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https://www.readbyqxmd.com/read/28819992/insulin-delivery-and-nocturnal-glucose-control-in-children-and-adolescents-with-type-1-diabetes
#1
Martin Tauschmann, Roman Hovorka
Nocturnal glucose control remains challenging in children and adolescents with type 1 diabetes due to highly variable overnight insulin requirements. The issue may be addressed by glucose responsive insulin delivery based on real-time continuous glucose measurements. Areas covered: This review outlines recent developments of glucose responsive insulin delivery systems from a paediatric perspective. We cover threshold-based suspend application, predictive low glucose suspend, and more advanced single hormone and dual-hormone closed-loop systems...
August 18, 2017: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/28819951/metformin-a-new-old-drug
#2
Marta Patrycja Wróbel, Bogdan Marek, Dariusz Kajdaniuk, Dominika Rokicka, Aleksandra Szymborska-Kajanek, Krzysztof Strojek
For many years metformin has been the gold standard in the treatment of type 2 diabetes. According to recommendations of the most important diabetes associations, this is the first-choice drug for use as monotherapy in patients with newly diagnosed type 2 diabetes. Metformin is also recommended in combined treatment when monotherapy is no longer effective. It is then combined with a sulfony-lurea, an incretin, flozin, or insulin, irrespective of the number of insulin injections per day. Besides its properties used in the treatment of diabetes, metformin has been treated for some time as a drug of a so-called pleiotropic activity, as each year brings new reports about its favourable effect in different conditions...
2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/28819949/addison-s-disease-concomitant-with-corticotropin-deficiency-and-pituitary-crh-resistance-a-case-report
#3
Krzysztof C Lewandowski, Katarzyna Malicka, Katarzyna Dąbrowska, Andrzej Lewiński
A 36-year-old woman was found to have a low morning ACTH concentration despite a history of Addison's disease. Past medical history: At the age of 23 years the subject developed Graves's disease, which was treated with radioiodine. At about the same time, she claimed to have two episodes of pancreatitis treated with cholecystectomy. About seven months later she was euthyroid on L-thyroxine (TSH 1.51 mIU/mL) but was admitted with hypotension, hyponatraemia (sodium 109 mmol/L), and low morning cortisol (119 nmol/L)...
2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/28817231/effect-of-once-weekly-dulaglutide-on-hba1c-and-fasting-blood-glucose-in-patient-subpopulations-by-gender-duration-of-diabetes-and-baseline-hba1c
#4
Baptist Gallwitz, Samuel Dagogo-Jack, Vivian Thieu, Luis-Emilio Garcia-Perez, Imre Pavo, Maria Yu, Kenneth E Robertson, Nan Zhang, Francesco Giorgino
To evaluate the efficacy and safety of dulaglutide 1.5 mg and 0.75 mg in type 2 diabetes patients by subgroups of gender, duration of diabetes, and baseline HbA1c in the dulaglutide clinical development program (AWARD-1 to -6 and -8 clinical trials). MATERIALS AND METHODS: Change in HbA1c was analysed by gender, duration of diabetes (<5 years, ≥5 years and <10 years, ≥10 years), and baseline HbA1c (<8.5%, ≥8.5%) in pooled and individual studies. Changes from baseline in weight, hypoglycaemia, and gastrointestinal adverse events were evaluated for individual trials...
August 17, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28815909/proximal-neuropathy-and-associated-skeletal-muscle-changes-resembling-denervation-atrophy-in-hind-limbs-of-chronic-hypoglycaemic-rats
#5
Vivi F H Jensen, Anne-Marie Molck, Henrik Soeborg, Jette Nowak, Melissa Chapman, Jens Lykkesfeldt, Ingrid B Bogh
Peripheral neuropathy is one of the most common complications of diabetic hyperglycaemia. Insulin-induced hypoglycaemia (IIH) might potentially exacerbate or contribute to neuropathy as hypoglycaemia also causes peripheral neuropathy. In rats, IIH induces neuropathy associated with skeletal muscle changes. Aims of the present study were to investigate the progression and sequence of histopathologic changes caused by chronic IIH in rat peripheral nerves and skeletal muscle, and whether such changes were reversible...
August 16, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28803366/does-hypoglycaemia-affect-the-improvement-in-qol-after-the-transition-to-insulin-in-people-with-type-2-diabetes
#6
T H Wieringa, M de Wit, J W R Twisk, F J Snoek
PURPOSE: Quality of Life (QoL) of insulin-naïve people with type 2 diabetes mellitus (T2DM) improves after transition to insulin. Little is known about the role of hypoglycaemia in this context. Secondary analyses of the Study of the Psychological Impact in Real care of Initiating insulin glargine Treatment (SPIRIT) aimed to investigate the relationship between hypoglycaemia and QoL when transitioning to insulin. METHODS: Insulin-naïve Dutch people with T2DM in suboptimal glycaemic control (HbA1c >53 mmol/mol; 7...
August 12, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28799221/repose-repositioning-insulin-pump-therapy-in-type-1-diabetes
#7
N S Oliver
In 2008, the National Institute for Health and Care Excellence (NICE) technology appraisal of continuous subcutaneous insulin infusion (CSII, insulin pump therapy) for people with Type 1 diabetes was published [1]. Implementation of this enables children under the age of 12 years to access CSII, and consideration of CSII for adults and children over 12 years with challenging hypo- or hyperglycaemia. In Scotland, the Scottish Intercollegiate Guidelines Network (SIGN) guidance for management of diabetes states that CSII therapy should be considered for people unable to achieve their glycaemic targets, for those who experience recurring episodes of severe hypoglycaemia, and in infants and very young children with very low basal insulin requirements, for whom even small doses of basal insulin analogue may result in hypoglycaemia [2]...
August 11, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28798227/novel-pet-tracer-68-ga-dotatate-pet-ct-can-be-alternative-imaging-method-in-patients-with-insulinomas
#8
Şadiye Altun Tuzcu, Zafer Pekkolay, Faruk Kılınç, Alpaslan Kemal Tuzcu
Insulinomas are the most common cause of hypoglycemia resulting from endogenous hyperinsulinism. The diagnosis of insulinoma is established by demonstrating inappropriately high serum insulin concentrations during a spontaneous or induced episode of hypoglycaemia. Most of the insulinomas are islet-cell tumors. They are often small (less than 2 cm), benign, and difficult to localize with current imaging techniques. The non-invasive procedures such as transabdominal ultrasonography, spiral computed tomography (CT), magnetic resonance imaging (MRI), 111-In-pentetreotide imaging, fluorine-18-L-dihydroxyphenylalanine positron emission tomography ((18)F-DOPA PET) and invasive procedures such as endoscopic ultrasonography or a selective arterial calcium stimulation test (SACST) with hepatic venous sampling can be used to show insulinomas...
August 10, 2017: Journal of Nuclear Medicine Technology
https://www.readbyqxmd.com/read/28796932/factors-associated-with-greater-benefit-of-a-national-reimbursement-policy-for-blood-glucose-test-strips-in-adult-patients-with-type-1-diabetes-a-prospective-cohort-study
#9
Sang-Man Jin, Jong Ha Baek, Sunghwan Suh, Chang Hee Jung, Woo Je Lee, Cheol-Young Park, Hae Kyung Yang, Jae Hyoung Cho, Byung-Wan Lee, Jae Hyeon Kim
AIMS/INTRODUCTION: We aimed to identify factors independently associated with greater benefit of a national reimbursement policy for blood glucose test strips in adult patients with type 1 diabetes (T1DM), in terms of glycemic control and rate of severe hypoglycemia. MATERIALS AND METHODS: This was a prospective cohort study of 466 adult patients with T1DM from five tertiary referral hospitals who registered for a national reimbursement program for blood glucose strips and were then followed-up for 12 months...
August 10, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28792170/consensus-on-basal-insulin-in-the-management-of-type-2-diabetes-which-when-and-how
#10
Samit Ghosal, Binayak Sinha, Anirban Majumder, Ashok Kumar Das, Awadhesh Kumar Singh, Biswajit Ghoshdastidar, Debasish Maji, Ghanshyam Goyal, Jagat Jyoti Mukherjee, Kalyan Kumar Gangopadhyay, Mathew John, Sanjay Chatterjee, Shalini Jaggi, Subir Ray, Sujoy Majumdar, Surendra Kumar Sharma
INTRODUCTION: Type 2 diabetes mellitus (T2DM) has attained epidemic proportions and continues to increase despite the availability of a number of oral antidiabetic medications and major advances made in insulin delivery since its discovery nearly a hundred years ago. One, amongst many other reasons responsible for the inability to achieve adequate glycaemic control in a substantial proportion of T2DM patients is the delayed initiation and inappropriate intensification of insulin treatment...
July 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28783529/creed-study-hypoglycaemia-during-ramadan-in-individuals-with-type-2-diabetes-mellitus-from-three-continents
#11
Abdul Jabbar, Mohamed Hassanein, Salem A Beshyah, Kristina S Boye, Maria Yu, Steven M Babineaux
AIMS: To describe diabetes treatment and hypoglycaemia in individuals with Type 2 diabetes mellitus during Ramadan. METHODS: A multi-country, retrospective, observational study with data captured before, during, and after Ramadan. We report on a cohort of people (N=3250) with Type 2 diabetes mellitus in four culturally distinct regions: Asia, North Africa, Europe, and the Middle East. RESULTS: During Ramadan, the proportion of participants on oral anti-diabetic medication alone ranged from 68...
July 13, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28782840/nutrient-re-routing-and-altered-gut-islet-cell-crosstalk-may-explain-early-relief-of-severe-postprandial-hypoglycaemia-after-reversal-of-roux-en-y-gastric-bypass
#12
M S Svane, M B Toft-Nielsen, V B Kristiansen, B Hartmann, J J Holst, S Madsbad, K N Bojsen-Møller
BACKGROUND: Roux-en-Y gastric bypass is associated with an increased risk of postprandial hyperinsulinaemic hypoglycaemia, but the underlying pathophysiology remains poorly understood. We therefore examined the effect of re-routing of nutrient delivery on gut-islet cell crosstalk in a person with severe postprandial hypoglycaemia after Roux-en-Y gastric bypass. CASE REPORT: A person with severe postprandial hypoglycaemia, who underwent surgical reversal of Roux-en-Y gastric bypass, was studied before reversal and at 2 weeks and 3 months after reversal surgery using liquid mixed meal tests and hyperinsulinaemic-euglycaemic clamps...
August 7, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28782312/epidemiologic-surveillance-of-glycemic-response-to-a-scored-breakable-extended-release-fixed-dose-combination-of-gliclazide-and-metformin-in-persons-with-type-2-diabetes
#13
Sanjay Kalra, Ashok Kumar Das
BACKGROUND: The combination of metformin and a sulphonylurea has been recommended for treatment of type 2 diabetes. A, scored, breakable, extended release, once daily fixed dose combination (FDC) of gliclazide and metformin is available in India. OBJECTIVE: To assess the initial blood glucose lowering efficacy, glycemic control and patient acceptability of the fixed dose combination of original gliclazide 60mg and metformin 500mg in an extended release, scored and breakable formulation (in a range of 1, 1½, and 2 tablets) among Indian patients in day to day practice...
June 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28781064/cardiovascular-mortality-and-morbidity-in-patients-with-type-2-diabetes-following-initiation-of-sodium-glucose-co-transporter-2-inhibitors-versus-other-glucose-lowering-drugs-cvd-real-nordic-a-multinational-observational-analysis
#14
Kåre I Birkeland, Marit E Jørgensen, Bendix Carstensen, Frederik Persson, Hanne L Gulseth, Marcus Thuresson, Peter Fenici, David Nathanson, Thomas Nyström, Jan W Eriksson, Johan Bodegård, Anna Norhammar
BACKGROUND: In patients with type 2 diabetes and a high cardiovascular risk profile, the sodium-glucose co-transporter-2 (SGLT2) inhibitors empagliflozin and canagliflozin have been shown to lower cardiovascular morbidity and mortality. Using real-world data from clinical practice, we aimed to compare cardiovascular mortality and morbidity in new users of SGLT2 inhibitors versus new users of other glucose-lowering drugs, in a population with a broad cardiovascular risk profile. METHODS: CVD-REAL Nordic was an observational analysis of individual patient-level data from the Prescribed Drug Registers, Cause of Death Registers, and National Patient Registers in Denmark, Norway, and Sweden...
August 3, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28776922/efficacy-and-pharmacokinetics-of-subcutaneous-exendin-9-39-in-patients-with-post-bariatric-hypoglycemia
#15
Colleen M Craig, Li-Fen Liu, Thi Nguyen, Candice Price, Justus Bingham, Tracey L McLaughlin
AIM: Post-bariatric hypoglycemia (PBH) is a rare but growing complication of bariatric surgery with severe, debilitating, potentially life-threatening consequences and no safe and effective treatment. Previous studies involving continuous intravenous (IV) infusion of the glucagon-like peptide-1 (GLP-1) receptor antagonist, exendin (9-39) (Ex-9) in patients with PBH have demonstrated efficacy in preventing symptomatic postprandial hypoglycemia. Subcutaneous (SC) injection of Ex-9 would represent a more practical therapeutic approach...
August 4, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28776081/metformin-historical-overview
#16
EDITORIAL
Clifford J Bailey
Metformin (dimethylbiguanide) has become the preferred first-line oral blood glucose-lowering agent to manage type 2 diabetes. Its history is linked to Galega officinalis (also known as goat's rue), a traditional herbal medicine in Europe, found to be rich in guanidine, which, in 1918, was shown to lower blood glucose. Guanidine derivatives, including metformin, were synthesised and some (not metformin) were used to treat diabetes in the 1920s and 1930s but were discontinued due to toxicity and the increased availability of insulin...
August 3, 2017: Diabetologia
https://www.readbyqxmd.com/read/28771289/screening-for-gestational-diabetes-mellitus-based-on-different-risk-profiles-and-settings-for-improving-maternal-and-infant-health
#17
REVIEW
Joanna Tieu, Andrew J McPhee, Caroline A Crowther, Philippa Middleton, Emily Shepherd
BACKGROUND: Gestational diabetes mellitus (GDM) is a form of diabetes that occurs in pregnancy. Although GDM usually resolves following birth, it is associated with significant morbidities for mothers and their infants in the short and long term. There is strong evidence to support treatment for GDM. However, there is uncertainty as to whether or not screening all pregnant women for GDM will improve maternal and infant health and if so, the most appropriate setting for screening. This review updates a Cochrane Review, first published in 2010, and subsequently updated in 2014...
August 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28763121/proportion-of-daily-capillary-blood-glucose-readings-required-in-the-target-range-for-target-glycaemic-control-shift-of-focus-from-target-range-to-proportion-in-range
#18
S Sivasubramaniyam, S Amiel, P Choudhary
AIM: Most guidelines provide people with Type 1 diabetes with pre- and post-meal capillary blood glucose (CBG) targets to achieve optimal glycaemic control. We evaluated the proportion of daily CBG readings between 4 and 10 mmol/l in people achieving different HbA1c levels. METHOD: We analysed CBG data from routine pump/meter downloads from 201 adults treated with continuous subcutaneous insulin infusion (CSII) at a single hospital clinic. Exclusion criteria were CSII < 6 months, < 3 CBG/day, pregnancy, haemoglobinopathy and continuous sensor use...
August 1, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28760227/relevance-of-weight-in-the-management-of-patients-with-type-2-diabetes-mellitus-towards-an-adipocentric-approach-to-diabetes
#19
Juan José Gorgojo Martínez
In recent decades, there has been a worldwide parallel increase in the prevalence of obesity and type 2 diabetes mellitus (T2DM), which is not surprising, given that increased visceral fat is the main risk factor for the development of T2DM in genetically predisposed individuals. An intervention focused on intensive blood glucose control in T2DM with classic drugs increases the risk of weight gain and the rate of hypoglycaemia. In contrast, weight loss through lifestyle changes, drugs and/or surgery simultaneously improves most cardiovascular (CV) risk factors, including hyperglycemia...
November 2016: Medicina Clínica
https://www.readbyqxmd.com/read/28753229/rapid-decline-in-insulin-antibodies-and-glutamic-acid-decarboxylase-autoantibodies-with-ibrutinib-therapy-of-chronic-lymphocytic-leukaemia
#20
C Skrabs, W F Pickl, T Perkmann, U Jäger, A Gessl
WHAT IS KNOWN AND OBJECTIVE: Ibrutinib is inhibiting the Bruton's tyrosine kinase (BTK), thereby influencing B-cell development. We describe an unexpected side effect of ibrutinib in two patients with chronic lymphocytic leukaemia concerning the vigorous decrease of two different diabetes-associated antibodies. CASE DESCRIPTION: Two weeks after onset of ibrutinib therapy, patient A frequently noticed symptoms of hypoglycaemia such as dizziness and blurred vision...
July 28, 2017: Journal of Clinical Pharmacy and Therapeutics
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