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Diabetes, Obesity & Metabolism | Page 2

John A Holland, William P Martin, Neil G Docherty, Carel W le Roux
Type 2 diabetes mellitus (T2DM) and obesity constitute interwoven pandemics challenging healthcare systems in developed countries, where diabetic kidney disease (DKD) is the most common cause of end-stage renal disease. Obesity accelerates renal functional decline in people with T2DM. Intentional weight loss (IWL) strategies in this population hold promise as a means of arresting DKD progression. We herein summarise the impact of IWL strategies (stratified by lifestyle intervention, medications, and metabolic surgery) on renal outcomes in obese people with DKD...
June 17, 2019: Diabetes, Obesity & Metabolism
Ronald M Goldenberg, Jeremy D Gilbert, Irene M Hramiak, Vincent C Woo, Bernard Zinman
Recent phase 3 clinical trials have evaluated the impact of adding sodium-glucose co-transporter (SGLT) inhibitors to the type 1 diabetes armamentarium. These trials studied SGLT2 inhibitors (dapagliflozin and empagliflozin) and a dual SGLT1 and SGLT2 inhibitor (sotagliflozin), and demonstrated that these oral non-insulin antihyperglycaemic medications are able not only to improve glycaemic control, but also to reduce body weight and extend time in range without increasing rates of hypoglycaemia in type 1 diabetes...
June 10, 2019: Diabetes, Obesity & Metabolism
Marc S Sabatine, Robert P Giugliano, Lawrence A Leiter
Drs. Van Bruggen and Luijendijk note they were confused by what they thought were differences in the prevalence and incidence of diabetes in different papers from FOURIER.1 The first paper they cite was the design paper which was published while the trial was ongoing.2 This article is protected by copyright. All rights reserved.
June 10, 2019: Diabetes, Obesity & Metabolism
Marie Louise Johansen, Morten Schou, Patrick Rossignol, Maria Refsgaard Holm, Jon Rasmussen, Niels Brandt, Mikkel Frandsen, Elizaveta Chabanova, Flemming Dela, Jens Faber, Caroline Kistorp
AIMS: To investigate whether the MR antagonist eplerenone has beneficial effects on liver fat and metabolism in patients with type 2 diabetes (T2D). MATERIAL AND METHODS: In this 26-week, double-blind, randomized, placebo-controlled trial, we enrolled 140 patients with T2D and high risk of cardiovascular disease. Patients were randomized 1:1 to either eplerenone with a target dose of 200 mg/day for patients with eGFR of 60 mL/min per 1.73 m2 or more and 100 mg/day for patients with eGFR between 41-59 mL/min per 1...
June 10, 2019: Diabetes, Obesity & Metabolism
Justin M Gregory, Guillaume Kraft, Melanie F Scott, Doss W Neal, Ben Farmer, Marta S Smith, Jon R Hastings, Peter Madsen, Thomas B Kjeldsen, Susanne Hostrup, Christian L Brand, Christian Fledelius, Erica Nishimura, Alan D Cherrington
AIMS: We previously quantified the hypoglycemia-sparing effect of portal vs peripheral human insulin delivery. This investigation determined whether a bioequivalent peripheral vein infusion of a hepatopreferential insulin analog (insulin-406) could similarly protect against hypoglycemia. MATERIALS AND METHODS: Dogs received human insulin infusions into either the hepatic portal vein (PoHI, n=7) or a peripheral vein (PeHI, n=7) for 180 min at a rate 4x basal (6.6 pmol/kg/min) in a previous study...
June 10, 2019: Diabetes, Obesity & Metabolism
Andreas Melmer, Thomas Züger, Dana M Lewis, Scott Leibrand, Christoph Stettler, Markus Laimer
Open source artificial pancreas systems (OpenAPS) have gained considerable interest in the diabetes community. We analyzed continuous glucose monitoring (CGM) records of 80 OpenAPS users with type 1 diabetes (T1D). A total of 19 495 days (53.4 years) of CGM records were available. Mean glucose was 7.6 ± 1.1 mmol/L, time in range 3.9-10 mmol/L was 77.5 ± 10.5%, <3.9 mmol/L was 4.3 ± 3.6%, <3.0 mmol/L was 1.3 ± 1.9%, >10 mmol/L was 18.2 ± 11.0% and > 13.9 mmol/L was 4...
June 10, 2019: Diabetes, Obesity & Metabolism
Kohei Kaku, Hiroyuki Isaka, Taishi Sakatani, Junko Toyoshima
AIM: To assess the efficacy and safety of once-daily 50-mg ipragliflozin versus placebo in Japanese patients with type 1 diabetes mellitus (T1DM) inadequately controlled with insulin. MATERIALS AND METHODS: We conducted a multicenter, double-blind, parallel-group, placebo-controlled phase 3 study. Patients (N=175) were randomized (2:1) to receive once-daily 50-mg ipragliflozin (n=115) or placebo (n=60), combined with insulin, for 24 weeks. The primary endpoint was change in glycated hemoglobin (HbA1c); key secondary endpoints included change in insulin dose and body weight...
June 7, 2019: Diabetes, Obesity & Metabolism
Sylvia Franc, Michael Joubert, Ahmed Daoudi, Cédric Fagour, Pierre-Yves Benhamou, Michel Rodier, Beatrix Boucherie, Eric Benamo, Pauline Schaepelynck, Bruno Guerci, Dured Dardari, Sophie Borot, Alfred Penfornis, Geneviève d'Orsay, Karine Mari, Yves Reznik, Caroline Randazzo, Guillaume Charpentier
TeleDiab-2 was a 13-month randomised controlled trial evaluating the efficacy and safety of two telemonitoring systems to optimise basal insulin (BI) initiation in subjects with inadequately controlled type-2 diabetes (T2D) (glycated haemoglobin [HbA1c], 7.5-10%). A total of 191 participants (mean age 58.7 years, mean HbA1c 8.9%) were randomised into: G1 (standard care, n=63), G2 (interactive voice response system, IVRS, n=64) and G3 (Diabeo-BI app software, n=64). The two telemonitoring systems proposed daily adjustments of BI doses, in order to facilitate the achievement of fasting blood glucose (FBG) values targeted at ~100 mg/dL...
June 7, 2019: Diabetes, Obesity & Metabolism
Mathias Ried-Larsen, Mette Y Johansen, Christopher S MacDonald, Katrine B Hansen, Robin Christensen, Anne-Sophie Wedell-Neergaard, Nanna Skytt Pilmark, Henning Langberg, Allan A Vaag, Bente K Pedersen, Kristian Karstoft
AIMS: To investigate whether intensive lifestyle intervention induce partial or complete type 2 diabetes (T2D) remission. MATERIALS AND METHODS: In a secondary analysis of a randomized, assessor-blinded, single-center trial, patients with non-insulin dependent T2D (duration<10 years), were randomly assigned (2:1, stratified by sex, from April 2015 to August 2016) to a lifestyle intervention group (n=64) or a standard care group (n=34). The primary outcome was partial or complete T2D remission defined as non-diabetic glycemia with no glucose-lowering medications at the outcome assessments at both 12- and 24-months from baseline...
June 5, 2019: Diabetes, Obesity & Metabolism
Vanita R Aroda, Trine Saugstrup, John B Buse, Morten Donsmark, Jeppe Zacho, Melanie J Davies
Regulatory guidelines describe the use of estimands when designing and conducting clinical trials. Estimands ensure alignment of the objectives with the design, conduct, and analysis of a trial. An estimand is defined by four inter-related attributes: the population of interest, the variable (endpoint) of interest, how to handle intercurrent events, and the population level summary. A trial may employ multiple estimands to evaluate treatment effects from different perspectives in order to address different scientific questions...
June 5, 2019: Diabetes, Obesity & Metabolism
Doti P Martono, Hiddo J L Heerspink, Eelko Hak, Petra Denig, Bob Wilffert
AIMS: To explore the added value of diabetes-related genetic risk scores to readily available clinical parameters in the prediction of HbA1c levels after initiation of glucose-regulating drugs. MATERIALS AND METHODS: Cohort study including people with type 2 diabetes (T2DM) from the GIANTT database initiating metformin or sulfonylurea derivatives, and for whom blood samples were genotyped. The primary outcome was HbA1c level at 6-months adjusted for baseline HbA1c...
June 5, 2019: Diabetes, Obesity & Metabolism
Basem M Mishriky, James R Powell, Jennifer A Wittwer, Jennifer X Chu, Kerry A Sewell, Qiang Wu, Doyle M Cummings
AIMS: While recent cardiovascular safety trials (CVST) of newer diabetes medications included mostly whites, results are being generalized to all races in recent guidelines. This raises a controversial question regarding the ability to apply CVST data to black patients with type 2 diabetes. MATERIALS AND METHODS: We searched for randomized trials comparing diabetic medications to placebo in type 2 diabetes and investigated 3- or 4-point major adverse cardiovascular events (MACE)...
June 5, 2019: Diabetes, Obesity & Metabolism
Yuan-Di Halvorsen, J Paul Lock, Wenjiong Zhou, Fang Zhu, Mason W Freeman
AIM: To compare the relative safety and effectiveness of bexagliflozin and sitagliptin as adjuncts to metformin for the treatment of adults with type 2 diabetes. METHODS: Participants (n = 386) were randomized to receive bexagliflozin (20 mg) or sitagliptin (100 mg) in addition to their existing doses of metformin. The primary endpoint was the noninferiority of bexagliflozin to sitagliptin for change in HbA1c from baseline to week 24. Changes from baseline to week 24 in fasting plasma glucose (FPG), body mass (in subjects with baseline BMI ≥ 25 kg m-2 ) and systolic blood pressure (SBP) were secondary endpoints...
June 4, 2019: Diabetes, Obesity & Metabolism
Ingrid K Hals, Hanne Fiskvik Fleiner, Nina Reimers, Marianne C Astor, Karin Filipsson, Zuheng Ma, Valdemar Grill, Anneli Björklund
OBJECTIVES: Scarcity of randomized clinical trials in LADA makes it uncertain whether a type 1 or 2 diabetes-like treatment is optimal in preserving beta cell function. Here we compared outcome of glucagon stimulated C-peptide tests (GSCT) after a 21-mo intervention with either insulin or the DPP-4 inhibitor sitagliptin. RESEARCH DESIGN AND METHODS: We included 64 GADA positive patients diagnosed with diabetes <3 years before the study, aged 30-70 years, and without clinical need for insulin treatment...
May 30, 2019: Diabetes, Obesity & Metabolism
Iskandar Idris
No abstract text is available yet for this article.
May 30, 2019: Diabetes, Obesity & Metabolism
Sean D Sullivan, Charlie J Nicholls, Rishab A Gupta MTech, Arjun A Meron, Jasmanda Wu, Jukka Westerbacka, Zsolt Bosnyak, Juan P Frias, Timothy S Bailey
AIMS: To compare glycaemic control, hypoglycaemia, and treatment discontinuation of insulin glargine 300 units/mL (Gla-300) and insulin degludec (IDeg) in a real-world study of insulin-naïve adults with type 2 diabetes (T2D). MATERIALS AND METHODS: DELIVER Naive D was a retrospective observational study that used electronic medical record data from the IBM® Watson Health™ Explorys database. Insulin-naïve adults with T2D who started Gla-300 or IDeg between March 2015 and September 2017 were identified...
May 30, 2019: Diabetes, Obesity & Metabolism
Milton Packer
The metabolic derangements in type 2 diabetes afflict nearly every organ in the body. Although physicians have traditionally focused on the effects on the retina, kidneys and peripheral nerves, the most serious consequences of the disease are seen in the cardiovascular system. This article is protected by copyright. All rights reserved.
May 30, 2019: Diabetes, Obesity & Metabolism
Marconi Abreu, Anna Tumyan, Ahmed Elhassan, Katherine Peicher, Olivia Papacostea, Perihan Dimachkie, Muhammad S Siddiqui, Laurentiu M Pop, Uma Gunasekaran, Luigi F Meneghini, Beverley Adams-Huet, Xilong Li, Ildiko Lingvay
AIMS: We compared the efficacy and safety of a GLP-1 receptor agonist (GLP1RA) plus basal insulin versus basal-bolus insulin treatment in patients with very uncontrolled type 2 diabetes. MATERIALS AND METHODS: The SIMPLE study was a 6-month pragmatic, randomized, open-label trial testing the effectiveness of 2 approaches to treat patients with type 2 diabetes and HbA1c≥10%. We randomized patients to detemir plus liraglutide or detemir plus aspart (before each meal)...
May 30, 2019: Diabetes, Obesity & Metabolism
Julio Rosenstock, Shira Perl, Eva Johnsson, Ricardo García-Sánchez, Stephan Jacob
AIMS: To evaluate efficacy and safety of triple therapy with low-dose dapagliflozin plus saxagliptin added to metformin in uncontrolled type 2 diabetes. MATERIALS AND METHODS: This 24-week, double-blind trial (NCT02681094), randomized 883 patients (HbA1c 7.5-10.0%) on metformin ≥1500 mg/day to add-on dapagliflozin 5 mg/day plus saxagliptin 5 mg/day or to add-on of either monocomponent. The primary end point was change in HbA1c from baseline. RESULTS: Baseline mean ± standard deviation patient characteristics were: age, 56...
May 30, 2019: Diabetes, Obesity & Metabolism
Caroline Christfort Øhrstrøm, Dorte Worm, Anna Højager, Ditte Andersen, Jens Juul Holst, Urd Lynge Kielgast, Dorte Lindqvist Hansen
AIMS: Post-bariatric hypoglycaemia (PBH) is a frequent and potentially severe complication after Roux-en-Y gastric bypass (RYGB) with few available treatment options. We aimed to investigate the effects of acarbose, sitagliptin, verapamil, liraglutide and pasireotide on PBH. MATERIAL AND METHODS: In a randomized crossover study, 11 RYGB-operated women with documented hypoglycaemia each completed a baseline period without treatment and 5 treatment periods with the following interventions: acarbose 50 mg for 1 week, sitagliptin 100 mg for 1 week, verapamil 120 mg for 1 week, liraglutide 1...
May 30, 2019: Diabetes, Obesity & Metabolism
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