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https://www.readbyqxmd.com/read/29406841/slow-titration-and-delayed-intensification-of-basal-insulin-among-patients-with-type-2-diabetes
#1
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...
November 16, 2017: 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
#2
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
#3
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...
January 30, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29316130/efficacy-and-safety-of-fast-acting-insulin-aspart-in-comparison-with-insulin-aspart-in-type-1-diabetes-onset%C3%A2-1-a-52-week-randomized-treat-to-target-phase%C3%A2-3-trial
#4
Chantal Mathieu, Bruce W Bode, Edward Franek, Athena Philis-Tsimikas, Ludger Rose, Tina Graungaard, Anne Birk Østerskov, David Russell-Jones
AIMS: Compare safety and efficacy of fast-acting insulin aspart (faster aspart) with conventional insulin aspart (IAsp) in adults with type 1 diabetes (T1D). MATERIALS AND METHODS: onset 1 was a randomized, multicentre, treat-to-target, phase 3, 52-week (initial 26 weeks + additional 26 weeks) trial conducted at 165 sites across nine countries. Adults with T1D were randomly allocated to double-blind mealtime faster aspart or IAsp, each with once- or twice-daily insulin detemir...
January 8, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29314667/clinical-characteristics-of-type-2-diabetes-patients-with-discordance-between-hba1c-and-fasting-plasma-glucose-in-the-real-world-an-analysis-of-the-orbit-study
#5
Hua Shu, Juming Lu, Puhong Zhang, Dongshan Zhu, Xian Li, Jiachao Ji, Fang Zhao, Linong Ji
BACKGROUND: We aimed to determine the clinical characteristics of type 2 diabetes patients on basal insulin therapy with inadequate glucose control due to discordance between glycated haemoglobin (HbA1c ) and fasting plasma glucose (FPG) in the real world. METHODS: This was a retrospective analysis of data from the ORBIT study in China. Clinical characteristics of patients with discordance between HbA1c and FPG at baseline and at the end of 6 months of follow-up were analysed using multinomial logistic regression in 4 study groups divided by HbA1c and FPG...
January 3, 2018: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/29300101/quality-of-life-and-treatment-satisfaction-in-actual-clinical-practice-of-patients-with-type-1-diabetes-mellitus-t1dm-and-hypoglycemia-treated-with-insulin-degludec
#6
Edurne Lecumberri, Maite Ortega, Marta Iturregui, José Antonio Quesada, Clotilde Vázquez, Domingo Orozco
OBJECTIVE: The frequency of hypoglycemia in patients with T1DM is high and results in a poorer quality of life and low treatment satisfaction. The aim of our study is to demonstrate the effect of changing the basal insulin (glargine or detemir) to insulin degludec. METHODS: We conducted an observational analytical study on a cohort of 110 patients with T1DM. The patients were administered 3 questionnaires to assess treatment satisfaction (DTSQ-s), fear of hypoglycemia (HFS-II) and quality of life (EQ-5D), before the change and at 6 months...
January 4, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29278460/relationship-between-treatment-persistence-and-a1c-trends-among-patients-with-type-2-diabetes-newly-initiated-on-basal-insulin
#7
Fang Liz Zhou, Lin Xie, Chunshen Pan, Yuexi Wang, Neel Vaidya, Fen Ye, Ronald Preblick, Luigi Meneghini
This study examines the relationship between glycated hemoglobin (A1C) levels and treatment persistence with, or time to discontinuation of, basal insulin in patients with type 2 diabetes (T2D) newly initiating insulin. Claims data were extracted from the Optum™ Clinformatics database from January 2010 to June 2015. Adult patients with T2D initiating insulin glargine 100 U/mL (Gla-100) or insulin detemir (DET) with ≥1 A1C measurement during 12-month baseline and 18-month follow-up periods were included...
December 26, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29276400/challenges-and-unmet-needs-in-basal-insulin-therapy-lessons-from-the-asian-experience
#8
REVIEW
Wing Bun Chan, Jung Fu Chen, Su-Yen Goh, Thi Thanh Huyen Vu, Iris Thiele Isip-Tan, Sony Wibisono Mudjanarko, Shailendra Bajpai, Maria Aileen Mabunay, Pongamorn Bunnag
Basal insulin therapy can improve glycemic control in people with type 2 diabetes. However, timely initiation, optimal titration, and proper adherence to prescribed basal insulin regimens are necessary to achieve optimal glycemic control. Even so, glycemic control may remain suboptimal in a significant proportion of patients. Unique circumstances in Asia (eg, limited resources, management of diabetes primarily in nonspecialist settings, and patient populations that are predominantly less educated) coupled with the limitations of current basal insulin options (eg, risk of hypoglycemia and dosing time inflexibility) amplify the challenge of optimal basal insulin therapy in Asia...
2017: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
https://www.readbyqxmd.com/read/29241887/basal-insulin-regimens-for-adults-with-type-1-diabetes-mellitus-a-cost-utility-analysis
#9
COMPARATIVE STUDY
Dalia Dawoud, Elisabetta Fenu, Bernard Higgins, David Wonderling, Stephanie A Amiel
OBJECTIVES: To assess the cost-effectiveness of basal insulin regimens for adults with type 1 diabetes mellitus in England. METHODS: A cost-utility analysis was conducted in accordance with the National Institute for Health and Care Excellence reference case. The UK National Health Service and personal and social services perspective was used and a 3.5% discount rate was applied for both costs and outcomes. Relative effectiveness estimates were based on a systematic review of published trials and a Bayesian network meta-analysis...
December 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29225702/the-influence-of-dopamine-beta-hydroxylase-and-catechol-o-methyltransferase-gene-polymorphism-on-the-efficacy-of-insulin-detemir-therapy-in-patients-with-type-2-diabetes-mellitus
#10
Tomislav Bozek, Antonela Blazekovic, Matea Nikolac Perkovic, Kristina Gotovac Jercic, Aleksandra Sustar, Lea Smircic-Duvnjak, Tiago F Outeiro, Nela Pivac, Fran Borovecki
Background: Type II diabetes is an important health problem with a complex connection to obesity, leading to a broad range of cardiovascular complications. Insulin therapy often results in weight gain and does not always ensure adequate glycemic control. However, previous studies reported that insulin detemir is an efficient long-acting insulin with a weight sparing effect. The aim of this study was to determine the association of catechol O-methyltransferase (COMT) Val108/158Met and dopamine-beta-hydroxylase (DBH) 1021C/T polymorphisms with the effectiveness of insulin detemir in achieving glucose control and body weight control...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/29090977/observational-registry-of-basal-insulin-treatment-in-patients-with-type-2-diabetes-in-china-safety-and-hypoglycemia-predictors
#11
Tingting Zhang, Linong Ji, Yan Gao, Puhong Zhang, Dongshan Zhu, Xian Li, Jiachao Ji, Fang Zhao, Heng Zhang, Xiaohui Guo
BACKGROUND: The Observational Registry of Basal Insulin Treatment (ORBIT) study evaluated the safety of basal insulin (BI) in real-world settings in China. METHODS: We analyzed 9002 patients with type 2 diabetes (T2D) inadequately controlled with oral hypoglycemic agents from 8 geographic regions and 2 hospital tiers in China who initiated and maintained BI treatment. Body weight and hypoglycemic episodes were recorded at baseline and 3 and 6 months. Serious adverse events (SAEs) were recorded at 3 and 6 months...
November 2017: Diabetes Technology & Therapeutics
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
#12
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
#13
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
#14
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
#15
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
#16
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...
November 10, 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
#17
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
#18
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 in type 2 diabetes patients. MATERIALS AND METHODS: The present study enrolled 30 patients with poorly controlled type 2 diabetes (8% ≤ glycated hemoglobin < 11%) being treated with oral hypoglycemic agent 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 oral hypoglycemic agents...
September 16, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28864965/pharmacological-management-of-gestational-diabetes-mellitus
#19
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...
October 2017: Drugs
https://www.readbyqxmd.com/read/28864828/-severe-atypical-ketoacidosis-due-to-sglt2-inhibitor-therapy-two-case-reports
#20
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
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