Latest & greatest articles for insulin

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Top results for insulin

121. Day-and-Night Closed-Loop Insulin Delivery in a Broad Population of Pregnant Women With Type 1 Diabetes: A Randomized Controlled Crossover Trial Full Text available with Trip Pro

Day-and-Night Closed-Loop Insulin Delivery in a Broad Population of Pregnant Women With Type 1 Diabetes: A Randomized Controlled Crossover Trial Despite advances in technology, optimal glucose control remains elusive and neonatal complications remain ubiquitous in type 1 diabetes (T1D) pregnancy. Our aim was to examine the safety, efficacy, and longer-term feasibility of day-and-night closed-loop insulin delivery.We recruited 16 pregnant women (mean [SD]: age 32.8 [5.0] years, T1D duration 19.4 (...) [10.2] years, HbA1c 8.0% [1.1], and BMI 26.6 [4.4] kg/m2) to an open-label, randomized, crossover trial. Participants completed 28 days of closed-loop and sensor-augmented pump (SAP) insulin delivery separated by a washout period. Afterward, participants could continue to use the closed-loop system up to 6 weeks postpartum. The primary end point was the proportion of time with glucose levels within the target range (63-140 mg/dL).The proportion of time with glucose levels within target

2018 EvidenceUpdates

122. Effect of prandial treatment timing adjustment, based on continuous glucose monitoring, in patients with type 2 diabetes uncontrolled with once-daily basal insulin: A randomized, phase IV study Full Text available with Trip Pro

Effect of prandial treatment timing adjustment, based on continuous glucose monitoring, in patients with type 2 diabetes uncontrolled with once-daily basal insulin: A randomized, phase IV study To evaluate the glycaemic control achieved by prandial once-daily insulin glulisine injection timing adjustment, based on a continuous glucose monitoring sensor, in comparison to once-daily insulin glulisine injection before breakfast in patients with type 2 diabetes who are uncontrolled with once-daily (...) basal insulin glargine.This was a 24-week open-label, randomized, controlled, multicentre trial. At the end of an 8-week period of basal insulin optimization, patients with HbA1c ≥ 7.5% and FPG < 130 mg/dL were randomized (1:1) to either arm A (no sensor) or arm B (sensor) to receive 16-week intensified prandial glulisine treatment. Patients in arm A received pre-breakfast glulisine, and patients in arm B received glulisine before the meal with the highest glucose elevation based on sensor data

2018 EvidenceUpdates

123. Sex Difference In the Effect of Fetal Exposure to Maternal Diabetes on Insulin Secretion Full Text available with Trip Pro

Sex Difference In the Effect of Fetal Exposure to Maternal Diabetes on Insulin Secretion We previously showed that fetal exposure to maternal type 1 diabetes (T1D) is associated with altered glucose-stimulated insulin secretion in adult offspring. Here, we investigated whether this β-cell defect displays a sex dimorphism. Twenty-nine adult nondiabetic offspring of T1D mothers (ODMs) were compared with 29 nondiabetic offspring of T1D fathers. We measured early insulin secretion in response (...) to oral glucose and insulin secretion rate in response to intravenous glucose ramping. Insulin sensitivity and body composition were assessed by a euglycemic, hyperinsulinemic clamp and dual-energy X-ray absorptiometry, respectively. In response to oral glucose, male and female ODMs displayed a reduced insulin secretion. In contrast, in response to graded intravenous glucose infusion, only female ODMs (not males) exhibited decreased insulin secretion. There was no defect in response to combined

2018 Journal of the Endocrine Society

124. Increase in hepatic and decrease in peripheral insulin clearance characterize abnormal temporal patterns of serum insulin in diabetic subjects Full Text available with Trip Pro

Increase in hepatic and decrease in peripheral insulin clearance characterize abnormal temporal patterns of serum insulin in diabetic subjects Insulin plays a central role in glucose homeostasis, and impairment of insulin action causes glucose intolerance and leads to type 2 diabetes mellitus (T2DM). A decrease in the transient peak and sustained increase of circulating insulin following an infusion of glucose accompany T2DM pathogenesis. However, the mechanism underlying this abnormal temporal (...) pattern of circulating insulin concentration remains unknown. Here we show that changes in opposite direction of hepatic and peripheral insulin clearance characterize this abnormal temporal pattern of circulating insulin concentration observed in T2DM. We developed a mathematical model using a hyperglycemic and hyperinsulinemic-euglycemic clamp in 111 subjects, including healthy normoglycemic and diabetic subjects. The hepatic and peripheral insulin clearance significantly increase and decrease

2018 NPJ systems biology and applications

125. Effect of pioglitazone on insulin resistance, progression of atherosclerosis and clinical course of coronary heart disease. (Abstract)

Effect of pioglitazone on insulin resistance, progression of atherosclerosis and clinical course of coronary heart disease. Pioglitazone, a medication of thiazolidinedione group, is capable of triggering the peroxisome proliferator-activated receptors (PPAR-γ). Activation of receptor PPAR-γ regulates carbohydrate and lipid metabolism, immune and inflammatory responses in heart tissues.Our aim was to study the effect of pioglitazone on insulin resistance, the clinical course of atherosclerosis (...) , as well as increased high-density lipoprotein (p<0.05).Long-term treatment with pioglitazone at low doses against the background of standard therapy contributes to functional and clinical condition of patients, promotes the prevention of atherosclerosis and reduction of insulin resistance, thereby improving the clinical manifestations of coronary heart disease.

2018 Wiadomosci lekarskie (Warsaw, Poland : 1960) Controlled trial quality: uncertain

126. Best Practice Guide: Continuous subcutaneous insulin infusion (CSII) A clinical guide for adult diabetes services

Best Practice Guide: Continuous subcutaneous insulin infusion (CSII) A clinical guide for adult diabetes services BEST PRACTICE GUIDE: Continuous subcutaneous insulin infusion (CSII) A clinical guide for adult diabetes servicesBEST PRACTICE GUIDE CONTINUOUS SUBCUTANEOUS INSULIN INFUSION (CSII) 02 CLINICAL GUIDELINE BEST PRACTICE GUIDE CONTINUOUS SUBCUTANEOUS INSULIN INFUSION (CSII) CONTENTS Page Contributors 4 Foreword 5 Objectives 6 Access to CSII across the four nations 7 Best Practice Guide (...) 8 Starting insulin pump therapy 11 Basal insulin 14 Bolus insulin 17 Calculating the ICR/ISF 18 Download interpretation 20 CSII and specific scenarios 21 Management of unexplained hyperglycaemia 21 Sick day rules 22 Problematic hypoglycaemia 23 CSII discontinuation 25 Transition 25 Exercise 26 Conclusions 27 References 28 Appendix 1: Basal rate testing protocol 30 Appendix 2: Gold score for hypoglycaemia awareness 30 Appendix 3: Clarke hypoglycaemia awareness questionnaire 31 03 CLINICAL

2018 Association of British Clinical Diabetologists

127. 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 Full Text available with Trip Pro

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 (...) glargine (IGlar U100) 20-50 units/day and metformin, randomized to IDegLira or IGlar U100 and insulin aspart ≤4 times per day.Glycated hemoglobin (HbA1c) decreased from 8.2% (66 mmol/mol) to 6.7% (50 mmol/mol) with IDegLira and from 8.2% (67 mmol/mol) to 6.7% (50 mmol/mol) with basal-bolus (estimated treatment difference [ETD] -0.02% [95% CI -0.16, 0.12]; -0.2 mmol/mol [95% CI -1.7, 1.3]), confirming IDegLira noninferiority versus basal-bolus (P < 0.0001). The number of severe or blood glucose

2018 EvidenceUpdates

128. Weight-based carbohydrate treatment of hypoglycaemia in people with Type 1 diabetes using insulin pump therapy: a randomized crossover clinical trial (Abstract)

Weight-based carbohydrate treatment of hypoglycaemia in people with Type 1 diabetes using insulin pump therapy: a randomized crossover clinical trial To test whether weight-based treatment is more effective than usual care in people with Type 1 diabetes receiving continuous subcutaneous insulin infusion therapy with regard to both hypoglycaemia and avoiding excessive rebound hyperglycaemia.Children and adults on continuous subcutaneous insulin infusion were enrolled into a study (...) with a single treatment using weight-based compared with usual treatment were 3.12 (95% CI 1.38 to 7.02; P=0.0070) in adults and 2.61 (95% CI 1.19 to 5.74; P=0.017) in children.Weight-based treatment using 0.3 g/kg glucose was more effective for symptomatic hypoglycaemia in children and adults with Type 1 diabetes who were using continuous subcutaneous insulin infusion than treatment based on current international recommendations.© 2017 Diabetes UK.

2018 EvidenceUpdates

129. Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial. Full Text available with Trip Pro

Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial. Dietary modification remains key to successful weight loss. Yet, no one dietary strategy is consistently superior to others for the general population. Previous research suggests genotype or insulin-glucose dynamics may modify the effects of diets.To determine the effect of a healthy low-fat (HLF) diet vs (...) a healthy low-carbohydrate (HLC) diet on weight change and if genotype pattern or insulin secretion are related to the dietary effects on weight loss.The Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS) randomized clinical trial included 609 adults aged 18 to 50 years without diabetes with a body mass index between 28 and 40. The trial enrollment was from January 29, 2013, through April 14, 2015; the date of final follow-up was May 16, 2016. Participants were

2018 JAMA Controlled trial quality: predicted high

130. Real-time continuous glucose monitoring in adults with type 1 diabetes and impaired hypoglycaemia awareness or severe hypoglycaemia treated with multiple daily insulin injections (HypoDE): a multicentre, randomised controlled trial. (Abstract)

Real-time continuous glucose monitoring in adults with type 1 diabetes and impaired hypoglycaemia awareness or severe hypoglycaemia treated with multiple daily insulin injections (HypoDE): a multicentre, randomised controlled trial. The effectiveness of real-time continuous glucose monitoring (rtCGM) in avoidance of hypoglycaemia among high-risk individuals with type 1 diabetes treated with multiple daily insulin injections (MDI) is unknown. We aimed to ascertain whether the incidence

2018 Lancet Controlled trial quality: predicted high

131. Insulin signaling as a potential natural killer cell checkpoint in fatty liver disease Full Text available with Trip Pro

Insulin signaling as a potential natural killer cell checkpoint in fatty liver disease Insulin resistance is a key risk factor in the progression of nonalcoholic fatty liver disease (NAFLD) and may lead to liver fibrosis. Natural killer (NK) cells are thought to exert an antifibrotic effect through their killing of activated hepatic stellate cells (HSCs). Here, we investigated how the interplay between NK cells and HSCs are modified by insulin resistance in NAFLD. Fresh peripheral blood NK (...) cells (clusters of differentiation [CD]56dim, CD16+) were collected from 22 healthy adults and 72 patients with NAFLD not currently taking any medications and without signs of metabolic syndrome. NK cells were assessed for insulin receptor expressions and cytotoxic activity when cultured in medium with HSCs. Fibrosis severities in patients with NAFLD were correlated linearly with elevated serum proinflammatory cytokine expression and insulin resistance severity. At the same time, fibrosis severities

2018 Hepatology communications

132. Pioglitazone Prevents Stroke in Patients With a Recent Transient Ischemic Attack or Ischemic Stroke: A Planned Secondary Analysis of the IRIS Trial (Insulin Resistance Intervention After Stroke) Full Text available with Trip Pro

Pioglitazone Prevents Stroke in Patients With a Recent Transient Ischemic Attack or Ischemic Stroke: A Planned Secondary Analysis of the IRIS Trial (Insulin Resistance Intervention After Stroke) The IRIS trial (Insulin Resistance Intervention after Stroke) demonstrated that pioglitazone reduced the risk for a composite outcome of stroke or myocardial infarction among nondiabetic patients with insulin resistance and a recent stroke or transient ischemic attack. The current planned secondary (...) strokes (HR, 0.72; 95% CI, 0.57-0.91; P=0.005) but had no effect on risk for hemorrhagic events (HR, 1.00; 95% CI, 0.50-2.00; P=1.00).Pioglitazone was effective for secondary prevention of ischemic stroke in nondiabetic patients with insulin resistance.URL: https://www.clinicaltrials.gov. Unique identifier: NCT00091949.© 2017 American Heart Association, Inc.

2018 EvidenceUpdates

133. Newer Drugs for Type 2 Diabetes: An Emerging Adjunctive Therapy to Insulin for Type 1 Diabetes?

Newer Drugs for Type 2 Diabetes: An Emerging Adjunctive Therapy to Insulin for Type 1 Diabetes? Newer Drugs for Type 2 Diabetes: An Emerging Adjunctive Therapy to Insulin for Type 1 Diabetes? | CADTH.ca CADTH Document Viewer Newer Drugs for Type 2 Diabetes: An Emerging Adjunctive Therapy to Insulin for Type 1 Diabetes? Table of Contents Search this document Newer Drugs for Type 2 Diabetes: An Emerging Adjunctive Therapy to Insulin for Type 1 Diabetes? January 2018 Summary There are two major (...) categories of diabetes. Type 1 diabetes (T1D) is characterized by severe impairment or an absolute deficiency of insulin due to autoimmune destruction of pancreatic cells. Type 2 diabetes (T2D) is characterized by a combination of insulin resistance and decreased insulin secretion. Insulin is the mainstay of treatment for T1D. However, it may be difficult for some patients to reach target glycated hemoglobin (A1C) levels on insulin monotherapy. In some cases, hypoglycemia, excessive glucose fluctuations

2018 CADTH - Issues in Emerging Health Technologies

134. GLP-1 and Insulin Recruit Muscle Microvasculature and Dilate Conduit Artery Individually But Not Additively in Healthy Humans Full Text available with Trip Pro

GLP-1 and Insulin Recruit Muscle Microvasculature and Dilate Conduit Artery Individually But Not Additively in Healthy Humans Glucagon-like peptide-1 (GLP-1) and insulin increase muscle microvascular perfusion, thereby increasing tissue endothelial surface area and nutrient delivery.To examine whether GLP-1 and insulin act additively on skeletal and cardiac microvasculature and conduit artery.Healthy adults underwent three study protocols in random order.Clinical Research Unit at the University (...) of Virginia.Overnight-fasted participants received an intravenous infusion of GLP-1 (1.2 pmol/kg/min) or normal saline for 150 minutes with or without a 2-hour euglycemic insulin clamp (1 mU/kg/min) superimposed from 30 minutes onward. Skeletal and cardiac muscle microvascular blood volume (MBV), flow velocity, and flow; brachial artery diameter, flow velocity, and blood flow; and pulse wave velocity (PWV) were measured.GLP-1 significantly increased skeletal and cardiac muscle MBV and microvascular blood flow (MBF

2018 Journal of the Endocrine Society

135. A new mechanism of action of glucagon‐like peptide‐1 agonist in hepatic steatosis: Promotion of hepatic insulin clearance through induction of carcinoembryonic antigen‐related cell adhesion molecule 1 Full Text available with Trip Pro

A new mechanism of action of glucagon‐like peptide‐1 agonist in hepatic steatosis: Promotion of hepatic insulin clearance through induction of carcinoembryonic antigen‐related cell adhesion molecule 1 29404506 2019 01 18 2471-254X 2 1 2018 01 Hepatology communications Hepatol Commun A new mechanism of action of glucagon-like peptide-1 agonist in hepatic steatosis: Promotion of hepatic insulin clearance through induction of carcinoembryonic antigen-related cell adhesion molecule 1. 9-12

2018 Hepatology communications

136. Insulin Pumps for Patients with Any Diabetes Type: Clinical Effectiveness and Guidelines

Insulin Pumps for Patients with Any Diabetes Type: Clinical Effectiveness and Guidelines Insulin Pumps for Patients with Any Diabetes Type: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Insulin Pumps for Patients with Any Diabetes Type: Clinical Effectiveness and Guidelines Insulin Pumps for Patients with Any Diabetes Type: Clinical Effectiveness and Guidelines Last updated: December 13, 2018 Project Number: RB1288-000 Product Line: Research Type: Devices (...) and Systems Report Type: Summary of Abstracts Result type: Report Question What is the clinical effectiveness of insulin pumps for patients with any type of diabetes? What are the evidence-based guidelines associated with use of insulin pumps for patients with any type of diabetes? Key Message Six systematic reviews with meta-analyses, eight randomized controlled trials, and one evidence-based guideline were identified regarding the clinical effectiveness and safety of insulin pumps for pediatric

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

137. 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 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 (...) , Cost-Effectiveness and Guidelines Last updated: October 26, 2018 Project Number: RC1033-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of insulin pumps for the treatment of type 2 diabetes in children, adolescents, or adults? What is the cost-effectiveness of insulin pumps for the treatment of type 2 diabetes in children, adolescents, or adults? What are the evidence-based guidelines for the use

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

138. Soliqua - lixisenatide + insulin glargine - Diabetes mellitus, Type 2

Soliqua - lixisenatide + insulin glargine - Diabetes mellitus, Type 2 lixisenatide + insulin glargine | CADTH.ca Find the information you need lixisenatide + insulin glargine lixisenatide + insulin glargine Last Updated: January 3, 2019 Result type: Reports Project Number: SR0564-000 Product Line: Generic Name: lixisenatide + insulin glargine Brand Name: Soliqua Manufacturer: sanofi-aventis Canada Inc. Indications: Diabetes mellitus, Type 2 Manufacturer Requested Reimbursement Criteria 1 (...) : Indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus when oral glucose-lowering medicinal products combined with basal insulin, or basal insulin alone do not provide adequate glycaemic control. Submission Type: New Combination Project Status: Complete Biosimilar: No Companion Diagnostics: No Date Recommendation Issued: December 24, 2018 Recommendation Type: Reimburse with clinical criteria and/or conditions Fee Schedule: Schedule

2018 Canadian Agency for Drugs and Technologies in Health - Common Drug Review

139. Effect of Bolus Insulin Administration Followed by a Continuous Insulin Infusion on Diabetic Ketoacidosis Management. Full Text available with Trip Pro

Effect of Bolus Insulin Administration Followed by a Continuous Insulin Infusion on Diabetic Ketoacidosis Management. Despite the high incidence of diabetic ketoacidosis (DKA) there is no consensus on the most appropriate way to manage insulin therapy. This study was conducted to evaluate the effect of an insulin bolus on the resolution of DKA. A retrospective chart review of patients admitted between 1 September 2014 and 30 June 2016 with a diagnosis of DKA was conducted. Patients were (...) assigned to the bolus or no bolus group based on provider preference. All patients were initiated on a 0.1 unit/kilogram (kg)/hour (h) intravenous (IV) regular insulin infusion, and patients in the bolus group were treated with a 0.1 unit/kg IV regular insulin bolus. Of the 145 admissions evaluated, 58 received a bolus and 87 did not. There was no difference in baseline demographics, except baseline blood glucose was higher in the bolus group (653 vs. 591 milligrams (mg)/deciliter (dL), p = 0.04

2018 Pharmacy (Basel, Switzerland) Controlled trial quality: uncertain

140. The Effect of Preoperative Oral Carbohydrate Administration on Insulin Resistance and Comfort Level in Patients Undergoing Surgery. (Abstract)

The Effect of Preoperative Oral Carbohydrate Administration on Insulin Resistance and Comfort Level in Patients Undergoing Surgery. The aim of this study was to evaluate the effect of preoperative oral carbohydrate solution (OCS) administration on postoperative insulin resistance and patient comfort in elective laparoscopic cholecystectomy.Randomized controlled clinical study.The experimental group received OCS. The control group did not eat or drink before surgery. Glucose and insulin level (...) were measured at baseline, 2 hours before surgery, and at the first and third hour after surgery. Insulin resistance was assessed by the homeostasis model assessment of insulin resistance (HOMA-IR). The visual analogue scale (VAS) and general comfort scale (GCS) were used to assess postoperative comfort level.A significant increase in the glucose level was observed in both groups (P < 0.05). A change in glucose level was significantly higher in the control group (P = .014). HOMA-IR values did

2018 Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses Controlled trial quality: uncertain