Latest & greatest articles for insulin

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Top results for insulin

821. Influence of human insulin on symptoms and awareness of hypoglycaemia: a randomised double blind crossover trial. Full Text available with Trip Pro

Influence of human insulin on symptoms and awareness of hypoglycaemia: a randomised double blind crossover trial. To investigate the apparent increased risk of severe hypoglycaemia associated with use of human insulin by comparing the pattern of symptoms of hypoglycaemia with human insulin and porcine insulin.Randomised controlled double blind crossover trial of treatment with human insulin and porcine insulin, with two treatment periods of six weeks.Diabetes outpatient department (...) of a university teaching hospital in Berne, Switzerland.44 patients (25 men, 19 women) aged 14 to 60 years, with insulin dependent diabetes mellitus. All patients met the following criteria: receiving treatment with fast acting soluble insulin and long acting protamine insulin; performing multiple daily fingerstick blood glucose self measurements; and had stable glycaemic control with about one mild hypoglycaemic episode a week during the preceding two months.Patients were randomised to receive either human

1991 BMJ Controlled trial quality: uncertain

822. Human insulin and awareness of acute hypoglycaemic symptoms in insulin-dependent diabetes. (Abstract)

Human insulin and awareness of acute hypoglycaemic symptoms in insulin-dependent diabetes. Some insulin-dependent diabetic patients who have clear symptoms of hypoglycaemia during animal insulin treatment have reported loss of these symptoms when human insulin preparations are introduced. A survey of Mersey Region, UK, identified eleven patients whose awareness of hypoglycaemia was lost after introduction of human insulin but returned with animal insulin treatment; seven took part in the study (...) . Acute hypoglycaemia was induced in these patients on two occasions by intravenous infusion of porcine or human soluble insulin (2.5 mU.kg-1, min-1) in random order. There was no significant difference between porcine and soluble insulin in the plasma glucose profile; mean (SEM) plasma glucose fell from 7.1 (0.4) mmol/l to a nadir of 1.5 (0.1) mmol/l with porcine insulin and from 7.1 (0.5) mmol/l to 1.6 (0.2) mmol/l with human insulin. An acute autonomic reaction occurred in all seven patients

1991 Lancet Controlled trial quality: uncertain

823. Intensified conventional insulin treatment and neuropsychological impairment. Full Text available with Trip Pro

Intensified conventional insulin treatment and neuropsychological impairment. To assess whether intensified insulin treatment, with an increased frequency of hypoglycaemic episodes, leads to cognitive deterioration.Prospective randomised trial of intensified conventional treatment and standard treatment.Outpatient clinic for patients with insulin dependent diabetes.96 patients with insulin dependent diabetes, high blood glucose concentrations, and non-proliferative retinopathy were randomised (...) interval 53% to 100%) of the patients given intensified treatment and 29 (56%, 36% to 75%) of the others had at least one episode of serious hypoglycaemia (p less than 0.05). The intensified conventional treatment group had a mean of 1.1 episodes of serious hypoglycaemia per patient per year compared with 0.4 episodes in the standard treatment group. Results of the neuropsychological tests were similar in the two groups after five years.Intensified conventional insulin treatment led to lower blood

1991 BMJ Controlled trial quality: uncertain

824. Comparison of insulin analogue B9AspB27Glu and soluble human insulin in insulin-treated diabetes. (Abstract)

Comparison of insulin analogue B9AspB27Glu and soluble human insulin in insulin-treated diabetes. Postprandial plasma glucose excursions and plasma levels of free insulin after subcutaneous bolus injection of a rapidly absorbed monomeric insulin analogue (B9AspB27Glu) or soluble human insulin ('Actrapid HM' U100) were studied in six insulin-treated diabetic subjects. 10 U actrapid or an equimolar amount of the analogue were injected, in random order with an interval of 1 week, immediately (...) before a 500 kcal test meal. Basal insulin levels were similar on the 2 study days (mean 74.1 [SE 5.1] pmol/l, actrapid; 79.7 [13.0] pmol/l, analogue). After injection of actrapid plasma free insulin levels rose slowly, reaching a plateau by 105 min at 222 (19) pmol/l. Injection of the analogue resulted in a rapid early peak at 30 min (798 [112] pmol/l), and levels were significantly higher than those after actrapid between 15 and 210 min. The more physiological plasma insulin levels achieved

1990 Lancet Controlled trial quality: uncertain

825. Rotation of the anatomic regions used for insulin injections and day-to-day variability of plasma glucose in type I diabetic subjects. (Abstract)

Rotation of the anatomic regions used for insulin injections and day-to-day variability of plasma glucose in type I diabetic subjects. Treatment of type I diabetes mellitus is hindered by the often large fluctuations in blood glucose concentration experienced by affected individuals. To determine to what extent day-to-day variation in blood glucose levels can be reduced if insulin is injected in the same anatomic region rather than in different regions using a rotational scheme, as is commonly (...) recommended, 12 type I diabetic subjects were studied. Insulin injections were given in the abdomen for 3 days and rotated among arms, abdomen, and thighs for 3 days using a crossover design with random assignment of treatment order. Blood samples for measurement of plasma glucose levels were obtained at nine scheduled times on each day. Insulin dose, diet, and physical activity were held constant for each subject. During the abdominal injection period, the mean SD of plasma glucose levels and the mean

1990 JAMA Controlled trial quality: uncertain

826. Nicotinic acid as therapy for dyslipidemia in non-insulin-dependent diabetes mellitus. (Abstract)

Nicotinic acid as therapy for dyslipidemia in non-insulin-dependent diabetes mellitus. Recently, nicotinic acid has been recommended as a first-line hypolipidemic drug. To determine the effectiveness of nicotinic acid in dyslipidemic patients with non-insulin-dependent diabetes mellitus, 13 patients were treated in a randomized crossover trial. Patients received either nicotinic acid (1.5 g three times daily) or no therapy (control period) for 8 weeks each. Compared with the control period (...) , and the induction of marked glycosuria in some patients. Furthermore, a consistent increase in plasma uric acid levels was observed. Therefore, despite improvement in lipid and lipoprotein concentrations, because of worsening hyperglycemia and the development of hyperuricemia, nicotinic acid must be used with caution in patients with non-insulin-dependent diabetes mellitus with dyslipidemia. We suggest that the drug not be used as a first-line hypolipidemic drug in patients with non-insulin-dependent diabetes

1990 JAMA Controlled trial quality: uncertain

827. Effect of long-term monitoring of glycosylated hemoglobin levels in insulin-dependent diabetes mellitus. (Abstract)

Effect of long-term monitoring of glycosylated hemoglobin levels in insulin-dependent diabetes mellitus. The value of routine measurements of glycosylated hemoglobin (hemoglobin A1c) in the care of patients with diabetes mellitus is uncertain. We undertook this study to determine whether knowledge of hemoglobin A1c values would result in improved metabolic control in a group of patients with insulin-dependent diabetes mellitus (IDDM).We randomly assigned 240 patients with IDDM to one of two (...) was monitored but did not change significantly (45 to 50 percent) in the control group. The patients in the group whose hemoglobin A1c level was monitored were seen and their insulin regimens changed more often, but they were hospitalized for acute care of their diabetes less often than those in the control group. A similar decrease in hemoglobin A1c values occurred in the control group in the following year, when their care givers knew their hemoglobin A1c values.Regular measurements of hemoglobin A1c lead

1990 NEJM Controlled trial quality: uncertain

828. Sensitivity to insulin during treatment with atenolol and metoprolol: a randomised, double blind study of effects on carbohydrate and lipoprotein metabolism in hypertensive patients. Full Text available with Trip Pro

Sensitivity to insulin during treatment with atenolol and metoprolol: a randomised, double blind study of effects on carbohydrate and lipoprotein metabolism in hypertensive patients. To compare the effects of metoprolol and atenolol on carbohydrate and lipid metabolism and on insulin response to an intravenous glucose load.Randomised, double blind, double dummy, controlled crossover trial.University Hospital, Uppsala, Sweden.60 Patients with primary hypertension (diastolic blood pressure when (...) on glucose, insulin, and lipid metabolism and glucose disposal mediated by insulin.Reduction of blood pressure was similar and satisfactory during treatment with both drugs. Glucose uptake mediated by insulin was measured during a euglycaemic hyperinsulinaemic clamp to evaluate patients' sensitivity to insulin. Glucose uptake decreased from 5.6 to 4.5 mg/kg/min when patients were taking metoprolol and from 5.6 to 4.9 mg/kg/min when they were taking atenolol. Both drugs caused a small increase in fasting

1989 BMJ Controlled trial quality: uncertain

829. NovoSol Basal: pharmacokinetics of a novel soluble long acting insulin analogue. Full Text available with Trip Pro

NovoSol Basal: pharmacokinetics of a novel soluble long acting insulin analogue. To determine the courses of absorption and the interindividual and intraindividual variations in absorption of iodine-125 labelled Ultratard HM and NovoSol Basal injected subcutaneously.Open randomised crossover study. Each patient was tested during two study periods of five days each, during which he or she received a subcutaneous injection of either 125I-NovoSol Basal or 125I-Ultratard HM on four consecutive days (...) . The aim was to detect a reduction in intraindividual standard deviation by a factor of two with a probability 0.95, taking 0.05 as the level of significance. This required 24 degrees of freedom and led to the choice of four courses in each of eight patients.Referrals to the diabetes research centre in Hvidøre, Copenhagen.Eight insulin dependent (type I) diabetics with low or undetectable C peptide concentrations who were receiving a multiple insulin injection regimen. One patient withdrew immediately

1989 BMJ Controlled trial quality: uncertain

830. Effect of captopril on blood pressure and kidney function in normotensive insulin dependent diabetics with nephropathy. Full Text available with Trip Pro

Effect of captopril on blood pressure and kidney function in normotensive insulin dependent diabetics with nephropathy. To assess whether inhibition of angiotensin converting enzyme protects kidney function in diabetic nephropathy.Open, randomised follow up study of normotensive insulin dependent diabetics with nephropathy either treated or not with captopril for one year.Outpatient diabetic clinic in a tertiary referral centre.32 Normotensive patients with insulin dependent diabetes (...) , albuminuria declined by 11% in the captopril treated group and rose by 55% in the controls, fractional albumin clearance fell by 17% in the captopril treated group and increased by 66% in the controls, and the glomerular filtration rate declined by 3.1 (2.8)ml/min/1.73 m2 with captopril and by 6.4 (3.1) ml/min/1.73 m2 in the controls.Inhibition of angiotensin converting enzyme arrests the progressive rise in albuminuria in normotensive insulin dependent diabetics with nephropathy.

1989 BMJ Controlled trial quality: uncertain

831. A randomized trial of intensive insulin therapy in newly diagnosed insulin-dependent diabetes mellitus. (Abstract)

A randomized trial of intensive insulin therapy in newly diagnosed insulin-dependent diabetes mellitus. A period of early, intensive insulin treatment is thought to improve subsequent beta-cell function in insulin-dependent diabetes mellitus (IDDM). To study this hypothesis, we randomly assigned adolescents with newly diagnosed IDDM to receive either conventional treatment (n = 14) (NPH insulin, 1 U per kilogram of body weight per day, in two divided doses) or an experimental treatment (n = 12 (...) ) (a two-week hospitalization with maintenance of blood glucose levels between 3.3 and 4.4 mmol per liter by continuous insulin infusion delivered by an external artificial pancreas [Biostator]). During the two-week intervention, the experimental-therapy group received four times more insulin than the conventionally treated group, and their endogenous insulin secretion was more completely suppressed, as evidenced by a urinary C-peptide excretion rate one seventh that of the conventionally treated group

1989 NEJM Controlled trial quality: uncertain

832. Responses to human and porcine insulin in healthy subjects. (Abstract)

Responses to human and porcine insulin in healthy subjects. In a double-blind randomised study, eight healthy men received equimolar amounts of human or porcine insulin by infusion (50 mU/kg per hour). Insulin potencies, in terms of the amount of glucose infused to maintain euglycaemia, were almost identical. Hypoglycaemia (blood glucose concentration 2 mmol/l or below) was then induced and the symptoms and hormonal counter-regulatory responses were recorded. The number of sympathoadrenergic (...) (but not neuroglycopenic) symptoms was significantly greater with porcine than with human insulin, as was the integrated noradrenaline response. Glucagon, growth hormone, cortisol, and adrenaline responses were similar for the two insulins.

1989 Lancet Controlled trial quality: uncertain

833. Partial normalization by dietary cod-liver oil of increased microvascular albumin leakage in patients with insulin-dependent diabetes and albuminuria. (Abstract)

Partial normalization by dietary cod-liver oil of increased microvascular albumin leakage in patients with insulin-dependent diabetes and albuminuria. In a double-blind crossover study, we compared the effects of eight weeks of dietary supplementation with cod-liver oil with the effects of supplementation with olive oil on endothelial permeability, blood pressure, and plasma lipid levels in 18 patients with insulin-dependent diabetes mellitus and albuminuria. When the patients received the cod (...) of very-low-density lipoprotein cholesterol and triglyceride increased (P less than 0.05 for all comparisons), but there was no change in the level of high-density lipoprotein. No changes were observed in the glomerular filtration rate, degree of albuminuria, insulin requirement, glycosylated hemoglobin level, or blood glucose level during supplementation with either oil. We conclude that dietary supplementation with cod-liver oil lowers the elevated transcapillary escape rate of albumin

1989 NEJM Controlled trial quality: uncertain

834. Warning symptoms of hypoglycaemia during treatment with human and porcine insulin in diabetes mellitus. (Abstract)

Warning symptoms of hypoglycaemia during treatment with human and porcine insulin in diabetes mellitus. 32 subjects with long-term insulin-dependent diabetes mellitus (IDDM) were entered into a double-blind, randomised crossover trial with human and porcine insulin. They were treated during both periods with regular insulin and with protamine (NPH) insulin. 18 subjects started with human and 14 with porcine insulin; the two insulin periods each lasted twelve weeks; the insulin doses were much (...) the same in the two periods (mean 23 [SD 9] U daily NPH; 14 [7] U daily regular insulin), as were blood glucose profiles and HbA1c values. There were 171 episodes of hypoglycaemia during human and 150 episodes during porcine insulin. Patients completed questionnaires after each hypoglycaemic episodes and at the end of the trial. Hunger and sweating without concomitant neuroglycopenic symptoms were significantly more frequent as initial warning symptoms during porcine than during human insulin (41% vs

1989 Lancet Controlled trial quality: uncertain

835. Protection of kidney function and decrease in albuminuria by captopril in insulin dependent diabetics with nephropathy. Full Text available with Trip Pro

Protection of kidney function and decrease in albuminuria by captopril in insulin dependent diabetics with nephropathy. To assess whether long term inhibition of angiotensin converting enzyme with captopril and frusemide or bendrofluazide protects kidney function in diabetic nephropathy.Non-randomised controlled before-after trial of matched hypertensive insulin dependent diabetics with nephropathy treated with captopril and frusemide or bendrofluazide.Outpatient diabetic clinic in tertiary (...) referral centre.Treatment group of 18 hypertensive insulin dependent diabetics with nephropathy (mean age 33), who had not been treated previously. Control group of 13 patients (mean age 32) fulfilling the same entry criteria from a prospective study.Treatment group was given daily captopril 37.5-100.0 mg and frusemide (mean) 98 mg (10 patients) or bendrofluazide (mean) 4 mg (seven). Treatment was continued for about two and a half years. Controls were not treated.Measurement of arterial blood pressure

1988 BMJ

836. Recombinant DNA derived monomeric insulin analogue: comparison with soluble human insulin in normal subjects. Full Text available with Trip Pro

Recombinant DNA derived monomeric insulin analogue: comparison with soluble human insulin in normal subjects. To compare the rate of absorption from subcutaneous tissue and the resulting hypoglycaemic effect of iodine-125 labelled soluble human insulin and a monomeric insulin analogue derived by recombinant DNA technology.Single blind randomised comparison of equimolar doses of 125I labelled soluble human insulin and insulin analogue.Study in normal people at a diabetes research unit (...) and a university department of medical physics.Seven healthy male volunteers aged 20-39 not receiving any other drugs.After an overnight fast and a basal period of one hour two doses (0.05 and 0.1 U/kg) of 125I labelled soluble human insulin and insulin analogue were injected subcutaneously into the anterior abdominal wall on four separate days.To find a fast acting insulin for meal related requirements in insulin dependent diabetics. MEASUREMENTS and main results--Residual radioactivity at the injection site

1988 BMJ Controlled trial quality: uncertain

837. Lovastatin for lowering cholesterol levels in non-insulin-dependent diabetes mellitus. (Abstract)

Lovastatin for lowering cholesterol levels in non-insulin-dependent diabetes mellitus. Coronary heart disease is an important cause of death in patients with non-insulin-dependent diabetes mellitus (NIDDM) and is particularly common in diabetic populations that have relatively high levels of plasma cholesterol. To determine whether plasma cholesterol levels in patients with NIDDM could be reduced by drug therapy, we assessed the effect of lovastatin, a potent inhibitor of 3-hydroxy-3

1988 NEJM Controlled trial quality: uncertain

838. Diabetic retinopathy after two years of intensified insulin treatment. Follow-up of the Kroc Collaborative Study. The Kroc Collaborative Study Group. (Abstract)

Diabetic retinopathy after two years of intensified insulin treatment. Follow-up of the Kroc Collaborative Study. The Kroc Collaborative Study Group. The progression of retinopathy was reevaluated at two years in 64 of the 68 patients with mild to moderate diabetic retinopathy, originally randomly assigned for an eight-month period either to intensified diabetic control with continuous subcutaneous insulin infusion (CSII) or to unchanged conventional injection treatment. Twenty-three of the 34

1988 JAMA Controlled trial quality: uncertain

839. Immunosuppression with azathioprine and prednisone in recent-onset insulin-dependent diabetes mellitus. (Abstract)

Immunosuppression with azathioprine and prednisone in recent-onset insulin-dependent diabetes mellitus. We randomly assigned 46 patients (mean age, 11.7 years; range, 4.5 to 32.8) with newly diagnosed insulin-dependent diabetes mellitus within two weeks of beginning insulin to receive either corticosteroids for 10 weeks plus daily azathioprine for one year or no immunosuppressive therapy. Half the 20 immunosuppressed patients completing the one-year trial had satisfactory metabolic outcomes (...) (hemoglobin A1c less than 6.8 percent; stimulated peak C peptide greater than 0.5 nmol per liter; insulin dose less than 0.4 U per kilogram of body weight per day) as compared with only 15 percent of the controls. Three of 20 immunosuppressed patients, but no controls, were insulin independent at one year. Two of these continue to receive azathioprine without insulin after more than 27 months of follow-up. The response to immunosuppression correlated with older age, better initial metabolic status

1988 NEJM Controlled trial quality: uncertain

840. Comparison of a high-carbohydrate diet with a high-monounsaturated-fat diet in patients with non-insulin-dependent diabetes mellitus. (Abstract)

Comparison of a high-carbohydrate diet with a high-monounsaturated-fat diet in patients with non-insulin-dependent diabetes mellitus. We compared a high-carbohydrate diet with a high-fat diet (specifically, a diet high in monounsaturated fatty acids) for effects on glycemic control and plasma lipoproteins in 10 patients with non-insulin-dependent diabetes mellitus (NIDDM) receiving insulin therapy. The patients were randomly assigned to receive first one diet and then the other, each for 28 (...) , the high-monounsaturated-fat diet resulted in lower mean plasma glucose levels and reduced insulin requirements, lower levels of plasma triglycerides and very-low-density lipoprotein cholesterol (lower by 25 and 35 percent, respectively; P less than 0.01), and higher levels of high-density lipoprotein (HDL) cholesterol (higher by 13 percent; P less than 0.005). Levels of total cholesterol and low-density lipoprotein (LDL) cholesterol did not differ significantly in patients on the two diets

1988 NEJM Controlled trial quality: uncertain