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nocturnal hypoglycemia

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https://www.readbyqxmd.com/read/28626170/investigating-the-relationship-between-morning-glycemic-variability-and-patient-characteristics-using-continuous-glucose-monitoring-data-in-patients-with-type-2-diabetes
#1
Soichi Takeishi, Akihiro Mori, Miyuka Kawai, Yohei Yoshida, Hiroki Hachiya, Takayuki Yumura, Shun Ito, Takashi Shibuya, Nobutoshi Fushimi, Noritsugu Ohashi, Hiromi Kawai
Objective To investigate the relationship between patient characteristics and morning glycemic variability. Methods We retrospectively evaluated 106 patients with type 2 diabetes who underwent continuous glucose monitoring during admission. The highest postprandial glucose level (within 3 hours after breakfast; 'highest level'), the time from the start of breakfast to the highest postprandial glucose level ('highest time'), the difference between the pre-breakfast and highest postprandial breakfast glucose level ('increase'), the area under the curve (AUC; ≥180 mg/dL) for the glycemic variability within 3 hours after breakfast ('morning AUC'), and the post-breakfast glucose gradient ('gradient') were calculated...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28609547/intensive-insulin-therapy-combined-with-metformin-is-associated-with-reduced-glucose-variability-and-nocturnal-hypoglycemia-in-patients-with-type-2-diabetes
#2
Yifei Zhang, Zhiyun Zhao, Shujie Wang, Wei Zhu, Yiran Jiang, Shouyue Sun, Chen Chen, Kai Wang, Liangshan Mu, Jinyi Cao, Yingxia Zhou, Weiqiong Gu, Jie Hong, Weiqing Wang, Guang Ning
BACKGROUND: The effect on glucose variability in patients with intensive insulin therapy has not been fully understood. This observational study investigated the different glucose variability and hypoglycemia pattern in type 2 diabetes patients treated with continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI) with or without metformin administration. METHODS: During hospitalization, totally 501 patients with poor glycemic control and in initial treatment with either CSII alone (n = 187), CSII + Metformin (n = 81), MDI alone (n = 146) or MDI + Metformin (n = 87), were involved in the final analysis...
June 13, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28585180/efficacy-and-safety-of-insulin-degludec-for-hyperglycemia-management-in-noncritical-hospitalized-patients-with-diabetes-an-observational-study
#3
Natalino Simioni, Alessio Filippi, Marco Scardapane, Antonio Nicolucci, Maria Chiara Rossi, Vera Frison
INTRODUCTION: To assess the efficacy and safety of insulin degludec administered in a basal-bolus regimen according to the GesTIO protocol in noncritical hospitalized patients with T1DM and T2DM. METHODS: Mean blood glucose levels (BG) and their standard deviations (SD) at admission vs. discharge were compared in 52 subjects (48.1% ≥75 years) managed through a basal-bolus scheme including degludec. The percentages of patients with BG at target (140-180 mg/dl) or below at discharge and the incidence rate (and the 95% confidence interval for it) of hypoglycemia were assessed...
June 5, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28579834/hypoglycemia-a-review-of-definitions-used-in-clinical-trials-evaluating-antihyperglycemic-drugs-for-diabetes
#4
REVIEW
Chakrapani Balijepalli, Eric Druyts, Gaye Siliman, Michel Joffres, Kristian Thorlund, Edward J Mills
OBJECTIVE: To understand the severity and potential impact of heterogeneity in definitions of hypoglycemia used in diabetes research, we aimed to review the hypoglycemia definitions adopted in randomized controlled trials (RCTs). METHODS: We reviewed 109 RCTs included in the Canadian Agency for Drugs and Technologies in Health reports for the second- and third-line therapy for the patients with type 2 diabetes (T2D). RESULTS: Nearly 60% (n=66) of the studies reviewed presented the definitions for overall hypoglycemia, and another 20% (n=22) of the studies reported the results for hypoglycemia but did not report a definition...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28547206/glycemic-variability-in-type-1-diabetes-compared-with-degludec-and-glargine-on-the-morning-injection-an-open-label-randomized-controlled-trial
#5
Ryo Iga, Hiroshi Uchino, Ken Kanazawa, Shuki Usui, Masahiko Miyagi, Naoki Kumashiro, Hiroshi Yoshino, Yasuyo Ando, Takahisa Hirose
INTRODUCTION: Optimal adjustment of basal insulin to overcome hypoglycemia and glycemic variability (GV) depends on its duration of action and peak-less profile. Owing to the ability of long-acting basal insulin to avoid hypoglycemia, we titrated pre-meal glucose to normal fasting blood glucose, 80-110 mg/dL (4.5-6.1 mmol/L), and post-meal glucose to 80-140 mg/dL (4.5-7.8 mmol/L). The purpose of this study was to evaluate two basal insulin analogues degludec (IDeg) and glargine (IGlar), injected in the morning, for GV using continuous glucose monitoring (CGM) in type 1 diabetes (T1DM)...
May 25, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28537449/understanding-how-pharmacokinetic-and-pharmacodynamic-differences-of-basal-analog-insulins-influence-clinical-practice
#6
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/28528246/the-canadian-hypoglycemia-assessment-tool-program-insights-into-rates-and-implications-of-hypoglycemia-from-an-observational-study
#7
Ronnie Aronson, Ronald Goldenberg, Damir Boras, Rasmus Skovgaard, Harpreet Bajaj
OBJECTIVE: The true prevalence of hypoglycemia in insulin-treated patients with diabetes and its impact on patients, employers and healthcare providers is poorly appreciated owing to a paucity of real-world data. The global Hypoglycemia Assessment Tool (HAT) study addressed this issue, and here we report data from the Canadian cohort of patients. METHODS: This noninterventional, 6-month retrospective and 4-week prospective study enrolled patients aged ≥18 years receiving insulin treatment for >12 months from community endocrinology practices...
May 17, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28520532/effectiveness-of-smartguard-technology-in-the-prevention-of-nocturnal-hypoglycemia-after-prolonged-physical-activity
#8
Lenka Petruzelkova, Klara Pickova, Zdenek Sumnik, Jan Soupal, Barbora Obermannova
BACKGROUND: The prevention of postexercise nocturnal hypoglycemia after prolonged physical activity using sensor-augmented pump (SAP) therapy with predictive low-glucose management (PLGM) has not been well studied. We conducted a study at a pediatric diabetes camp to determine whether a SAP with PLGM reduces the frequency of nocturnal hypoglycemia after prolonged physical activity more effectively than a SAP with a carbohydrate intake algorithm. METHODS: During a 1-week sport camp, 20 children (aged 10-13 years) with type 1 diabetes (T1D) managed by SAP therapy either with (n = 7) or without PLGM (n = 13) were studied...
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28476567/dietary-intake-and-risk-of-non-severe-hypoglycemia-in-adolescents-with-type-1-diabetes
#9
Victor W Zhong, Jamie L Crandell, Christina M Shay, Penny Gordon-Larsen, Stephen R Cole, Juhaeri Juhaeri, Anna R Kahkoska, David M Maahs, Michael Seid, Gregory P Forlenza, Elizabeth J Mayer-Davis
AIMS: To determine the association between dietary intake and risk of non-severe hypoglycemia in adolescents with type 1 diabetes. METHODS: Type 1 adolescents from a randomized trial wore a blinded continuous glucose monitoring (CGM) system at baseline for one week in free-living conditions. Dietary intake was calculated as the average from two 24-h dietary recalls. Non-severe hypoglycemia was defined as having blood glucose <70mg/dL for ≥10min but not requiring external assistance, categorized as daytime and nocturnal (11PM-7AM)...
April 20, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28467113/efficacy-and-safety-of-insulin-glargine-300-u-ml-versus-insulin-glargine-100-u-ml-in-high-risk-and-low-risk-patients-with-type-2-diabetes-stratified-using-common-clinical-performance-measures
#10
Ildiko Lingvay, Jason Chao, Mehul R Dalal, Luigi F Meneghini
BACKGROUND: To determine whether previously reported reductions in hypoglycemia associated with insulin glargine 300 U/mL (Gla-300) compared with insulin glargine 100 U/mL (Gla-100) are impacted by patient risk category in type 2 diabetes (T2D), clinical performance measures based on the Healthcare Effectiveness Data and Information Set (HEDIS) were applied to patient-level data from the EDITION 2 and EDITION 3 clinical trials that compared Gla-300 and Gla-100. METHODS: In this post hoc analysis, patients were stratified as low risk (LR) if patients were <65 years old with no comorbidities derived from HEDIS (HbA1c target <7...
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28459617/outpatient-closed-loop-control-with-unannounced-moderate-exercise-in-adolescents-using-zone-model-predictive-control
#11
Lauren M Huyett, Trang T Ly, Gregory P Forlenza, Suzette Reuschel-DiVirgilio, Laurel H Messer, R Paul Wadwa, Ravi Gondhalekar, Francis J Doyle, Jordan E Pinsker, David M Maahs, Bruce A Buckingham, Eyal Dassau
BACKGROUND: The artificial pancreas (AP) has the potential to improve glycemic control in adolescents. This article presents the first evaluation in adolescents of the Zone Model Predictive Control and Health Monitoring System (ZMPC+HMS) AP algorithms, and their first evaluation in a supervised outpatient setting with frequent exercise. MATERIALS AND METHODS: Adolescents with type 1 diabetes underwent 3 days of closed-loop control (CLC) in a hotel setting with the ZMPC+HMS algorithms on the Diabetes Assistant platform...
June 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28458515/united-states-experience-of-insulin-degludec-alone-or-in-combination-for-type-1-and-type-2-diabetes
#12
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/28425230/attitudes-wishes-and-needs-of-diabetes-patients-and-their-relatives-turkish-data-from-the-dawn2-study
#13
İlhan Tarkun, Suzan Dumanli Özgöksu
BACKGROUND/AIM: The DAWN2 (Diabetes Attitudes, Wishes, and Needs) study was conducted in order to ascertain the wishes, needs, and attitudes of diabetes patients, their relatives, and healthcare professionals. The study was conducted across 17 countries, including Turkey, and its objective was to introduce policies that could successfully meet these requirements. In this article, the needs, wishes, and attitudes of diabetes patients and their relatives in Turkey are compared with those from other countries...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28401454/use-of-flash-glucose-sensing-technology-for-12%C3%A2-months-as-a-replacement-for-blood-glucose-monitoring-in-insulin-treated-type-2-diabetes
#14
Thomas Haak, Hélène Hanaire, Ramzi Ajjan, Norbert Hermanns, Jean-Pierre Riveline, Gerry Rayman
INTRODUCTION: Published evaluations of sensor glucose monitoring use in insulin treated type 2 diabetes are limited. The aim of this study was to assess the impact of flash glucose-sensing technology as a replacement for self-monitoring of blood glucose (SMBG) over a 12-month period in participants with type 2 diabetes who were on intensive insulin therapy. METHODS: An open-label, randomized, controlled study in adults with type 2 diabetes on intensive insulin therapy from 26 European diabetes centers aimed at assessing flash glucose sensing technology was conducted...
June 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28371567/open-label-randomized-study-comparing-basal-insulin-peglispro-and-insulin-glargine-in-combination-with-oral-antihyperglycemic-medications-in-insulin-na%C3%A3-ve-asian-patients-with-type-2-diabetes
#15
Takahisa Hirose, Zhihong Cai, Kwee Poo Yeo, Makoto Imori, Kenji Ohwaki, Takeshi Imaoka
INTRODUCTION: The present phase 3, randomized, open-label study compared the efficacy and safety of basal insulin peglispro with insulin glargine after 26 weeks of treatment when added to oral antihyperglycemic medications in insulin-naïve Asian patients with type 2 diabetes. MATERIALS AND METHODS: The primary objective was to show non-inferiority of the change in glycated hemoglobin from baseline to 26 weeks. RESULTS: At 26 weeks, insulin peglispro was non-inferior to glargine, meeting the primary objective...
March 31, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28371461/comparison-of-morning-basal-1-bolus-insulin-therapy-insulin-glulisine-insulin-glargine-300-u-ml-vs-insulin-lispro-insulin-glargine-biosimilar-using-continuous-glucose-monitoring-a-randomized-crossover-study
#16
Soichi Takeishi, Hiroki Tsuboi, Shodo Takekoshi
INTRODUCTION: We compared the effects of morning administration of insulin glulisine + insulin glargine 300 U/mL (G + G300) with that of insulin lispro + insulin glargine biosimilar (L + GB). MATERIALS AND METHODS: A total of 30 patients with type 2 diabetes who wore a continuous glucose monitoring device on admission after glucose levels were stabilized by morning long-acting and ultra-rapid-acting insulins were randomly allocated to groups who received G + G300 on days 1 and 2, and the same dose L + GB on days 3 and 4, or vice versa...
March 28, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28367916/analysis-of-efficacy-and-safety-of-dulaglutide-0-75-mg-stratified-by-sex-in-patients-with-type-2-diabetes-in-2-randomized-controlled-phase-3-studies-in-japan
#17
Yukiko Onishi, Tomonori Oura, Akiko Matsui, Jun Matsuura, Noriyuki Iwamoto
We analyzed the efficacy and safety of once weekly dulaglutide 0.75 mg by sex in 2 randomized, controlled phase 3 studies in Japanese patients with type 2 diabetes (a 52-week monotherapy study [comparator liraglutide 0.9 mg] and a 26-week combination therapy study [comparator insulin glargine]). Females comprised 18% of patients in the monotherapy study and 29% of patients in the combination therapy study. Mean reductions from baseline in glycated hemoglobin (HbA1c) were similar between the sexes for dulaglutide- and liraglutide-treated patients (range -1...
March 29, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28271075/continuous-glucose-monitoring-in-newly-diagnosed-type-2-diabetes-patients-reveals-a-potential-risk-of-hypoglycemia-in-older-men
#18
Feng-Fei Li, Bing-Li Liu, Hong-Hong Zhu, Ting Li, Wen-Li Zhang, Xiao-Fei Su, Jin-Dan Wu, Xue-Qin Wang, Ning Xu, Wei-Nan Yu, Qun Yuan, Guan-Cheng Qi, Lei Ye, Kok-Onn Lee, Jian-Hua Ma
Objectives. We performed continuous glucose monitoring (CGM) to define the features of patients with newly diagnosed type 2 diabetes (T2D) before and after Continuous Subcutaneous Insulin Infusion (CSII) therapy. Methods. This was a retrospective analysis. Newly diagnosed T2D patients (106) were admitted from eight centers in China. They were divided into a younger patient group (<60 years) and an older patient group (≥60 years). Each group was further divided into male and female patients. CSII therapy was maintained for 3 weeks after the glycemic target was reached...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28251726/outcomes-of-algorithm-based-modifications-of-insulinotherapy-during-exercise-in-mdi-vs-insulin-pump-treated-children-with-type-1-diabetes-results-from-the-tread-diab-study
#19
S Moniotte, M Owen, T Barrea, A Robert, P A Lysy
OBJECTIVES: To evaluate the evolution of subcutaneous glucose (SG) after a standardized aerobic exercise in children and adolescents treated with continuous subcutaneous insulin infusion (CSII) or multiple daily injection (MDI) regimen before and after adaptation of insulin doses. RESEARCH DESIGN AND METHODS: Eleven CSII- and 13 MDI-treated patients performed 2 30-minute sessions of moderate to vigorous (70% of age-based maximal heart rate) exercise on a treadmill under continuous glucose monitoring (CGM)...
March 2, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28223296/cardiac-effects-of-sulfonylurea-related-hypoglycemia
#20
Timothy L Middleton, Jencia Wong, Lynda Molyneaux, Belinda A Brooks, Dennis K Yue, Stephen M Twigg, Ted Wu
OBJECTIVE: To determine the effect of sulfonylurea-related hypoglycemia on cardiac repolarization and ectopy in the setting of well-controlled type 2 diabetes. RESEARCH DESIGN AND METHODS: Thirty subjects with sulfonylurea-treated type 2 diabetes underwent 48 h of concurrent continuous glucose monitoring and ambulatory electrocardiography. Ventricular repolarization (QTc) and QT dynamicity were analyzed during periods of hypoglycemia (<3.5 mmol/L for >20 min) and compared with periods of euglycemia and hyperglycemia combined...
May 2017: Diabetes Care
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