scholarly journals Pharmacoeconomic comparison of the second generation insulin analogs and insulins on their base

2021 ◽  
Vol 20 (1) ◽  
pp. 4-15
Author(s):  
I. N. Dyakov ◽  
S. K. Zyryanov
Keyword(s):  
Second Generation ◽  
Indirect Costs ◽  
Insulin Degludec ◽  
Effective Control ◽  
Medication Cost ◽  
Insulin Analogs ◽  
Number Of Patients ◽  
Control Of Diabetes ◽  
Dm Type 2

Effective control of Diabetes Mellitus (DM) is an actual task from clinical and economic points of view. The second generation insulin analogs increase level of DM compensation without hypoglycemia. The economic aspects of their usage have been evaluated early, but it is still actual due to changes in prices and new data about clinical efficacy were published.Materials and methods: Clinical-economic comparison of insulin glargine 300 U/ml (iGla 300), insulin degludec (iDeg) and insulin degludec/ insulin aspart (iDegAsp) in the Russian conditions has been performed in naïve patients’ group as well as in the group of patients with previous insulintherapy. Number of patients with HbA1c <7 % was chosen as efficacy criterion. Direct and indirect costs (medications, treatment of CV-complications, GDP loses etc.) were indicated and calculated based on the constructed model.Results: iGla 300 can give an economy till 20 % for medication cost and till 10 % for direct medical expenditures in compare with iDeg in DM Type 1. For both patients’ groups iGla 300 can save 10-23 % of sources in compare with iGed and iDegAsp in DM Type 2. In DM2T iGla 300 had more efficacy and less cost in compare with iDeg in elderly patients with renal insufficiency.Conclusion: An effective control of DM with modern insulins is profitable from government position of payment due to decreasing expenditures for complications treatment.

scholarly journals Pharmacoeconomic characteristics of agonists of receptors for glucagon-like peptide-1 and medicines on their base

2021 ◽  
pp. 4-15
Author(s):  
I. N. Dyakov ◽  
S. K. Zyryanov
Keyword(s):  
Pharmacoeconomic Analysis ◽  
Economic Value ◽  
Indirect Costs ◽  
Direct Costs ◽  
Effective Control ◽  
Actual Problem ◽  
Local Conditions ◽  
Number Of Patients ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

The effective control of Diabetes Mellitus (DM) is an actual problem from optimal expenditures of health care system point of view. Agonists of receptors for glucagon like peptide-1 (aGLP-1) are one of the modern option for glycemia control in DM Type 2 and included in all current guidelines for the treatment control. The economic comparative aspects of the use of these drugs in the local conditions have not been studied. Materials and methods. Comparative economic evaluation of insulin glargine + lixisenatide (iGlaLixi), exenatide (Exe), dulaglutide (Dula), liraglutide (Lira) and combinations of their aGLP-1 with iGla 100 U has been performed base on published clinical data of efficacy. Number of patients with HbA1c <7 % was chosen as efficacy criterion. Non-direct comparison with Odds Ratio (OR) calculation was prepared. Direct and indirect costs (medications, treatment of CV-complications, GDP loses etc.) were indicated and calculated based on constructed model. Sensitivity analysis has been provided for validation of results. Results. Pharmacoeconomic analysis based on non-direct efficacy comparisons of iGlaLixi, Exe, Lira and Dula has shown of economic advantages of effective DM2T control. iGlaLixi has demonstrated economic advantages as well usage aGLP-1 only (direct costs decreasing vs Exe on 23,8 %, vs Dula on 15,6 %, vs Lira on 54,4 %) as their combinations with iGla 100 U (direct costs decreasing vs iGla 100 U + Exe on 23,8 %, vs iGla 100 U + Dula on 15,2 %). iGlaLixi decreased a total cost (direct and non-direct) better than Exe, Dula and Lira (on 19,9, 9,3 и 45,2 % accordingly). Conclusion. An effective control of DM2T with aGLP-1 and medicines on their base has an economic value because lead to expenditures for complications decreasing from government position.

270-OR: Nocturnal Hypoglycemia with Insulin Degludec and Glargine U100 in Patients with Type 1 Diabetes Prone to Severe Nocturnal Hypoglycemia (HypoDeg): A CGM Substudy

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 270-OR
Author(s):  
JULIE M. BRØSEN ◽  
RIKKE M. AGESEN ◽  
AMRA CIRIC ALIBEGOVIC ◽  
HENRIK U. ANDERSEN ◽  
PETER GUSTENHOFF ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Degludec ◽  
Nocturnal Hypoglycemia

269-OR: Effect of Insulin Degludec on Frequency of Severe Hypoglycemia in Patients with Type 1 Diabetes Prone to Nocturnal Severe Hypoglycemia: The HypoDeg Trial

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 269-OR
Author(s):  
RIKKE M. AGESEN ◽  
AMRA CIRIC ALIBEGOVIC ◽  
HENRIK U. ANDERSEN ◽  
PETER GUSTENHOFF ◽  
TROELS K. HANSEN ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Severe Hypoglycemia ◽  
Insulin Degludec

scholarly journals Limited Sustained Local Transmission of HIV-1 CRF01_AE in New South Wales, Australia

Viruses ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 482 ◽  
Author(s):  
Francesca Di Giallonardo ◽  
Angie N. Pinto ◽  
Phillip Keen ◽  
Ansari Shaik ◽  
Alex Carrera ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
New South ◽  
New South Wales ◽  
Incidence Rates ◽  
Effective Control ◽  
South Wales ◽  
Immunodeficiency Virus ◽  
Hiv 1 ◽  
Local Transmission

Australia’s response to the human immunodeficiency virus type 1 (HIV-1) pandemic led to effective control of HIV transmission and one of the world’s lowest HIV incidence rates—0.14%. Although there has been a recent decline in new HIV diagnoses in New South Wales (NSW), the most populous state in Australia, there has been a concomitant increase with non-B subtype infections, particularly for the HIV-1 circulating recombinant form CRF01_AE. This aforementioned CRF01_AE sampled in NSW, were combined with those sampled globally to identify NSW-specific viral clades. The population growth of these clades was assessed in two-year period intervals from 2009 to 2017. Overall, 109 NSW-specific clades were identified, most comprising pairs of sequences; however, five large clades comprising ≥10 sequences were also found. Forty-four clades grew over time with one or two sequences added to each in different two-year periods. Importantly, while 10 of these clades have seemingly discontinued, the remaining 34 were still active in 2016/2017. Seven such clades each comprised ≥10 sequences, and are representative of individual sub-epidemics in NSW. Thus, although the majority of new CRF01_AE infections were associated with small clades that rarely establish ongoing chains of local transmission, individual sub-epidemics are present and should be closely monitored.

scholarly journals Insulin doses requirements in patients with type 1 diabetes using glargine U300 or degludec in routine clinical practice

2021 ◽  
pp. jim-2020-001633
Author(s):  
Florentino Carral San Laureano ◽  
Mariana Tomé Fernández-Ladreda ◽  
Ana Isabel Jiménez Millán ◽  
Concepción García Calzado ◽  
María del Carmen Ayala Ortega
Keyword(s):  
Type 1 Diabetes ◽  
Clinical Practice ◽  
Retrospective Study ◽  
Real World ◽  
Glycosylated Hemoglobin ◽  
Routine Clinical Practice ◽  
Insulin Analogs ◽  
Total P ◽  
Real Clinical Practice

There are not many real-world studies evaluating daily insulin doses requirements (DIDR) in patients with type 1 diabetes (T1D) using second-generation basal insulin analogs, and such comparison is necessary. The aim of this study was to compare DIDR in individuals with T1D using glargine 300 UI/mL (IGlar-300) or degludec (IDeg) in real clinical practice. An observational, retrospective study was designed in 412 patients with T1D (males: 52%; median age 37.0±13.4 years, diabetes duration: 18.7±12.3 years) using IDeg and IGla-300 ≥6 months to compare DIDR between groups. Patients using IGla-300 (n=187) were more frequently males (59% vs 45.8%; p=0.004) and had lower glycosylated hemoglobin (HbA1c) (7.6±1.2 vs 8.1%±1.5%; p<0.001) than patients using IDeg (n=225). Total (0.77±0.36 unit/kg/day), basal (0.43±0.20 unit/kg/day) and prandial (0.33±0.23 unit/kg/day) DIDR were similar in IGla-300 and IDeg groups. Patients with HbA1c ≤7% (n=113) used significantly lower basal (p=0.045) and total (p=0.024) DIDR, but not prandial insulin (p=0.241), than patients with HbA1c between 7.1% and 8% and >8%. Patients using IGla-300 and IDeg used similar basal, prandial and total DIDR regardless of metabolic control subgroup. No difference in basal, prandial and total DIDR was observed between patients with T1D using IGla-300 or IDeg during at least 6 months in routine clinical practice.

Piroxicam reduces acute and chronic pain response in type 1 diabetic rats

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Abbas Alimoradian ◽  
Fatemeh Samimi ◽  
Hadise Aslfalah ◽  
Seied Amirhossein Latifi ◽  
Mehdi Salehi ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Normal Saline ◽  
Life Quality ◽  
Chronic Phase ◽  
Diabetic Rats ◽  
Effective Control ◽  
Diabetic Patients ◽  
Formalin Injection ◽  
Analgesic Effects

Abstract Objectives Pain associated with various underlying pathologies is a major cause of morbidity and diminished life quality in diabetic patients. Effective control of pain requires the use of analgesics with the best efficacy and with minimal side effects. Therefore, our aim in this study was to investigate the effects of non-steroidal anti-inflammatory drugs (NSAIDs) on pain in diabetic rats. Methods In this study, we investigated the analgesic effects of drugs belonging to three different classes of NSAIDs in a rat model of diabetes. Four diabetic groups received normal saline, diclofenac, piroxicam and ketorolac, respectively, and four non-diabetic groups received normal saline, diclofenac, piroxicam and ketorolac. Type 1 diabetes was induced in rats by a single injection of streptozotocin (60 mg/kg bw). Formalin (50 µL of 2.5%) nociception assay was used to examine the effect of treatment with diclofenac, piroxicam and ketorolac on acute and chronic pain in healthy and diabetic rats. Results Piroxicam showed significant analgesic effects both in the acute phase of pain (5–10 min after injection of formalin into the left hind paw), and in the chronic phase (20–60 min after formalin injection) in healthy as well as diabetic rats. Diclofenac and ketorolac also reduced pain scores in healthy rats. However, these two drugs failed to diminish pain in diabetic rats. Conclusion Our data point for better efficacy of piroxicam in controlling pain in diabetes.

THYROID PATHOLOGY IN CHILDREN WITH TYPE 1 DIABETES

Vestnik ◽  
2021 ◽  
pp. 107-111
Author(s):  
С.И. Сабирова ◽  
С.Г. Надырова ◽  
А.Б. Жанзак ◽  
А.Е. Манасбаева ◽  
Ж.Ж. Нургалиева
Keyword(s):  
Type 1 Diabetes ◽  
Thyroid Gland ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Development Indicators ◽  
Clinical Hospital ◽  
Number Of Children ◽  
Thyroid Pathology ◽  
Number Of Patients

Целью научной работы является изучение структуры заболеваний щитовидной железы у больных сахарным диабетом 1 типа. В данной статье мы ретроспективно проанализировали 972 историй болезни больных детей с СД 1 типа, находившихся на стационарном лечении в ДГКБ №2 г. Алматы (Казахстан) в период с 2014 по 2019 гг. Были изучены и оценены показатели физического развития, объективные данные (кожные покровы, ЧСС, АД, пальпация ЩЖ), лабораторно - уровней гормонов ТТГ, свТ4, свТ3, а/т к ТПО, а/т к ТГ в сыворотки крови, инструментально - УЗИ ЩЖ. Всего за 2014-2019 гг. через отделение эндокринологии ДГКБ №2 прошли 972 детей с диагнозом СД 1 типа. Большинство детей (382 человек, 79,9%) имели стаж болезни СД до 5 лет. 88 детей (18,5%) со стажем от 5 до 10 лет, 8 человек (1,7%) страдали СД более 10 лет. СД1 в основном был диагностирован в возрасте 7-12 лет (245-51,3%), меньше всего выявили СД 1 типа у детей до 3 лет (21 - 4,4%). Из общего количества пациентов с СД1 (972) было обследовано на функцию ЩЖ 478 детей (49,2%). Среди них было выявлено 319 детей с дисфункцией ЩЖ, что составляет 66,7%. Так, за 2014 год из 92 детей - 7 (7,6%), обследованных на функцию щитовидной железы, в результате чего было выявлено 6 (85,7%) детей с дисфункцией щитовидной железы. С каждым годом росло количество детей, которых направляли на обследование ЩЖ, так в сравнении с 2014 годом, когда из 92 детей - 7 (7,6%) были обследованы на функцию щитовидной железы, в 2019 году были обследованы уже 222 (92,1%) детей из 241. Симптомы как гиперфункции, так и гипофункции ЩЖ, особенно их субклинические варианты протекают под маской других заболевании и не сразу обнаруживаются, исходя из этого следует сразу обследовать на функцию ЩЖ при поступлении и в дальнейшим их наблюдать в динамике. В ходе исследования дисфункция щитовидной железы диагностирована у 319 (67,7%) пациентов, что должно привлечь внимание не только эндокринологов, но и врачей общей практики, педиатров и настроить их на прицельный поиск этой патологии и своевременную коррекцию гипотиреоза или другой патологии ЩЖ при его наличии The purpose of this research is to study the structure of thyroid diseases in patients with type 1 diabetes. In this article, we retrospectively analyzed 972 case histories of sick children with type 1 diabetes who were treated in the children's city clinical hospital No. 2 in Almaty (Kazakhstan) in the period from 2014 to 2019. Physical development indicators, objective data (skin, heart rate, blood pressure, thyroid palpation), laboratory levels of TSH, thyroxine, triiodothyronine, antibodies to thyroperoxidase, antibodies to thyroglobulin in blood serum, instrumental ultrasound examination of the thyroid gland were studied and evaluated. In total, in 2014-2019, 972 children with a diagnosis of type 1 diabetes mellitus passed through the endocrinology Department of the children's city clinical hospital No. 2.The majority of children (382 people, 79.9%) had a history of diabetes up to 5 years. 88 children (18.5%) with experience from 5 to 10 years, 8 people (1.7%) had diabetes for more than 10 years. Type 1 diabetes was mainly diagnosed at the age of 7-12 years (245-51. 3%), the least detected type 1 diabetes in children under 3 years (21 - 4.4%). Out of the total number of patients with type 1 diabetes (972), 478 children (49.2%) were examined for thyroid function. Among them, 319 children with thyroid dysfunction were identified, which is 66.7%. So, in 2014, out of 92 children, 7 (7.6%) were examined for thyroid function, as a result of which 6 (85.7%) children had thyroid dysfunction. Every year, the number of children referred for thyroid examination increased, so compared to 2014, when out of 92 children - 7 (7.6%) were examined for thyroid function, in 2019, 222 (92.1%) children out of 241 were examined. Symptoms of both hyperfunction and hypofunction of the thyroid gland, especially their subclinical variants, occur under the guise of other diseases and are not immediately detected, so you should immediately investigate the function of the thyroid gland at admission and further observe them in dynamics. During the study, thyroid dysfunction was diagnosed in 319 (67.7%) patients, which should attract the attention of not only endocrinologists, but also General practitioners, pediatricians and set them up for a targeted search for this pathology and timely correction of hypothyroidism or other thyroid pathology if it is present.

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