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https://www.readbyqxmd.com/read/28079250/use-of-the-ketogenic-diet-in-the-neonatal-intensive-care-unit-safety-and-tolerability
#1
Lindsey Thompson, Erin Fecske, Mohammad Salim, Ara Hall
Drug-resistant epilepsy poses a challenge in neonatal patients, especially those in the neonatal intensive care unit (NICU), who have various secondary comorbidities. We present results of four children with a history of drug-resistant epilepsy for whom a ketogenic diet was initiated and used in the NICU. A nonfasting induction into ketosis over 1-2 weeks was utilized, with gradual increases in the ketogenic ratio every 2-3 days. Data were collected retrospectively from a database, which included medical history, daily progress notes, relevant laboratory data, and imaging and diagnostic information...
January 12, 2017: Epilepsia
https://www.readbyqxmd.com/read/28077460/glyburide-versus-metformin-and-their-combination-for-the-treatment-of-gestational-diabetes-mellitus-a-randomized-controlled-study
#2
Zohar Nachum, Noah Zafran, Raed Salim, Noura Hissin, Jamal Hasanein, Yifat Gam Ze Letova, Abeer Suleiman, Enav Yefet
OBJECTIVE: To compare the efficacy and safety of glyburide versus metformin and their combination for the treatment of gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS: In this prospective randomized controlled study, we randomly assigned patients with GDM at 13-33 weeks gestation and whose blood glucose was poorly controlled by diet to receive either glyburide or metformin. If optimal glycemic control was not achieved, the other drug was added. If adverse effects occurred, the drug was replaced...
January 11, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28074109/improvement-of-quality-of-life-through-glycemic-control-by-liraglutide-a-glp-1-analog-in-insulin-naive-patients-with-type-2-diabetes-mellitus-the-page1-study
#3
Hitoshi Ishii, Tetsuji Niiya, Yasuhiro Ono, Naoyuki Inaba, Hideaki Jinnouchi, Hirotaka Watada
BACKGROUND: In addition to achieving good glycemic control, diabetes care management aims to improve the quality of life (QOL) in patients. Treatment-associated difficulties and side effects frequently cause deterioration in QOL. Liraglutide, a GLP-1 receptor agonist, is a novel injection drug that promotes insulin secretion. It is a user-friendly, once-daily injection with fewer hypoglycemic events. In this study, we aimed to examine the effect of liraglutide therapy on QOL in patients...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28070480/central-congenital-hypoventilation-syndrome-associated-with-hypoglycemia-and-seizure
#4
Emily Hopkins, James Stark, Ricardo A Mosquera
Central Congenital Hypoventilation Syndrome (CCHS) is a rare diagnosis that presents with various forms of autonomic dysfunction. The disease is characterized by reduced chemoreflexes and severe hypoventilation during sleep. Several case reports have noted that patients with CCHS have been found to suffer from hypoglycemic episodes, which frequently present as a seizure. In this report, we will review previous case presentations to alert the physicians about this association with hypoglycemic episodes. Early treatment and monitoring of hypoglycemia will prevent further complications for these populations...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28069424/different-regulation-of-insulin-on-glucose-and-lipid-metabolism-in-2-strains-of-gibel-carp
#5
Junyan Jin, Xiaoming Zhu, Dong Han, Yunxia Yang, Haokun Liu, Shouqi Xie
To test the hypothesis that response to insulin by regulating glucose and lipid metabolism in gibel carp A strain may be different from that in DT strain, bovine insulin was injected into both strains of gibel carp after previous fasting for 48 h. The results showed that insulin induced hypoglycemia at 3 h in 2 strains, and that this was coupled with increased expression of glucose transporters (GLUT2 in the liver and GLUT1, GLUT4 in the muscle) and glycolytic enzyme (HK2 in the muscle) in both strains. Insulin induced increased glycolysis (GK) and fatty acid oxidation (ACO3 in the liver and CPT1a, ACO3 in the muscle) in the DT strain...
January 6, 2017: General and Comparative Endocrinology
https://www.readbyqxmd.com/read/28065242/advances-in-glycemic-characteristics-complications-and-treatment-for-patients-undergoing-total-pancreatectomy
#6
Ying Zhou, Wei-Gang Zhao
Total pancreatectomy has been mainly used to treat malignant diseases of the pancreas, di-ffuse ductal involvement, and severe chronic pancreatitis. Patients may develop pancreatic diabetes after the surgery, in whom the glucose levels fluctuate widely and are hard to control, which increases the incidence of recurrent hypoglycemia. Postoperative complications are closely associated with the glucose levels. Thus, tighter glycemic management is essential for increasing the survival of these patients. Few cases have been discribed in China...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28061430/exploring-the-characteristics-of-suboptimally-controlled-patients-after-24weeks-of-basal-insulin-treatment-an-individualized-approach-to-intensification
#7
Kamlesh Khunti, Taner Damci, Lise Lotte Husemoen, Vinay Babu, Andreas Liebl
AIM: To identify characteristics of suboptimally controlled patients with type 2 diabetes (T2DM) on basal insulin treatment who may benefit from intensive titration or further intensification of treatment. METHODS: A post hoc analysis of SOLVE: a 24-week, international, observational study conducted in 17,374 patients with T2DM inadequately controlled on oral antidiabetic drugs (OADs) started on once-daily insulin detemir. Patients were divided into two groups based on whether they achieved HbA1c<7...
December 9, 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28060579/a-comparison-of-the-metabolic-complications-and-hospital-course-of-severe-anorexia-nervosa-by-binge-purge-and-restricting-subtypes
#8
Melanie Rylander, John T Brinton, Allison L Sabel, Philip S Mehler, Jennifer L Gaudiani
This study examines adult patients with severe, life-threatening anorexia nervosa who were admitted to an inpatient, medical stabilization unit between October 1, 2008 and December 31, 2014. Specifically, the study compares anorexia nervosa, binge purge subtype (AN-BP) and anorexia nervosa, restricting subtype (AN-R) on admission measures, hospital course, and outcomes. Of the 232 patients, 46% (N = 108) had AN-BP. Patients with AN-R manifested a higher frequency of underweight-mediated medical complications, including bone marrow dysfunction, hepatic dysfunction, and hypoglycemia...
January 6, 2017: Eating Disorders
https://www.readbyqxmd.com/read/28057693/assessing-the-safety-of-sitagliptin-in-older-participants-in-the-trial-evaluating-cardiovascular-outcomes-with-sitagliptin-tecos
#9
M Angelyn Bethel, Samuel S Engel, Jennifer B Green, Zhen Huang, Robert G Josse, Keith D Kaufman, Eberhard Standl, Shailaja Suryawanshi, Frans Van de Werf, Darren K McGuire, Eric D Peterson, Rury R Holman
OBJECTIVE: Limited data exist regarding safety and efficacy of antihyperglycemic drugs in older patients with type 2 diabetes. The Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS) was a randomized, double-blind, placebo-controlled trial assessing the impact of sitagliptin on a primary composite outcome of cardiovascular death, nonfatal stroke, nonfatal myocardial infarction, or unstable angina hospitalizations in patients with type 2 diabetes (HbA1c ≥6.5% [48 mmol/mol] and ≤8...
January 5, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28056431/second-line-initiation-of-insulin-compared-with-dpp-4-inhibitors-after-metformin-monotherapy-is-associated-with-increased-risk-of-all-cause-mortality-cardiovascular-events-and-severe-hypoglycemia
#10
Thomas Nyström, Johan Bodegard, David Nathanson, Marcus Thuresson, Anna Norhammar, Jan W Eriksson
AIMS: The objective of this nationwide study was to compare the risk of all-cause mortality, fatal and nonfatal cardiovascular disease (CVD), and severe hypoglycemia in patients with type 2 diabetes (T2D) on metformin monotherapy treatment starting second-line treatment with either insulin or dipeptidyl peptidase-4 inhibitor (DPP-4i). METHODS: All patients with T2D in Sweden who initiated second-line treatment with insulin or DPP-4i after metformin monotherapy during 2007-2014 identified in the Swedish Prescribed Drug Register were followed for outcome in the Cause of Death and National Patient Registers...
December 19, 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28054743/hypoglycemia-evaluation-and-reporting-in-diabetes-importance-for-the-development-of-new-therapies
#11
David C Klonoff, G Alexander Fleming, Douglas B Muchmore, Brian M Frier
Hypoglycemia complicating diabetes therapy is well recognized to be an ever-present threat to patients, their families, providers, payers and regulators. Despite this being widely acknowledged, the regulatory stance on hypoglycemia as an endpoint in clinical trials to support new product registration has not evolved in any meaningful way since the publication of a position paper by an American Diabetes Association (ADA) Workgroup in 2005. As the impact of hypoglycemia on persons affected by diabetes is of major importance when assessing new treatments, the historical position of regulatory agencies on hypoglycemia is reviewed with respect to product approvals...
January 5, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28053550/real-world-medication-persistence-and-outcomes-associated-with-basal-insulin-and-glucagon-like-peptide-1-receptor-agonist-free-dose-combination-therapy-in-patients-with-type-2-diabetes-in-the-us
#12
Jay Lin, Melissa Lingohr-Smith, Tao Fan
BACKGROUND: Free-dose combination treatment with basal insulin and short-acting glucagon-like peptide-1 receptor agonists (GLP-1 RAs) reduces hyperglycemia via complementary targeting of fasting and postprandial blood glucose levels, however, in the real world, due to injection burden and clinical inertia, the full efficacy may not be able to translate into clinical and economic benefits. OBJECTIVE: The aim of the study was to evaluate treatment persistence and associated outcomes in patients with type 2 diabetes (T2D) treated with a GLP-1 RA in free-dose combination with basal insulin...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28049286/is-islet-transplantation-a-realistic-approach-to-curing-diabetes
#13
REVIEW
Sang-Man Jin, Kwang-Won Kim
Since the report of type 1 diabetes reversal in seven consecutive patients by the Edmonton protocol in 2000, pancreatic islet transplantation has been reappraised based on accumulated clinical evidence. Although initially expected to therapeutically target long-term insulin independence, islet transplantation is now indicated for more specific clinical benefits. With the long-awaited report of the first phase 3 clinical trial in 2016, allogeneic islet transplantation is now transitioning from an experimental to a proven therapy for type 1 diabetes with problematic hypoglycemia...
January 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28040350/improved-treatment-satisfaction-in-patients-with-type-1-diabetes-treated-with-insulin-glargine-100u-ml-versus-neutral-protamine-hagedorn-insulin-an-exploration-of-key-predictors-from-two-randomized-controlled-trials
#14
William Polonsky, Louise Traylor, Ling Gao, Wenhui Wei, Barbara Ameer, Andreas Stuhr, Aleksandra Vlajnic
AIM: Investigate contributors to treatment satisfaction in type 1 diabetes (T1D). METHODS: Post-hoc analysis using the Diabetes Treatment Satisfaction Questionnaire status version (DTSQs) in 771 T1D patients from two 28-week trials comparing once-daily insulin glargine 100U/mL (Gla-100) with once- or twice-daily NPH neutral protamine Hagedorn (NPH) insulin. RESULTS: Gla-100 was associated with a significant improvement in treatment satisfaction versus NPH (overall population adjusted mean [standard error] DTSQs change from baseline: +1...
December 8, 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28039172/toward-defining-the-threshold-between-low-and-high-glucose-variability-in-diabetes
#15
Louis Monnier, Claude Colette, Anne Wojtusciszyn, Sylvie Dejager, Eric Renard, Nicolas Molinari, David R Owens
OBJECTIVE: To define the threshold for excess glucose variability (GV), one of the main features of dysglycemia in diabetes. RESEARCH DESIGN AND METHODS: A total of 376 persons with diabetes investigated at the University Hospital of Montpellier (Montpellier, France) underwent continuous glucose monitoring. Participants with type 2 diabetes were divided into several groups-groups 1, 2a, 2b, and 3 (n = 82, 28, 65, and 79, respectively)-according to treatment: 1) diet and/or insulin sensitizers alone; 2) oral therapy including an insulinotropic agent, dipeptidyl peptidase 4 inhibitors (group 2a), or sulfonylureas (group 2b); or 3) insulin...
December 30, 2016: Diabetes Care
https://www.readbyqxmd.com/read/28036112/protocol-of-glucose-control-safety-and-efficacy-in-type-2-diabetes-a-network-meta-analysis-glucose-dinet-protocol-rational-and-design
#16
REVIEW
Guillaume Grenet, Audrey Lajoinie, Shams Ribault, Gia Bao Nguyen, Thomas Linet, Augustin Metge, Catherine Cornu, Michel Cucherat, Philippe Moulin, François Gueyffier
The aim of this study is to propose a ranking of the currently available antidiabetic drugs, regarding vascular clinical outcomes, in type 2 diabetic patients, through a network meta-analysis approach. Randomized clinical trials, regardless of the blinding design, testing contemporary antidiabetic drugs and considering clinically relevant outcomes in patients with type 2 diabetes mellitus will be included. The primary outcomes of this analysis will be overall mortality, cardiovascular mortality, and major cardiovascular events...
December 30, 2016: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28035868/a-randomized-clinical-trial-of-the-safety-and-efficacy-of-sitagliptin-in-patients-with-type-2-diabetes-mellitus-inadequately-controlled-by-acarbose-alone
#17
Weiqing Wang, Guang Ning, Jianhua Ma, Xiaomin Liu, Shaoxiong Zheng, Fan Wu, Lei Xu, Edward A O'Neill, Kenji P Fujita, Samuel S Engel, Keith D Kaufman, R Ravi Shankar
OBJECTIVE: To evaluate the safety and efficacy of sitagliptin when added to the treatment of patients with type 2 diabetes mellitus (T2DM) and inadequate glycemic control on acarbose monotherapy. RESEARCH DESIGN AND METHODS: This was a multicenter, randomized, placebo-controlled, double-blind clinical trial. Patients (N = 381) with T2DM and inadequate glycemic control (glycated hemoglobin [HbA1c] ≥7.0% and ≤10.0%) on acarbose monotherapy (at least 50 mg three times daily) were randomized in a 1:1 ratio to receive the addition of sitagliptin 100 mg or matching placebo once daily for 24 weeks...
December 30, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28035840/cost-effectiveness-of-switching-to-insulin-degludec-from-other-basal-insulins-evidence-from-swedish-real-world-data
#18
Lena Landstedt-Hallin, Jens Gundgaard, Åsa Ericsson, Susanne Ellfors-Zetterlund
OBJECTIVES: Health economic analysis from a health care and societal point of view was conducted to assess cost-effectiveness of insulin degludec (IDeg) after switching from other basal insulins in people with type 1 diabetes. MATERIAL AND METHODS: This was a prospective, open-label, single arm, observational follow-up from August 2013-October 2015 of 476 consecutive patients at Danderyd Hospital [Stockholm, Sweden] who switched to IDeg from other basal insulins (99% basal insulin analogs)...
December 30, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28031777/place-of-technosphere-inhaled-insulin-in-treatment-of-diabetes
#19
REVIEW
Nasser Mikhail
Technosphere insulin (TI), Afrezza, is a powder form of short-acting regular insulin taken by oral inhalation with meals. Action of TI peaks after approximately 40-60 min and lasts for 2-3 h. TI is slightly less effective than subcutaneous insulin aspart, with mean hemoglobin A1c (HbA1c) reduction of 0.21% and 0.4%, respectively. When compared with technosphere inhaled placebo, the decrease in HbA1c levels was 0.8% and 0.4% with TI and placebo, respectively. Compared with insulin aspart, TI is associated with lower risk of late post-prandial hypoglycemia and weight gain...
December 15, 2016: World Journal of Diabetes
https://www.readbyqxmd.com/read/28029018/exenatide-versus-insulin-lispro-added-to-basal-insulin-in-a-subgroup-of-korean-patients-with-type-2-diabetes-mellitus
#20
Kun Ho Yoon, Elise Hardy, Jenny Han
BACKGROUND: The prevalence of type 2 diabetes mellitus (T2DM) and obesity is increasing in Korea. Clinical studies in patients with T2DM have shown that combining the glucagon-like peptide-1 receptor agonist exenatide twice daily with basal insulin is an effective glucose-lowering strategy. However, these studies were predominantly conducted in non-Asian populations. METHODS: We conducted a subgroup analysis of data from a multinational, 30-week, randomized, open-label trial to compare the effects of exenatide twice daily (n=10) or three times daily mealtime insulin lispro (n=13) among Korean patients with T2DM inadequately controlled (glycosylated hemoglobin [HbA1c] >7...
December 26, 2016: Diabetes & Metabolism Journal
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