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nocturnal hypoglycemia

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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
#1
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
#2
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
#3
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...
February 21, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28221823/evaluation-of-a-predictive-low-glucose-management-system-in-clinic
#4
Bruce A Buckingham, Timothy S Bailey, Mark Christiansen, Satish Garg, Stuart Weinzimer, Bruce Bode, Stacey M Anderson, Ron Brazg, Trang Ly, Francine R Kaufman
BACKGROUND: Predictions based on continuous glucose monitoring (CGM) data are the basis for automatic suspension and resumption of insulin delivery by a predictive low-glucose management feature termed "suspend before low," which is part of the Medtronic MiniMed(®) 640G combined insulin pump and CGM system. This study assessed the safety and performance characteristics of the system in an in-clinic setting at eight sites. MATERIALS AND METHODS: In-clinic standardized increases in basal insulin delivery rates were used to induce nocturnal hypoglycemia in subjects (14-75 years) with type 1 diabetes wearing the MiniMed 640G system...
February 16, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28213374/diurnal-differences-in-risk-of-cardiac-arrhythmias-during-spontaneous-hypoglycemia-in-young-people-with-type-1-diabetes
#5
Peter Novodvorsky, Alan Bernjak, Elaine Chow, Ahmed Iqbal, Lianne Sellors, Scott Williams, Robert A Fawdry, Bhavin Parekh, Richard M Jacques, Jefferson L B Marques, Paul J Sheridan, Simon R Heller
OBJECTIVE: Hypoglycemia may exert proarrhythmogenic effects on the heart via sympathoadrenal stimulation and hypokalemia. Hypoglycemia-induced cardiac dysrhythmias are linked to the "dead-in-bed syndrome," a rare, but devastating, condition. We examined the effect of nocturnal and daytime clinical hypoglycemia on electrocardiogram (ECG) in young people with type 1 diabetes. RESEARCH DESIGN AND METHODS: Thirty-seven individuals with type 1 diabetes underwent 96 h of simultaneous ambulatory ECG and blinded continuous interstitial glucose monitoring (CGM) while symptomatic hypoglycemia was recorded...
February 17, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28187863/a-review-of-the-clinical-efficacy-and-safety-of-insulin-degludec-and-glargine-300-u-ml-in-the-treatment-of-diabetes-mellitus
#6
REVIEW
Vincent C Woo
PURPOSE: The treatment of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) using insulin is not ideal at this time. Despite advances made with basal insulin analogues, many individuals achieve less than optimal glycemic control or are at risk for hypoglycemia. Currently available basal insulin analogues do not deliver steady, peakless, continuous insulin for >24 hours and are associated with adverse events, including hypoglycemia. The objective of this paper was to review the clinical efficacy and safety of upcoming long-acting insulin analogues such as insulin degludec and insulin glargine 300 U/mL (Gla-300)...
February 7, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28151905/impact-of-patient-and-treatment-characteristics-on-glycemic-control-and-hypoglycemia-in-patients-with-type-2-diabetes-initiated-to-insulin-glargine-or-nph-a-post-hoc-pooled-patient-level-analysis-of-6-randomized-controlled-trials
#7
Francesca Porcellati, Jay Lin, Paola Lucidi, Geremia B Bolli, Carmine G Fanelli
BACKGROUND: The goal of this post hoc analysis was to determine key patient and treatment-related factors impacting glycosylated hemoglobin (A1C) and hypoglycemia in patients with uncontrolled type 2 diabetes who were initiated to basal insulin (neutral protamine Hagedorn [NPH] or glargine). METHODS: Using individual patient-level data pooled from 6 treat-to-target trials, 2600 patients with type 2 diabetes on oral antidiabetic agents initiated to insulin glargine or NPH and treated for 24 to 36 weeks were analyzed...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28149328/health-related-quality-of-life-and-utility-values-associated-to-hypoglycemia-in-patients-with-type-1-diabetes-mellitus-treated-in-the-brazilian-public-health-system-a-multicenter-study
#8
Luciana Bahia, Rosane Kupfer, Denise Momesso, Debora A P Cabral, Balduino Tschiedel, Marcia Puñales, Suzana Lavigne, Cristina F S Façanha, Adriana C Forti, Angela D N Mendes, Bernardo R Tura
BACKGROUND: Hypoglycemia is a critical and limiting factor of a good metabolic control and can adversely affect the quality of life of diabetic patients. The aim of the study was to evaluate the health-related quality of life and calculate utilities values associated with hypoglycemia in patients with type 1 diabetes mellitus (T1DM). METHODS: A multicenter, cross-sectional and observational study with T1DM patients from reference centers of the Brazilian public health system was conducted in three cities...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28115474/comparison-of-insulin-glargine-300-units-ml-and-100-units-ml-in-adults-with-type-1-diabetes-continuous-glucose-monitoring-profiles-and-variability-using-morning-or-evening-injections
#9
Richard M Bergenstal, Timothy S Bailey, David Rodbard, Monika Ziemen, Hailing Guo, Isabel Muehlen-Bartmer, Andrew J Ahmann
OBJECTIVE: The objective of this study was to compare glucose control in participants with type 1 diabetes receiving insulin glargine 300 units/mL (Gla-300) or glargine 100 units/mL (Gla-100) in the morning or evening, in combination with mealtime insulin. RESEARCH DESIGN AND METHODS: In this 16-week, exploratory, open-label, parallel-group, two-period crossover study (clinicaltrials.gov identifier NCT01658579), 59 adults with type 1 diabetes were randomized (1:1:1:1) to once-daily Gla-300 or Gla-100 given in the morning or evening (with crossover in the injection schedule)...
April 2017: Diabetes Care
https://www.readbyqxmd.com/read/28077204/review-of-the-next-generation-of-long-acting-basal-insulins-insulin-degludec-and-insulin-glargine
#10
Matthew Stailey, Susan E Conway
Older adults are at an increased risk of developing type 2 diabetes mellitus (T2DM). Although oral agents (i.e., metformin) are the preferred first-line therapy, older adults often eventually require the addition of insulin to control their blood glucose. Long-acting insulin analogues are the preferred insulin products for older adults with T2DM. Insulin degludec and insulin glargine U-300 are both new generation long-acting insulins. When compared with the standard of care, long-acting insulin product insulin glargine U-100, insulin degludec, and insulin glargine U-300 had similar glucose-lowering effects, longer half-lives and durations of action, and a more even distribution over a 24-hour period...
January 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28063503/does-oral-glutamine-improve-insulin-sensitivity-in-adolescents-with-type-1-diabetes
#11
Lournaris Torres-Santiago, Nelly Mauras, Jobayer Hossain, Arthur L Weltman, Dominique Darmaun
OBJECTIVE: The decline in insulin sensitivity (SI) associated with puberty increases the difficulty of achieving glycemic control in adolescents with type 1 diabetes (T1D). The aim of this study was to determine whether glutamine supplementation affects blood glucose by enhancing SI in adolescents with T1D. METHODS: Thirteen adolescents with T1D (HbA1C 8.2 ± 0.1%) were admitted to perform afternoon exercise (four 15-min treadmill/5-min rest cycles of exercise) on two occasions within a 4-wk period...
February 2017: Nutrition
https://www.readbyqxmd.com/read/28035840/cost-effectiveness-of-switching-to-insulin-degludec-from-other-basal-insulins-evidence-from-swedish-real-world-data
#12
Lena Landstedt-Hallin, Jens Gundgaard, Åsa Ericsson, Susanne Ellfors-Zetterlund
OBJECTIVES: Health economic analysis from a healthcare and societal point of view was conducted to assess the cost-effectiveness of insulin degludec (IDeg) after switching from other basal insulins in people with type 1 diabetes. MATERIAL AND METHODS: This was a prospective, open-label, single arm, observational follow-up from August 2013 to October 2015 of 476 consecutive patients at Danderyd Hospital (Stockholm, Sweden) who switched to IDeg from other basal insulins (99% basal insulin analogs)...
January 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27908250/hypoglycemia-and-cardiac-arrhythmia-mechanisms-evidence-base-and-current-recommendations
#13
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
#14
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
#15
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...
December 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
#16
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
#17
Fumitaka Okajima, Tomoko Nagamine, Yuko Nakamura, Naomi Hattori, Hitoshi Sugihara, Naoya Emoto
The efficacy of the administration of sodium-glucose co-transporter 2 inhibitor or the co-administration of sodium-glucose co-transporter 2 inhibitor and dipeptidyl peptidase-4 inhibitor to insulin therapy is not well known. A total of 58 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 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
#18
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
#19
COMPARATIVE STUDY
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
#20
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...
February 27, 2017: Endocrine Journal
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