C‐peptide, glycemic control and diabetic complications in T2DM: a real‐world study

Author(s):  
Yajing HUANG ◽  
Yahao WANG ◽  
Chuanfeng LIU ◽  
Yue ZHOU ◽  
Xiang WANG ◽  
...  
Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 878-P
Author(s):  
KATHERINE TWEDEN ◽  
SAMANWOY GHOSH-DASTIDAR ◽  
ANDREW D. DEHENNIS ◽  
FRANCINE KAUFMAN

2019 ◽  
Vol 15 (6) ◽  
pp. 510-519 ◽  
Author(s):  
Amit Gupta

Objective: The epidemic of T2DM is rising across the globe. Systemic inflammation plays a pivotal role in the pathogenesis and complications of T2DM. Combination of two or more oral hypoglycemic agents (OHA) is widely prescribed in patients with T2DM, however many patients have poor glycemic control despite receiving combination therapy. The new antidiabetic drugs are relatively costly or many patients have anxiety over the use of injectable insulin. The objective of this observational study was to investigate the effectiveness and tolerability of hydroxychloroquine (HCQ) in T2DM patients uncontrolled on multiple OHA and despite high sugar level not willing to initiate insulin therapy in a real-world clinical setting. Methods: A prospective, investigator-initiated, observational, single-centred study was conducted where 250 patients (18-65 years) with T2DM for more than 5 years, with uncontrolled glycemia despite on a combination of multiple OHA, HbA1c between ≥7% and <10.5%, FPG >130 mg/dL or PPG >180 mg/dL and BMI between >25 and <39 kg/m2, were prescribed hydroxychloroquine sulphate 400 mg once daily for 48 weeks. Percentage of drugs used at the baseline were as follows: metformin 2000 mg (100%), glimepiride 4 mg (100%), pioglitazone 30 mg (100%), sitagliptin 100 mg (100%), canagliflozin 300 mg (52.4%), empagliflozin 25 mg (22.8%), dapagliflozin 10 mg (17.6%) and voglibose 0.3 mg (62%). Mean change in HbA1c, blood glucose and hs-CRP at baseline, week 12, 24 and 48 were assessed using the paired t-test. Results: After 48 weeks of add-on treatment with HCQ, almost all SGLT-2 inhibitors were withdrawn; metformin dose was reduced to 1000 mg, glimepiride reduced to 1 mg and sitagliptin reduced to 50 mg OD. Patients continued to have good glycemic control. HbA1c was reduced from 8.83% to 6.44%. Reduction in FPG was 40.78% (baseline 177.30 mg/dL) and PPG was reduced by 58.95% (baseline 329.86 mg/dL). Change in mean body weight was -4.66 Kg. The reduction in glycemic parameters and mean body weight was significant (p < 0.0001). Hs-CRP was significantly reduced from 2.70±1.98 mg/L to 0.71±0.30 mg/L 9 (p < 0.0001). More reduction in glycemic parameters and body weight was observed among the patients with higher hs-CRP (> 3 mg/L) as compared to patients with baseline hs- CRP ≤ 3 mg/L. Most common adverse events reported with the drug therapy were GI irritation (3.6%) and hypoglycemia (2%). None of the patients required medical assistance for hypoglycemia. Conclusion: Add-on treatment of HCQ effectively improved glycemic control in T2DM patients uncontrolled on multiple antidiabetic drugs. By virtue of its antidiabetic and anti-inflammatory properties, it may emerge as a valuable therapeutic intervention for the patients with T2DM.


2012 ◽  
Vol 50 (3) ◽  
pp. 319-324 ◽  
Author(s):  
Sjoerd F. Bakker ◽  
Maarten E. Tushuizen ◽  
Mary E. von Blomberg ◽  
Chris J. Mulder ◽  
Suat Simsek

1985 ◽  
Vol 110 (4_Suppl) ◽  
pp. S57-S60 ◽  
Author(s):  
Kristian F. Hanssen ◽  
Knut Dahl-Jørgensen ◽  
Olaf Brinchmann-Hansen ◽  
_ _

Abstract. We studied 45 IDDM without c-peptide response, duration 7-22 years, without proliferative retinopathy. After 2 months run-in period, they were randomly assigned to: (P) 15 received CSII: (C) 15 received muliple s.c. injections via butterfly 5-6x daily;: (M) 15 received twice daily mixed rapid and long acting insulin. All groups improved blood glucose control in the run-in period (p<0.0001). After change of treatment (P) and (M) improved further (p<0.01) but (C) was unchanged. GFR was supranormal and decreased in (P) and (M). No regression of retinopathy was shown in any group. One in (P) had transient florid pre-proliferative retinopathy which regressed spontaneously without laser treatment. We conclude that retinal response to strict control is complex. A transient deterioration may been seen.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Robert Alan Vigersky ◽  
Michael Stone ◽  
Pratik Agrawal ◽  
Alex Zhong ◽  
Kevin Velado ◽  
...  

Abstract Introduction: The MiniMed™ 670G system was FDA-approved in 2016 for adults and adolescents ≥14yrs, and in 2018 for children ages 7-13yrs with T1D. Since then, use of the system has grown to over 180,000 people in the U.S. The glycemic control benefits of real-world MiniMed™ 670G system Auto Mode use in the U.S. were assessed. Methods: System data (aggregated five-minute instances of sensor glucose [SG]) uploaded from March 2017 to July 2019 by individuals (N=118,737) with T1D and ≥7yrs of age who enabled Auto Mode were analyzed to determine the mean % of overall time spent &lt;54mg/dL/&lt;70mg/dL (TBR); between 70-180mg/dL (TIR); and &gt;180mg/dL/&gt;250mg/dL (TAR). The impact of Auto Mode was further assessed in a sub-group of individuals (N=51,254) with, at least, 7 days of SG data for both Auto Mode turned ON and turned OFF. The % of TIR, TBR and TAR, and the associated glucose management indicator (GMI) were evaluated for the overall OFF (2,524,570 days) and ON (6,308,806 days) periods, and across different age groups. Results: System data TIR was 71.3%; TBR was 0.4% and 1.9%, respectively; and TAR was 26.8% and 6.2%, respectively. User-wise data of Auto Mode OFF versus ON showed a mean of 70.3% of the time spent in Auto Mode, that TIR increased from 60.9% to 69.9%; and that both TBR and TAR decreased. For those 7-13yrs (N=1,417), TIR increased from 48.7% to 61.5%; TBR increased from 0.5% to 0.6% and from 2.0% to 2.2%, respectively; and TAR decreased from 49.3% to 36.3% and from 20.5% to 13.0%, respectively. For those 14-21yrs (N=4,194), TIR increased from 51.0% to 61.5%; TBR decreased from 0.7% to 0.6% and from 2.3% to 2.0%, respectively; and TAR decreased from 46.7% to 36.5% and from 18.5% to 12.5%, respectively. For those ≥22yrs (N=45,643), TIR increased from 62.2% to 70.9%; TBR decreased from 0.7% to 0.5% and from 2.6% to 1.9%, respectively; and TAR decreased from 35.2% to 27.3% and from 9.9% to 6.3%, respectively. The mean GMI decreased by 0.23% (overall), 0.48% (7-13yrs), 0.35% (14-21yrs), and 0.22% (≥22yrs), respectively, with Auto Mode ON versus OFF. Discussion: In over 6 million days of real-world MiniMed™ 670G system Auto Mode use in the U.S., TIR of a large pediatric and adult population with T1D improved by 9% compared to when Auto Mode was OFF, which was comparable to or exceeded the TIR observed in the smaller pivotal trials. These results further support outcomes of the pivotal trials and increased glycemic control with system use.


2019 ◽  
Vol 43 (7) ◽  
pp. S36
Author(s):  
Jina Hahn ◽  
Leonard Egede ◽  
Alina Bogdanov ◽  
Lauren Fischer ◽  
Joao Diogo Da Rocha Fernandes ◽  
...  
Keyword(s):  

2019 ◽  
Vol 10 (5) ◽  
pp. 1847-1858 ◽  
Author(s):  
Edward B. Jude ◽  
Mark Nixon ◽  
Caroline O’Leary ◽  
Melissa Myland ◽  
Nick Gooch ◽  
...  

2019 ◽  
Vol 36 (5) ◽  
pp. 1201-1210 ◽  
Author(s):  
Nikolaos Tentolouris ◽  
Søren T. Knudsen ◽  
Annunziata Lapolla ◽  
Michael Lyng Wolden ◽  
Steffen Haldrup ◽  
...  

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Wagner Martorina ◽  
Almir Tavares

Aims. Sleep duration (SD) has been associated with metabolic outcomes. Is there an independent association between short/long SD and glycemic control (GC) in type 2 diabetes mellitus (T2DM) outpatients, compared to intermediate SD? Employing up-to-date definitions of SD, we comprehensively considered, simultaneously, all known confounding/mediating factors that recently emerged in the literature: age, gender, diet, physical activity, obesity, night pain, nocturnal diuresis, sleep quality, chronotype, sleep apnea, depressive symptoms, alcohol, caffeine, tobacco, number of endocrinologist appointments, T2DM family history, and sleep medication. Methods. A cross-sectional study of 140 consecutive T2DM outpatients, ages 40-65, glycohemoglobin HbA1c goal≤7. We searched for variables (including HbA1c) significantly associated with short (<6 hours) or long (>8 hours) SD, in comparison to intermediate SD (6-8 hours). Results. Higher HbA1c levels increased the chance of belonging to the group that sleeps <6 hours (p≤0.001). Better sleep quality, nocturnal diuresis, and morningness increased the chance of belonging to the group that sleeps >8 hours (p<0.05). Conclusions. There is an independent association between short SD and elevated HbA1c, in real-world T2DM outpatients. Future interventional studies could evaluate weather consistent, long-term sleep extension, from <6 hours to 7–9 hours per 24 hours, improves GC in T2DM outpatients.


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