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33 papers 0 to 25 followers Related to managing patients with diabetes
By Michael Kelly Assistant Professor
Eirik Søfteland, Juris J Meier, Bente Vangen, Robert Toorawa, Mario Maldonado-Lutomirsky, Uli C Broedl
OBJECTIVE: To evaluate the efficacy and safety of empagliflozin versus placebo as add-on therapy in patients with type 2 diabetes and inadequate glycemic control with linagliptin and metformin. RESEARCH DESIGN AND METHODS: Patients with HbA1c ≥8.0% and ≤10.5% (≥64 and ≤91 mmol/mol) while receiving stable-dose metformin received open-label linagliptin 5 mg (n = 606) for 16 weeks. Subsequently, those with HbA1c ≥7.0 and ≤10.5% (≥53 and ≤91 mmol/mol) were randomized to receive double-blind, double-dummy treatment with empagliflozin 10 mg (n = 112), empagliflozin 25 mg (n = 111), or placebo (n = 110) for 24 weeks; all patients continued treatment with metformin and linagliptin 5 mg...
December 2, 2016: Diabetes Care
Helena W Rodbard
The availability of human insulin and subsequently insulin analogs that more closely mimic the body's physiology have contributed to increased safety in patients with diabetes and a greater role in patients with T2DM. This greater role is supported by clear evidence that early use of insulin in T2DM results in long-term improvements in glycemic control and beta-cell function compared with oral agents.
October 2016: Journal of Family Practice
Laura Dwyer-Lindgren, Johan P Mackenbach, Frank J van Lenthe, Abraham D Flaxman, Ali H Mokdad
OBJECTIVE: Previous analyses of diabetes prevalence in the U.S. have considered either only large geographic regions or only individuals in whom diabetes had been diagnosed. We estimated county-level trends in the prevalence of diagnosed, undiagnosed, and total diabetes as well as rates of diagnosis and effective treatment from 1999 to 2012. RESEARCH DESIGN AND METHODS: We used a two-stage modeling procedure. In the first stage, self-reported and biomarker data from the National Health and Nutrition Examination Survey (NHANES) were used to build models for predicting true diabetes status, which were applied to impute true diabetes status for respondents in the Behavioral Risk Factor Surveillance System (BRFSS)...
September 2016: Diabetes Care
L Duvnjak, K Blaslov, M Vučić Lovrenčić, J Knežević Ćuća
AIMS: We aimed to determine serum dipeptidyl peptidase-4 (DPP-4) activity in a group of persons with latent autoimmune diabetes in adults (LADA) and to compare it with persons with type 1, type 2 diabetes and healthy controls. METHODS: DPP-4 activity measurement was performed in 67 persons (21 with type 1, 26 type 2 and 19 with LADA) and 13 healthy age and gender matched controls. RESULTS: Persons with LADA showed highest DPP-4 activity among the study groups (32...
September 21, 2016: Diabetes Research and Clinical Practice
André J Scheen
Inhibitors of sodium-glucose cotransporters type 2 (SGLT2) reduce hyperglycemia by increasing urinary glucose excretion. They have been evaluated in patients with type 2 diabetes treated with diet/exercise, metformin, dual oral therapy or insulin. Three agents are available in Europe and the USA (canagliflozin, dapagliflozin, empagliflozin) and others are commercialized in Japan or in clinical development. SGLT2 inhibitors reduce glycated hemoglobin, with a minimal risk of hypoglycemia. They exert favorable effects beyond glucose control with consistent body weight, blood pressure, and serum uric acid reductions...
October 2016: Current Diabetes Reports
Ronnie Aronson, Naomi Orzech, Chenglin Ye, Ruth E Brown, Ronald Goldenberg, Vivien Brown
OBJECTIVE: To highlight the utility of a large patient registry to identify functionally refractory patients (persistent HbA1c ≥75 mmol/mol [9.0%]) with type 2 diabetes, identify their barriers to glycemic control, and implement barrier-specific care path strategies to improve glycemic control. RESEARCH DESIGN AND METHODS: A working group developed a structured tool to optimize the collection of information on barriers to glycemic control and designed structured care paths to address each barrier...
October 2016: Diabetes Care
Jodi B Segal, Nisa M Maruthur
No abstract text is available yet for this article.
December 2014: JAMA Internal Medicine
Jamie Wroge, Nancy Toedter Williams
OBJECTIVE: To evaluate the literature about the use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in the treatment of cardiac disorders, specifically myocardial infarction (MI) and heart failure (HF). DATA SOURCES: Searches were conducted in MEDLINE (1946-May 2016) and Excerpta Medica (1980-May 2016) using EMBASE with the search terms glucagon-like peptide 1, exenatide, albiglutide, liraglutide, dulaglutide, myocardial infarction, heart failure, and cardiovascular The references of relevant articles were reviewed to identify additional citations...
August 16, 2016: Annals of Pharmacotherapy
Jessica L Browne, Adriana D Ventura, Kylie Mosely, Jane Speight
OBJECTIVE: To develop and validate a self-report measure of perceived and experienced stigma for use with adults with type 2 diabetes: the Type 2 Diabetes Stigma Assessment Scale (DSAS-2). RESEARCH DESIGN AND METHODS: An item pool was drafted based on qualitative data from 25 adults with type 2 diabetes and content from other health-related stigma questionnaires. Thirteen adults with type 2 diabetes completed 57 draft diabetes stigma items and participated in cognitive debriefing interviews...
August 11, 2016: Diabetes Care
Kevin M Pantalone, Brian J Wells, Kevin M Chagin, Flavia Ejzykowicz, Changhong Yu, Alex Milinovich, Janine M Bauman, Michael W Kattan, Swapnil Rajpathak, Robert S Zimmerman
OBJECTIVE: "Clinical inertia" has been used to describe the delay in the intensification of type 2 diabetes treatment among patients with poor glycemic control. Previous studies may have exaggerated the prevalence of clinical inertia by failing to adequately monitor drug dose changes and nonmedication interventions. This project evaluated the intensification of diabetes therapy and hemoglobin A1c (A1C) goal attainment among patients with newly diagnosed type 2 diabetes when metformin monotherapy failed...
September 2016: Diabetes Care
David R Repaske
Epidemiological studies and case reports have demonstrated an increased rate of development of diabetes mellitus consequent to taking diverse types of medication. This review explores this evidence linking these medications and development of diabetes and presents postulated mechanisms by which the medications might cause diabetes. Some medications are associated with a reduction in insulin production, some with reduction in insulin sensitivity, and some appear to be associated with both reduction in insulin production and insulin sensitivity...
September 2016: Pediatric Diabetes
Hiddo J L Heerspink, Bruce A Perkins, David H Fitchett, Mansoor Husain, David Z I Cherney
Sodium-glucose cotransporter-2 (SGLT2) inhibitors, including empagliflozin, dapagliflozin, and canagliflozin, are now widely approved antihyperglycemic therapies. Because of their unique glycosuric mechanism, SGLT2 inhibitors also reduce weight. Perhaps more important are the osmotic diuretic and natriuretic effects contributing to plasma volume contraction, and decreases in systolic and diastolic blood pressures by 4 to 6 and 1 to 2 mm Hg, respectively, which may underlie cardiovascular and kidney benefits...
September 6, 2016: Circulation
Yong Mong Bee, Ada Portia M Batcagan-Abueg, Choy-Lye Chei, Young Kyung Do, Benjamin Haaland, Su-Yen Goh, Phong Ching Lee, Priscilla Pei Sze Chiam, Emily Tse Lin Ho, David B Matchar
No abstract text is available yet for this article.
October 2016: Diabetes Care
Bo Ahrén, Irl B Hirsch, Thomas R Pieber, Chantal Mathieu, Fernando Gómez-Peralta, Troels Krarup Hansen, Areti Philotheou, Sune Birch, Erik Christiansen, Thomas Jon Jensen, John B Buse
OBJECTIVE: To investigate the efficacy and safety of liraglutide added to capped insulin doses in subjects with type 1 diabetes. RESEARCH DESIGN AND METHODS: A 26-week, placebo-controlled, double-blind, parallel-group trial enrolling 835 subjects randomized 3:1 receiving once-daily subcutaneous liraglutide (1.8, 1.2, and 0.6 mg) or placebo added to an individually capped total daily dose of insulin. RESULTS: Mean baseline glycated hemoglobin (HbA1c) (8...
October 2016: Diabetes Care
Samy Hadjadj, Julio Rosenstock, Thomas Meinicke, Hans J Woerle, Uli C Broedl
OBJECTIVE: This study compared the efficacy and safety of initial combinations of empagliflozin + metformin with empagliflozin and metformin monotherapy in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: The study randomized 1,364 drug-naïve patients (HbA1c >7.5 to ≤12% [>58 to ≤108 mmol/mol]) for 24 weeks to empagliflozin 12.5 mg b.i.d. + metformin 1,000 mg b.i.d., empagliflozin 12.5 mg b.i.d. + metformin 500 mg b.i.d., empagliflozin 5 mg b...
October 2016: Diabetes Care
Roy Eldor, Giuseppe Daniele, Claudia Huerta, Mariam Al-Atrash, John Adams, Ralph DeFronzo, Timothy Duong, John Lancaster, Mahmoud Zirie, Amin Jayyousi, Muhammad Abdul-Ghani
OBJECTIVE: This study examined the effect of exenatide on brain activity measured by functional (f)MRI and on insulin secretion in lean and obese normal-glucose-tolerant individuals. RESEARCH DESIGN AND METHODS: The brain fMRI signal in response to high-calorie-content food pictures was measured with and without intravenous exenatide infusion in 10 lean and 10 obese healthy volunteers. Insulin secretion was measured with a two-step (+100 and +200 mg/dL) hyperglycemic clamp with exenatide and with saline infusion...
October 2016: Diabetes Care
Kristen J Nadeau, Barbara J Anderson, Erika G Berg, Jane L Chiang, Hubert Chou, Kenneth C Copeland, Tamara S Hannon, Terry T-K Huang, Jane L Lynch, Jeff Powell, Elizabeth Sellers, William V Tamborlane, Philip Zeitler
Type 2 diabetes is a significant and increasing burden in adolescents and young adults. Clear strategies for research, prevention, and treatment of the disease in these vulnerable patients are needed. Evidence suggests that type 2 diabetes in children is different not only from type 1 but also from type 2 diabetes in adults. Understanding the unique pathophysiology of type 2 diabetes in youth, as well as the risk of complications and the psychosocial impact, will enable industry, academia, funding agencies, advocacy groups, and regulators to collectively evaluate both current and future research, treatment, and prevention approaches...
September 2016: Diabetes Care
Carol H Wysham, Leigh MacConell, Elise Hardy
OBJECTIVE: This study investigated the efficacy and safety of multiple exenatide once-monthly suspension (QMS) doses of exenatide-containing microspheres in Miglyol referenced against the clinical dose of exenatide once-weekly (QW) microspheres in aqueous solution. RESEARCH DESIGN AND METHODS: In this phase II, randomized, controlled, single-blind study, 121 adults (∼30/arm) with type 2 diabetes and HbA1c 7.1-11.0% (54-97 mmol/mol) were randomized 1:1:1:1 to subcutaneous exenatide QW 2 mg (self-administered) or exenatide QMS 5, 8, or 11 mg (caregiver-administered) for 20 weeks...
October 2016: Diabetes Care
Kenneth Cusi, Beverly Orsak, Fernando Bril, Romina Lomonaco, Joan Hecht, Carolina Ortiz-Lopez, Fermin Tio, Jean Hardies, Celia Darland, Nicolas Musi, Amy Webb, Paola Portillo-Sanchez
BACKGROUND: The metabolic defects of nonalcoholic steatohepatitis (NASH) and prediabetes or type 2 diabetes mellitus (T2DM) seem to be specifically targeted by pioglitazone. However, information about its long-term use in this population is limited. OBJECTIVE: To determine the efficacy and safety of long-term pioglitazone treatment in patients with NASH and prediabetes or T2DM. DESIGN: Randomized, double-blind, placebo-controlled trial. (ClinicalTrials...
September 6, 2016: Annals of Internal Medicine
Abeer Anabtawi, John M Miles
Metformin is the most commonly prescribed drug for the treatment of type 2 diabetes because of its apparent robust effects in reducing cardiovascular risk. The United Kingdom Prospective Diabetes Study suggests that metformin reduces the risk of myocardial infarction, and more recent retrospective studies have shown an association between metformin and a reduction in stroke, atrial fibrillation and all-cause mortality. The mechanism(s) explaining these putative benefits are not clear but may involve decreased energy intake (with attendant weight loss), improvement in lipids, and lowering of blood pressure; a review of selected literature suggests that metformin lowers blood pressure when it is elevated, but not when it is normal...
May 23, 2016: Endocrine Practice
2016-07-08 21:34:16
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