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https://www.readbyqxmd.com/read/28334539/-long-acting-insulins-in-the-treatment-of-type-2%C3%A2-diabetes-and-their-position-in-the-current-treatment-algorithm
#1
Martin Haluzík
Insulin therapy has been for many years an inseparable part of the treatment of patients with type 2 diabetes, in particular those with longer diabetes duration. Current national and international guidelines list insulin treatment as a possible second choice therapy in patient with unsatisfactory glucose control on monotherapy with metformin. In reality, insulin therapy is often initiated later than it optimally should be. The reasons include among others the fear of patients and sometimes also of physicians from the side effects of insulin...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28332871/sodium-glucose-cotransporter-2-and-dipeptidyl-peptidase-4-inhibition-promise-of-a-dynamic-duo
#2
Ildiko Lingvay
OBJECTIVE: This article reviews evidence supporting sodium glucose cotransporter 2 (SGLT2) inhibitor and dipeptidyl peptidase-4 (DPP-4) inhibitor combination therapy for management of type 2 diabetes mellitus (T2DM). METHODS: We conducted a non-systematic review of the literature focusing on single-pill or fixed-dose combinations of SGLT2 inhibitors and DPP-4 inhibitors available in the United States. RESULTS: SGLT2 inhibitors and DPP-4 inhibitors have complementary mechanisms of action that address several of the underlying pathophysiological abnormalities present in T2DM without overlapping toxicities...
March 23, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28332144/efficacy-and-safety-of-ideglira-in-participants-with-type-2-diabetes-in-india-uncontrolled-on-oral-antidiabetic-drugs-and-basal-insulin-data-from-the-dual-clinical-trial-program
#3
Kamlesh Khunti, Viswanathan Mohan, Sunil M Jain, Trine Welløv Boesgaard, Kamilla Begtrup, Bipin Sethi
INTRODUCTION: The efficacy and safety of insulin degludec/liraglutide (IDegLira) has been evaluated in the Dual Action of Liraglutide and Insulin Degludec in Type 2 Diabetes (DUAL) phase 3 clinical trial program. In this post hoc analysis, we compared the efficacy and safety of IDegLira in the Indian subpopulation with the results from the global trial population of DUAL trials. The analysis includes participants uncontrolled on oral antidiabetic drugs (OADs) in DUAL I and DUAL IV and participants uncontrolled on basal insulin and OADs in DUAL II...
March 22, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28328816/a-case-report-liraglutide-as-a-novel-treatment-option-in-late-dumping-syndrome
#4
Sonja Chiappetta, Christine Stier
RATIONALE: Postprandial hyperinsulinemic hypoglycemia, known as late dumping syndrome, is a rare but often misdiagnosed complication after gastric surgery. The pathophysiological mechanisms are poorly understood and the treatment of this syndrome is challenging. PATIENT CONCERNS: New-onset postsurgical late dumping syndrome after Toupet fundoplication. DIAGNOSES: Sigstad Score, OGTT, CGM. INTERVENTIONS: Daily subcutaneous injection of liraglutide (0...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328679/results-of-a-multicenter-prospective-pivotal-trial-of-the-first-inline-continuous-glucose-monitor-in-critically-ill-patients
#5
Grant V Bochicchio, Stan Nasraway, Laura Moore, Anthony Furnary, Eden Nohra, Kelly Bochicchio
INTRODUCTION: We have previously demonstrated that tight glycemic control (80-120 mg/dl) improves outcome in critically injured patients. However, many centers have gotten away from aggressive glucose control due to the workload and risk of hypoglycemia. The objective of this pivotal trial is to evaluate the first in human continuous inline glucose monitor (OptiScanner) in critically ill patients. METHODS: A multicenter pivotal trial was conducted over a 1 year period (2014-2015) at 4 major academic centers in 200 critically ill patients...
March 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28325801/insulin-and-glucagon-like-peptide-1-receptor-agonist-combination-therapy-in-type-2-diabetes-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#6
REVIEW
Maria Ida Maiorino, Paolo Chiodini, Giuseppe Bellastella, Annalisa Capuano, Katherine Esposito, Dario Giugliano
OBJECTIVE: The combination of basal insulin plus a glucagon-like peptide 1 receptor agonist (GLP-1RA) has been proposed as a treatment option to intensify insulin therapy in type 2 diabetes. We performed a meta-analysis of randomized controlled trials (RCTs) comparing this combination strategy to other injectable antidiabetes treatments on metabolic control in adult patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: We conducted an electronic search until November 2016 on many electronic databases to identify RCTs assessing changes in HbA1c, proportion of patients at HbA1c target ≤7% (53 mmol/mol), hypoglycemia, and weight change...
April 2017: Diabetes Care
https://www.readbyqxmd.com/read/28322073/sglt2-inhibitor-dpp-4-inhibitor-combination-therapy-complementary-mechanisms-of-action-for-management-of-type-2-diabetes-mellitus
#7
Jayant Dey
Type 2 diabetes mellitus is a progressive disease with multiple underlying pathophysiologic defects. Monotherapy alone cannot maintain glycemic control and leads to treatment failure. Ideally, a combination of glucose-lowering agents should have complementary mechanisms of action that address multiple pathophysiologic pathways, can be used at all stages of the disease, and be generally well tolerated with no increased risk of hypoglycemia, cardiovascular events, or weight gain. The combination should also provide conveniences for patients, such as oral dosing, single-pill formulations, and once-daily administration, potentially translating to improved adherence...
March 21, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28321056/sodium-glucose-co-transporter-2-inhibitors-reduce-the-abdominal-visceral-fat-area-and-may-influence-the-renal-function-in-patients-with-type-2-diabetes
#8
Takahiro Tosaki, Hideki Kamiya, Tatsuhito Himeno, Yoshiro Kato, Masaki Kondo, Kaori Toyota, Tomoyo Nishida, Megumi Shiroma, Kaori Tsubonaka, Hitomi Asai, Miho Moribe, Yuki Nakaya, Jiro Nakamura
Objective and Methods An SGLT2 inhibitor (ipragliflozin, dapagliflozin, luseogliflozin, tofogliflozin, or canagliflozin) was administered to 132 outpatients with type 2 diabetes mellitus with or without other antidiabetic drugs for 6 months to evaluate its efficacy, the incidence of adverse events, and its influence on the renal function. Results The patient's mean glycated hemoglobin level significantly improved from 7.52±1.16% to 6.95±0.98% (p<0.001). The body weight of the patients was significantly reduced from 78...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28316225/-the-clinical-impact-of-artery-first-approach-combined-with-vascular-resection-and-reconstruction-in-the-treatment-of-pancreatic-head-carcinoma
#9
J L Huang, W G Li, F Z Chen, Z J Su, F M Li, B Liu
Objective: To evaluate the application of artery first, combined vascular resection and reconstruction in the treatment of pancreatic head carcinoma. Methods: The clinical data of 13 patients with pancreatic head cancer were retrospectively analyzed from February 2014 to March 2016 in the Affiliated Hospital of Xiamen University. Preoperative computed tomography of high resolution layer or magnetic resonance imaging examination demonstrated pancreatic head carcinoma, as well as close adhesion, stenosis, compression or displacement of superior mesenteric vein or portal vein wall...
March 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28314484/impact-of-health-policy-and-practice-on-finding-the-best-fit-for-patients-with-type-2-diabetes-after-metformin-failure-croatian-pilot-study
#10
Maja Cigrovski Berković, Davorka Herman Mahečić, Marina Gradišer, Ines Bilić-Ćurčić
AIM: We assessed the impact of clinical practice and health policy on the choice and efficacy of different second-line therapies for the treatment of type 2 diabetes (T2DM) after failure of metformin. METHODS: This retrospective database analysis included 200 patients with a follow-up period of 6 months. The primary end-point was achievement of HbA1c <7% and fasting (FBG) and postprandial glucose levels (PPG) <7.2mmol/L and <10mmol/L, respectively after three and six months of different add-on treatments...
March 14, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28303721/effectiveness-and-safety-of-vildagliptin-and-vildagliptin-add-on-to-metformin-in-real-world-settings-in-egypt-results-from-the-guard-study
#11
Salah Shelbaya, Sameh Rakha
OBJECTIVE: The GUARD study evaluated the effectiveness, safety, and tolerability of vildagliptin treatment with or without metformin in patients with type 2 diabetes mellitus (T2DM) in real-life settings. Here we present the results of the GUARD study for the patient subset from Egypt. RESEARCH DESIGN AND METHODS: This was a 24 ± 6 weeks, prospective, non-interventional study that enrolled adult patients with T2DM receiving vildagliptin or vildagliptin + metformin combination therapy as per local prescribing information...
March 17, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28303514/euglycemic-ketosis-in-patients-with-type-2-diabetes-on-sglt2-inhibitor-therapy-an-emerging-problem-and-solutions-offered-by-diabetes-technology
#12
A Pfützner, D Klonoff, L Heinemann, N Ejskjaer, J Pickup
Diabetic ketoacidosis is an infrequent but life-threatening acute complication of diabetes, affecting predominantly patients with type 1 diabetes, children, and pregnant women, where ketosis is usually associated with marked hyperglycemia. Recently, an increasing number of cases have been reported of euglycemic diabetic ketoacidosis in patients with type 2 diabetes receiving sodium-glucose cotransporter 2 inhibitor treatment in routine practice. There is a minor, but not negligible diabetic ketoacidosis risk associated with this drug class, which was not seen in randomized clinical trials...
March 17, 2017: Endocrine
https://www.readbyqxmd.com/read/28302958/efficacy-and-safety-analyses-across-4-subgroups-combining-low-and-high-age-and-body-mass-index-groups-in-japanese-phase-3-studies-of-dulaglutide-0-75-mg-after-26-weeks-of-treatment
#13
Kumiko Hamano, Hiroshi Nishiyama, Akiko Matsui, Manaka Sato, Masakazu Takeuchi
In 855 Japanese patients with type 2 diabetes receiving once weekly dulaglutide 0.75 mg in 3 phase 3 studies, the effects on efficacy and safety at week 26 (last observation carried forward) were investigated in a post hoc descriptive analysis of subgroups of age (<65 years [young], ≥65 years [elderly]) and body mass index (BMI [<25 kg/m(2), ≥25 kg/m(2)]). The 4 subgroups were as follows: 1) the young/low-BMI subgroup (Y/L) (n = 255); 2) the young/high-BMI subgroup (Y/H) (n = 386), 3) the elderly/low-BMI subgroup (E/L) (n = 137), and 4) the elderly/high-BMI subgroup (E/H) (n = 77)...
March 7, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28294641/evaluation-of-the-long-term-cost-effectiveness-of-ideglira-versus-liraglutide-added-to-basal-insulin-for-patients-with-type-2-diabetes-failing-to-achieve-glycemic-control-on-basal-insulin-in-the-usa
#14
B Hunt, M Mocarski, W J Valentine, J Langer
BACKGROUND AND AIMS: IDegLira, a fixed ratio combination of insulin degludec and glucagon-like peptide-1 receptor agonist liraglutide, utilizes the complementary mechanisms of action of these two agents to improve glycemic control with low risk of hypoglycemia and avoidance of weight gain. The aim of the present analysis was to assess the long-term cost-effectiveness of IDegLira vs liraglutide added to basal insulin, for patients with type 2 diabetes not achieving glycemic control on basal insulin in the US setting...
March 3, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28293906/who-should-be-considered-for-islet-transplantation-alone
#15
REVIEW
Nantia Othonos, Pratik Choudhary
PURPOSE OF REVIEW: Episodic hypoglycemia is an almost inevitable consequence of exogenous insulin treatment of type 1 diabetes, and in up to 30% of patients, this can lead to impaired awareness of hypoglycemia. This predisposes to recurrent severe hypoglycemia and has a huge impact on quality of life. Although many patients can get resolution of severe hypoglycemia through novel education and technology, some patients continue to have ongoing life-threatening hypoglycemia. Islet transplantation offers an alternative therapeutic option for these patients, in whom these conventional approaches have been unsuccessful...
April 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28292283/carnitine-related-hypoglycemia-caused-by-3%C3%A2-days-of-pivalate-antibiotic-therapy-in-a-patient-with-severe-muscular-dystrophy-a-case-report
#16
Masanori Ito, Mitsumasa Fukuda, Yuka Suzuki, Hiroyuki Wakamoto, Eiichi Ishii
BACKGROUND: Long-term treatment with antibiotics containing pivalic acid may decrease serum carnitine concentration and can sometimes be associated with severe hypoglycemia and encephalopathy in infants. Little has been reported, however, on severe hypocarnitinemia induced by acute administration in older children. CASE PRESENTATION: We describe a 6-year-old Japanese girl with Fukuyama-type congenital muscular dystrophy who lost consciousness after 3 days of treatment with an antibiotic containing pivalic acid (cefditoren pivoxil)...
March 14, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28286340/intensive-gestational-glycemic-management-and-childhood-obesity-a-systematic-review-and-meta-analysis
#17
REVIEW
L Guillemette, A Durksen, R Rabbani, R Zarychanski, A M Abou-Setta, T A Duhamel, J M McGavock, B Wicklow
BACKGROUND AND OBJECTIVES: Hyperglycemia in pregnancy is associated with increased risk of offspring childhood obesity. Treatment reduces macrosomia, however it is unclear if this effect translates into a reduced risk of childhood obesity. We performed a systematic review and meta-analysis of randomized controlled trials to evaluate the efficacy and safety of intensive glycemic management in pregnancy in preventing childhood obesity. METHODS: We searched MEDLINE, EMBASE, CENTRAL, and ClinicalTrials...
March 13, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28285645/treatment-of-reactive-hypoglycemia-with-the-macrobiotic-ma-pi-2-diet-as-assessed-by-continuous-glucose-monitoring-the-mahyp-randomized-crossover-trial
#18
Andreea Soare, Yeganeh Manon Khazrai, Lucia Fontana, Rossella Del Toro, Maria Concetta Lazzaro, Claudia Di Rosa, Antonia Buldo, Elvira Fioriti, Ernesto Maddaloni, Silvia Angeletti, Antonio Di Mauro, Rosaria Gesuita, Edlira Skrami, Dario Tuccinardi, Sara Fallucca, Mario Pianesi, Paolo Pozzilli
BACKGROUND AND AIMS: Nutritional therapy is recommended for management of reactive hypoglycemia (RH), a condition characterized by hypoglycemia that occurs within four hours after a meal. The macrobiotic Ma-Pi 2 diet improves glycemic control in subjects with type 2 diabetes. We explored the effect of this diet on outcomes in non-diabetic individuals with RH. MATERIALS AND METHODS: Twelve subjects with RH were randomized to the Ma-Pi 2 diet for three days and a control diet for three days in a randomized crossover design...
April 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28284809/discovery-of-orally-active-hepatoselective-glucokinase-activators-for-treatment-of-type-ii-diabetes-mellitus
#19
Jiayi Xu, Songnian Lin, Robert W Myers, Maria E Trujillo, Michele J Pachanski, Sunita Malkani, Hsuan-Shen Chen, Zhesheng Chen, Brian Campbell, George J Eiermann, Nadine Elowe, Brian T Farrer, Wen Feng, Qinghong Fu, Roman Kats-Kagan, Michael Kavana, Daniel R McMasters, Kaushik Mitra, Xinchun Tong, Libo Xu, Fengqi Zhang, Rui Zhang, George H Addona, Joel P Berger, Bei Zhang, Emma R Parmee
Systemically acting glucokinase activators (GKA) have been demonstrated in clinical trials to effectively lower blood glucose in patients with type II diabetes. However, mechanism-based hypoglycemia is a major adverse effect that limits the therapeutic potential of these agents. We hypothesized that the predominant mechanism leading to hypoglycemia is GKA-induced excessive insulin secretion from pancreatic β-cells at (sub-)euglycemic levels. We further hypothesized that restricting GK activation to hepatocytes would maintain glucose-lowering efficacy while significantly reducing hypoglycemic risk...
October 31, 2016: Bioorganic & Medicinal Chemistry Letters
https://www.readbyqxmd.com/read/28281218/evaluation-of-the-short-term-cost-effectiveness-of-ideglira-versus-continued-up-titration-of-insulin-glargine-u100-in-patients-with-type-2-diabetes-in-the-usa
#20
Barnaby Hunt, Michelle Mocarski, William J Valentine, Jakob Langer
INTRODUCTION: Effective glycemic control can reduce the risk of complications and their related costs in type 2 diabetes mellitus (T2DM). However, many patients fail to reach glycemic targets, often because of adverse effects of treatment (including hypoglycemia or weight gain). The present analysis evaluated the short-term cost-effectiveness of IDegLira versus continued up-titration of insulin glargine U100 in patients with T2DM failing to achieve glycemic control on basal insulin in the US setting...
March 9, 2017: Advances in Therapy
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