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https://www.readbyqxmd.com/read/28923465/continuous-glucose-monitoring-in-pregnant-women-with-type-1-diabetes-conceptt-a-multicentre-international-randomised-controlled-trial
#1
Denice S Feig, Lois E Donovan, Rosa Corcoy, Kellie E Murphy, Stephanie A Amiel, Katharine F Hunt, Elisabeth Asztalos, Jon F R Barrett, J Johanna Sanchez, Alberto de Leiva, Moshe Hod, Lois Jovanovic, Erin Keely, Ruth McManus, Eileen K Hutton, Claire L Meek, Zoe A Stewart, Tim Wysocki, Robert O'Brien, Katrina Ruedy, Craig Kollman, George Tomlinson, Helen R Murphy
BACKGROUND: Pregnant women with type 1 diabetes are a high-risk population who are recommended to strive for optimal glucose control, but neonatal outcomes attributed to maternal hyperglycaemia remain suboptimal. Our aim was to examine the effectiveness of continuous glucose monitoring (CGM) on maternal glucose control and obstetric and neonatal health outcomes. METHODS: In this multicentre, open-label, randomised controlled trial, we recruited women aged 18-40 years with type 1 diabetes for a minimum of 12 months who were receiving intensive insulin therapy...
September 14, 2017: Lancet
https://www.readbyqxmd.com/read/28922987/admissions-for-hypoglycaemia-after-35%C3%A2-weeks-of-gestation-perinatal-predictors-of-cost-of-stay
#2
Theodore Dassios, Anne Greenough, Stamatina Leontiadi, Ann Hickey, Nick Kametas
BACKGROUND: Hypoglycaemia accounts for approximately one tenth of term admissions to neonatal units, can cause long-term neurodevelopmental impairment and is associated with significant burden to the affected infants, families and the health system. OBJECTIVE: To define the prevalence, length and cost of admissions for hypoglycaemia in infants born at greater than 35 weeks gestation and to identify antenatal and perinatal predictors of those outcomes. MATERIAL AND METHODS: This was a retrospective audit of infants admitted for hypoglycaemia between 1/1/2012 and 31/12/2015, in a level three neonatal intensive care unit at King's College Hospital NHS Foundation Trust, London...
September 18, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28922582/relationship-between-optimum-mini-doses-of-glucagon-and-insulin-levels-when-treating-mild-hypoglycaemia-in-patients-with-type-1-diabetes-a-simulation-study
#3
Ajenthen Ranjan, Sabrina L Wendt, Signe Schmidt, Sten Madsbad, Jens J Holst, Henrik Madsen, Carsten B Knudsen, John B Jørgensen, Kirsten Nørgaard
Hypoglycaemia remains the main limiting factor in type 1 diabetes management. We developed an insulin-dependent glucagon dosing regimen for treatment of mild hypoglycaemia based on simulations. A validated glucose-insulin-glucagon model was used to describe seven virtual patients with insulin pump-treated type 1 diabetes. In each simulation, one of ten different and individualised subcutaneous insulin boluses was administered to decrease plasma glucose (PG) from 7.0 to ≤3.9 mmol/l. Insulin levels were estimated as ratio of actual to baseline serum insulin concentration (se/ba-insulin), insulin on board (IOB) or percentage of IOB to total daily insulin dose (IOB/TDD)...
September 18, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28921862/efficacy-and-safety-of-the-addition-of-ertugliflozin-in-patients-with-type-2-diabetes-mellitus-inadequately-controlled-with-metformin-and-sitagliptin-the-vertis-sita2-placebo-controlled-randomized-study
#4
Samuel Dagogo-Jack, Jie Liu, Roy Eldor, Guillermo Amorin, Jeremy Johnson, Darcy Hille, Yuqin Liao, Susan Huyck, Gregory Golm, Steven G Terra, James P Mancuso, Samuel S Engel, Brett Lauring
AIMS: To assess ertugliflozin in patients with type 2 diabetes inadequately controlled on metformin and sitagliptin. MATERIALS AND METHODS: In this double-blind randomized study (NCT02036515), patients (glycated haemoglobin [HbA1c] 7.0-10.5% [53-91 mmol/mol] on metformin ≥1500 mg/day and sitagliptin 100 mg/day; estimated glomerular filtration rate [eGFR] ≥60 mL/min/1.73 m(2) ) were randomized to ertugliflozin 5 mg once-daily, 15 mg once-daily, or placebo. Primary efficacy endpoint was change from baseline in HbA1c at Week 26; treatment was continued until Week 52...
September 17, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28919061/efficacy-and-safety-of-dapagliflozin-in-patients-with-inadequately-controlled-type-1-diabetes-depict-1-24-week-results-from-a-multicentre-double-blind-phase-3-randomised-controlled-trial
#5
Paresh Dandona, Chantal Mathieu, Moshe Phillip, Lars Hansen, Steven C Griffen, Diethelm Tschöpe, Fredrik Thorén, John Xu, Anna Maria Langkilde
BACKGROUND: Dapagliflozin is a sodium-glucose cotransporter-2 inhibitor approved for the treatment of type 2 diabetes. We aimed to assess the efficacy and safety of dapagliflozin as an add-on to adjustable insulin in patients with inadequately controlled type 1 diabetes. METHODS: DEPICT-1 was a double-blind, randomised, parallel-controlled, three-arm, phase 3, multicentre study done at 143 sites in 17 countries. Eligible patients were aged 18-75 years and had inadequately controlled type 1 diabetes (HbA1c between ≥7·7% and ≤11·0% [≥61·0 mmol/mol and ≤97·0 mmol/mol]) and had been prescribed insulin for at least 12 months before enrolment...
September 13, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28918470/assessment-of-glucose-regulation-in-pregnancy-after-gastric-bypass-surgery
#6
Christian S Göbl, Latife Bozkurt, Andrea Tura, Michael Leutner, Laura Andrei, Lukas Fahr, Peter Husslein, Wolfgang Eppel, Alexandra Kautzky-Willer
AIMS/HYPOTHESIS: Roux-en-Y gastric bypass (RYGB) surgery is characterised by glycaemic variability. Prospective studies of glucose metabolism in pregnancy after RYGB are not available, therefore this study aimed to evaluate physiological alterations in glucose metabolism in pregnancy following RYGB. METHODS: Sixty-three pregnant women (25 who underwent RYGB, 19 non-operated obese control women and 19 normal weight control women) were included. Frequently sampled 3 h OGTTs and 1 h IVGTTs were performed between 24 and 28 weeks of gestation and, in a subgroup, were repeated at 3-6 months after delivery...
September 16, 2017: Diabetologia
https://www.readbyqxmd.com/read/28918198/are-we-missing-hypoglycaemia-elderly-patients-with-insulin-treated-diabetes-present-to-primary-care-frequently-with-non-specific-symptoms-associated-with-hypoglycaemia
#7
Suzy V Hope, Phil J Taylor, Beverley M Shields, Andrew T Hattersley, Willie Hamilton
INTRODUCTION: We assessed if patients with known hypoglycaemia present on other occasions with non-specific symptoms associated with (but not diagnosed as) hypoglycaemia, potentially representing missed hypoglycaemia. METHODS: 335 primary care records (5/2/12-4/2/13) from patients aged >65 (79 on insulin, 85 on sulphonylureas, 121 on metformin only, 50 without diabetes) were assessed for hypoglycaemia episodes and consultations with non-specific symptoms, "hypo clues"...
September 11, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28917544/effects-on-the-incidence-of-cardiovascular-events-of-the-addition-of-pioglitazone-versus-sulfonylureas-in-patients-with-type-2-diabetes-inadequately-controlled-with-metformin-tosca-it-a-randomised-multicentre-trial
#8
Olga Vaccaro, Maria Masulli, Antonio Nicolucci, Enzo Bonora, Stefano Del Prato, Aldo P Maggioni, Angela A Rivellese, Sebastiano Squatrito, Carlo B Giorda, Giorgio Sesti, Paolo Mocarelli, Giuseppe Lucisano, Michele Sacco, Stefano Signorini, Fabrizio Cappellini, Gabriele Perriello, Anna Carla Babini, Annunziata Lapolla, Giovanna Gregori, Carla Giordano, Laura Corsi, Raffaella Buzzetti, Gennaro Clemente, Graziano Di Cianni, Rossella Iannarelli, Renzo Cordera, Olga La Macchia, Chiara Zamboni, Cristiana Scaranna, Massimo Boemi, Ciro Iovine, Davide Lauro, Sergio Leotta, Elisabetta Dall'Aglio, Emanuela Cannarsa, Laura Tonutti, Giuseppe Pugliese, Antonio C Bossi, Roberto Anichini, Francesco Dotta, Antonino Di Benedetto, Giuseppe Citro, Daniela Antenucci, Lucia Ricci, Francesco Giorgino, Costanza Santini, Agostino Gnasso, Salvatore De Cosmo, Donatella Zavaroni, Monica Vedovato, Agostino Consoli, Maria Calabrese, Paolo di Bartolo, Paolo Fornengo, Gabriele Riccardi
BACKGROUND: The best treatment option for patients with type 2 diabetes in whom treatment with metformin alone fails to achieve adequate glycaemic control is debated. We aimed to compare the long-term effects of pioglitazone versus sulfonylureas, given in addition to metformin, on cardiovascular events in patients with type 2 diabetes. METHODS: TOSCA.IT was a multicentre, randomised, pragmatic clinical trial, in which patients aged 50-75 years with type 2 diabetes inadequately controlled with metformin monotherapy (2-3 g per day) were recruited from 57 diabetes clinics in Italy...
September 12, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28914271/surgery-postprandial-hypoglycaemia-following-bariatric-surgery
#9
Alan Morris
No abstract text is available yet for this article.
September 15, 2017: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/28913602/devoting-attention-to-glucose-variability-and-hypoglycaemia-in-type-2-diabetes
#10
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
#11
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
#12
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/28911254/acceptance-of-home-blood-glucose-monitoring-by-owners-of-recently-diagnosed-diabetic-cats-and-impact-on-quality-of-life-changes-in-cat-and-owner
#13
Katarina Hazuchova, Ruth Gostelow, Christopher Scudder, Yaiza Forcada, David B Church, Stijn Jm Niessen
Objectives This study aimed to evaluate the acceptance of home blood glucose monitoring (HBGM) by owners of recently diagnosed diabetic cats, and the impact of choosing HBGM on the quality of life (QoL) changes of cat and owner, in addition to glycaemic changes during 6 months of follow-up. Methods Owners of cats diagnosed with diabetes mellitus (DM) and treated with insulin for 6-20 weeks were divided into an HBGM group and a non-HBGM group, based on their ability and willingness to perform HBGM after a standardised instruction session...
September 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28901544/effect-of-obesity-on-neonatal-hypoglycaemia-in-mothers-with-gestational-diabetes-a-comparative-study
#14
Katherine Collins, Raoul Oehmen, Shailender Mehta
BACKGROUND: Rates of pre-gestational obesity and gestational diabetes mellitus (GDM) are increasing in Australia. While both are established risk factors for neonatal hypoglycaemia, the additive effect of both risks on neonatal hypoglycaemia is not well understood. AIMS: To determine the influence of obesity on neonatal hypoglycaemia among infants born to GDM mothers. The authors hypothesise the presence of a greater frequency and severity of neonatal hypoglycaemia in infants born to obese GDM women...
September 13, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
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
#15
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/28892731/a-new-integrated-care-pathway-for-ambulance-attended-severe-hypoglycaemia-in-the-east-of-england-the-eastern-academic-health-science-network-eahsn-model
#16
Michael Sampson, Marcus Bailey, John Clark, Mark L Evans, Rebekah Fong, Helen Hall, Clare Hambling, Martin Hadley-Brown, Nick Morrish, Helen Murphy, Gerry A Rayman, Karunakaran Vithian, Peter Winocour, Amanda Harries
AIMS: We developed a new clinical integrated pathway linking a regional Ambulance Trust with a severe hypoglycaemia (SH) prevention team. We present clinical data from the first 2000 emergency calls taken through this new clinical pathway in the East of England. METHODS: SH patients attended by Ambulance crew receive written information on SH avoidance, and are contacted for further education through a new regional SH prevention team. All patients are contacted unless they actively decline...
September 1, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28891142/network-meta-analysis-of-lorcaserin-and-oral-hypoglycaemics-for-patients-with-type-2-diabetes-mellitus-and-obesity
#17
L M Neff, M S Broder, D Beenhouwer, E Chang, E Papoyan, Z W Wang
In addition to weight loss, randomized controlled trials have shown improvement in glycaemic control in patients taking lorcaserin. The aim of this study aim was to compare adding lorcaserin or other glucose lowering medications to metformin on weight and glycaemic control. A systematic review and network meta-analysis of randomized controlled trials were conducted. Included studies (published 1990-2014) were of lorcaserin or glucose lowering medications in type 2 diabetic patients compared to placebo or different active treatments...
September 10, 2017: Clinical Obesity
https://www.readbyqxmd.com/read/28888993/the-risks-of-nocturnal-hypoglycaemia-in-insulin-treated-diabetes
#18
REVIEW
Alex J Graveling, Brian M Frier
Over half of all episodes of severe hypoglycaemia (requiring external help) occur during sleep, but nocturnal hypoglycaemia is often asymptomatic and unrecognised. The precise incidence of nocturnal hypoglycaemia is difficult to determine with no agreed definition, but continuous glucose monitoring has shown that it occurs frequently in people taking insulin. Attenuation of the counter-regulatory responses to hypoglycaemia during sleep may explain why some episodes are undetected and more prolonged, and modifies cardiovascular responses...
August 23, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28886728/correlation-of-cord-blood-telomere-length-with-birth-weight
#19
Siew-Peng Lee, Prakash Hande, George Sh Yeo, Ene-Choo Tan
BACKGROUND: Intrauterine growth restriction affects 3% of newborns; and the lightest 10% of whom are classified as small for gestational age (SGA). These low-birth weight newborns are at increased risk of neonatal morbidity such as hypoxia and hypoglycaemia. In later life, they are at higher risk of several age-related diseases such as cardiovascular and metabolic disorders and dementia. As having short telomeres is also associated with these diseases, we tested if these newborns might already start with shorter telomeres at birth...
September 8, 2017: BMC Research Notes
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
#20
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]
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