Latest & greatest articles for insulin

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Top results for insulin

141. Insulin pumps not much better than multiple injections for intensive control of type 1 diabetes

Insulin pumps not much better than multiple injections for intensive control of type 1 diabetes Insulin pumps not much better than multiple injections for intensive control of type 1 diabetes Discover Portal Discover Portal Insulin pumps not much better than multiple injections for intensive control of type 1 diabetes Published on 11 July 2017 doi: People with type 1 diabetes offered insulin pumps did not achieve better blood glucose control compared with those using multiple daily injections (...) . Education remains important. While both groups saw improvements in blood glucose levels and fewer hypoglycaemic episodes (very low blood sugar) over two years, only one in four participants met NICE blood glucose targets. Insulin pump users showed some modest improvements in satisfaction, dietary freedom and daily hassle. All participants in this NIHR trial attended a training course on managing their insulin levels before randomisation. This is important because previously observed benefits from pump

2018 NIHR Dissemination Centre

142. 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

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

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2018 EvidenceUpdates

143. Day-and-Night Closed-Loop Insulin Delivery in a Broad Population of Pregnant Women With Type 1 Diabetes: A Randomized Controlled Crossover Trial

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

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2018 EvidenceUpdates

144. Sex Difference In the Effect of Fetal Exposure to Maternal Diabetes on Insulin Secretion (PubMed)

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

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2018 Journal of the Endocrine Society

145. Increase in hepatic and decrease in peripheral insulin clearance characterize abnormal temporal patterns of serum insulin in diabetic subjects (PubMed)

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

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2018 NPJ systems biology and applications

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

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)

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

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

148. 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

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

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2018 EvidenceUpdates

149. 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

150. 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. (PubMed)

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

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2018 JAMA

151. 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. (PubMed)

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

152. Insulin signaling as a potential natural killer cell checkpoint in fatty liver disease (PubMed)

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

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2018 Hepatology communications

153. Different effects of metformin and insulin on primary and secondary chemoprevention of colorectal adenoma in diabetes type 2: Traditional and Bayesian meta-analysis. (PubMed)

Different effects of metformin and insulin on primary and secondary chemoprevention of colorectal adenoma in diabetes type 2: Traditional and Bayesian meta-analysis. Metformin and insulin differently affect the risk of colon cancer in type 2 diabetic patients, however their effects on colon adenoma is not clear. PubMed, ISI, Scopus and Cochrane databases were searched for studies reporting. The outcomes were total adenoma; advanced adenoma and recurrent adenoma. Traditional and Bayesian meta (...) included in the analysis to determine the effect of insulin therapy. Insulin significantly increased the risk of colorectal adenoma (OR= 1.43, p=0.002). These findings indicate that metformin has no protective effect on total and recurrent adenoma, whilst it significantly reduces the risk of advanced adenoma, but insulin increases the risk of total adenoma.

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2018 EXCLI journal

154. 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)

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

155. 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

156. GLP-1 and Insulin Recruit Muscle Microvasculature and Dilate Conduit Artery Individually But Not Additively in Healthy Humans (PubMed)

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

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2018 Journal of the Endocrine Society

157. 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 (PubMed)

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

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2018 Hepatology communications

158. Continuous Glucose Monitoring Versus Usual Care in Patients With Type 2 Diabetes Receiving Multiple Daily Insulin Injections. (PubMed)

Continuous Glucose Monitoring Versus Usual Care in Patients With Type 2 Diabetes Receiving Multiple Daily Insulin Injections. 29610905 2018 04 03 1539-3704 168 7 2018 Apr 03 Annals of internal medicine Ann. Intern. Med. Continuous Glucose Monitoring Versus Usual Care in Patients With Type 2 Diabetes Receiving Multiple Daily Insulin Injections. 526-527 10.7326/L17-0706 Beck Roy W RW Jaeb Center for Health Research, Tampa, Florida (R.W.B., T.D.R.). Riddlesworth Tonya D TD Jaeb Center for Health

2018 Annals of Internal Medicine

159. Continuous Glucose Monitoring Versus Usual Care in Patients With Type 2 Diabetes Receiving Multiple Daily Insulin Injections. (PubMed)

Continuous Glucose Monitoring Versus Usual Care in Patients With Type 2 Diabetes Receiving Multiple Daily Insulin Injections. 29610904 2018 04 03 1539-3704 168 7 2018 Apr 03 Annals of internal medicine Ann. Intern. Med. Continuous Glucose Monitoring Versus Usual Care in Patients With Type 2 Diabetes Receiving Multiple Daily Insulin Injections. 525-526 10.7326/L17-0705 Haak Thomas T Diabetes Center Mergentheim, Bad Mergentheim, Germany (T.H.). eng Journal Article United States Ann Intern Med

2018 Annals of Internal Medicine

160. Effects of Local Use of Insulin on Wound Healing in Non-diabetic Patients. (PubMed)

Effects of Local Use of Insulin on Wound Healing in Non-diabetic Patients. Clinical trials have shown the positive effects of local insulin therapy in the formation of new vessels and fibrosis in acute and chronic diabetic wounds without major adverse effects.The aim of this study was to investigate the effects of local insulin use on wound healing in non-diabetic patients.A randomized, split-plot, double-blind, placebo-controlled trial was conducted. Ten non-diabetic patients with full (...) -thickness acute wounds were recruited (5 due to trauma, 3 to burns, and 2 to pressure). All wounds received standard bedside treatment. Each wound was divided into 2 zones. One side received a standard care plus insulin, while the other received standard care plus injection of saline solution. A biopsy specimen was taken from both sites on days 0 and 14. The amount of blood vessel growth and the percentage of fibrosis were evaluated.A significant difference in the number of new vessels was observed

2018 Plastic surgery (Oakville, Ont.)