Latest & greatest articles for insulin

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Top results for insulin

181. Insulin Pens in Acute Care Settings: Clinical Effectiveness, Cost-Effectiveness, and Guidelines

Insulin Pens in Acute Care Settings: Clinical Effectiveness, Cost-Effectiveness, and Guidelines Insulin Pens in Acute Care Settings: Clinical Effectiveness, Cost-Effectiveness, and Guidelines | CADTH.ca Find the information you need Insulin Pens in Acute Care Settings: Clinical Effectiveness, Cost-Effectiveness, and Guidelines Insulin Pens in Acute Care Settings: Clinical Effectiveness, Cost-Effectiveness, and Guidelines Published on: July 24, 2017 Project Number: RB1121-000 Product Line (...) : Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What is the clinical effectiveness of insulin pens compared to insulin vials in acute care settings? What is the cost-effectiveness of insulin pens compared to insulin vials in acute care settings? What are the evidence-based guidelines regarding the use of insulin pens in acute care settings? Key Message Two systematic reviews (one with meta-analysis), four non-randomized studies, and three economic

2017 Canadian Agency for Drugs and Technologies in Health - Rapid Review

182. Effect of Insulin Degludec vs Insulin Glargine U100 on Hypoglycemia in Patients With Type 1 Diabetes: The SWITCH 1 Randomized Clinical Trial. Full Text available with Trip Pro

Effect of Insulin Degludec vs Insulin Glargine U100 on Hypoglycemia in Patients With Type 1 Diabetes: The SWITCH 1 Randomized Clinical Trial. Hypoglycemia, common in patients with type 1 diabetes, is a major barrier to achieving good glycemic control. Severe hypoglycemia can lead to coma or death.To determine whether insulin degludec is noninferior or superior to insulin glargine U100 in reducing the rate of symptomatic hypoglycemic episodes.Double-blind, randomized, crossover noninferiority (...) trial involving 501 adults with at least 1 hypoglycemia risk factor treated at 84 US and 6 Polish centers (January 2014-January 12, 2016) for two 32-week treatment periods, each with a 16-week titration and a 16-week maintenance period.Patients were randomized 1:1 to receive once-daily insulin degludec followed by insulin glargine U100 (n = 249) or to receive insulin glargine U100 followed by insulin degludec (n = 252) and randomized 1:1 to morning or evening dosing within each treatment

2017 JAMA Controlled trial quality: predicted high

183. Effect of Insulin Degludec vs Insulin Glargine U100 on Hypoglycemia in Patients With Type 2 Diabetes: The SWITCH 2 Randomized Clinical Trial. Full Text available with Trip Pro

Effect of Insulin Degludec vs Insulin Glargine U100 on Hypoglycemia in Patients With Type 2 Diabetes: The SWITCH 2 Randomized Clinical Trial. Hypoglycemia, a serious risk for insulin-treated patients with type 2 diabetes, negatively affects glycemic control.To test whether treatment with basal insulin degludec is associated with a lower rate of hypoglycemia compared with insulin glargine U100 in patients with type 2 diabetes.Randomized, double-blind, treat-to-target crossover trial including (...) two 32-week treatment periods, each with a 16-week titration period and a 16-week maintenance period. The trial was conducted at 152 US centers between January 2014 and December 2015 in 721 adults with type 2 diabetes and at least 1 hypoglycemia risk factor who were previously treated with basal insulin with or without oral antidiabetic drugs.Patients were randomized 1:1 to receive once-daily insulin degludec followed by insulin glargine U100 (n = 361) or to receive insulin glargine U100 followed

2017 JAMA Controlled trial quality: predicted high

184. Glucose Self-monitoring in Non-Insulin-Treated Patients With Type 2 Diabetes in Primary Care Settings: A Randomized Trial Full Text available with Trip Pro

Glucose Self-monitoring in Non-Insulin-Treated Patients With Type 2 Diabetes in Primary Care Settings: A Randomized Trial The value of self-monitoring of blood glucose (SMBG) levels in patients with non-insulin-treated type 2 diabetes has been debated.To compare 3 approaches of SMBG for effects on hemoglobin A1c levels and health-related quality of life (HRQOL) among people with non-insulin-treated type 2 diabetes in primary care practice.The Monitor Trial study was a pragmatic, open-label (...) randomized trial conducted in 15 primary care practices in central North Carolina. Participants were randomized between January 2014 and July 2015. Eligible patients with type 2 non-insulin-treated diabetes were: older than 30 years, established with a primary care physician at a participating practice, had glycemic control (hemoglobin A1c) levels higher than 6.5% but lower than 9.5% within the 6 months preceding screening, as obtained from the electronic medical record, and willing to comply

2017 EvidenceUpdates

185. Islet Cell Replacement Therapy for Insulin-Dependent Diabetes

Islet Cell Replacement Therapy for Insulin-Dependent Diabetes Islet Cell Replacement Therapy for Insulin-Dependent Diabetes | CADTH.ca CADTH Document Viewer Islet Cell Replacement Therapy for Insulin-Dependent Diabetes Table of Contents Search this document Islet Cell Replacement Therapy for Insulin-Dependent Diabetes June 2017 Summary ViaCyte’s PEC-Direct and PEC-Encap (VC-01) products offer a potential “functional cure” for patients with type 1 diabetes and insulin-dependent type 2 diabetes (...) . Using human pancreatic progenitor cells (PEC-01) created in the lab, both the PEC-Direct and the PEC-Encap products are implanted into patients, where they mature into functional pancreatic islet tissue that includes glucose-responsive insulin-producing beta cells. The PEC-Encap product offers the additional benefit of an encapsulation device designed to protect the cells from the immune system. The current evidence is limited to phase I and II human trials evaluating the safety of the PEC-Encap

2017 CADTH - Issues in Emerging Health Technologies

186. Islet Cell Replacement Therapy for Insulin-Dependent Diabetes

Islet Cell Replacement Therapy for Insulin-Dependent Diabetes Islet Cell Replacement Therapy for Insulin-Dependent Diabetes | CADTH.ca CADTH Document Viewer Islet Cell Replacement Therapy for Insulin-Dependent Diabetes Table of Contents Search this document Islet Cell Replacement Therapy for Insulin-Dependent Diabetes June 2017 Summary ViaCyte’s PEC-Direct and PEC-Encap (VC-01) products offer a potential “functional cure” for patients with type 1 diabetes and insulin-dependent type 2 diabetes (...) . Using human pancreatic progenitor cells (PEC-01) created in the lab, both the PEC-Direct and the PEC-Encap products are implanted into patients, where they mature into functional pancreatic islet tissue that includes glucose-responsive insulin-producing beta cells. The PEC-Encap product offers the additional benefit of an encapsulation device designed to protect the cells from the immune system. The current evidence is limited to phase I and II human trials evaluating the safety of the PEC-Encap

2017 CADTH - Issues in Emerging Health Technologies

187. A Hybrid Closed-Loop Insulin Delivery System for the Treatment of Type 1 Diabetes

A Hybrid Closed-Loop Insulin Delivery System for the Treatment of Type 1 Diabetes A Hybrid Closed-Loop Insulin Delivery System for the Treatment of Type 1 Diabetes | CADTH.ca CADTH Document Viewer A Hybrid Closed-Loop Insulin Delivery System for the Treatment of Type 1 Diabetes Table of Contents Search this document A Hybrid Closed-Loop Insulin Delivery System for the Treatment of Type 1 Diabetes June 2017 Summary Because their bodies no longer produce enough insulin, people with type 1 (...) diabetes mellitus must check their blood glucose — or blood sugar — levels several times a day and then calculate and inject an appropriate insulin dosage. Wearable systems, sometimes referred to as an “artificial pancreas,” are now available to replicate some of the functions of the pancreas in controlling insulin delivery. The MiniMed 670G is currently the only hybrid closed-loop system licensed for commercial use. Available evidence supports the safety of the MiniMed 670G system for individuals

2017 CADTH - Issues in Emerging Health Technologies

188. A cluster randomised trial, cost-effectiveness analysis and psychosocial evaluation of insulin pump therapy compared with multiple injections during flexible intensive insulin therapy for type 1 diabetes: the REPOSE Trial

A cluster randomised trial, cost-effectiveness analysis and psychosocial evaluation of insulin pump therapy compared with multiple injections during flexible intensive insulin therapy for type 1 diabetes: the REPOSE Trial A cluster randomised trial, cost-effectiveness analysis and psychosocial evaluation of insulin pump therapy compared with multiple injections during flexible intensive insulin therapy for type 1 diabetes: the REPOSE Trial A cluster randomised trial, cost-effectiveness analysis (...) and psychosocial evaluation of insulin pump therapy compared with multiple injections during flexible intensive insulin therapy for type 1 diabetes: the REPOSE Trial Heller S, White D, Lee E, Lawton J, Pollard D, Waugh N, Amiel S, Barnard K, Beckwith A, Brennan A, Campbell M, Cooper C, Dimairo M, Dixon S, Elliott J, Evans M, Green F, Hackney G, Hammond P, Hallowell N, Jaap A, Kennon B, Kirkham J, Lindsay R, Mansell P, Papaioannou D, Rankin D, Royle P, Smithson WH & Taylor C Record Status

2017 Health Technology Assessment (HTA) Database.

189. Insulin Resistance, Hyperinsulinemia, and Mitochondria Dysfunction in Nonobese Girls With Polycystic Ovarian Syndrome Full Text available with Trip Pro

Insulin Resistance, Hyperinsulinemia, and Mitochondria Dysfunction in Nonobese Girls With Polycystic Ovarian Syndrome Obese girls with polycystic ovarian syndrome (PCOS) have decreased insulin sensitivity (IS), muscle mitochondrial dysfunction and increased liver fat, which may contribute to their increased risk for type 2 diabetes. Less is known regarding normal-weight girls with PCOS.Normal-weight girls with PCOS [n =18, age 15.9 ± 1.8 years, body mass index (BMI) percentile 68 ± 18 (...) and fasting laboratory values, except for increased total testosterone and DHEAS in PCOS. Clamp-assessed peripheral IS was lower in PCOS (10.4 ± 2.4 mg/kg/min vs 12.7 ± 2.1; P = 0.024). The 120-minute OGTT insulin and glucose concentrations were higher in PCOS (114 IU/mL ± 26 vs 41 ± 25, P = <0.001 and 119 ± 22 mg/dL vs 85 ± 23, P = 0.01, respectively). Muscle mitochondrial ADP and phosphocreatine time constants were slower in PCOS. Despite a higher percentage liver fat in PCOS, hepatic IS was similar

2017 Journal of the Endocrine Society

190. Ovarian morphology is associated with insulin resistance in women with polycystic ovary syndrome: a cross sectional study Full Text available with Trip Pro

Ovarian morphology is associated with insulin resistance in women with polycystic ovary syndrome: a cross sectional study Polycystic ovary syndrome (PCOS) is a very common disorder well known to be associated with insulin resistance and metabolic disease. Insulin resistance is likely involved in the promotion of the PCOS reproductive phenotype and may mediate some of the ovarian morphology seen in the disorder. The phenotype of each individual woman with PCOS can vary widely as can her (...) regression was employed to evaluate the association between ovarian volume or follicle number and metabolic parameters (fasting insulin, HOMA-IR, fasting glucose, 2 h glucose, waist circumference) and hyperandrogenism (free testosterone, total testosterone, DHEAS, acanthosis nigricans), controlling for age.Three-hundred thirteen patients seen during the study period met Rotterdam criteria for PCOS and had sufficient measurements for inclusion in our analysis. The odds ratio of elevated HOMA-IR

2017 Fertility research and practice

191. The Management of Insulin Administration and Blood Glucose Monitoring in Children with Type 1 Diabetes Mellitus: Guidelines

The Management of Insulin Administration and Blood Glucose Monitoring in Children with Type 1 Diabetes Mellitus: Guidelines The Management of Insulin Administration and Blood Glucose Monitoring in Children with Type 1 Diabetes Mellitus: Guidelines | CADTH.ca Find the information you need The Management of Insulin Administration and Blood Glucose Monitoring in Children with Type 1 Diabetes Mellitus: Guidelines The Management of Insulin Administration and Blood Glucose Monitoring in Children (...) with Type 1 Diabetes Mellitus: Guidelines Published on: May 24, 2017 Project Number: RB1094-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What are the evidence-based guidelines regarding the management of insulin administration in children with type 1 diabetes mellitus? What are the evidence-based guidelines regarding the monitoring of blood glucose in children with type 1 diabetes mellitus? Key Message Three evidence-based guidelines

2017 Canadian Agency for Drugs and Technologies in Health - Rapid Review

192. Major Pathophysiology in Prediabetes and Type 2 Diabetes: Decreased Insulin in Lean and Insulin Resistance in Obese Full Text available with Trip Pro

Major Pathophysiology in Prediabetes and Type 2 Diabetes: Decreased Insulin in Lean and Insulin Resistance in Obese Lowering of body mass index (BMI) to ≥25 kg/m2 as obesity by ADA suggests insulin resistance as a major mechanism of impaired glucose metabolism (IGM) in Asians. However, glimepiride, an insulin secretagogue, delayed onset of type 2 diabetes (DM2) from prediabetes (PreDM), indicating decreased insulin secretion (IS) as a major factor in lean (L; BMI < 27 kg/m2) subjects (...) with IGM.Assessment of IS and insulin resistance (IR) in L and obese (Ob; BMI ≥ 27 kg/m2) subjects with euglycemia (N), PreDM, and new onset DM2.Seventy-five men and 45 women ages 36 to 75 years were divided into six groups: LN, LPreDM, LDM2, ObN, ObPreDM, and ObDM2.Determination of IS by insulinogenic indices (I/G) at fasting (FI/FG), first phase (∆I/∆G), and cumulative responses over 2 hours of OGTT (CRI/CRG), and IR by FIXFG, ∆IX∆G, and CRIXCRG. Changes in IS and IR for PreDM and DM2 were calculated as % fall

2017 Journal of the Endocrine Society

193. Prevention of Hypoglycemia With Predictive Low Glucose Insulin Suspension in Children With Type 1 Diabetes: A Randomized Controlled Trial Full Text available with Trip Pro

Prevention of Hypoglycemia With Predictive Low Glucose Insulin Suspension in Children With Type 1 Diabetes: A Randomized Controlled Trial To investigate whether predictive low glucose management (PLGM) of the MiniMed 640G system significantly reduces the rate of hypoglycemia compared with the sensor-augmented insulin pump in children with type 1 diabetes.This randomized, two-arm, parallel, controlled, two-center open-label study included 100 children and adolescents with type 1 diabetes (...) and glycated hemoglobin A1c ≤10% (≤86 mmol/mol) and using continuous subcutaneous insulin infusion. Patients were randomly assigned to either an intervention group with PLGM features enabled (PLGM ON) or a control group (PLGM OFF), in a 1:1 ratio, all using the same type of sensor-augmented insulin pump. The primary end point was the number of hypoglycemic events below 65 mg/dL (3.6 mmol/L), based on sensor glucose readings, during a 14-day study treatment. The analysis was performed by intention to treat

2017 EvidenceUpdates

194. Fast-Acting Insulin Aspart Improves Glycemic Control in Basal-Bolus Treatment for Type 1 Diabetes: Results of a 26-Week Multicenter, Active-Controlled, Treat-to-Target, Randomized, Parallel-Group Trial (Onset 1) Full Text available with Trip Pro

Fast-Acting Insulin Aspart Improves Glycemic Control in Basal-Bolus Treatment for Type 1 Diabetes: Results of a 26-Week Multicenter, Active-Controlled, Treat-to-Target, Randomized, Parallel-Group Trial (Onset 1) This multicenter, treat-to-target, phase 3 trial evaluated the efficacy and safety of fast-acting insulin aspart (faster aspart) versus conventional insulin aspart (IAsp) in adults with type 1 diabetes.The primary end point was change from baseline in HbA1c after 26 weeks. After an 8 (...) -week run-in, subjects were randomized (1:1:1) to double-blind mealtime faster aspart (n = 381), IAsp (n = 380), or open-label postmeal faster aspart (n = 382)-each with insulin detemir.HbA1c was reduced in both treatment groups, and noninferiority to IAsp was confirmed for both mealtime and postmeal faster aspart (estimated treatment difference [ETD] faster aspart-IAsp, mealtime, -0.15% [95% CI -0.23; -0.07], and postmeal, 0.04% [-0.04; 0.12]); mealtime faster aspart statistically significantly

2017 EvidenceUpdates

195. A placebo-controlled, randomised trial of the addition of once weekly GLP-1 receptor agonist dulaglutide to titrated daily insulin glargine in patients with type 2 diabetes (AWARD-9) Full Text available with Trip Pro

A placebo-controlled, randomised trial of the addition of once weekly GLP-1 receptor agonist dulaglutide to titrated daily insulin glargine in patients with type 2 diabetes (AWARD-9) To compare the addition of weekly dulaglutide vs the addition of placebo to titrated glargine in patients with type 2 diabetes (T2D) with sub-optimum glycated haemoglobin (HbA1c) concentration.Patients (N = 300) from this phase III, double-blind, parallel-arm, placebo-controlled study were randomized to weekly (...) ; placebo/glargine, 65 ± 2 U). The hypoglycaemia rate (≤3.9 mmol/L threshold) was 7.69 ± 15.15 and 8.56 ± 16.13 events/patient/year, respectively (P = .488). One episode of severe hypoglycaemia occurred in the dulaglutide/glargine group. Common gastrointestinal adverse events with dulaglutide were nausea (12.0%), diarrhoea (11.3%) and vomiting (6.0%).Weekly dulaglutide 1.5 mg added to basal insulin is an efficacious and well tolerated treatment option for patients with T2D.© 2017 John Wiley & Sons Ltd.

2017 EvidenceUpdates

196. Diabetes: avoid insulin degludec in combination with liraglutide

Diabetes: avoid insulin degludec in combination with liraglutide Prescrire IN ENGLISH - Spotlight ''Diabetes: avoid insulin degludec in combination with liraglutide'', 1 May 2017 {1} {1} {1} | | > > > Diabetes: avoid insulin degludec in combination with liraglutide Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight Diabetes: avoid insulin degludec (...) in combination with liraglutide In patients with type 2 diabetes, the combination of insulin degludec and liraglutide in an injection pen has more disadvantages than advantages. In patients with type 2 diabetes, when metformin does not provide satisfactory glycaemic control, there is no evidence that the combination of liraglutide with an insulin is of any benefit in preventing clinical complications of diabetes. A fixed-dose combination in an injection pen of insulin degludec, a long-acting insulin

2017 Prescrire

197. Plasma Amino Acids vs Conventional Predictors of Insulin Resistance Measured by the Hyperinsulinemic Clamp Full Text available with Trip Pro

Plasma Amino Acids vs Conventional Predictors of Insulin Resistance Measured by the Hyperinsulinemic Clamp Specific plasma amino acid (AA) profiles including elevated postabsorptive branched-chain amino acids (BCAAs) have been associated with insulin resistance (IR), mostly estimated by homeostatic model assessment. This study assessed the associations of postabsorptive AAs with IR directly measured by insulin-mediated glucose disposal and determined the quantitative value of AAs (...) , waist circumference, fasting glucose, insulin, and free fatty acids (FFAs) negatively predicted 64% of the M/I variance; glutamate added 2% more. In nondiabetic participants, IR was predicted by waist circumference, insulin, and FFAs, without contribution from AAs.Several postabsorptive AAs correlated with IR but added limited predictive value to conventional markers because levels were determined largely by abdominal adiposity. Data suggest a sex-specific regulation of AA metabolism by excess

2017 Journal of the Endocrine Society

198. A Comparison of Inpatient Cost Per Day in General Surgery Patients with Type 2 Diabetes Treated with Basal-Bolus versus Sliding Scale Insulin Regimens Full Text available with Trip Pro

A Comparison of Inpatient Cost Per Day in General Surgery Patients with Type 2 Diabetes Treated with Basal-Bolus versus Sliding Scale Insulin Regimens The identification of cost-effective glycaemic management strategies is critical to hospitals. Treatment with a basal-bolus insulin (BBI) regimen has been shown to result in better glycaemic control and fewer complications than sliding scale regular insulin (SSI) in general surgery patients with type 2 diabetes mellitus (T2DM), but the effect

2017 PharmacoEconomics open Controlled trial quality: uncertain

199. Effects of KDT501 on Metabolic Parameters in Insulin-Resistant Prediabetic Humans Full Text available with Trip Pro

Effects of KDT501 on Metabolic Parameters in Insulin-Resistant Prediabetic Humans KDT501 is an isohumulone drug that has demonstrated beneficial effects on metabolic parameters in mice.This study was intended to examine potential improvements in metabolism in humans.Changes in carbohydrate and lipid metabolism, along with inflammatory markers, were evaluated in prediabetic humans in a clinical research center.Nine obese patients participated. All had prediabetes or normal glucose tolerance plus (...) three features of metabolic syndrome.All participants were treated with escalating doses of KDT501 to a maximum dose of 1000 mg every 12 hours for a total of 28 days.Changes in carbohydrate metabolism were measured with oral glucose tolerance, homeostatic model of insulin resistance, and euglycemic clamp; changes in plasma lipids and response to a lipid tolerance test; and changes in plasma inflammatory markers.The drug was well tolerated. After KDT501 treatment, plasma triglycerides were reduced

2017 Journal of the Endocrine Society

200. A Ratiometric Sensor for Imaging Insulin Secretion in Single β Cells Full Text available with Trip Pro

A Ratiometric Sensor for Imaging Insulin Secretion in Single β Cells Despite the urgent need for assays to visualize insulin secretion there is to date no reliable method available for measuring insulin release from single cells. To address this need, we developed a genetically encoded reporter termed RINS1 based on proinsulin superfolder GFP (sfGFP) and mCherry fusions for monitoring insulin secretion. RINS1 expression in MIN6 β cells resulted in proper processing yielding single-labeled (...) insulin species. Unexpectedly, glucose or drug stimulation of insulin secretion in β cells led to the preferential release of the insulin-sfGFP construct, while the mCherry-fused C-peptide remained trapped in exocytic granules. This physical separation was used to monitor glucose-stimulated insulin secretion ratiometrically by total internal reflection fluorescence microscopy in single MIN6 and primary mouse β cells. Further, RINS1 enabled parallel monitoring of pulsatile insulin release

2017 Cell chemical biology