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elderly insulin treatment

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https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#1
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28397367/continuous-glucose-monitoring-reveals-hypoglycemia-risk-in-elderly-patients-with-type-2-diabetes-mellitus
#2
Takahiro Ishikawa, Masaya Koshizaka, Yoshiro Maezawa, Minoru Takemoto, Yoshiharu Tokuyama, Toshihiro Saito, Koutaro Yokote
INTRODUCTION: The incidence of type 2 diabetes is higher in elderly patients, in whom this disease is associated with dementia, falling, stroke, and death. We utilized a continuous glucose monitoring (CGM) device to analyze the relationship between hypoglycemia and diabetes treatments to identify risk factors for hypoglycemia (defined as a blood glucose level <70 mg/dL). MATERIALS AND METHODS: We classified 170 patients aged ≥65 years with type 2 diabetes who were receiving steady-state medication (29 of whom were inpatients) into hypoglycemic and non-hypoglycemic groups, and compared their HbA1c levels, treatment types, continuous glucose monitoring data, and other parameters...
April 11, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28393573/persistence-with-rapid-acting-insulin-and-its-association-with-a1c-level-and-severe-hypoglycemia-among-elderly-patients-with-type-2-diabetes
#3
Usha Sambamoorthi, Rahul Garg, Arijita Deb, Tao Fan, Anders Boss
OBJECTIVE: To examine the persistence with rapid-acting insulin (RAI) and its association with clinical outcomes among elderly patients with type 2 diabetes (T2D). METHODS: This observational, retrospective cohort study analyzed RAI persistence and its association with change in A1C and risk of severe hypoglycemia among elderly (≥65 years) Medicare beneficiaries with T2D who added RAI to their basal insulin regimen. RESULTS: Among T2D patients with >1 RAI prescriptions (n = 3,927), only 21% were persistent...
April 10, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28382782/fatty-acid-binding-protein-4-regulates-fatty-infiltration-after-rotator-cuff-tear-by-hypoxia-inducible-factor-1-in-mice
#4
Yong-Soo Lee, Ja-Yeon Kim, Kyung-Soo Oh, Seok Won Chung
BACKGROUND: Fatty infiltration in skeletal muscle is directly linked to loss of muscle strength and is associated with various adverse physical outcomes such as muscle atrophy, inflammation, insulin resistance, mobility impairments, and even mortality in the elderly. Aging, mechanical unloading, muscle injury, and hormonal imbalance are main causes of muscle fat accumulation, and the fat cells are derived from muscle stem cells via adipogenic differentiation. However, the pathogenesis and molecular mechanisms of fatty infiltration in muscles are still not fully defined...
April 5, 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/28372715/management-of-hyperglycemic-crises-diabetic-ketoacidosis-and-hyperglycemic-hyperosmolar-state
#5
REVIEW
Maya Fayfman, Francisco J Pasquel, Guillermo E Umpierrez
Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are the most serious and life-threatening hyperglycemic emergencies in diabetes. DKA is more common in young people with type 1 diabetes and HHS in adult and elderly patients with type 2 diabetes. Features of the 2 disorders with ketoacidosis and hyperosmolality may coexist. Both are characterized by insulinopenia and severe hyperglycemia. Early diagnosis and management are paramount. Treatment is aggressive rehydration, insulin therapy, electrolyte replacement, and treatment of underlying precipitating events...
May 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28324596/blood-pressure-and-metabolic-changes-after-3-month-cpap-therapy-in-a-very-elderly-obese-with-severe-obstructive-sleep-apnea-a-case-report-and-review-of-the-literature
#6
Francesco Spannella, Federico Giulietti, Chiara Di Pentima, Francesca Elena Lombardi, Elisabetta Borioni, Riccardo Sarzani
Age is one of the main risk factor for the presence of obstructive sleep apnea (OSA). This syndrome is associated with hypertension, cardiovascular disease, cognitive impairment and metabolic abnormalities, such as type 2 diabetes. Continuous positive airway pressure (CPAP) represents the gold standard therapy, but its benefit is still to be determined in very elderly. We report the blood pressure and metabolic changes in a very elderly obese with severe OSA after 3-month CPAP therapy. We have evaluated a very elderly obese male affected by severe symptomatic OSA, poor controlled nocturnal hypertension and insulin resistance...
March 21, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28314656/safety-and-efficacy-of-a-basal-plus-regimen-with-insulin-glargine-and-insulin-glulisine-for-elderly-patients-with-high-cardiovascular-risk-and-type-2-diabetes-mellitus
#7
R Gómez-Huelgas, J Sabán-Ruiz, F J García-Román, N Quintela-Fernández, J M Seguí-Ripoll, M V Bonilla-Hernández, G Romero-Meliá
OBJECTIVES: To assess the safety and efficacy of a basal-plus (BP) regimen with insulin glargine (as basal insulin) and insulin glulisine (as prandial insulin) with the main meal for elderly patients with type 2 diabetes mellitus (DM2) and high cardiovascular risk, following standard clinical practice. PATIENTS AND METHODS: An observational, retrospective study was conducted in 21 centres of internal medicine in Spain. The study included patients aged 65 years or older with DM2, undergoing treatment with a BP regimen for 4 to 12 months before inclusion in the study and a diagnosis of cardiovascular disease or high cardiovascular risk...
March 14, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28300617/sex-and-gender-related-prevalence-cardiovascular-risk-and-therapeutic-approach-in-metabolic-syndrome-a-review-of-the-literature
#8
REVIEW
Giacomo Pucci, Riccardo Alcidi, Lisanne Tap, Francesca Battista, Francesco Mattace-Raso, Giuseppe Schillaci
Metabolic syndrome (MS), a cluster of metabolic abnormalities linked to insulin-resistance and abdominal obesity, is associated with an increased risk of Type II diabetes mellitus (DM) and cardiovascular (CV) disease. Its prevalence is high, affecting 20%-30% of the general population, and increases with age in a sex-specific manner: in fact, while below 50 years it is slightly higher in men, it reverses after 50 years. The pronounced age-related increase in the prevalence of MS in women occurs as the result of several factors, which may be classified into sex- and gender-related factors...
March 12, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28295976/insulin-like-growth-factor-1-deficiency-exacerbates-hypertension-induced-cerebral-microhemorrhages-in-mice-mimicking-the-aging-phenotype
#9
Stefano Tarantini, Noa M Valcarcel-Ares, Andriy Yabluchanskiy, Zsolt Springo, Gabor A Fulop, Nicole Ashpole, Tripti Gautam, Cory B Giles, Jonathan D Wren, William E Sonntag, Anna Csiszar, Zoltan Ungvari
Clinical and experimental studies show that aging exacerbates hypertension-induced cerebral microhemorrhages (CMHs), which progressively impair neuronal function. There is growing evidence that aging promotes insulin-like growth factor 1 (IGF-1) deficiency, which compromises multiple aspects of cerebromicrovascular and brain health. To determine the role of IGF-1 deficiency in the pathogenesis of CMHs, we induced hypertension in mice with liver-specific knockdown of IGF-1 (Igf1(f/f)  + TBG-Cre-AAV8) and control mice by angiotensin II plus l-NAME treatment...
March 14, 2017: Aging Cell
https://www.readbyqxmd.com/read/28253329/metformin-inhibits-the-proliferation-of-benign-prostatic-epithelial-cells
#10
Zongwei Wang, Xingyuan Xiao, Rongbin Ge, Jijun Li, Cameron W Johnson, Cyrus Rassoulian, Aria F Olumi
OBJECTIVE: Benign prostatic hyperplasia (BPH) is the most common proliferative abnormality of the prostate affecting elderly men throughout the world. Epidemiologic studies have shown that diabetes significantly increases the risk of developing BPH, although whether anti-diabetic medications preventing the development of BPH remains to be defined. We have previously found that stromally expressed insulin-like growth factor 1 (IGF-1) promotes benign prostatic epithelial cell proliferation through paracrine mechanisms...
2017: PloS One
https://www.readbyqxmd.com/read/28238154/the-gestio-protocol-experience-safety-of-a-standardized-order-set-for-subcutaneous-insulin-regimen-in-elderly-hospitalized-patients
#11
Alessandro Franchin, Alberto Maran, Daniela Bruttomesso, Maria L Corradin, Francesco Rossi, Federica Zanatta, Gian-Maria Barbato, Nicola Sicolo, Enzo Manzato
BACKGROUNDS: In non-critical hospitalized patients with diabetes mellitus, guidelines suggest subcutaneous insulin therapy with basal-bolus regimen, even in old and vulnerable inpatients. AIM: To evaluate safety, efficacy, and benefit on clinical management of the GesTIO protocol, a set of subcutaneous insulin administration rules, in old and vulnerable non-ICU inpatients. METHODS: Retrospective, observational study. Patients admitted to Geriatric Clinic of Padua were studied...
February 25, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28099900/skeletal-muscle-aging-influence-of-oxidative-stress-and-physical-exercise
#12
REVIEW
Mariana Janini Gomes, Paula Felippe Martinez, Luana Urbano Pagan, Ricardo Luiz Damatto, Marcelo Diacardia Mariano Cezar, Aline Regina Ruiz Lima, Katashi Okoshi, Marina Politi Okoshi
Skeletal muscle abnormalities are responsible for significant disability in the elderly. Sarcopenia is the main alteration occurring during senescence and a key public health issue as it predicts frailty, poor quality of life, and mortality. Several factors such as reduced physical activity, hormonal changes, insulin resistance, genetic susceptibility, appetite loss, and nutritional deficiencies are involved in the physiopathology of muscle changes. Sarcopenia is characterized by structural, biochemical, molecular and functional muscle changes...
March 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/28056470/-anti-diabetic-medication-during-the-first-four-years-of-treatment-a-study-based-on-claims-data
#13
Veronika Lappe, Ingrid Köster, Ingrid Schubert
Background Ever since the UKPDS study reassessed the usefulness of the substance metformin in 1998, it has been the first-line medication in anti-diabetic treatment. In addition, new classes and agents released on the market have given rise to new treatment options. The present study investigates prescription practice at the onset of treatment and in the years thereafter and measures it against German diabetes guidelines. Database and Methods Database: Statutory health insurance sample AOK/KV Hesse; Ages: 40 and over (N = 142514)...
January 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28043897/natural-products-against-alzheimer-s-disease-pharmaco-therapeutics-and-biotechnological-interventions
#14
REVIEW
Abhijit Dey, Raktim Bhattacharya, Anuradha Mukherjee, Devendra Kumar Pandey
Alzheimer's disease (AD) is a severe, chronic and progressive neurodegenerative disease associated with memory and cognition impairment ultimately leading to death. It is the commonest reason of dementia in elderly populations mostly affecting beyond the age of 65. The pathogenesis is indicated by accumulation of the amyloid-beta (Aβ) plaques and neurofibrillary tangles (NFT) in brain tissues and hyperphosphorylation of tau protein in neurons. The main cause is considered to be the formation of reactive oxygen species (ROS) due to oxidative stress...
March 2017: Biotechnology Advances
https://www.readbyqxmd.com/read/27921419/-metabolic-syndrome-in-patients-with-diabetes-mellitus-type-1-prevalence-impact-on-morbidity-and-mortality
#15
Jitka Brožová, Daniela Čechurová, Silvie Lacigová
Aim of this retrospective observational study was to determine the prevalence of metabolic syndrome (MS) in patients with diabetes mellitus type 1 (DM1Z) at baseline (in 2003) and find the parameters that determine the difference between group with (MS+) and without MS (MS-). Did the presence of MS affect morbidity and mortality in the subsequent 10 years? METHODS: 278 patients were enrolled to the study with age average 39 ± 13 years with medical history of diabetes 15.9 ± 9 years...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27885860/pioglitazone-for-the-treatment-of-alzheimer-s-disease
#16
REVIEW
Daniela Galimberti, Elio Scarpini
Alzheimer's disease (AD) is the most common cause of dementia in the elderly. Pharmacological treatment of AD includes Anticholinesterase Inhibitors (AChEIs) for mild-moderate AD, and memantine for severe AD. These drugs provide mainly symptomatic short-term benefits without clearly influencing the progression of the disease. Pioglitazone (AD4833) is an insulin sensitizer of the thiazolidinedione class of nuclear Peroxisome-Proliferator Activated Receptor γ (PPARγ) agonists. It binds to PPARγ, affecting gene transcription and reducing inflammation...
January 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27882107/effects-of-sitagliptin-as-initial-therapy-in-newly-diagnosed-elderly-type-2-diabetics-a-randomized-controlled-study
#17
Xiaoyan Xiao, Xiaopei Cui, Jianbo Zhang, Zhenxia Han, Yu Xiao, Nan Chen, Baoying Li, Mei Cheng, Haiqing Gao, Kuanxiao Tang
The objective of this study was to investigate the characteristics of blood glycemic excursion, incretins and pancreatic hormone secretion in elderly people with newly diagnosed type 2 diabetes mellitus (T2DM) and to study the effects of sitagliptin on glycemic excursion in these subjects. A total of 129 newly diagnosed T2DM patients were enrolled in the study from March 2012 to August 2013. Clinical data, serum incretin, pancreatic hormone and continuous glucose monitoring data were collected. Among these subjects, elderly patients (NEDM) randomly received metformin combined with sitagliptin phosphate or glimepiride for 24 weeks...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27843832/evaluation-of-quality-of-life-and-depression-levels-in-individuals-with-type-2-diabetes
#18
Ali Altınok, Kamile Marakoğlu, Nisa Çetin Kargın
INTRODUCTION: Improving the quality of life in diabetic individuals is known to reduce morbidity and mortality. We aimed to investigate the quality of life and depression symptomatology situations and the related factors in patients with Type 2 diabetes mellitus (DM) in this study. MATERIALS AND METHODS: In this study, 440 adult patients with Type 2 DM and under treatment admitted to Selcuk University Family Medicine Outpatient Diabetes Education Clinic were included in the study...
April 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/27789974/nationwide-trends-in-glucose-lowering-drug-use-denmark-1999-2014
#19
Diana Hedevang Christensen, Jørgen Rungby, Reimar Wernich Thomsen
PURPOSE: The objective of this study was to examine nationwide population-based time trends in the utilization of all glucose-lowering drugs in Denmark from 1999 to 2014. METHODS: Based on nationwide data from the Register of Medicinal Products Statistics, we retrieved sales statistics on glucose-lowering drugs and reported the total number of users and the prevalence of users per 1,000 inhabitants in 1-year intervals for all glucose-lowering drug classes. RESULTS: The annual prevalence of glucose-lowering drug users increased more than twofold from 19 per 1,000 inhabitants in 1999 (n=98,362) to 41 per 1,000 in 2014 (n=233,230)...
2016: Clinical Epidemiology
https://www.readbyqxmd.com/read/27771738/serum-dehydroepiandrosterone-levels-are-associated-with-lower-risk-of-type-2-diabetes-the-rotterdam-study
#20
Adela Brahimaj, Taulant Muka, Maryam Kavousi, Joop S E Laven, Abbas Dehghan, Oscar H Franco
AIMS/HYPOTHESIS: Previous literature documents controversial results for the impact of dehydroepiandrosterone (DHEA) in glucose metabolism. We aimed to assess the associations between serum levels of DHEA and its main derivatives DHEA sulphate (DHEAS) and androstenedione, as well as the ratio of DHEAS to DHEA, and risk of type 2 diabetes. METHODS: We used data on serum levels of DHEA, DHEAS and androstenedione from 5189 middle-aged and elderly men and women from the prospective population-based Rotterdam Study...
January 2017: Diabetologia
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