scholarly journals Multimorbidity, glycaemic variability and time in target range in people with type 2 diabetes: A baseline analysis of the GP-OSMOTIC trial

2020 ◽  
Vol 169 ◽  
pp. 108451
Author(s):  
Jason I. Chiang ◽  
Jo-Anne Manski-Nankervis ◽  
Sharmala Thuraisingam ◽  
Alicia Jenkins ◽  
David O'Neal ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Target Range ◽  
Glycaemic Variability ◽  
Time In Target Range

scholarly journals Breakfast replacement with a liquid formula improves glycaemic variability in patients with type 2 diabetes: a randomised clinical trial

2019 ◽  
Vol 121 (5) ◽  
pp. 560-566 ◽  
Author(s):  
Jiahui Peng ◽  
Jingyi Lu ◽  
Xiaojing Ma ◽  
Lingwen Ying ◽  
Wei Lu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Glucose Monitoring ◽  
Mean Amplitude ◽  
Randomised Clinical Trial ◽  
Postprandial Blood Glucose ◽  
Glycaemic Variability ◽  
Intervention Measures ◽  
Before And After

AbstractThere is emerging evidence that glycaemic variability (GV) plays an important role in the development of diabetic complications. The current study aimed to compare the effects of lifestyle intervention (LI) with and without partial meal replacement (MR) on GV. A total of 123 patients with newly diagnosed and untreated type 2 diabetes (T2D) were randomised to receive either LI together with breakfast replacement with a liquid formula (LI+MR) (n 62) or LI alone (n 61) for 4 weeks and completed the study. Each participant was instructed to have three main meals per d and underwent 72-h continuous glucose monitoring (CGM) both before and after intervention. Measures of GV assessed by CGM included the incremental AUC of postprandial blood glucose (AUCpp), standard deviation of blood glucose (SDBG), glucose CV and mean amplitude of glycaemic excursions (MAGE). After a 4-week intervention, the improvements in systolic blood pressure (P=0·046) and time in range (P=0·033) were more pronounced in the LI+MR group than in the LI group. Furthermore, LI+MR caused significantly greater improvements in all GV metrics including SDBG (P=0·005), CV (P=0·002), MAGE (P=0·016) and AUCpp (P<0·001) than did LI. LI+MR (v. LI) was independently associated with improvements in GV after adjustment of covariates (all P<0·05). Our study showed that LI+MR led to significantly greater improvements in GV compared with LI, suggesting that LI+MR could be an effective treatment to alleviate glucose excursions.

Relationship between serum osteocalcin and glycaemic variability in Type 2 diabetes

2010 ◽  
Vol 38 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Yu-Qian Bao ◽  
Mi Zhou ◽  
Jian Zhou ◽  
Wei Lu ◽  
Yun-Chao Gao ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Serum Osteocalcin ◽  
Glycaemic Variability

scholarly journals Roux-en-Y gastric bypass increases glycaemic variability and time in hypoglycaemia in patients with obesity and pre-diabetes/type 2 diabetes mellitus: a prospective cohort study

2020 ◽  
Author(s):  
Ibiyemi Ilesanmi ◽  
George Tharakan ◽  
Kleopatra Alexiadou ◽  
Preeshila Behary ◽  
Haya Alessimii ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gastric Bypass ◽  
Diabetes Type 2 ◽  
Diabetes Type ◽  
Glucose Measurement ◽  
Glycaemic Variability ◽  
Study Objective ◽  
Post Surgery ◽  
Glucagon Like Peptide 1

<b>Objective:</b> Roux-en-Y gastric bypass (RYGB) is an established treatment for type 2 diabetes. The study objective was to establish RYGB’s effects on glycaemic variability (GV) and hypoglycaemia. <p><b>Research Design and Methods:</b> Prospective observational study of 10 participants with pre-diabetes/Type 2 diabetes undergoing RYGB, studied before surgery (Pre), 1 month (1m), 1 year (1y) and 2 years (2y) post-surgery with continuous glucose measurement (CGM). A mixed meal test (MMT) was performed at Pre, 1m and 1y. [ClinicalTrials.gov NCT01945840]</p> <p><b>Results:</b> After RYGB, mean CGM glucose fell (at 1m, 1y and 2y), and GV increased (at 1y and 2y). Fifty percent (5/10) of participants exhibited a percentage time in range <3.0 mmol/L [54 mg/dl] (%TIR<3.0) greater than the consensus target of 1% at 1y or 2y. Peak glucagon-like peptide-1 (GLP-1) and glucagon area-under-curve (AUC) during MMT were respectively positively and negatively associated with contemporaneous %TIR<3.0. </p> <b>Conclusions:</b> Patients undergoing RYGB are at risk of developing post-bariatric hypoglycaemia due to a combination of reduced mean glucose, increased GV and increased GLP-1 response.

scholarly journals OR30-02 Efficacy and Safety Comparison Between U100 Regular Human Insulin and U100 Rapid Acting Insulin When Delivered by a 24 Hour Wearable Insulin Delivery Device in Type 2 Diabetes

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Pablo Mora ◽  
David R Sutton ◽  
Ashwini Gore ◽  
Bantwal S Baliga ◽  
Rebecca Goldfaden, PharmD ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Mixed Model ◽  
Insulin Delivery ◽  
Target Range ◽  
Total Daily Dose ◽  
Efficacy And Safety ◽  
Delivery Device ◽  
Acting Insulin ◽  
The Mean

Abstract Introduction: Increasing insulin prices have led to a renewed debate to determine if Rapid Acting Insulin (RAI) analogs offer an advantage over less expensive Regular Human Insulins (RHI). The steep increase in the cost of RAI has led to rationing of insulin or the total discontinuance of therapy by many patients due to cost. For many, RHI provides a more affordable option for insulin therapy when compared to RAI, especially if the limitations of the insulin profile can be overcome by delivering RHI through continuous subcutaneous insulin infusion (CSII) using a wearable insulin delivery device. To our knowledge, no data exists in a type 2 diabetes (T2D) population comparing RAI to RHI when delivered via CSII. Methods: This 14 week multi-center prospective, randomized parallel, non-inferiority study in a T2D population compared the efficacy and safety of RAI versus RHI when delivered by V-Go®, a 24-hr wearable patch-like insulin delivery device that provides a preset continuous basal rate of insulin and on-demand bolus dosing. This study was conducted in a real-world practice setting under usual standard of care. Glucose lowering agents were to remain stable unless removal warranted due to documented clinically significant hypoglycemia and the only specific guidance for insulin titration was to down-titrate if blood glucose levels were consistently lower than target range. Patients administering RAI with V-Go were randomized 1:1 to continue RAI or to switch to RHI. Primary endpoint assessed non-inferiority for the between group net difference in HbA1c derived from a mixed model analysis. Between group differences from baseline for insulin total daily dose (TDD) and hypoglycemia (based on 7 point glucose profiles) were evaluated as secondary endpoints. Results: One hundred thirteen patients (59 RHI and 54 RAI) were evaluated. Baseline characteristics were similar between cohorts. The mean change in HbA1c with RHI was -0.60% from a baseline of 8.41% vs -0.38% from a baseline of 8.33% with RAI (estimated treatment difference [ETD]: -0.22%; 95% confidence interval [CI] -0.67% to 0.22%; non-inferiority margin&lt;0.4% and p=0.007). The mean change in TDD with RHI was 0.8 U/day from a baseline of 61.0 U/day vs 1.8 U/day from a baseline of 61.3 U/day with RAI (ETD: -1.04 U/day; 95% CI: -3.18 U/day to 1.11 U/day; p=0.92). The absolute change in percent of patients reporting hypoglycemia (≤ 70 mg/dL) from pre-randomization to post-randomization was +5.08% with RHI vs + 5.56% with RAI (ETD: -0.48%; 95% CI: -10.6% to 9.1%; p=0.91). Severe hypoglycemia was not reported in either cohort. Conclusion: Patients with T2D administering RAI with V-Go can safely switch to RHI maintaining similar glycemic control.

scholarly journals Association of Type 2 Diabetes, According to the Number of Risk Factors Within Target Range, With Structural Brain Abnormalities, Cognitive Performance, and Risk of Dementia

2021 ◽  
Author(s):  
April C.E. van Gennip ◽  
Coen D.A. Stehouwer ◽  
Martin P.J. van Boxtel ◽  
Frans R.J. Verhey ◽  
Annemarie Koster ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cognitive Performance ◽  
Target Range ◽  
Brain Abnormalities ◽  
Brain Volumes ◽  
Dementia Risk ◽  
Incident Dementia

<b>Objective </b>Type 2 diabetes is associated with increased risks of cognitive dysfunction and brain abnormalities. The extent to which risk factor modification can mitigate these risks is unclear. We investigated the associations between incident dementia, cognitive performance and brain abnormalities among individuals with type 2 diabetes, according to the number of risk factors on target, compared to controls without diabetes. <div><p><b>Research Design and Methods</b> Prospective data from UK Biobank of 87,856 individuals (n=10,663 diabetes/n=77,193 controls; baseline 2006-2010; dementia follow-up until February, 2018). Individuals with diabetes were categorized according to the number of seven selected risk factors within guideline-recommended target range (nonsmoking; guideline-recommended levels of HbA1c, blood pressure, BMI, albuminuria, physical activity, diet). Outcomes were incident dementia, domain-specific cognitive performance, white matter hyperintensities and total brain volume.</p> <p><b>Results </b>After a mean follow-up of 9.0 years, 147(1.4%) individuals with diabetes and 412(0.5%) controls had incident dementia. Among individuals with diabetes, excess dementia risk decreased stepwise for a higher number of risk factors on target. Compared to controls (incidence rate per 1,000 person-years 0.62(95%CI:0.56;0.68)), individuals with diabetes who had 5-7 risk factors on target had no significant excess dementia risk (absolute rate difference per 1,000 person-years 0.20(-0.11;0.52); HR:1.32(0.89;1.95)). Similarly, differences in processing speed, executive function, and brain volumes were progressively smaller for a higher number of risk factors on target; these results were replicated in the Maastricht Study.</p> <p><b>Conclusions </b>Among individuals with diabetes, excess dementia risk, lower cognitive performance and brain abnormalities decreased stepwise for a higher number of risk factors on target.</p></div>

scholarly journals Socioeconomic status and time in glucose target range in people with type 2 diabetes: a baseline analysis of the GP-OSMOTIC study

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Mei Lyn Tan ◽  
Jo-Anne Manski-Nankervis ◽  
Sharmala Thuraisingam ◽  
Alicia Jenkins ◽  
David O’Neal ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Socioeconomic Status ◽  
Target Range
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