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elderly insulin treatment

D L Liang, X Y Li, L Wang, H Xu, X P Tuo, Z J Jian
Objective: To investigate the current status and influence factors of ACEI/ARB application in elderly coronary heart disease outpatients complicated with diabetes mellitus in 21 provinces of China. Methods: In this multicenter, non-intervention and cross-sectional survey, the elderly coronary heart disease patients aged 60 years or over were recruited from 165 hospitals in 21 provinces across China from April to July 2011. Current status and influence factors of ACEI/ARB application among 1 789 cases with diabetes mellitus were investigated in the survey...
September 27, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Shokei Kim-Mitsuyama
There is accumulating evidence that RAS inhibitors not only reduce blood pressure, but also exert pleiotropic effects, including a renoprotective effect, amelioration of insulin resistance, reduction in onset of diabetes, and suppression of cardiovascular remodelling,. However, the definite benefit of RAS inhibition in treatment of hypertension with CKD or DM is not conclusive. We previously performed the OlmeSartan and Calcium Antagonists Randomized (OSCAR) study comparing the preventive effect of high-dose ARB therapy versus ARB plus CCB combination therapy on cardiovascular morbidity and mortality in 1164 Japanese elderly hypertensive patients with baseline type 2 diabetes and/or CVD (Am J Med (2012))...
September 2016: Journal of Hypertension
Rajendra Pradeepa, Jayagopi Surendar, Karunakaran Indulekha, Sundarapandi Chella, Ranjit Mohan Anjana, Viswanathan Mohan
OBJECTIVE: The aim of this study was to assess the prevalence of metabolic syndrome (MS) and its association with coronary artery disease (CAD) among an elderly urban population in south India. METHODS: Individuals aged ≥60 years (n=222) were recruited from Phase 3 of the Chennai Urban Rural Epidemiology Study. Anthropometric and blood pressure measurements, oral glucose tolerance test, lipids and fasting insulin were carried out. Prevalence of MS was estimated using the World Health Organization (WHO), Modified National Cholesterol Education Program's Adult Treatment Panel III (ATP-III) and International Diabetes Federation (IDF) criteria...
May 2016: Journal of the Association of Physicians of India
Hanne Haahr, Edmond G Fita, Tim Heise
Insulin degludec/insulin aspart (IDegAsp; 70 % IDeg and 30 % IAsp) is a soluble combination of two individual insulin analogues in one product, designed to provide mealtime glycaemic control due to the IAsp component and basal glucose-lowering effect from the IDeg component. The pharmacokinetic and pharmacodynamic characteristics of IDegAsp have been investigated in a series of clinical pharmacology studies with generally comparable designs, methodologies and patient inclusion/exclusion criteria. The glucose-lowering effect profile of IDegAsp during once-daily dosing at steady state shows distinct and clearly separated action from the prandial and basal components of IDegAsp...
October 1, 2016: Clinical Pharmacokinetics
Märit Wallander, Kristian Axelsson, Anna G Nilsson, Dan Lundh, Mattias Lorentzon
Questions remain about whether the increased risk of fractures in patients with type 2 diabetes (T2DM) is related mainly to increased risk of falling or to bone-specific properties. The primary aim of this study was to investigate the risk of hip fractures and non-skeletal fall injuries in older men and women with and without T2DM. We included 429,313 individuals (80.8 ± 8.2 years (mean ± SD), 58% women) from the Swedish registry "Senior Alert" and linked the data to several nation-wide registers...
September 24, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Shokei Kim-Mitsuyama
There is accumulating evidence that RAS inhibitors not only reduce blood pressure, but also exert pleiotropic effects, including a renoprotective effect, amelioration of insulin resistance, reduction in onset of diabetes, and suppression of cardiovascular remodelling,. However, the definite benefit of RAS inhibition in treatment of hypertension with CKD or DM is not conclusive. We previously performed the OlmeSartan and Calcium Antagonists Randomized (OSCAR) study comparing the preventive effect of high-dose ARB therapy versus ARB plus CCB combination therapy on cardiovascular morbidity and mortality in 1164 Japanese elderly hypertensive patients with baseline type 2 diabetes and/or CVD (Am J Med (2012))...
September 2016: Journal of Hypertension
Yoshio Nagai, Mariko Murakami, Kana Igarashi, Yuta Nakamura, Hidekazu Tsukiyama, Fumiaki Matsubara, Ami Nishine, Toshihiko Ohshige, Satoshi Ishii, Hiroyuki Kato, Yasushi Tanaka
As life expectancy becomes longer in Japan, there has been an increase of elderly patients with type 2 diabetes who need insulin therapy but cannot perform self-injection due to dementia or other conditions. Therefore, the aim of this study was to investigate the efficacy and safety of thrice-weekly insulin degludec therapy in elderly patients with poorly controlled diabetes. The subjects were 22 hospitalized elderly Japanese patients with type 2 diabetes who had difficulty with self-injection. After becoming stable on once-daily insulin degludec treatment, they were assigned to continue once-daily injection (OD group) or were switched to thrice-weekly injection (TW group) for one week...
September 2, 2016: Endocrine Journal
Bruce C Stuart, Xian Shen, Charlene C Quinn, Nicole Brandt, Pamela Roberto, F Ellen Loh, Franklin Hendrick, Caroline Kim, Xingyue Huang, Swapnil Rajpathak
BACKGROUND: Noninsulin antihyperglycemic agents (NAAs) are the mainstay of treatment for type 2 diabetes, yet persistence in NAA use is suboptimal in many diabetes patients. Most of the research on NAA discontinuance has focused on sociodemographic characteristics and general health status, but such factors are inherently limited in explaining dynamic events such as discontinuance. OBJECTIVE: To assess the relative importance of static and proximal dynamic factors in explaining long-term NAA discontinuance among Medicare beneficiaries with diabetes...
September 2016: Journal of Managed Care & Specialty Pharmacy
Carla Sancho-Mestre, David Vivas-Consuelo, Luis Alvis-Estrada, Martin Romero, Ruth Usó-Talamantes, Vicent Caballer-Tarazona
BACKGROUND: The objective of the study is to estimate the frequency of multimorbidity in type 2 diabetes patients classified by health statuses in a European region and to determine the impact on pharmaceutical expenditure. METHODS: Cross-sectional study of the inhabitants of a southeastern European region with a population of 5,150,054, using data extracted from Electronic Health Records for 2012. 491,854 diabetic individuals were identified and selected through clinical codes, Clinical Risk Groups and diabetes treatment and/or blood glucose reagent strips...
2016: BMC Health Services Research
Vincent Lak, Ann-Marie Svensson, Mervete Miftaraj, Stefan Franzén, Björn Eliasson
INTRODUCTION: Studies comparing direct-acting insulin analogs (DAIs) in terms of effectiveness and long-term safety are scarce. Our aim was to explore these variables in clinical practice among patients with type 1 diabetes, including the elderly and those with renal impairment. METHODS: We linked four national registers in a population-based cohort study. Patients with type 1 diabetes and continuous use of all currently available DAIs (lispro, aspart, or glulisine) in 2005-2013 were monitored for up to 7...
September 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Masaki Mogi, Katsuhiko Kohara, Hirotomo Nakaoka, Harumi Kan-No, Kana Tsukuda, Xiao-Li Wang, Toshiyuki Chisaka, Hui-Yu Bai, Bao-Shuai Shan, Masayoshi Kukida, Jun Iwanami, Tetsuro Miki, Masatsugu Horiuchi
BACKGROUND: Sarcopenic obesity, age-related muscle loss, which is compensated by an increase in fat mass, impairs quality of life in elderly people. Although the increase in intramuscular fat is associated with decreased insulin sensitivity and increased metabolic risk factors, the origin of diabetes-associated intramuscular fat has not been elucidated. Here, we investigated intramuscular fat deposition using a muscle injury model in type 2 diabetic mice. METHODS: Male 8-week-old C57BL/6 and 8-week-old and 26-week-old KKAy underwent intramuscular injection of cardiotoxin (Ctx) (100 μL/10 μM) into the tibialis anterior (TA) muscles...
May 2016: Journal of Cachexia, Sarcopenia and Muscle
Ki-Hoon Park, Jae-Yong Kim, Inho Choi, Jae-Ryong Kim, Kyu Chang Won, Kyung-Hyun Cho
Glycation of apolipoproteins is a major feature of the production of dysfunctional high-density lipoprotein (HDL), which is associated with the incidence of several metabolic diseases such as coronary artery disease and diabetes. In this report, fructated apoA-I (fA-I) induced by fructose treatment showed a covalently multimerized band without cross-linking, and lysine residues were irreversibly modified to prevent crosslinking. Using pancreatic β-cells, insulin secretion was impaired by fA-I in the lipid-free and reconstituted HDL (rHDL) states, by up to 35%, and 40%, respectively, under hyperglycemic conditions (25 mmol/L glucose)...
August 2016: Biochemistry and Cell Biology, Biochimie et Biologie Cellulaire
Anne Camirand, David Goltzman, Ajay Gupta, Mohammadi Kaouass, Dibyendu Panda, Andrew Karaplis
Prolonged skeletal unloading through bedrest results in bone loss similar to that observed in elderly osteoporotic patients, but with an accelerated timeframe. This rapid effect on weight-bearing bones is also observed in astronauts who can lose up to 2% of their bone mass per month spent in Space. Despite the important implications for Spaceflight travelers and bedridden patients, the exact mechanisms involved in disuse osteoporosis have not been elucidated. Parathyroid hormone-related protein (PTHrP) regulates many physiological processes including skeletal development, and has been proposed as a mechanosensor...
2016: PloS One
Ghada El-Hajj Fuleihan, Rafic Baddoura, Robert H Habib, Georges Halaby, Asma Arabi, Maya Rahme, Ravinder J Singh, Moustapha Kassem, Ziyad Mahfoud, Maha Hoteit, Rose T Daher, Mohamed-Faisal Kassir
BACKGROUND: It is unclear whether and at what dose vitamin D supplementation affects insulin resistance (IR). OBJECTIVE: We sought to investigate whether vitamin D at doses higher than currently recommended decreases indexes of IR in an ambulatory population of overweight elderly subjects. DESIGN: This double-blind, randomized, controlled multicenter trial enrolled 257 elderly overweight individuals aged ≥65 y with baseline 25-hydroxyvitamin D [25(OH)D] concentrations between 10 and 30 ng/mL...
August 2016: American Journal of Clinical Nutrition
Mark W Hamrick, Meghan E McGee-Lawrence, Danielle M Frechette
Skeletal muscle and bone share common embryological origins from mesodermal cell populations and also display common growth trajectories early in life. Moreover, muscle and bone are both mechanoresponsive tissues, and the mass and strength of both tissues decline with age. The decline in muscle and bone strength that occurs with aging is accompanied in both cases by an accumulation of adipose tissue. In bone, adipocyte (AC) accumulation occurs in the marrow cavities of long bones and is known to increase with estrogen deficiency, mechanical unloading, and exposure to glucocorticoids...
2016: Frontiers in Endocrinology
Thewjitcharoen Yotsapon, Krittiyawong Sirinate, Wanothayaroj Ekgaluck, Vongterapak Somboon, Anuntakulnatee Tawee, Kittipoom Worawit, Nakasatien Soontaree, Himathongkam Thep
BACKGROUND: Advance in medicine has led to an increase in life expectancy of elderly diabetic patients especially on the growing population called the "oldest old", those in their mid-80s upwards. The aim of this study is to describe clinical characteristics and outcomes of "oldest old" patients in a specialized diabetes center. METHODS: A retrospective review was conducted on medical records of type 2 diabetes who were older than 85 years at Theptarin hospital from September 2014 to August 2015...
2016: BMC Endocrine Disorders
Jiří Hradec, Eva Račická
Type 2 diabetes mellitus represents a serious medical, social and economic problem, since it has become a pandemic in recent years, affecting up to 1/3 of the Czech population in old age. It is the clinically most significant metabolic disease in older age. A pharmacotherapeutic approach needs to be adjusted to the presence of multiple comorbidities in the elderly and to the patients ability to cooperate with treatment, and owing to the feared hypoglycemia which may contribute to increased morbidity, it detracts from the quality of life and limits the possibilities of treatment in many cases...
March 2016: Vnitr̆ní Lékar̆ství
P Mayr, K S Kuhn, P Klein, J F Stover, E A Pestana
AIMS: Reducing the intake of low molecular weight carbohydrates with artificial nutrition may lower glycaemic response in patients with diabetes. We evaluated effects of a diabetes-specific carbohydrate modified oral nutritional supplement (ONS) during 12 weeks administration in 40 elderly type 2 normal weight patients with diabetes with previous involuntary weight loss. METHODS: Prospective, randomised, double-blind, controlled trial. Patients ingested 2×200 ml/day diabetes-specific or isocaloric standard ONS (control) in addition to their regular diet...
July 2016: Experimental and Clinical Endocrinology & Diabetes
M R Mast, I Walraven, T Hoekstra, A P D Jansen, A A W A van der Heijden, P J M Elders, R J Heine, J M Dekker, G Nijpels, J G Hugtenburg
AIMS: To identify HbA1c trajectories after the start of insulin treatment and to identify clinically applicable predictors of the response to insulin therapy. METHODS: The study population comprised 1203 people with Type 2 diabetes included in the Hoorn Diabetes Care System (n = 9849). Inclusion criteria were: age ≥ 40 years; initiation of insulin during follow-up after failure to reach HbA1c levels ≤ 53 mmol/mol (7%) with oral glucose-lowering agents; and a follow up ≥ 2 years after initiating insulin...
June 2016: Diabetic Medicine: a Journal of the British Diabetic Association
Mark E Cleasby, Pauline M Jamieson, Philip J Atherton
Insulin resistance (IR) in skeletal muscle is a key defect mediating the link between obesity and type 2 diabetes, a disease that typically affects people in later life. Sarcopenia (age-related loss of muscle mass and quality) is a risk factor for a number of frailty-related conditions that occur in the elderly. In addition, a syndrome of 'sarcopenic obesity' (SO) is now increasingly recognised, which is common in older people and is applied to individuals that simultaneously show obesity, IR and sarcopenia...
May 2016: Journal of Endocrinology
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