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Insulin Dosing

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81. Randomized placebo controlled trial evaluating the safety and efficacy of single low-dose intracoronary insulin-like growth factor following percutaneous coronary intervention in acute myocardial infarction (RESUS-AMI). (PubMed)

Randomized placebo controlled trial evaluating the safety and efficacy of single low-dose intracoronary insulin-like growth factor following percutaneous coronary intervention in acute myocardial infarction (RESUS-AMI). Residual and significant postinfarction left ventricular (LV) dysfunction, despite technically successful percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI), remains an important clinical issue. In preclinical models, low-dose insulin-like (...) growth factor 1 (IGF1) has potent cytoprotective and positive cardiac remodeling effects. We studied the safety and efficacy of immediate post-PCI low-dose intracoronary IGF1 infusion in STEMI patients.Using a double-blind, placebo-controlled, multidose study design, we randomized 47 STEMI patients with significantly reduced (≤40%) LV ejection fraction (LVEF) after successful PCI to single intracoronary infusion of placebo (n = 15), 1.5 ng IGF1 (n = 16), or 15 ng IGF1 (n = 16). All received optimal

2018 American Heart Journal Controlled trial quality: predicted high

82. A randomized comparison of three prandial insulin dosing algorithms for children and adolescents with Type 1 diabetes. (PubMed)

A randomized comparison of three prandial insulin dosing algorithms for children and adolescents with Type 1 diabetes. To compare systematically the impact of two novel insulin-dosing algorithms (the Pankowska Equation and the Food Insulin Index) with carbohydrate counting on postprandial glucose excursions following a high fat and a high protein meal.A randomized, crossover trial at two Paediatric Diabetes centres was conducted. On each day, participants consumed a high protein or high fat (...) hyperglycaemia at the expense of an increase in hypoglycaemia. There were no significant differences when carbohydrate counting was compared to the Food Insulin Index. Further research is required to optimize prandial insulin dosing.© 2018 Diabetes UK.

2018 Diabetic Medicine Controlled trial quality: uncertain

83. Mealtime dosing of a rapid-acting insulin analog reduces glucose variability and suppresses daytime cardiac sympathetic activity: a randomized controlled study in hospitalized patients with type 2 diabetes (PubMed)

Mealtime dosing of a rapid-acting insulin analog reduces glucose variability and suppresses daytime cardiac sympathetic activity: a randomized controlled study in hospitalized patients with type 2 diabetes Glucose variability induces endothelial dysfunction and cardiac autonomic nerve abnormality. Here we compared the effects of mealtime insulin aspart and bedtime insulin detemir on glucose variability, endothelial function, and cardiac autonomic nerve activity among Japanese patients with type (...) analysis using a Holter ECG were employed as indices of cardiac autonomic nerve function.M-values and MBG levels showed a considerably greater decrease in the insulin aspart group than in the insulin detemir group (p=0.006  vs p=0.001); no change in FMD was observed in either group. Daytime LF:HF ratio significantly decreased in the insulin aspart group but not in the insulin detemir group. Total insulin dose at endpoint in the insulin aspart group was significantly higher than that in the insulin

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2018 BMJ open diabetes research & care Controlled trial quality: uncertain

84. Influence of Flexible Insulin Dosing with Carbohydrate Counting Method on Metabolic and Clinical Parameters in Type 1 Diabetes Patients (PubMed)

Influence of Flexible Insulin Dosing with Carbohydrate Counting Method on Metabolic and Clinical Parameters in Type 1 Diabetes Patients The purpose of providing and maintaining a proper metabolic control is to prevent the development of chronic complications. In this study, we aimed to determine the influence of flexible insulin dosing with carbohydrate counting method on metabolic and clinical parameters in type 1 diabetes patients.This study was conducted with patients following up (...) levels were compared at standard dose insulin use and after carbohydrate counting (P < 0.005). Among the parameters measured when the patients received standard dose of insulin without counting carbohydrate and flexible insulin dosing by counting carbohydrate, statistically, significant differences were not detected for baseline insulin dose, bolus insulin dose, triglyceride level, body mass index, or monthly hypoglycemia episodes (P > 0.05).Flexible insulin dosing with carbohydrate counting provides

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2018 Open access Macedonian journal of medical sciences

85. A Review of Insulin-Dosing Formulas for Continuous Subcutaneous Insulin Infusion (CSII) for Adults with Type 1 Diabetes (PubMed)

A Review of Insulin-Dosing Formulas for Continuous Subcutaneous Insulin Infusion (CSII) for Adults with Type 1 Diabetes Dosing guidelines for patients with type 1 diabetes using continuous subcutaneous insulin infusion (CSII), which are historically based on clinical experience and retrospective studies of patients consuming an American diet, recommend that basal insulin should represent approximately 50 % of the total daily dose (TDD). Recent prospective studies in the USA and Japan conclude (...) that the more appropriate proportion is closer to 30-40 % of TDD. In addition, currently used formulas for calculating the carbohydrate-to-insulin ratio (CIR) and correction factor (CF) may lead to underdosing of bolus insulin by as much as 12.8-50 % for a hypothetical patient. The discrepancies between traditional formulas and data from newer studies can be accounted for by the more rigorous design of the newer studies (e.g., prospective design, controlled diets, meal omission, and frequent glucose

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2016 Current diabetes reports

86. Comparison of Combined Tofogliflozin and Glargine, Tofogliflozin Added to Insulin, and Insulin Dose-Increase Therapy in Uncontrolled Type 2 Diabetes (PubMed)

Comparison of Combined Tofogliflozin and Glargine, Tofogliflozin Added to Insulin, and Insulin Dose-Increase Therapy in Uncontrolled Type 2 Diabetes Some patients with type 2 diabetes mellitus (T2DM) on insulin have poor glycemic control and require add-on therapy to reach target glucose values. Increased insulin doses or the addition of an oral antidiabetic drug (OAD) may improve glycemic control, but many patients fail to achieve target values. The aim of this study was to compare (...) on insulin therapy. Treatment was continued for 24 weeks with insulin dose-increase therapy, tofogliflozin add-on therapy, or a combination of insulin glargine + tofogliflozin. The primary endpoints were HbA1c, weight, and total insulin dose. Secondary endpoints included fasting plasma glucose (FPG), blood pressure, lipid profiles, and incidence of adverse events.At baseline, the participants' median age was 59.0 years, mean BMI was 28.7 kg/m2, mean eGFR was 89.2 mL/min/1.73 m2, mean HbA1c was 8.7

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2016 Journal of clinical medicine research

87. Excess weight gain during insulin pump therapy is associated with higher basal insulin doses (PubMed)

Excess weight gain during insulin pump therapy is associated with higher basal insulin doses While higher total daily dose (TDD) of insulin has been associated with excess weight gain on insulin pump therapy, the role of higher total basal dose (TBD) of insulin on weight gain has not been studied. We evaluated the impact of higher TBD on weight gain in relationship to glycosylated hemoglobin (HbA1c), hypoglycemic episodes, and change in body mass index (BMI) z score in a group of pediatric (...) ratio (1.8 ± 0.6 vs. 1.5 ± 0.6, p < 0.05). While Groups 1 and 2 had similar HbA1c values (7.7 ± 0.7 vs. 7.70 ± 0.6 %; p = 0.79) and activity levels (2.2 ± 0.6 vs. 2.2 ± 0.7; p = 0.15), Group 2 had higher rates of hypoglycemic episodes (1.0 ± 0.4 vs. 1.5 ± 0.9, p < 0.01).Excess weight gain was associated with lower bolus to basal insulin ratios independent of glycemic control and activity level. Evaluation of bolus and basal insulin doses during insulin therapy is warranted in order to avoid excess

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2016 Journal of diabetes and metabolic disorders

88. Calculated Daily Insulin Dosages Overestimate Prescribed Insulin Doses in Type 2 Diabetes: A Primary Care Database Study (PubMed)

Calculated Daily Insulin Dosages Overestimate Prescribed Insulin Doses in Type 2 Diabetes: A Primary Care Database Study The aim was to compare the prescribed and calculated daily insulin dosages based on prescription data in type 2 diabetes patients in a general practice database.A total of 17 782 type 2 diabetes patients (age: 70.0 ± 11.5 years; 52% males; 16% diabetologist care) with ≥2 insulin prescriptions from 834 practices were analyzed (Disease Analyser: 01/2011-12/2015). Prescribed (...) daily dosage (PDD) (physician documentation) and calculated daily dose (CDD) (pack size × strength × volume / days between 2 prescriptions) were calculated for short-acting, long-acting, and premixed insulins. PDD and CDD were compared using paired t-tests. Linear regression models assessed the associations of insulin dosage difference (CDD-PDD) with age, sex, diabetologist care, private health insurance, obesity, HbA1c, hypertension, hyperlipidemia, macro- and microvascular complications.Mean [SD

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2016 Journal of diabetes science and technology

89. A Study to Demonstrate Bioequivalence Between Insulin Glulisine U300 and Insulin Glulisine U100 After a Single Subcutaneous Dose Using the Euglycemic Clamp Technique, in Patients With Type 1 Diabetes Mellitus

A Study to Demonstrate Bioequivalence Between Insulin Glulisine U300 and Insulin Glulisine U100 After a Single Subcutaneous Dose Using the Euglycemic Clamp Technique, in Patients With Type 1 Diabetes Mellitus A Study to Demonstrate Bioequivalence Between Insulin Glulisine U300 and Insulin Glulisine U100 After a Single Subcutaneous Dose Using the Euglycemic Clamp Technique, in Patients With Type 1 Diabetes Mellitus - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record (...) managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. A Study to Demonstrate Bioequivalence Between Insulin Glulisine U300 and Insulin Glulisine U100 After a Single Subcutaneous Dose Using the Euglycemic Clamp Technique, in Patients With Type 1 Diabetes Mellitus The safety and scientific

2016 Clinical Trials

90. Understanding Bolus Insulin Dose Timing: The Characteristics and Experiences of People with Diabetes Who Take Bolus Insulin. (PubMed)

Understanding Bolus Insulin Dose Timing: The Characteristics and Experiences of People with Diabetes Who Take Bolus Insulin. Despite the increased popularity of newer, fast-acting bolus insulin treatment options that allow for more flexibility in the timing of bolus insulin dosing in recent years, relatively little is known about people with diabetes who administer bolus insulin at differing times in relation to their meals. The purpose of this study was to investigate bolus insulin dose timing (...) in relation to meals among people with type 1 (T1D) and type 2 (T2D) diabetes, as well as to better understand the characteristics and experiences of people who bolus dose at differing times.A web-based survey of adults with T1D and T2D treated with bolus insulin therapy in Germany, the UK, and USA was conducted.A total of 906 respondents completed the survey (39% T1D; 61% T2D). A majority of respondents reported bolus dosing before meals in the previous week (57.0%), followed by after meals (18.9

2016 Current medical research and opinion

91. Incorrect AM/PM Insulin Pump Clock Settings Can Result in an Unstable Insulin Dosing Feedback Loop (PubMed)

Incorrect AM/PM Insulin Pump Clock Settings Can Result in an Unstable Insulin Dosing Feedback Loop 28625082 2018 07 04 2018 12 02 1932-2968 11 4 2017 07 Journal of diabetes science and technology J Diabetes Sci Technol Incorrect AM/PM Insulin Pump Clock Settings Can Result in an Unstable Insulin Dosing Feedback Loop. 842-843 10.1177/1932296816678633 Lunt Helen H 1 Christchurch Diabetes Centre, New Zealand. eng Letter Comment 2016 11 15 United States J Diabetes Sci Technol 101306166 1932-2968 0 (...) Blood Glucose 0 Hypoglycemic Agents 0 Insulin IM J Diabetes Sci Technol. 2014 Nov;8(6):1215-20 25355713 Blood Glucose Diabetes Mellitus, Type 1 Hypoglycemic Agents Insulin Insulin Infusion Systems 12-hour clock 24-hour clock dys-syncrony insulin pumps phase shift type 1 diabetes 2017 6 20 6 0 2018 7 5 6 0 2017 6 20 6 0 ppublish 28625082 10.1177/1932296816678633 PMC5588815 Diabetes Technol Ther. 2005 Oct;7(5):663-4 16241864 J Diabetes Sci Technol. 2014 Nov;8(6):1215-20 25355713

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2016 Journal of diabetes science and technology

92. Pharmacokinetic and Pharmacodynamic Properties of Faster-Acting Insulin Aspart versus Insulin Aspart Across a Clinically Relevant Dose Range in Subjects with Type 1 Diabetes Mellitus (PubMed)

Pharmacokinetic and Pharmacodynamic Properties of Faster-Acting Insulin Aspart versus Insulin Aspart Across a Clinically Relevant Dose Range in Subjects with Type 1 Diabetes Mellitus Absorption of current rapid-acting insulins is too slow for patients with diabetes mellitus to achieve optimal postprandial glucose control. Faster-acting insulin aspart (faster aspart) is insulin aspart in a new formulation with faster early absorption. We compared the pharmacokinetic/pharmacodynamic properties (...) of faster aspart and insulin aspart across a clinically relevant dose range.In this randomised, double-blind, crossover trial, 46 subjects with type 1 diabetes mellitus received single subcutaneous doses of faster aspart and insulin aspart at 0.1, 0.2 (repeated three times to estimate within-subject variability) and 0.4 U/kg in a euglycaemic clamp setting (target 5.5 mmol/L).Consistently for the three doses, faster aspart demonstrated faster onset and greater early absorption and glucose-lowering effect

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2016 Clinical pharmacokinetics Controlled trial quality: uncertain

93. Exenatide Add-on to Continuous Subcutaneous Insulin Infusion Therapy Reduces Bolus Insulin Doses in Patients with Type 2 Diabetes: A Randomized, Controlled, Open-Label Trial. (PubMed)

Exenatide Add-on to Continuous Subcutaneous Insulin Infusion Therapy Reduces Bolus Insulin Doses in Patients with Type 2 Diabetes: A Randomized, Controlled, Open-Label Trial. The objective of this study was to investigate the effect of adding exenatide to continuous subcutaneous insulin infusion (CSII) therapy on the precise insulin doses required by type 2 diabetic patients to maintain glycemic control.This was a single-center, randomized, controlled, open-label trial. Uncontrolled T2D (...) patients were recruited between March 2010 and November 2011 at Nanjing First Hospital, China. Subjects were randomly assigned (1:1) to either an exenatide add-on to CSII group or a CSII therapy only (i.e., control) group (n = 18, respectively) for 5 weeks. Patients were subjected to 3 days of continuous glucose monitoring (CGM) during the screening period and after therapy. The precise insulin doses, the times taken by the patients to achieve euglycemic control, and the mean amplitude of glycemic

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2016 Diabetes therapy : research, treatment and education of diabetes and related disorders Controlled trial quality: uncertain

94. Clinical Application of the Food Insulin Index for Mealtime Insulin Dosing in Adults with Type 1 Diabetes: A Randomized Controlled Trial. (PubMed)

Clinical Application of the Food Insulin Index for Mealtime Insulin Dosing in Adults with Type 1 Diabetes: A Randomized Controlled Trial. The Food Insulin Index (FII) is a novel algorithm for ranking foods based on their insulin demand relative to an isoenergetic reference food. We compared the effect of carbohydrate counting (CC) versus the FII algorithm for estimating insulin dosage on glycemic control in type 1 diabetes.In a randomized, controlled trial, adults (n = 26) using insulin pump (...) therapy were assigned to using either traditional CC or the novel Food Insulin Demand (FID) counting for 12 weeks. Subjects participated in group education and individual sessions. At baseline and on completion of the trial, glycated hemoglobin A1c (HbA1c), day-long glycemia (6-day continuous glucose monitoring), fasting lipids, and C-reactive protein were determined.Changes in HbA1c from baseline to 12 weeks were small and not significant in both groups (mean ± SEM; FII vs. CC, -0.1 ± 0.1% vs. -0.3

2016 Diabetes technology & therapeutics Controlled trial quality: uncertain

95. Effects of subcutaneous, low-dose glucagon on insulin-induced mild hypoglycaemia in patients with insulin pump treated type 1 diabetes. (PubMed)

Effects of subcutaneous, low-dose glucagon on insulin-induced mild hypoglycaemia in patients with insulin pump treated type 1 diabetes. To investigate the dose-response relationship of subcutaneous (s.c.) glucagon administration on plasma glucose and on counter-regulatory hormone responses during s.c. insulin-induced mild hypoglycaemia in patients with type 1 diabetes treated with insulin pumps.Eight insulin pump-treated patients completed a blinded, randomized, placebo-controlled study (...) ) and 5.0 (4.3-5.6) mmol/l to 6.1 (4.9-7.4), 7.9 (6.4-9.3) and 8.7 (7.8-9.5) vs 3.6 (3.4-3.9) mmol/l (p < 0.001) after the three different glucagon doses as compared with saline, and the increase was neither correlated with weight nor insulin levels. Area under the plasma glucose curve, peak plasma glucose, time to peak plasma glucose and duration of plasma glucose level above baseline were significantly enhanced with increasing glucagon doses; however, these were not significantly different between 200

2016 obesity & metabolism Controlled trial quality: uncertain

96. Computerised insulin dosing calculators for the management of continuous insulin infusions after cardiac surgery: A systematic review and meta-analysis. (PubMed)

Computerised insulin dosing calculators for the management of continuous insulin infusions after cardiac surgery: A systematic review and meta-analysis. To investigate the effectiveness of computerised insulin dosing calculators for the management of continuous insulin infusions in adult patients who underwent cardiac surgery.A systematic review was conducted. The CINAHL, MEDLINE and Cochrane databases were searched for primary studies that compared a computerised insulin dosing calculator (...) in comparison to the paper protocol groups. No significant difference in the incidence of severe hypoglycaemia was demonstrated (OR 0.21, 95% CI 0.02-1.79), p=0.15. No difference was found in time (hours) to reach target blood glucose range (MD -1.47, 95% CI -3.75 to 0.81), p=0.21.There is some evidence to support the use of computerised insulin dosing calculators for insulin infusion management within critical care environments.Copyright © 2016 Elsevier Ltd. All rights reserved.

2016 Intensive & critical care nursing

97. Superior efficacy of insulin degludec/liraglutide versus insulin glargine U100 as add-on to sodium-glucose co-transporter-2 inhibitor therapy: A randomized clinical trial in people with uncontrolled type 2 diabetes

); total daily insulin dose (difference -15.37 U; 95% CI -19.60, -11.13). The overall treatment-emergent adverse event rate was higher with IDegLira as a result of higher increased lipase and nausea rates.The favourable safety and efficacy profile of IDegLira in people with uncontrolled T2D on SGLT2 inhibitors, and lower weight gain and hypoglycaemia risk versus IGlar U100, suggest that clinicians should consider IDegLira initiation in this population.© 2019 The Authors. Diabetes, Obesity (...) Superior efficacy of insulin degludec/liraglutide versus insulin glargine U100 as add-on to sodium-glucose co-transporter-2 inhibitor therapy: A randomized clinical trial in people with uncontrolled type 2 diabetes To investigate the efficacy and safety of insulin degludec/liraglutide (IDegLira) versus insulin glargine 100 units/mL (IGlar U100) as add-on to sodium-glucose co-transporter-2 (SGLT2) inhibitor therapy.In this 26-week, phase IIIb, open-label, parallel-group, treat-to-target trial

2019 EvidenceUpdates

98. Comparison of Standard vs Higher Starting Dose of Insulin Glargine in Chinese Patients With Type 2 Diabetes (Glargine Starting Dose)

Comparison of Standard vs Higher Starting Dose of Insulin Glargine in Chinese Patients With Type 2 Diabetes (Glargine Starting Dose) Comparison of Standard vs Higher Starting Dose of Insulin Glargine in Chinese Patients With Type 2 Diabetes (Glargine Starting Dose) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You (...) have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Comparison of Standard vs Higher Starting Dose of Insulin Glargine in Chinese Patients With Type 2 Diabetes (Glargine Starting Dose) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02836704

2016 Clinical Trials

99. Efficacy and safety of once-daily insulin degludec dosed flexibly at convenient times vs fixed dosing at the same time each day in a Japanese cohort with type 2 diabetes: A randomized, 26-week, treat-to-target trial. (PubMed)

Efficacy and safety of once-daily insulin degludec dosed flexibly at convenient times vs fixed dosing at the same time each day in a Japanese cohort with type 2 diabetes: A randomized, 26-week, treat-to-target trial. This trial assessed the efficacy and safety of the possibility of varying the daily injection time of once-daily, long-acting basal insulin degludec (IDeg) in Japanese patients with type 2 diabetes inadequately controlled with insulin glargine.This was a 26-week, multicenter, open (...) -label, randomized, treat-to-target trial, with a 2 × 2 factorial design comparing IDeg flexible (allowing dosing ±8 h from an agreed dosing time) with IDeg fixed dosing (at the same time each day). It was carried out in 458 adult patients who were inadequately controlled on insulin glargine with or without oral antidiabetic drugs.The majority of doses were taken within 2 h of the agreed dosing time, showing a high level of adherence among Japanese patients. After 26 weeks, IDeg flexible was non

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2016 Journal of Diabetes Investigation Controlled trial quality: uncertain

100. Superior efficacy with a fixed-ratio combination of insulin degludec and liraglutide (IDegLira) compared with insulin degludec and liraglutide in insulin-naïve Japanese patients with type 2 diabetes in a phase 3, open-label, randomized trial. (PubMed)

-confirmed hypoglycaemia for IDegLira were lower versus degludec (rate ratio 0.48 [95% CI 0.35; 0.68]; P < .0001), but higher versus liraglutide (rate ratio 37.58 [95% CI 19.80; 71.31]; P < .0001). Mean daily total insulin dose was lower with IDegLira (27.7 U) versus degludec (34.8 U; P < .0001). Overall adverse event (AE) rates were similar. In total, 34.9%, 22.9% and 41.8% of IDegLira-, degludec- and liraglutide-treated participants experienced gastrointestinal AEs.IDegLira was superior to degludec (...) Superior efficacy with a fixed-ratio combination of insulin degludec and liraglutide (IDegLira) compared with insulin degludec and liraglutide in insulin-naïve Japanese patients with type 2 diabetes in a phase 3, open-label, randomized trial. To investigate the efficacy and safety of insulin degludec/liraglutide (IDegLira) compared with its individual components in Japanese people with type 2 diabetes (T2D) uncontrolled on an oral antidiabetic drug (OAD).This 52-week, open-label, multicentre

2019 obesity & metabolism Controlled trial quality: uncertain

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