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https://www.readbyqxmd.com/read/29892561/reduction-of-glycemic-variability-with-degludec-insulin-in-patients-with-unstable-diabetes
#1
Diana Cristina Henao-Carrillo, Oscar M Muñoz, Ana M Gómez, Martín Rondón, Christian Colón, L Chica, Claudia Rubio, Fabián León-Vargas, Maria Alejandra Calvachi, Ana María Perea
Introduction: Degludec (IDeg) is an ultralong-acting insulin, with stable pharmacodynamic profile which leads to lower fluctuations in glucose levels. The effect of IDeg has not been specifically assessed in patients with unstable diabetes, defined as increased glycemic variability (GV). Methods: A prospective before-after pilot study was conducted, including patients managed at Hospital Universitario San Ignacio in Bogotá, Colombia. The impact of the switch from a Glargine or Detemir insulin to a basal insulin regimen with IDeg for 12 weeks on GV measured by continuous glucose monitoring, on A1c levels, and on the incidence of episodes of global and nocturnal hypoglycemia was assessed in a group of patients with (coefficient of variation >34%) or without increased basal GV using a Generalised Estimating Equation (GEE) analysis...
June 2018: Journal of Clinical & Translational Endocrinology
https://www.readbyqxmd.com/read/29844693/evaluating-the-cost-effectiveness-of-insulin-detemir-versus-neutral-protamine-hagedorn-insulin-in-patients-with-type-1-or-type-2-diabetes-in-the-uk-using-a-short-term-modeling-approach
#2
Richard F Pollock, Barrie Chubb, William J Valentine, Simon Heller
Background: To estimate the short-term cost-effectiveness of insulin detemir (IDet) versus neutral protamine Hagedorn (NPH) insulin based on the incidence of non-severe hypoglycemia and changes in body weight in subjects with type 1 diabetes (T1D) or type 2 diabetes (T2D) in the UK. Methods: A model was developed to evaluate cost-effectiveness based on non-severe hypoglycemia, body mass index, and pharmacy costs over 1 year. Published rates of non-severe hypoglycemia were employed in the T1D and T2D analyses, while reduced weight gain with IDet was modeled in the T2D analysis only...
2018: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
https://www.readbyqxmd.com/read/29770892/identification-of-n-terminally-truncated-derivatives-of-insulin-analogs-formed-in-pharmaceutical-formulations
#3
Joanna Zielińska, Jacek Stadnik, Anna Bierczyńska-Krzysik, Dorota Stadnik
PURPOSE: Isolation and identification of unknown impurities of recombinant insulin lispro (produced at IBA) formed during accelerated stability testing of pharmaceutical solutions. For comparative purposes also commercially available formulations of recombinant human insulin (Humulin S®; Lilly), recombinant insulin lispro (Humalog®; Lilly), recombinant insulin aspart (NovoRapid® Penfill®; Novo Nordisk), recombinant insulin detemir (Levemir®; Novo Nordisk) and recombinant insulin glargine (Lantus®; Sanofi-Aventis) were analyzed...
May 16, 2018: Pharmaceutical Research
https://www.readbyqxmd.com/read/29770552/variability-of-insulin-degludec-and-glargine-u300-a-matter-of-methodology-or-just-marketing
#4
Tim Heise, Sascha Heckermann, J Hans DeVries
The variability in the time-action profiles of insulin preparations, in particular basal insulins, has been a matter of debate ever since the publication of a glucose clamp study comparing the day-to-day variability of three different basal insulins (glargine U100, detemir and NPH) in 2004 [1]. While critics did not contest the findings of a lower variability of some basal insulins in this and a later [2] glucose clamp study, they did question the relevance of a lower pharmacokinetic (PK) and pharmacodynamic (PD) variability for clinical endpoints [3, 4]...
May 17, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29741925/glycemic-control-in-adult-type-1-diabetes-patients-with-insulin-glargine-insulin-detemir-or-continuous-subcutaneous-insulin-infusion-in-daily-practice
#5
Päivi Rautiainen, Hilkka Tirkkonen, Tiina Laatikainen
BACKGROUNDS: This study aims to compare glycemic control of persons with type 1 diabetes using multiple daily injections (MDI) with insulin glargine versus insulin detemir or with continuous subcutaneous insulin infusion (CSII) in daily practice. SUBJECTS AND METHODS: All adult individuals with type 1 diabetes (n = 1053) were identified from the electronic patient database in North Karelia, Finland. The persons' individual data for insulin treatment, diabetic ketoacidosis (DKA), and hemoglobin A1c (HbA1c) measurements during the year 2014 were obtained from medical records...
May 9, 2018: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29730391/pharmacotherapy-for-hyperglycemia-in-pregnancy-the-new-insulins
#6
REVIEW
Yoel Toledano, Eran Hadar, Moshe Hod
Hyperglycemia in pregnancy may lead to adverse maternal, fetal and neonatal outcomes. Tight glycemic control is prudent in order to reduce pregnancy complications. For many years, the gold standard pharmacological therapy during pregnancy was human insulin. Recently, insulin analogues were also introduced to clinical use in pregnancy. This brief review aims to summarize the information on the efficacy and safety of insulin analogue therapy during gestation. The strengths and pitfalls of insulin analogue administration during gestation, compared with human insulin, are presented...
May 3, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29719376/theoretical-overview-of-clinical-and-pharmacological-aspects-of-the-use-of-etelcalcetide-in-diabetic-patients-undergoing-hemodialysis
#7
REVIEW
Jianzhen Ye, Guangrui Deng, Feng Gao
Etelcalcetide is the first intravenous calcimimetic agent authorized for the treatment of secondary hyperparathyroidism (sHPT) in patients undergoing hemodialysis in Europe, the US, and Japan. The relationship between sHPT and diabetes resides on complex, bidirectional effects and largely unknown homeostatic mechanisms. Although 30% or more patients with end-stage renal disease are diabetics and about the same percentage of those patients suffer from sHPT associated with hemodialysis, no data on the specificities of the use of etelcalcetide in such patients are available yet...
2018: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29709796/pharmacodynamics-and-pharmacokinetics-of-insulin-detemir-and-insulin-glargine-300-u-ml-in-healthy-dogs
#8
H Fink, C Herbert, C Gilor
Insulin glargine 300 U/mL and insulin detemir are synthetic long-acting insulin analogs associated with minimal day-to-day variability or episodes of hypoglycemia in people. Here, 8 healthy purpose-bred dogs each received 2.4 nmol/kg subcutaneous injections of insulin detemir (0.1 U/kg) and insulin glargine 300 U/mL (0.4 U/kg) on 2 different days, >1 wk apart, in random order. Blood glucose (BG) was measured every 5 min, and glucose was administered intravenously at a variable rate with the goal of maintaining BG within 10% of baseline BG ("isoglycemic clamp")...
April 10, 2018: Domestic Animal Endocrinology
https://www.readbyqxmd.com/read/29692348/effects-of-insulin-and-analogues-on-carcinogen-induced-mammary-tumours-in-high-fat-fed-rats
#9
Yusaku Mori, Eunhyoung Ko, Rudolf Furrer, Linda C Qu, Stuart C Wiber, I George Fantus, Mario Thevis, Alan Medline, Adria Giacca
It is not fully clarified whether insulin glargine, an analogue with a high affinity for insulin-like growth factor-1 receptor (IGF-1R), increases the risk for cancers that abundantly express IGF-1R such as breast cancer or some types of breast cancer. To gain insight into this issue, female Sprague-Dawley rats fed a high-fat diet were given the carcinogen N-methyl-N-nitrosourea and randomly assigned to vehicle (control), NPH (unmodified human insulin), glargine or detemir ( n  = 30 per treatment). Insulins were given subcutaneously (15 U/kg/day) 5 days a week...
May 2018: Endocrine Connections
https://www.readbyqxmd.com/read/29649221/long-acting-insulin-analogues-for-type-1-diabetes-an-overview-of-systematic-reviews-and-meta-analysis-of-randomized-controlled-trials
#10
Fernanda O Laranjeira, Keitty R C de Andrade, Ana C M G Figueiredo, Everton N Silva, Mauricio G Pereira
BACKGROUND: The comparison between long acting insulin analogues (LAIA) and human insulin (NPH) has been investigated for decades, with many randomized controlled trials (RCTs) and systematic reviews giving mixed results. This overlapping and contradictory evidence has increased uncertainty on coverage decisions at health systems level. AIM: To conduct an overview of systematic reviews and update existing reviews, preparing new meta-analysis to determine whether LAIA are effective for T1D patients compared to NPH...
2018: PloS One
https://www.readbyqxmd.com/read/29619926/parenteral-nutrition-and-insulin-per-protocol-improve-diabetes-management-after-total-pancreatectomy
#11
Sakshi Andersen, Andreas Andersen, Lene Ringholm, Carsten Palnæs Hansen, Jan Storkholm, Kerstin Lillpers, Charlotte Schiøtz, Elisabeth Reinhardt Mathiesen
INTRODUCTION: Pancreatogenic diabetes develops in patients undergoing total pancreatectomy and complicates post-surgical management. The aim of this study was to compare parenteral nutrition (PN) with protocolled insulin treatment to intravenous glucose treatment after total pancreatectomy. METHODS: This was a retrospective study of 97 patients undergoing total pancreatectomy between 2009 and 2014. Patients were divided into a PN cohort (n = 57) and a glucose cohort (n = 40)...
April 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29619381/efficacy-and-safety-of-insulin-glargine-300-u-ml-versus-100-u-ml-in-diabetes-mellitus-a-comprehensive-review-of-the-literature
#12
REVIEW
Hernando Vargas-Uricoechea
To achieve good metabolic control in diabetes and maintain it in the long term, a combination of changes in lifestyle and pharmacological treatment is necessary. The need for insulin depends upon the balance between insulin secretion and insulin resistance. Insulin is considered the most effective glucose-lowering therapy available and is required by people with type 1 diabetes mellitus to control their blood glucose levels; yet, many people with type 2 diabetes mellitus will also eventually require insulin therapy, due to the progressive nature of the disease...
2018: Journal of Diabetes Research
https://www.readbyqxmd.com/read/29615978/genome-wide-analyses-identify-filamin-a-as-a-novel-downstream-target-for-insulin-and-igf1-action
#13
Daniel Aizen, Metsada Pasmanik-Chor, Rive Sarfstein, Zvi Laron, Ilan Bruchim, Haim Werner
Insulin analogs were developed to improve diabetes therapy. However, certain modifications introduced into the insulin molecule were shown to enhance their affinity to the insulin-like growth factor-1 receptor (IGF1R). Most tumors, including endometrial cancers, express high levels of IGF1R. The present study was aimed at identifying the entire set of genes that are differentially activated by insulin glargine or detemir, in comparison to insulin and IGF1, in Type 1 and Type 2 endometrial cancer cell lines (ECC-1 and USPC-1, respectively)...
2018: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29596514/characterisation-of-insulin-analogues-therapeutically-available-to-patients
#14
Gary G Adams, Andrew Meal, Paul S Morgan, Qushmua E Alzahrani, Hanne Zobel, Ryan Lithgo, M Samil Kok, David T M Besong, Shahwar I Jiwani, Simon Ballance, Stephen E Harding, Naomi Chayen, Richard B Gillis
The structure and function of clinical dosage insulin and its analogues were assessed. This included 'native insulins' (human recombinant, bovine, porcine), 'fast-acting analogues' (aspart, glulisine, lispro) and 'slow-acting analogues' (glargine, detemir, degludec). Analytical ultracentrifugation, both sedimentation velocity and equilibrium experiments, were employed to yield distributions of both molar mass and sedimentation coefficient of all nine insulins. Size exclusion chromatography, coupled to multi-angle light scattering, was also used to explore the function of these analogues...
2018: PloS One
https://www.readbyqxmd.com/read/29565719/effect-of-insulin-analogs-on-frequency-of-non-severe-hypoglycemia-in-patients-with-type-1-diabetes-prone-to-severe-hypoglycemia-much-higher-rates-detected-by-continuous-glucose-monitoring-than-by-self-monitoring-of-blood-glucose-the-hypoana-trial
#15
Rikke Mette Agesen, Peter Lommer Kristensen, Henning Beck-Nielsen, Kirsten Nørgaard, Hans Perrild, Tonny Jensen, Hans-Henrik Parving, Birger Thorsteinsson, Lise Tarnow, Ulrik Pedersen-Bjergaard
BACKGROUND: Hypoglycemia is an increasingly important endpoint in clinical diabetes trials. The assessment of hypoglycemia should therefore be as complete as possible. Blinded continuous glucose monitoring (CGM) provides an improved opportunity to capture asymptomatic and nocturnal events. Here we report results from the HypoAna trial comparing all-analog-insulin therapy (aspart/detemir) with all-human-insulin therapy (neutral protamine Hagedorn/regular) on non-severe hypoglycemia (symptomatic and asymptomatic hypoglycemia) as assessed by blinded CGM and compared with data obtained by self-monitoring of blood glucose (SMBG) in patients with type 1 diabetes and recurrent severe hypoglycemia...
March 2018: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29477399/basal-insulin-regimens-for-adults-with-type-1-diabetes-mellitus-a-systematic-review-and-network-meta-analysis
#16
REVIEW
Dalia Dawoud, Rachel O'Mahony, David Wonderling, Jill Cobb, Bernard Higgins, Stephanie A Amiel
OBJECTIVE: To assess the relative efficacy and safety of basal insulin regimens in adults with type 1 diabetes mellitus (T1DM). METHODS: A systematic review and Bayesian network meta-analysis (NMA) of randomized controlled trials comparing two or more basal insulin regimens were conducted. The following basal insulin regimens were included: Neutral Protamine Hagedorn (iNPH) (once [od], twice [bid], and four times daily [qid]), insulin detemir (iDet) (od and bid), insulin glargine 100 IU (iGlarg) (od), and insulin degludec (iDegl) (od)...
February 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29462782/utilizing-elisa-plate-based-immunopurification-and-liquid-chromatography-tandem-mass-spectrometry-for-the-urinary-detection-of-short-and-long-acting-human-insulin-analogues
#17
Péter Judák, Peter Van Eenoo, Koen Deventer
The measurement of human insulin and its synthetic analogues in biological matrices has become increasingly important not only in clinical fields but also in doping control. The use of insulin and its analogues have been included in the list of prohibited substances published by the World Anti-Doping Agency (WADA). This study describes a qualitative method for detection of insulin analogues (lispro, aspart, glulisine, glargine, degludec, detemir) in human urine. The sample preparation consists of a preconcentration step using ultrafiltration followed by an immunoaffinity extraction with an antibody precoated ELISA plate...
May 10, 2018: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29406841/slow-titration-and-delayed-intensification-of-basal-insulin-among-patients-with-type-2-diabetes
#18
Michelle Mocarski, Jason Yeaw, Victoria Divino, Mitch DeKoven, German Guerrero, Jakob Langer, Brian Larsen Thorsted
BACKGROUND: Clinical inertia in type 2 diabetes mellitus (T2DM) refers to the failure of clinicians to intensify therapy when indicated. Many T2DM patients remain suboptimally controlled after initiating basal insulin. OBJECTIVE: To examine the prevalence of patients treated with basal insulin but in poor glycemic control (hemoglobin A1c [A1c] ≥ 7%) after initiation and subsequent treatment intensification patterns and glycemic outcomes in a real-world setting...
April 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29395808/effect-of-short-term-intensive-insulin-therapy-on-the-incretin-response-in-early-type-2-diabetes
#19
H Choi, C K Kramer, B Zinman, P W Connelly, R Retnakaran
AIMS: Short-term intensive insulin therapy (IIT) and gastric bypass surgery are both interventions that can improve beta-cell function, reduce insulin resistance and induce remission of type 2 diabetes. Whereas gastric bypass yields an enhanced glucagon-like peptide-1 (GLP-1) response that may contribute to its metabolic benefits, the effect of short-term IIT on the incretin response is unclear. Thus, we sought to evaluate the impact of IIT on GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) secretion in early type 2 diabetes...
January 11, 2018: Diabetes & Metabolism
https://www.readbyqxmd.com/read/29381818/role-of-omalizumab-in-insulin-hypersensitivity-a-case-report-and-review-of-the-literature
#20
S Mishra, L Connors, B Tugwell
BACKGROUND: Insulin allergy is a rare yet severe side effect of exogenous insulin use. Management typically involves use of alternative antihyperglycaemic agents, symptom control with antihistamines, use of different insulin formulations, and induction of tolerance with incremental doses of insulin. This treatment regimen is not always successful, and the use of omalizumab, an anti-IgE monoclonal antibody, has been used to induce tolerance to insulin. CASE REPORT: G...
May 2018: Diabetic Medicine: a Journal of the British Diabetic Association
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