scholarly journals Nocturnal Glycemic Control with New Insulin Glargine 300 U/mL

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Neng Chun Yu
Keyword(s):  
Blood Glucose ◽  
Insulin Glargine ◽  
Insulin Therapy ◽  
Real World ◽  
Statistical Significance ◽  
Treatment Phase ◽  
Glycemic Variability ◽  
The Real ◽  
Nocturnal Hypoglycemia ◽  
Glucose Levels

Insulin glargine 300 U/mL (Gla-300) is a new generation basal insulin product that has been demonstrated to have more stable pharmacokinetic and pharmacodynamic characteristics than insulin glargine 100 U/mL (Gla-100). To evaluate the real-world benefits of Gla-300 in reducing nocturnal fluctuations in blood glucose levels and nocturnal hypoglycemia, 10 Taiwanese patients using Gla-100 for insulin therapy were switched to Gla-300 and continuous glucose monitoring (CGM) was applied at nighttime to monitor changes to nocturnal glycemic variability parameters. Glycemic variability parameters measured to assess between- and within-night glycemic variability included mean 6-hour nocturnal (00:00–6:00 AM) glucose levels, standard deviation (SD), and coefficient of variance (CV) of mean nocturnal glucose levels and mean glucose excursion (MAGE). In this study, Gla-300 demonstrated comparable glycemic efficacy to Gla-100 and the potential to further reduce nocturnal hypoglycemia risk. Overall, nocturnal glycemic variability parameters measured during the Gla-300 treatment period were numerically smaller than those measured during the Gla-100 treatment phase although statistical significance was not reached. In terms of within-night glucose management, SD and CV values of mean nocturnal glucose levels were found to be statistically lower during the Gla-300 treatment phase than the Gla-100 treatment phase on nights individuals displayed normal blood glucose level readings at the beginning of the night. In summary, this study represents the first of its kind from Taiwan to evaluate the real-world clinical benefits of switching Taiwanese diabetes patients from Gla-100 to Gla-300 insulin therapy in reducing nighttime glucose variability by means of CGM.

Blood Glucose Monitoring In Pediatric Patients—Looking Toward Better Diabetes Management and Perspectives for the Future

2010 ◽  
Vol 06 (01) ◽  
pp. 54
Author(s):  
William L Clarke ◽  
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Artificial Pancreas ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Blood Glucose Monitoring ◽  
Intensive Glucose Control ◽  
Nocturnal Hypoglycemia ◽  
Glucose Levels ◽  
Analytical Accuracy

Self-blood glucose monitoring (SBGM) is an important component of day-to-day diabetes management for children and their families. Despite some recent concerns in terms of its analytical accuracy, it has been used successfully to implement intensive glucose control in the Diabetes Control and Complications Trial, reduce glycated hemoglobin (HbA1c) levels, prevent acute complications, and make it possible for children to attend school and participate in sports activities safely. While still in its infancy, continuous glucose monitoring (CGM) has been shown to be useful in reducing the occurrence of nocturnal hypoglycemia, lowering HbA1clevels, and reducing glycemic variability. Its analytical accuracy has prevented its approval as an alternative to SBGM for insulin decision-making. However, it has made possible the development and testing of closed-loop ‘artificial pancreas’ systems for controlling glucose levels in adults and adolescents.

Trends in Insulin Therapy—A1C and Age at the Time of Insulin Initiation in the Real-World Setting

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 2328-PUB
Author(s):  
RAJIV KOVIL ◽  
MANOJ S. CHAWLA ◽  
PURVI M. CHAWLA ◽  
MIKHIL C. KOTHARI ◽  
AMBARI F. SHAIKH
Keyword(s):  
Insulin Therapy ◽  
Real World ◽  
Insulin Initiation ◽  
The Real ◽  
Real World Setting

scholarly journals A review of flash glucose monitoring in type 2 diabetes

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Marcio Krakauer ◽  
Jose Fernando Botero ◽  
Fernando J. Lavalle-González ◽  
Adrian Proietti ◽  
Douglas Eugenio Barbieri
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Real World ◽  
Glucose Monitoring ◽  
Well Being ◽  
Main Body ◽  
Flash Glucose Monitoring ◽  
Glucose Levels ◽  
Freestyle Libre

Abstract Background Continuous glucose monitoring systems are increasingly being adopted as an alternative to self-monitoring of blood glucose (SMBG) by persons with diabetes mellitus receiving insulin therapy. Main body The FreeStyle Libre flash glucose monitoring system (Abbott Diabetes Care, Witney, United Kingdom) consists of a factory-calibrated sensor worn on the back of the arm which measures glucose levels in the interstitial fluid every minute and stores the reading automatically every 15 min. Swiping the reader device over the sensor retrieves stored data and displays current interstitial glucose levels, a glucose trend arrow, and a graph of glucose readings over the preceding 8 h. In patients with type 2 diabetes (T2D) receiving insulin therapy, pivotal efficacy data were provided by the 6-month REPLACE randomized controlled trial (RCT) and 6-month extension study. Compared to SMBG, the flash system significantly reduced the time spent in hypoglycemia and frequency of hypoglycemic events, although no significant change was observed in glycosylated hemoglobin (HbA1c) levels. Subsequent RCTs and real-world chart review studies have since shown that flash glucose monitoring significantly reduces HbA1c from baseline. Real-world studies in both type 1 diabetes or T2D populations also showed that flash glucose monitoring improved glycemic control. Higher (versus lower) scanning frequency was associated with significantly greater reductions in HbA1c and significant improvements in other measures such as time spent in hypoglycemia, time spent in hyperglycemia, and time in range. Additional benefits associated with flash glucose monitoring versus SMBG include reductions in acute diabetes events, all-cause hospitalizations and hospitalized ketoacidosis episodes; improved well-being and decreased disease burden; and greater treatment satisfaction. Conclusion T2D patients who use flash glucose monitoring might expect to achieve significant improvement in HbA1c and glycemic parameters and several associated benefits.

scholarly journals Glycemic variability and cardiovascular disease in patients with type 2 diabetes

2021 ◽  
Vol 9 (1) ◽  
pp. e002032
Author(s):  
Marcela Martinez ◽  
Jimena Santamarina ◽  
Adrian Pavesi ◽  
Carla Musso ◽  
Guillermo E Umpierrez
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Glycated Hemoglobin ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Cardiovascular Complications ◽  
Glucose Levels ◽  
Increased Risk ◽  
Patients With Diabetes

Glycated hemoglobin is currently the gold standard for assessment of long-term glycemic control and response to medical treatment in patients with diabetes. Glycated hemoglobin, however, does not address fluctuations in blood glucose. Glycemic variability (GV) refers to fluctuations in blood glucose levels. Recent clinical data indicate that GV is associated with increased risk of hypoglycemia, microvascular and macrovascular complications, and mortality in patients with diabetes, independently of glycated hemoglobin level. The use of continuous glucose monitoring devices has markedly improved the assessment of GV in clinical practice and facilitated the assessment of GV as well as hypoglycemia and hyperglycemia events in patients with diabetes. We review current concepts on the definition and assessment of GV and its association with cardiovascular complications in patients with type 2 diabetes.

scholarly journals Indicadores de variabilidade glicêmica e mortalidade em pacientes críticos com terapia nutricional

2020 ◽  
Vol 34 (4) ◽  
pp. 355-360
Author(s):  
Josiane Monteiro Almeida ◽  
Lucas Lima de Carvalho
Keyword(s):  
Logistic Regression ◽  
Intensive Care ◽  
Blood Glucose ◽  
Demographic Data ◽  
Glycemic Variability ◽  
Nutrition Therapy ◽  
Multivariate Logistic Regression Model ◽  
Chi Square ◽  
Glucose Levels ◽  
Enteral Diet

Introduction: Glycemic variability (GV) has been associated with mortality in critically ill patients. Several methods have been used to measure it, but no guideline has so far proposed a gold standard. The aim of this study was to associate different GV measurement methods with mortality in patients in an intensive care unit (ICU) under nutrition therapy (NT). Methods: Retrospective longitudinal study conducted between April and September 2018, in which 82 patients were enrolled in intensive care, with more than 48 hours of hospitalization and using NT. Demographic data, clinical data and all blood glucose values measured during hospitalization were collected. The GV was evaluated through three indicators: standard deviation (SD), coefficient of variation (CV) and glycemic mean (MGL). Statistical analysis was performed using Whitney and Pearson Chi-square tests, univariate and multiple logistic regression, and odds ratio. The analyzes were processed and evaluated using the Statistical Data Analysis software version 12.0. Results: 11,676 blood glucose levels were measured. Most of the sample received enteral diet. Mortality was 42.7%. A total of 36.58% of the patients had a previous diagnosis of diabetes mellitus (DM) and these presented higher values for all evaluated parameters of VG compared to non-diabetics. CV, SD and MGL values were higher among the patients who died. Univariate logistic regression analysis showed that the variables CV, SD and MGL were significantly associated with mortality. However, based on the multivariate logistic regression model, only PD maintained a relationship with mortality. Conclusion: The SD is an indicator of GV is independently associated with increased mortality in a cohort of heterogeneous patients on TN in the ICU.

Intensive Insulin Therapy and Pentastarch Resuscitation in Sepsis

2018 ◽  
pp. 109-113
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Blood Glucose ◽  
Insulin Therapy ◽  
Fluid Resuscitation ◽  
Intensive Insulin Therapy ◽  
Safety And Efficacy ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Ringer’S Lactate

This case focuses on the use of intensive insulin therapy with sepsis by asking the question: What are the safety and efficacy of intensive insulin therapy compared with conventional therapy and hydroxyethyl starch (HES) compared with Ringer’s lactate in patients with severe sepsis or septic shock? This study demonstrated that critically ill patients did not benefit from intensive insulin therapy targeting blood glucose levels of 80–110 mg/dL vs. conventional insulin therapy nor from fluid resuscitation with HES vs. Ringer’s lactate. Neither intensive insulin therapy nor fluid resuscitation with HES is currently recommended in major sepsis guidelines.

scholarly journals Transient bilateral diabetic cataracts in a Brazilian Terrier puppy

2005 ◽  
Vol 35 (3) ◽  
pp. 709-712
Author(s):  
Carla de Freitas Campos ◽  
Lilian Stefanoni Ferreira ◽  
Marlos Gonçalves Sousa ◽  
Fernanda Gomes Velasque Gama ◽  
José Luiz Laus ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Lens Opacity ◽  
Human Beings ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
And Control

A case of a Brazilian Terrier puppy presenting diabetic lens opacity that restored transparency after insulin therapy and control of blood glucose levels is reported. This entity has been rarely reported in human beings and has not been reported in dogs before. The rapid glycemic control may have been responsible for the transparency recovery.

scholarly journals Leptin contributes to the beneficial effects of insulin treatment in streptozotocin-diabetic male mice

2018 ◽  
Vol 315 (6) ◽  
pp. E1264-E1273
Author(s):  
Ursula H. Neumann ◽  
Michelle M. Kwon ◽  
Robert K. Baker ◽  
Timothy J. Kieffer
Keyword(s):  
Blood Glucose ◽  
Insulin Therapy ◽  
Daily Injection ◽  
Diabetic Mice ◽  
Glucose Lowering ◽  
Beneficial Effects ◽  
Glucose Levels ◽  
Lowering Effect ◽  
Blood Glucose Levels ◽  
Glucose Lowering Effect

It was long thought that the only hormone capable of reversing the catabolic consequences of diabetes was insulin. However, various studies have demonstrated that the adipocyte-derived hormone leptin can robustly lower blood glucose levels in rodent models of insulin-deficient diabetes. In addition, it has been suggested that some of the metabolic manifestations of insulin-deficient diabetes are due to hypoleptinemia as opposed to hypoinsulinemia. Because insulin therapy increases leptin levels, we sought to investigate the contribution of leptin to the beneficial effects of insulin therapy. To do this, we tested insulin therapy in streptozotocin (STZ) diabetic mice that were either on an ob/ ob background or that were given a leptin antagonist to determine if blocking leptin action would blunt the glucose-lowering effects of insulin therapy. We found that STZ diabetic ob/ ob mice have a diminished blood glucose-lowering effect in response to insulin therapy compared with STZ diabetic controls and exhibited more severe weight loss post-STZ injection. In addition, STZ diabetic mice administered a leptin antagonist through daily injection or plasmid expression respond less robustly to insulin therapy as assessed by both fasting blood glucose levels and blood glucose levels during an oral glucose tolerance test. However, leptin antagonism did not prevent the insulin-induced reduction in β-hydroxybutyrate and triglyceride levels. Therefore, we conclude that elevated leptin levels can contribute to the glucose-lowering effect of insulin therapy in insulin-deficient diabetes.

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