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Insulin Dosing

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101. Low dose prednisolone and insulin sensitivity differentially affect arterial stiffness and endothelial function: An open interventional and cross-sectional study. (Abstract)

Low dose prednisolone and insulin sensitivity differentially affect arterial stiffness and endothelial function: An open interventional and cross-sectional study. Glucocorticoids could impair vascular function directly, or indirectly by reducing insulin sensitivity. The aim of this study was to determine the direct and indirect effects of acute and chronic low dose prednisolone on arterial stiffness and endothelial function.Twelve subjects with inflammatory arthritis, who had not taken oral (...) during hyperinsulinemic-euglycemic clamp (p = 0.02), but not with suppression of endogenous glucose production (p = 0.15) or glucocorticoid use (p = 0.70). Chronic (2.4 ± 0.2 vs. 1.9 ± 0.1, p = 0.02), but not acute (1.8 ± 0.2 vs. 1.9 ± 0.1, p = 0.24), prednisolone resulted in a higher RHI.Arterial stiffness is not affected by low dose prednisolone per se, but is negatively associated with peripheral insulin sensitivity. Patients with rheumatoid arthritis taking long-term prednisolone had better

2017 Atherosclerosis

102. Effect of Two Different Doses of Vitamin D Supplementation on Metabolic Profiles of Insulin-Resistant Patients with Polycystic Ovary Syndrome Full Text available with Trip Pro

Effect of Two Different Doses of Vitamin D Supplementation on Metabolic Profiles of Insulin-Resistant Patients with Polycystic Ovary Syndrome This study was carried out to evaluate the effects of vitamin D supplementation on the metabolic profiles of insulin-resistant subjects with polycystic ovary syndrome (PCOS). This randomized double-blind, placebo-controlled trial was conducted on 90 insulin-resistant women with PCOS. Participants were randomly assigned to three groups to intake either (...) vitamin D administration for 12 weeks to insulin-resistant women with PCOS had beneficial effects on total testosterone, SHBG, FAI, serum hs-CRP and plasma TAC levels compared with low-dose vitamin D and placebo groups.

2017 Nutrients Controlled trial quality: predicted high

103. A comparison of insulin doses for the treatment of hyperkalemia in patients with renal insufficiency. (Abstract)

A comparison of insulin doses for the treatment of hyperkalemia in patients with renal insufficiency. To compare the safety and efficacy of 5 units versus 10 units of insulin for the treatment of hyperkalemia in patients with renal insufficiency.Retrospective cohort study.Large academic medical center emergency department.Between March 1, 2008, and February 29, 2016, 675 patients met the inclusion criteria of age 18 years and older, serum potassium greater than 5 mEq/L, renal insufficiency, 5 (...) occurred in 26 of 133 patients receiving 5 units of insulin (19.5%) and in 155 of 542 patients receiving 10 units (28.6%) (difference = -9.1%, 95% confidence interval [CI] -16.8% to -1.3%). Severe hypoglycemia occurred in 4 of 133 patients (3.0%) and 37 of 542 patients (6.8%) receiving insulin 5 units and 10 units, respectively (difference = -3.8%, 95% CI -7.4% to 0%). Change in serum potassium was similar between groups (-1.0 ± 0.8 vs -1.0 ± 0.7 mEq/L, difference = 0, 95% CI -0.1 to 0.1).In patients

2017 Pharmacotherapy

104. An information and communication technology-based centralized clinical trial to determine the efficacy and safety of insulin dose adjustment education based on a smartphone personal health record application: a randomized controlled trial. Full Text available with Trip Pro

of detailed data. The benefits of PHRs can be maximized in insulin dose adjustment for patients starting or intensifying insulin regimens, as frequent self-monitoring of glucose, self-adjustment of insulin dose, and precise at-home data collection during the visit-to-visit period are important for glycemic control. The aim of this study is to examine the efficacy and safety of insulin dose adjustment based on a smartphone PHR application in patients with diabetes mellitus (DM) and to confirm the validity (...) and stability of an information and communication technology (ICT)-based centralized clinical trial monitoring system.This is a 24-week, open-label, randomized, multi-center trial. There are three follow-up measures: baseline, post-intervention at week 12, and at week 24. Subjects diagnosed with type 1 DM, type 2 DM, and/or post-transplant DM who initiate basal insulin or intensify their insulin regimen to a basal-bolus regimen are included. After education on insulin dose titration and prevention

2017 Medical Informatics and Decision Making Controlled trial quality: uncertain

105. Low Dose Insulin as an Anti-Scarring Therapy in Breast Surgery: A Randomised Controlled Trial. (Abstract)

Low Dose Insulin as an Anti-Scarring Therapy in Breast Surgery: A Randomised Controlled Trial. The role of insulin in expediting wound healing is firmly established within the context of major trauma and burns; however, only limited clinical evidence exists as to its effects on scar formation. This study aims to build on previous laboratory work to examine the potential antiscarring properties of insulin in a clinical environment.Ninety-one patients undergoing bilateral aesthetic breast (...) operations were recruited to receive low-dose insulin and placebo injections to the medial 3 cm of their submammary incisions within the context of a randomized, intrapatient, placebo-controlled trial, and scar quality was assessed at 3-, 6-, and 12-month reviews using the Manchester Scar Scale.Across the cohort at 12-month review, the insulin-treated scars had lower scar scores (p = 0.055) compared with placebo. Subgroup analysis of individuals with heavier scars showed that median scar scores were

2017 Plastic and reconstructive surgery Controlled trial quality: uncertain

106. Erratum to: An information and communication technology-based centralized clinical trial to determine the efficacy and safety of insulin dose adjustment education based on a smartphone personal health record application: a randomized controlled trial. Full Text available with Trip Pro

Erratum to: An information and communication technology-based centralized clinical trial to determine the efficacy and safety of insulin dose adjustment education based on a smartphone personal health record application: a randomized controlled trial. After publication of the original article [1] it was noted that both the figures and captions and relating to Figs. 1 and 2 had been interchanged.

2017 Medical Informatics and Decision Making Controlled trial quality: uncertain

107. Dose-response effects of exercise on insulin among colon cancer survivors. Full Text available with Trip Pro

Dose-response effects of exercise on insulin among colon cancer survivors. Physical activity is associated with a lower risk of disease recurrence among colon cancer survivors. The pathways through which physical activity may alter disease outcomes are unknown, but may include changes in metabolic growth factors, such as insulin. Between January 2015 and August 2015, 39 stage I-III colon cancer survivors were randomized to one of the three groups: usual care control, 150 min/week of aerobic (...) exercise (low-dose) and 300 min/week of aerobic exercise (high-dose) for six months. The pre-specified key metabolic growth factor outcome was fasting insulin. Insulin resistance was quantified using the homeostatic model assessment. Mean age was 56.5 ± 10.0 years, 51% had stage III disease, 72% were treated with chemotherapy and the mean time since finishing treatment was 10.9 ± 6.1 months. Over six months, the low-dose group completed 141.5 ± 9.9 min/week of aerobic exercise, and the high-dose group

2017 Endocrine-Related Cancer

108. Dose dependent effects of intranasal insulin on resting-state brain activity. Full Text available with Trip Pro

Dose dependent effects of intranasal insulin on resting-state brain activity. Insulin action in the human brain influences eating behavior, cognition, and whole-body metabolism. Studies investigating brain insulin rely on intranasal application.To investigate effects of three doses of insulin and placebo as nasal sprays on the central and autonomous nervous system and analyze absorption of insulin into the bloodstream.Nine healthy men received placebo or 40 U, 80 U, and 160 U insulin spray (...) in randomized order. Before and after spray, brain activity was assessed by functional magnetic resonance imaging, and heart rate variability (HRV) was assessed from electrocardiogram. Plasma insulin, C-peptide, and glucose were measured regularly.General community.Nasal insulin administration dose-dependently modulated regional brain activity and the normalized high-frequency component of the HRV. Post hoc analyses revealed that only 160 U insulin showed a considerable difference from placebo. Dose

2017 Journal of Clinical Endocrinology and Metabolism Controlled trial quality: uncertain

109. Effect of Dosing Time and Meal on IN-105 (Insulin Tregopil) PK and PD

Effect of Dosing Time and Meal on IN-105 (Insulin Tregopil) PK and PD Effect of Dosing Time and Meal on IN-105 (Insulin Tregopil) PK and PD - 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. Effect of Dosing (...) Details Study Description Go to Brief Summary: A study to evaluate the PK and PD of oral IN-105 (Insulin Tregopil) w.r.t. time of dosing prior to meal, duration between meals and type of meal . Condition or disease Intervention/treatment Phase Type 2 Diabetes Mellitus Drug: IN-105 (Insulin Tregopil) Other: Placebo comparator Phase 1 Detailed Description: A Phase 1, Randomized, Placebo Controlled, Crossover Trial in Type 2 Diabetes Patients to evaluate the effect of pre-meal dosing time, inter-meal

2017 Clinical Trials

110. Nonadjunctive Use of Continuous Glucose Monitors for Insulin Dosing: Is It Safe? Full Text available with Trip Pro

Nonadjunctive Use of Continuous Glucose Monitors for Insulin Dosing: Is It Safe? With the increasing accuracy of continuous glucose monitors (CGM) have come calls for the Food and Drug Administration (FDA) to label these devices as safe for nonadjunctive dosing of insulin. However, there is evidence that these devices are subject to sporadic, unpredictable, large errors. A text analysis of reports to the FDA MAUDE database since 2015 reveals over 25 000 complaints of CGM sensor inaccuracy

2017 Journal of diabetes science and technology

111. Commentary Regarding Shapiro, “Nonadjunctive Use of Continuous Glucose Monitors for Insulin Dosing: Is It Safe?” Full Text available with Trip Pro

Commentary Regarding Shapiro, “Nonadjunctive Use of Continuous Glucose Monitors for Insulin Dosing: Is It Safe?” The FDA recently expanded the approved use of Dexcom's G5 Mobile continuous glucose monitoring (CGM) system to allow for diabetes treatment decisions. This decision is expected to reduce the burden of SMBG testing and increase the adoption and persistent use of CGM. The safety of nonadjunctive CGM use was questioned because of sporadic large discrepancies between CGM and SMBG

2017 Journal of diabetes science and technology

112. A Large Difference in Dose Timing of Basal Insulin Introduces Risk of Hypoglycemia and Overweight: A Cross-Sectional Study Full Text available with Trip Pro

A Large Difference in Dose Timing of Basal Insulin Introduces Risk of Hypoglycemia and Overweight: A Cross-Sectional Study Basal insulin should be injected at the same time each day, but people with diabetes sometimes mistime their injections. It is not known whether irregular daily dose timing affects diabetes-related factors. We report here our evaluation of the effects of deviations from a regular dosing schedule on glycemic control and hypoglycemia on patients treated with long-acting (...) insulin (insulin glargine U100). We also consider the effects of ultra-long-acting insulin (insulin degludec) in this context.Nineteen individuals with type 1 diabetes and 58 with type 2 diabetes were enrolled. Demographic data on all participants were retrieved from their medical records. Variation in dose timing was determined as the difference between the time of the earliest mistimed dose and the time of the latest mistimed dose, for each participant, over a 2-week period. All participants

2017 Diabetes Therapy

113. Associations Between Home Insulin Dose Adjustments and Glycemic Outcomes at Hospital Admission Full Text available with Trip Pro

Associations Between Home Insulin Dose Adjustments and Glycemic Outcomes at Hospital Admission To describe patterns of home insulin dose adjustments for non-surgical, non-critically ill patients at admission and to describe associations between these adjustments and inpatient glycemic control.Hospital records of non-critically ill patients treated with basal insulin prior to admission were identified. After exclusion of records in which a confounding factor influencing insulin dosing (...) was present, 258 patient-admissions over a 3-year time period were included. Multivariate logistic regression was used to analyze the association between adjustments to home insulin total daily dose (TDD) and inpatient glycemic control within the first 48h, adjusting for relevant confounders.On hospital days 1 (HD1) and 2 (HD2), the home insulin TDD was reduced by 43.5% and 23.9%, respectively. Reductions in the home TDD ranging from 10% to 50% were not associated with normoglycemia or hyperglycemia

2017 Diabetes research and clinical practice

114. A Methodology to Compare Insulin Dosing Recommendations in Real-Life Settings Full Text available with Trip Pro

A Methodology to Compare Insulin Dosing Recommendations in Real-Life Settings We propose a methodology to analyze complex real-life glucose data in insulin pump users.Patients with type 1 diabetes (T1D) on insulin pumps were recruited from an academic endocrinology practice. Glucose data, insulin bolus (IB) amounts, and self-reported alcohol consumption and exercise events were collected for 30 days. Rules were developed to retrospectively compare IB recommendations from the insulin pump bolus (...) postprandial glucose was higher than target, the PDA suggested higher doses in 25%, lower doses in 13%, and equivalent doses in 62%. In 64% of all alcohol events the PDA would have provided appropriate advice. In 75% of exercise events, the PDA appropriately advised an IB, a carbohydrate snack, or neither.This study provides a methodology to systematically analyze real-life data generated by insulin pumps and allowed a preliminary analysis of the performance of the PDA for insulin dosing. Further testing

2017 Journal of diabetes science and technology

115. Dose Accuracy, Injection Force, and Usability Assessment of a New Half-Unit, Prefilled Insulin Pen Full Text available with Trip Pro

Dose Accuracy, Injection Force, and Usability Assessment of a New Half-Unit, Prefilled Insulin Pen This study examines the utility of the first prefilled, rapid-acting insulin pen that can be dialed in half-unit increments. Dose accuracy and injection force were examined through a series of design-verification tests, and usability was established by human factors validation testing.Devices were tested for dose accuracy at 3 different doses and temperatures and under free fall, vibration (...) , and cold storage conditioning. Injection force was measured at the maximum dose (30 units). Both experiments used the same semiautomated testing system. Usability was validated in a human factors simulated-use study that included 60 participants (patients with type 1 or type 2 diabetes [aged 10-79 years], adult caregivers, and health care providers).The pen met the International Organization for Standardization (ISO) 11608-1:2014 requirements for dose accuracy at all settings and conditions tested

2017 Journal of diabetes science and technology

116. Glargine and degludec: Solution behaviour of higher dose synthetic insulins Full Text available with Trip Pro

Glargine and degludec: Solution behaviour of higher dose synthetic insulins Single, double and triple doses of the synthetic insulins glargine and degludec currently used in patient therapy are characterised using macromolecular hydrodynamic techniques (dynamic light scattering and analytical ultracentrifugation) in an attempt to provide the basis for improved personalised insulin profiling in patients with diabetes. Using dynamic light scattering and sedimentation velocity in the analytical (...) doses of synthetic insulins remaining in the physiological system for extended periods of time, in some case 24-40 hours, double and triple dose insulins may impact adversely on personalised insulin profiling in patients with diabetes.

2017 Scientific reports

117. Dose-Dependent Effect of Sitagliptin on Carotid Atherosclerosis in Patients with Type 2 Diabetes Mellitus Receiving Insulin Treatment: A Post Hoc Analysis Full Text available with Trip Pro

Dose-Dependent Effect of Sitagliptin on Carotid Atherosclerosis in Patients with Type 2 Diabetes Mellitus Receiving Insulin Treatment: A Post Hoc Analysis Dipeptidyl peptidase-4 (DPP-4) inhibitors reduce blood glucose in a dose-dependent manner, but the dose-dependent effect relationship between DPP-4 inhibitors and atherosclerosis has not been investigated.Patients with type 2 diabetes mellitus (T2DM) treated with insulin were randomized to the sitagliptin (n = 137) or conventional treatment (...) compared with conventional treatment. Multiple linear regression analysis showed that changes in mean-IMT-CCA and left max-IMT-CCA decreased with higher sitagliptin dose.Addition of sitagliptin to insulin therapy might attenuate the progression of atherosclerosis in patients with T2DM in a dose-dependent manner.Mitsubishi Tanabe Pharma Co., Ono Pharmaceutical Co., and Novo Nordisk.UMIN000007396.

2017 Diabetes Therapy Controlled trial quality: uncertain

118. Low-dose YC-1 combined with glucose and insulin selectively induces apoptosis in hypoxic gastric carcinoma cells by inhibiting anaerobic glycolysis Full Text available with Trip Pro

Low-dose YC-1 combined with glucose and insulin selectively induces apoptosis in hypoxic gastric carcinoma cells by inhibiting anaerobic glycolysis This study aimed to establish a therapeutic strategy targeting hypoxic cancer cells in gastric carcinoma (GC). YC-1 is a HIF-1α inhibitor, and we revealed that low-dose YC-1 (10 µM) suppressed HIF-1α expression, and induced hypoxia-dependent apoptosis in the GC cell line 58As9. This hypoxia-specific apoptosis induction by YC-1 involved excessive (...) reactive oxygen species (ROS) generation. The apoptotic effect of 10 µM YC-1 was enhanced by additional glucose (G) and insulin (I) treatments. RT-PCR demonstrated that 10 µM YC-1 reduced hypoxia-induced expression of HIF-1α targets involved in anaerobic glycolysis. Metabolic analysis showed that YC-1 shifted glucose metabolism in hypoxic cells from anaerobic glycolysis to oxidative phosphorylation (OXPHOS). Additional GI accelerated membranous GLUT1 translocation, elevating glucose uptake

2017 Scientific reports

119. In Silico Modeling of Minimal Effective Insulin Doses Using the UVA/PADOVA Type 1 Diabetes Simulator Full Text available with Trip Pro

In Silico Modeling of Minimal Effective Insulin Doses Using the UVA/PADOVA Type 1 Diabetes Simulator The objective of this study was to identify the minimum basal insulin infusion rates and bolus insulin doses that would result in clinically relevant changes in blood glucose levels in the most insulin sensitive subjects with type 1 diabetes.The UVA/PADOVA Type 1 Diabetes Simulator in silico population of children, adolescents, and adults was administered a basal insulin infusion rate (...) to maintain blood glucose concentrations at 120 mg/dL (6.7 mmol/L). Two scenarios were modeled independently after 1 hour of simulated time: (1) basal insulin infusion rates in increments of 0.01 U/h were administered and (2) bolus doses in increments of 0.01 U were injected. Subjects were observed for 4 hours to determine insulin delivery required to change blood glucose by 12.5 mg/dL (0.7 mmol/L) and 25 mg/dL (1.4 mmol/L) in only 5% of the in silico population.The basal insulin infusion rates required

2017 Journal of diabetes science and technology

120. Higher-Than-Conventional Subcutaneous Regular Insulin Doses Following Diabetic Ketoacidosis in Children and Adolescents Full Text available with Trip Pro

Higher-Than-Conventional Subcutaneous Regular Insulin Doses Following Diabetic Ketoacidosis in Children and Adolescents To evaluate the effect of initial insulin dosage on glycemic control in the first 48 hours of subcutaneous regular insulin therapy after resolution of diabetic ketoacidosis (DKA).Records of patients with DKA hospitalized in the past 3 years [n=76, median age=10.0 (6.0-12.0) years, Male/Female: 44/32] were reviewed. The patients were designated into two groups according (...) to distribution of starting doses of subcutaneous insulin. Group 1 (n=28) received a median dose of 1.45 U/kg/day (1.41-1.5) and group 2 (n=48) a median dose of 0.96 U/kg/day (0.89-1). Clinical and laboratory data were analyzed.Median, minimum, and maximum blood glucose levels of Group 1 in the first 48 hours of treatment were significantly lower than that of Group 2 [213 (171-242) vs. 255 (222-316), p=<0.001; 102 (85-151) vs. 129 (105-199), p=0.004; and 335 (290-365) vs. 375 (341-438), p=0.001, respectively

2017 Journal of clinical research in pediatric endocrinology

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