Clinical Outcomes of Patients with Diabetes Who Exhibit Upper-Quartile Insulin Antibody Responses After Treatment with LY2963016 or Lantus® Insulin Glargine

Background: This study investigated the effectiveness and safety of switching from Basalin® to Lantus® in Chinese patients with diabetes mellitus (DM). Methods: A retrospective chart review conducted using the electronic medical records of patients hospitalized at the Qingdao Endocrine and Diabetes Hospital from 2005 to 2016. All patients were diagnosed with DM and underwent switching of insulin from Basalin to Lantus during hospitalization. Data collected included fasting (FBG), pre- and post-prandial whole blood glucose, insulin dose, reasons for insulin switching and hypoglycemia. Four study time points were defined as: hospital admission, Basalin initiation, insulin switching (date of final dose of Basalin), and hospital discharge. Blood glucose measurements were imputed as the values recorded closest to the dates of these four time points for each patient. Results: Data from 73 patients (70 patients with type 2 diabetes, 2 with type 1, and 1 undisclosed) were analyzed. At admission, mean glycated hemoglobin (HbA1c) and FBG were 8.9% (SD=1.75) and 9.98 (3.22) mmol/L, respectively. Between Basalin initiation and insulin switch, mean FBG decreased from 9.68 mmol/L to 8.03 mmol/L (p<0.0001), over a mean 10.8 (SD=6.85) days of Basalin treatment, and reduced further to 7.30 mmol/L at discharge (p=0.0116) following a mean 6.6 (7.36) days of Lantus. The final doses of Basalin and Lantus were similar (0.23 vs. 0.24 IU/kg/day; p=0.2409). Furthermore, reductions in pre- and post-prandial blood glucose were also observed between Basalin initiation, insulin switch and hospital discharge. The incidence of confirmed hypoglycemia was low during Basalin (2 [2.4%]) and Lantus (1 [1.2%]) treatment, with no cases of severe hypoglycemia. Conclusion: In this study population, switching from Basalin to Lantus was associated with further reductions in blood glucose, although the dose of insulin glargine did not increase. Further studies are required to verify these findings and determine the reason for this phenomenon.

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IMPACT OF CHRONIC KIDNEY DISEASE ON CLINICAL OUTCOMES IN PATIENTS WITH DIABETES MELLITUS UNDERWENT PERCUTANEOUS CORONARY INTERVENTION USING DRUG-ELUTING STENT

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(15)61829-0 ◽

2015 ◽

Vol 65 (10) ◽

pp. A1829

Author(s):

Young Jin Youn ◽

Su-Min Kim ◽

Ji Hyun Lee ◽

Jun-Won Lee ◽

Sung-Gyun Ahn ◽

...

Keyword(s):

Diabetes Mellitus ◽

Chronic Kidney Disease ◽

Percutaneous Coronary Intervention ◽

Kidney Disease ◽

Clinical Outcomes ◽

Coronary Intervention ◽

Drug Eluting Stent ◽

Percutaneous Coronary ◽

Patients With Diabetes ◽

Drug Eluting

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Special aspects of concentrated insulins: basic characteristics and research findings

Diabetes Mellitus ◽

10.14341/dm10334 ◽

2020 ◽

Vol 22 (5) ◽

pp. 481-490

Author(s):

Tatiana Y. Demidova ◽

Olga V. Balutina

Keyword(s):

Clinical Practice ◽

Insulin Glargine ◽

Microvascular Complications ◽

Severe Hypoglycemia ◽

Glucose Lowering ◽

Practice Experience ◽

Patients With Diabetes ◽

Research Findings ◽

Basic Characteristics ◽

Diabetic Microvascular Complications

The appearance of concentrated insulins in clinical practice determines the need to analyze product priorities in appropriate groups of patients with diabetes. The aim of this article is to summarize the literature on concentrated insulins (i.e. insulin lispro 200 units/mL, insulin degludec 200 units/mL, insulin glargine 300 units/mL) from randomized controlled trials, derive guidance on appropriate and safe use of these agents and demonstrate experience in real clinical practice. Severe hypoglycemia in all studies was generally low (though higher with prandial plus concentrated basal analogue therapy), and statistical improvements in other hypoglycemia categories were observed for concentrated basal insulins versus insulin glargine 100 units/mL. In all analyzed data hypoglycemic effect of insulin glargine 300 units/mL was equitable to insulin glargine 100 units/mL. Other important findings demonstrate more constant and prolonged insulin action with low within-subject/ between-day variability for insulin glargine 300 units/mL versus insulin glargine 100 units/mL, therefore, more physiological treatment might prevent from diabetic microvascular complications. The results of randomized trials are comparable with our clinical practice experience and indicate efficacious and safe glucose-lowering properties without risk of severe hypoglycemia.

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Insulin Glargine and Acarbose in the treatment of elderly patients with diabetes

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.3.86 ◽

2019 ◽

Vol 35 (3) ◽

Author(s):

Jing Li ◽

Jinzhi Ji ◽

Fuyan Liu ◽

Lingling Wang

Keyword(s):

Quality Of Life ◽

Blood Glucose ◽

Elderly Patients ◽

Insulin Glargine ◽

Adverse Reactions ◽

Postprandial Blood Glucose ◽

Control Group ◽

Observation Group ◽

Patients With Diabetes

Objective: To investigate the clinical efficacy of insulin glargine combined with acarbose in the treatment of elderly patients with diabetes. Methods: One hundred and forty-four elderly patients with diabetes who received treatment between December 2016 and December 2017 in Binzhou People’s Hospital, China, were selected and divided into a control group and an observation group, 72 each, using random number table. The control group was treated with insulin glargine, while the observation group was treated with insulin glargine combined with acarbose. The therapeutic effect, improvement of quality of life and adverse reactions were compared between the two groups. Results: After treatment, fasting blood glucose (FBG), 2h postprandial blood glucose (PBG) and glycosylated hemoglobin (Hb Alc) of the two groups were lower than those before treatment, and the decrease degree of the observation group was significantly larger than that of the control group (P<0.05). The time needed for blood glucose reaching the standard level and daily insulin dosage of the observation group were significantly lower than that of the control group, and the differences were statistically significant (P<0.05). SF-36 scale score of the observation group was significantly better than the control group, and the difference was statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: The combination of insulin Glargine and Acarbose can significantly control the blood glucose level of elderly patients with diabetes, improve the biochemical indicators, and enhance the quality of life. It is worth promotion in clinical practice. doi: https://doi.org/10.12669/pjms.35.3.86 How to cite this:Li J, Ji J, Liu F, Wang L. Insulin Glargine and Acarbose in the treatment of elderly patients with diabetes. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.86 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Health literacy and exercise interventions on clinical outcomes in Chinese patients with diabetes: a propensity score-matched comparison

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001179 ◽

2020 ◽

Vol 8 (1) ◽

pp. e001179

Author(s):

Yan Wei ◽

Yingyao Chen ◽

Yingnan Zhao ◽

Russell Rothman ◽

Jian Ming ◽

...

Keyword(s):

Health Literacy ◽

Propensity Score ◽

Propensity Score Matching ◽

Clinical Outcomes ◽

Exercise Intervention ◽

Controlled Trial ◽

Literacy Intervention ◽

Chinese Patients ◽

Exercise Interventions ◽

Patients With Diabetes

IntroductionPatients with diabetes in China have low health literacy, which likely leads to poor clinical outcomes. This study aimed to assess the effectiveness of health literacy and exercise interventions on clinical measurements in Chinese adults with type 2 diabetes mellitus (T2DM).Research design and methodsA cluster randomized controlled trial was conducted from February 2015 through April 2017 in Shanghai, China. 799 patients with T2DM aged 18 years or older recruited from eight Community Healthcare Centers were randomized into one control arm and three intervention arms receiving 1-year health literacy intervention, exercise intervention or both as the comprehensive intervention. Propensity score matching was employed to minimize potential imbalance in randomization. The intervention-attributable effects on main clinical outcomes were estimated using a difference-in-difference regression approach.ResultsAfter propensity score matching, 634 patients were included in the analysis. The three intervention groups had decreased hemoglobin A1c (A1c) level after 12 months of intervention. The largest adjusted decrease was observed in the health literacy group (−0.95%, 95% CI: −1.30 to −0.59), followed by the exercise group (−0.81%, 95% CI: −1.17 to −0.45). However, A1c was observed to increase in the health literacy and the comprehensive groups from 12 to 24 months. No obvious changes were observed for other measurements including high-density and low-density lipoprotein cholesterols, and systolic and diastolic blood pressures.ConclusionsHealth literacy and exercise-focused interventions improve glycemic control in Chinese patients with diabetes after 12 months of intervention, and the health literacy intervention shows the greatest effect. Our results suggest that the interventions may have the potential to improve diabetes self-management and reduce diabetes burden in China.Trial registration numberISRCTN76130594.

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