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Insuline Glargin

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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/29034415/a-diabetic-ketoacidosis-in-a-context-of-hyperglycemia-addiction
#2
Guillaume Rousseau, Cristian Palmiere, Vincent Dupont, Marion Verschoore, Caroline Savary, Nathalie Jousset, Clotilde Rougé-Maillart
We herein present a case of a 20-year-old woman who suffered from type I diabetes mellitus and died from a diabetic ketoacidosis in a context of addiction to hyperglycemia. Diabetic ketoacidosis is a lethal complication of insulin-dependent diabetes mellitus, which can result from insulin therapy stoppage. This can occur voluntarily with suicidal intent or involuntarily due to treatment inaccessibility, forgotten injections, or material deficiency. A new possibility is investigated in our case study: hyperglycemia addiction...
October 15, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/29029025/insulin-deficient-mouse-%C3%AE-cells-do-not-fully-mature-but-can-be-remedied-through-insulin-replacement-by-islet-transplantation
#3
Adam Ramzy, Majid Mojibian, Timothy J Kieffer
Insulin receptor insufficiency in β-cells leads to impaired insulin secretion and reduced β-cell hyperplasia in response to hyperglycemia. Selective insulin receptor deficiency in β-cells in later embryological development may lead to compensatory β-cell hyperplasia. Though these findings suggest insulin signaling on the β-cell is important for β-cell function, they are confounded by loss of signaling by the IGFs through the insulin receptor. To determine if insulin itself is necessary for β-cell development and maturation, we performed a characterization of pancreatic islets in mice with deletions of both non-allelic insulin genes (Ins1-/-Ins2-/-)...
September 27, 2017: Endocrinology
https://www.readbyqxmd.com/read/29017173/insulin-regimens-to-treat-hyperglycemia-in-hospitalized-patients-on-nutritional-support-systematic-review-and-meta-analyses
#4
Marina Verçoza Viana, Luciana Verçoza Viana, Ana Laura Tavares, Mirela Jobim de Azevedo
BACKGROUND: The best insulin regimen to treat hyperglycemia in hospitalized patients on nutritional support (NS) is unclear. METHODS: We searched electronic databases to identify cohort studies or randomized clinical trials in order to evaluate the efficacy of different insulin regimens used to treat hyperglycemia in hospitalized patients on NS on diverse outcomes: mean blood glucose (MBG), hypoglycemia, length of stay in hospital, and mortality. RESULTS: Seventeen studies from a total of 5,030 were included...
October 6, 2017: Annals of Nutrition & Metabolism
https://www.readbyqxmd.com/read/28970434/comparison-of-insulin-detemir-and-insulin-glargine-for-hospitalized-patients-on-a-basal-bolus-protocol
#5
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/28960085/the-clinical-effectiveness-of-insulin-glargine-in-patients-with-type-i-diabetes-in-brazil-findings-and-implications
#6
Lays P Marra, Vânia E Araújo, Gerusa Cc Oliveira, Leonardo M Diniz, Augusto A Guerra Júnior, Francisco de Assis Acurcio, Brian Godman, Juliana Álvares
AIM: Published studies have challenged the cost-effectiveness of insulin glargine versus neutral protamine hagedorn (NPH) insulins in Brazil with limited evidence of increased effectiveness despite considerably higher acquisition costs. However, still a controversy. Consequently, there is a need to address this. MATERIALS & METHODS: Retrospective cohort study of Type I diabetes patients receiving insulin glargine in Brazil following NPH insulin who met the criteria...
September 29, 2017: Journal of Comparative Effectiveness 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
#7
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/28946756/day-to-day-and-within-day-variability-in-glucose-lowering-effect-between-insulin-degludec-and-insulin-glargine-100-u-ml-and-300-u-ml-a-comparison-across-studies
#8
Tim Heise, Kadriye Kaplan, Hanne L Haahr
BACKGROUND: Insulin degludec (IDeg) has significantly lower day-to-day and within-day variability compared to insulin glargine (IGlar) 100U/mL (U100) and 300U/mL (U300). Here, we report post hoc assessments to confirm the robustness of these observations while accounting for potential experimental confounders. METHODS: Two euglycemic clamp studies in type 1 diabetes patients, comparing IDeg to IGlar-U100 (Study A, parallel design, 54 patients; Study B, crossover, 22 patients) and one study comparing IDeg to IGlar-U300 (Study C, crossover, 57 patients), all dosed at 0...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28945173/insulin-degludec-versus-insulin-glargine-u100-for-patients-with-type-1-or-type-2-diabetes-in-the-us-a-budget-impact-analysis-with-rebate-tables
#9
Wendy S Lane, James Weatherall, Jens Gundgaard, Richard F Pollock
BACKGROUND AND AIMS: Drug rebates are almost universally negotiated privately between the manufacturer and the payer in the US. The aim of the present study was to illustrate the use of a "rebate table" to improve the transparency and utility of published budget impact analyses in the US by modeling ranges of hypothetical rebates for two comparators. Worked examples were conducted to illustrate the budgetary implications of using insulin degludec (IDeg) relative to insulin glargine (IGlar) U100 in patients with type 1 or 2 diabetes...
October 12, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28940840/ly2963016-insulin-glargine-and-insulin-glargine-lantus-produce-comparable-pharmacokinetics-and-pharmacodynamics-at-two-dose-levels
#10
Xin Zhang, Eric Chen Quin Lam, Mary E Seger, David Coutant, Laiyi Chua, Lai Hock Tan, Danny Soon, Helle Linnebjerg
LY2963016 (LY IGlar) and Lantus (IGlar) are insulin glargine products with identical amino acid sequences. This was a phase 1 single-site, randomized, subject- and investigator-blinded, 4-treatment, 4-period crossover study to compare the pharmacokinetic (PK) and pharmacodynamic (PD) properties of LY IGlar and IGlar at 2 different doses. Fasted healthy subjects were randomly assigned to receive 2 single doses of LY IGlar and IGlar (0.3 and 0.6 U/kg for each product). Blood samples were collected up to 24 hours postdose to assess PK, and a euglycemic clamp lasting up to 24 hours postdose was conducted to assess PD...
September 21, 2017: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/28913602/devoting-attention-to-glucose-variability-and-hypoglycaemia-in-type-2-diabetes
#11
EDITORIAL
Martin K Rutter
In the Trial Comparing Cardiovascular Safety of Insulin Degludec vs Insulin Glargine in Patients with Type 2 Diabetes at High Risk of Cardiovascular Events (DEVOTE), insulin degludec was non-inferior to insulin glargine in terms of cardiovascular events and mortality. However, there were lower rates of severe hypoglycaemia with insulin degludec. DEVOTE investigators now extend these findings by presenting the results of two observational epidemiological analyses based on trial data. In the first of these analyses (DEVOTE 2), Zinman et al (Diabetologia DOI: 10...
September 15, 2017: Diabetologia
https://www.readbyqxmd.com/read/28913575/day-to-day-fasting-glycaemic-variability-in-devote-associations-with-severe-hypoglycaemia-and-cardiovascular-outcomes-devote-2
#12
Bernard Zinman, Steven P Marso, Neil R Poulter, Scott S Emerson, Thomas R Pieber, Richard E Pratley, Martin Lange, Kirstine Brown-Frandsen, Alan Moses, Ann Marie Ocampo Francisco, Jesper Barner Lekdorf, Kajsa Kvist, John B Buse
AIMS/HYPOTHESIS: The Trial Comparing Cardiovascular Safety of Insulin Degludec vs Insulin Glargine in Patients with Type 2 Diabetes at High Risk of Cardiovascular Events (DEVOTE) was a double-blind, randomised, event-driven, treat-to-target prospective trial comparing the cardiovascular safety of insulin degludec with that of insulin glargine U100 (100 units/ml) in patients with type 2 diabetes at high risk of cardiovascular events. This paper reports a secondary analysis investigating associations of day-to-day fasting glycaemic variability (pre-breakfast self-measured blood glucose [SMBG]) with severe hypoglycaemia and cardiovascular outcomes...
September 15, 2017: Diabetologia
https://www.readbyqxmd.com/read/28913543/devote-3-temporal-relationships-between-severe-hypoglycaemia-cardiovascular-outcomes-and-mortality
#13
Thomas R Pieber, Steven P Marso, Darren K McGuire, Bernard Zinman, Neil R Poulter, Scott S Emerson, Richard E Pratley, Vincent Woo, Simon Heller, Martin Lange, Kirstine Brown-Frandsen, Alan Moses, Jesper Barner Lekdorf, Lucine Lehmann, Kajsa Kvist, John B Buse
AIMS/HYPOTHESIS: The double-blind Trial Comparing Cardiovascular Safety of Insulin Degludec vs Insulin Glargine in Patients with Type 2 Diabetes at High Risk of Cardiovascular Events (DEVOTE) assessed the cardiovascular safety of insulin degludec. The incidence and rates of adjudicated severe hypoglycaemia, and all-cause mortality were also determined. This paper reports a secondary analysis investigating associations of severe hypoglycaemia with cardiovascular outcomes and mortality...
September 15, 2017: Diabetologia
https://www.readbyqxmd.com/read/28904247/efficacy-and-safety-of-subgroup-analysis-stratified-by-baseline-hba1c-in-a-japanese-phase-3-study-of-dulaglutide-0-75-mg-compared-with-insulin-glargine-in-patients-with-type-2-diabetes
#14
Shizuka Kaneko, Tomonori Oura, Akiko Matsui, Tomotaka Shingaki, Masakazu Takeuchi
The efficacy and safety of once-weekly dulaglutide 0.75 mg (dulaglutide) compared with once-daily insulin glargine (glargine) in Japanese patients with type 2 diabetes were evaluated according to subgroups stratified by baseline glycated hemoglobin (HbA1c) (≤8.5% or >8.5%). This exploratory analysis of a randomized, open-label, phase 3 study included 361 patients. In both HbA1c subgroups (patients with baseline HbA1c ≤8.5% or >8.5%), a statistically significantly greater reduction in HbA1c was observed in dulaglutide-treated patients compared with glargine-treated patients after 26 weeks of treatment (HbA1c ≤8...
September 14, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28895655/insulin-resistance-and-cardiovascular-outcomes-in-the-origin-trial
#15
Hertzel C Gerstein, Ele Ferrannini, Matthew C Riddle, Salim Yusuf
AIMS: In the Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial, titrated doses of basal insulin glargine targeting fasting normoglycemia had a neutral effect on cardiovascular outcomes. The dose of insulin required to achieve normoglycemia provides a unique measurement of each individual's resistance to insulin's action, and was therefore used to examine the link between insulin resistance and cardiovascular outcomes. MATERIALS AND METHODS: Self-titration of insulin doses targeting a fasting plasma glucose < 5...
September 12, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28895030/type-2-diabetes-and-cardiovascular-prevention-the-dogmas-disputed
#16
Dario Giugliano, Maria Ida Maiorino, Giuseppe Bellastella, Katherine Esposito
In randomized controlled trials (RCTs), more intensive glucose control in patients with type 2 diabetes leads to a modest (9%) reduction in major cardiovascular events (MACE), associated with a 20% reduction of kidney events and 13% reduction of eye events. The FDA issued guidance in 2008 led to the conduct of numerous cardiovascular outcomes (CVOT) trials to assess cardiovascular safety of new antihyperglycemic therapies in patients with type 2 diabetes. The results of these trials show that insulin glargine, three different dipeptidyl peptidase-4 (DPP-4) inhibitors (saxagliptin, alogliptin, and sitagliptin) and lixisenatide (a glucagon like peptide-1 receptor agonist) produce no significant difference in CVOT when compared with usual care or placebo...
September 11, 2017: Endocrine
https://www.readbyqxmd.com/read/28892956/short-term-efficacy-and-safety-of-insulin-glargine-in-type-2-diabetes-inadequately-controlled-with-single-or-two-oral-agents-a-prospective-open-label-study
#17
Ajay Aggarwal, Roopak Wadhwa
INTRODUCTION: Basal insulin is among the second line treatment options for Type 2 Diabetes Mellitus (T2DM). Efficacy and safety of basal insulin in patients of T2DM, uncontrolled with Oral Antidiabetic Agents (OAAs) remains understudied in the Indian setting. AIM: To assess the efficacy and safety of insulin glargine in patients with T2DM who have uncontrolled glycaemic levels despite single or two OAAs therapy. MATERIALS AND METHODS: In this prospective, open label study, T2DM patients above 40 years of age, having inadequate glycaemic control [Glycosylated Haemoglobin (HbA1c) above 8% and/or fasting glucose level of 140 mg/dl and above] with single or two OAAs over three consecutive months were included...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28870034/-the-efficacy-and-safety-of-insulin-degludec-versus-insulin-glargine-in-insulin-naive-subjects-with-type-2-diabetes-results-of-a-chinese-cohort-from-a-multinational-randomized-controlled-trial
#18
Y M Mu, L X Guo, L Li, Y M Li, X J Xu, Q M Li, M T Xu, L Y Zhu, G Y Yuan, Y Liu, C Xu, Z J Wang, F X Shen, Y Luo, J Y Liu, Q F Li, W H Wang, X Y Lai, H F Xu, C Y Pan
Objective: To compare the safety and efficacy of insulin degludec (IDeg) with those of insulin glargine (IGlar) in insulin-naive subjects with type 2 diabetes (T2DM). Methods: This was a 26-week, randomized, open-label, parallel-group, treat-to-target trial in 560 Chinese subjects with T2DM (men/women: 274/263, mean age 56 years, mean diabetes duration 7 years) inadequately controlled on oral antidiabetic drugs (OADs). Subjects were randomized 2∶1 to once-daily IDeg (373 subjects) or IGlar(187 subjects), both in combination with metformin...
September 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
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...
September 2, 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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