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Mehul R Dalal, Mahmood R Kazemi, Fen Ye
OBJECTIVE: To evaluate the impact of 6-month hypoglycemia on treatment discontinuation and hospitalization of patients initiating basal insulin for type 2 diabetes (T2D) in real-world practice. METHODS: This was a retrospective cohort study of patient-level data using electronic medical records (EMR) in the Predictive Health Intelligence diabetes dataset. Data from adult patients with T2D initiating basal insulin glargine, insulin detemir, or Neutral Protamine Hagedorn insulin between January 2008 and March 2014 were analyzed...
October 14, 2016: Current Medical Research and Opinion
S Galasso, A Facchinetti, B M Bonora, V Mariano, F Boscari, E Cipponeri, A Maran, A Avogaro, G P Fadini, D Bruttomesso
BACKGROUND AND AIMS: Degludec is an ultralong-acting insulin analogue with a flat and reproducible pharmacodynamic profile. As some patients with type 1 diabetes (T1D) fail to achieve 24-h coverage with glargine or detemir despite twice-daily injections, we studied the effect of switching T1D patients from twice-daily glargine or detemir to degludec. METHODS AND RESULTS: In this prospective observational study, T1D patients on twice-daily glargine or detemir were enrolled...
August 6, 2016: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
Adam Morton, Josephine Laurie
No abstract text is available yet for this article.
July 2016: Australian Family Physician
Nandu Thalange, Abdullah Bereket, Lisbeth Bjerring Jensen, Line Conradsen Hiort, Valentina Peterkova
BACKGROUND: To study the long-term development (104 weeks) of insulin antibodies during treatment with insulin detemir (IDet) and insulin aspart (IAsp) in children with type 1 diabetes aged 2-16 years. METHODS: A 52-week, two-arm, randomized trial comparing IDet and neutral protamine Hagedorn insulin, both in combination with IAsp, was followed by a one-arm, 52-week extension trial of the IDet + IAsp arm. The present analysis was conducted in children who completed the randomized trial and entered into the extension trial...
September 6, 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Ronit Koren, Eran Ashwal, Moshe Hod, Yoel Toledano
AIM: To evaluate the safety, efficacy and pregnancy outcomes of insulin detemir (IDet) versus glyburide treatment in women with gestational diabetes mellitus (GDM). METHODS: We conducted a retrospective cohort study of women with GDM who were treated with either glyburide or IDet for GDM in a university-affiliated tertiary hospital. RESULTS: Ninety-one patients with GDM were enrolled, 62 were administered glyburide and 29 IDet. Maternal age, pregestational body mass index (BMI) and rate of abnormal oral glucose tolerance test (OGTT) blood glucose values were not significantly different between groups...
September 5, 2016: Gynecological Endocrinology
Tim Heise, Chantal Mathieu
Manufacturers of insulin products for diabetes therapy have long sought ways to modify the absorption rate of exogenously administered insulins in an effort to better reproduce the naturally occurring pharmacokinetics of endogenous insulin secretion. Several mechanisms of protraction have been used in pursuit of a basal insulin for which a low injection frequency would provide tolerable and reproducible glucose control; these mechanisms have met with varying degrees of success. Before the advent of recombinant DNA technology, development focused on modifications to the formulation that increased insulin self-association, such as supplementation with zinc or the development of pre-formed precipitates using protamine...
September 4, 2016: Diabetes, Obesity & Metabolism
Tina Sartorius, Anita M Hennige, Andreas Fritsche, Hans-Ulrich Häring
AIMS: Recent studies have identified unique brain effects of insulin detemir (Levemir®). Due to its pharmacologic properties, insulin detemir may reach higher concentrations in the brain than regular insulin. This might explain the observed increased brain stimulation after acute insulin detemir application but it remained unclear whether chronic insulin detemir treatment causes alterations in brain activity as a consequence of overstimulation. METHODS: In mice, we examined insulin detemir's prolonged brain exposure by continuous subcutaneous (s...
2016: PloS One
Caroline K Kramer, Bernard Zinman, Haysook Choi, Ravi Retnakaran
OBJECTIVE: In early type 2 diabetes (T2DM), short-term intensive insulin therapy (IIT) for 2-4 weeks can decrease insulin resistance, reduce glucagonemia, improve β-cell function, and even induce a remission of diabetes that can last up to 1 year in some patients. However, little is known about the predictors of such a sustained remission. METHODS: We evaluated data from the placebo arm of a double-blind randomized controlled trial in which patients with early T2DM (≤7 years duration) underwent 4 weeks of IIT (basal detemir, bolus aspart), followed by placebo therapy for 48 weeks (n=25)...
2016: BMJ Open Diabetes Research & Care
Renata Pavlov, Ivančica Topličan, Mladenka Vrcić Keglević
Objectives. To investigate trends of diabetes mellitus (DM) morbidity and antidiabetic drug utilization in Croatian primary health care (PHC) from 2005 to 2014. Method. Routinely collected morbidity data from all PHC units, presented in Croatian health-statistics yearbooks, were retrieved. Data on drug utilization were retrieved from the Annual Reports of the Croatian Agency for Medicinal Products and Medical Devices (ATC/DDD, antidiabetic, A10). Results. Total morbidity increased by 33.3% and DM increased by 65...
2016: International Journal of Family Medicine
S M Kandel, J A Cosgriff
UNLABELLED: Clinicians are often presented with the scenario of what to do when one medication in a drug class has failed a therapeutic trial on a patient. We encountered a patient who developed profound resistance to glargine, aspart and regular insulin, but had a rapid and sustained response to detemir. The mechanism of the increased sensitivity to detemir is unclear, but may be related to an additional carbon chain on detemir shielding it from an antibody response. This case highlights the profound impact that subtle differences in molecular structure can have on biological activity and thus patient outcomes...
2016: Endocrinology, Diabetes & Metabolism Case Reports
Abdel Rahman El Shiekh, Hesham A Farrag, Tarek Ashour, Khalid Zaki Alshali, Waleed AbdelFattah
AIM: To evaluate the safety profile of insulin detemir (IDet) in people with Type 2 diabetes mellitus (T2DM) in the Gulf countries in the 32-week, noninterventional LevSafe study. METHODS: People with T2DM whose physicians had opted to start IDet therapy were included in the study. Safety parameters, including serious adverse drug reactions (SADRs) and hypoglycemia, and changes in body weight and glycemic control were evaluated at baseline, week 16 and week 32. RESULTS: A total of 686 patients were exposed to IDet therapy with a mean (±standard deviation) age, body mass index, and diabetes duration of 51...
July 2016: Indian Journal of Endocrinology and Metabolism
Ulrik Pedersen-Bjergaard, Peter Lommer Kristensen, Kirsten Nørgaard, Hans Perrild, Tonny Jensen, Birger Thorsteinsson, Annie Nikolajsen, Lise Tarnow
OBJECTIVE: Based on the data of the HypoAna trial ( NCT00346996), a short-term cost-effectiveness analysis was conducted comparing an all insulin analogue regimen with an all human insulin regimen in people with type 1 diabetes who are prone to recurrent severe hypoglycaemia. METHODS: Clinical data from the HypoAna trial and Danish cost data related to the treatment of severe hypoglycaemia were used to populate a 1-year cost-effectiveness analysis...
June 21, 2016: Current Medical Research and Opinion
Emily J Gallagher, Zara Zelenko, Aviva Tobin-Hess, Ulrich Werner, Norbert Tennagels, Derek LeRoith
AIMS/HYPOTHESIS: Previous epidemiological studies have reported a potential link between insulin analogues and breast cancer; however, a prospective randomised controlled trial showed neutral effects of insulin glargine on cancer risk. Insulin glargine is metabolised in vivo to an M1 metabolite. A question remains whether a subset of individuals with slower rates of glargine metabolism or who are on high doses could, theoretically, have an increased risk of cancer progression if a tumour is already present...
September 2016: Diabetologia
Seiya Shimoda, Miki Sato, Taiji Sekigami, Hiroyuki Motoshima, Ryohei Yoshimura, Kazuki Fukuda, Yasuto Matsuo, Hideyuki Noda, Mina Okubo, Shinji Ichimori, Kazuo Fujisawa, Makiko Fukunaga, Eiichi Araki
AIMS/INTRODUCTION: The aim of the present prospective observational study was to assess long-term efficacy and safety of insulin degludec as a part of a basal-bolus therapy for Japanese patients with type 1 or type 2 diabetes in routine clinical practice. MATERIALS AND METHODS: In the present study, 93 type 1 diabetes patients and 135 type 2 diabetes patients treated with insulin glargine or detemir were switched from their basal insulin to insulin degludec. The primary end-points were the changes in glycated hemoglobin (HbA1c) from baseline at 3, 6 and 12 months...
September 2016: Journal of Diabetes Investigation
Peter Hammond
Type 1 diabetes affects around 370,000 adults in the UK, about 10% of all those diagnosed with diabetes. In type 1 diabetes there is a lack of beta cell insulin secretion as a result of autoimmune destruction of the beta cells. However, patients are not affected by insulin resistance, and so do not routinely experience the features of metabolic syndrome that occur in type 2 diabetes. NICE recommends considering further investigation with autoantibody testing or measurement of C-peptide when: type 1 diabetes is suspected but the presentation includes atypical features (e...
January 2016: Practitioner
H Makino, A Tanaka, H Hosoda, R Koezuka, M Tochiya, Y Ohata, T Tamanaha, Y Miyamoto, K Kangawa, I Kishimoto
AIM: To compare the effects of the basal insulin analogues glargine and detemir on endothelial function and adipocytokine levels in people with Type 2 diabetes. METHODS: We studied 32 people with Type 2 diabetes whose blood glucose control was unsatisfactory while receiving only oral hypoglycaemic drugs. Participants were randomized to either insulin glargine or detemir for 24 weeks and then crossed over to the other treatment without a washout period. Flow-mediated vasodilatation, adipocytokine levels (plasminogen activator inhibitor-1 and leptin/adiponectin ratio), and fasting ghrelin levels were monitored...
May 6, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
Yoel Toledano, Eran Hadar, Moshe Hod
INTRODUCTION: Diabetes during pregnancy may lead to maternal, fetal and neonatal complications. In order to limit unwarranted outcomes, strict glycemic control is essential. In the past, human insulin was the only insulin formulation administered in pregnancy. However, insulin analogues have also been used for this indication in recent years. AREAS COVERED: This article reviews the published data regarding the safety of insulin analogue use during pregnancy. We present the qualities, advantages and pitfalls of insulin analogue use in pregnancy compared with human insulin...
July 2016: Expert Opinion on Drug Safety
Mark Stecker, Matthew Stevenson
AIMS: To assess the effects of insulin on peripheral nerve under normoglycemic and hyperglycemic conditions in the presence and absence of anoxia. METHODS: This study uses the in-vitro sciatic nerve model to assess the effect of insulin on peripheral nerve with the nerve action potential (NAP) as an index of nerve function. RESULTS: Under normoglycemic conditions, low concentrations of regular insulin (0.01nM) reduced the conduction velocity of oxygenated nerves...
July 2016: Journal of Diabetes and its Complications
R M Agesen, P L Kristensen, H Beck-Nielsen, K Nørgaard, H Perrild, J S Christiansen, T Jensen, P Hougaard, H H Parving, B Thorsteinsson, L Tarnow, U Pedersen-Bjergaard
AIM: Insulin analogues reduce the risk of hypoglycaemia compared with human insulin in patients with type 1 diabetes (T1D) and minor hypoglycaemia problems. The HypoAna trial showed that, in patients with recurrent severe hypoglycaemia, treatment based on insulin analogues reduces the risk of severe hypoglycaemia. The present study aims to assess whether this also applies to non-severe hypoglycaemia events during the day and at night. METHODS: This 2-year investigator-initiated multicentre, prospective, randomized, open, blinded endpoint (PROBE) trial involved patients with T1D and at least two episodes of severe hypoglycaemia during the previous year...
September 2016: Diabetes & Metabolism
Ippei Ikushima, Kohei Kaku, Koichi Hirao, Lars Bardtrum, Hanne Haahr
INTRODUCTION: The present study aimed to evaluate the pharmacokinetic and pharmacodynamic properties of insulin degludec (IDeg) in Japanese patients with type 1 diabetes. MATERIALS AND METHODS: This was a randomized, single-center, double-blind, two-period, crossover, multiple-dose trial. Patients were randomized into two treatment sequences, and received IDeg or insulin detemir for 6 days and a washout period (7-21 days) before switching treatment. Blood samples for pharmacokinetic measurements were obtained before each dose and up to 120 h after the last dose of each treatment period...
March 2016: Journal of Diabetes Investigation
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