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Monitoring of diabetes treatment

Raimund Weitgasser, Martin Clodi, Sarah Cvach, Michaela Riedl, Monika Lechleitner, Bernhard Ludvik
Diabetes education and self-management play a critical role in diabetes care. Patient empowerment aims to actively influence the course of the disease by self-monitoring and subsequent treatment modification as well as the ability of patients to integrate diabetes into their daily life and to appropriately adapt it to their life style situation. Diabetes education has to be made accessible for all persons with the disease. In order to be able to provide a structured and validated education program, adequate personnel as well as space, organizational and financial prerequisites are required...
April 12, 2019: Wiener Klinische Wochenschrift
Susanne Kaser, Harald Sourij, Martin Clodi, Bruno Schneeweiß, Anton N Laggner, Anton Luger
Diabetic ketoacidosis (DKA) and the hyperglycemic hyperosmolar state (HHS) represent potentially life-threatening situations in adults. Therefore, rapid comprehensive diagnostic and therapeutic measures with close monitoring of vital and laboratory parameters are required. The treatment of DKA and HHS is essentially the same and replacement of the mostly substantial fluid deficit with several liters of a physiological crystalloid solution is the first and most important step. Serum potassium concentrations need to be carefully monitored to guide its substitution...
April 12, 2019: Wiener Klinische Wochenschrift
Stephan Radda, Matthias Bolz, Stefan Egger, Vanessa Gasser-Steiner, Martina Kralinger, Stefan Mennel, Christoph Scholda, Ulrike Stolba, Andreas Wedrich
Diabetes mellitus can cause diabetic retinopathy, diabetic macular edema, optic neuropathy, cataract or dysfunction of the eye muscles. The incidence of these defects correlates with disease duration and quality of metabolic control. Recommendations of the Austrian Diabetes Association for diagnosis, therapeutic procedures and requirements for adequate follow-up depending on stage of diabetic eye disease are summarized.
April 12, 2019: Wiener Klinische Wochenschrift
Athena Philis-Tsimikas, Irene Stratton, Lone Nørgård Troelsen, Britta Anker Bak, Lawrence A Leiter
BACKGROUND: A head-to-head trial (NCT03078478) between insulin degludec and insulin glargine U300 with the primary objective of comparing the risk of hypoglycemia is being conducted. During trial conduct, safety concerns related to the glycemic data collection system led to a postinitiation protocol amendment, described here. METHODS: This randomized (1:1), open-label, treat-to-target, multinational trial was initiated in March 2017 with a planned treatment period of 52 weeks (16 weeks titration + 36 weeks maintenance)...
April 11, 2019: Journal of Diabetes Science and Technology
R R Wang, Z M Lv, Y P Dan, K Y Chen, C Zhang
The effects of acarbose and sitagliptin on blood glucose fluctuation and islet β-cell function in patients with type 2 diabetes mellitus (T2DM) were studied. One hundred and three patients with poorly controlled T2DM with insulin aspart 30 were selected and randomly divided into three groups: group A [continuous subcutaneous insulin infusion (CSII) treatment group], group B (CSII combined with acarbose treatment), group C (CSII combined with sitagliptin treatment). The treatment lasted for two weeks and the clinical indicators in the three groups were measured...
March 2019: Journal of Biological Regulators and Homeostatic Agents
Anna R Kahkoska, Linda A Adair, Allison E Aiello, Kyle S Burger, John B Buse, Jamie Crandell, David M Maahs, Crystal T Nguyen, Michael R Kosorok, Elizabeth J Mayer-Davis
BACKGROUND AND OBJECTIVE: To identify and characterize subgroups of adolescents with type 1 diabetes (T1D) and elevated hemoglobin A1c (HbA1c) who share patterns in their continuous glucose monitoring (CGM) data as 'dysglycemia phenotypes.' METHODS: Data were analyzed from the Flexible Lifestyles Empowering Change randomized trial. Adolescents with T1D (13-16 years, duration>1 year, HbA1c 8-13% (64-119 mmol/mol) wore blinded CGM at baseline for 7-days. Participants were clustered based on eight CGM metrics measuring hypoglycemia, hyperglycemia, and glycemic variability...
April 10, 2019: Pediatric Diabetes
Li Wei, Edward Chia-Cheng Lai, Yea-Huei Kao-Yang, Brian R Walker, Thomas M MacDonald, Ruth Andrew
OBJECTIVE: To investigate the incidence of new onset type 2 diabetes mellitus in men receiving steroid 5α-reductase inhibitors (dutasteride or finasteride) for long term treatment of benign prostatic hyperplasia. DESIGN: Population based cohort study. SETTING: UK Clinical Practice Research Datalink (CPRD; 2003-14) and Taiwanese National Health Insurance Research Database (NHIRD; 2002-12). PARTICIPANTS: Men in the CPRD who received dutasteride (n=8231), finasteride (n=30 774), or tamsulosin (n=16 270) were evaluated...
April 10, 2019: BMJ: British Medical Journal
Chantal Mathieu, Paresh Dandona, Moshe Phillip, Tal Oron, Marcus Lind, Lars Hansen, Fredrik Thorén, John Xu, Anna Maria Langkilde
OBJECTIVE: This pooled analysis assessed continuous glucose monitoring (CGM) in patients with inadequately controlled type 1 diabetes (HbA1c ≥7.7 to ≤11.0% [≥61 to ≤97 mmol/mol]) who received dapagliflozin as an adjunct to adjustable insulin. RESEARCH DESIGN AND METHODS: CGM data were pooled from two 24-week, double-blind, randomized, phase 3 studies: Dapagliflozin Evaluation in Patients with Inadequately Controlled Type 1 diabetes (DEPICT-1 and DEPICT-2)...
April 9, 2019: Diabetes Care
Damiana Scuteri, Ada Vero, Mariacristina Zito, Maria Diana Naturale, Giacinto Bagetta, Carlo Nucci, Paolo Tonin, Maria Tiziana Corasaniti
The aged population is constantly growing, thus fostering an increase in age-dependent diseases. Among these, diabetic retinopathy (DR) along with age-related macular degeneration entails progressive vision loss. Since such conditions are associated with the proliferation of novel vessels, their pharmacotherapeutic management consists of the intravitreal injection of anti-vascular endothelial growth factor drugs, able to hinder the driving of vascular proliferation prompted by vascular endothelial growth factor...
August 2019: Neural Regeneration Research
Ulrika Öberg, Ulf Isaksson, Lena Jutterström, Carljohan Orre, Åsa Hörnsten
BACKGROUND: Type 2 diabetes (T2D) is increasing as the population ages. The development of new medical treatments is promising and important, but the basic treatment remains self-management, even if adherence to lifestyle advice is low. Electronic health (eHealth) or mHealth interventions can increase empowerment among people living with T2D and may compensate for the lack of professional resources and geographical distances. The interactive self-management support (iSMS) project aims at including digital tools to support people living with T2D in their self-management and facilitating their interaction with diabetes specialist nurses (DSNs)...
April 8, 2019: JMIR Research Protocols
Alvin Lee Day, Jasvinder A Singh
The prevalence of rheumatoid arthritis (RA), the most common autoimmune inflammatory arthritis, is increasing, partly due to the aging of the general population. RA is an independent risk factor for the development of cardiovascular disease (CVD). Older adults and elderly patients with RA develop CVD at a younger age compared with their general population peers. Both the traditional cardiovascular risk factors (age, sex, smoking, diabetes mellitus, hypertension), and systemic inflammation (i.e. high disease activity) are contributors to accelerated CVD in people with RA...
April 5, 2019: Drugs & Aging
R C Bonadonna, A Giaccari, R Buzzetti, G Aimaretti, D Cucinotta, A Avogaro, G Perseghin, M Larosa, G B Bolli, C G Fanelli
BACKGROUND AND AIMS: Fostering patient's self-managing of basal insulin therapy could improve glucose control, by removing patient's and physician's barriers to basal insulin initiation, titration and glucose monitoring. The Italian Titration Approaches Study (ITAS) aims at demonstrating non-inferiority (<0.3% margin) in efficacy of glucose control (change in glycated hemoglobin [HbA1c] after 24 weeks) by the same titration algorithm of insulin glargine 300 U/mL (Gla-300), managed by the (nurse assisted) patient versus the physician, in insulin naïve patients with Type 2 Diabetes Mellitus (T2DM), uncontrolled with previous treatments...
February 8, 2019: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
D Bruttomesso, L Laviola, A Avogaro, E Bonora, S Del Prato, S Frontoni, E Orsi, I Rabbone, G Sesti, F Purrello
Until recently, in Italy, the use of continuous glucose monitoring (CGM) systems has been limited, but is now rapidly increasing, including the so-called real-time CGM (rtCGM) and the intermittently viewed CGM (iCGM), also called Flash Glucose Monitoring (FGM). These technologies overcome many of the limitations of self-monitoring of blood glucose (SMBG) by fingerprick and allow to go beyond HbA1c to check glucose control in diabetes. However, standardized protocols for applying and interpreting rtCGM and FGM data are lacking...
February 10, 2019: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
Diabetes Association Of The Republic Of China Taiwan
It is estimated that there were 1.73-2.20 million people with diabetes in Taiwan in 2014-2015. The executive summary briefly introduced recommendations from the Diabetes Association of Republic of China (DAROC) clinical practice guidelines for diabetes care- 2018. We described the diagnostic criteria for diabetes, pre-diabetes and gestational diabetes, and the screening methods for diabetes in asymptomatic subjects. Treatment goals for adults with diabetes, older adults with diabetes, children and adolescents with type 1 diabetes, women with gestational diabetes and inpatients were recommended...
April 2, 2019: Journal of the Formosan Medical Association
Megumi Inoue, Masanari Shiramoto, Tomonori Oura, Risa Nasu, Masako Nakano, Masakazu Takeuchi
INTRODUCTION: Dulaglutide is a recombinant glucagon-like peptide-1 immunoglobulin G4 Fc fusion protein approved for treating patients with type 2 diabetes (T2D). The aim of this study was to assess postprandial data over 4 weeks for dulaglutide (0.75 mg) versus placebo after a standardized test meal in Japanese patients with T2D. METHODS: The pharmacodynamic (PD) effects of once-weekly dulaglutide (0.75 mg) in Japanese patients with T2D on diet and exercise therapy (N = 12) were evaluated by assessing postprandial data up to week 4 in a phase 4, single-center, randomized, cross-over, single-blind, placebo-controlled study...
April 4, 2019: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Lene Ringholm, Peter Damm, Elisabeth R Mathiesen
Women with pre-existing (type 1 or type 2) diabetes mellitus are at increased risk of pregnancy complications, such as congenital malformations, preeclampsia and preterm delivery, compared with women who do not have diabetes mellitus. Approximately half of pregnancies in women with pre-existing diabetes mellitus are complicated by fetal overgrowth, which results in infants who are overweight at birth and at risk of birth trauma and, later in life, the metabolic syndrome, cardiovascular disease and type 2 diabetes mellitus...
April 4, 2019: Nature Reviews. Endocrinology
Adele Boyd, Chris Bleakley, Deirdre A Hurley, Chris Gill, Mary Hannon-Fletcher, Pamela Bell, Suzanne McDonough
BACKGROUND: Neuropathic pain is a consequence of damage to the central nervous system (CNS), for example, cerebrovascular accident, multiple sclerosis or spinal cord injury, or peripheral nervous system (PNS), for example, painful diabetic neuropathy (PDN), postherpetic neuralgia (PHN), or surgery. Evidence suggests that people suffering from neuropathic pain are likely to seek alternative modes of pain relief such as herbal medicinal products due to adverse events brought about by current pharmacological agents used to treat neuropathic pain...
April 2, 2019: Cochrane Database of Systematic Reviews
Martin Klietz, Stephan Greten, Florian Wegner, Günter U Höglinger
Parkinson's disease is a chronic neurodegenerative movement disorder affecting people mainly beyond their 50s. Geriatric patients with Parkinson's disease experience a specific profile of comorbidities. Multimorbidity and resulting polypharmacotherapy are frequent at this age. Comorbid diseases, widely spread, involve arterial hypertension, ischemic heart disease, heart failure, atrial fibrillation, polyneuropathy, diabetes mellitus, cerebrovascular disease, sarcopenia, and frailty. Following years of drug development, levodopa is still the most effective drug for the treatment of motor symptoms...
April 2, 2019: Drugs & Aging
Ravneet Bajwa, Anmol Cheema, Taimoor Khan, Alireza Amirpour, Anju Paul, Saira Chaughtai, Shrinil Patel, Tejas Patel, Joshua Bramson, Varsha Gupta, Michael Levitt, Arif Asif, Mohammad A Hossain
In recent years the use of immunomodulating therapy to treat various cancers has been on the rise. Three checkpoint inhibitors have been approved by the Food and Drug Administration (ipilimumab, pembrolizumab and nivolumab). The use of these drugs comes with serious adverse events related to excessive immune activation, collectively known as immune-related adverse events (irAEs). We conducted a system-based review of 139 case reports/case series that have described these adverse events between January 2016 and April 2018, found in the PubMed database...
April 2019: Journal of Clinical Medicine Research
Chinmay Patel, Courtney Thompson, Megan Copley-Harris, Yousef Hattab
We report a case of rhabdomyolysis and severe acute kidney injury (AKI) requiring dialysis in a 69-year-old male who was recently started on sitagliptin while on chronic simvastatin therapy. This potential interaction is not included in the package insert for sitagliptin. A comprehensive literature review revealed six previous reports of rhabdomyolysis due to drug interaction between sitagliptin and statins including simvastatin, lovastatin, and atorvastatin. Of these six cases, only two had developed rhabdomyolysis-associated AKI, none of which were severe enough to require dialysis...
2019: Case Reports in Medicine
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