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Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. BACKGROUND: Polycystic ovary syndrome (PCOS) is characterised by infrequent or absent ovulation, and high levels of androgens and insulin (hyperinsulinaemia). Hyperinsulinaemia occurs secondary to insulin resistance and is associated with increased risk of cardiovascular disease and diabetes mellitus. Insulin-sensitising agents (...) such as metformin may be effective in treating PCOS-related anovulation. OBJECTIVES: To evaluate the effectiveness and safety of insulin-sensitising drugs in improving reproductive and metabolic outcomes for women with PCOS undergoing ovulation induction. SEARCH METHODS: We searched the following databases from inception to January 2017: Cochrane Gynaecology and Fertility Group Specialised Register, CENTRAL, MEDLINE, Embase, PsycINFO and CINAHL. We searched registers of ongoing trials and reference lists from
Early Intensive Insulin Use May Preserve Î²-Cell Function in Neonatal Diabetes Due to Mutations in the Proinsulin Gene ISSN 2472-1972 Early Intensive Insulin Use May Preserve b-CellFunctioninNeonatalDiabetesDue toMutationsintheProinsulinGene Lisa R. Letourneau, 1 David Carmody, 2 Louis H. Philipson, 1 and Siri Atma W. Greeley 1,3 1 Department of Medicine, Section of Adult and Pediatric Endocrinology, Diabetes and Metabolism, University of Chicago, Chicago, Illinois, 60637; 2 Department (...) thatmoreintensiveinsulintreatmentofS2mayhaveresultedinbetterclinicaloutcomes.S1wasdiagnosed withdiabetesafterpresentingwithserumglucoseof404mg/dL(22.4mmol/L)andstartedmultipledaily insulin injections at age 4 months, followed by continuous subcutaneous insulin infusion (CSII) at age 42 months. S1 had positive genetic testing at age 4 months for the GlyB8Ser or Gly32Ser mutation in proinsulin. S2 had positive research-based genetic testing, age 1 month, before she had consistently el- evated blood glucose levels. Continuous glucose monitoring revealed abnormal excursions to 200 mg/dL
Effect of Oral Insulin on Prevention of Diabetes in Relatives of Patients With Type 1 Diabetes: A Randomized Clinical Trial. Importance: Type 1 diabetes requires major lifestyle changes and carries increased morbidity and mortality. Prevention or delay of diabetes would have major clinical effect. Objective: To determine whether oral insulin delays onset of type 1 diabetes in autoantibody-positive relatives of patients with type 1 diabetes. Design, Setting, and Participants: Between March 2 (...) , 2007, and December 21, 2015, relatives with at least 2 autoantibodies, including insulin autoantibodies and normal glucose tolerance, were enrolled in Canada, the United States, Australia, New Zealand, the United Kingdom, Italy, Sweden, Finland, and Germany. The main study group (n = 389) had first-phase insulin release on an intravenous glucose tolerance test that was higher than the threshold. The 55 patients in the secondary stratum 1 had an identical antibody profile as the main study group
Serine/threonine protein kinase 25 antisense oligonucleotide treatment reverses glucose intolerance, insulin resistance, and nonalcoholic fatty liver disease in mice Serine/Threonine Protein Kinase 25 Antisense Oligonucleotide Treatment Reverses Glucose Intolerance, Insulin Resistance, and Nonalcoholic Fatty Liver Disease in Mice Esther Nu~ nez-Dur an, 1 Mariam Aghajan, 2 Manoj Amrutkar, 3 Silva S€ utt, 1 Emmelie Cansby, 1 Sheri L. Booten, 2 Andrew Watt, 2 Marcus Ståhlman, 4 Norbert Stefan, 5,6 (...) Hans-Ulrich H€ aring, 5,6 Harald Staiger, 5-7 Jan Bor en , 4 Hanns-Ulrich Marschall, 4 and Margit Mahlapuu 1 Nonalcoholic fatty liver disease (NAFLD) contributes to the pathogenesis of type 2 diabetes and cardiovascular disease, and patients with nonalcoholic steatohepatitis (NASH) are also at risk of developing cirrhosis, liver failure, and hepatocel- lular carcinoma. To date, no speci?c therapy exists for NAFLD/NASH, which has been recognized as one of the major unmet medical needs of the twenty
Immunosuppressive Therapy in Treatment of Refractory Hypoglycemia in Type B Insulin Resistance: A Case Report 29264467 2018 11 13 2472-1972 1 12 2017 Dec 01 Journal of the Endocrine Society J Endocr Soc Immunosuppressive Therapy in Treatment of Refractory Hypoglycemia in Type B Insulin Resistance: A Case Report. 1435-1439 10.1210/js.2017-00292 Type B insulin resistance is a rare syndrome characterized by fluctuating glucose levels (ranging from hyperglycemia with extreme insulin resistance (...) to intractable hypoglycemia without exogenous insulin administration), high serum insulin levels, and insulin receptor autoantibodies. Most cases occur in the African American population in association with other underlying autoimmune systemic diseases. Treatments with high-dose steroids, immunosuppressants, and plasmapheresis have been used, with variable outcomes, in patients without spontaneous remission. We report the case of a 60-year-old African American woman with history
Efficacy and safety of alirocumab in insulin-treated individuals with type 1 or type 2 diabetes and high cardiovascular risk: The ODYSSEY DM-INSULIN randomized trial 28905478 2017 09 14 2017 11 06 1463-1326 19 12 2017 Dec Diabetes, obesity & metabolism Diabetes Obes Metab Efficacy and safety of alirocumab in insulin-treated individuals with type 1 or type 2 diabetes and high cardiovascular risk: The ODYSSEY DM-INSULIN randomized trial. 1781-1792 10.1111/dom.13114 To investigate the efficacy (...) and safety of alirocumab in participants with type 2 (T2D) or type 1 diabetes (T1D) treated with insulin who have elevated LDL cholesterol levels despite maximally tolerated statin therapy. Participants at high cardiovascular risk with T2D (n = 441) or T1D (n = 76) and LDL cholesterol levels ≥1.8 mmol/L (≥70 mg/dL) were randomized 2:1 to alirocumab:placebo administered subcutaneously every 2 weeks, for 24 weeks' double-blind treatment. Alirocumab-treated participants received 75 mg every 2 weeks
Efficacy and safety of lixisenatide in a predominantly Asian population with type 2 diabetes insufficiently controlled with basal insulin: The GetGoal-L-C randomized trial 28742225 2017 07 25 2017 10 05 1463-1326 2017 Jul 25 Diabetes, obesity & metabolism Diabetes Obes Metab Efficacy and safety of lixisenatide in a predominantly Asian population with type 2 diabetes insufficiently controlled with basal insulin: The GetGoal-L-C randomized trial. 10.1111/dom.13072 To assess the effects (...) on glycaemic control of lixisenatide vs placebo as add-on treatment to basal insulin (BI) ± metformin and effects on glycated haemoglobin (HbA1c) reduction in patients with insufficiently controlled type 2 diabetes (T2D). Patients (n = 448) with inadequately controlled T2D were randomized (1:1) to lixisenatide or placebo as add-on to BI ± metformin for 24 weeks after an 8-week run-in phase, during which BI was titrated to a target self-monitored plasma glucose (SMPG; 4.4-5.6 mmol/L). The primary endpoint
Treatment of Hyperkalemia With a Low-Dose Insulin Protocol Is Effective andÂ Results in ReducedÂ Hypoglycemia 29725636 2018 11 14 2468-0249 3 2 2018 Mar Kidney international reports Kidney Int Rep Treatment of Hyperkalemia With a Low-Dose Insulin Protocol Is Effective and Results in Reduced Hypoglycemia. 328-336 10.1016/j.ekir.2017.10.009 Complications associated with insulin treatment for hyperkalemia are serious and common. We hypothesize that, in chronic kidney disease (CKD) and end-stage (...) renal disease (ESRD), giving 5 units instead of 10 units of i.v. regular insulin may reduce the risk of causing hypoglycemia when treating hyperkalemia. A retrospective quality improvement study on hyperkalemia management (K + ≥ 6 mEq/l) from June 2013 through December 2013 was conducted at an urban emergency department center. Electronic medical records were reviewed, and data were extracted on presentation, management of hyperkalemia, incidence and timing of hypoglycemia, and whether treatment
Oral Hypoglycemic Agents Added to Insulin Monotherapy for Type 2 Diabetes. Clinical Question: Among patients with type 2 diabetes mellitus who do not achieve optimal glycemic control with insulin monotherapy, is the addition of oral hypoglycemic agents associated with benefits (measured by lowering of hemoglobin A1c) or adverse effects? Bottom Line: Adding a sulfonylurea to insulin was associated with more hypoglycemic events compared with insulin alone, but this association was not observed (...) for metformin. Adding a sulfonylurea or metformin to insulin was associated with a decrease in hemoglobin A1c of approximately 1.0%.
Association between insulin resistance and preeclampsia in obese non-diabetic women receiving metformin 29225676 2018 11 13 1753-495X 10 4 2017 Dec Obstetric medicine Obstet Med Association between insulin resistance and preeclampsia in obese non-diabetic women receiving metformin. 170-173 10.1177/1753495X17725465 To examine whether the reduced incidence of preeclampsia in non-diabetic obese pregnant women treated with metformin is mediated by changes in insulin resistance. This was a secondary (...) analysis of obese pregnant women in a randomised trial (MOP trial). Fasting plasma glucose and insulin were measured in 384 of the 400 women who participated in the MOP trial. Homeostasis model assessment of insulin resistance (HOMA-IR) was compared in the metformin and placebo groups and in those that developed preeclampsia versus those that did not develop preeclampsia. At 28 weeks, median HOMA-IR was significantly lower in the metformin group. Logistic regression analysis demonstrated
Hyperinsulinemia and Insulin Receptor Gene Mutation in Nonobese Healthy Subjects in Japan 29264459 2018 11 13 2472-1972 1 11 2017 Nov 01 Journal of the Endocrine Society J Endocr Soc Hyperinsulinemia and Insulin Receptor Gene Mutation in Nonobese Healthy Subjects in Japan. 1351-1361 10.1210/js.2017-00332 Hyperinsulinemia is often observed in obese people, owing to their insulin resistance accompanied by visceral fat accumulation, but the frequency of hyperinsulinemia in nonobese people (...) is not well known. Mutations in the insulin receptor gene are known to cause insulin resistance and hyperinsulinemia in type A insulin resistance syndrome, Rabson-Mendenhall syndrome, and Donohue syndrome. However, insulin receptor gene abnormalities have not been investigated in asymptomatic hyperinsulinemic subjects. The aim of the current study was to investigate the prevalence of hyperinsulinemia in nonobese Japanese subjects and to examine the involvement of insulin receptor gene mutations. We
Association of Insulin Pump Therapy vs Insulin Injection Therapy With Severe Hypoglycemia, Ketoacidosis, and Glycemic Control Among Children, Adolescents, and Young Adults With Type 1 Diabetes. Importance: Insulin pump therapy may improve metabolic control in young patients with type 1 diabetes, but the association with short-term diabetes complications is unclear. Objective: To determine whether rates of severe hypoglycemia and diabetic ketoacidosis are lower with insulin pump therapy compared (...) with insulin injection therapy in children, adolescents, and young adults with type 1 diabetes. Design, Setting, and Participants: Population-based cohort study conducted between January 2011 and December 2015 in 446 diabetes centers participating in the Diabetes Prospective Follow-up Initiative in Germany, Austria, and Luxembourg. Patients with type 1 diabetes younger than 20 years and diabetes duration of more than 1 year were identified. Propensity score matching and inverse probability of treatment
Increased IRS2 mRNA Expression in SGA Neonates: PCR Analysis of Insulin/IGF Signaling in Cord Blood 29264464 2018 11 13 2472-1972 1 12 2017 Dec 01 Journal of the Endocrine Society J Endocr Soc Increased IRS2 mRNA Expression in SGA Neonates: PCR Analysis of Insulin/IGF Signaling in Cord Blood. 1408-1416 10.1210/js.2017-00294 Hypoglycemia is the most common metabolic problem among small-for-gestational-age (SGA) neonates. However, the pathological mechanism and insulin/ insulin-like growth factor (...) (IGF) signaling axis in neonates remain unknown. To determine the insulin/IGF axis in neonates, we analyzed the messenger RNA (mRNA) expression of insulin/IGF signaling in fetal umbilical cord blood. The Perinatal Medical Center of Tottori University Hospital. Fifty-two [42 appropriate-for-gestational-age (AGA) and 10 SGA] neonates. Immediately collected cord blood was placed into a PAXgene Blood RNA Tube. Total RNA from the blood was purified using reagents provided in the PAXgene Blood RNA Kit
Breast cancer risk factors in relation to estrogen receptor, progesterone receptor, insulin-like growth factor-1 receptor, and Ki67 expression in normal breast tissue 28979927 2018 11 13 2374-4677 3 2017 NPJ breast cancer NPJ Breast Cancer Breast cancer risk factors in relation to estrogen receptor, progesterone receptor, insulin-like growth factor-1 receptor, and Ki67 expression in normal breast tissue. 39 10.1038/s41523-017-0041-7 Studies have suggested that hormone receptor and Ki67 (...) expression in normal breast tissue are associated with subsequent breast cancer risk. We examined the associations of breast cancer risk factors with estrogen receptor (ER), progesterone receptor (PR), insulin-like growth factor-1 receptor (IGF-1R), and Ki67 expression in normal breast tissue. This analysis included 388 women with benign breast disease (ages 17-67 years) in the Nurses' Health Studies. Immunohistochemical staining was performed on tissue microarrays constructed from benign biopsies
Glycaemic control and hypoglycaemia in people with type 2 diabetes switching from twice-daily basal insulin to once-daily insulin glargine 300 U/mL or insulin glargine 100 U/mL (EDITION 1 and EDITION 2 subgroup analysis) 28736942 2017 07 24 2017 09 14 1463-1326 2017 Jul 24 Diabetes, obesity & metabolism Diabetes Obes Metab Glycaemic control and hypoglycaemia in people with type 2 diabetes switching from twice-daily basal insulin to once-daily insulin glargine 300 U/mL or insulin glargine 100 U (...) /mL (EDITION 1 and EDITION 2 subgroup analysis). 10.1111/dom.13071 In this post hoc analysis we compared glycaemic control and hypoglycaemia between insulin glargine 300 U/mL (Gla-300) and glargine 100 U/mL (Gla-100) administered once daily in people with type 2 diabetes (T2DM) from the EDITION 1 (basal plus mealtime insulin) and EDITION 2 (basal insulin plus oral antihyperglycaemic drugs) trials who were previously receiving twice-daily insulin. At randomization, 16.9% and 20.0% of people
Red wine polyphenols do not improve obesity-associated insulin resistance: A randomized controlled trial 28643477 2017 06 23 2017 08 14 1463-1326 2017 Jun 23 Diabetes, obesity & metabolism Diabetes Obes Metab Red wine polyphenols do not improve obesity-associated insulin resistance: A randomized controlled trial. 10.1111/dom.13044 Preclinical studies have suggested that polyphenols extracted from red wine (RWPs) favourably affect insulin sensitivity, but there is controversy over whether RWPs (...) exert similar effects in humans. The aim of the present study was to determine whether RWPs improve insulin sensitivity in obese volunteers. Obese (body mass index >30 kg/m(2) ) volunteers were randomly allocated to RWPs 600 mg/d (n = 14) or matched placebo (n = 15) in a double-blind parallel-arm study for 8 weeks. The participants were investigated at baseline and at the end of the study. Insulin sensitivity was determined using a hyperinsulinaemic-euglycaemic clamp (M-value), a mixed-meal test
Sotagliflozin tablets as an adjuct therapy to insulin for Type 1 diabetes mellitus Sotagliflozin tablets as an adjuct therapy to insulin for Type 1 diabetes mellitus ‐ NIHR Innovation Observatory ☰ Menu Search Filter by Specialty Filter by Year Sotagliflozin tablets as an adjuct therapy to insulin for Type 1 diabetes mellitus September 2017 Technology Description: Sotagliflozin is a drug being developed to lower blood sugar levels in type 1 diabetes by increasing the amount of sugars (...) excreted in the urine. It is taken once a day tablet in conjunction with insulin to prevent large rises and falls in blood sugar levels. This may be especially useful for people who cannot control their blood sugar levels with insulin alone. Sotagliflozin is currently in clinical trials which have shown that sotagliflozin has the potential to reduce and control blood sugar levels when taken with insulin. Specialty You may also be interested in: Jun 2014 Specialty: Jun 2014 Specialty: Apr 2014 Specialty
Effects of Sotagliflozin Added to Insulin in Patients with Type 1 Diabetes. Background In most patients with type 1 diabetes, adequate glycemic control is not achieved with insulin therapy alone. We evaluated the safety and efficacy of sotagliflozin, an oral inhibitor of sodium-glucose cotransporters 1 and 2, in combination with insulin treatment in patients with type 1 diabetes. Methods In this phase 3, double-blind trial, which was conducted at 133 centers worldwide, we randomly assigned 1402 (...) patients with type 1 diabetes who were receiving treatment with any insulin therapy (pump or injections) to receive sotagliflozin (400 mg per day) or placebo for 24 weeks. The primary end point was a glycated hemoglobin level lower than 7.0% at week 24, with no episodes of severe hypoglycemia or diabetic ketoacidosis after randomization. Secondary end points included the change from baseline in glycated hemoglobin level, weight, systolic blood pressure, and mean daily bolus dose of insulin. Results
Clopidogrel-Induced Insulin Autoimmune Syndrome: A Newly Recognized Cause of Hypoglycemia in a Patient Without Diabetes 29264578 2018 11 13 2472-1972 1 9 2017 Sep 01 Journal of the Endocrine Society J Endocr Soc Clopidogrel-Induced Insulin Autoimmune Syndrome: A Newly Recognized Cause of Hypoglycemia in a Patient Without Diabetes. 1217-1223 10.1210/js.2017-00316 Insulin autoimmune syndrome (IAS), defined as hyperinsulinemic hypoglycemia with high titers of anti-insulin antibodies, is frequently (...) reported in Japanese patients but rarely observed in whites. We report in this study on a 79-year-old white male without diabetes who developed IAS following exposure to clopidogrel, a drug not previously known to cause hypoglycemia. The patient presented with recurrent symptomatic hypoglycemia. During one episode, serum glucose was 45 mg/dL, whereas insulin and C-peptide levels were 40,000 mIU/mL and 40 ng/mL, respectively. Additional studies revealed no intake of insulin or its secretagogues, whereas