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https://www.readbyqxmd.com/read/28537449/understanding-how-pharmacokinetic-and-pharmacodynamic-differences-of-basal-analog-insulins-influence-clinical-practice
#1
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...
May 24, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28511140/different-impacts-of-acylated-and-non-acylated-long-acting-insulin-analogs-on-neural-functions-in-vitro-and-in-vivo
#2
Hiroshi Tsuneki, Hitomi Yoshida, Kosuke Endo, Norihiko Mori, Shuji Hosoh, Masaaki Tsuda, Tsutomu Wada, Toshiyasu Sasaoka
AIMS: Centrally administered insulin improves cognitive functions in patients with Alzheimer's disease; however, it remains unknown whether long-acting insulin analogs exert more pronounced effects than insulin. In the present study, we directly compared the effects of insulin and its analogs on neural functions in vitro and in vivo. METHODS: Cultured rat cerebral cortical neurons were treated with insulin, insulin glargine U100 (Gla), insulin detemir (Det), or insulin degludec (Deg)...
May 4, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28485557/when-the-treatment-becomes-the-problem
#3
Vivek-Thomas J Sankoorikal, Janet Ricks
A 47-year-old white male with a 5-year history of type 2 diabetes mellitus presented to clinic with uncontrolled hyperglycemia, weight loss, and body aches that impeded his ability to work and sleep. He had initially controlled his diabetes successfully with weight loss and exercise. However, in the previous 6 months he had noticed unintentional weight loss. He was evaluated at another clinic where he was prescribed sitagliptin/metformin (Janumet) for his uncontrolled hyperglycemia. After 6 weeks his blood glucose had not significantly improved, and an endocrinologist prescribed insulin glargine (Lantus) and insulin aspart (NovoLog)...
July 2016: Journal of the Mississippi State Medical Association
https://www.readbyqxmd.com/read/28458515/united-states-experience-of-insulin-degludec-alone-or-in-combination-for-type-1-and-type-2-diabetes
#4
REVIEW
Marc Rendell
Insulin degludec has been the product of a sophisticated and systematic biochemical engineering program which began with the release of insulin detemir. The goal was to produce a long-lasting basal insulin with low individual variability. Certainly, this goal has been achieved. Degludec has a duration of action approaching twice that of glargine. Another advantage of degludec is in its lack of unpredictable copolymerization of added aspart. In several studies, degludec has shown lower rates of nocturnal hypoglycemia than glargine...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28394183/assessing-the-impact-of-insulin-glargine-and-detemir-treatment-to-serum-total-igf1-levels-in-the-insulin-naive-type-2-diabetic-patients
#5
Soner Cander, Ozen Oz Gul, Oguzhan Sitki Dizdar, Nizameddin Koca, Taner Aydın, Emre Sarandol, Canan Ersoy
AIM: The mitogenic potential of analog insulins due to their different insulin-like growth factor-1 (IGF1) receptor affinity is a situation that causes concern related to cancer risk. We aimed to examine the changes in the serum IGF1 levels formed by insulin glargine and detemir in the insulin-naive type 2 diabetic patients. METHODS: The serum total IGF1 levels of the 62 insulin-naive type 2 diabetic patients were studied before and after 12 weeks of the started treatment with basal insulin analogs...
June 2017: Metabolic Syndrome and related Disorders
https://www.readbyqxmd.com/read/28372335/effects-of-regular-and-long-acting-insulin-on-cognition-and-alzheimer-s-disease-biomarkers-a-pilot-clinical-trial
#6
Suzanne Craft, Amy Claxton, Laura D Baker, Angela J Hanson, Brenna Cholerton, Emily H Trittschuh, Deborah Dahl, Erin Caulder, Bryan Neth, Thomas J Montine, Youngkyoo Jung, Joseph Maldjian, Christopher Whitlow, Seth Friedman
BACKGROUND: Long acting insulin detemir administered intranasally for three weeks enhanced memory for adults with Alzheimer's disease dementia (AD) or amnestic mild cognitive impairment (MCI). The investigation of longer-term administration is necessary to determine whether benefits persist, whether they are similar to benefits provided by regular insulin, and whether either form of insulin therapy affects AD biomarkers. OBJECTIVE: The present study aimed to determine whether four months of treatment with intranasal insulin detemir or regular insulin improves cognition, daily functioning, and AD biomarkers for adults with MCI or AD...
2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28368217/long-acting-insulin-allergy-in-a-diabetic-child
#7
Carla Mastrorilli, Laura Rizzuti, Antonina Marta Cangelosi, Brunella Iovane, Giovanni Chiari, Carlo Caffarelli
Insulin allergy has been uncommon since the introduction of human recombinant insulin preparations; the prevalence is 2.4%. Insulin injection could elicit immediate reactions, which are usually induced by an IgE-mediated mechanism, within the first hour after drug administration. In the present study, we describe the case of a child who experienced immediate urticaria after long-acting insulin injection. A 9-year-old girl affected by type I diabetes mellitus referred a history of three episodes of urticaria 30 min after insulin subcutaneous injection...
April 1, 2017: International Journal of Immunopathology and Pharmacology
https://www.readbyqxmd.com/read/28356319/fast-acting-insulin-aspart-improves-glycemic-control-in-basal-bolus-treatment-for-type-1-diabetes-results-of-a-26-week-multicenter-active-controlled-treat-to-target-randomized-parallel-group-trial-onset-1
#8
David Russell-Jones, Bruce W Bode, Christophe De Block, Edward Franek, Simon R Heller, Chantal Mathieu, Athena Philis-Tsimikas, Ludger Rose, Vincent C Woo, Anne Birk Østerskov, Tina Graungaard, Richard M Bergenstal
OBJECTIVE: This multicenter, treat-to-target, phase 3 trial evaluated the efficacy and safety of fast-acting insulin aspart (faster aspart) versus conventional insulin aspart (IAsp) in adults with type 1 diabetes. RESEARCH DESIGN AND METHODS: The primary end point was change from baseline in HbA1c after 26 weeks. After an 8-week run-in, subjects were randomized (1:1:1) to double-blind mealtime faster aspart (n = 381), IAsp (n = 380), or open-label postmeal faster aspart (n = 382)-each with insulin detemir...
March 29, 2017: Diabetes Care
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
#9
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/28277867/the-role-of-the-new-basal-insulin-analogs-in-addressing-unmet-clinical-needs-in-people-with-type-1-and-type-2-diabetes
#10
Rosemarie Lajara, Eda Cengiz, Robert J Tanenberg
BACKGROUND: Despite improvements in anti-hyperglycemic therapies, there are many unmet clinical needs that hinder successful glycemic control in people being treated with current basal insulin analogs. OBJECTIVE: This paper reviews the unmet needs associated with current basal insulin therapy and describes the most recent basal insulins for the treatment of diabetes. METHODS: PubMed was searched for articles on basal insulin analogs published between 2000 and April 2016...
June 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28274680/a-retrospective-review-of-insulin-requirements-in-patients-using-u-500-insulin-hospitalized-to-a-veterans-affairs-hospital
#11
Rohit Kedia, Cyrus Desouza, Lynette M Smith, Vijay Shivaswamy
AIMS: The aim of this study was to compare the changes in the total daily dose (TDD) of insulin of patients on U-500 insulin; before hospitalization, during hospitalization and six weeks after discharge. METHODS: A retrospective chart review of veterans with type 2 diabetes receiving U-500 insulin in the ambulatory setting and who were admitted between 2012 and 2015 was performed. During hospitalization, patients were transitioned to receive U-100 insulin (detemir or glargine for basal and aspart for bolus)...
May 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28230445/benchmarking-insulin-treatment-persistence-among-patients-with-type-2-diabetes-across-different-u-s-payer-segments
#12
Wenhui Wei, Jenny Jiang, Youbei Lou, Sohini Ganguli, Mark S Matusik
BACKGROUND: Treatment persistence with basal insulins is crucial to achieving sustained glycemic control, which is associated with a reduced risk of microvascular disease and other complications of type 2 diabetes (T2D). However, studies suggest that persistence with basal insulin treatment is often poor. OBJECTIVE: To measure and benchmark real-world basal insulin treatment persistence among patients with T2D across different payer segments in the United States...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230322/comparative-effectiveness-and-safety-of-different-basal-insulins-in-a-real-world-setting
#13
Linong Ji, Puhong Zhang, Dongshan Zhu, Juming Lu, Xiaohui Guo, Yangfeng Wu, Xian Li, Jiachao Ji, Weiping Jia, Wenying Yang, Dajin Zou, Zhiguang Zhou, Yan Gao, Satish K Garg, Changyu Pan, Jianping Weng, Sanjoy K Paul
AIMS: To compare glucose control and safety of different basal insulin therapies (BI, including Insulin NPH, glargine and detemir) in real-world clinical settings based on a large-scale registry study. METHODS: In this multi-center 6-month prospective observational study, patients with type 2 diabetes (HbA1c ≥ 7%) who were uncontrolled by oral anti-diabetic drugs (OADs) and were willing to initiate BI therapy were enrolled from 209 hospitals within 8 regions of China...
February 23, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28156005/different-insulin-types-and-regimens-for-pregnant-women-with-pre-existing-diabetes
#14
REVIEW
Sinéad M O'Neill, Louise C Kenny, Ali S Khashan, Helen M West, Rebecca Md Smyth, Patricia M Kearney
BACKGROUND: Insulin requirements may change during pregnancy, and the optimal treatment for pre-existing diabetes is unclear. There are several insulin regimens (e.g. via syringe, pen) and types of insulin (e.g. fast-acting insulin, human insulin). OBJECTIVES: To assess the effects of different insulin types and different insulin regimens in pregnant women with pre-existing type 1 or type 2 diabetes. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 October 2016), ClinicalTrials...
February 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28133990/economic-outcomes-with-the-conversion-of-insulin-delivery-methods-in-hospitals
#15
Kari A Kelton, Sinem Perk, Scott Loveland, Magaly Perez-Nieves, Haoda Fu, Xiaomei Peng
PURPOSE: To evaluate the insulin wastage and associated acquisition costs when switching from individual patient supply (IPS) of 3-mL pens of rapid-acting insulin (RAI) aspart to floor stock (FS) dispensing of 3-mL vials of RAI lispro, and with conversion from IPS of 3-mL pens to centralized unit dose (CUD) of 10-mL vials of basal insulin detemir. METHODS: Data from September 2010 to December 2012 from three hospitals in the Roper St. Francis Healthcare (RSFH) were used: Roper Hospital (368 beds), Bon Secours St...
February 16, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28115821/insulin-detemir-in-combination-with-oral-antidiabetic-drugs-improves-glycemic-control-in-persons-with-type-2-diabetes-in-near-east-countries-results-from-the-lebanese-subgroup
#16
Akram Echtay, Emile Andari, Paola Atallah, Roland Moufarrege, Rita Nemr
OBJECTIVE: To evaluate the effectiveness and safety of insulin detemir treatment as add-on therapy in a real-world setting of Lebanese insulin naïve persons, with type 2 diabetes poorly controlled on oral antidiabetic drugs (OADs). METHODS: Our study was a prospective, observational study representing the Lebanese arm of the multinational prospective and observational study involving 2,155 persons across Near East countries, Lebanon, Pakistan, Israel and Jordan...
January 19, 2017: Ethnicity & Disease
https://www.readbyqxmd.com/read/28105735/observational-registry-of-basal-insulin-treatment-orbit-in-patients-with-type-2-diabetes-uncontrolled-with-oral-antihyperglycaemic-drugs-real-life-use-of-basal-insulin-in-china
#17
Linong Ji, Puhong Zhang, Dongshan Zhu, Xian Li, Jiachao Ji, Juming Lu, Xiaohui Guo, Weiping Jia, Jianping Weng, Yangfeng Wu, Wenying Yang, Dajin Zou, Zhiguang Zhou, Changyu Pan, Yan Gao, Satish K Garg
AIMS: To examine treatment patterns following basal insulin (BI) introduction in type 2 diabetes mellitus (T2DM) patients under real-world conditions across China. MATERIALS AND METHODS: Overall, 18 995 patients inadequately controlled (HbA1c ≥ 53 mmol/mol [7%]) with oral antihyperglycaemic drugs (OADs) and willing to receive BI treatment were registered at 209 hospitals and followed at baseline (visit 1), 3 months (visit 2) and 6 months (visit 3)...
June 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28100192/design-and-rationale-of-a-large-international-prospective-cohort-study-to-evaluate-the-occurrence-of-malformations-and-perinatal-neonatal-death-using-insulin-detemir-in-pregnant-women-with-diabetes-in-comparison-with-other-long-acting-insulins
#18
Elisabeth R Mathiesen, Henning Andersen, Sofia I I Kring, Peter Damm
BACKGROUND: There are a lack of data regarding the effect of basal insulin analogues on rates of events like congenital malformation and perinatal mortality in diabetic pregnancy. METHODS: The present study is a prospective, non-interventional, multicentre cohort study conducted in seven countries, designed to assess the safety of insulin detemir during pregnancy, and to monitor the health status of resulting infants (exposed in utero) up to 1 year of age. The study population includes women with type 1 or type 2 diabetes, who are pregnant and being treated with insulin...
January 18, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28099755/comparing-effects-of-insulin-analogues-and-human-insulin-on-nocturnal-glycaemia-in-hypoglycaemia-prone-people-with-type-1-diabetes
#19
P L Kristensen, L Tarnow, C Bay, K Nørgaard, T Jensen, H-H Parving, H Perrild, H Beck-Nielsen, J S Christiansen, B Thorsteinsson, U Pedersen-Bjergaard
AIMS: To assess the difference between analogue and human insulin with regard to nocturnal glucose profiles and risk of hypoglycaemia in people with recurrent severe hypoglycaemia. METHODS: A total of 72 people [46 men, mean ± sd age 54 ± 12 years, mean ± sd HbA1c 65 ± 12 mmol/mol (8.1 ± 1.1%), mean ± sd duration of diabetes 30 ± 14 years], who participated in a 2-year randomized, crossover trial of basal-bolus therapy with insulin detemir/insulin aspart or human NPH insulin/human regular insulin (the HypoAna trial) were studied for 2 nights during each treatment...
January 18, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28061430/exploring-the-characteristics-of-suboptimally-controlled-patients-after-24weeks-of-basal-insulin-treatment-an-individualized-approach-to-intensification
#20
Kamlesh Khunti, Taner Damci, Lise Lotte Husemoen, Vinay Babu, Andreas Liebl
AIM: To identify characteristics of suboptimally controlled patients with type 2 diabetes (T2DM) on basal insulin treatment who may benefit from intensive titration or further intensification of treatment. METHODS: A post hoc analysis of SOLVE: a 24-week, international, observational study conducted in 17,374 patients with T2DM inadequately controlled on oral antidiabetic drugs (OADs) started on once-daily insulin detemir. Patients were divided into two groups based on whether they achieved HbA1c<7...
January 2017: Diabetes Research and Clinical Practice
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