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https://www.readbyqxmd.com/read/29140602/the-cardiovascular-safety-of-long-acting-insulin-analogues-in-type-2-diabetes-is-there-a-better-basal-insulin
#1
Chia-Hsuin Chang, Lee-Ming Chuang
In 2008, the U.S. Food and Drug Administration requested that all new type 2 anti-diabetic drugs, including long-acting insulin analogues, need to be rigorously examined to preclude undesirable cardiovascular risks. The Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial is the first trial to provide conclusive evidence of the cardiovascular safety of insulin glargine. A total of 12,537 people with cardiovascular risk factors plus impaired fasting glucose, impaired glucose tolerance, or type 2 diabetes were randomized to receive insulin glargine or standard care...
November 15, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/29135080/a-comparison-of-adherence-and-persistence-by-medication-class-in-type-2-diabetes-a-systematic-review-and-meta-analysis
#2
Andrew McGovern, Zayd Tippu, William Hinton, Neil Munro, Martin Whyte, Simon de Lusignan
Limited medication adherence and persistence are barriers to successful treatment in type 2 diabetes (T2D). We searched MEDLINE, EMBASE, The Cochrane Library, The Register of Controlled Trials, PsychINFO, and CINAHL for observational and interventional studies comparing medication adherence or persistence between two or more glucose lowering medications in people with T2D. Where several studies (n≥5) provided the same comparison a random effects meta-analysis was performed reporting mean difference (MD), odds ratio (OR), or hazard ratio (HR) depending on the pooled study outcomes...
November 14, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29127752/-faster-insulin-aspart-a-new-prandial-insulin-analogue
#3
Milan Flekač
Preventing postprandial blood glucose excursions is one of the most challenging aspects of achieving adequate control, especially in patients with better long-term compensation of diabetes. Contemporary prandial insulin analogues that have more favorable properties than human insulin in terms of accelerated absorption, earlier onset of action and shorter duration of action are still significantly slower than endogenous insulin in healthy individuals. Fast-acting insulin aspart (FIAsp - faster aspart) is insulin aspart enriched with two excipients, of which niacinamide is responsible for accelerating absorption after subcutaneous administration...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29123106/developmental-diet-regulates-drosophila-lifespan-via-lipid-autotoxins
#4
M Irina Stefana, Paul C Driscoll, Fumiaki Obata, Ana Raquel Pengelly, Clare L Newell, James I MacRae, Alex P Gould
Early-life nourishment exerts long-term influences upon adult physiology and disease risk. These lasting effects of diet are well established but the underlying mechanisms are only partially understood. Here we show that restricting dietary yeast during Drosophila development can, depending upon the subsequent adult environment, more than double median lifespan. Developmental diet acts via a long-term influence upon the adult production of toxic molecules, which we term autotoxins, that are shed into the environment and shorten the lifespan of both sexes...
November 9, 2017: Nature Communications
https://www.readbyqxmd.com/read/29122893/prospective-postmarketing-surveillance-of-acute-myocardial-infarction-in-new-users-of-saxagliptin-a-population-based-study
#5
Sengwee Toh, Marsha E Reichman, David J Graham, Christian Hampp, Rongmei Zhang, Melissa G Butler, Aarthi Iyer, Malcolm Rucker, Madelyn Pimentel, Jack Hamilton, Samuel Lendle, Bruce H Fireman
OBJECTIVE: The cardiovascular safety of saxagliptin, a dipeptidyl-peptidase 4 inhibitor, compared with other antihyperglycemic treatments is not well understood. We prospectively examined the association between saxagliptin use and acute myocardial infarction (AMI). RESEARCH DESIGN AND METHODS: We identified patients aged ≥18 years, starting from the approval date of saxagliptin in 2009 and continuing through August 2014, using data from 18 Mini-Sentinel data partners...
November 9, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29116584/use-of-50-50-premixed-insulin-analogs-in-type-2-diabetes-systematic-review-and-clinical-recommendations
#6
REVIEW
Gary Deed, Gary Kilov, Trisha Dunning, Richard Cutfield, Jane Overland, Ted Wu
INTRODUCTION: Premixed insulin analogs represent an alternative to basal or basal-bolus insulin regimens for the treatment of type 2 diabetes (T2D). "Low-mix" formulations with a low rapid-acting to long-acting analog ratio (e.g., 25/75) are commonly used, but 50/50 formulations (Mix50) may be more appropriate for some patients. We conducted a systematic literature review to assess the efficacy and safety of Mix50, compared with low-mix, basal, or basal-bolus therapy, for insulin initiation and intensification...
December 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29113464/a-new-treatment-strategy-for-parkinson-s-disease-through-the-gut-brain-axis-the-glucagon-like-peptide-1-receptor-pathway
#7
Dong Seok Kim, Ho-Il Choi, Yun Wang, Yu Luo, Barry J Hoffer, Nigel H Greig
Molecular communications in the gut-brain axis, between the central nervous system and the gastrointestinal tract, are critical for maintaining healthy brain function, particularly in aging. Epidemiological analyses indicate type 2 diabetes mellitus (T2DM) is a risk factor for neurodegenerative disorders including Alzheimer's disease (AD) and Parkinson's diseases (PD) for which aging shows a major correlative association. Common pathophysiological features exist between T2DM, AD, and PD, including oxidative stress, inflammation, insulin resistance, abnormal protein processing, and cognitive decline, and suggest that effective drugs for T2DM that positively impact the gut-brain axis could provide an effective treatment option for neurodegenerative diseases...
September 2017: Cell Transplantation
https://www.readbyqxmd.com/read/29100450/meglitinides-increase-the-risk-of-hypoglycemia-in-diabetic-patients-with-advanced-chronic-kidney-disease-a-nationwide-population-based-study
#8
Pei-Chen Wu, Vin-Cent Wu, Cheng-Jui Lin, Chi-Feng Pan, Chih-Yang Chen, Tao-Min Huang, Che-Hsiung Wu, Likwang Chen, Chih-Jen Wu
The safety of short-acting meglitinides in diabetic patients with advanced chronic kidney disease (CKD) has not been widely reported. Diabetic patients with advanced CKD who had a serum creatinine level of > 6 mg/dL a hematocrit level of ≦ 28% and received erythropoiesis-stimulating agent treatment between 2000 and 2010, were included in this nationwide study in Taiwan. The outcomes of interest were defined as hypoglycemia and long-term mortality. The risks of hypoglycemia and death were analyzed using Cox proportional hazards models, with end-stage renal disease and anti-diabetic drugs as time-dependent variables...
September 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/29073329/comparative-risks-of-diabetes-related-complications-of-basal-insulins-a-longitudinal-population-based-cohort-of-type-1-diabetes-1999-2013-in-taiwan
#9
Huang-Tz Ou, Tsung-Ying Lee, Ye-Fong Du, Chung-Yi Li
AIM: We compared the effects of basal insulins: long-acting insulin analogues versus intermediate/long-acting human insulin, on diabetes-related complications in type 1 diabetes. METHODS: 1,188 type 1 diabetes newly on long-acting insulin analogues or intermediate/long-acting human insulin were identified in 2004-2008 and followed until death or 2013. Clinical outcomes included acute (i.e., hyperglycemia, hypoglycemia) and chronic (i.e., nephropathy, retinopathy, neuropathy, cardiovascular diseases) complications...
October 26, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29061371/puerarin-acts-on-the-skeletal-muscle-to-improve-insulin-sensitivity-in-diabetic-rats-involving-%C3%AE-opioid-receptor
#10
Xiufang Chen, Lei Wang, Shanshan Fan, Shiyu Song, Haiyan Min, Yongzheng Wu, Xuan He, Qiao Liang, Yong Wang, Long Yi, Qian Gao
Puerarin, a major active isoflavone extracted from the root of Pueraria lobate, significantly increases plasma β-endorphin and insulin levels and improves impaired insulin signaling in diabetic animals. However, the target tissues and underlying mechanisms in and through which puerarin functions to ameliorating insulin resistance remains largely unclear. In this study, we showed that puerarin enhanced μ-opioid receptor expression and phosphorylation, and increased insulin-stimulated glucose transporter 4 translocation to the plasma membrane in the skeletal muscle of diabetic rats, which were recaptured by a direct application of puerarin in the palmitate-induced insulin-resistant L6 myotubes...
October 20, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29058131/insulin-and-its-cardiovascular-effects-what-is-the-current-evidence
#11
REVIEW
Sahana Pai Dongerkery, Pamela R Schroeder, Mansur E Shomali
PURPOSE OF REVIEW: In this article, we examine the nature of the complex relationship between insulin and cardiovascular disease. With metabolic abnormalities comes increased risk for cardiovascular complications. We discuss the key factors implicated in development and progression of cardiovascular disease, its relationship to insulin therapy, and what can be learned from large, recent cardiovascular outcome studies. RECENT FINDINGS: Preclinical studies suggest that insulin has positive effects of facilitating glucose entry into cells and maintaining euglycemia and negative effects of favoring obesity and atherogenesis under certain conditions...
October 23, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/29055921/hepatitis-c-and-its-metabolic-complications-in-kidney-disease
#12
Fabrizio Fabrizi, Francesca M Donato, Piergiorgio Messa
INTRODUCTION: Evidence has been accumulated during the last decade showing that HCV infection plays an important activity at hepatic and extra-hepatic level. Chronic HCV is associated with a large spectrum of extra-hepatic manifestations including lympho-proliferative diseases and metabolic abnormalities (such as insulin resistance and fatty liver disease). MATERIAL AND METHODS: We have performed an extensive review of the medical literature regarding the increased risk of cardiovascular and kidney disease that has been observed in various groups of HCV-infected patients...
October 16, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/29051554/recombinant-incretin-secreting-microbe-improves-metabolic-dysfunction-in-high-fat-diet-fed-rodents
#13
Paul M Ryan, Elaine Patterson, Robert M Kent, Helena Stack, Paula M O'Connor, Kiera Murphy, Veronica L Peterson, Rupasri Mandal, David S Wishart, Timothy G Dinan, John F Cryan, Randy J Seeley, Catherine Stanton, R Paul Ross
The gut hormone glucagon-like peptide (GLP)-1 and its analogues represent a new generation of anti-diabetic drugs, which have also demonstrated propensity to modulate host lipid metabolism. Despite this, drugs of this nature are currently limited to intramuscular administration routes due to intestinal degradation. The aim of this study was to design a recombinant microbial delivery vector for a GLP-1 analogue and assess the efficacy of the therapeutic in improving host glucose, lipid and cholesterol metabolism in diet induced obese rodents...
October 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29050674/the-outcomes-of-glucose-abnormalities-in-chronic-hepatitis-c-patients-receiving-interferon-free-direct-antiviral-agents
#14
Jee-Fu Huang, Chung-Feng Huang, Ming-Lun Yeh, Chia-Yen Dai, Meng-Hsuan Hsieh, Jeng-Fu Yang, Ching-I Huang, Yi-Hung Lin, Po-Cheng Liang, Zu-Yau Lin, Shinn-Chern Chen, Ming-Lung Yu, Wan-Long Chuang
Direct-acting antiviral agents (DAAs) have been widely used for chronic hepatitis C (CHC) treatment recently. The characteristics of glucose abnormalities after DAAs therapy however, remain elusive. We aimed to elucidate the mutual impact between treatment response and parameters of glucose abnormalities after DAAs therapy in CHC patients. CHC patients who received DAAs therapy were recruited. The primary outcome measurements were their insulin resistance (IR) and beta-cell function assessed by the homeostasis model assessment (HOMA) method before treatment and at end-of-follow-up (EOF)...
November 2017: Kaohsiung Journal of Medical Sciences
https://www.readbyqxmd.com/read/29044018/-insulin-therapy-in-special-conditions
#15
León E Litwak, Alicia Elbert, Cristina Faingold, Luis A Grosembacher, Adrián Proietti, Félix Puchulu
Hyperglycemia during hospitalization is a common condition associated with poor prognosis. To date, insulin is the best strategy to treat hyperglycemia in these patients. An adequate glycemic control is associated with better clinical results. Nevertheless, glycemic goals are still controversial due to the increase of hypoglycemia and other adverse events. Diabetes mellitus is still the main cause of chronic renal failure in our country and its treatment deserves a special analysis considering that insulin pharmacokinetics is altered...
2017: Medicina
https://www.readbyqxmd.com/read/29032696/impact-of-improving-postprandial-glycemic-control-with-intensifying-insulin-therapy-in-type-2-diabetes
#16
Tamer Yacoub
Worldwide, many people with type 2 diabetes are not at recommended glycemic targets and remain at increased risk of microvascular and macrovascular complications. Reaching recommended glycemic targets requires normalizing both fasting and postprandial glucose (PPG). For some patients, this will require addition of a prandial insulin delivered by injection to control PPG excursions. Evidence from epidemiological studies suggests an association between postprandial hyperglycemia and cardiovascular disease, and thus, expert guidelines recommend that treatment for elevated PPG not be delayed...
October 14, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/29017373/clinical-considerations-for-use-of-insulin-degludec-insulin-aspart-in-japanese-patients
#17
Takahisa Hirose, Takuya Awata, Yuiko Yamamoto, Mads Peter Hemmingsen
Co-formulation of basal and bolus insulin components provides a simpler regimen for patients with type 2 diabetes than separate basal-bolus treatment. However, conventional premixed insulin products include a suboptimal protaminated basal component that requires resuspension prior to injection. Insulin degludec/insulin aspart (IDegAsp) is the first soluble co-formulation of a basal insulin with an ultra-long duration of action (IDeg) and a rapid-acting bolus insulin (IAsp) in a single injection. Areas covered: In this review, the authors summarize findings from pre-clinical studies and the clinical trial program and provide guidance for the initiating and switching of IDegAsp in different patient populations...
October 11, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28993757/painful-and-prolonged-muscle-cramps-following-insulin-injections-in-a-patient-with-type-2-diabetes-mellitus-revisiting-the-1992-duke-case
#18
Rami A Ballout, Asma Arabi
A 56-year-old middle-eastern male with a long-standing history of poorly controlled type 2 diabetes mellitus presented to us complaining of severely painful bilateral upper and lower extremity cramps occurring shortly after his rapid-acting insulin analog injection(s). The cramps had started 6 months ago and have been occurring intermittently in non-predictable episodes since then. He had otherwise never experienced any insulin-related adverse reaction(s) before. His cramps are very painful and debilitating, interfering with his daily activities and placing him in a state of constant fear/anxiety of re-experiencing them...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28966594/the-role-of-the-autonomic-nervous-system-in-the-pathophysiology-of-obesity
#19
REVIEW
Daniela Guarino, Monica Nannipieri, Giorgio Iervasi, Stefano Taddei, Rosa Maria Bruno
Obesity is reaching epidemic proportions globally and represents a major cause of comorbidities, mostly related to cardiovascular disease. The autonomic nervous system (ANS) dysfunction has a two-way relationship with obesity. Indeed, alterations of the ANS might be involved in the pathogenesis of obesity, acting on different pathways. On the other hand, the excess weight induces ANS dysfunction, which may be involved in the haemodynamic and metabolic alterations that increase the cardiovascular risk of obese individuals, i...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28961041/mechanisms-of-gut-microbiota-mediated-bone-remodeling
#20
Jing Yan, Ayumi Takakura, Kambiz Zandi-Nejad, Julia F Charles
The mechanisms underlying the systemic effects mediated by gut microbiota are under active investigation. In addition to local, direct effects of gut microbiota on the host, metabolic products from microbiota may act peripherally, reaching distal organs through the circulation. In our recent publication we demonstrated that gut microbiota influence bone remodeling distally, promoting both bone resorption and formation. We proposed that these effects are mediated, at least in part, by the induction of insulin like growth factor (IGF-1) by the microbiota metabolite short chain fatty acids (SCFA)...
September 29, 2017: Gut Microbes
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