Effect of Conventional and Intensified Insulin Therapy on Free-Insulin Profiles and Glycemic Control in NIDDM

Diabetes Care ◽  
1992 ◽  
Vol 15 (1) ◽  
pp. 27-34 ◽  
Author(s):  
T. H. Lindstrom ◽  
H. J. Arnqvist ◽  
H. H. v. Schenck
Keyword(s):  
Glycemic Control ◽  
Insulin Therapy ◽  
Intensified Insulin Therapy ◽  
Free Insulin

Insulin Therapy in Uremic Diabetic Patients on Continuous Ambulatory Peritoneal Diaysis; Comparison of Intraperitoneal and Subcutaneous Administration

1994 ◽  
Vol 14 (2) ◽  
pp. 127-131 ◽  
Author(s):  
Lino Scarpioni ◽  
Sergio Ballocchi ◽  
Aurelio Castelli ◽  
Roberto Scarpioni
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Subcutaneous Administration ◽  
Diabetic Patients ◽  
Insulin Administration ◽  
Good Glycemic Control ◽  
Free Insulin ◽  
Insulin Dependent Diabetic ◽  
Beta Hydroxybutyrate

Objective To compare, in diabetic uremic patients on continuous ambulatory peritoneal dialysis (CAPD), the effects of two patterns of insulin administration, four times daily subcutaneous (SC) injections and intraperitoneal (IP) route, on blood glucose, insulin, lactate, beta-hydroxybutyrate and glycerol levels. Patients and Methods We examined 6 uremic insulin-dependent diabetic patients on CAPD. The two insulin regimens, SC and IP, were tested successively in randomized sequence in each patient. At the end of each treatment period we determined the 24-our profiles of blood glucose, free insulin, lactate, beta-hydroxybutyrate, and glycerol. Results Mean blood glucose over 24 hours (SC 7.21 ±0.61 mmol/L, IP 7.49±0.93 mmol/L), Schlichtkrull's M value, an index of glycemic control and stability (SC 10±3, IP 10±5), and the blood intermediate metabolites beta-hydroxybutyrate, lactate, and glycerol were similar in both groups. Mean serum free insulin was significantly higher during subcutaneous treatment (SC 257. 4±127.2 pmol/L, IP 170.4±83.4 pmol/L, p < 0.001). Insulin requirements were 2.5 times greater for the intraperitoneal route (SC 51 ±4 U/24 hours, IP 130±43 U/24 hours). Conclusions In uremic diabetic patients on CAPD, good glycemic control may be achieved either with subcutaneous intensive insulin therapy or with intraperitoneal insulin administration. The latter method allows reduction of circulating free insulin levels, but requires a higher dose of insulin per day.

148-OR: IDegLira Improves Glycemic Control in Japanese Patients with Type 2 Diabetes (T2D) Uncontrolled on Premixed Insulin Therapy

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 148-OR ◽  
Author(s):  
HIROTAKA WATADA ◽  
BUE F. AGNER ◽  
ANKUR DOSHI ◽  
RANDI GRØN ◽  
MATTIS F. RANTHE ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Japanese Patients ◽  
Premixed Insulin

Real-World Clinical Effectiveness and Tolerability of Hydroxychloroquine 400 Mg in Uncontrolled Type 2 Diabetes Subjects who are not Willing to Initiate Insulin Therapy (HYQ-Real-World Study)

2019 ◽  
Vol 15 (6) ◽  
pp. 510-519 ◽  
Author(s):  
Amit Gupta
Keyword(s):  
Body Weight ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Real World ◽  
Antidiabetic Drugs ◽  
Hypoglycemic Agents ◽  
Oral Hypoglycemic Agents ◽  
Good Glycemic Control ◽  
Hs Crp ◽  
Change In Mean

Objective: The epidemic of T2DM is rising across the globe. Systemic inflammation plays a pivotal role in the pathogenesis and complications of T2DM. Combination of two or more oral hypoglycemic agents (OHA) is widely prescribed in patients with T2DM, however many patients have poor glycemic control despite receiving combination therapy. The new antidiabetic drugs are relatively costly or many patients have anxiety over the use of injectable insulin. The objective of this observational study was to investigate the effectiveness and tolerability of hydroxychloroquine (HCQ) in T2DM patients uncontrolled on multiple OHA and despite high sugar level not willing to initiate insulin therapy in a real-world clinical setting. Methods: A prospective, investigator-initiated, observational, single-centred study was conducted where 250 patients (18-65 years) with T2DM for more than 5 years, with uncontrolled glycemia despite on a combination of multiple OHA, HbA1c between ≥7% and <10.5%, FPG >130 mg/dL or PPG >180 mg/dL and BMI between >25 and <39 kg/m2, were prescribed hydroxychloroquine sulphate 400 mg once daily for 48 weeks. Percentage of drugs used at the baseline were as follows: metformin 2000 mg (100%), glimepiride 4 mg (100%), pioglitazone 30 mg (100%), sitagliptin 100 mg (100%), canagliflozin 300 mg (52.4%), empagliflozin 25 mg (22.8%), dapagliflozin 10 mg (17.6%) and voglibose 0.3 mg (62%). Mean change in HbA1c, blood glucose and hs-CRP at baseline, week 12, 24 and 48 were assessed using the paired t-test. Results: After 48 weeks of add-on treatment with HCQ, almost all SGLT-2 inhibitors were withdrawn; metformin dose was reduced to 1000 mg, glimepiride reduced to 1 mg and sitagliptin reduced to 50 mg OD. Patients continued to have good glycemic control. HbA1c was reduced from 8.83% to 6.44%. Reduction in FPG was 40.78% (baseline 177.30 mg/dL) and PPG was reduced by 58.95% (baseline 329.86 mg/dL). Change in mean body weight was -4.66 Kg. The reduction in glycemic parameters and mean body weight was significant (p < 0.0001). Hs-CRP was significantly reduced from 2.70±1.98 mg/L to 0.71±0.30 mg/L 9 (p < 0.0001). More reduction in glycemic parameters and body weight was observed among the patients with higher hs-CRP (> 3 mg/L) as compared to patients with baseline hs- CRP ≤ 3 mg/L. Most common adverse events reported with the drug therapy were GI irritation (3.6%) and hypoglycemia (2%). None of the patients required medical assistance for hypoglycemia. Conclusion: Add-on treatment of HCQ effectively improved glycemic control in T2DM patients uncontrolled on multiple antidiabetic drugs. By virtue of its antidiabetic and anti-inflammatory properties, it may emerge as a valuable therapeutic intervention for the patients with T2DM.

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