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Latest & greatest articles for insulin
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Cohort study of insulin glargine and risk of breast, prostate, and colorectal cancer among patients with diabetes To examine whether use of insulin glargine, compared with another long-acting insulin, is associated with risk of breast, prostate, colorectal cancer, or all cancers combined.Computerized health records from Kaiser Permanente Northern and Southern California regions starting in 2001 and ending in 2009 were used to conduct a population-based cohort study among patients with diabetes (...) aged ≥18 years. With use of Cox regression modeling, cancer risk in users of insulin glargine (n = 27,418) was compared with cancer risk in users of NPH (n = 100,757).The cohort had a median follow-up of 3.3 years during which there was a median of 1.2 years of glargine use and 1.4 years of NPH use. Among users of NPH at baseline, there was no clear increase in risk of breast, prostate, colorectal, or all cancers combined associated with switching to glargine. Among those initiating insulin, ever
Preterm birth and random plasma insulin levels at birth and in early childhood. Although previous reports have linked preterm birth with insulin resistance in children and adults, it is not known whether altered insulin homeostasis is detectable at birth and tracks from birth through childhood.To investigate whether preterm birth is associated with elevated plasma insulin levels at birth and whether this association persists into early childhood.A prospective birth cohort of 1358 children (...) recruited at birth from 1998 to 2010 and followed-up with prospectively from 2005 to 2012 at the Boston Medical Center in Massachusetts.Random plasma insulin levels were measured at 2 time points: at birth (cord blood) and in early childhood (venous blood). The median age was 1.4 years (interquartile range [IQR], 0.8-3.3) among 4 gestational age groups: full term (≥39 wk), early term (37-38 wk), late preterm (34-36 wk), and early preterm (<34 wk).The geometric mean of insulin levels at birth were 9.2
Light physical activity determined by a motion sensor decreases insulin resistance, improves lipid homeostasis and reduces visceral fat in high-risk subjects: PreDiabEx study RCT To examine physical activity (PA) thresholds affecting glucose, insulin and lipid concentrations and body fat composition in high-risk patients for type 2 diabetes (T2D).A total of 113 subjects of both genders having abnormal glucose levels in the oral glucose tolerance test were contacted. A total of 78 subjects (...) <0.029). Between 0 and 3 months no significant changes were observed in fasting and 2-h glucose, body weight or maximal oxygen uptake. In contrast, changes in fasting and 2-h insulin (-3.4 mU l(-1), P=0.035 and -26.6, P=0.003, respectively), homeostasis model assessment-estimated insulin resistance (-1.0, P=0.036), total cholesterol (-0.55 mmol l(-1), P=0.041), low-density lipoprotein (LDL) cholesterol (-0.36 mmol l(-1), P=0.008) and visceral fat area (-5.5 cm(2), P=0.030) were significantly greater
Standing orders for insulin administration in hospitalized patients with type I or type II diabetes: clinical evidence Standing orders for insulin administration in hospitalized patients with type I or type II diabetes: clinical evidence Standing orders for insulin administration in hospitalized patients with type I or type II diabetes: clinical evidence CADTH Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation (...) of the quality of this assessment has been made for the HTA database. Citation CADTH. Standing orders for insulin administration in hospitalized patients with type I or type II diabetes: clinical evidence. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH). Rapid Response - Summary of Abstracts. 2013 Authors' conclusions Two randomized controlled trials and six non-randomized studies were identified regarding the effectiveness of standing insulin order protocols to guide subcutaneous
Abasaglar, previously Abasria(insulin glargine) 7 Westferry Circus ? Canary Wharf ? London E14 4HB ? United Kingdom An agency of the European Union Telephone +44 (0)20 7418 8400 Facsimile +44 (0)20 7523 7455 E-mail firstname.lastname@example.org Website www.ema.europa.eu 26 June 2014 EMA/CHMP/340840/2014 Committee for Medicinal Products for Human Use (CHMP) Assessment report Abasria International non-proprietary name: insulin glargine Procedure No. EMEA/H/C/002835/0000 Note Assessment report as adopted (...) report EMA/CHMP/340840/2014 Page 3/65 List of abbreviations ADA Anti-drug antibodies AE Adverse event ALT Alanine aminotransferase ANCOVA Analysis of covariance AST Aspartate aminotransferase AUC Area under the concentration-time curve AUC 0-8 Area under the concentration-time curve from time zero to infinity AUC t Area under the concentration-time curve over the dosing interval AUC (0-24) Area under the serum insulin glargine concentration-time curve from zero to 24 hours AUC (0-tlast) Area under
Insulin glargine USE OF INSULIN GLARGINE IN PREGNANCY 0344 892 0909 USE OF INSULIN GLARGINE IN PREGNANCY (Date of issue: August 2011 , Version: 1 ) This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a . Please encourage all women to complete an . Summary Insulin glargine is a long-acting basal insulin analogue indicated for the regulation of glucose metabolism (...) in diabetes mellitus. After subcutaneous injection, micro-precipitates form which release small amounts of insulin glargine for a period of 18 to 26 hours. Uncontrolled diabetes in pregnancy is associated with an increased risk of adverse maternal and fetal outcomes including congenital malformations, fetal macrosomia, shoulder dystocia, pre-eclampsia, preterm delivery, intrauterine death and neonatal hypoglycaemia, therefore adequate treatment is essential to ensure maternal glycaemic control. Close
Insulin USE OF INSULIN IN PREGNANCY 0344 892 0909 USE OF INSULIN IN PREGNANCY (Date of issue: October 2011 , Version: 2 ) This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a . Please encourage all women to complete an . Summary Insulin is a hormone produced by the pancreas to regulate carbohydrate and fat metabolism. Insulin is required for glucose uptake by the body (...) and is indicated in the treatment of diabetes mellitus. Insulin may be derived from human, porcine or recombinant sources and is administered via subcutaneous injection or continuous subcutaneous infusion. Uncontrolled diabetes in pregnancy is associated with an increased risk of adverse maternal and fetal outcomes including congenital malformations, fetal macrosomia, pre-eclampsia, preterm delivery, delivery-related complications such as shoulder dystocia, intrauterine death and neonatal hypoglycaemia
A Comparison of 1-Year Treatment Costs in Patients with Type 2 Diabetes Following Initiation of Insulin Glargine or Insulin Detemir in Argentina. To estimate and compare type 2 diabetes mellitus treatment costs in insulin-naive patients following initiation of therapy with either insulin glargine (IG) or insulin detemir (ID) over 1-year time horizon from a payers' perspective in Argentina.We used a pharmacoeconomic model based on a randomized trial comparing IG and ID (Rosenstock J, Davies M (...) , Home PD, et al. A randomised, 52-week, treat-to-target trial comparing insulin detemir with insulin glargine when administered as add-on to glucose-lowering drugs in insulin-naive people with type 2 diabetes. Diabetologia 2008;51:408-16) and Argentinean sources. Clinical, resource use, and cost data were combined to estimate direct medical costs (insulin, test strips, and needles) during the first year. Price per international unit of insulin is similar for IG and ID in the local market
Variable rate insulin infusion (VRII) for medical inpatients with diabetes The use of variable rate intravenous insulin infusion (VRIII) in medical inpatients October 2014This document is coded JBDS 09 in the series of JBDS documents: Other JBDS documents: Management of Hyperglycaemia and Steroid (Glucocorticoid) Therapy October 2014 JBDS 08 Admissions avoidance and diabetes: guidance for clinical commissioning groups and clinical teams December 2013 JBDS 07 The management of the hyperosmolar (...) Revised September 2013 JBDS 01 These documents are available to download from the ABCD website at http://www.diabetologists-abcd.org.uk/JBDS/JBDS.htm and the Diabetes UK website at www.diabetes.org.uk We are eager to find out about your experiences using this guideline- particularly any data from audits of its use in situ. This will be used in the next update of the guideline. Please contact Dr Stella George at: email@example.com This guideline is for the use of a variable rate intravenous insulin
Point of Care Tests to exclude preterm labour: Phosphorylated Insulin-like Growth Factor Binding Protein test App Pho Applic Date o Context at www 1. An appl Phosph false pr Austral A relate (PoCTs (Applic 2. After co effectiv for pred test perf MSAC verifica but also lication osphory cant: of MSAC c t for decisio w.msac.gov. Purpose o lication req orylated Ins reterm labou ia) by the D ed applicatio s) for predic cation Numb MSAC’s a onsidering t veness phosp dicting pre-t formance an noted (...) that t ation of addi o evidence t Pub 1335 – P ylated Ins onsiderat on: MSAC m au of applica questing the sulin-like G ur was recei Department on proposin cting false p ber 1351) an advice to t the availabl phorylated i term labour nd thus una the evidenc itive value o that use of th lic Sum Point of C sulin-like Ale ion: MS makes its ad tion and l Medicare B Growth Facto ived from A of Health in ng MBS list preterm labo nd consider the Ministe e evidence insulin-like r, MSAC did acceptable o e
Insulin pump treatment compared with multiple daily injections for treatment of type 2 diabetes (OpT2mise): a randomised open-label controlled trial. Many patients with advanced type 2 diabetes do not meet their glycated haemoglobin targets and randomised controlled studies comparing the efficacy of pump treatment and multiple daily injections for lowering glucose in insulin-treated patients have yielded inconclusive results. We aimed to resolve this uncertainty with a randomised controlled (...) trial (OpT2mise).We did this multicentre, controlled trial at 36 hospitals, tertiary care centres, and referal centres in Canada, Europe, Israel, South Africa, and the USA. Patients with type 2 diabetes who had poor glycaemic control despite multiple daily injections with insulin analogues were enrolled into a 2-month dose-optimisation run-in period. After the run-in period, patients with glycated haemoglobin of 8·0-12·0% (64-108 mmol/mol) were randomly assigned (1:1) by a computer-generated
2014LancetControlled trial quality: predicted high
Combination use of insulin and fipeptidyl peptidase-4 (DDP-4) inhibitors in Type 2 diabetes: clinical effectiveness Combination use of insulin and fipeptidyl peptidase-4 (DDP-4) inhibitors in Type 2 diabetes: clinical effectiveness Combination use of insulin and fipeptidyl peptidase-4 (DDP-4) inhibitors in Type 2 diabetes: clinical effectiveness CADTH Citation CADTH. Combination use of insulin and fipeptidyl peptidase-4 (DDP-4) inhibitors in Type 2 diabetes: clinical effectiveness. Ottawa (...) : Canadian Agency for Drugs and Technologies in Health (CADTH). Rapid Response. 2014 Authors' conclusions Four systematic reviews and seven randomized controlled trials were identified regarding the clinical efficacy and safety of DPP-4 inhibitors used in combination with insulin for patients withinadequate glycemic control on a basal or biphasic insulin regimen. Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Diabetes Mellitus, Type 2s; Dipeptidyl-Peptidase IV Inhibitors
Effect of sensor-augmented insulin pump therapy and automated insulin suspension vs standard insulin pump therapy on hypoglycemia in patients with type 1 diabetes: a randomized clinical trial. Hypoglycemia is a critical obstacle to the care of patients with type 1 diabetes. Sensor-augmented insulin pump with automated low-glucose insulin suspension has the potential to reduce the incidence of major hypoglycemic events.To determine the incidence of severe and moderate hypoglycemia with sensor (...) -augmented pump with low-glucose suspension compared with standard insulin pump therapy.A randomized clinical trial involving 95 patients with type 1 diabetes, recruited from December 2009 to January 2012 in Australia.Patients were randomized to insulin pump only or automated insulin suspension for 6 months.The primary outcome was the combined incidence of severe (hypoglycemic seizure or coma) and moderate hypoglycemia (an event requiring assistance for treatment). In a subgroup, counterregulatory
Use of an Insulin Bolus Advisor Improves Glycemic Control in Multiple Daily Insulin Injection (MDI) Therapy Patients With Suboptimal Glycemic Control: First results from the ABACUS trial Use of automated bolus advisors is associated with improved glycemic control in patients treated with insulin pump therapy. We conducted a study to assess the impact of using an insulin bolus advisor embedded in a blood glucose (BG) meter on glycemic control and treatment satisfaction in patients treated (...) with multiple daily insulin injection (MDI) therapy. The study goal was to achieve >0.5% A1C reduction in most patients.This was a 26-week, prospective, randomized, controlled, multinational study that enrolled 218 MDI-treated patients with poorly controlled diabetes (202 with type 1 diabetes, 16 with type 2 diabetes) who were 18 years of age or older. Participants had mean baseline A1C of 8.9% (SD, 1.2 [74 mmol/mol]), mean age of 42.4 years (SD, 14.0), mean BMI of 26.5 kg/m(2) (SD, 4.2), and mean diabetes
Assessment of the fatty liver index as an indicator of hepatic steatosis for predicting incident diabetes independently of insulin resistance in a Korean population Fatty liver disease, especially non-alcoholic fatty liver disease, is considered to be the hepatic manifestation of the metabolic syndrome, both closely associated with insulin resistance. Furthermore, fatty liver disease assessed by ultrasonography is known to be a predictor of the development of Type 2 diabetes mellitus. However (...) , it remains unclear whether fatty liver disease plays a role in the pathogenesis of Type 2 diabetes independently of insulin resistance. In this study, we investigated whether fatty liver disease assessed by the fatty liver index can predict the development of Type 2 diabetes independently of systemic insulin resistance.We examined the clinical and laboratory data of 7860 subjects without diabetes who underwent general routine health evaluations at the Asan Medical Center in 2007 and had returned
Insulin and oral agents for managing cystic fibrosis-related diabetes. The Cystic Fibrosis Foundation recommends both short-term and long-acting insulin therapy when cystic fibrosis-related diabetes has been diagnosed. Diagnosis is based on: an elevated fasting blood glucose level greater than 6.94 mmol/liter (125 mg/deciliter); or symptomatic diabetes for random glucose levels greater than 11.11 mmol/liter (200 mg/deciliter); or glycated hemoglobin levels of at least 6.5%.To establish (...) of the most recent search of the Group's Cystic Fibrosis Trials Register: 22 July 2013.Randomized controlled trials comparing all methods of diabetes therapy in people with diagnosed cystic fibrosis-related diabetes.Two authors independently extracted data and assessed the risk of bias in the included studies.The searches identified 19 studies (28 references). Three studies (107 participants) are included: one comparing insulin with oral repaglinide and no medication (short-term single-center study
Threshold-Based Insulin-Pump Interruption for Reduction of Hypoglycemia. The threshold-suspend feature of sensor-augmented insulin pumps is designed to minimize the risk of hypoglycemia by interrupting insulin delivery at a preset sensor glucose value. We evaluated sensor-augmented insulin-pump therapy with and without the threshold-suspend feature in patients with nocturnal hypoglycemia.We randomly assigned patients with type 1 diabetes and documented nocturnal hypoglycemia to receive sensor (...) -augmented insulin-pump therapy with or without the threshold-suspend feature for 3 months. The primary safety outcome was the change in the glycated hemoglobin level. The primary efficacy outcome was the area under the curve (AUC) for nocturnal hypoglycemic events. Two-hour threshold-suspend events were analyzed with respect to subsequent sensor glucose values.A total of 247 patients were randomly assigned to receive sensor-augmented insulin-pump therapy with the threshold-suspend feature (threshold
Insulin glargine (Lantus®) 100 units/ml solution for injection Insulin glargine (Lantus®) 100 units/ml solution for injection Insulin glargine (Lantus®) 100 units/ml solution for injection All Wales Medicines Strategy Group (AWMSG) Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation All Wales Medicines Strategy Group (AWMSG). Insulin glargine (Lantus®) 100 units/ml (...) solution for injection. Penarth: All Wales Therapeutics and Toxicology Centre (AWTTC), secretariat of the All Wales Medicines Strategy Group (AWMSG). AWMSG Secretariat Assessment Report Advice No. 0413. 2013 Authors' conclusions Insulin glargine (Lantus®) 100 units/ml solution for injection is recommended as an option for use within NHS Wales for the treatment of diabetes mellitus in children aged 2 to less than 6 years. Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Child