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https://www.readbyqxmd.com/read/28432748/future-challenges-and-therapeutic-opportunities-in-type-2-diabetes-changing-the-paradigm-of-current-therapy
#1
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/28427496/mortality-risk-factors-in-intensive-care-unit-patients-with-acute-kidney-injury-requiring-renal-replacement-therapy-a-retrospective-cohort-study%C3%A2
#2
Michael Schmitz, Frank P Tillmann, Ausra Paluckaite, Erich A Laufer, Brian Rayner, Lars C Rump, Peter J Heering
BACKGROUND: Mortality of critically-ill patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) in an intensive-care setting continues to remain high. There is still uncertainty as to which factors should guide clinical judgement. METHODS: A cohort of 155 patients admitted to an intensive-care unit and necessitating RRT due to AKI were retrospectively analyzed. Demographic and clinical parameters at the time of RRT initiation were retrieved...
April 21, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28423374/hyperbaric-oxygen-therapy-as-adjuvant-treatment-for-idiopathic-sudden-sensorineural-hearing-loss-after-failure-of-systemic-steroids
#3
Seiji Hosokawa, Ken-Ichi Sugiyama, Goro Takahashi, Yu-Ichi Hashimoto, Kumiko Hosokawa, Satoru Takebayashi, Hiroyuki Mineta
We evaluated the outcomes of and prognostic factors for idiopathic sudden sensorineural hearing loss (ISSNHL) treated with adjuvant hyperbaric oxygen therapy (HBOT). A retrospective review of clinical data was performed for 167 patients with ISSNHL who failed to respond to systemic steroids and were treated by adjuvant HBOT at Shizuoka Saiseikai General Hospital. We analysed the clinical outcomes, the averaged 5-frequency hearing level after systemic steroids, patient age, the interval between post-steroids and pre-HBOT, vertigo as a complication, the presence of diabetes mellitus, smoking history, and hypertension...
April 20, 2017: Audiology & Neuro-otology
https://www.readbyqxmd.com/read/28418262/adherence-and-persistence-in-patients-with-type-2-diabetes-mellitus-newly-initiating-canagliflozin-dapagliflozin-dpp-4s-or-glp-1s-in-the-united-states
#4
Jennifer Cai, Victoria Divino, Chakkarin Burudpakdee
OBJECTIVE: Sodium-glucose co-transporter 2 inhibitors were first approved in the US in 2013; therefore, real-world (RW) studies describing outcomes are limited. This retrospective study evaluated adherence and persistence among patients initiating canagliflozin (CANA), dapagliflozin (DAPA), GLP-1 agonists (GLP-1s) and DPP-4 inhibitors (DPP-4s) over a 12-month follow-up from a US managed care perspective. METHODS: Patients newly initiating CANA, DAPA, GLP-1s, or DPP-4s from 2/1/2014-6/30/2014 were identified from the QuintilesIMS PharMetrics Plus Database...
April 18, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28415672/efficacy-and-safety-of-pramlintide-injection-adjunct-to-insulin-therapy-in-patients-with-type-1-diabetes-mellitus-a-systematic-review-and-meta-analysis
#5
Yong-Chao Qiao, Wei Ling, Yan-Hong Pan, Yin-Ling Chen, Dan Zhou, Yan-Mei Huang, Xiao-Xi Zhang, Hai-Lu Zhao
AIMS: We aim to assess the efficacy and safety of pramlintide plus insulin therapy in patients with type 1 diabetes. METHODS: We included clinical studies comparing pramlintide plus insulin to placebo plus insulin. Efficacy was reflected by glycemic control and reduction in body weight and insulin use. Safety concerns were hypoglycemia and other adverse events. Subgroup analysis was performed for different doses (30, 60, 90 µg/meal) and durations (≤4, 26, 29, >29 weeks) of the treatment...
March 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28413872/favorable-effect-on-blood-volume-control-in-hemodialysis-patients-with-type-2-diabetes-after-switching-from-insulin-therapy-to-liraglutide-a-human-glucagon-like-peptide-1-analog-results-from-a-pilot-study-in-japan
#6
Masumi Kondo, Masao Toyoda, Moritsugu Kimura, Naoto Ishida, Masafumi Fukagawa
OBJECTIVE: Hemodialysis patients are advised to limit the intake of foods in order to control volume status and body weight (BW). We report the clinical course of five Japanese hemodialysis patients with type 2 diabetes mellitus (T2DM) who were switched from insulin to liraglutide, and the efficacy of the treatment, especially in terms of changes in interdialysis weight gain (IDWG). METHODS: This retrospective pilot study included 5 Japanese hemodialysis patients with T2DM...
April 20, 2017: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/28392998/resistive-index-as-a-predictor-of-renal-progression-in-patients-with-moderate-renal-dysfunction-regardless-of-angiotensin-converting-enzyme-inhibitor-or-angiotensin-receptor-antagonist-medication
#7
Jae Hoon Kim, Su Mi Lee, Young Ki Son, Seong Eun Kim, Won Suk An
BACKGROUND: Previous studies have shown that a higher resistive index (RI) on renal duplex ultrasonography was related with renal progression and acute kidney injury, especially in patients with chronic kidney disease (CKD) using an angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor antagonist (ARB). We evaluated whether a RI value is a predictive factor for renal progression regardless of ACEI or ARB medication in patients with moderate renal dysfunction. METHODS: We retrospectively analyzed 119 patients with moderate renal dysfunction that had been evaluated with renal duplex ultrasonography from February 2011 to April 2015...
March 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28385600/mesenchymal-stem-cells-and-differentiated-insulin-producing-cells-are-new-horizons-for-pancreatic-regeneration-in-type-i-diabetes-mellitus
#8
Ayat M Domouky, Ashraf S Hegab, Amal Al-Shahat, Nermin Raafat
BACKGROUND: Diabetes mellitus has become the third human killer following cancer and cardiovascular disease. Millions of patients, often children, suffer from type 1 diabetes (T1D). Stem cells created hopes to regenerate damaged body tissues and restore their function. AIM: This work aimed at clarifying and comparing the therapeutic potential of differentiated and non-differentiated mesenchymal stem cells (MSCs) as a new line of therapy for T1D. METHODS: 40 Female albino rats divided into group I (control): 10 rats and group II (diabetic), III and IV, 10 rats in each, were injected with streptozotocin (50mg/kg body weight)...
April 3, 2017: International Journal of Biochemistry & Cell Biology
https://www.readbyqxmd.com/read/28381265/thiazolidinedione-use-and-atrial-fibrillation-in-diabetic-patients-a-meta-analysis
#9
Zhiwei Zhang, Xiaowei Zhang, Panagiotis Korantzopoulos, Konstantinos P Letsas, Gary Tse, Mengqi Gong, Lei Meng, Guangping Li, Tong Liu
BACKGROUND: Accumulating evidence suggests that thiazolidinediones (TZDs) may exert protective effects in atrial fibrillation (AF). The present meta-analysis investigated the association between TZD use and the incidence of AF in diabetic patients. METHODS: Electronic databases were searched until December 2016. Of the 346 initially identified records, 3 randomized clinical trials (RCTs) and 4 observational studies with 130,854 diabetic patients were included in the final analysis...
April 5, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28379903/inhaled-insulin-a-clinical-and-historical-review
#10
Jason Chan, Angela Cheng-Lai
Insulin is the most effective blood glucose lowering agent and remains one of the cornerstones of diabetes management. However, many individuals with diabetes are either reluctant to initiate or are nonadherent to their insulin therapy for various reasons, including fear of frequent injections. Technosphere Insulin (TI) is a novel inhaled insulin powder that is approved by the United States Food and Drug Administration for the management of diabetes. The results from 2 phase III clinical trials have shown that TI was noninferior to subcutaneous insulin aspart and superior to inhaled placebo in lowering HbA1c in patients with diabetes mellitus types 1 and 2, respectively...
May 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28374407/cutaneous-manifestations-of-diabetes-mellitus-a-review
#11
REVIEW
Ana Luiza Lima, Tanja Illing, Sibylle Schliemann, Peter Elsner
Diabetes mellitus is a widespread endocrine disease with severe impact on health systems worldwide. Increased serum glucose causes damage to a wide range of cell types, including endothelial cells, neurons, and renal cells, but also keratinocytes and fibroblasts. Skin disorders can be found in about one third of all people with diabetes and frequently occur before the diagnosis, thus playing an important role in the initial recognition of underlying disease. Noninfectious as well as infectious diseases have been described as dermatologic manifestations of diabetes mellitus...
April 3, 2017: American Journal of Clinical Dermatology
https://www.readbyqxmd.com/read/28356718/sodium-glucose-cotransporter-2-inhibitors-combined-with-dipeptidyl-peptidase-4-inhibitors-in-the-management-of-type-2-diabetes-a-review-of-current-clinical-evidence-and-rationale
#12
REVIEW
Sayf A Yassin, Vanita R Aroda
Type 2 diabetes mellitus (T2DM) is a progressive and multifactorial cardiometabolic disorder. Almost half of adults with diabetes fail to achieve their recommended glucose control target. This has prompted some clinicians to advocate the use of more intensive initial therapy, including the use of combination therapy to target multiple physiologic defects in diabetes with the goal of achieving and sustaining glucose control. Numerous options exist for combining the various classes of glucose-lowering agents in the treatment of T2DM...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28355466/invasive-mould-infections-in-the-icu-setting-complexities-and-solutions
#13
Matteo Bassetti, Emilio Bouza
Infections caused by filamentous fungi represent a major burden in the ICU. Invasive aspergillosis is emerging in non-neutropenic individuals with predisposing conditions, e.g. corticosteroid treatment, chronic obstructive pulmonary disease, liver cirrhosis, solid organ cancer, HIV infection and transplantation. Diagnosis is challenging because the signs and symptoms are non-specific, and initiation of additional diagnostic examinations is often delayed because clinical suspicion is low. Isolation of an Aspergillus species from the respiratory tract in critically ill patients, and tests such as serum galactomannan, bronchoalveolar lavage 1-3-β-d-glucan and specific PCR should be interpreted with caution...
March 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28349930/pharmacogenetics-of-posttransplant-diabetes-mellitus
#14
REVIEW
P Lancia, T Adam de Beaumais, E Jacqz-Aigrain
Many factors (physiological, pathological, environmental or genetic) are associated with variability in drug effect. Most patients respond to a standard treatment but the drug may be ineffective or toxic. In this review, we focused on genetic markers of posttransplant diabetes mellitus (PTDM) after renal transplantation, a frequent complication of immunosuppressive therapy and important risk factor of graft loss and mortality. An initial literature search identified 100 publications and among them 32 association studies were retrieved under 'Pharmacogenetics and PTDM'...
March 28, 2017: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/28348533/clinical-characteristics-of-diabetes-mellitus-and-suicide-risk
#15
REVIEW
Chiara Conti, Chiara Mennitto, Giulia Di Francesco, Federica Fraticelli, Ester Vitacolonna, Mario Fulcheri
BACKGROUND: Diabetes mellitus (DM) is a chronic illness with impaired health-related quality of life and a high risk of psychiatric disorders. We carried out a systematic review analyzing the relationship between DM and suicide by providing a qualitative data synthesis of the studies. METHODS: We conducted, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search of the literature in PubMed, Scopus, ISI Web of Science, PsycINFO, Google Scholar, and ScienceDirect...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28347531/ultrasound-stimulation-of-insulin-release-from-pancreatic-beta-cells-as-a-potential-novel-treatment-for-type-2-diabetes
#16
Ivan Suarez Castellanos, Aleksandar Jeremic, Joshua Cohen, Vesna Zderic
Type 2 diabetes mellitus is a complex metabolic disease that has reached epidemic proportions in the United States and around the world. This disease is characterized by loss of insulin secretion and, eventually, destruction of insulin-producing pancreatic beta cells. Controlling type 2 diabetes is often difficult as pharmacological management routinely requires complex therapy with multiple medications, and loses its effectiveness over time. The objective of this study was to explore the effectiveness of a novel, non-pharmacological approach that uses the application of ultrasound energy to augment insulin release from rat INS 832/13 beta cells...
March 24, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28345986/children-and-young-people-with-diabetes-recognition-and-management
#17
Hamish Hamilton, Grace Knudsen, Camelia Laura Vaina, Michelle Smith, Siba Prosad Paul
Diabetes mellitus (type 1) is an autoimmune condition leading to absolute insulin deficiency resulting in hyperglycaemia and its associated manifestations. It is the most common type of diabetes seen in children, characterised by the 4Ts (toilet, thinner, thirsty, tired). The signs and symptoms can sometimes be non-specific and a delay or missed diagnosis may be catastrophic to the health of the child. Children with an established diagnosis of diabetes often present to the health service with issues such as hypoglycaemia, hyperglycaemia, or diabetic ketoacidosis...
March 23, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28342563/type-2-diabetes-mellitus-treatment-patterns-across-europe-a-population-based-multi-database-study
#18
Jetty A Overbeek, Edith M Heintjes, Daniel Prieto-Alhambra, Patrick Blin, Régis Lassalle, Gillian C Hall, Francesco Lapi, Elisa Bianchini, Niklas Hammar, Irene D Bezemer, Ron M C Herings
PURPOSE: The aim of this study was to determine the similarities and differences of type 2 diabetes mellitus (T2DM) treatment patterns in daily practice in 5 European countries and whether these reflect differences in guidelines. METHODS: Prescriptions for drugs used in diabetes treatment during a 5-year study period were obtained from electronic databases. Patients initiating T2DM treatment during the study period were included. An SAS analysis tool was developed to create episodes of use of drug classes, which resulted in treatment patterns...
March 22, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28334539/-long-acting-insulins-in-the-treatment-of-type-2%C3%A2-diabetes-and-their-position-in-the-current-treatment-algorithm
#19
Martin Haluzík
Insulin therapy has been for many years an inseparable part of the treatment of patients with type 2 diabetes, in particular those with longer diabetes duration. Current national and international guidelines list insulin treatment as a possible second choice therapy in patient with unsatisfactory glucose control on monotherapy with metformin. In reality, insulin therapy is often initiated later than it optimally should be. The reasons include among others the fear of patients and sometimes also of physicians from the side effects of insulin...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28322429/treatment-challenges-in-type-1-diabetes-after-roux-en-y-gastric-bypass
#20
Lucie Favre, François Pralong, Michel Suter, François R Jornayvaz
Bariatric surgery is an effective treatment of type 2 diabetes in obese patients. The obesity epidemic does not spare patients with type 1 diabetes mellitus (T1DM), but there is no consensus regarding the role of surgery in the management of obese T1DM patients. Published data consistently report significant weight loss after surgery in obese T1DM patients, but long-term glycaemic control remains difficult to achieve. Here we present our experience with a challenging patient and a review of the literature. Our patient successfully underwent a roux-en-Y gastric bypass (RYGB) when she was 28 years old...
March 21, 2017: Swiss Medical Weekly
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