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Efficacy of insulin and sulfonylurea combination therapy in type II diabetes: a meta-analysis of the randomised placebo-controlled trials Efficacy of insulin and sulfonylurea combination therapy in type II diabetes: a meta-analysis of the randomised placebo-controlled trials Efficacy of insulin and sulfonylurea combination therapy in type II diabetes: a meta-analysis of the randomised placebo-controlled trials Johnson J L, Wolf S L, Kubadi U M Authors' objectives To assess the efficacy (...) of insulin and sulfonylurea combination therapy in type II diabetes mellitus. Searching MEDLINE was searched from January 1980 to March 1992 using the keywords 'sulfonylurea', 'insulin' and 'combination therapy in type II diabetes', and bibliographies of identified papers were examined. Citations reported in non-English language journals, without English translation, were excluded. Study selection Study designs of evaluations included in the review Randomised placebo-controlled trials of the same
Decreases in ovarian cytochrome P450c17 alpha activity and serum free testosterone after reduction of insulin secretion in polycystic ovary syndrome. Insulin resistance and increased ovarian cytochrome P450c17 alpha activity are both features of the polycystic ovary syndrome. P450c17 alpha, which is involved in androgen biosynthesis, has both 17 alpha-hydroxylase and 17,20-lyase activities. Increased activity of this enzyme results in exaggerated conversion of progesterone to 17 alpha (...) syndrome.In the 11 women given metformin, the mean (+/- SE) area under the serum insulin curve after oral glucose administration decreased from 9303 +/- 1603 to 4982 +/- 911 microU per milliliter per minute (56 +/- 10 to 30 +/- 6 nmol per liter per minute) (P = 0.004). This decrease was associated with a reduction in the basal serum 17 alpha-hydroxyprogesterone concentration from 135 +/- 21 to 66 +/- 7 ng per deciliter (4.1 +/- 0.6 to 2.0 +/- 0.2 nmol per liter) (P = 0.01) and a reduction
Continuous subcutaneous insulin infusion (CSII) in children and adolescents with chronic poorly controlled type 1 diabetes mellitus Continuous subcutaneous insulin infusion (CSII) in children and adolescents with chronic poorly controlled type 1 diabetes mellitus Continuous subcutaneous insulin infusion (CSII) in children and adolescents with chronic poorly controlled type 1 diabetes mellitus Steindel B S, Roe T R, Costin G, Carlson M, Kaufman F R Record Status This is a critical abstract (...) of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Continuous subcutaneous insulin infusion using the MiniMed (Sylmar, CA) CSII system. Type of intervention Secondary prevention, treatment. Economic study type Cost-effectiveness analysis. Study population Children and adolescents
Cost-effectiveness analyses of the conversion of patients with non-insulin-dependent diabetes mellitus from glipizide to glyburide and of the accompanying pharmacy follow-up clinic Cost-effectiveness analyses of the conversion of patients with non-insulin-dependent diabetes mellitus from glipizide to glyburide and of the accompanying pharmacy follow-up clinic Cost-effectiveness analyses of the conversion of patients with non-insulin-dependent diabetes mellitus from glipizide to glyburide (...) and of the accompanying pharmacy follow-up clinic Law A, Pathak D, Segraves A, Weinstein C, Arneson W Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Treatment for non-insulin-dependent diabetes mellitus. In particular: (1) glipizide therapy; (2
Screening to prevent renal failure in insulin dependent diabetic patients: an economic evaluation Screening to prevent renal failure in insulin dependent diabetic patients: an economic evaluation Screening to prevent renal failure in insulin dependent diabetic patients: an economic evaluation Kiberd B A, Jindal K K Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods (...) , macroproteinuria or both (dipstick >0.3 g/l orpositive Albustix confirmed with >300 mg/day or >200 micrograms/minute proteinuria). Type of intervention Screening and secondary prevention. Economic study type Cost-utility analysis. Study population Hypothetical cohort of patients with insulin dependent diabetes for at least five years and patients with hypertension or macroproteinuria. Setting Hospital/primary care. The economic evaluation was carried out in Nova Scotia, Canada. Dates to which data relate
A review of the weight loss interventions for obese people with non-insulin-dependent diabetes mellitus A review of the weight loss interventions for obese people with non-insulin-dependent diabetes mellitus A review of the weight loss interventions for obese people with non-insulin-dependent diabetes mellitus Ciliska D, Kelly C, Petrov N, Chalmers J Authors' objectives To review the literature on the long-term results of weight loss in the non-insulin-dependent diabetes mellitus (NIDDM (...) ) population. Searching MEDLINE, CINAHL and PsycINFO were searched from 1985 using the terms 'non-insulin-dependent diabetes mellitus' combined with 'weight loss' or 'diet'. Reference lists of retrieved articles were searched for additional references, including those before 1985. Two experts in the field were asked to review the list of retrieved articles to identify if any key articles were missing. Study selection Study designs of evaluations included in the review Studies with a comparison group
Cost-effectiveness of medical nutrition therapy provided by dietitians for persons with non-insulin-dependent diabetes mellitus Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Increased risk of non-insulin dependent diabetes mellitus at low plasma vitamin E concentrations: a four year follow up study in men. To investigate whether low vitamin E status is a risk factor for incident non-insulin dependent diabetes mellitus.Population based follow up study with diabetes assessed at baseline and at four years.Eastern Finland.Random sample of 944 men aged 42-60 who had no diabetes at the baseline examination.Oral glucose tolerance test at four year follow up.A man (...) was defined diabetic if he had either (a) a fasting blood glucose concentration > or = 6.7 mmol/l, or (b) a blood glucose concentration > or = 10.0 mmol/l two hours after a glucose load, or (c) a clinical diagnosis of diabetes with either dietary, oral, or insulin treatment.45 men developed diabetes during the follow up period. In a multivariate logistic regression model including the strongest predictors of diabetes, a low lipid standardised plasma vitamin E (below median) concentration was associated
Intensive therapy and progression to clinical albuminuria in patients with insulin dependent diabetes mellitus and microalbuminuria. Microalbuminuria Collaborative Study Group, United Kingdom. To study the effect of intensive therapy of diabetes on the progression to clinical albuminuria in insulin dependent diabetic patients with microalbuminuria.Randomised controlled clinical trial of intensive versus conventional therapy of diabetes for a median of 5 years (range 2-8).Nine hospital based (...) specialist diabetes centres in England and Wales.70 European insulin dependent diabetic patients aged 17-59 years with microalbuminuria (albumin excretion 30-199 micrograms/min), but without arterial hypertension, recruited from the nine hospital based specialist diabetes centres.Intensive diabetic therapy was allocated to 36 patients (27 men, 9 women) and conventional diabetic therapy to 34 (24 men, 10 women).Development of clinical albuminuria, defined as albumin excretion greater than 200 micrograms
Effect of low-dose heparin on urinary albumin excretion in insulin-dependent diabetes mellitus. We investigated the effect of heparin on urinary albumin excretion in patients with insulin-dependent diabetes mellitus. 39 patients with persistent urinary albumin excretion of 30-300 mg/24 h were randomly treated for 3 months with subcutaneous injections twice daily of isotonic saline, 5000 IU unfractionated heparin, or 2000 anti-Xa IU low-molecular-weight heparin. Unfractionated and low-molecular
Postprandial versus preprandial blood glucose monitoring in women with gestational diabetes mellitus requiring insulin therapy. The fetuses of women with gestational diabetes mellitus are at risk for macrosomia and its attendant complications. The best method of achieving euglycemia in these women and reducing morbidity in their infants is not known. We compared the efficacy of postprandial and preprandial monitoring in achieving glycemic control in women with gestational diabetes.We studied 66 (...) women with gestational diabetes mellitus who required insulin therapy at 30 weeks of gestation or earlier. The women were randomly assigned to have their diabetes managed according to the results of preprandial monitoring or postprandial monitoring (one hour after meals) of blood glucose concentrations. Both groups were also monitored with fasting blood glucose measurements. The goal of insulin therapy was a preprandial value of 60 to 105 mg per deciliter (3.3 to 5.9 mmol per liter
Efficacy of metformin in patients with non-insulin-dependent diabetes mellitus. The Multicenter Metformin Study Group. Sulfonylurea drugs have been the only oral therapy available for patients with non-insulin-dependent diabetes mellitus (NIDDM) in the United States. Recently, however, metformin has been approved for the treatment of NIDDM.We performed two large, randomized, parallel-group, double-blind, controlled studies in which metformin or another treatment was given for 29 weeks (...) to moderately obese patients with NIDDM whose diabetes was inadequately controlled by diet (protocol 1: metformin vs. placebo; 289 patients), or diet plus glyburide (protocol 2: metformin and glyburide vs. metformin vs. glyburide; 632 patients). To determine efficacy we measured plasma glucose (while the patients were fasting and after the oral administration of glucose), lactate, lipids, insulin, and glycosylated hemoglobin before, during, and at the end of the study.In protocol 1, at the end of the study
United Kingdom Prospective Diabetes Study (UKPDS). 13: Relative efficacy of randomly allocated diet, sulphonylurea, insulin, or metformin in patients with newly diagnosed non-insulin dependent diabetes followed for three years. To assess the relative efficacy of treatments for non-insulin dependent diabetes over three years from diagnosis.Multicentre, randomised, controlled trial allocating patients to treatment with diet alone or additional chlorpropamide, glibenclamide, insulin, or metformin (...) (if obese) to achieve fasting plasma glucose concentrations < or = 6 mmol/l.Outpatient diabetic clinics in 15 British hospitals.2520 subjects who, after a three month dietary run in period, had fasting plasma glucose concentrations of 6.1-14.9 mmol/l but no hyperglycaemic symptoms.Fasting plasma glucose, glycated haemoglobin, and fasting plasma insulin concentrations; body weight; compliance; and hypoglycaemia.Median fasting plasma glucose concentrations were significantly lower at three years
Effect of glycemic control on early diabetic renal lesions. A 5-year randomized controlled clinical trial of insulin-dependent diabetic kidney transplant recipients. To determine whether optimized glycemic control in type I diabetic recipients of renal allografts will prevent or delay diabetic renal lesions in the allograft.Prospective, controlled, and randomized trial of glycemic control in an inception cohort of type I diabetic renal allograft recipients. The experimental group underwent (...) the trial.Subcutaneous insulin given several times a day or continuously (maximized group) and once or twice each day (standard group) was used throughout the trial. A significant difference for hemoglobin A1 level was maintained (mean +/- SD: standard, 0.117 +/- 0.013; maximized, 0.096 +/- 0.016; P < 0.001).The primary end point of this trial was the difference between the groups in renal glomerular mesangial expansion as determined by electron microscopy.There was a more than twofold increase in the volume
[Insulin treatment for diabetes on the day of surgery]. 1670109 1994 06 09 2011 11 17 0012-7183 106 5 1990 Duodecim; laaketieteellinen aikakauskirja Duodecim [Insulin treatment for diabetes on the day of surgery]. 415-21 Kuusisto A A Jorvin sairaala, Espoo, Finland. fin Clinical Trial Controlled Clinical Trial Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't Diabeteksen insuliinihoito leikkauspäivänä. Finland Duodecim 0373207 0012-7183 0 Blood Glucose 0 Insulin IM (...) Blood Glucose metabolism Diabetes Mellitus, Type 1 blood drug therapy Humans Injections, Subcutaneous Insulin administration & dosage Insulin Infusion Systems Preoperative Care 1990 1 1 1990 1 1 0 1 1990 1 1 0 0 ppublish 1670109
Effectiveness and cost-benefit analysis of intensive treatment and teaching programmes for Type 1 (insulin-dependent) diabetes mellitus in Moscow: blood glucose versus urine glucose self-monitoring Effectiveness and cost-benefit analysis of intensive treatment and teaching programmes for Type 1 (insulin-dependent) diabetes mellitus in Moscow: blood glucose versus urine glucose self-monitoring Effectiveness and cost-benefit analysis of intensive treatment and teaching programmes for Type 1 (...) (insulin-dependent) diabetes mellitus in Moscow: blood glucose versus urine glucose self-monitoring Starostina E G, Antsiferov M, Galstyan G R, Trautner C, Jorgens V, Muhlhauser I, Berger M, Dedov I I Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn
Effects of varying carbohydrate content of diet in patients with non-insulin-dependent diabetes mellitus. To study effects of variation in carbohydrate content of diet on glycemia and plasma lipoproteins in patients with non-insulin-dependent diabetes mellitus (NIDDM).A four-center randomized crossover trial.Outpatient and inpatient evaluation in metabolic units.Forty-two NIDDM patients receiving glipizide therapy.A high-carbohydrate diet containing 55% of the total energy as carbohydrates (...) and 30% as fats was compared with a high-monounsaturated-fat diet containing 40% carbohydrates and 45% fats. The amounts of saturated fats, polyunsaturated fats, cholesterol, sucrose, and protein were similar. The study diets, prepared in metabolic kitchens, were provided as the sole nutrients to subjects for 6 weeks each. To assess longer-term effects, a subgroup of 21 patients continued the diet they received second for an additional 8 weeks.Fasting plasma glucose, insulin, lipoproteins
Effects of low dose versus conventional dose thiazide diuretic on insulin action in essential hypertension. To see whether low dose thiazide diuretics given to patients with essential hypertension might avoid the adverse metabolic consequences seen with conventional doses.Double blind randomised crossover study of two 12 week treatment periods with either low dose (1.25 mg) or conventional dose (5.0 mg) bendrofluazide given after a six week placebo run in period.Outpatient clinics serving (...) the greater Belfast area.16 white non-diabetic patients (9 male) under 65 with essential hypertension recruited from general practices within the greater Belfast area.Systolic and diastolic blood pressure and peripheral and hepatic insulin action.One man failed to complete the study. There were no differences between doses in their effects on systolic and diastolic blood pressure. Bendrofluazide 1.25 mg had substantially less effect on serum potassium concentration than the 5.0 mg dose. There were
Improvement in glucose tolerance and insulin resistance in obese subjects treated with troglitazone. Troglitazone decreases insulin resistance and hyperglycemia in patients with non-insulin-dependent diabetes mellitus (NIDDM), but its effects on subjects without diabetes are not known.We performed oral and intravenous glucose-tolerance tests, studies with the euglycemic-hyperinsulinemic clamp, meal-tolerance tests, and 24-hour blood-pressure measurements at base line and after (...) the administration of troglitazone, 200 mg orally twice daily, or placebo for 12 weeks in 18 nondiabetic obese subjects, 9 of whom had impaired glucose tolerance.The mean (+/- SD) rates of glucose disposal increased from 4.7 +/- 1.7 to 6.0 +/- 1.7 mg per kilogram of body weight per minute (P = 0.004) and from 9.0 +/- 1.8 to 9.9 +/- 1.3 mg per kilogram per minute (P = 0.02) during insulin infusions of 40 and 300 mU per square meter of body-surface area per minute, respectively, in the troglitazone group
Effect of captopril on progression to clinical proteinuria in patients with insulin-dependent diabetes mellitus and microalbuminuria. European Microalbuminuria Captopril Study Group. To study the effect of angiotensin converting enzyme inhibition on the rate of progression to clinical proteinuria and the rate of change of albumin excretion rates in patients with insulin-dependent diabetes mellitus and persistent microalbuminuria.Randomized, double-blind, placebo-controlled clinical trial of 2 (...) years' duration at 12 hospital-based diabetes centers.Ninety-two patients with insulin-dependent diabetes mellitus and persistent microalbuminuria but no hypertension.The patients were randomly allocated in blocks of two to receive either captopril, 50 mg, or placebo twice per day.Albumin excretion rate, blood pressure, glycosylated hemoglobin level, and fructosamine level every 3 months; urinary urea nitrogen excretion every 6 months; and glomerular filtration rate every 12 months.Twelve patients