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nocturnal hypoglycemia

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https://www.readbyqxmd.com/read/27908250/hypoglycemia-and-cardiac-arrhythmia-mechanisms-evidence-base-and-current-recommendations
#1
Sitara Gulrukh Khan, Mohammed Shahriar Huda
BACKGROUND: With the use of intensive insulin therapy and insulin secretagogues to optimize glycemic control in diabetes, hypoglycemia continues to present a clinical challenge. Hypoglycemia has been implicated in nocturnal sudden death in type 1 diabetes, and the mechanism underlying this is postulated to be cardiac arrhythmia. OBJECTIVE: This article reviews the evidence surrounding hypoglycemia and cardiac arrhythmia. METHODS: A structured search of the Pubmed bibliographic database was undertaken, and relevant peer-reviewed articles on the topic were included in the review...
December 1, 2016: Current Diabetes Reviews
https://www.readbyqxmd.com/read/27846339/an-evolutionary-perspective-on-basal-insulin-in-diabetes-treatment-innovations-in-insulin-insulin-glargine-u-300
#2
John E Anderson
Rates of confirmed and severe, as well as nocturnal, hypoglycemia are generally lower with insulin glargine U-300 than insulin glargine U-100, thereby reducing an important concern of providers and patients regarding insulin therapy. Although a higher dose of insulin glargine U-300 than U-100 is required in most patients, the observed increase in body weight is small and less than with insulin glargine U-100.
October 2016: Journal of Family Practice
https://www.readbyqxmd.com/read/27835037/glycemia-treatment-satisfaction-cognition-and-sleep-quality-in-adults-and-adolescents-with-type-1-diabetes-when-using-a-closed-loop-system-overnight-versus-sensor-augmented-pump-with-low-glucose-suspend-function-a-randomized-crossover-study
#3
Amin Sharifi, Martin I De Bock, Dilshani Jayawardene, Margaret M Loh, Jodie C Horsburgh, Carolyn L Berthold, Nirubasini Paramalingam, Leon A Bach, Peter G Colman, Elizabeth A Davis, Benyamin Grosman, Christel Hendrieckx, Alicia J Jenkins, Kavita Kumareswaran, Natalie Kurtz, Andrew Kyoong, Richard J MacIsaac, Jane Speight, Steven Trawley, Glenn M Ward, Anirban Roy, Timothy W Jones, David N O'Neal
BACKGROUND: We compared glycemia, treatment satisfaction, sleep quality, and cognition using a nighttime Android-based hybrid closed-loop system (Android-HCLS) with sensor-augmented pump with low-glucose suspend function (SAP-LGS) in people with type 1 diabetes. MATERIALS AND METHODS: An open-label, prospective, randomized crossover study of 16 adults (mean [SD] age 42.1 [9.6] years) and 12 adolescents (15.2 [1.6] years) was conducted. All participants completed four consecutive nights at home with Android-HCLS (proportional integral derivative with insulin feedback algorithm; Medtronic) and SAP-LGS...
November 11, 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27799746/insulin-glargine-300-u-ml-in-the-management-of-diabetes-clinical-utility-and-patient-perspectives
#4
REVIEW
Bastiaan E de Galan
There is ongoing interest in optimizing basal insulin treatment by developing insulins with a flat pharmacological profile, a long duration of action (typically beyond 24 hours) and minimum day-to-day variation. Glargine-300 is a modified form of the long-acting insulin analog glargine in that it has been concentrated at 300 units/mL rather than the conventional 100 units/mL. Glargine-300 has a longer duration of action and a flatter pharmacological profile than original glargine-100. This property allows for more flexibility around the timing of administration, when injected once per day...
2016: Patient Preference and Adherence
https://www.readbyqxmd.com/read/27762088/preventive-effect-of-ipragliflozin-on-nocturnal-hypoglycemia-in-patients-with-type-2-diabetes-treated-with-basal-bolus-insulin-therapy-an-open-label-single-center-parallel-randomized-control-study
#5
Fumitaka Okajima, Tomoko Nagamine, Yuko Nakamura, Naomi Hattori, Hitoshi Sugihara, Naoya Emoto
The efficacy of the administration of sodium-glucose co-transporter 2 inhibitor (SGLT2I) or the co-administration of SGLT2I and dipeptidyl peptidase-4 inhibitor (DPP-4I) to insulin therapy is not well known. Fifty-eight patients with type 2 diabetes, admitted for glycemic control, were randomized to basal-bolus insulin therapy (BBT) alone or BBT plus 50 mg ipragliflozin and/or 20 mg teneligliptin. Insulin doses were adjusted to maintain normal blood glucose levels. Plasma glucose profiles were estimated by continuous glucose monitoring (CGM) before discharge...
October 20, 2016: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/27760129/efficacy-and-safety-of-once-daily-insulin-degludec-insulin-aspart-versus-insulin-glargine-u100-for-52-weeks-in-insulin-na%C3%A3-ve-patients-with-type-2-diabetes-a-randomized-controlled-trial
#6
Ajay Kumar, Edward Franek, Jonathan Wise, Marcus Niemeyer, Henriette Mersebach, Rafael Simó
PURPOSE: The efficacy and safety of insulin degludec/insulin aspart (IDegAsp) once daily (OD) compared with insulin glargine U100 (IGlar) OD over 52 weeks in insulin-naïve adults with type 2 diabetes mellitus (T2DM) was investigated. METHODS: In this open-label, parallel-group treat-to-target trial, participants were randomized (1:1) to receive IDegAsp OD (breakfast, n = 266) or IGlar OD (as per label, n = 264). Participants then entered a 26-week extension phase (IDegAsp OD, n = 192; IGlar OD, n = 221)...
2016: PloS One
https://www.readbyqxmd.com/read/27746428/major-increases-between-pre-and-post-breakfast-glucose-levels-may-predict-nocturnal-hypoglycemia-in-type-2-diabetes
#7
Soichi Takeishi, Akihiro Mori, Miyuka Kawai, Yohei Yoshida, Hiroki Hachiya, Takayuki Yumura, Shun Ito, Takashi Shibuya, Nobutoshi Fushimi, Noritsugu Ohashi, Hiromi Kawai
Objective The aim of this study was to determine whether nocturnal hypoglycemia may be predicted according to morning glucose levels. Methods We retrospectively evaluated 106 patients with type 2 diabetes who underwent continuous glucose monitoring during admission. The pre-breakfast glucose level (Pre-breakfast level), highest postprandial glucose level within 3 hours after breakfast (Highest level), time from the start of breakfast to the highest postprandial glucose level (Highest time), difference between the pre-breakfast and highest postprandial breakfast glucose levels (Increase), area under the glucose curve (≥180 mg/dL) within 3 hours after breakfast (Morning AUC), post-breakfast glucose gradient (Gradient), and the increase-to-pre-breakfast ratio (Increase/Pre-breakfast) were calculated...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27746408/a-randomized-crossover-study-of-the-efficacy-and-safety-of-switching-from-insulin-glargine-to-insulin-degludec-in-children-with-type-1-diabetes
#8
Tatsuhiko Urakami, Yusuke Mine, Masako Aoki, Misako Okuno, Junichi Suzuki
This study implemented a randomized crossover design to evaluate the efficacy and safety of switching from insulin glargine (IGlar) to insulin degludec (IDeg) in 18 children (11 males, 7 females; age 11.0 ± 0.5 years) with type 1 diabetes. All subjects had previously used IGlar once daily at bedtime. We compared fasting plasma glucose (FPG) and HbA1c levels, frequencies of overall and nocturnal (2200 h - 0659 h) hypoglycemia, and basal insulin dose at the baseline with those measured during a 24-week period during which IGlar or IDeg was administered in combination with pre-meal rapid acting insulin analogues...
October 14, 2016: Endocrine Journal
https://www.readbyqxmd.com/read/27699623/clinical-pharmacokinetics-and-pharmacodynamics-of-insulin-glargine-300%C3%A2-u-ml
#9
Jennifer N Clements, Tiffaney Threatt, Eileen Ward, Kayce M Shealy
Concentrated insulin analogs have recently been approved and are available for clinical use in the management of diabetes mellitus. One new product is insulin glargine U-300 (Sanofi), a basal concentrated insulin of 300 U/mL. Several studies have been conducted and completed evaluating blood samples for the pharmacokinetics of insulin glargine U-300 and euglycemic clamp procedures for the pharmacodynamics. This concentrated insulin has a low within-day variability and high day-to-day reproducibility, allowing for a more constant and prolonged duration of action, compared with insulin glargine U-100 (100 U/mL)...
October 4, 2016: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/27690710/achieve-control-a-pragmatic-clinical-trial-of-insulin-glargine-300-u-ml-versus-other-basal-insulins-in-insulin-na%C3%A3-ve-patients-with-type-2-diabetes
#10
Gerry Oster, Sean D Sullivan, Mehul R Dalal, Mahmood R Kazemi, Maria Rojeski, Carol H Wysham, Jennifer Sung, Bryan Johnstone, Anna M G Cali, L J Wei, Louise Traylor, Henry Anhalt, Michelle Hull, John Van Vleet, Luigi F Meneghini
OBJECTIVE: This study aims to compare the effectiveness of insulin glargine 300 U/mL (Gla-300) with its accompanying patient support program with that of other basal insulin and available patient support programs in patients with type 2 diabetes (T2D) in a real-world setting in terms of achieving HEDIS (Healthcare Effectiveness Data and Information Set) individualized glycemic targets without documented symptomatic hypoglycemia. STUDY DESIGN AND METHODS: Achieve Control is a US-based, multicenter, randomized, open-label, active-controlled, parallel group pragmatic Phase IV trial in insulin-naïve patients with T2D uncontrolled on ≥2 oral antidiabetes drugs (OAD) and/or glucagon-like peptide-1 receptor antagonists (GLP-1 RA)...
October 3, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27663113/correlates-and-outcomes-of-worries-about-hypoglycemia-in-family-members-of-adults-with-diabetes-the-second-diabetes-attitudes-wishes-and-needs-dawn2-study
#11
Giesje Nefs, François Pouwer, Richard I G Holt, Søren Skovlund, Norbert Hermanns, Antonio Nicolucci, Mark Peyrot
OBJECTIVE: We examined (a) the demographic and clinical correlates of worries about hypoglycemia in adult family members of adults with diabetes, and (b) the association of these worries with measures of diabetes support. METHODS: The second multinational Diabetes Attitudes, Wishes and Needs (DAWN2) study cross-sectionally surveyed 2057 family members from 17 countries. Participants completed questions about demographics, diabetes, and psychosocial functioning, including worry about overall and nocturnal hypoglycemia...
October 2016: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/27660190/glycemic-control-indices-and-their-aggregation-in-the-prediction-of-nocturnal-hypoglycemia-from-intermittent-blood-glucose-measurements
#12
Sivananthan Sampath, Pavlo Tkachenko, Eric Renard, Sergei V Pereverzev
BACKGROUND: Despite the risk associated with nocturnal hypoglycemia (NH) there are only a few methods aiming at the prediction of such events based on intermittent blood glucose monitoring data. One of the first methods that potentially can be used for NH prediction is based on the low blood glucose index (LBGI) and suggested, for example, in Accu-Chek® Connect as a hypoglycemia risk indicator. On the other hand, nowadays there are other glucose control indices (GCI), which could be used for NH prediction in the same spirit as LBGI...
November 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/27569727/glucose-variability-indices-predict-the-episodes-of-nocturnal-hypoglycemia-in-elderly-type-2-diabetic-patients-treated-with-insulin
#13
Vadim V Klimontov, Natalia E Myakina
AIM: O determine the applicability of glucose variability (GV) indices derived from continuous glucose monitoring (CGM) data for prediction of nocturnal hypoglycemia (NH) in elderly patients with type 2 diabetes treated with insulin. METHODS: We observed 83 insulin-treated in-patients, 65-80 years of age. Blinded CGM data for 176 nights were analyzed. Daytime (06:00-22:59) mean glucose, Standard Deviation (SD), 2-h Continuous Overlapping Net Glycemic Action (CONGA2) and Mean Absolute Glucose (MAG), pre-midnight (23:00-23:59) mean glucose, SD and MAG, 24-h Mean Amplitude of Glucose Excursions (MAGE), were estimated...
August 23, 2016: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/27560769/insulin-degludec-insulin-aspart-vs-biphasic-insulin-aspart-30-twice-daily-in-japanese-patients-with-type-2-diabetes-a-randomized-controlled-trial
#14
Yukiko Onishi, Kenichi Yamada, Jeppe Zacho, Jan Ekelund, Yasuhiko Iwamoto
AIMS/INTRODUCTION: Insulin degludec/insulin aspart (IDegAsp) is a soluble combination of insulin degludec (70%) and insulin aspart (30%). The present exploratory trial investigated the safety of switching unit-to-unit from twice-daily basal or pre-mix insulin to twice-daily IDegAsp in Japanese patients with type 2 diabetes. MATERIALS AND METHODS: In this 6-week, open-label, parallel-group, controlled trial, 66 participants were randomized (1:1) to receive either IDegAsp or biphasic insulin aspart 30 (BIAsp 30) twice daily at the same total daily dose as pre-trial insulin...
August 25, 2016: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/27488802/do-children-adolescents-and-young-adults-with-type-1-diabetes-have-increased-prevalence-of-sleep-disorders
#15
Avital Adler, Michal-Yackobovitz Gavan, Riva Tauman, Moshe Phillip, Shlomit Shalitin
BACKGROUND: Sleep has been shown to impact glucose regulation, and may be altered in persons with type 1 diabetes (T1D). OBJECTIVE: To assess sleep characteristics in T1D patients and the possible association between sleep disturbances and diabetes-related variables. SUBJECTS AND METHODS: In a cross-sectional study in 154 young patients with T1D and 154 age-range-matched nondiabetic controls subjective sleep characteristics were assessed using validated questionnaires: Sleep Disturbance Scale for Children (SDSC), Adolescent Sleep-Wake Scale (ASWS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS)...
August 3, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27484021/reduced-nocturnal-hypoglycaemia-with-basal-insulin-peglispro-compared-with-insulin-glargine-pooled-analyses-of-five-randomized-controlled-trials
#16
Julio Rosenstock, Michel Marre, Yongming Qu, Shuyu Zhang, Edward J Bastyr, Melvin J Prince, Annette M Chang
Basal insulin peglispro (BIL) is a novel basal insulin with hepato-preferential action, resulting from reduced peripheral effects. This report summarizes hypoglycaemia data from five BIL phase III studies with insulin glargine as the comparator, including three double-blind trials. Prespecified pooled analyses (n = 4927) included: patients with type 2 diabetes (T2D) receiving basal insulin only, those with T2D on basal-bolus therapy, and those with type 1 diabetes (T1D). BIL treatment resulted in a 36-45% lower nocturnal hypoglycaemia rate compared with glargine, despite greater reduction in glycated haemoglobin (HbA1c) and higher basal insulin dosing...
November 2016: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/27478509/the-relationship-between-hba1c-values-and-the-occurrence-of-hypoglycemia-as-assessed-by-continuous-glucose-monitoring-in-patients-with-type-1-diabetes
#17
Daisuke Tsujino, Rimei Nishimura, Yoshiko Onda, Chiaki Seo, Kiyotaka Ando, Aya Morimoto, Kazunori Utsunomiya
BACKGROUND: We aimed to examine the relationship between the occurrence of hypo-/hyperglycemia and HbA1c values, as assessed by continuous glucose monitoring (CGM) in patients with type 1 diabetes. METHODS: The study subjects comprised 101 type 1 diabetic patients on basal-bolus insulin therapy, who were put on masked CGM immediately after admission. The subjects were divided into four groups equally by HbA1c values and the 24-h CGM data were compared among the groups...
2016: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/27477293/continuous-subcutaneous-insulin-infusion-versus-multiple-daily-injections-in-individuals-with-type-1-diabetes-a-systematic-review-and-meta-analysis
#18
Khalid Benkhadra, Fares Alahdab, Shrikant U Tamhane, Rozalina G McCoy, Larry J Prokop, Mohammad Hassan Murad
The relative efficacy of continuous subcutaneous insulin infusion and multiple daily injections in individuals with type 1 diabetes is unclear. We sought to synthesize the existing evidence about the effect of continuous subcutaneous insulin infusion on glycosylated hemoglobin, hypoglycemic events, and time spent in hypoglycemia compared to multiple daily injections. We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Database of Systematic Reviews, and Scopus from January 2008 through November 2015 for randomized controlled trials that enrolled children or adults with type 1 diabetes...
August 1, 2016: Endocrine
https://www.readbyqxmd.com/read/27453980/pharmacokinetics-and-pharmacodynamics-of-insulin-glargine-300-u-ml-in-the-treatment-of-diabetes-and-their-clinical-relevance
#19
David R Owens
INTRODUCTION: A more concentrated insulin glargine formulation, containing 300 U/mL (Gla-300) was approved in 2015 in the US and Europe for the treatment of diabetes mellitus in adults. AREAS COVERED: This drug evaluation focuses on the pharmacokinetics (PK) and pharmacodynamics (PD) of Gla-300 from studies published up to May 2016. The clinical relevance of this new formulation will be addressed. EXPERT OPINION: Gla-300 was developed to produce a flatter and more prolonged PK/PD profile compared with insulin glargine 100 U/mL (Gla-100) in order to maintain effective glycemic control and reduce the risk of hypoglycemia...
August 2016: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/27393697/a-randomized-clinical-trial-comparing-basal-insulin-peglispro-and-insulin-glargine-in-combination-with-prandial-insulin-lispro-in-patients-with-type-1-diabetes-imagine-1
#20
(no author information available yet)
This article will be part of a supplement and will be republished when the entire issue is complete.
July 8, 2016: Diabetes, Obesity & Metabolism
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