Effect of Continuous Glucose Monitoring on Glycemic Control in Adults With Type 1 Diabetes Using Insulin Injections: The DIAMOND Randomized Clinical Trial. Previous clinical trials showing the benefit of continuous glucose monitoring (CGM) in the management of type 1 diabetes predominantly have included adults using insulin pumps, even though the majority of adults with type 1 diabetes administer insulin by injection.To determine the effectiveness of CGM in adults with type 1 diabetes treated (...) with insulin injections.Randomized clinical trial conducted between October 2014 and May 2016 at 24 endocrinology practices in the United States that included 158 adults with type 1 diabetes who were using multiple daily insulin injections and had hemoglobin A1c (HbA1c) levels of 7.5% to 9.9%.Random assignment 2:1 to CGM (n = 105) or usual care (control group; n = 53).Primary outcome measure was the difference in change in central-laboratory-measured HbA1c level from baseline to 24 weeks. There were 18

Continuous Glucose Monitoring vs Conventional Therapy for Glycemic Control in Adults With Type 1 Diabetes Treated With Multiple Daily Insulin Injections: The GOLD Randomized Clinical Trial. The majority of individuals with type 1 diabetes do not meet recommended glycemic targets.To evaluate the effects of continuous glucose monitoring in adults with type 1 diabetes treated with multiple daily insulin injections.Open-label crossover randomized clinical trial conducted in 15 diabetes outpatient (...) clinics in Sweden between February 24, 2014, and June 1, 2016 that included 161 individuals with type 1 diabetes and hemoglobin A1c (HbA1c) of at least 7.5% (58 mmol/mol) treated with multiple daily insulin injections.Participants were randomized to receive treatment using a continuous glucose monitoring system or conventional treatment for 26 weeks, separated by a washout period of 17 weeks.Difference in HbA1c between weeks 26 and 69 for the 2 treatments. Adverse events including severe hypoglycemia

Combined immunotherapy with “anti-insulin resistance” therapy as a novel therapeutic strategy against neurodegenerative diseases Protein aggregation is a pathological hallmark of and may play a central role in the neurotoxicity in age-associated neurodegenerative diseases, such as Alzheimer's disease and Parkinson's disease. Accordingly, inhibiting aggregation of amyloidogenic proteins, including amyloid β and α-synuclein, has been a main therapeutic target for these disorders. Among (...) neurodegenerative diseases may lead to increasing efficacy. Meanwhile, type II diabetes mellitus has been associated with an increased risk of neurodegenerative disease, such as Alzheimer's disease and Parkinson's disease, and studies have shown that metabolic dysfunction and abnormalities surrounding insulin signaling may underlie disease progression. Naturally, "anti-insulin resistance" therapy has emerged as a novel paradigm in the therapy of neurodegenerative diseases. Indeed, incretin agonists, which

Basal-Bolus Versus Sliding-Scale Insulin Therapy in the Acute Care Hospital Setting: A Review of Comparative Clinical Effectiveness and Cost-Effectiveness Basal-Bolus Versus Sliding-Scale Insulin Therapy in the Acute Care Hospital Setting: A Review of Comparative Clinical Effectiveness and Cost-Effectiveness | CADTH.ca Find the information you need Basal-Bolus Versus Sliding-Scale Insulin Therapy in the Acute Care Hospital Setting: A Review of Comparative Clinical Effectiveness and Cost (...) -Effectiveness Basal-Bolus Versus Sliding-Scale Insulin Therapy in the Acute Care Hospital Setting: A Review of Comparative Clinical Effectiveness and Cost-Effectiveness Published on: January 12, 2017 Project Number: RC0840-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the comparative clinical effectiveness of basal-bolus versus sliding-scale insulin therapy for adult patients with type 1 and type 2 diabetes in the acute care hospital

Breastfeeding an Infant or Young Child with Insulin-Dependent Diabetes ABM Protocol ABM Clinical Protocol #27: Breastfeeding an Infant or Young Child with Insulin-Dependent Diabetes Diana Miller, 1,2 Leena Mamilly, 1 Shannon Fourtner, 1 Casey Rosen-Carole, 3 and the Academy of Breastfeeding Medicine A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing (...) commonmedicalproblemsthatmayimpactbreastfeedingsuccess.Theseprotocolsserveonlyasguidelinesforthe careofbreastfeedingmothersandinfantsanddonotdelineateanexclusivecourseoftreatmentorserveasstandards ofmedicalcare.Variationsintreatmentmaybeappropriateaccordingtotheneedsofanindividualpatient. Purpose T o provide guidance for the care of breastfeeding in- fants or young children with insulin-dependent diabetes mellitus (called diabetes in this protocol) and their families, describing: 1. The basis of insulin dosing for carbohydrate intake for breastfeeding infants 2. The basis of assessing

Insulin Degludec (Tresiba, Novo Nordisk A/S) for the Treatment of Diabetes: Effectiveness, Value, and Value-Based Price Benchmarks ©Institute for Clinical and Economic Review, 2016 Insulin Degludec (Tresiba®, Novo Nordisk A/S) for the Treatment of Diabetes: Effectiveness, Value, and Value-Based Price Benchmarks Final Report March 14, 2016 Institute for Clinical and Economic Review ©Institute for Clinical and Economic Review, 2016 Page i Final Report – Insulin Degludec AUTHORS: Jeffrey A. Tice (...) Review DATE OF PUBLICATION: March 14, 2016 We would also like to thank Shanshan Liu, Elizabeth Russo, Matt Seidner, Patricia Synnott, and Karin Travers of ICER for their contributions to this report. ©Institute for Clinical and Economic Review, 2016 Page ii Final Report – Insulin Degludec About ICER The Institute for Clinical and Economic Review (ICER) is an independent non-profit research organization that evaluates medical evidence and convenes public deliberative bodies to help stakeholders

Insulin management

Insulin for type 2 diabetes with suboptimal glycemic control

LEVEMIR (insulin detemir), long-acting human insulin analogue Haute Autorité de Santé - LEVEMIR (insuline détémir), analogue de l’insuline humaine d’action lente Développer la qualité dans le champ sanitaire, social et médico-social Recherche Évaluation & Recommandation La HAS Accréditation & Certification Outils, Guides & Méthodes Agenda Avis sur les Médicaments LEVEMIR (insuline détémir), analogue de l’insuline humaine d’action lente Substance active (DCI) insuline détémir DIABETOLOGIE (...) - Nouvelle indication Nature de la demande Extension d'indication Avis de la CT du 21 septembre 2016 Pas d’avantage clinique démontré par rapport à TRESIBA dans la prise en charge du diabète de type 1 de l’enfant âgé de 1 an à 2 ans LEVEMIR a désormais l’AMM dans le diabète de type 1 chez l’enfant dès l’âge de 1 an. Les données cliniques d’efficacité disponibles chez l’enfant entre 1 et 2 ans, sont limitées à une étude de non infériorité versus insuline dégludec portant sur un effectif de 350 enfants

Xultophy (insulin degludec and liraglutide) - type 2 diabetes Xultophy® (insulin degludec and liraglutide) × Insert searchphrase to search the website Insert searchphrase to search the website > > > Xultophy® (insulin degludec and liraglutide) Conclusion Xultophy® (insulin degludec and liraglutide) is a combination product for treatment of type 2 diabetes administered by one daily injection consisting of insulin degludec and the GLP-1 receptor agonist (GLP1-RA) liraglutide. The dose (...) is administered by a pre-filled injection pen with a fixed-ratio combination of insulin degludec and liraglutide, which offers a less flexible dose adjustment. The maximum daily dose is 50 dose steps corresponding to 50 units insulin degludec/1.8 mg liraglutide. In clinical studies, Xultophy has been demonstrated to reduce HbA1c more than both insulin degludec, liraglutide and insulin glargin in combination with existing treatment with different oral antidiabetics. Compared to the above-mentioned insulins

Insulin glargine (Lusduna) - Diabetes Mellitus 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5520 Send a question via our website www.ema.europa.eu/contact © European Medicines Agency, 2017. Reproduction is authorised provided the source is acknowledged. 10 November 2016 EMA/813309/2016 Committee for Medicinal Products for Human Use (CHMP) Assessment report LUSDUNA International non (...) -proprietary name: insulin glargine Procedure No. EMEA/H/C/004101/0000 Note Assessment report as adopted by the CHMP with all information of a commercially confidential nature deleted. Medicinal product no longer authorised Assessment report EMA/813309/2016 Page 2/76 Table of contents 1. Background information on the procedure 10 1.1. Submission of the dossier 10 1.2. Steps taken for the assessment of the product 10 2. Scientific discussion 11 2.1. Introduction 11 2.2. Quality aspects 12 2.2.1

Insulin independence after living-donor distal pancreatectomy and islet allotransplantation. Rising demand for islet transplantation will lead to severe donor shortage in the near future, especially in countries where cadaveric organ donation is scarce. We undertook a successful transplantation of living-donor islets for unstable diabetes. The recipient was a 27-year-old woman who had had brittle, insulin-dependent diabetes mellitus for 12 years. The donor, who was a healthy 56-year-old woman (...) and mother of the recipient, underwent a distal pancreatectomy. After isolation, 408 114 islet equivalents were transplanted immediately. The transplants functioned immediately and the recipient became insulin-independent 22 days after the operation. The donor had no complications and both women showed healthy glucose tolerance. Transplantation of living-donor islets from the distal pancreas can be sufficient to reverse brittle diabetes.

Initiating basal insulin in type 2 diabetes mellitus '); } else { document.write(' '); } ACE | Initiating basal insulin in type 2 diabetes mellitus Search > > Initiating basal insulin in type 2 diabetes mellitus - Initiating basal insulin in type 2 diabetes mellitus Published on 20 November 2017 This Appropriate Care Guide (ACG) continues from the ACG on oral glucose-lowering agents in type 2 diabetes mellitus (T2DM) and highlights the importance of not delaying insulin therapy. It provides (...) clinicians with a practical guide on initiating basal insulin in T2DM and how to prevent and manage hypoglycaemia. Download the PDF below to access the full ACG. Key Messages 1. Start insulin therapy if glycaemic goals are not met on oral glucose-lowering agents alone. 2. Initiate with basal insulin, such as intermediate- or long-acting insulin. 3. When initiating insulin, review concomitant oral glucose-lowering agents. Continue metformin +/- SGLT-2 inhibitors where appropriate. 4. Educate patients

Insulin glargine biosimilar (Basaglar) for the treatment of type 1 and type 2 diabetes mellitus '); } else { document.write(' '); } ACE | Insulin glargine biosimilar (Basaglar) for the treatment of type 1 and type 2 diabetes mellitus Search > > Insulin glargine biosimilar (Basaglar) for the treatment of type 1 and type 2 diabetes mellitus - Insulin glargine biosimilar (Basaglar) for the treatment of type 1 and type 2 diabetes mellitus Published on 16 October 2017 Guidance Recommendation (...) The Ministry of Health's Drug Advisory Committee has recommended: Insulin glargine biosimilar (Basaglar) injection 100 units/ml cartridge for the treatment of type 1 and type 2 diabetes mellitus in adults, adolescents and children aged 6 years or above, where treatment with insulin is required. Subsidy status Insulin glargine biosimilar (Basaglar) injection 100 units/ml cartridge is recommended for inclusion on the Standard Drug List (SDL) for the abovementioned indication. The manufacturer has offered

Home use of a bihormonal bionic pancreas versus insulin pump therapy in adults with type 1 diabetes: a multicentre randomised crossover trial. The safety and effectiveness of a continuous, day-and-night automated glycaemic control system using insulin and glucagon has not been shown in a free-living, home-use setting. We aimed to assess whether bihormonal bionic pancreas initialised only with body mass can safely reduce mean glycaemia and hypoglycaemia in adults with type 1 diabetes who were (...) living at home and participating in their normal daily routines without restrictions on diet or physical activity.We did a random-order crossover study in volunteers at least 18 years old who had type 1 diabetes and lived within a 30 min drive of four sites in the USA. Participants were randomly assigned (1:1) in blocks of two using sequentially numbered sealed envelopes to glycaemic regulation with a bihormonal bionic pancreas or usual care (conventional or sensor-augmented insulin pump therapy

Glucagon People/Insulin People Glucagon People/Insulin People – Clinical Correlations Search Glucagon People/Insulin People November 23, 2016 4 min read By Michael Tanner , MD Glucagon : a 29-amino-acid polypeptide secreted by the alpha cells of the pancreas in response to hypoglycemia or starvation. Insulin : a 51-amino-acid polypeptide secreted by the beta cells of the pancreas in response to nutrient consumption. It’s December 13 th , 1932, Camden, New Jersey. You are playing alto sax (...) of the ribs on the can, and pumpkin cannolis for dessert. Uncle Jack’s parasympathetic nervous system is totally kicked in; he has just nodded out on the sofa in front of the television. The Detroit Lions are losing to the Green Bay Packers 24-0 in the fourth quarter. Aunt Mary Anne gasps and says, “Oh my God! I forgot to put out the blueberry pies!” They are sitting in the oven, untouched. You and your family are running on insulin. The 1430 base pairs that make up the insulin gene on the short arm

High Molecular Weight Adiponectin Levels are Neither Influenced by Adiponectin Polymorphisms Nor Associated with Insulin Resistance in Mixed-ancestry Hyperglycemic Subjects from South Africa High molecular weight (HMW) adiponectin has antiatherogenic, antiinflammatory and antidiabetic properties and these effects have been linked to its effect on high density lipoprotein cholesterol (HDL-c). Single nucleotide polymorphisms (SNPs) in the adiponectin gene influence adiponectin levels. We examined

Insulin degludec (Tresiba) for the treatment of diabetes mellitus Final Appraisal Recommendation Advice No: 2816 – October 2016 Insulin degludec (Tresiba ® ? ) 100 units/ml and 200 units/ml solution for injection in prefilled pen (FlexTouch ® ) or 100 units/ml solution for injection in cartridge (Penfill ® ) Resubmission by Novo Nordisk Ltd Additional note(s): • Please refer to the Summary of Product Characteristics for the full licensed indication. In reaching the above recommendation AWMSG (...) years. Statement of use: No part of this recommendation may be reproduced without the whole recommendation being quoted in full and cited as: All Wales Medicines Strategy Group. Final Appraisal Recommendation – 2816: Insulin degludec (Tresiba ® ? ) 100 units/ml and 200 units/ml solution for injection in prefilled pen (FlexTouch ® ) or 100 units/ml solution for injection in cartridge (Penfill ® ). October 2016. Recommendation of AWMSG Insulin degludec (Tresiba ® ? ) is recommended as an option

Sodium-glucose co-transporter 2 inhibitors in addition to insulin therapy for management of type 2 diabetes mellitus: A meta-analysis of randomized controlled trials Given inconsistent trial results of sodium-glucose cotransporter 2 (SGLT2) inhibitors in addition to insulin therapy for treating type 2 diabetes mellitus (T2DM), a meta-analysis was performed to evaluate the efficacy and safety of this combination for T2DM by searching available randomized trials from PubMed, Embase, CENTRAL (...) and ClinicalTrials.gov. Our meta-analysis included seven eligible placebo-controlled trials involving 4235 patients. Compared with placebo, SGLT2 inhibitor treatment was significantly associated with a mean reduction in HbA1c of -0.56%, fasting plasma glucose of -0.95 mmol/L, body weight of -2.63 kg and insulin dose of -8.79 IU, but an increased risk of drug-related adverse events by 36%, urinary tract infections by 29% and genital infections by 357%. No significant increase was observed in risk of overall adverse

Effectiveness of HypoAware, a Brief Partly Web-Based Psychoeducational Intervention for Adults With Type 1 and Insulin-Treated Type 2 Diabetes and Problematic Hypoglycemia: A Cluster Randomized Controlled Trial To establish the effectiveness of a brief, partly web-based group intervention, HypoAware, in patients with problematic hypoglycemia, in terms of the reduction of severe hypoglycemic episodes, impaired hypoglycemia awareness, and worries.A two-arm, cluster randomized controlled trial (...) was conducted in insulin-treated patients with problematic hypoglycemia in eight Dutch clinics comparing HypoAware with care as usual. Primary outcomes included self-reported severe hypoglycemia, impaired hypoglycemia awareness (Gold score), and worries and distress about hypoglycemia (Hypoglycemia Fear Survey-II/Problem Areas In Diabetes scale hypo-item), assessed at baseline, and at 2, 4, and 6 months of follow-up. We used t tests, nonparametric tests, and intention-to-treat generalized estimation