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https://www.readbyqxmd.com/read/28720103/an-information-and-communication-technology-based-centralized-clinical-trial-to-determine-the-efficacy-and-safety-of-insulin-dose-adjustment-education-based-on-a-smartphone-personal-health-record-application-a-randomized-controlled-trial
#1
Gyuri Kim, Ji Cheol Bae, Byoung Kee Yi, Kyu Yeon Hur, Dong Kyung Chang, Moon-Kyu Lee, Jae Hyeon Kim, Sang-Man Jin
BACKGROUND: A Personal Health Record (PHR) is an online application that allows patients to access, manage, and share their health data. PHRs not only enhance shared decision making with healthcare providers, but also enable remote monitoring and at-home-collection of detailed data. The benefits of PHRs can be maximized in insulin dose adjustment for patients starting or intensifying insulin regimens, as frequent self-monitoring of glucose, self-adjustment of insulin dose, and precise at-home data collection during the visit-to-visit period are important for glycemic control...
July 18, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28710224/assessing-the-effectiveness-of-a-3-month-day-and-night-home-closed-loop-control-combined-with-pump-suspend-feature-compared-with-sensor-augmented-pump-therapy-in-youths-and-adults-with-suboptimally-controlled-type-1-diabetes-a-randomised-parallel-study-protocol
#2
Lia Bally, Hood Thabit, Martin Tauschmann, Janet M Allen, Sara Hartnell, Malgorzata E Wilinska, Jane Exall, Viki Huegel, Judy Sibayan, Sarah Borgman, Peiyao Cheng, Maxine Blackburn, Julia Lawton, Daniela Elleri, Lalantha Leelarathna, Carlo L Acerini, Fiona Campbell, Viral N Shah, Amy Criego, Mark L Evans, David B Dunger, Craig Kollman, Richard M Bergenstal, Roman Hovorka
INTRODUCTION: Despite therapeutic advances, many individuals with type 1 diabetes are unable to achieve tight glycaemic target without increasing the risk of hypoglycaemia. The objective of this study is to determine the effectiveness of a 3-month day-and-night home closed-loop glucose control combined with a pump suspend feature, compared with sensor-augmented insulin pump therapy in youths and adults with suboptimally controlled type 1 diabetes. METHODS AND ANALYSIS: The study adopts an open-label, multi-centre, multi-national (UK and USA), randomised, single-period, parallel design and aims for 84 randomised patients...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28683300/three-year-data-from-5-harmony-phase-3-clinical-trials-of-albiglutide-in-type-2-diabetes-mellitus-long-term-efficacy-with-or-without-rescue-therapy
#3
Philip D Home, Bo Ahrén, Jane E B Reusch, Marc Rendell, Peter N Weissman, Deborah T Cirkel, Diane Miller, Philip Ambery, Molly C Carr, Michael A Nauck
AIMS: Diabetes therapies that provide durable glycaemic control for people with type 2 diabetes mellitus (T2DM) are needed. We present efficacy results of albiglutide, a glucagon-like peptide-1 receptor agonist, in people with T2DM over a 3-year period. METHODS: Five of the 8 HARMONY phase 3 trials, comparing albiglutide with other therapies or placebo across a spectrum of clinical care, lasted for a preplanned 3years. Participants with uncontrolled hyperglycaemia who met predetermined criteria could receive rescue medication...
June 15, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28683068/prediction-of-nocturnal-hypoglycemia-unawareness-by-fasting-glucose-levels-or-post-breakfast-glucose-fluctuations-in-patients-with-type-1-diabetes-receiving-insulin-degludec-a-pilot-study
#4
Hiroshi Takahashi, Rimei Nishimura, Yoshiko Onda, Kiyotaka Ando, Daisuke Tsujino, Kazunori Utsunomiya
OBJECTIVE: To evaluate whether nocturnal asymptomatic hypoglycemia (NAH) can be predicted by fasting glucose levels or post-breakfast glucose fluctuations in patients with type 1 diabetes (T1D) receiving insulin degludec. METHODS: Patients with T1D receiving insulin degludec underwent at-home CGM assessments. Indices for glycemic variability before and after breakfast included fasting glucose levels and the range of post-breakfast glucose elevation. For comparison, the patients were classified into those with NAH and those without...
2017: PloS One
https://www.readbyqxmd.com/read/28681986/metformin-associated-prevention-of-weight-gain-in-insulin-treated-type-2-diabetic-patients-cannot-be-explained-by-decreased-energy-intake-a-post-hoc-analysis-of-a-randomized-placebo-controlled-4-3-year-trial
#5
Mattijs Out, Ida Miedema, Harriët Jager-Wittenaar, Cees van der Schans, Wim Krijnen, Philippe Lehert, Coen Stehouwer, Adriaan Kooy
Metformin prevents weight gain in patients with type 2 diabetes (T2D). However, the mechanisms involved are still unknown. In this post-hoc analysis of the HOME trial, we aimed to determine whether metformin affects energy intake. Patients with T2D were treated with 850 mg metformin or placebo (1-3 times daily) added to insulin for 4.3 years. Dietary intake was assessed at baseline, after 1 year and after 4.3 years, according to the dietary history method. Of the 310 included participants, 179 completed (93 placebo, 86 metformin) all three dietary assessments...
July 6, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28680863/adherence-to-insulin-self-administration-and-associated-factors-among-diabetes-mellitus-patients-at-tikur-anbessa-specialized-hospital
#6
Yusuf Gerada, Zuriyash Mengistu, Asrat Demessie, Atsede Fantahun, Kahsu Gebrekirstos
BACKGROUND: The goals of diabetes treatment are to keep blood glucose levels as near normal as possible while avoiding complications. Despite the benefits of insulin therapy, many people with diabetes don't adhere to treatment. Some avoid insulin therapy or refuse to start it. Several studies investigating adherence to chronic disease treatment have evidenced that patients often discontinue their medications or even do not take them at all because they consider them ineffective or experience untoward side effects...
2017: Journal of Diabetes and Metabolic Disorders
https://www.readbyqxmd.com/read/28666360/overnight-closed-loop-control-improves-glycemic-control-in-a-multicenter-study-of-adults-with-type-1-diabetes
#7
Sue A Brown, Marc D Breton, Stacey M Anderson, Laura Kollar, Patrick Keith-Hynes, Carol J Levy, David W Lam, Camilla Levister, Nihat Baysal, Yogish C Kudva, Ananda Basu, Vikash Dadlani, Ling Hinshaw, Shelly McCrady-Spitzer, Daniela Bruttomesso, Roberto Visentin, Silvia Galasso, Simone Del Favero, Yenny Leal, Federico Boscari, Angelo Avogaro, Claudio Cobelli, Boris P Kovatchev
Context: Closed-loop control (CLC) for the management of T1D is a novel method for optimizing glucose control and strategies for individualized implementation are being developed. Objective: Analyze glycemic control in an Overnight CLC system designed to "reset" the patient to near normal glycemic targets every morning. Design: Randomized cross-over multicenter clinical trial. Participants: 44 subjects with T1D on insulin pump therapy...
June 28, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28661585/glycaemic-control-and-hypoglycaemia-during-12-months-of-randomized-treatment-with-insulin-glargine-300-u-ml-versus-glargine-100-u-ml-in-people-with-type-1-diabetes-edition-4
#8
Philip D Home, Richard M Bergenstal, Geremia B Bolli, Monika Ziemen, Maria Rojeski, Melanie Espinasse, Matthew C Riddle
AIMS: Insulin glargine 300 U/mL (Gla-300) offers a flatter pharmacodynamic profile than insulin glargine 100 U/mL (Gla-100). We have compared these insulins over 1 year in people with type 1 diabetes (T1DM). METHODS: EDITION 4 was a 6-month, multicentre, randomized, open-label phase 3 study. People with T1DM completing the 6 months continued their randomized Gla-300 or Gla-100 once daily, morning or evening, for a further 6 months. RESULTS: Of 549 participants randomized, 444 completed the 12-month study period (Gla-300, 80%; Gla-100, 82%)...
June 29, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28652909/a-case-of-hypoglycemiainduced-qt-prolongation-leading-to-torsade-de-pointes-and-a-review-of-pathophysiological-mechanisms
#9
Faris Hannoodi, Hashim Alwash, Kushal Shah, Israa Ali, Sarwan Kumar, Khalid Zakaria
Torsades de pointes is a life-threatening cardiac arrhythmia. Occurrence of this arrhythmia as a result of hypoglycemia has not been reported in the literature. We describe an interesting case of an insulin-dependent diabetic patient presenting with torsades de pointes resulting from hypoglycemia. A 62-year-old male was admitted to the hospital following an episode of severe insulin-induced hypoglycemia and a cardiac arrest. He was found to unresponsive at home after taking insulin. His serum glucose was found to be 18...
June 7, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28642988/development-of-pulmonary-hypertension-during-treatment-with-diazoxide-a-case-series-and-literature-review
#10
Matthew R Timlin, Alexander B Black, Heather M Delaney, Renée I Matos, Candace S Percival
Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in infancy. The mainstay of medical management for CHI is diazoxide. Diazoxide inhibits insulin release from the pancreas, but also causes smooth muscle relaxation and fluid retention so it is typically given with chlorothiazide. In July 2015, the FDA issued a drug safety communication warning that pulmonary hypertension (PH) had been reported in 11 infants being treated with diazoxide and that the PH resolved with withdrawal of diazoxide...
June 22, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28622950/glycaemic-control-and-hypoglycaemia-with-insulin-glargine-300u-ml-versus-insulin-glargine-100u-ml-in-insulin-na%C3%A3-ve-people-with-type-2%C3%A2-diabetes-12-month-results-from-the-edition-3-trial
#11
G B Bolli, M C Riddle, R M Bergenstal, M Wardecki, H Goyeau, P D Home
AIM: To explore if efficacy and safety findings for insulin glargine 300U/mL (Gla-300) versus insulin glargine 100U/mL (Gla-100), observed over 6 months in insulin-naïve people with type 2 diabetes, are maintained after 12 months. METHODS: EDITION 3 was a phase 3a, randomized, multicentre, open-label, parallel-group, treat-to-target study of once-daily Gla-300 versus Gla-100 (target fasting self-monitored plasma glucose, 4.4-5.6mmol/L [80-100mg/dL]). Participants completing the initial 6-month treatment phase continued their previously allocated basal insulin...
June 13, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28617838/safety-and-metabolic-effects-of-tesamorelin-a-growth-hormone-releasing-factor-analogue-in-patients-with-type-2-diabetes-a-randomized-placebo-controlled-trial
#12
David R Clemmons, Sam Miller, Jean-Claude Mamputu
OBJECTIVE: Use of growth hormone is associated with side effects, including insulin resistance. The objective of this study was to determine whether tesamorelin, a stabilized growth hormone-releasing hormone analogue, would alter insulin sensitivity or control of diabetes. DESIGN: A 12-week randomized, placebo-controlled study of 53 patients with type 2 diabetes. Three treatment groups: placebo, 1 and 2 mg tesamorelin. MEASUREMENTS: Fasting glucose, glucose and insulin from oral glucose tolerance test, glycosylated hemoglobin (HbA1c), home blood glucose, insulin-like growth factor-1, and lipids...
2017: PloS One
https://www.readbyqxmd.com/read/28584075/application-of-zone-model-predictive-control-artificial-pancreas-during-extended-use-of-infusion-set-and-sensor-a-randomized-crossover-controlled-home-use-trial
#13
Gregory P Forlenza, Sunil Deshpande, Trang T Ly, Daniel P Howsmon, Faye Cameron, Nihat Baysal, Eric Mauritzen, Tatiana Marcal, Lindsey Towers, B Wayne Bequette, Lauren M Huyett, Jordan E Pinsker, Ravi Gondhalekar, Francis J Doyle, David M Maahs, Bruce A Buckingham, Eyal Dassau
OBJECTIVE: As artificial pancreas (AP) becomes standard of care, consideration of extended use of insulin infusion sets (IIS) and continuous glucose monitors (CGMs) becomes vital. We conducted an outpatient randomized crossover study to test the safety and efficacy of a zone model predictive control (zone-MPC)-based AP system versus sensor augmented pump (SAP) therapy in which IIS and CGM failures were provoked via extended wear to 7 and 21 days, respectively. RESEARCH DESIGN AND METHODS: A smartphone-based AP system was used by 19 adults (median age 23 years [IQR 10], mean 8...
June 5, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28545656/cord-plasma-insulin-and-in-utero-exposure-to-ambient-air-pollution
#14
Narjes Madhloum, Bram G Janssen, Dries S Martens, Nelly D Saenen, Esmée Bijnens, Wilfried Gyselaers, Joris Penders, Charlotte Vanpoucke, Wouter Lefebvre, Michelle Plusquin, Tim S Nawrot
INTRODUCTION: Cardio-metabolic risk factors including insulin levels are at young age barely perceived as harmful, but over time these risk factors may track and lead to higher risk of metabolic syndrome. Studies showed that exposure to air pollution is associated with an increased risk of insulin resistance in childhood. We determined whether the origin of type 2 diabetes can be found in the early childhood by examining the levels of insulin in the neonatal cord blood and whether this can be considered as a disease marker for later life...
August 2017: Environment International
https://www.readbyqxmd.com/read/28541137/clinical-use-of-continuous-glucose-monitoring-in-adults-with-type-2-diabetes
#15
Anders L Carlson, Deborah M Mullen, Richard M Bergenstal
Hemoglobin A1c is an excellent population health measure for the risk of vascular complications in diabetes, while continuous glucose monitoring (CGM) is a tool to help personalize a diabetes treatment plan. The value of CGM in individuals with type 1 diabetes (T1D) has been well demonstrated when compared with utilizing self-monitoring of blood glucose (SMBG) to guide treatment decisions. CGM is a tool for patients and clinicians to visualize the important role that diet, exercise, stress management, and the appropriate selection of diabetes medications can have in managing type 2 diabetes (T2D)...
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28539088/prescription-patterns-and-disease-control-in-type-2-diabetes-mellitus-patients-in-nursing-home-and-home-care-settings-a-retrospective-analysis-in-germany
#16
Karel Kostev, Timo Rockel, Louis Jacob
AIM: The aim of this study was to analyze prescription patterns and disease control in patients with type 2 diabetes mellitus (T2DM) in nursing home and home care settings in Germany. METHODS: The present study is based on data from the Disease Analyzer database (QuintilesIMS). Patients with an initial diagnosis of T2DM and documented HbA1c values between January 2011 and December 2015 were included in the analysis. The index date corresponded to the last documented HbA1c value...
May 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28495347/a-web-based-clinical-decision-support-system-for-gestational-diabetes-automatic-diet-prescription-and-detection-of-insulin-needs
#17
Estefanía Caballero-Ruiz, Gema García-Sáez, Mercedes Rigla, María Villaplana, Belen Pons, M Elena Hernando
BACKGROUND: The growth of diabetes prevalence is causing an increasing demand in health care services which affects the clinicians' workload as medical resources do not grow at the same rate as the diabetic population. Decision support tools can help clinicians with the inspection of monitoring data, providing a preliminary analysis to ease their interpretation and reduce the evaluation time per patient. This paper presents Sinedie, a clinical decision support system designed to manage the treatment of patients with gestational diabetes...
June 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28492721/treatment-of-acromegaly-patients-at-the-federal-university-of-tri%C3%A3-ngulo-mineiro-uftm-experience-report
#18
Maria de Fátima Borges, Beatriz Hallal Jorge Lara, Janaíne Machado Tomé, Leopoldo Prezia de Araújo, Flávio Cesar Lucas Bugiga, Júlio Cláudio Sousa, Jacqueline Mendes Fonseca Soares, Roberto Alexandre Dezena, Beatriz Pires Ferreira
OBJECTIVE: To evaluate the effectiveness of the treatment of acromegaly patients at the Federal University of Triangulo Mineiro. METHODS: Cross-sectional and retrospective study of thirty cases treated over a period of two decades. RESULTS: 17 men (56.7%) aged 14-67 years and 13 women aged 14-86 years were analyzed. Twenty-one patients underwent transphenoidal surgery, whichwas associated with somatostatin receptor ligands in 11 patients (39...
April 2017: Clinics
https://www.readbyqxmd.com/read/28483805/treating-the-dysfunctional-placenta
#19
REVIEW
Colin P Sibley
Placental dysfunction underlies major obstetric diseases such as pre-eclampsia and fetal growth restriction (FGR). Whilst there has been a little progress in prophylaxis, there are still no treatments for placental dysfunction in normal obstetric practice. However, a combination of increasingly well-described in vitro systems for studying the human placenta, together with the availability of more appropriate animal models of pre-eclampsia and FGR, has facilitated a recent surge in work aimed at repurposing drugs and therapies, developed for other conditions, as treatments for placental dysfunction...
August 2017: Journal of Endocrinology
https://www.readbyqxmd.com/read/28428728/randomized-face-to-face-vs-home-exercise-interventions-in-pregnant-women-with-gestational-diabetes
#20
Danielle Symons Downs, Jennifer M Dinallo, Leann L Birch, Ian M Paul, Jan S Ulbrecht
OBJECTIVES: Evaluate effects of a theoretically-based, semi-intensive (Face-to-Face; F2F) exercise intervention and minimum-contact (Home) exercise intervention to the standard care (Control) on exercise, its motivational determinants, blood glucose levels, and insulin use of pregnant women with gestational diabetes mellitus (GDM). DESIGN: Randomized control trial with two intervention arms and control (standard care). METHOD: Participants (N=65) were randomized to a Control (standard prenatal care/GDM dietary counseling), Home (standard care + phone education/support + home exercise), or F2F (standard care + on-site education/support + guided exercise with instructor on 2 days/week) group from ~20 weeks gestation to delivery...
May 2017: Psychology of Sport and Exercise
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