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Insulin Dosing

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141. Cross-Over Study Comparing Postprandial Glycemic Increase After Addition of a Fixed-Dose Mitiglinide/Voglibose Combination or a Dipeptidyl Peptidase-4 Inhibitor to Basal Insulin Therapy in Patients with Type 2 Diabetes Mellitus. (PubMed)

Cross-Over Study Comparing Postprandial Glycemic Increase After Addition of a Fixed-Dose Mitiglinide/Voglibose Combination or a Dipeptidyl Peptidase-4 Inhibitor to Basal Insulin Therapy in Patients with Type 2 Diabetes Mellitus. BACKGROUND Although the efficacy of combination therapy consisting of basal insulin and oral hypoglycemic agents (OHAs) has been shown, which OHAs are the most efficient remains unclear. MATERIAL AND METHODS Five patients with type 2 diabetes were enrolled and treated (...) with insulin degludec and metformin as a basal therapy. The patients were randomized in a cross-over fashion to receive a combination of mitiglinide (10 mg) and voglibose (0.2 mg) (M+V) 3 times daily or linagliptin (5 mg) (L) once daily for 8 weeks. After 8 weeks, 2 kinds of meal tolerance tests were performed as breakfast on 2 consecutive days. The first breakfast contained 460 kcal (carbohydrates, 49.1%; protein, 15.7%; fat, 35.2%), while the second contained 462 kcal (carbohydrates, 37.2%; protein, 19.6

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2017 Medical science monitor basic research Controlled trial quality: uncertain

142. Impact of ELKa, the Electronic Device for Prandial Insulin Dose Calculation, on Metabolic Control in Children and Adolescents with Type 1 Diabetes Mellitus: A Randomized Controlled Trial. (PubMed)

Impact of ELKa, the Electronic Device for Prandial Insulin Dose Calculation, on Metabolic Control in Children and Adolescents with Type 1 Diabetes Mellitus: A Randomized Controlled Trial. Background. The ELKa system is composed of computer software, with a database of nutrients, and a dedicated USB kitchen scale. It was designed to automatize the everyday calculations of food exchanges and prandial insulin doses. Aim. To investigate the influence of the ELKa on metabolic control in children (...) with type 1 diabetes mellitus (T1DM). Methods. A randomized, parallel, open-label clinical trial involved 106 patients aged <18 years with T1DM, HbA1C ≤ 10%, undergoing intensive insulin therapy, allocated to the intervention group, who used the ELKa (n = 53), or the control group (n = 53), who used conventional calculation methods. Results. After the 26-week follow-up, the intention-to-treat analysis showed no differences to all endpoints. In per protocol analysis, 22/53 (41.5%) patients reporting ELKa

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2017 Journal of diabetes research Controlled trial quality: uncertain

143. Combined low-dose spironolactone plus vitamin E vs. vitamin E monotherapy on insulin resistance, noninvasive indices of steatosis and fibrosis and adipokine levels in nonalcoholic fatty liver disease: A randomized controlled trial. (PubMed)

Combined low-dose spironolactone plus vitamin E vs. vitamin E monotherapy on insulin resistance, noninvasive indices of steatosis and fibrosis and adipokine levels in nonalcoholic fatty liver disease: A randomized controlled trial. The beneficial effects of mineralocorticoid receptor blockade by spironolactone have been shown in animal models of non-alcoholic fatty liver disease (NAFLD). The aim of the present 52-week randomized controlled trial was to compare the effects of low-dose (...) in the combination treatment group (P = .028), but not in the vitamin E group, and the difference for group*time interaction was significant (P = .047). Alanine aminotransferase-to-platelet ratio index, an index of fibrosis, did not change. Insulin levels and HOMA-IR decreased significantly only within the combination group (P = .011 and P = .011, respectively). In conclusion, the combined low-dose spironolactone plus vitamin E regimen significantly decreased NAFLD liver fat score. Larger-scale trials are needed

2017 obesity & metabolism Controlled trial quality: uncertain

144. 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. (PubMed)

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. A Personal Health Record (PHR) is an online application that allows patients to access, manage, and share their health data. PHRs not only enhance shared decision making with healthcare providers, but also enable remote monitoring and at-home-collection (...) 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

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2017 Medical Informatics and Decision Making Controlled trial quality: uncertain

145. The effect of baseline characteristics on clinical efficacy of liraglutide in patients treated with high-dose insulin. (PubMed)

The effect of baseline characteristics on clinical efficacy of liraglutide in patients treated with high-dose insulin. In patients requiring high-dose insulin treatment, a randomized, double-blind, placebo-controlled study showed that liraglutide improved glycaemic control and treatment satisfaction while promoting weight loss. We performed a post hoc analysis to evaluate if patients' baseline characteristics impact the efficacy of liraglutide, and which outcomes correlate with treatment (...) satisfaction. We used regression analysis to model the change in HbA1c and weight, with treatment assignment and baseline characteristics [HbA1c, age, body mass index (BMI), total daily dose (TDD) of insulin, duration of insulin treatment, and type of insulin regimen] as independent variables. Improvement in HbA1c was best predicted by treatment with liraglutide, followed by higher baseline HbA1c, BMI and age. Changes in weight were only associated with liraglutide treatment, independent of all baseline

2017 obesity & metabolism Controlled trial quality: uncertain

146. Effect of Two Different Doses of Vitamin D Supplementation on Metabolic Profiles of Insulin-Resistant Patients with Polycystic Ovary Syndrome (PubMed)

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.

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2017 Nutrients Controlled trial quality: predicted high

147. Twice-daily insulin degludec/insulin aspart provides superior fasting plasma glucose control and a reduced rate of hypoglycaemia compared with biphasic insulin aspart 30 in insulin-naive adults with Type 2 diabetes (PubMed)

mmol/mol (6.5%) with biphasic insulin aspart 30. Insulin degludec/insulin aspart achieved the prespecified non-inferiority margin (estimated treatment difference 0.02%; 95% CI -0.12, 0.17). Insulin degludec/insulin aspart was superior in lowering fasting plasma glucose (estimated treatment difference -1.00 mmol/l; 95% CI -1.4, -0.6; P < 0.001) and reducing overall and nocturnal confirmed hypoglycaemia at a similar overall insulin dose compared with biphasic insulin aspart 30. Similar proportions (...) Twice-daily insulin degludec/insulin aspart provides superior fasting plasma glucose control and a reduced rate of hypoglycaemia compared with biphasic insulin aspart 30 in insulin-naive adults with Type 2 diabetes To evaluate the efficacy and safety of twice-daily insulin degludec/insulin aspart vs. twice-daily biphasic insulin aspart 30 in people with Type 2 diabetes mellitus who were naïve to insulin.In this 26-week, multinational, open-label, controlled, two-arm, parallel-group, treat

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2016 EvidenceUpdates Controlled trial quality: uncertain

148. Insulin and glucose-lowering agents for treating people with diabetes and chronic kidney disease. (PubMed)

peptide-1 (GLP-1) agonists to placebo; 8 studies compared glitazones to no glitazone treatment; 1 study compared glinide to no glinide treatment; and 4 studies compared different types, doses or modes of administration of insulin. In addition, 2 studies compared sitagliptin to glipizide; and 1 study compared each of sitagliptin to insulin, glitazars to pioglitazone, vildagliptin to sitagliptin, linagliptin to voglibose, and albiglutide to sitagliptin. Most studies had a high risk of bias due (...) Insulin and glucose-lowering agents for treating people with diabetes and chronic kidney disease. Diabetes is the commonest cause of chronic kidney disease (CKD). Both conditions commonly co-exist. Glucometabolic changes and concurrent dialysis in diabetes and CKD make glucose-lowering challenging, increasing the risk of hypoglycaemia. Glucose-lowering agents have been mainly studied in people with near-normal kidney function. It is important to characterise existing knowledge of glucose

2018 Cochrane

149. Comparison of morning basal + 1 bolus insulin therapy (insulin glulisine + insulin glargine 300 U/ml vs. insulin lispro + insulin glargine biosimilar) using continuous glucose monitoring (CGM): a randomized crossover study. (PubMed)

on admission after glucose levels were stabilized by morning long-acting and ultra-rapid-acting insulins were randomly allocated to groups who received G + G300 on days 1 and 2, and the same dose L + GB on days 3 and 4, or vice versa. Data collected on days 2 and 4 (mean amplitude of glycemic excursion, mean of daily differences: all days) were analyzed. Insulin was injected at 08.00 h. A day was defined as the period from 08.00 h one day, to 08.00 h the next day. Test meals were given.Increased post (...) Comparison of morning basal + 1 bolus insulin therapy (insulin glulisine + insulin glargine 300 U/ml vs. insulin lispro + insulin glargine biosimilar) using continuous glucose monitoring (CGM): a randomized crossover study. We compared the effects of morning administration of insulin glulisine + insulin glargine 300 U/mL (G + G300) with that of insulin lispro + insulin glargine biosimilar (L + GB).A total of 30 patients with type 2 diabetes who wore a continuous glucose monitoring device

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2017 Journal of Diabetes Investigation Controlled trial quality: uncertain

150. The co-formulation of insulin degludec and insulin aspart lowers fasting plasma glucose and rates of confirmed and nocturnal hypoglycaemia, independent of baseline glycated haemoglobin levels, disease duration or body mass index: A pooled meta-analysis of

FPG <5.5 mmol/L). Significantly lower insulin doses were observed with IDegAsp vs comparators in all baseline characteristic and half of the category groups, and significantly lower rates of confirmed and nocturnal confirmed hypoglycaemia were observed with IDegAsp vs comparators in all baseline variable and category groups.IDegAsp retains a consistent safety and efficacy profile in patients with different baseline characteristics.© 2018 The Authors. Diabetes, Obesity and Metabolism published (...) The co-formulation of insulin degludec and insulin aspart lowers fasting plasma glucose and rates of confirmed and nocturnal hypoglycaemia, independent of baseline glycated haemoglobin levels, disease duration or body mass index: A pooled meta-analysis of To investigate whether the proven benefits of insulin degludec (IDeg) combined with insulin aspart (IAsp), known as IDegAsp, given twice daily, extend across a wide spectrum of patients with diabetes.This was a post hoc pooled analysis of 5

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2018 EvidenceUpdates

151. A randomized, open-label, multicentre, parallel-controlled study comparing the efficacy and safety of biphasic insulin aspart 30 plus metformin with biphasic insulin aspart 30 monotherapy for type 2 diabetes patients inadequately controlled with oral anti

A randomized, open-label, multicentre, parallel-controlled study comparing the efficacy and safety of biphasic insulin aspart 30 plus metformin with biphasic insulin aspart 30 monotherapy for type 2 diabetes patients inadequately controlled with oral anti To confirm non-inferiority of biphasic insulin aspart 30 (BIAsp 30) plus metformin to BIAsp 30 in lowering glycated haemoglobin (HbA1c) in Chinese patients with inadequately controlled type 2 diabetes using oral antidiabetic drugs.In this 16 (...) dose (P < 0.001) and weight gain were significantly lower (P < 0.05) in the BIAsp 30 plus metformin group compared with the BIAsp 30 group. No between-group differences in number of hypoglycaemic events were observed.BIAsp 30 plus metformin was non-inferior to BIAsp 30 in safely reducing HbA1c in this study.© 2018 John Wiley & Sons Ltd.

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2018 EvidenceUpdates

152. Efficacy and safety of MK-1293 insulin glargine compared with originator insulin glargine (Lantus) in type 2 diabetes: a randomized, open-label clinical trial

for or currently taking basal insulin (≥10 U/day). Participants were randomized 1:1 to once-daily Mk-Gla (n = 263) or Sa-Gla (n = 263). Titration of insulin was guided by a fasting plasma glucose (FPG)-based dosing algorithm. The primary efficacy objective was to demonstrate the non-inferiority of change from baseline in HbA1c (margin of 0.40% [4.4 mmol/mol]) with Mk-Gla versus Sa-Gla after 24 weeks. The primary safety objective was anti-insulin antibody development after 24 weeks.For Mk-Gla and Sa-Gla (...) , the least squares (LS) mean HbA1c change from baseline (95% CI) was -1.28 (-1.41, -1.15)% (-14.0 [-15.4, -12.6] mmol/mol) and -1.30 (-1.43, -1.18)% (-14.2 [-15.6, -12.8] mmol/mol). The LS mean HbA1c difference (Mk-Gla minus Sa-Gla) was 0.03 (-0.12, 0.18)% (0.3 [-1.4, 1.9] mmol/mol), meeting non-inferiority and equivalence (secondary objective) criteria. Insulin doses, FPG, and seven-point plasma glucose profiles were similar between groups. Safety and tolerability, including anti-insulin antibody

2018 EvidenceUpdates

153. Efficacy and safety of MK-1293 insulin glargine compared with originator insulin glargine (Lantus) in type 1 diabetes: A randomized, open-label clinical trial

) taking basal and prandial insulin. Participants were randomized 1:1 to once-daily Mk-Gla (n = 245) or Sa-Gla (n = 263). Dose titration of basal insulin was by a pre-breakfast plasma glucose dosing algorithm. The primary efficacy objective was assessment of the non-inferiority of HbA1c change from baseline (margin of 0.40% [4.4 mmol/mol]) for Mk-Gla compared with Sa-Gla over 24 weeks. The primary safety objective was assessment of anti-insulin antibody development over 24 weeks.The least squares (LS (...) ) mean HbA1c change from baseline at week 24 was -0.62 (95% CI -0.79, -0.45)% (-6.8 [-8.7, -4.9] mmol/mol) and -0.66 (-0.82, -0.50)% (-7.2 [-9.0, -5.4] mmol/mol) for Mk-Gla and Sa-Gla. The LS mean HbA1c difference was 0.04 (-0.11, 0.19)% (0.4 [-1.2, 2.0] mmol/mol) for Mk-Gla minus Sa-Gla, meeting the primary and secondary objective criteria for non-inferiority and equivalence. Week 24 mean insulin glargine dose for Mk-Gla and Sa-Gla was 0.46 and 0.48 U/kg, respectively. Similarity of HbA1c response

2018 EvidenceUpdates

154. Efficacy and Safety of IDegLira Versus Basal-Bolus Insulin Therapy in Patients With Type 2 Diabetes Uncontrolled on Metformin and Basal Insulin; DUAL VII Randomized Clinical Trial

<7.0% (53 mmol/mol). Total daily insulin dose was lower with IDegLira (40 units) than basal-bolus (84 units total; 52 units basal).In patients with uncontrolled type 2 diabetes on IGlar U100 and metformin, IDegLira treatment elicited HbA1c reductions comparable to basal-bolus, with statistically superior lower hypoglycemia rates and weight loss versus weight gain.© 2018 by the American Diabetes Association. (...) Efficacy and Safety of IDegLira Versus Basal-Bolus Insulin Therapy in Patients With Type 2 Diabetes Uncontrolled on Metformin and Basal Insulin; DUAL VII Randomized Clinical Trial In patients with uncontrolled type 2 diabetes on basal insulin, prandial insulin may be initiated. We assessed the efficacy and safety of initiating insulin degludec/liraglutide fixed-ratio combination (IDegLira) versus basal-bolus insulin.A phase 3b trial examined patients with uncontrolled type 2 diabetes on insulin

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2018 EvidenceUpdates

155. Insulin

practice throughout the Trust. The aim of this document is to ensure that: The right patient receives the right type and dose of insulin , at the right time by the most appropriate delivery device (...) The most appropriate technique is used to inject insulin with the most commonly used insulin pens The most appropriate insulin syringe is used to prepare insulin for an insulin infusion Insulin therapy in diabetes Diabetes mellitus is a group of metabolic diseases characterised by chronic hyperglycaemia (...) Insulin Top results for insulin - Trip Database or use your Google+ account Find evidence fast ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading

2018 Trip Latest and Greatest

156. GLP-1 receptor agonists: reports of diabetic ketoacidosis when concomitant insulin was rapidly reduced or discontinued

ketoacidosis has been reported in patients with type 2 diabetes on a combination of a GLP-1 receptor agonist and insulin who had doses of concomitant insulin rapidly reduced or discontinued. GLP-1 receptor agonists are not substitutes for insulin, and any reduction of insulin should be done in a stepwise manner with careful glucose self-monitoring. Abrupt discontinuation or reduction in insulin doses can lead to poor glycaemic control, with a risk of diabetic ketoacidosis. Published 19 June 2019 From (...) : Therapeutic area: Contents Advice for healthcare professionals: serious and life-threatening cases of diabetic ketoacidosis have been reported in association with exenatide, liraglutide, and dulaglutide, particularly after discontinuation or reduction of concomitant insulin blood glucose self-monitoring is necessary when adjusting the dose of insulin, particularly when GLP-1 receptor agonist therapy is initiated and insulin is reduced if the insulin dose is to be reduced, a stepwise approach

2019 MHRA Drug Safety Update

157. Blood on your hands: what’s the point of glucose self-monitoring in non-insulin treated diabetes?

testing is not a uniform intervention with standardized doses and protocols, it’s a tool. And like any tool, it’s not simply a matter of whether it’s used, but how it’s used. In a 12-month, prospective, cluster-randomized, multicenter study, Polonsky and colleagues recruited 483 poorly-controlled (A1c ≥7.5%) non-insulin T2DM . 13 Practices were randomized to an active control group (ACG, n= 227) with enhanced usual care or a structured testing group (STG, n= 256) with enhanced usual care and use (...) Blood on your hands: what’s the point of glucose self-monitoring in non-insulin treated diabetes? Blood On Your Hands: What’s The Point of Glucose Self-Monitoring in Non-Insulin Treated Diabetes? – Clinical Correlations Search Blood On Your Hands: What’s The Point of Glucose Self-Monitoring in Non-Insulin Treated Diabetes? March 26, 2019 6 min read By Gerardo Velez Peer Reviewed Mr. H is a 71-year-old patient with uncontrolled type 2 diabetes mellitus (T2DM) who came in for his routine follow

2019 Clinical Correlations

158. Insulin Pumps for the Management of Type 2 Diabetes: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines

levels and were effective in diabetes care, but when directly compared with multiple daily injections the results were mixed. Data from one systematic review and nine RCTs showed that continuous subcutaneous insulin infusion (CSII), sensor augmented pumps, and closed-loop therapy appear to lower HbA1c levels and reduce the total daily insulin dose of patients with T2DM, but differences were not always statistically significant.. Adverse events, including serious hypoglycemic events appear to be rare (...) Insulin Pumps for the Management of Type 2 Diabetes: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines Insulin Pumps for the Management of Type 2 Diabetes: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines | CADTH.ca Find the information you need Insulin Pumps for the Management of Type 2 Diabetes: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines Insulin Pumps for the Management of Type 2 Diabetes: A Review of Clinical Effectiveness

2018 Canadian Agency for Drugs and Technologies in Health - Rapid Review

159. Relationship between acne vulgaris and insulin resistance markers and effect of isotretinoin on insulin resistance markers in patients with acne vulgaris: a systematic review and meta-analysis

Relationship between acne vulgaris and insulin resistance markers and effect of isotretinoin on insulin resistance markers in patients with acne vulgaris: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears (...) , anaesthetic agent used, method of induction of cardiac ischemia, duration of ischemia and duration of reperfusion (if applicable). ">Data to be extracted: animal model Example: Dose, timing of administration, frequency of administration, route of administration, vehicle. ">Data to be extracted: intervention of interest Example: Serum creatinine; continuous; umol/L (may be recalculated from mg/dL). ">Data to be extracted: primary outcome(s) Example: Blood urea nitrogen; continuous; mmol/L (may

2019 PROSPERO

160. Insulin resistance and insulin-like growth factor-I levels in patients with acne: a systematic review and meta-analysis

Insulin resistance and insulin-like growth factor-I levels in patients with acne: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any (...) of reperfusion (if applicable). ">Data to be extracted: animal model Example: Dose, timing of administration, frequency of administration, route of administration, vehicle. ">Data to be extracted: intervention of interest Example: Serum creatinine; continuous; umol/L (may be recalculated from mg/dL). ">Data to be extracted: primary outcome(s) Example: Blood urea nitrogen; continuous; mmol/L (may be recalculated from mg/dL); Renal histological damage as assessed by Jablonski scale; continuous; Jablonski score

2019 PROSPERO

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