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https://www.readbyqxmd.com/read/28635331/network-meta-analysis-of-liraglutide-versus-dpp-4-inhibitors-for-the-treatment-of-type-2-diabetes-in-japanese-patients
#1
Dieter Ayers, Steve Kanters, Rachel Goldgrub, Monica Hughes, Ryo Kato, Nana Kragh
AIMS: To determine the comparative efficacy and safety of liraglutide and dipeptidyl peptidiase-4 (DPP-4) inhibitors as antidiabetics for Japanese patients with uncontrolled type 2 diabetes (T2DM). METHODS AND MATERIALS: We searched for randomized-controlled trials (RCTs) evaluating outcomes among Japanese adults with uncontrolled T2DM and including liraglutide or DPP-4 inhibitors up to August 2016. We extracted data on trial and patient characteristics, and the following outcomes: HbA1c, weight, patients meeting HbA1c <7%, patients experiencing hypoglycemic events, microalbuminuria, estimated glomerular filtration rate (eGFR) and creatinine...
June 21, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28633537/extensive-assessment-of-blood-glucose-monitoring-during-postprandial-period-and-its-impact-on-closed-loop-performance
#2
Lyvia Biagi, Arthur Hirata Bertachi, Ignacio Conget, Carmen Quirós, Marga Giménez, F Javier Ampudia-Blasco, Paolo Rossetti, Jorge Bondia, Josep Vehí
BACKGROUND: Closed-loop (CL) systems aims to outperform usual treatments in blood glucose control and continuous glucose monitors (CGM) are a key component in such systems. Meals represents one of the main disturbances in blood glucose control, and postprandial period (PP) is a challenging situation for both CL system and CGM accuracy. METHODS: We performed an extensive analysis of sensor's performance by numerical accuracy and precision during PP, as well as its influence in blood glucose control under CL therapy...
June 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28631762/-safety-and-tolerability-of-oral-hypoglycemic-therapies-in-type-2-diabetes-mellitus-patients-at-high-cardiovascular-risk
#3
Giuseppe Ambrosio, Gaetano M De Ferrari, Massimo Federici, Pasquale Perrone Filardi
Oral hypoglycemic drugs for type 2 diabetes aim at preventing the metabolic effects of hyperglycemia and cardiovascular (CV) events. The evidence of the possible CV risk related to the prescription of some antidiabetic drugs prompted regulatory agencies to require safety studies. This review provides an updated analysis of CV safety profiles for antidiabetic drugs used for the treatment of patients with high CV risk.The most recent studies analyze different aspects of CV morbidity, such as ischemic events, heart failure and arrhythmia, and their interactions with hyperglycemia...
June 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28631216/safety-and-tolerability-of-empagliflozin-in-patients-with-type-2-diabetes-pooled-analysis-of-phase-i-iii-clinical-trials
#4
Sven Kohler, Cordula Zeller, Hristo Iliev, Stefan Kaspers
INTRODUCTION: We characterized the safety and tolerability of empagliflozin in patients with type 2 diabetes (T2DM) randomized 1:1:1 to placebo, empagliflozin 10 mg, or empagliflozin 25 mg in clinical trials. METHODS: Pooled data were analyzed from patients with T2DM treated with placebo (N = 4203), empagliflozin 10 mg (N = 4221), or empagliflozin 25 mg (N = 4196) in 15 randomized phase I-III trials plus four extension studies. Adverse events (AEs) were assessed descriptively in participants who took at least one dose of study drug...
June 19, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28627374/characterization-of-the-concurrent-metabolic-changes-in-brain-and-plasma-during-insulin-induced-moderate-hypoglycemia-using-1-h-nmr-spectroscopy-in-juvenile-rats
#5
Kathleen Ennis, Elizabeth Lusczek, Raghavendra Rao
Treatment of hypoglycemia in children is currently based on plasma glucose measurements. This approach may not ensure neuroprotection since plasma glucose does not reflect the dynamic state of cerebral energy metabolism. To determine whether cerebral metabolic changes during hypoglycemia could be better characterized using plasma metabolomic analysis, insulin-induced acute hypoglycemia was induced in 4-week-old rats. Brain tissue and concurrent plasma samples were collected from hypoglycemic (N=7) and control (N=7) rats after focused microwave fixation to prevent post-mortem metabolic changes...
June 14, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28626178/hypoglycemic-coma-induced-by-the-use-of-succinic-acid-cibenzoline-in-frail-late-stage-elderly-subjects
#6
Yurie Hirata, Shinji Kamei, Fuminori Tatsumi, Masashi Shimoda, Akihito Tanabe, Junpei Sanada, Yoshiro Fushimi, Shintaro Irie, Tomoatsu Mune, Kohei Kaku, Hideaki Kaneto
Succinic acid cibenzoline (CZ) is an antiarrhythmic agent often used for the treatment of tachyarrhythmia. However, hypoglycemia should be avoided in the treatment of diabetes. We herein report two late-stage elderly subjects who experienced a severe and prolonged hypoglycemic coma after the usage of CZ. These cases suggest that, when CZ is administered to elderly subjects with renal dysfunction and/or frailty, we should be aware of the possibility that this medicine may induce hypoglycemia and should adjust the dose as appropriate and monitor the concentration of CZ to avoid severe hypoglycemia...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28625506/long-term-cost-effectiveness-of-two-glp-1-receptor-agonists-for-the-treatment-of-type-2-diabetes-mellitus-in-the-italian-setting-liraglutide-versus-lixisenatide
#7
Barnaby Hunt, Nana Kragh, Ceilidh C McConnachie, William J Valentine, Maria C Rossi, Roberta Montagnoli
PURPOSE: Maintaining glycemic control is the key treatment target for patients with type 2 diabetes mellitus. In addition, the glucagon-like peptide-1 (GLP-1) receptor agonists may be associated with other favorable treatment characteristics, such as reduction in body weight and reduced risk of hypoglycemia compared with traditional diabetes interventions. The aim of the present analysis was to compare the long-term cost-effectiveness of 2 GLP-1 receptor agonists, liraglutide 1.8 mg and lixisenatide 20 μg (both administered once daily), in the treatment of patients with type 2 diabetes failing to achieve glycemic control with metformin monotherapy in the Italian setting...
June 15, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28616805/effects-of-insulin-plus-glucagon-like-peptide-1-receptor-agonists-glp-1ras-in-treating-type-1-diabetes-mellitus-a-systematic-review-and-meta-analysis
#8
REVIEW
Weihao Wang, Hongyan Liu, Shumin Xiao, Shuaihui Liu, Xin Li, Pei Yu
INTRODUCTION: Combination therapy with insulin and glucagon-like peptide-1 receptor agonists (GLP-1RAs) has already been proven an efficient treatment option for type 2 diabetes. This combination can effectively improve glycated hemoglobin levels, cause weight loss and reduce the dosage of insulin. In addition, it can also reduce the risk of hypoglycemia. Several randomized controlled trials have confirmed that this treatment may be just as effective for type 1 diabetes mellitus (T1DM) patients...
June 14, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28615049/a-case-of-acute-sheehan-s-syndrome-and-literature-review-a-rare-but-life-threatening-complication-of-postpartum-hemorrhage
#9
Shinya Matsuzaki, Masayuki Endo, Yutaka Ueda, Kazuya Mimura, Aiko Kakigano, Tomomi Egawa-Takata, Keiichi Kumasawa, Kiyoshi Yoshino, Tadashi Kimura
BACKGROUND: Sheehan's syndrome occurs because of severe postpartum hemorrhage causing ischemic pituitary necrosis. Sheehan's syndrome is a well-known condition that is generally diagnosed several years postpartum. However, acute Sheehan's syndrome is rare, and clinicians have little exposure to it. It can be life-threatening. There have been no reviews of acute Sheehan's syndrome and no reports of successful pregnancies after acute Sheehan's syndrome. We present such a case, and to understand this rare condition, we have reviewed and discussed the literature pertaining to it...
June 14, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28609547/intensive-insulin-therapy-combined-with-metformin-is-associated-with-reduced-glucose-variability-and-nocturnal-hypoglycemia-in-patients-with-type-2-diabetes
#10
Yifei Zhang, Zhiyun Zhao, Shujie Wang, Wei Zhu, Yiran Jiang, Shouyue Sun, Chen Chen, Kai Wang, Liangshan Mu, Jinyi Cao, Yingxia Zhou, Weiqiong Gu, Jie Hong, Weiqing Wang, Guang Ning
BACKGROUND: The effect on glucose variability in patients with intensive insulin therapy has not been fully understood. This observational study investigated the different glucose variability and hypoglycemia pattern in type 2 diabetes patients treated with continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI) with or without metformin administration. METHODS: During hospitalization, totally 501 patients with poor glycemic control and in initial treatment with either CSII alone (n = 187), CSII + Metformin (n = 81), MDI alone (n = 146) or MDI + Metformin (n = 87), were involved in the final analysis...
June 13, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28606343/pharmacologic-management-of-type-2-diabetes-mellitus-available-therapies
#11
James Thrasher
Choices for the treatment of type 2 diabetes mellitus (T2DM) have multiplied as our understanding of the underlying pathophysiologic defects has evolved. Treatment should target multiple defects in T2DM and follow a patient-centered approach that considers factors beyond glycemic control, including cardiovascular risk reduction. The American Association of Clinical Endocrinologists/American College of Endocrinology and the American Diabetes Association recommend an initial approach consisting of lifestyle changes and monotherapy, preferably with metformin...
July 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28605468/attenuation-of-insulin-action-by-an-allosteric-insulin-receptor-antibody-in-healthy-volunteers
#12
Kirk W Johnson, Ann Neale, Allan Gordon, Julie Roessig, Padma Bezwada, Sabine Vukelich, Ira Goldfine, Paul Rubin
Background: X358 (X358) is a fully human monoclonal antibody to the insulin receptor (InsR) that acts as a negative allosteric modulator of insulin signaling. It is being developed as a novel treatment for hyperinsulinemic hypoglycemia. This report describes pharmacokinetic (PK), and pharmacodynamic (PD) data from a first-in-human clinical trial. Methods: A double-blind, placebo-controlled, single ascending dose study was performed with 29 healthy adult males randomized to intravenous infusion of placebo or X358 at 0...
June 9, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28597971/diagnosis-of-congenital-hyperinsulinism-biochemical-profiles-during-hypoglycemia
#13
Azumi Sakakibara, Yukiko Hashimoto, Rie Kawakita, Yuki Hosokawa, Keiko Nagahara, Yukihiro Hasegawa, Shin Hoshino, Hironori Nagasaka, Tohru Yorifuji
OBJECTIVES: To define the ranges of biochemical markers during hypoglycemia for the diagnosis of congenital hyperinsulinism (CHI), using high sensitivity insulin assays. SUBJECTS: A total of 298 patients with CHI and 58 control patients with non-hyperinsulinemic hypoglycemia, who were diagnosed after 2007. METHODS: The levels of biochemical markers (glucose, insulin, β-hydroxybutyrate [BHB], free fatty acids [FFA], lactate, ammonia) at the time of hypoglycemia were analyzed along with the maximal glucose infusion rate (GIR) to maintain euglycemia and clinical outcomes...
June 9, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28594772/gestational-diabetes-mellitus-and-frequency-of-blood-glucose-monitoring-a-randomized-controlled-trial
#14
Hector Mendez-Figueroa, Meike Schuster, Lindsay Maggio, Claudia Pedroza, Suneet P Chauhan, Michael J Paglia
OBJECTIVE: To assess whether testing blood glucose four times daily compared with four times every other day would lead to similar birth weights among patients with gestational diabetes mellitus (GDM). METHODS: This noninferiority randomized controlled trial was conducted at five centers. After receiving a diagnosis of GDM, women tested their blood glucose every day for 7 days. After that period, compliant women without hyperglycemia requiring treatment were randomized to either blood glucose testing four times a day or every other day...
June 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28594575/bolus-calculator-reduces-hypoglycemia-in-the-short-term-and-fear-of-hypoglycemia-in-the-long-term-in-subjects-with-type-1-diabetes-cbmdi-study
#15
María Del Rosario Vallejo Mora, Monica Carreira, María Teresa Anarte, Francisca Linares, Gabriel Olveira, Stella González Romero
BACKGROUND: In a previous study we demonstrated improvement in metabolic control and reduction in hypoglycemia in people with type 1 diabetes on multiple daily injections, after having used a bolus calculator for 4 months. OBJECTIVE: To demonstrate whether (1) extending its use (2) or introducing it in the control group, previously subjected to treatment intensification, could further improve metabolic control and related psychological issues. METHODS: After the previous clinical trial, in which the subjects were randomized either to treatment with the calculator or to control group for 4 months, both groups used the calculator during an additional 4-month period...
June 8, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28594482/non-severe-hypoglycemia-risk-difference-between-sulfonylurea-and-sodium-glucose-cotransporter-2-inhibitors-sglt2-i-as-an-add-on-to-metformin-in-randomized-controlled-trials
#16
Pendar Farahani
BACKGROUND: Non-severe hypoglycemia reduces well-being, lowers quality of life, reduces productivity and increases treatment costs. The non-severe hypoglycemia rate, attributable to sulfonylurea (SU) utilization compared with newer classes such as SGLT2-I, could be of clinical significance. OBJECTIVES: To explore the non-severe hypoglycemia risk difference (RD) for SU use compared with SGLT2-I in randomized controlled trials (RCTs) as an add on to metformin. METHODS: A search was conducted for RCTs of SGLT2-I...
May 23, 2017: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/28592737/octreotide-lar-was-useful-for-avoiding-hypoglycemia-in-an-elderly-patient-with-insulinoma
#17
Ayaka Kanno, Kana Ide, Kenichi Kurita, Takashi Terano, Kyohei Yamamoto
An 80-year-old woman was admitted to our hospital with a hypoglycemia attack. She was diagnosed with insulinoma based on her high insulin level at the time of the hypoglycemia attack and the presence of a hypervascular tumor in her pancreas. The patient refused surgical treatment and octreotide was used to prevent hypoglycemia.It is known that octreotide suppresses the secretion of insulin from the pancreas; however, insulin secretion is not always suppressed in patients with insulinoma. Moreover, there is no particular protocol for the use of octreotide in the treatment of insulinoma...
2017: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/28592706/efficacy-and-safety-of-long-acting-pasireotide-in-japanese-patients-with-acromegaly-or-pituitary-gigantism-results-from-a-multicenter-open-label-randomized-phase-2-study
#18
Shigeyuki Tahara, Mami Murakami, Tomomi Kaneko, Akira Shimatsu
A multicenter, open-label, phase 2 study was conducted to investigate the efficacy and safety of long-acting pasireotide formulation in Japanese patients with acromegaly or pituitary gigantism. Medically naïve or inadequately controlled patients (on somatostatin analogues or dopamine agonists) were included. Primary end point was the proportion of all patients who achieved biochemical control (mean growth hormone [GH] levels<2.5μg/L and normalized insulin-like growth factor-1 [IGF-1]) at month 3. Thirty-three patients (acromegaly, n=32; pituitary gigantism, n=1) were enrolled and randomized 1:1:1 to receive open-label pasireotide 20mg, 40mg, or 60mg...
June 8, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28591776/efficacy-and-safety-of-mini-dose-glucagon-for-treatment-of-non-severe-hypoglycemia-in-adults-with-type-1-diabetes
#19
Morey W Haymond, Stephanie N DuBose, Michael R Rickels, Howard Wolpert, Viral N Shah, Jennifer L Sherr, Ruth S Weinstock, Shivani Agarwal, Alandra S Verdejo, Martin J Cummins, Brett Newswanger, Roy W Beck
Context: Standard treatment for hypoglycemia is oral carbohydrate, but often results in hyperglycemia and requires extra caloric intake. Objective: To evaluate the use of low-dose glucagon to treat mild hypoglycemia in ambulatory adults with type 1 diabetes (T1D). Design: Randomized crossover trial (two 3-week periods). Setting: Five U.S. diabetes clinics. Patients: Twenty adults with T1D using an insulin pump and continuous glucose monitor (CGM) and experiencing frequent mild hypoglycemia...
June 7, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28589493/a-randomized-placebo-controlled-trial-evaluating-the-safety-and-efficacy-of-adding-omarigliptin-to-antihyperglycemic-therapies-in-japanese-patients-with-type-2-diabetes-and-inadequate-glycemic-control
#20
Ira Gantz, Taro Okamoto, Yuka Ito, Asako Sato, Kotoba Okuyama, Edward A O'Neill, Samuel S Engel, Eseng Lai
INTRODUCTION: Daily dipeptidyl peptidase-4 (DPP-4) inhibitors are commonly used with other orally administered antihyperglycemic agents (AHA), as combination therapy, to treat Japanese patients with type 2 diabetes. When combination therapy is indicated, use of a once-weekly (q.w.) orally administered DPP-4 inhibitor might be an appropriate therapeutic option for some patients. METHODS: A 52-week trial was conducted to assess the safety and tolerability (primary objectives) and glycemic efficacy (secondary objectives) of the q...
June 6, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
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