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https://www.readbyqxmd.com/read/29119712/impact-of-delaying-treatment-intensification-with-a-glucagon-like-peptide-1-receptor-agonist-in-patients-with-type-2-diabetes-uncontrolled-on-basal-insulin-a-longitudinal-study-of-a-us-administrative-claims-database
#1
L Tong, C Pan, H Wang, M Bertolini, E Lew, L F Meneghini
AIM: To evaluate the effect of delaying treatment intensification with a glucagon-like peptide-1 receptor agonist (GLP-1 RA) on clinical and economic outcomes in patients with type 2 diabetes (T2D). METHODS: We conducted a retrospective observational claims study using IMPACT(TM) , in adult patients with T2D who initiated basal insulin between 1 January 2005 and 31 December 2012 with or without OADs, but remained uncontrolled (glycated haemoglobin [HbA1c] ≥7.0%)...
November 8, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29110384/long-term-efficacy-and-safety-of-canagliflozin-in-combination-with-insulin-in-japanese-patients-with-type-2-diabetes-mellitus
#2
Nobuya Inagaki, Shin-Ichi Harashima, Kohei Kaku, Kazuoki Kondo, Nobuko Maruyama, Makiko Otsuka, Yutaka Kawaguchi, Hiroaki Iijima
AIM: The aim of this study was to assess the long-term efficacy and safety of canagliflozin as add-on therapy in Japanese patients with type 2 diabetes mellitus who had inadequate glycaemic control with insulin. MATERIALS AND METHODS: The study comprised a 16-week, double-blind period in which patients were randomized to either placebo (P; N=70) or canagliflozin (100 mg, CAN; N=76), followed by a 36-week open-label period in which all patients received canagliflozin...
November 7, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29101135/retrospective-interrupted-time-series-examining-hypertension-and-diabetes-medicines-usage-following-changes-in-patient-cost-sharing-in-the-farm%C3%A3-cia-popular-programme-in-brazil
#3
Isabel Cristina Martins Emmerick, Monica Rodrigues Campos, Vera Lucia Luiza, Luisa Arueira Chaves, Andrea Dâmaso Bertoldi, Dennis Ross-Degnan
OBJECTIVES: 'Farmácia Popular' (FP) programme was launched in 2004, expanded in 2006 and changed the cost sharing for oral hypoglycaemic (OH) and antihypertensive (AH) medicines in 2009 and in 2011. This paper describes patterns of usage and continuity of coverage for OH and AH medicines following changes in patient cost sharing in the FP. STUDY DESIGN: Interrupted time series study using retrospective administrative data. METHODS: Monthly programme participation (PP) and proportion of days covered (PDC) were the two outcome measures...
November 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/29062399/self-reported-hypoglycaemia-in-patients-treated-with-insulin-a-large-slovenian-retrospectively-prospective-study
#4
Draženka Pongrac Barlovič, Andrej Zavratnik, Aleš Skvarča, Karmen Janša, Bojana Vukelič, Marjeta Tomažič, Maja Ravnik Oblak
INTRODUCTION: Hypoglycaemia is the major barrier for glycaemic target achievement in patients treated with insulin. The aim of the present study was to investigate real-world incidence and predictors of hypoglycaemia in insulin-treated patients. METHODS: More than 300 consecutive patients with type 1 or type 2 diabetes treated with insulin were enrolled during regular out-patient visits from 36 diabetes practices throughout the whole country. They completed a comprehensive questionnaire on hypoglycaemia knowledge, awareness, and incidence in the last month and last six months...
October 2017: Zdravstveno Varstvo
https://www.readbyqxmd.com/read/29058615/defatting-of-acetone-leaf-extract-of-acacia-karroo-hayne-enhances-its-hypoglycaemic-potential
#5
Idris Njanje, Victor P Bagla, Brian K Beseni, Vusi Mbazima, Kgomotso W Lebogo, Leseilane Mampuru, Matlou P Mokgotho
BACKGROUND: Conventional drugs used to treat diabetes are too expensive, toxic and rarely available to rural communities. This study was aimed at investigating the phytochemical differences and hypoglycaemic effects (α-amylase enzyme inhibition, glucose uptake, GLUT4 translocation and phosphorylation of MAPKs) of non-defatted and defatted acetone leaf extract of Acacia karroo. METHODS: Qualitative phytochemical analyses of extracts were determined using standard chemical tests and total phenolic contents using the Folin-Ciocalteu reagent method...
October 23, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/29047219/addition-of-dipeptidyl-peptidase-4-inhibitors-to-insulin-treatment-in-type-2-diabetes-patients-a-meta-analysis
#6
Wenjia Yang, Xiaoling Cai, Xueying Gao, Yifei Chen, Chen Ling, Linong Ji
AIMS: To evaluate the efficacy and safety of combining insulin therapy with dipeptidyl peptidase 4 (DPP-4) inhibitors compared to combining insulin therapy with placebo or other antihyperglycaemic agents. MATERIALS AND METHODS: A literature search was conducted via electronic databases. The inclusion criteria were randomized controlled trials (RCTs) comparing the addition of DPP-4 inhibitors to insulin with the addition of placebo or other active hypoglycaemic agents to insulin therapy, study duration of no less than 12 weeks performed in type 2 diabetes patients, and the availability of outcome data to evaluate a change in the HbA1c ...
October 19, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/29039071/potential-applications-of-gliclazide-in-treating-type-1-diabetes-mellitus-formulation-with-bile-acids-and-probiotics
#7
Momir Mikov, Maja Đanić, Nebojša Pavlović, Bojan Stanimirov, Svetlana Goločorbin-Kon, Karmen Stankov, Hani Al-Salami
A major advancement in therapy of type 1 diabetes mellitus (T1DM) is the discovery of new treatment which avoids and even replaces the absolute requirement for injected insulin. The need for multiple drug therapy of comorbidities associated with T1DM increases demand for developing novel therapeutic alternatives with new mechanisms of actions. Compared to other sulphonylurea drugs used in the treatment of type 2 diabetes mellitus, gliclazide exhibits a pleiotropic action outside pancreatic β cells, the so-called extrapancreatic effects, such as antiinflammatory and cellular protective effects, which might be beneficial in the treatment of T1DM...
October 16, 2017: European Journal of Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/29034085/amp-activated-protein-kinase-not-just-an-energy-sensor
#8
REVIEW
David Grahame Hardie, Sheng-Cai Lin
Orthologues of AMP-activated protein kinase (AMPK) occur in essentially all eukaryotes as heterotrimeric complexes comprising catalytic α subunits and regulatory β and γ subunits. The canonical role of AMPK is as an energy sensor, monitoring levels of the nucleotides AMP, ADP, and ATP that bind competitively to the γ subunit. Once activated, AMPK acts to restore energy homeostasis by switching on alternate ATP-generating catabolic pathways while switching off ATP-consuming anabolic pathways. However, its ancestral role in unicellular eukaryotes may have been in sensing of glucose rather than energy...
2017: F1000Research
https://www.readbyqxmd.com/read/29025080/exposure-to-perchlorate-nitrate-and-thiocyanate-and-prevalence-of-diabetes-mellitus
#9
Gang Liu, Geng Zong, Klodian Dhana, Yang Hu, Benjamin C Blount, Maria Morel-Espinosa, Qi Sun
Background: It is known that perchlorate, nitrate and thiocyanate have the property of inhibiting sodium iodide symporter. Animal studies have suggested that these compounds, especially perchlorate, might also interfere with insulin secretion. However, the association between their exposure and diabetes risk is largely unknown in humans. Methods: Among 11 443 participants (mean age 42.3 years) from the National Health and Nutritional Examination Survey 2001-14, urinary perchlorate, nitrate and thiocyanate were measured by using ion chromatography coupled with electrospray tandem mass spectrometry...
September 11, 2017: International Journal of Epidemiology
https://www.readbyqxmd.com/read/28982699/sitagliptin-100%C3%A2-mg-vs-glimepiride-1-3%C3%A2-mg-as-an-add-on-to-insulin-and-metformin-in-type-2-diabetes-swim
#10
Jothydev Kesavadev, Pradeep Babu Sadasivan Pillai, Arun Shankar, Gopika Krishnan, Sunitha Jothydev
OBJECTIVE: To compare the effect of sitagliptin (100 mg) vs glimepiride (1-3 mg) as add-on therapy in Indian type 2 diabetes (T2DM) patients on treatment with insulin and metformin (SWIM study). RESEARCH DESIGN AND METHODS: This 24-week, controlled, open-label study randomized T2DM patients (n = 440) receiving a stable dose of metformin and insulin combination therapy to sitagliptin (100 mg) or glimepiride (1-3 mg) as add-on therapy. Baseline HbA1c was ≥7...
November 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28980272/pathogenesis-clinical-features-and-treatment-of-diabetic-cardiomyopathy
#11
Núria Alonso, Pedro Moliner, Dídac Mauricio
Patients with type 1 and type 2 diabetes mellitus (T1D and T2D) show an increased incidence of heart failure (HF) even after adjustment for well established risk factors for HF such as hypertension and ischaemic heart disease. The resulting specific form of cardiomyopathy is known as diabetic cardiomyopathy" (DCM). Pathogenetic mechanisms underlying DCM are likely to be multifactorial, from altered myocardial metabolism (hyperglycaemia, hyperinsulinaemia, increased circulating fatty acids and trglycerides) to microvascular disease, autonomic neuropathy, and altered myocardial structure with fibrosis...
October 5, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28979539/co-trimoxazole-induced-hypoglycaemia-in-an-immunosuppressed-intensive-care-patient
#12
Katherine A Richards, Simon Raby
An 18-year-old female inpatient on a neurosciences intensive care unitwith new onset super-refractory epilepsy became hypoglycaemic 48 h after commencing co-trimoxazole. She had been placed on this for prophylaxis against Pneumocystis jiroveci infection in the context of significant immunosuppression with high-dose corticosteroid therapy. In order to maintain glucose control, she required a continuous infusion of 10% dextrose at rates of 15-25 ml/h. Recurrent attempts to wean this were limited by further hypoglycaemia, until she spontaneously regained normoglycaemia after 73 days...
February 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28978579/nocturnal-reactive-hypoglycaemia-well-treated-subjectively-and-objectively-with-voglibose
#13
Hiroyuki Koyama, Hideomi Ohguchi, Takashi Yagi, Kenro Imaeda
Clinicians sometimes encounter difficulty in diagnosing hypoglycaemia. Here, we present a case report of a 53-year-old woman with recurrent nocturnal hypoglycaemia. A continuous glucose monitoring system (CGMS) revealed postprandial hyperglycaemia and subsequent hypoglycaemia, and an oral glucose tolerance test showed an impaired glycaemic and delayed hyperinsulinaemic pattern. On the basis of these clinical findings, we diagnosed her unexplained hypoglycaemia as reactive hypoglycaemia. CGMS showed a sharp contrast of diurnal variation in blood glucose levels including hypoglycaemia between before and after treatment with an alpha-glucosidase inhibitor, voglibose...
October 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28956663/microspheres-for-the-oral-delivery-of-insulin-preparation-evaluation-and-hypoglycaemic-effect-in-streptozotocin-induced-diabetic-rats
#14
Huan Zhang, Weimei Wang, Haoran Li, Yi Peng, Zhiqing Zhang
Insulin-loaded microspheres were prepared by alternating deposition film layers that were composed of insulin and poly(vinyl sulfate) potassium on the surface of poly(lactic acid) (PLA) microspheres. The preparation of the insulin-loaded microspheres was optimized by an orthogonal test design, and the relationship between drug loading (DL) and film layers was studied. The particle size, DL and encapsulation efficiency of the obtained insulin-loaded microspheres with 10 films were 5.25 ± 0.15 µm, 111...
October 17, 2017: Drug Development and Industrial Pharmacy
https://www.readbyqxmd.com/read/28948952/efficacy-of-metformin-in-improving-glycaemic-control-perinatal-outcome-in-gestational-diabetes-mellitus-a-non-randomized-study
#15
Neeta Singh, Malti Madhu, Perumal Vanamail, Nisha Malik, Sunesh Kumar
BACKGROUND & OBJECTIVES: Gestational diabetes mellitus (GDM) can cause adverse perinatal outcome if not treated. Although insulin therapy has been the main treatment modality over decades but considering its cost and parenteral mode of administration, it does not seem to be appropriate, especially in low-resource settings. The objective of this study was to evaluate the role of metformin in GDM and know its efficacy as well as adverse effect on foetus and mother. METHODS: All pregnant women with GDM who were not controlled on medical nutrition therapy and required metformin therapy were included in the study...
May 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28941578/hypoglycaemia-in-the-over-75s-understanding-the-predisposing-factors-in-type-2-diabetes-t2dm
#16
Adrian Hugh Heald, Simon George Anderson, Gabriela Janet Cortes, Videlina Cholokova, Marcos Narajos, Adnan Khan, Gemma Donnahey, Mark Livingston
INTRODUCTION: Hypoglycaemia has been recognised as a problem in the treatment for type 2 diabetes. Here we describe how levels of HbA1C and treatment with a sulphonylurea or insulin relate to risk of significant hypoglycaemia. METHODS: Incident hypoglycaemia as recorded for the previous 10 years was determined from the GP records for patients with T2DM aged 75 years or more. RESULTS: The anonymised GP records of 5974 T2DM patients (2934 men and 3040 women) aged 75 years or more were analysed...
September 20, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28928256/melioidosis-mimicking-tubercular-cold-abscess
#17
Raghuraj Suresh Kundangar, Shyamasunder N Bhat, Simanchal P Mohanty
Burkholderia pseudomallei is a Gram-negative bacillus found in soil. The infection is thought to occur by inoculation or inhalation. It usually affects people with predisposing factors like diabetes mellitus and chronic alcoholism. A 36-year-old man, on the treatment of diabetes in the past 4 years, on oral hypoglycaemic drugs, presented to us with pain and insidious onset of swelling over left loin like a lumbar cold abscess. He underwent incision and drainage of the abscess. As per the culture report, we used ceftazidime for 2 weeks, followed by cotrimoxazole for 6 months...
September 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28923465/continuous-glucose-monitoring-in-pregnant-women-with-type-1-diabetes-conceptt-a-multicentre-international-randomised-controlled-trial
#18
Denice S Feig, Lois E Donovan, Rosa Corcoy, Kellie E Murphy, Stephanie A Amiel, Katharine F Hunt, Elizabeth 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 15, 2017: Lancet
https://www.readbyqxmd.com/read/28918410/-just-like-a-normal-pain-what-do-people-with-diabetes-mellitus-experience-when-having-a-myocardial-infarction-a-qualitative-study-recruited-from-uk-hospitals
#19
Nikita Berman, Melvyn Mark Jones, Daan A De Coster
OBJECTIVE: The objective of the study was to investigate the symptoms people with diabetes experience when having a myocardial infarction (MI), their illness narrative and how they present their symptoms to the health service. SETTING: Three London (UK) hospitals (coronary care units and medical wards). PARTICIPANTS: Patients were recruited with diabetes mellitus (DM) (types 1 and 2) with a clinical presentation of MI (ST elevated MI (STEMI), non-ST elevated MI (NSTEMI), acute MI unspecified and cardiac arrest)...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28913543/devote-3-temporal-relationships-between-severe-hypoglycaemia-cardiovascular-outcomes-and-mortality
#20
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
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