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https://www.readbyqxmd.com/read/29044860/effects-of-exenatide-twice-daily-exenatide-once-weekly-or-insulin-in-patients-with-type-2-diabetes-and-baseline-hba1c-%C3%A2-10-0-two-pooled-analyses-including-20-randomised-controlled-trials
#1
Robert S Busch, James Ruggles, Jenny Han, Elise Hardy
AIMS: Patients with advanced type 2 diabetes (T2D) and high glycated haemoglobin (HbA1c) values can be difficult to treat because of their severe metabolic disease. This pooled analysis examined the treatment effects of exenatide twice daily (BID), exenatide once weekly (QW) and insulin in patients with high baseline HbA1c (≥10.0%). METHODS: This post hoc analysis used pooled data from 12 and 8 randomised controlled trials of exenatide BID and exenatide QW, respectively...
October 17, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29028123/impact-of-insulin-detemir-administration-time-on-hypoglycemia-rates-in-hospitalized-patients
#2
Jennifer L Grelle, Sydney N Kutter, Megan E Giruzzi, John C Tawwater
STUDY OBJECTIVE: To determine if insulin detemir administration time affects the frequency of hypoglycemia (blood glucose level <70 mg/dL) in hospitalized patients. DESIGN: Retrospective cohort study. PATIENTS: A total of 357 adults (aged 18-89 yrs) who received insulin detemir for at least 48 hours while hospitalized between January 1, 2014, and December 31, 2015, were included. Patients were categorized into one of three groups according to insulin detemir administration time: detemir given once daily between 7 A...
October 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28970434/comparison-of-insulin-detemir-and-insulin-glargine-for-hospitalized-patients-on-a-basal-bolus-protocol
#3
Sondra Davis, Chad Friece, Nicki Roderman, Darrell Newcomer, Evangelina Castaneda
BACKGROUND: The primary purpose of this study is to determine whether insulin detemir is equivalent to insulin glargine in controlling hyperglycemia for the adult hospitalized patient on a basal-bolus treatment regimen. METHODS: A retrospective study was conducted at two acute care hospitals within the same health system. Patients from both facilities who were initiated on a basal-bolus subcutaneous insulin regimen were included in the study. The basal-bolus regimen consisted of three components: basal, bolus, and corrective insulin with only the data from the first seven days analyzed...
April 23, 2017: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/28954218/effects-of-insulin-analogs-as-an-add-on-to-metformin-on-cutaneous-microcirculation-in-type-2-diabetic-patients
#4
Marinos Fysekidis, Emmanuel Cosson, Karim Takbou, Angela Sutton, Nathalie Charnaux, Isabella Banu, Eric Vicaut, Paul Valensi
BACKGROUND: A single insulin injection was shown to improve microcirculatory blood flow. Our aim was to examine the effects of 4weeks of insulin therapy by three randomly assigned insulin analog regimens (Detemir, Aspart, and their combination) on cutaneous blood flow (CBF) and microcirculatory endothelial function as an add-on to metformin in type 2 diabetic patients poorly controlled on oral antidiabetic treatment. METHODS: Fourty-two type 2 diabetic patients with no history of cardiovascular disease in secondary failure to oral antidiabetic agents had CBF measurements before and after acetylcholine (Ach) iontophoretic administration...
September 24, 2017: Microvascular Research
https://www.readbyqxmd.com/read/28953430/long-term-use-of-long-acting-insulin-analogs-and-breast-cancer-incidence-in-women-with-type-2-diabetes
#5
Jennifer W Wu, Laurent Azoulay, Agnieszka Majdan, Jean-François Boivin, Michael Pollak, Samy Suissa
Purpose The association between long-acting insulin analogs and increased breast cancer risk is uncertain, particularly with the short follow-up in previous studies. We assessed this risk long term in women with type 2 diabetes. Methods A population-based cohort of women 40 years or older, all of whom were treated with long-acting (glargine, detemir) or neutral protamine Hagedorn (NPH) insulin between 2002 and 2012, was formed using the United Kingdom's Clinical Practice Research Datalink. Women were followed until February 2015 or breast cancer diagnosis...
September 27, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28927285/impact-of-a-basal-bolus-insulin-regimen-on-metabolic-control-and-risk-of-hypoglycemia-in-patients-with-diabetes-undergoing-peritoneal-dialysis
#6
Ana María Gómez, Santiago Vallejo, Freddy Ardila, Oscar M Muñoz, Álvaro J Ruiz, Mauricio Sanabria, Alfonso Bunch, Elly Morros, Laura Kattah, Maira García-Jaramillo, Fabián León-Vargas
INTRODUCTION: Clinical interventional studies in diabetes mellitus usually exclude patients undergoing peritoneal dialysis (PD). This study evaluates the impact of an educational program and a basal-bolus insulin regimen on the blood glucose level control and risk of hypoglycemia in this population. METHODS: A before-and-after study was conducted in type 1 and type 2 DM patients undergoing PD at the Renal Therapy Services (RTS) clinic network, Bogota, Colombia. An intervention was instituted consisting of a three-month educational program and a basal-bolus detemir (Levemir, NovoNordisk) and aspart (Novorapid, NovoNordisk) insulin regimen...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28921908/biphasic-insulin-aspart-30-reduces-glycemic-variability-to-a-greater-degree-than-insulin-detemir-a-randomized-controlled-trial-of-once-daily-insulin-regimens-using-continuous-glucose-monitoring
#7
Daisuke Tsujino, Rimei Nishimura, Yoshiko Onda, Chiaki Seo, Kiyotaka Ando, Kazunori Utsunomiya
INTRODUCTION: We compared the efficacy of insulin detemir and biphasic insulin aspart-30 given in the morning as an add-on to oral hypoglycemic agents (OHAs) in type 2 diabetic patients. MATERIALS AND METHODS: This study enrolled 30 patients with poorly controlled type 2 diabetes (8%≤HbA1c<11%) being treated with OHA mono- or combination therapy with biguanides, sulfonylureas, or thiazolidinediones. The patients were randomly assigned to insulin detemir (group D) or insulin aspart-30 (group A) given in the morning as add-on to OHAs...
September 16, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28864965/pharmacological-management-of-gestational-diabetes-mellitus
#8
Geetha Mukerji, Denice S Feig
Gestational diabetes mellitus (GDM) is associated with an increased risk of adverse pregnancy outcomes in the setting of poor glycemic control. The initial management for GDM includes intensive lifestyle modification, which often requires behavioral and nutritional changes to optimize glycemic control. Pharmacotherapy for GDM is initiated when glycemic targets are not met. The rapid-acting bolus analogues aspart and lispro achieve postprandial targets with less hypoglycemia compared to regular insulin, with similar fetal outcomes...
September 2, 2017: Drugs
https://www.readbyqxmd.com/read/28864828/-severe-atypical-ketoacidosis-due-to-sglt2-inhibitor-therapy-two-case-reports
#9
T G K Breuer, K Kampmann, A Wutzler, C Steinfort, W Uhl, W E Schmidt, J J Meier
Two female patients were admitted due to ketoacidosis. Serum glucose was moderately elevated. The patients exhibited abdominal and neurologic symptoms. Treatment consisted of metformin, insulin glargin and empagliflozin, as well as glimepiride, insulin detemir and empagliflozin, respectively. Treatment with intravenous fluid replacement, insulin, glucose, potassium and buffer solution led to a normalisation of pH and serum glucose levels. Our report describes two cases of atypical ketoacidosis with moderately elevated serum glucose during sodium-glucose co-transporter-2 (SGLT2) inhibitor therapy...
September 1, 2017: Der Internist
https://www.readbyqxmd.com/read/28792170/consensus-on-basal-insulin-in-the-management-of-type-2-diabetes-which-when-and-how
#10
Samit Ghosal, Binayak Sinha, Anirban Majumder, Ashok Kumar Das, Awadhesh Kumar Singh, Biswajit Ghoshdastidar, Debasish Maji, Ghanshyam Goyal, Jagat Jyoti Mukherjee, Kalyan Kumar Gangopadhyay, Mathew John, Sanjay Chatterjee, Shalini Jaggi, Subir Ray, Sujoy Majumdar, Surendra Kumar Sharma
INTRODUCTION: Type 2 diabetes mellitus (T2DM) has attained epidemic proportions and continues to increase despite the availability of a number of oral antidiabetic medications and major advances made in insulin delivery since its discovery nearly a hundred years ago. One, amongst many other reasons responsible for the inability to achieve adequate glycaemic control in a substantial proportion of T2DM patients is the delayed initiation and inappropriate intensification of insulin treatment...
July 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28758947/adiponectin-leptin-and-leptin-receptor-in-obese-patients-with-type-2-diabetes-treated-with-insulin-detemir
#11
Paweł Olczyk, Robert Koprowski, Katarzyna Komosinska-Vassev, Agnieszka Jura-Półtorak, Katarzyna Winsz-Szczotka, Kornelia Kuźnik-Trocha, Łukasz Mencner, Alicja Telega, Diana Ivanova, Krystyna Olczyk
The aim of the present study is to quantitatively assess the expression of selected regulatory molecules, such as leptin, leptin receptor, and adiponectin in the blood of obese patients with type 2 diabetes both before treatment and after six months of pharmacological therapy with the long-lasting insulin analogue, insulin detemir. A significant decrease in the analysed regulatory molecules, i.e., leptin receptor and adiponectin, was found in blood plasma of the patients with untreated type 2 diabetes. These changes were accompanied by an increase in plasma leptin concentrations...
July 30, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28720583/central-effects-of-insulin-detemir-on-feeding-body-weight-and-metabolism-in-rats
#12
Joseph R Vasselli, F Xavier Pi-Sunyer, Daniel G Wall, Catherine S John, Colin D Chapman, Paul J Currie
Insulin detemir (DET) is a basal insulin analog that, in contrast to other long-acting forms of insulin, has significant weight-gain sparing effects in diabetic patients. We hypothesized that this effect of DET may be due to its enhanced catabolic action in the CNS. We investigated the long-term effects of single third ventricular (3V) microinjections of equimolar doses of DET and regular insulin in normal male rats on feeding, body weight, energy expenditure (EE) and respiratory quotient (RQ). Also in acute testing, we assessed the ability of lower doses of DET to alter feeding, EE and RQ when microinjected directly into the paraventricular nucleus (PVN)...
July 18, 2017: American Journal of Physiology. Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28704062/flextouch-an-insulin-pen-injector-with-a-low-activation-force-across-different-insulin-formulations-needle-technologies-and-temperature-conditions
#13
Niels Gudiksen, Thibaud Hofstätter, Birgitte B Rønn, Thomas Sparre
FlexTouch® (Novo Nordisk A/S, Bagsvaerd, Denmark) is a pen-injector with a torque spring mechanism requiring a low activation force. This laboratory-based study compared the activation force of FlexTouch during the injection of insulin with different needles and at temperature conditions within the range at which the device is recommended for use. Using a tensile tester, activation force was measured at maximum dose settings for insulin detemir (100 U/mL) and insulin degludec (100 and 200 U/mL) at standard (23°C ± 5°C), cool (5°C ± 3°C), and warm (30°C ± 2°C) conditions...
October 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28683239/comparison-of-efficacy-and-safety-of-glargine-and-detemir-insulin-in-the-management-of-inpatient-hyperglycemia-and-diabetes
#14
Rodolfo J Galindo, Georgia M Davis, Maya Fayfman, David Reyes-Umpierrez, David Alfa, Limin Peng, Ronald Tamler, Francisco J Pasquel, Guillermo E Umpierrez
OBJECTIVE: Glargine and detemir insulin are the two most commonly prescribed basal insulin analogues for the ambulatory and inpatient management of diabetes. The efficacy and safety of basal insulin analogues in the hospital setting has not been established. METHODS: This observational study compared differences in glycemic control and outcomes in non-intensive care unit patients with blood glucose (BG) >140 mg/dL who were treated with glargine or detemir, between January 1, 2012, and September 30, 2015, in two academic centers...
September 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28649943/cost-effectiveness-of-insulin-detemir-versus-insulin-glargine-for-thai-type-2-diabetes-from-a-payer-s-perspective
#15
Unchalee Permsuwan, Kednapa Thavorn, Piyameth Dilokthornsakul, Surasak Saokaew, Nathorn Chaiyakunapruk
AIMS: An economic evidence is a vital tool that can inform the decision to use costly insulin analogs. This study aimed to evaluate long-term cost-effectiveness of insulin detemir (IDet) compared with insulin glargine (IGlar) in type 2 diabetes (T2DM) from the Thai payer's perspective. METHODS: Long-term costs and outcomes were projected using a validated IMS CORE Diabetes Model, version 8.5. Cohort characteristics, baseline risk factors, and costs of diabetes complications were derived from Thai data sources...
July 11, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28579834/hypoglycemia-a-review-of-definitions-used-in-clinical-trials-evaluating-antihyperglycemic-drugs-for-diabetes
#16
REVIEW
Chakrapani Balijepalli, Eric Druyts, Gaye Siliman, Michel Joffres, Kristian Thorlund, Edward J Mills
OBJECTIVE: To understand the severity and potential impact of heterogeneity in definitions of hypoglycemia used in diabetes research, we aimed to review the hypoglycemia definitions adopted in randomized controlled trials (RCTs). METHODS: We reviewed 109 RCTs included in the Canadian Agency for Drugs and Technologies in Health reports for the second- and third-line therapy for the patients with type 2 diabetes (T2D). RESULTS: Nearly 60% (n=66) of the studies reviewed presented the definitions for overall hypoglycemia, and another 20% (n=22) of the studies reported the results for hypoglycemia but did not report a definition...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28573394/cancer-risk-among-insulin-users-comparing-analogues-with-human-insulin-in-the-caring-five-country-cohort-study
#17
Anna But, Marie L De Bruin, Marloes T Bazelier, Vidar Hjellvik, Morten Andersen, Anssi Auvinen, Jakob Starup-Linde, Marjanka K Schmidt, Kari Furu, Frank de Vries, Øystein Karlstad, Nils Ekström, Jari Haukka
AIMS/HYPOTHESIS: The aim of this work was to investigate the relationship between use of certain insulins and risk for cancer, when addressing the limitations and biases involved in previous studies. METHODS: National Health Registries from Denmark (1996-2010), Finland (1996-2011), Norway (2005-2010) and Sweden (2007-2012) and the UK Clinical Practice Research Datalink database (1987-2013) were used to conduct a cohort study on new insulin users (N = 327,112)...
June 1, 2017: Diabetologia
https://www.readbyqxmd.com/read/28570711/igf1-and-igf2-specificities-to-the-two-insulin-receptor-isoforms-are-determined-by-insulin-receptor-amino-acid-718
#18
Mie Andersen, Dorte Nørgaard-Pedersen, Jakob Brandt, Ingrid Pettersson, Rita Slaaby
METHODS: Alanine scan of insulin receptor (IR)-B exon 11 and site-directed mutagenesis of amino acid 718 in human IR-A and IR-B were performed. Ligand affinities to wild type and mutated receptors were studied by displacement of radioactive insulin in binding assay on secreted soluble midi receptors or solubilized semi-purified full length receptors stably expressed in Baby Hamster Kidney cells. Phosphorylation of IR in response to insulin, IGF1 and IGF2 was measured using ELISA. RESULTS: Insulin, insulin detemir and insulin glargine maximally showed two fold differences in affinity for human IR-A and IR-B, but IGF1 and IGF2 had up to 10 fold preference for IR-A...
2017: PloS One
https://www.readbyqxmd.com/read/28559127/effects-of-maternal-hypoglycemia-on-fetal-eye-and-skeleton-development-in-rats
#19
Chiharu Kuwata, Naoko Saeki, Kumi Honda, Toshiki Matsuoka, Yoshimi Tsuchiya, Kazuhiro Shimomura
The relationship between insulin-induced maternal hypoglycemia and teratogenicity was investigated in detail. We injected 4 different forms of insulin (insulin human, aspart, glargine, and detemir) subcutaneously at 1 or 2 dose levels to Sprague-Dawley rats from Days 6 to 11 of pregnancy, measured blood glucose levels, and conducted fetal examination. In the insulin human and aspart (low dose) groups, while severe hypoglycemia (approximately 50mg/dL) was seen, it lasted only 6h and no fetal anomalies were observed...
May 27, 2017: Reproductive Toxicology
https://www.readbyqxmd.com/read/28537449/understanding-how-pharmacokinetic-and-pharmacodynamic-differences-of-basal-analog-insulins-influence-clinical-practice
#20
Jennifer Goldman, Christoph Kapitza, Jeremy Pettus, Tim Heise
This article reviews pharmacokinetic (PK) and pharmacodynamic (PD) concepts relating to the pharmacology of basal insulin analogs. Understanding the pharmacology of currently available long-acting basal insulins and the techniques used to assess PK and PD parameters (e.g. the euglycemic clamp method) is important when considering the efficacy and safety of these agents, and can help in understanding the rationale for specific dosing strategies when tailoring therapy for a specific patient. Basal insulins such as insulin glargine 100 units (U)/mL and insulin detemir show improved PK/PD characteristics compared with the intermediate-acting NPH insulin, with a longer duration of action, a more consistent glucose-lowering effect and less prominent concentration peaks...
June 23, 2017: Current Medical Research and Opinion
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