Latest & greatest articles for insulin

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Top results for insulin

181. Fast-Acting Insulin Aspart Improves Glycemic Control in Basal-Bolus Treatment for Type 1 Diabetes: Results of a 26-Week Multicenter, Active-Controlled, Treat-to-Target, Randomized, Parallel-Group Trial (Onset 1) Full Text available with Trip Pro

Fast-Acting Insulin Aspart Improves Glycemic Control in Basal-Bolus Treatment for Type 1 Diabetes: Results of a 26-Week Multicenter, Active-Controlled, Treat-to-Target, Randomized, Parallel-Group Trial (Onset 1) This multicenter, treat-to-target, phase 3 trial evaluated the efficacy and safety of fast-acting insulin aspart (faster aspart) versus conventional insulin aspart (IAsp) in adults with type 1 diabetes.The primary end point was change from baseline in HbA1c after 26 weeks. After an 8 (...) -week run-in, subjects were randomized (1:1:1) to double-blind mealtime faster aspart (n = 381), IAsp (n = 380), or open-label postmeal faster aspart (n = 382)-each with insulin detemir.HbA1c was reduced in both treatment groups, and noninferiority to IAsp was confirmed for both mealtime and postmeal faster aspart (estimated treatment difference [ETD] faster aspart-IAsp, mealtime, -0.15% [95% CI -0.23; -0.07], and postmeal, 0.04% [-0.04; 0.12]); mealtime faster aspart statistically significantly

2017 EvidenceUpdates

182. A placebo-controlled, randomised trial of the addition of once weekly GLP-1 receptor agonist dulaglutide to titrated daily insulin glargine in patients with type 2 diabetes (AWARD-9) Full Text available with Trip Pro

A placebo-controlled, randomised trial of the addition of once weekly GLP-1 receptor agonist dulaglutide to titrated daily insulin glargine in patients with type 2 diabetes (AWARD-9) To compare the addition of weekly dulaglutide vs the addition of placebo to titrated glargine in patients with type 2 diabetes (T2D) with sub-optimum glycated haemoglobin (HbA1c) concentration.Patients (N = 300) from this phase III, double-blind, parallel-arm, placebo-controlled study were randomized to weekly (...) ; placebo/glargine, 65 ± 2 U). The hypoglycaemia rate (≤3.9 mmol/L threshold) was 7.69 ± 15.15 and 8.56 ± 16.13 events/patient/year, respectively (P = .488). One episode of severe hypoglycaemia occurred in the dulaglutide/glargine group. Common gastrointestinal adverse events with dulaglutide were nausea (12.0%), diarrhoea (11.3%) and vomiting (6.0%).Weekly dulaglutide 1.5 mg added to basal insulin is an efficacious and well tolerated treatment option for patients with T2D.© 2017 John Wiley & Sons Ltd.

2017 EvidenceUpdates

183. Diabetes: avoid insulin degludec in combination with liraglutide

Diabetes: avoid insulin degludec in combination with liraglutide Prescrire IN ENGLISH - Spotlight ''Diabetes: avoid insulin degludec in combination with liraglutide'', 1 May 2017 {1} {1} {1} | | > > > Diabetes: avoid insulin degludec in combination with liraglutide Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight Diabetes: avoid insulin degludec (...) in combination with liraglutide In patients with type 2 diabetes, the combination of insulin degludec and liraglutide in an injection pen has more disadvantages than advantages. In patients with type 2 diabetes, when metformin does not provide satisfactory glycaemic control, there is no evidence that the combination of liraglutide with an insulin is of any benefit in preventing clinical complications of diabetes. A fixed-dose combination in an injection pen of insulin degludec, a long-acting insulin

2017 Prescrire

184. Plasma Amino Acids vs Conventional Predictors of Insulin Resistance Measured by the Hyperinsulinemic Clamp Full Text available with Trip Pro

Plasma Amino Acids vs Conventional Predictors of Insulin Resistance Measured by the Hyperinsulinemic Clamp Specific plasma amino acid (AA) profiles including elevated postabsorptive branched-chain amino acids (BCAAs) have been associated with insulin resistance (IR), mostly estimated by homeostatic model assessment. This study assessed the associations of postabsorptive AAs with IR directly measured by insulin-mediated glucose disposal and determined the quantitative value of AAs (...) , waist circumference, fasting glucose, insulin, and free fatty acids (FFAs) negatively predicted 64% of the M/I variance; glutamate added 2% more. In nondiabetic participants, IR was predicted by waist circumference, insulin, and FFAs, without contribution from AAs.Several postabsorptive AAs correlated with IR but added limited predictive value to conventional markers because levels were determined largely by abdominal adiposity. Data suggest a sex-specific regulation of AA metabolism by excess

2017 Journal of the Endocrine Society

185. A Comparison of Inpatient Cost Per Day in General Surgery Patients with Type 2 Diabetes Treated with Basal-Bolus versus Sliding Scale Insulin Regimens Full Text available with Trip Pro

A Comparison of Inpatient Cost Per Day in General Surgery Patients with Type 2 Diabetes Treated with Basal-Bolus versus Sliding Scale Insulin Regimens The identification of cost-effective glycaemic management strategies is critical to hospitals. Treatment with a basal-bolus insulin (BBI) regimen has been shown to result in better glycaemic control and fewer complications than sliding scale regular insulin (SSI) in general surgery patients with type 2 diabetes mellitus (T2DM), but the effect

2017 PharmacoEconomics open Controlled trial quality: uncertain

186. Effects of KDT501 on Metabolic Parameters in Insulin-Resistant Prediabetic Humans Full Text available with Trip Pro

Effects of KDT501 on Metabolic Parameters in Insulin-Resistant Prediabetic Humans KDT501 is an isohumulone drug that has demonstrated beneficial effects on metabolic parameters in mice.This study was intended to examine potential improvements in metabolism in humans.Changes in carbohydrate and lipid metabolism, along with inflammatory markers, were evaluated in prediabetic humans in a clinical research center.Nine obese patients participated. All had prediabetes or normal glucose tolerance plus (...) three features of metabolic syndrome.All participants were treated with escalating doses of KDT501 to a maximum dose of 1000 mg every 12 hours for a total of 28 days.Changes in carbohydrate metabolism were measured with oral glucose tolerance, homeostatic model of insulin resistance, and euglycemic clamp; changes in plasma lipids and response to a lipid tolerance test; and changes in plasma inflammatory markers.The drug was well tolerated. After KDT501 treatment, plasma triglycerides were reduced

2017 Journal of the Endocrine Society

187. A Ratiometric Sensor for Imaging Insulin Secretion in Single β Cells Full Text available with Trip Pro

A Ratiometric Sensor for Imaging Insulin Secretion in Single β Cells Despite the urgent need for assays to visualize insulin secretion there is to date no reliable method available for measuring insulin release from single cells. To address this need, we developed a genetically encoded reporter termed RINS1 based on proinsulin superfolder GFP (sfGFP) and mCherry fusions for monitoring insulin secretion. RINS1 expression in MIN6 β cells resulted in proper processing yielding single-labeled (...) insulin species. Unexpectedly, glucose or drug stimulation of insulin secretion in β cells led to the preferential release of the insulin-sfGFP construct, while the mCherry-fused C-peptide remained trapped in exocytic granules. This physical separation was used to monitor glucose-stimulated insulin secretion ratiometrically by total internal reflection fluorescence microscopy in single MIN6 and primary mouse β cells. Further, RINS1 enabled parallel monitoring of pulsatile insulin release

2017 Cell chemical biology

188. F2-Isoprostanes Reflect Oxidative Stress Correlated With Lean Mass and Bone Density but Not Insulin Resistance Full Text available with Trip Pro

F2-Isoprostanes Reflect Oxidative Stress Correlated With Lean Mass and Bone Density but Not Insulin Resistance F2-isoprostanes (F2-isoPs) are biomarkers for oxidative stress in humans and have been shown to be elevated in obesity, cardiovascular disease, and diabetes. Therefore, F2-isoPs are often implicated in oxidative stress contributing to insulin resistance, although this has not been rigorously examined.To determine whether urinary F2-isoPs are predictive of insulin sensitivity and other (...) clinical metabolic parameters.Sedentary, weight-stable, nondiabetic adults equilibrated on a standard isocaloric diet.Insulin sensitivity via hyperinsulinemic-euglycemic clamp, urinary F2-isoPs by gas chromatography-mass spectrometry, and body composition by dual-energy x-ray absorptiometry.No correlation was found between 15-F2t-IsoP nor its major metabolite, 2,3-dinor-5,6-dihydro-15-F2t-IsoP, with insulin sensitivity, even after adjusting for age, race, sex, BMI, and smoking status. 15-F2t-IsoP

2017 Journal of the Endocrine Society

189. Local Insulin Delivery Around Titanium Implants at the Time of Placement Increases Biomechanical Retention in Rats

Local Insulin Delivery Around Titanium Implants at the Time of Placement Increases Biomechanical Retention in Rats UTCAT3224, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Local Insulin Delivery Around Titanium Implants at the Time of Placement Increases Biomechanical Retention in Rats Clinical Question Will local insulin delivery in type 1 and type 2 diabetics improve biomechanical retention of titanium implants (...) relative to that in type 1 and type 2 diabetics who do not receive local insulin delivery? Clinical Bottom Line In diabetic rats, local insulin delivery around titanium implants at time of placement improved biomechanical implant retention, bone-implant contact, and bone volume relative to diabetic rats who did not receive local insulin. Human studies have yet to be conducted. Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type

2017 UTHSCSA Dental School CAT Library

190. Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE). Full Text available with Trip Pro

Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE). Objective To compare the effectiveness of insulin pumps with multiple daily injections for adults with type 1 diabetes, with both groups receiving equivalent training in flexible insulin treatment.Design Pragmatic, multicentre, open label, parallel group, cluster randomised controlled trial (...) (Relative Effectiveness of Pumps Over MDI and Structured Education (REPOSE) trial).Setting Eight secondary care centres in England and Scotland.Participants Adults with type 1 diabetes who were willing to undertake intensive insulin treatment, with no preference for pumps or multiple daily injections. Participants were allocated a place on established group training courses that taught flexible intensive insulin treatment ("dose adjustment for normal eating," DAFNE). The course groups (the clusters

2017 BMJ Controlled trial quality: predicted high

191. Evaluating the effect of insulin sensitizers metformin and pioglitazone alone and in combination on women with polycystic ovary syndrome: An RCT. Full Text available with Trip Pro

Evaluating the effect of insulin sensitizers metformin and pioglitazone alone and in combination on women with polycystic ovary syndrome: An RCT. Insulin resistance and hyperinsulinemia may play a role in pathogenesis of PCOS. One of the common therapeutic methods is using insulin-sensitizing drugs such as metformin and thiazolidinediones.The purpose was to determine the effect of metformin and pioglitazone on clinical, hormonal and metabolic parameters in women with PCOS.Eighty four women (...) randomly received one of the following for 3 months: metformin (n=28) (500 mg three times a day), pioglitazone (30 mg daily) (n=28) and combination of both metformin and pioglitazone (n=28) (30 mg/day pioglitazone plus 500 mg metformin three times a day). Hormonal profile, fasting serum insulin, body weight, body mass index, menstrual status and waist to hip ratio were evaluated before and after treatment.Metformin and pioglitazone and combination therapy induced favorable changes in fasting serum

2017 International journal of reproductive biomedicine (Yazd, Iran) Controlled trial quality: uncertain

192. Supporting insulin initiation in type 2 diabetes in primary care: results of the Stepping Up pragmatic cluster randomised controlled clinical trial. Full Text available with Trip Pro

Supporting insulin initiation in type 2 diabetes in primary care: results of the Stepping Up pragmatic cluster randomised controlled clinical trial. Objective To compare the effectiveness of a novel model of care ("Stepping Up") with usual primary care in normalising insulin initiation for type 2 diabetes, leading to improved glycated haemoglobin (HbA1c) levels.Design Cluster randomised controlled trial.Setting Primary care practices in Victoria, Australia, with a practice nurse and at least (...) one consenting eligible patient (HbA1c ≥7.5% with maximal oral treatment).Participants 266 patients with type 2 diabetes and 74 practices (mean cluster size 4 (range 1-8) patients), followed up for 12 months.Intervention The Stepping Up model of care intervention involved theory based change in practice systems and reorientation of the roles of health professionals in the primary care diabetes team. The core components were an enhanced role for the practice nurse in leading insulin initiation

2017 BMJ

193. Both overlapping and independent mechanisms determine how diet and insulin-ligand knockouts extend lifespan of Drosophila melanogaster Full Text available with Trip Pro

Both overlapping and independent mechanisms determine how diet and insulin-ligand knockouts extend lifespan of Drosophila melanogaster Lifespan in many organisms, including Drosophila melanogaster, can be increased by reduced insulin-IGF-like signaling (IIS) or by changes in diet. Most studies testing whether IIS is involved in diet-mediated lifespan extension employ only a few diets, but recent data shows that a broad range of nutritional environments is required. Here, we present lifespan (...) data of long-lived Drosophila, lacking three of the eight insulin-like peptides [Drosophila insulin-like peptides 2,3,5 (dilp2-3,5)] on nine different diets that surround the optimum for lifespan. Their nutritional content was varied by manipulating sugar and yeast concentrations independently, and thus incorporated changes in both diet restriction and nutrient balance. The mutants were substantially longer-lived than controls on every diet, but the effects on the lifespan response to sugar

2017 NPJ aging and mechanisms of disease

194. Different insulin types and regimens for pregnant women with pre-existing diabetes. Full Text available with Trip Pro

Different insulin types and regimens for pregnant women with pre-existing diabetes. Insulin requirements may change during pregnancy, and the optimal treatment for pre-existing diabetes is unclear. There are several insulin regimens (e.g. via syringe, pen) and types of insulin (e.g. fast-acting insulin, human insulin).To assess the effects of different insulin types and different insulin regimens in pregnant women with pre-existing type 1 or type 2 diabetes.We searched the Cochrane Pregnancy (...) and Childbirth Group's Trials Register (30 October 2016), ClinicalTrials.gov (17 October 2016), the WHO International Clinical Trials Registry Platform (ICTRP; 17 October 2016), and the reference lists of retrieved studies.We included randomised controlled trials (RCTs) that compared different insulin types and regimens in pregnant women with pre-existing diabetes.We had planned to include cluster-RCTs, but none were identified. We excluded quasi-randomised controlled trials and cross-over trials. We

2017 Cochrane

195. Insulin aspart (Fiasp) - Diabetes Mellitus

Insulin aspart (Fiasp) - 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 10 November 2016 EMA/CHMP/50360/2017 Committee for Medicinal Products for Human Use (CHMP) Assessment report Fiasp International non-proprietary name: insulin aspart Procedure No. EMEA/H/C/004046/0000 Note Assessment report as adopted (...) by the CHMP with all information of a commercially confidential nature deleted. Assessment report EMA/CHMP/50360/2017 Page 2/132 Administrative information Name of the medicinal product: Fiasp Applicant: Novo Nordisk A/S Novo Alle 2880 Bagsvaerd DENMARK Active substance: INSULIN ASPART International Non-proprietary Name/Common Name: insulin aspart Pharmaco-therapeutic group (ATC Code): insulins and analogues, insulins and analogues for injection, fast-acting (A10AB05) Therapeutic indication(s): Treatment

2017 European Medicines Agency - EPARs

196. [Impact evaluation of optimal use guidelines implementation for self-monitoring of blood glucose by adult patients with type 2 diabetes and not using insulin]

[Impact evaluation of optimal use guidelines implementation for self-monitoring of blood glucose by adult patients with type 2 diabetes and not using insulin] Évaluation des retombées de la mise en oeuvre du guide d'usage optimal sur l'autosurveillance glycémique chez les adultes atteints de diabète de type 2 non traités par l'insuline [Impact evaluation of optimal use guidelines implementation for self-monitoring of blood glucose by adult patients with type 2 diabetes and not using insulin (...) ] Évaluation des retombées de la mise en oeuvre du guide d'usage optimal sur l'autosurveillance glycémique chez les adultes atteints de diabète de type 2 non traités par l'insuline [Impact evaluation of optimal use guidelines implementation for self-monitoring of blood glucose by adult patients with type 2 diabetes and not using insulin] Lobè C, Tremblay E, Premont A Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation

2017 Health Technology Assessment (HTA) Database.

197. Safer insulin prescribing

Safer insulin prescribing Safer insulin prescribing Safer insulin prescribing Key therapeutic topic Published: 16 January 2017 nice.org.uk/guidance/ktt20 pathways K Ke ey points y points Several new insulin products have been launched in recent years, including high-strength, fixed-combination and biosimilar insulins. The Medicines and Healthcare products Regulatory Agency (MHRA) has issued advice for healthcare professionals to minimise the risk of medication error with these products (...) . Hypoglycaemia is an inevitable adverse effect of insulin therapy. All the NICE guidelines on diabetes recommend that people receiving insulin therapy are provided with education and information about awareness and management of hypoglycaemia. Diabetes features in the NHS Long T erm Plan published in January 2019. Options for local implementation: Options for local implementation: Be aware of the differences between insulin products and ensure that people receive appropriate training on their correct use

2017 National Institute for Health and Clinical Excellence - Advice

198. Effect of Continuous Glucose Monitoring on Glycemic Control in Adults With Type 1 Diabetes Using Insulin Injections: The DIAMOND Randomized Clinical Trial. (Abstract)

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

2017 JAMA Controlled trial quality: predicted high

199. 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. (Abstract)

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

2017 JAMA Controlled trial quality: predicted high

200. Combined immunotherapy with “anti-insulin resistance” therapy as a novel therapeutic strategy against neurodegenerative diseases Full Text available with Trip Pro

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

2017 NPJ Parkinson's disease