Latest & greatest articles for insulin

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Top results for insulin

1081. 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

1082. 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

1083. 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

1084. 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

1085. 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

1086. 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

1087. 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

1088. 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

1089. 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

1090. The cost-utility of diet and exercise interventions in non-insulin-dependent diabetes mellitus

The cost-utility of diet and exercise interventions in non-insulin-dependent diabetes mellitus The cost-utility of diet and exercise interventions in non-insulin-dependent diabetes mellitus The cost-utility of diet and exercise interventions in non-insulin-dependent diabetes mellitus Kaplan R M, Atkins C J, Wilson D 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 (...) , the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Diet, exercise, education and physical therapy in non-insulin-dependent diabetes mellitus. Type of intervention Treatment Economic study type Cost-utility analysis Study population Obese non-insulin-dependent diabetics. Setting The study was carried out in the USA. Dates to which data relate Price related to 1986. Source of effectiveness data Single study

1988 NHS Economic Evaluation Database.

1091. One-year trial of a remote-controlled implantable insulin infusion system in type I diabetic patients. Point Study Group. (Abstract)

One-year trial of a remote-controlled implantable insulin infusion system in type I diabetic patients. Point Study Group. Twenty remote-controlled insulin pumps (Siemens AG) were implanted into insulin-dependent type I diabetic patients for a one-year feasibility trial in four centres. The total observation time was 18.2 patient-years. Three pumps had to be prematurely removed after 101, 141, and 236 days. Patients self-monitored blood glucose levels with a mean of 5.5 (range 1-17) measurements (...) problems, the pump, when used with a stable insulin preparation, was an effective means of treating insulin-dependent patients.

1988 Lancet

1092. 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

1093. 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

1094. 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

1095. Treating hypertension in black compared with white non-insulin dependent diabetics: a double blind trial of verapamil and metoprolol. Full Text available with Trip Pro

Treating hypertension in black compared with white non-insulin dependent diabetics: a double blind trial of verapamil and metoprolol. To compare responses of blood pressure to the calcium antagonist verapamil and the beta blocker metoprolol in black compared with white diabetics with hypertension and to monitor urinary albumin excretion in relation to fall in blood pressure.Double blind, placebo controlled, random order crossover trial with four week placebo run in period and two six week

1988 BMJ Controlled trial quality: uncertain

1096. 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

1097. 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

1098. Addition of sulfonylurea to insulin treatment in poorly controlled type II diabetes. A double-blind, randomized clinical trial. (Abstract)

Addition of sulfonylurea to insulin treatment in poorly controlled type II diabetes. A double-blind, randomized clinical trial. This study examined the potential beneficial effects of the addition of a second-generation sulfonylurea to insulin therapy for poorly controlled type II diabetes. A randomized, double-blind, crossover experimental design was utilized in 16 type II diabetic patients for a period of eight months. Treatment with glyburide, 20 mg/d (plus insulin), compared with placebo (...) (plus insulin) resulted in a significant reduction in mean basal glucose (232 +/- 12 vs 262 +/- 11 mg/dL [12.8 vs 14.4 mmol/L]) and hemoglobin A1C (10.2% +/- 0.5% vs 10.9% +/- 03%) concentrations. Concomitant with this change, basal C-peptide and free insulin values increased with glyburide therapy, but this pharmacological agent did not alter the ability of the patient's erythrocytes to bind insulin. We conclude that in type II diabetic subjects receiving more than 28 units of insulin per day

1987 JAMA Controlled trial quality: uncertain

1099. Kidney function during 12 months of strict metabolic control in insulin-dependent diabetic patients with incipient nephropathy. (Abstract)

Kidney function during 12 months of strict metabolic control in insulin-dependent diabetic patients with incipient nephropathy. Thirty-six patients with insulin-dependent diabetes mellitus who had Albustix-negative urine but elevated urinary albumin excretion (30 to 300 mg per 24 hours) were matched in pairs according to their urinary albumin level, blood glycosylated hemoglobin level, and sex and assigned randomly to either unchanged conventional treatment or continuous insulin infusion (...) . During the next 12 months a significant improvement in glycemic control was observed in the insulin-infusion group, with a reduction in the mean glycosylated hemoglobin level from 9.5 to 7.3 percent. There was no change in the control group (9.3 to 9.2 percent). No significant change in albumin excretion was observed in either group. The mean blood pressure increased slightly in both groups (from 98 to 101 mm Hg in the insulin-infusion group and from 98 to 103 mm Hg in the control group). Kidney size

1986 NEJM Controlled trial quality: uncertain

1100. Cyclosporin increases the rate and length of remissions in insulin-dependent diabetes of recent onset. Results of a multicentre double-blind trial. (Abstract)

Cyclosporin increases the rate and length of remissions in insulin-dependent diabetes of recent onset. Results of a multicentre double-blind trial. In a double-blind trial 122 patients aged 15-40 years with insulin-dependent diabetes of recent onset were randomly assigned to cyclosporin 7.5 mg/kg per day or placebo. At the sixth month 25.4% of the cyclosporin group and 18.6% of the placebo group were in complete remission (not a significant difference). Treatment was continued in those patients (...) with complete or partial remission (insulin requirement less than 0.25 U/kg per day) and 106 patients were followed to nine months, at which stage 24.1% of the original cyclosporin group and 5.8% of the original placebo group were in complete remission (p less than 0.01). For those patients whose whole-blood trough cyclosporin levels in the first three months averaged 300 ng/ml or more, the rates of complete remission at six and nine months were 37.5% and 37%. The rates of partial remission were also higher

1986 Lancet Controlled trial quality: uncertain