scholarly journals Humán inzulinról glargininzulin-alapú bázis-bolus kezelésre váltott betegek glykaemiás állapotának javulása a váltás után

2018 ◽  
Vol 159 (29) ◽  
pp. 1201-1207
Author(s):  
Erzsébet Nagy ◽  
Gábor Kovács
Keyword(s):  
Blood Glucose ◽  
Glycaemic Control ◽  
Insulin Glargine ◽  
Control Method ◽  
Fasting Blood Glucose ◽  
Postprandial Blood Glucose ◽  
Efficacy Analysis ◽  
Before And After ◽  
Bolus Insulin ◽  
Basal Bolus

Abstract: Introduction: The effectiveness of human and analogue insulins is similar but the latter have more advantageous pharmacokinetic features, leading to an improvement in hypoglycaemia and come closer to achieving the physiologic insulin profile. Aim: To demonstrate that switching from a human basal-bolus insulin treatment to an insulin glargine-based basal-bolus regimen can achieve a better glycaemic control. Method: This 3-month prospective, non-interventional study, including a 12-month retrospective data collection phase, enrolled patients who were switched to the insulin glargine- – 100 U/mL – based basal-bolus treatment at the time of enrolment if they were inadequately controlled and had at least one additional HbA1c result in the 12 months before the switch. Of 1513 patients 1181 had the data that were needed for the efficacy analysis. Results: The mean age of the efficacy population was 58.3 years and 48.1% were male. Their mean HbA1c levels remained unchanged in the year before the switch: it was 8.8 ± 1.4% at 12 months prior to the switch and 8.8 ± 1.2% at the switch, but decreased significantly to 7.7 ± 1.0% (p<0.001) after 3 months. Between the baseline and 3 months, the fasting blood glucose and the postprandial blood glucose improved significantly (from 10.0 ± 3.2 mmol/L to 7.4 ± 1.9 mmol/L, p<0.001 and from 11.1 ± 2.8 mmol/L to 8.8 ± 1.7 mmol/L, p<0.001, respectively). Insulin doses were increased both before and after the switch. Conclusions: Switch to an insulin glargine-based basal-bolus regimen could achieve a significant improvement in the glycaemic control in patients who were inadequately controlled prior to the switch. Orv Hetil. 2018; 159(29): 1201–1207.

scholarly journals Clinical Research out of Insulin Glargine U300 basal bolus therapy and Insulin Degludec/Aspart Co-Formulation in Type 2 Diabetes Mellitus: A Real World Experience

2021 ◽  
Author(s):  
savas volkan Kisioglu ◽  
Ahmet Suat Demir ◽  
damla tufekci ◽  
Yasemin Emur Gunay ◽  
Hulya Coskun ◽  
...  
Keyword(s):  
Body Weight ◽  
Blood Glucose ◽  
Insulin Glargine ◽  
Fasting Blood Glucose ◽  
Insulin Degludec ◽  
Treatment Modalities ◽  
Insulin Analogs ◽  
Bolus Insulin ◽  
Basal Bolus ◽  
Hba1c Levels

Aims/Introduction: Insulin Degludec/Aspart (IDegAsp) and Insulin Glargine U300 (IGlarU300) have recently emerged as popular new-generation insulin analogs. The aim of this real-life study was to investigate the patient profiles in which IGlarU300 and IDegAsp were preferred and the insulin combinations after which each of them were mostly used, and also to analyze the effect of these two insulin analogs on blood glucose regulation and hypoglycemia. Materials and Methods: The retrospective study included 174 patients that were switched from basal insulin, basal+bolus insulin, or premixed insulin to IGlarU300 or IDegAsp due to uncontrolled blood glucose levels or history of hypoglycemia. Hypoglycemia, body weight, body mass index (BMI), fasting blood glucose (FBG), and HbA1c levels over three-month periods were evaluated for each patient. Results: There were 84 and 90 patients in the IGlarU300 and IDegAsp groups, respectively. Body weight was similar in both groups. Baseline FBG and HbA1c levels in the IGlarU300 and IDegAsp groups were 9.0%, 175.5 mg/dl and 9.4%, 193.5 mg/dl, respectively. A significant decrease was found in FBG and HbA1c levels in both groups (138.5, 7.8 vs. 141.5, 8.2; p<0.001 for all). Moreover, a significant weight gain was observed in both groups (p<0.05 for both). The prevalence of hypoglycemia in both groups decreased significantly and consistently between month 1 and 9 (p<0.001). At month 12, although this decrease continued in the IGlarU300 group (p=0.013), no significant decrease was observed in the IDegAsp group(p=0.057). Conclusion: Both twice-daily IDegAsp±bolus insulin and IGlarU300+bolus insulin therapies are effective and safe treatment modalities.

Intensive conservative insulin treatment in patients with type 2 diabetes mellitus

2012 ◽  
Vol 153 (38) ◽  
pp. 1487-1493
Author(s):  
György Jermendy
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Conventional Treatment ◽  
Insulin Treatment ◽  
Fasting Blood Glucose ◽  
Insulin Analogues ◽  
Postprandial Blood Glucose ◽  
Medical Team ◽  
Basal Bolus

In the last couple of years, the intensive conservative insulin treatment (basal-bolus regime) became more and more popular even in patients with type 2 diabetes. Using this insulin treatment, continuous patient education, co-operation between the medical team (diabetologist, dietician and diabetes-nurses) and the patient as well as the availability of modern insulins, pens and glucometers are of great importance. Clearly, the basal-bolus treatment with human insulin has advantages over the conservative (conventional) treatment with twice daily premix insulins. Moreover, the basal-bolus treatment with insulin-analogues proved to be superior in some aspects as compared to human insulins. The intensive insulin treatment (basal-bolus regime with insulin-analogues) approaches the optimal insulin substitution and, with its use the adequate correction of each element of the glucose triad (fasting blood glucose, postprandial blood glucose, HbA1c) should be considered feasible even in patients with type 2 diabetes. Orv. Hetil., 2012, 153, 1487–1493.

scholarly journals Desvenlafaxine-associated hyperglycemia: A case report and literature review

2020 ◽  
Vol 10 (3) ◽  
pp. 85-89
Author(s):  
Andrea D. Mekonnen ◽  
Aubrey A. Mills ◽  
Andrea L. Wilhite ◽  
Theresa K. Hoffman
Keyword(s):  
Blood Glucose ◽  
Insulin Glargine ◽  
Fasting Blood Glucose ◽  
Postprandial Blood Glucose ◽  
Drug Induced ◽  
Glucose Levels ◽  
Altered Glucose ◽  
Causative Factors ◽  
Glucose Dysregulation ◽  
Norepinephrine Reuptake Inhibitor

Abstract Desvenlafaxine is a potent selective serotonin and norepinephrine reuptake inhibitor used to treat depression and anxiety. Several antidepressants have been associated with drug-induced hyperglycemia, but currently there are no reports for desvenlafaxine. A case of suspected desvenlafaxine-induced hyperglycemia is presented involving a 59-year-old female with type 2 diabetes whose average blood glucose increased by 30 mg/dL for fasting blood glucose and 75 mg/dL for postprandial blood glucose 1 month after switching from venlafaxine to desvenlafaxine. Prior to starting desvenlafaxine, she was stable on metformin 1000 mg twice daily, insulin glargine 8 units daily, and dulaglutide 1.5 mg once weekly. Over the course of 3 months after desvenlafaxine initiation, insulin glargine was increased and insulin lispro was initiated as the patient refused alternative antidepressant therapy due to favorable improvements in anxiety and depression. No other cause for elevated blood glucose could be elucidated. The Naranjo scale resulted in a score of 3, indicating a possible cause for the adverse drug reaction. Antidepressants have been associated with glucose dysregulation. However, literature also demonstrates improved glycemic control in treated versus untreated depression. If altered glucose levels are noted, all potential causative factors should be evaluated and risks and benefits weighed to guide therapy.

scholarly journals Analysis of “Comparison an Electronic Glycemic Management System Versus Provider Managed Subcutaneous Basal Bolus Insulin Therapy in the Hospital Setting”

2016 ◽  
Vol 11 (1) ◽  
pp. 17-19
Author(s):  
Silvia Leitgeb ◽  
Julia K. Mader
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Management System ◽  
Positive Impact ◽  
Hospital Setting ◽  
Before And After ◽  
Bolus Insulin ◽  
Basal Bolus ◽  
Glycemic Management

Safety and efficacy of a nurse-directed electronic glycemic management system (eGMS) in comparison to basal-bolus subcutaneous insulin therapy managed by providers has been evaluated recently by Aloi et al. They included 993 non–critically ill patients across 9 different hospitals in a retrospective observational crossover study and compared mean blood glucose, number of hypoglycemic events <40 mg/dl and <70 mg/dl and the percentage of blood glucose in target (140-180 mg/dl) before, during and after the use of eGMS. Conclusion was that eGMS can lead to better glycemic control with less hypoglycemic events compared to provider managed basal-bolus insulin therapy (before and after eGMS). Although some limitations exist, the authors made a strong case that eGMS has positive impact on glycemic control in hospitalized patients with diabetes.

scholarly journals A glargin és glulizin inzulinnal folytatott bázis-bolus kezelési rendszer egyéves eredményessége 2-es típusú cukorbetegségben. Elemzés a gyógyszerár-támogatás tükrében

2018 ◽  
Vol 159 (50) ◽  
pp. 2122-2128
Author(s):  
György Jermendy ◽  
Gábor Kovács
Keyword(s):  
Glycaemic Control ◽  
Insulin Glargine ◽  
Target Range ◽  
Glargine Insulin ◽  
Efficacy Analysis ◽  
Safety Outcome ◽  
Target Value ◽  
Insulin Glulisine ◽  
Analogue Insulins ◽  
Basal Bolus

Abstract: Introduction: Being entitled for no patient co-payment, the Hungarian reimbursement condition of analogue insulins as part of basal-bolus treatment in type 2 diabetes mellitus (T2DM) requires that two HbA1c levels should achieve <8.0% target value within 12 months (measured two months apart) after switching from treatment with human insulins. Achieving this target, the treatment should be considered effective from drug reimbursement perspective. Aim: The aims of the study were to investigate the effectiveness of insulin glargine + insulin glulisine basal-bolus regimen from the payer’s perspective and to investigate the ability to maintain the achieved glycaemic control in previously uncontrolled T2DM patients (HbA1c >9.0%). Method: This one-year, non-interventional study included patients with T2DM inadequately controlled (HbA1c >9.0%) on previous human basal-bolus treatment. The main outcomes were the proportion of patients who achieved the adequate glycaemic control (defined by the reimbursement rules) and the proportion of patients who achieved reimbursement rules defined HbA1c <8.0% target value by the 6 months after switch and could maintain this glycaemic control for upcoming further 6 months. As safety outcome, the hypoglycaemic events were recorded. Results: Out of the 557 patients enrolled, 287 had available data to be included in the efficacy analysis. Out of the 287 efficacy analysis patients, 169 (58.9%) achieved the reimbursement rules defined glycaemic control. At 6 months, 167 patients had HbA1c value <8.0% and 152 (91.0%) remained in this target range until the end of the 12-month observational period. Overall, 1221 non-severe and 6 severe hypoglycaemic events were reported. Conclusions: More than half of the patients with T2DM who were newly switched to insulin glargine + glulisine basal-bolus treatment could achieve the reimbursement rule criteria requiring for prescription of the analogue insulins with no co-payment beyond 1 year of treatment in Hungary. However, the results revealed that glycaemic control assessment with HbA1c measurements had not met the reimbursement requirements in a significant part of patients. Orv Hetil. 2018; 159(50): 2122–2128.

scholarly journals Clinical Observation of Miglitol Combined with Insulin in Newly Diagnosed Type 2 Diabetes Mellitus

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Shengting Huang ◽  
Shiying Huang
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Insulin Glargine ◽  
Adverse Reactions ◽  
Fasting Blood Glucose ◽  
Postprandial Blood Glucose ◽  
Control Group ◽  
Observation Group ◽  
Newly Diagnosed

Objective — To study the clinical efficacy of miglitol combined with insulin in the treatment of newly diagnosed type 2 diabetes mellitus. Methods — 96 newly diagnosed type 2 diabetes patients admitted to our hospital from January 2021 to September 2021 were selected as the subjects of this study. They were randomly divided into two groups by drawing lots. The control group was treated with acarbose combined with insulin glargine, and the observation group was treated with miglitol combined with insulin glargine. Fasting blood glucose, 2h postprandial blood glucose, glycosylated hemoglobin (HbA1c), blood glucose compliance time, occurrence of adverse reactions and quality of life score of 2 groups were measured before and after treatment. Results — After treatment, fasting blood glucose, 2h postprandial blood glucose and HbA1c in both groups were lower than before (P < 0.05), and there was no statistical significance in the difference between the two groups and the time of blood glucose reaching the standard (P > 0.05). The incidence of adverse reactions in observation group was lower than that in control group, and the quality of life score in observation group was better than that in control group (P < 0.05). Conclusions — Miglitol or acarbose combined with insulin glargine can effectively control blood glucose in patients with newly diagnosed type 2 diabetes, but miglitol combined with insulin glargine has fewer adverse reactions, which can be used as the first choice for clinical treatment of newly diagnosed type 2 diabetes.

scholarly journals Fasting Blood Glucose and 2-h Postprandial Blood Glucose Predict Hypertension: A Report from the REACTION Study

2021 ◽  
Vol 12 (4) ◽  
pp. 1117-1128
Author(s):  
Yingkui Si ◽  
Anping Wang ◽  
Yunshuang Yang ◽  
Hongzhou Liu ◽  
Shi Gu ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Postprandial Blood Glucose ◽  
Reaction Study

Elevated Circulating Levels of Motilin are Associated with Diabetes in Individuals after Acute Pancreatitis

2019 ◽  
Vol 128 (01) ◽  
pp. 43-51 ◽  
Author(s):  
Fuchsia D. Gold-Smith ◽  
Ruma G. Singh ◽  
Maxim S. Petrov
Keyword(s):  
Acute Pancreatitis ◽  
Blood Glucose ◽  
Glycaemic Control ◽  
Confidence Interval ◽  
Gastrointestinal Motility ◽  
Fasting Blood Glucose ◽  
Glycated Haemoglobin ◽  
Symptom Index ◽  
Plasma Motilin ◽  
Cardinal Symptom

Abstract Aim The study aimed to investigate the associations between glycaemic control after acute pancreatitis and gastrointestinal motility, using plasma motilin concentration and gastroparesis cardinal symptom index score as proxies. Methods This cross-sectional study recruited a total of 93 individuals after acute pancreatitis. Gastroparesis cardinal index scores, demographic and anthropometric factors, as well as pancreatitis-related factors were analysed. Fasting venous blood was collected to measure motilin, glycated haemoglobin, and fasting blood glucose. Linear regression analyses were conducted to investigate the associations between glycaemic control and gastrointestinal motility in unadjusted and adjusted models. Results Motilin was significantly higher in individuals with diabetes across all adjusted models, with the highest ß-coefficient (95% confidence interval) of 588.89 (138.50, 1039.28); P=0.010. Fasting blood glucose was significantly associated with motilin across all models, with the highest ß-coefficient (95% confidence interval) of 156.30 (55.49, 257.10); P=0.002. Glycated haemoglobin was significantly associated with motilin in one adjusted model with ß-coefficient (95% confidence interval) of 18.78 (1.53, 36.02); P=0.033. Gastroparesis cardinal symptom index was not significantly associated with any measure of glycaemic control. Conclusions Diabetes in individuals after acute pancreatitis appears to be characterised by elevated plasma motilin but not gastroparesis cardinal symptom index. The role of motilin in this setting warrants further investigations.

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