scholarly journals Adverse Changes in HbA1c, Body Weight and Insulin Use in People with Type 1 Diabetes Mellitus Following Dapagliflozin Discontinuation in the DEPICT Clinical Trial Programme

2020 ◽  
Vol 11 (5) ◽  
pp. 1135-1146
Author(s):  
Jason Gordon ◽  
Thomas Danne ◽  
Lee Beresford-Hulme ◽  
Hayley Bennet ◽  
Amarjeet Tank ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Trial ◽  
Type 1 Diabetes ◽  
Body Weight ◽  
Type 1 Diabetes Mellitus ◽  
Clinical Trial Programme ◽  
Insulin Use

Liraglutide as an Additional Treatment to Insulin in Patients with Type 1 Diabetes Mellitus—A 52-Week Randomized Double-Blinded Placebo-Controlled Clinical Trial

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 3-LB ◽  
Author(s):  
PARESH DANDONA ◽  
HUSAM GHANIM ◽  
NITESH D. KUHADIYA ◽  
TANVI SHAH ◽  
JEANNE M. HEJNA ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Trial ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Additional Treatment ◽  
Controlled Clinical Trial ◽  
Double Blinded

scholarly journals Adherence to Insulin Pump Behaviors in Young Children With Type 1 Diabetes Mellitus

2016 ◽  
Vol 11 (1) ◽  
pp. 87-91 ◽  
Author(s):  
Susana R. Patton ◽  
Kimberly A. Driscoll ◽  
Mark A. Clements
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Young Children ◽  
Type 1 Diabetes Mellitus ◽  
Insulin Pump ◽  
Insulin Use

Background: Parents of young children are responsible for daily type 1 diabetes (T1DM) cares including insulin bolusing. For optimal insulin pump management, parents should enter a blood glucose result (SMBG) and a carbohydrate estimate (if food will be consumed) into the bolus advisor in their child’s pump to assist in delivering the recommended insulin bolus. Previously, pump adherence behaviors were described in adolescents; we describe these behaviors in a sample of young children. Methods: Pump data covering between 14-30 consecutive days were obtained for 116 children. Assessed adherence to essential pump adherence behaviors (eg, SMBG, carbohydrate entry, and insulin use) and adherence to 3 Wizard/Bolus Advisor steps: SMBG–carbohydrate entry–insulin bolus delivered. Results: Parents completed SMBG ≥4 times on 99% of days, bolused insulin ≥3 times on 95% of days, and entered carbohydrates ≥3 times on 93% of days, but they corrected for hyperglycemia (≥250 mg/dl or 13.9 mmol/l) only 63% of the time. Parents completed Wizard/Bolus Advisor steps (SMBG, carbohydrate entry, insulin bolus) within 30 minutes for 43% of boluses. Inverse correlations were found between children’s mean daily glucose and the percentage of days with ≥4 SMBG and ≥3 carbohydrate entries as well as the percentage of boluses where all Wizard/Bolus Advisor steps were completed. Conclusions: Parents of young children adhered to individual pump behaviors, but showed some variability in their adherence to Wizard/Bolus Advisor steps. Parents showed low adherence to recommendations to correct for hyperglycemia. Like adolescents, targeting pump behaviors in young children may have the potential to optimize glycemic control.

scholarly journals Type 1 Diabetes Mellitus and Familial Hypokalemic Periodic Paralysis: A Management Dilemma

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A463-A464
Author(s):  
Aye H Khine ◽  
Joel Hernandez ◽  
Aalam Sohal ◽  
Ngwe Yin
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Serum Potassium ◽  
Periodic Paralysis ◽  
Subcutaneous Insulin ◽  
Hypokalemic Periodic Paralysis ◽  
Upper And Lower Extremities ◽  
Insulin Use

Abstract Background: Familial hypokalemic periodic paralysis (FHPP) is a rare condition characterized by episodes of painless muscle weakness associated with hypokalemia. It can be precipitated by heavy exercise and high carbohydrate meals. There have been cases illustrating treatment options to decrease the frequency of episodic weakness. However, insulin use in patients with FHPP has not been well studied or documented in literature. Clinical Case: A 21-year-old male with known FHPP (heterozygous positive CACNA1S R1239H mutation) presented with nausea, vomiting, abdominal pain, and profound weakness. He had 1/5 strength in his upper and lower extremities bilaterally on examination. He was found to be in diabetic ketoacidosis (DKA). Insulin drip was initiated per DKA protocol and eventually converted to subcutaneous insulin. He continued to be weak and persistently hypokalemic, requiring potassium replacement (200 mEq/day). He had been on acetazolamide as preventive treatment for FHPP. It was switched to spironolactone in efforts to better control his potassium levels. His strength improved gradually, and he recovered 5/5 strength in his upper and lower extremities bilaterally by day 3 of admission. His weakness did not acutely worsen after receiving subcutaneous insulin. Further testing revealed elevated glutamic acid decarboxylase (GAD) antibodies consistent with type 1 diabetes mellitus (T1DM). His serum potassium on discharge was 4.4 mEq/L. He was discharged with subcutaneous insulin, potassium chloride 40 mEq three times daily, and spironolactone 100 mg daily. After discharge, serum potassium levels remained stable and potassium requirement decreased significantly to 40 mEq once daily. Conclusion: This case illustrates the management dilemma between an unusual combination of diseases. The balance of potassium levels between insulin use in T1DM and FHPP creates significant challenges. Fortunately, the use of subcutaneous insulin in this patient did not appear to trigger episodic weakness. Further studies of hypokalemic periodic paralysis are critical to the institution of appropriate therapy and prevention of symptoms in patients with these conditions. Careful replacement and monitoring of potassium is recommended as patients require high doses of potassium during acute episodes of flaccid paralysis, and requirement significantly decreases after an acute episode.

scholarly journals The Role of SGLT-2 Inhibitors as an Adjuvant to Insulin Therapy in Type-1 Diabetes Mellitus- Literature Review

2021 ◽  
pp. 333-337
Author(s):  
Sultan Ali Alshehri ◽  
Sultan Abdulwahab M. Asiri ◽  
Aalaa Mohammad Algarni ◽  
Manal Mohammed Alamari
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 1 Diabetes ◽  
Body Weight ◽  
Insulin Therapy ◽  
Type 1 Diabetes Mellitus ◽  
Insulin Regimen ◽  
Increase Body Weight ◽  
Pubmed Database

Background: Type 1 diabetes mellitus is the main risk factor for cardiovascular complications. Therefore, intensified insulin therapy might be needed to achieve better glycemic control in some patients. However, insulin therapy might lead to increase body weight and induce hypoglycemia. Increase body weight is directly correlated to insulin resistance, the main factor for cardiovascular risk.  Objective: To assess the effectiveness of adding SGLT2 inhibitors to insulin therapy in type 1 diabetes mellitus.  Methods: We searched in the PubMed database looking for relevant articles on the topic. We used Mesh words search, including SGLT2 inhibitor, sotagliflozin, type 1 diabetes mellitus, insulin treatment.  Conclusion: Adding oral antidiabetic agents, such as SGLT2 or dual SGLT inhibitors to insulin regimen might be beneficial in improving insulin resistance. Thus, it achieved better insulin resistance by decrease daily insulin requirements and bodyweight control, leading to better cardiovascular outcomes among Type-1 diabetes patients.

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