cerdà, Paula Garcia-Perez, Antonio Iradi, Carlos Sánchez, Benjamin Climent, Carmen Tormos, Antonio Vázquez-Prado, Javier Girbés, Nuria Estáñ, Sebastián Blesa, Raquel Cortés, Felipe J Chaves, Guillermo T Sáez
Obesity has grown worldwide over the last few decades. In its different degrees, obesity is accompanied by many clinical and biochemical alterations reflecting the pathological condition of various body tissues. Among the mechanisms underlying the pathogenesis of obesity and associated complications, oxidative stress (OS) may be playing an important role. In the present study, we have characterized at systemic level the degree of OS status in a group of morbid obese patients (BMI>40kg/m(2)) at basal sate and its modulation during one year after bariatric surgery using the laparoscopic sleeve gastrectomy (LSG) technique...
February 14, 2017: Redox Biology
https://www.readbyqxmd.com/read/28319802/associations-between-home-insulin-dose-adjustments-and-glycemic-outcomes-at-hospital-admission
#17
Saira Khan, Sherita Hill Golden, Nestoras Mathioudakis
AIMS: To describe patterns of home insulin dose adjustments for non-surgical, non-critically ill patients at admission and to describe associations between these adjustments and inpatient glycemic control. METHODS: Hospital records of non-critically ill patients treated with basal insulin prior to admission were identified. After exclusion of records in which a confounding factor influencing insulin dosing was present, 258 patient-admissions over a 3-year time period were included...
March 7, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28319140/role-of-muscle-il-6-in-gender-specific-metabolism-in-mice
#18
Amalia Molinero, Antonio Fernandez-Perez, Aina Mogas, Mercedes Giralt, Gemma Comes, Olaya Fernandez-Gayol, Mario Vallejo, Juan Hidalgo
The aim of the present work was to further explore the physiological roles of muscle-derived IL-6. Adult-floxed and conditional skeletal muscle IL-6 knock out male and female mice were used to study energy expenditure (indirect calorimetry at rest and during treadmill exercise, and body temperature cycle during the light phase) and energy intake (response to fast/refeeding). We also evaluated the responses to leptin and the activity of the insulin signalling pathway in skeletal muscle and liver by phosphorylation of Akt at Ser 473...
2017: PloS One
https://www.readbyqxmd.com/read/28318878/insulin-stimulates-transport-of-organic-anion-compounds-mediated-by-organic-anion-transporting-polypeptide-2b1-in-the-human-intestinal-cell-line-caco-2
#19
Taku Kobayashi, Takahiro Koizumi, Masaki Kobayashi, Jiro Ogura, Yuichi Horiuchi, Yuki Kimura, Ayuko Kondo, Ayako Furugen, Katsuya Narumi, Natsuko Takahashi, Ken Iseki
Organic anion transporting polypeptide 2B1 (OATP2B1) is the major uptake transporter in the intestine, and transports various clinically used therapeutic agents. Insulin acts through the insulin receptor in targeted cells, and Rab8A is one of the insulin signaling pathways. The small intestine in humans also expresses insulin receptor and Rab8A. It has been reported that insulin stimulates peptide transporter 1 (PEPT1) expression at the apical membrane and increases uptake of PEPT1 substrates in small intestine epithelial model cells (Caco-2 cells)...
December 27, 2016: Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/28315574/consensus-statement-on-insulin-therapy-in-chronic-kidney-disease
#20
REVIEW
Rajesh Rajput, Binayak Sinha, Sujoy Majumdar, M Shunmugavelu, Sarita Bajaj
INTRODUCTION: Diabetes mellitus (DM) is one of the leading causes of chronic kidney disease (CKD) which eventually leads to insulin resistance and decreased insulin degradation. In patients with diabetic kidney disease (DKD), the overall insulin requirement declines which necessitates the reassessment for individualization, adjustment and titration of insulin doses depending on the severity of kidney disease. OBJECTIVE: To provide simple and easily implementable guidelines to primary care physicians on appropriate insulin dosing and titration of various insulin regimens in patients with DKD...
February 27, 2017: Diabetes Research and Clinical Practice
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