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https://www.readbyqxmd.com/read/28440211/a-cluster-randomised-trial-cost-effectiveness-analysis-and-psychosocial-evaluation-of-insulin-pump-therapy-compared-with-multiple-injections-during-flexible-intensive-insulin-therapy-for-type-1-diabetes-the-repose-trial
#1
Simon Heller, David White, Ellen Lee, Julia Lawton, Daniel Pollard, Norman Waugh, Stephanie Amiel, Katharine Barnard, Anita Beckwith, Alan Brennan, Michael Campbell, Cindy Cooper, Munyaradzi Dimairo, Simon Dixon, Jackie Elliott, Mark Evans, Fiona Green, Gemma Hackney, Peter Hammond, Nina Hallowell, Alan Jaap, Brian Kennon, Jackie Kirkham, Robert Lindsay, Peter Mansell, Diana Papaioannou, David Rankin, Pamela Royle, W Henry Smithson, Carolin Taylor
BACKGROUND: Insulin is generally administered to people with type 1 diabetes mellitus (T1DM) using multiple daily injections (MDIs), but can also be delivered using infusion pumps. In the UK, pumps are recommended for patients with the greatest need and adult use is less than in comparable countries. Previous trials have been small, of short duration and have failed to control for training in insulin adjustment. OBJECTIVE: To assess the clinical effectiveness and cost-effectiveness of pump therapy compared with MDI for adults with T1DM, with both groups receiving equivalent structured training in flexible insulin therapy...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28440009/sodium-glucose-co-transporter-2-inhibitors-for-type-2-diabetes-mellitus-an-overview-for-the-primary-care-physician
#2
REVIEW
Paresh Dandona, Ajay Chaudhuri
AIMS: Sodium-glucose co-transporter type 2 (SGLT2) inhibitors are a new class of anti-hyperglycaemic agents in type 2 diabetes mellitus (T2DM). This review examines their mechanism of action and provides an overview of safety and efficacy from the main studies of SGLT2 inhibitors marketed in the United States and Europe, namely, canagliflozin, dapagliflozin and empagliflozin. METHODS: We searched the PubMed database to identify relevant publications on the mechanism of action of SGLT2 inhibitors and clinical trial reports...
April 24, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28439221/congenital-hyperinsulinism-caused-by-a-de-novo-mutation-in-the-abcc8-gene-a-case-report
#3
Zsuzsanna Molnár, Lfdia Balogh, János Kappelmayer, László Madar, Éva Gombos, István Balogh
Congenital hyperinsulinism (CHI) is a rare genetic disorder characterized by inappropriate insulin secretion and severe hypoglycaemia. There are two histological subtypes: diffuse and focal form. Diffuse form is most common in autosomal recessive mutations in ABCC8/KCNJ11 gene, while focal CHI is caused a paternally inherited mutation and a somatic maternal allele loss. Here we report a case of a term male infant presented with severe hyperinsulinaemic hypoglycaemia. Gene panel testing was performed to give rapid genetic diagnosis...
March 2017: EJIFCC
https://www.readbyqxmd.com/read/28438244/exploration-of-glycaemic-states-in-children-with-type-1-diabetes
#4
Genoveva Granados Gámez, Verónica V Márquez Hernández
BACKGROUND: The prevention of severe hypoglycaemia is based in art on accurately anticipating its occurrence. The aim of the study was to analyse the effect of a feedback procedure on the glycaemic state of children with type 1 diabetes, aswell as the associated symptoms and estimated BGL. METHOD: For 7 days, 17 participants performed both scheduled capillary blood tests, and an estimate and self-analysis whenever they thought that there were changes in their BGL...
May 2017: Psicothema
https://www.readbyqxmd.com/read/28433560/glycaemic-control-and-hypoglycaemia-with-insulin-glargine-300-u-ml-compared-with-glargine-100-u-ml-in-japanese-adults-with-type-2-diabetes-using-basal-insulin-plus-oral-anti-hyperglycaemic-drugs-edition-jp-2-randomised-12-month-trial-including-6-month-extension
#5
Y Terauchi, M Koyama, X Cheng, M Sumi, M C Riddle, G B Bolli, T Hirose
AIMS: To compare insulin glargine 300 U/mL (Gla-300) with glargine 100 U/mL (Gla-100) in Japanese adults with uncontrolled type 2 diabetes on basal insulin and oral anti-hyperglycaemic drugs over 12 months. METHODS: EDITION JP 2 was a randomised, open-label, phase 3 study. Following a 6-month treatment period, participants continued receiving previously assigned once daily Gla-300 or Gla-100, plus oral anti-hyperglycaemic drugs, in a 6-month extension period. Glycaemic control, hypoglycaemia and adverse events were assessed...
April 19, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28432748/future-challenges-and-therapeutic-opportunities-in-type-2-diabetes-changing-the-paradigm-of-current-therapy
#6
REVIEW
D R Owens, L Monnier, A H Barnett
Most algorithms for type 2 diabetes mellitus (T2DM) do not recommend treatment escalation until glycated haemoglobin (HbA1c) fails to reach the recommended target of 7% (53 mmol/mol) within approximately 3 months on any treatment regimen ('treat to failure'). Clinical inertia and/or poor adherence to therapy contribute to patients not reaching glycaemic targets when managed according to this paradigm. Clinical inertia exists across the entire spectrum of anti-diabetes therapies, although it is most pronounced when initiating and optimizing insulin therapy...
April 21, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28432746/impact-of-baseline-hba1c-diabetes-duration-and-bmi-on-clinical-outcomes-in-the-lixilan-o-trial-testing-iglarlixi-insulin-glargine-lixisenatide-titratable-fixed-ratio-combination-versus-insulin-glargine-and-lixisenatide-monocomponents
#7
M J Davies, L A Leiter, B Guerci, G Grunberger, F J Ampudia-Blasco, C Yu, W Stager, E Niemoeller, E Souhami, J Rosenstock
To determine whether baseline characteristics impact clinical outcomes in the LixiLan-O trial (N = 1170), the efficacy and safety of iGlarLixi, a titratable fixed-ratio combination of insulin glargine 100 U (iGlar) and lixisenatide (Lixi) was compared with iGlar or Lixi alone in patients with uncontrolled type 2 diabetes mellitus (T2DM) on oral therapy. Subgroups according to baseline glycated haemoglobin (HbA1c; <8%, ≥8% [<64, ≥64 mmol/mol]); T2DM disease duration (<7, ≥7 years) and body mass index (BMI; <30, ≥30 kg/m(2) ) were investigated...
April 22, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28432082/effect-of-oral-contraceptives-and-or-metformin-on-glp-1-secretion-and-reactive-hypoglycemia-in-pcos
#8
Dorte Glintborg, Hanne Mumm, Jens Juul Holst, Marianne Andersen
CONTEXT: Insulin resistance in polycystic ovary syndrome (PCOS) may increase the risk of reactive hypoglycaemia (RH) and decrease glucagon-like peptide-1 (GLP-1) secretion. The possible effects of treatment with oral contraceptives (OCP) and/or metformin on GLP-1 secretion and risk of RH in PCOS is undetermined. SETTING: Outpatient clinic. PATIENTS AND INTERVENTIONS: Randomized, controlled clinical trial. Ninety women with PCOS were randomized to 12 month treatment with OCP (150 mg desogestrel+30 microgram ethinylestradiol), metformin (2 g/day), or metformin +OCP...
April 21, 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28430381/continuous-subcutaneous-insulin-infusion-csii-therapy-at-derby-teaching-hospitals-sustained-benefits-in-glucose-control
#9
U Anyanwagu, H Olaoye, P Jennings, S Ashton-Cleary, S Sugunendran, D Hughes, I Idris, E G Wilmot
AIM: In the short term, continuous subcutaneous insulin infusion (CSII) has been associated with improved glycaemic control, reduced hypoglycaemia and improved quality of life (QOL). However, limited data are available on its long-term benefits, particularly in the UK. We aimed to assess the impact of CSII on longer term outcomes. METHOD: Patient-level data were obtained for CSII users at Derby Teaching Hospitals, UK. Patient confidence and satisfaction questionnaires using the Likert scale were used to assess confidence in self-management...
April 21, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28429780/insulin-analogues-in-type-1-diabetes-mellitus-getting-better-all-the-time
#10
REVIEW
Chantal Mathieu, Pieter Gillard, Katrien Benhalima
The treatment of type 1 diabetes mellitus consists of external replacement of the functions of β cells in an attempt to achieve blood levels of glucose as close to the normal range as possible. This approach means that glucose sensing needs to be replaced and levels of insulin need to mimic physiological insulin-action profiles, including basal coverage and changes around meals. Training and educating patients are crucial for the achievement of good glycaemic control, but having insulin preparations with action profiles that provide stable basal insulin coverage and appropriate mealtime insulin peaks helps people with type 1 diabetes mellitus to live active lives without sacrificing tight glycaemic control...
April 21, 2017: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/28421336/achievement-of-metabolic-control-among-children-and-adolescents-with-type-1-diabetes-in-spain
#11
Itxaso Rica, Andrés Mingorance, Ana Lucía Gómez-Gila, María Clemente, Isabel González, María Caimari, Beatriz García-Cuartero, Raquel Barrio
AIMS: To assess metabolic control in a paediatric T1D population in Spain and analyse the rate of severe acute decompensations and chronic complications. METHODS: Data from patients treated at eight paediatric diabetes units with experienced diabetes teams between June and December 2014 were analysed in an observational prospective study. Variables included: age, sex, diabetes duration, number of follow-up visits/year, anthropometrical data, insulin treatment modalities, mean annual HbA1c and the prevalence of acute and chronic complications...
April 18, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/28421113/chronic-hyperinsulinaemic-hypoglycaemia-in-rats-is-accompanied-by-increased-body-weight-hyperleptinaemia-and-decreased-neuronal-glucose-transporter-levels-in-the-brain
#12
Vivi F H Jensen, Anne-Marie Mølck, Melissa Chapman, Lene Alifrangis, Lene Andersen, Jens Lykkesfeldt, Ingrid B Bøgh
The brain is vulnerable to hypoglycaemia due to a continuous need of energy substrates to meet its high metabolic demands. Studies have shown that severe acute insulin-induced hypoglycaemia results in oxidative stress in the rat brain, when neuroglycopenia cannot be evaded despite increased levels of cerebral glucose transporters. Compensatory measures in the brain during chronic insulin-induced hypoglycaemia are less well understood. The present study investigated how the brain of nondiabetic rats copes with chronic insulin-induced hypoglycaemia for up to eight weeks...
2017: International Journal of Endocrinology
https://www.readbyqxmd.com/read/28420935/prevention-of-hypoglycaemia-the-asap-anticipate-suspect-act-prevent-strategy
#13
Sanjay Kalra, Yashdeep Gupta
This article describes a simple framework to prevent hypoglycaemia. Four strategies of prevention are detailed, which correspond to four levels of prevention (primordial, primary, secondary and tertiary). This framework, given the mnemonic ASAP (As Soon As Possible) includes action to Anticipate and Avoid, and Suspect and Screen hypoglycaemia. It also enjoins us to Act and Assist persons with hypoglycaemia in a timely manner, while working to Prevent and Protect them by using safer glucose lowering drugs and insulins...
April 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28420574/vitamin-supplements-in-type-2-diabetes-mellitus-management-a-review
#14
REVIEW
Mabel Kar-Wai Yan, Hanan Khalil
Type 2 diabetes mellitus (T2DM) is a major public health challenge that affects countries across the world. The use of pharmacological therapy is often limited in some patients due to a loss of effect over time or development of adverse effects such as weight gain or hypoglycaemia. This has prompted searches into the role of non-pharmacological therapies in T2DM. The availability and use of vitamin supplements in developed countries have increased significantly and there is evidence that certain vitamins may have roles in the management of T2DM...
April 12, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28417535/rates-of-hypoglycaemia-are-lower-in-patients-treated-with-insulin-degludec-liraglutide-ideglira-than-with-ideg-or-insulin-glargine-regardless-of-the-hypoglycaemia-definition-used
#15
P Norwood, R Chen, E Jaeckel, I Lingvay, H Jarlov, L Lehmann, S Heller
AIMS: The rates of hypoglycaemia reported in clinical trials are affected by the definitions of hypoglycaemia used. This post-hoc analysis took data from two trials comparing the once-daily, fixed ratio combination of insulin degludec/liraglutide (IDegLira) with basal insulin regimens, and re-analysed these data using alternative hypoglycaemia definitions and stratified outcomes by dosing time and baseline characteristics. MATERIALS AND METHODS: Post hoc analyses of the DUAL I (patients uncontrolled on oral antidiabetic drugs) and DUAL V (patients uncontrolled on insulin glargine (IGlar) U100) trials were carried out using different definitions of hypoglycaemia and by whether treatments were administered in the AM or PM...
April 17, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28403422/hypoglycaemia-after-accidental-ocular-insulin-injection
#16
Y Nakadate, T Sato, H Sato, V Koeva, T Schricker
No abstract text is available yet for this article.
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28401444/fixed-ratio-combinations-of-glucagon-like-peptide-1-receptor-agonists-with-basal-insulin-a-systematic-review-and-meta-analysis
#17
Paraskevi Liakopoulou, Aris Liakos, Despoina Vasilakou, Eleni Athanasiadou, Eleni Bekiari, Kyriakos Kazakos, Apostolos Tsapas
PURPOSE: Basal insulin controls primarily fasting plasma glucose but causes hypoglycaemia and weight gain, whilst glucagon like peptide 1 receptor agonists induce weight loss without increasing risk for hypoglycaemia. We conducted a systematic review and meta-analysis of randomised controlled trials to investigate the efficacy and safety of fixed ratio combinations of basal insulin with glucagon like peptide 1 receptor agonists. METHODS: We searched Medline, Embase, and the Cochrane Library as well as conference abstracts up to December 2016...
April 12, 2017: Endocrine
https://www.readbyqxmd.com/read/28400862/an-audit-of-clinical-practice-in-a-single-centre-in-kuwait-management-of-children-on-continuous-subcutaneous-insulin-infusion-and-cardiovascular-risk-factors-screening
#18
Dina Omar, Hala Alsanae, Mona Al Khawari, Majedah Abdulrasoul, Zahraa Rahme, Faisal Al Refaei, Kazem Behbehani, Azza Shaltout
OBJECTIVES: To audit the current clinical practice of continuous subcutaneous insulin infusion (CSII) for the treatment of type 1 diabetes mellitus (T1D) in children and adolescents attending a single centre in Kuwait. METHODS: A one year retrospective audit was performed in children and adolescents with T1D on CSII, who attended the paediatric diabetes clinic, Dasman Diabetes Institute during 2012. The primary outcome measure was glycaemic control as evidenced by glycated haemoglobin (HbA1c) level and the secondary outcome measures were the frequency of monitoring of the risk for microvascular complications and occurrence of acute complications and adverse events...
2017: Open Cardiovascular Medicine Journal
https://www.readbyqxmd.com/read/28400403/molecular-imaging-in-the-investigation-of-hypoglycaemic-syndromes-and-their-management
#19
David A Pattison, Rodney J Hicks
There has been recent progress in molecular imaging using a variety of cellular targets for the investigation of adult non-diabetic hypoglycaemic syndromes and its integration into patient management. These targets include peptide receptors - somatostatin receptors (SSTR) and glucagon-like peptide-1 receptor (GLP-1R) - the Amine Precursor Uptake and Decarboxylation system utilising the diphydroxyphenylaline (DOPA) analogue 6-[18F]-L-fluoro-L-3, 4-dihydroxyphenylalanine (18F-FDOPA), and glycolytic metabolism with 2-[18F]Fluoro-2-Deoxy-D-Glucose (FDG)...
April 11, 2017: Endocrine-related Cancer
https://www.readbyqxmd.com/read/28397655/-liver-failure-in-neonatal-children-is-a-diagnostic-challenge
#20
Heidi Smedegaard, Vibeke Brix Christensen, Morten Hanefeld Dziegiel, Marianne Hørby Jørgensen
This case report presents a newborn boy with hypoglycaemia, anaemia, jaundice and severe coagulopathy during the first day of his life, imitating sepsis and disseminated intravascular coagulation. One week after the birth he was diagnosed with acute liver failure due to gestational alloimmune liver disease (GALD). Despite the fact that GALD is rare, it must be suspected in all unexplained stillborn children and infants with severe liver disease. If diagnosed, it is possible to prevent death and severe liver failure in future newborns by treating the affected women with immunoglobulin during pregnancy...
March 27, 2017: Ugeskrift for Laeger
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