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    A Metabolomics Study of the Effects of Inflammation, Hypoxia, and High Glucose on Isolated Human Pancreatic Islets.
    J Proteome Res 2017 Apr 28. Epub 2017 Apr 28.
    The transplantation of human pancreatic islets is a therapeutic possibility for a subset of type 1 diabetic patients who experience severe hypoglycemia. Pre- and post-transplantation loss in islet viability and function, however, is a major efficacy-limiting impediment. To investigate the effects of inflammation and hypoxia, the main obstacles hampering the survival and function of isolated, cultured, and transplanted islets, we conducted a comprehensive metabolomics evaluation of human islets in parallel with dynamic glucose-stimulated insulin release (GSIR) perifusion studies for functional evaluation. Read More

    Cost-Effectiveness of Exenatide twice daily versus Insulin Glargine as add-on Therapy to Oral Anti-diabetic Agents in Type 2 Diabetes in China.
    Diabetes Obes Metab 2017 Apr 28. Epub 2017 Apr 28.
    Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.
    Aims: This study aimed to estimate long-term cost-effectiveness of exenatide twice daily (EBID) versus insulin glargine once daily (IGQD) as add-on therapy to oral anti-diabetic agents (OADs) for Chinese patients with type 2 diabetes (T2DM).

    Materials And Methods: Cardiff Diabetes Model was used to simulate disease progression and estimate long-term effects of EBID versus IGQD. Model-required patient profiles and treatment effects were obtained from literature reviews (English and Chinese databases) and meta-analysis of eight randomized clinical trials comparing EBID versus IGQD add-on to OADs for T2DM in China. Read More

    Islet cell transplant: Update on current clinical trials.
    Curr Transplant Rep 2016 Sep 17;3(3):254-263. Epub 2016 May 17.
    Islet transplantation laboratory, Division of Transplantation, Department of Surgery.
    In the last 15 years clinical islet transplantation has made the leap from experimental procedure to standard of care for a highly selective group of patients. Due to a risk-benefit calculation involving the required systemic immunosuppression the procedure is only considered in patients with type 1 diabetes, complicated by severe hypoglycemia or end stage renal disease. In this review we summarize current outcomes of the procedure and take a look at ongoing and future improvements and refinements of beta cell therapy. Read More

    Characteristics and provision of care of patients with the acute respiratory distress syndrome: descriptive findings from the DACAPO cohort baseline and comparison with international findings.
    J Thorac Dis 2017 Mar;9(3):818-830
    Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
    Background: Little is known about the characteristics and real world life circumstances of ARDS (acute respiratory distress syndrome) patient populations. This knowledge is essential for transferring evidence-based therapy into routine healthcare. The aim of this study was to report socio-demographic and clinical characteristics in an unselected population of ARDS patients and to compare these results to findings from other large ARDS cohorts. Read More

    Strengths and Limitations of Healthcare Databases in the Evaluation of Hypoglycaemia.
    Diabetes Obes Metab 2017 Apr 27. Epub 2017 Apr 27.
    Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ.
    In this issue of DOM, Zaccardi et al. present an analysis of hypoglycaemia-related hospitalizations in the Hospital Episodes Statistics (HES) administrative database of the English National Health Service. [1] Notable strengths of the work include a large sample size involving more than 100 000 cases of hypoglycaemia, and nationwide capture spanning a duration of ten years. Read More

    Effects of age, gender, and body mass index on efficacy and hypoglycaemia outcomes across treat-to-target trials with insulin glargine 100 U/ml added to oral antidiabetes agents in type 2 diabetes.
    Diabetes Obes Metab 2017 Apr 27. Epub 2017 Apr 27.
    Department of Endocrinology & Diabetes, Gender Medicine, Medical University of Vienna, Vienna, Austria.
    Aims: Analyse effects of patient characteristics and different OAD use on standardised clinical outcomes in type 2 diabetes patients initiating insulin glargine 100 U/ml (Gla-100).

    Materials And Methods: Patient-level data were analysed from 16 randomised, treat-to-target clinical trials that added Gla-100 to existing metformin (MET), sulfonylurea (SU), or metformin plus sulfonylurea (MET+SU) in insulin-naïve patients inadequately controlled on oral therapy and followed for ≥24 weeks. Change in glycated haemoglobin A1c (HbA1c) from baseline to Week 24, other glycaemic endpoints, and incidence of hypoglycaemia (overall, nocturnal, and severe) were analysed by age (<65 vs. Read More

    A randomized, placebo- and sitagliptin-controlled trial of the safety and efficacy of omarigliptin, a once-weekly DPP-4 inhibitor, in Japanese patients with type 2 diabetes.
    Diabetes Obes Metab 2017 Apr 27. Epub 2017 Apr 27.
    Merck & Co., Inc., Kenilworth, NJ, USA.
    Aims: To assess the safety and efficacy of omarigliptin in Japanese patients with type 2 diabetes (T2D).

    Materials And Methods: In a 24-week double-blind trial, 414 patients with T2D were randomized to omarigliptin 25 mg once-weekly (q.w. Read More

    Efficacy and safety of lixisenatide in patients with type 2 diabetes and renal impairment.
    Diabetes Obes Metab 2017 Apr 27. Epub 2017 Apr 27.
    Internal Medicine Department, University Regional Hospital, Malaga, Spain; Malaga Institute of Biomedicine (IBIMA), Malaga, Spain.
    Aims: This post hoc assessment evaluated the efficacy and safety of once-daily, prandial glucagon-like peptide-1 receptor agonist lixisenatide in patients with type 2 diabetes (T2D) and normal renal function (eGFR ≥90 mL/min), or mild (60-89 mL/min) or moderate (30-59 mL/min) renal impairment.

    Methods: Patients from nine lixisenatide trials in the GetGoal clinical trial programme were categorized by baseline creatinine clearance: normal renal function (lixisenatide n = 2094, placebo n = 1150); renal impairment (mild: lixisenatide n = 637, placebo n = 414; moderate: lixisenatide n = 122, placebo n = 68). Meta-analyses of placebo-adjusted mean differences between baseline renal categories were performed for efficacy and safety outcomes. Read More

    A randomised, double-blind, trial of the safety and efficacy of omarigliptin (a once-weekly DPP-4 inhibitor) in subjects with type 2 diabetes and renal impairment.
    Int J Clin Pract 2017 Apr 27. Epub 2017 Apr 27.
    Merck & Co., Inc., Kenilworth, NJ, USA.
    Aims: To assess the safety and efficacy of omarigliptin in subjects with type 2 diabetes mellitus (T2DM) and chronic renal impairment (RI).

    Methods: Patients with T2DM with moderate RI (estimated glomerular filtration rate [eGFR] ≥30 to <60 mL/min/1.73 m(2) ) (N=114), severe RI (eGFR <30 mL/min/1. Read More

    The placental factor in spontaneous preterm birth in twin vs. singleton pregnancies.
    Eur J Obstet Gynecol Reprod Biol 2017 Apr 22;214:1-5. Epub 2017 Apr 22.
    Department of Obstetrics & Gynecology, The Edith Wolfson Medical Center, Holon, Israel(1).
    Objective: The association between infection and inflammatory response in singleton preterm birth (PTB) is well established, yet, less is known about PTB in twins. We aimed to compare the placental component and pregnancy outcome in pregnancies complicated with PTB of singletons vs. twin deliveries. Read More

    Efficacy and Safety of Evogliptin Monotherapy in Patients with Type 2 Diabetes and Moderately Elevated HbA1c by Diet and Exercise.
    Diabetes Obes Metab 2017 Apr 27. Epub 2017 Apr 27.
    Department of Endocrinology and Metabolism, Division of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
    Background And Aims: To evaluate the efficacy and safety of evogliptin, a newly developed dipeptidyl peptidase-4 inhibitor, in patients with type 2 diabetes (T2D) inadequately controlled by diet and exercise.

    Materials And Methods: In this randomized, double-blind, placebo-controlled, parallel-group, multicenter, phase III study, 160 patients with T2D were assigned to either an evogliptin 5 mg or placebo group for 24 weeks. The primary endpoint was the mean change in glycated hemoglobin (HbA1c) from baseline to week 24. Read More

    Once-weekly dipeptidyl peptidase-4 inhibitors for type 2 diabetes: a systematic review and meta-analysis.
    Expert Opin Pharmacother 2017 Apr 27. Epub 2017 Apr 27.
    a Clinical Research and Evidence Based Medicine Unit, Second Medical Department , Aristotle University Thessaloniki , Thessaloniki , Greece.
    Objective: To assess the efficacy and safety of omarigliptin and trelagliptin, novel dipeptidyl peptidase-4 inhibitors administered once-weekly (DPP-4i QW).

    Methods: We systematically searched for placebo- and active-controlled randomized trials in adults with type 2 diabetes mellitus.

    Results: Fifteen primary studies with 5709 participants were included. Read More

    "Liquid Crystalline Nanoparticles": Rationally designed vehicle to improve stability and therapeutic efficacy of insulin following oral administration.
    Mol Pharm 2017 Apr 27. Epub 2017 Apr 27.
    In the present report we investigate the feasibility of liquid crystalline nanoparticles (LCNPs) to improve the stability and therapeutic efficacy of insulin following oral administration. Compatibility studies of different formulation ingredients with insulin and extensive optimization of different process variables resulted into the formation of LCNPs with particle size of 245.50 ± 6. Read More

    Jump starting shared medical appointments for diabetes with weight management: Rationale and design of a randomized controlled trial.
    Contemp Clin Trials 2017 Apr 23. Epub 2017 Apr 23.
    Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC, United States; Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, Durham, NC, United States; Duke Diet and Fitness Center, Durham, NC, United States.
    Background: Rates of glycemic control remain suboptimal nationwide. Medication intensification for diabetes can have undesirable side effects (weight gain, hypoglycemia), which offset the benefits of glycemic control. A Shared Medical Appointment (SMA) intervention for diabetes that emphasizes weight management could improve glycemic outcomes and reduce weight while simultaneously lowering diabetes medication needs, resulting in less hypoglycemia and better quality of life. Read More

    Regulation of organelle function by metformin.
    IUBMB Life 2017 Apr 26. Epub 2017 Apr 26.
    Nagoya Research Center for Brain and Neural Circuits, Graduate School of Science, Nagoya University, Nagoya, Japan.
    Metformin ameliorates hyperglycemia without the side effects of lactic acidosis or hypoglycemia. Metformin lowers the blood glucose level by decreasing hepatic glucose production in the liver and by increasing glucose uptake in the muscle. Recent studies show that metformin induces cell death in certain cancer cell lines by interfering with the metabolism of the cancer cells. Read More

    Influence of the SLCO1B3 Gene on Sulfonylurea Failure in Patients with Type 2 Diabetes in China.
    Exp Clin Endocrinol Diabetes 2017 Apr 25. Epub 2017 Apr 25.
    Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, P. R. China.
    Sulfonylureas are widely used class of drugs for the treatment of type 2 diabetes (T2DM). Recent research has demonstrated that SLCO1B3 functions as a determinant of the insulinotropic effect of glibenclamide at the tissue level. However, whether this gene can influence the efficacy of glibenclamide in type 2 diabetic patients is not currently well-understood. Read More

    Glucagon-like peptide-1 and glucagon-like peptide-1 receptor agonists in the treatment of type 2 diabetes.
    Ann Pediatr Endocrinol Metab 2017 Mar 31;22(1):15-26. Epub 2017 Mar 31.
    Department of Bioengineering, College of Engineering, and BK21 PLUS Future Biopharmaceutical Human Resources Training and Research Team, Hanyang University, Seoul, Korea.
    The prevalence of type 2 diabetes (T2D) is increasing worldwide. Patients with T2D suffer from various diabetes-related complications. Since there are many patients with T2D that cannot be controlled by previously developed drugs, it has been necessary to develop new drugs, one of which is a glucagon-like peptide-1 (GLP-1) based therapy. Read More

    Analysis of Purified Pancreatic Islet Beta and Alpha Cell Transcriptomes Reveals 11β-Hydroxysteroid Dehydrogenase (Hsd11b1) as a Novel Disallowed Gene.
    Front Genet 2017 10;8:41. Epub 2017 Apr 10.
    Section of Cell Biology and Functional Genomics, Department of Medicine, Imperial College LondonLondon, UK.
    We and others have previously identified a group of genes, dubbed "disallowed," whose expression is markedly lower in pancreatic islets than in other mammalian cell types. Forced mis-expression of several members of this family leads to defective insulin secretion, demonstrating the likely importance of disallowance for normal beta cell function. Up to now, transcriptomic comparisons have been based solely on data from whole islets. Read More

    Insulin Degludec 200 Units/mL Is Associated With Lower Injection Frequency and Improved Patient-Reported Outcomes Compared With Insulin Glargine 100 Units/mL in Patients With Type 2 Diabetes Requiring High-Dose Insulin.
    Clin Diabetes 2017 Apr;35(2):90-95
    Valley Research, Fresno, CA.
    IN BRIEF Many patients with type 2 diabetes require high basal insulin doses, necessitating multiple injections, increasing patient burden, and resulting in reduced treatment adherence. This randomized, controlled, crossover trial compared the efficacy, safety, and patient-reported outcomes for a concentrated formulation of insulin degludec (200 units/mL) to those of insulin glargine in patients requiring high doses of basal insulin. By offering equivalent glycemic control while reducing the rate of confirmed hypoglycemia and the number of injections required for administration, insulin degludec 200 units/mL may be preferred by patients with type 2 diabetes who require high basal insulin doses. Read More

    Functional and Metabolomic Consequences of ATP-dependent Potassium Channel Inactivation in Human Islets.
    Diabetes 2017 Apr 25. Epub 2017 Apr 25.
    Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104.
    Loss-of-function mutations of β-cell KATP channels cause the most severe form of congenital hyperinsulinism (KATPHI). KATPHI is characterized by fasting and protein-induced hypoglycemia that is unresponsive to medical therapy. For a better understanding of the pathophysiology of KATPHI, we examined cytosolic calcium, insulin secretion, oxygen consumption, and [U-(13)C]glucose metabolism in islets isolated from the pancreases of children with KATPHI who required pancreatectomy. Read More

    Hypoglycaemia and brief interventions in the emergency department - A systematic review.
    Int Emerg Nurs 2017 Apr 22. Epub 2017 Apr 22.
    Florence Nightingale Faculty of Nursing and Midwifery, King's College London, James Clerk Maxwell Building, 57 Waterloo Rd, SE1 8WA London, UK.
    Objective: For people with diabetes, severe hypoglycaemia is the most common reason for emergency service usage and emergency department (ED) presentations. Brief interventions (BI) are a recognised intervention strategy in the ED for other conditions but to date, they have not been applied to those with hypoglycemia. This review aims to identify components and outcomes of BI for people with diabetes mellitus to inform the development of BI in the ED. Read More

    Discharge Criteria for the Late Preterm Infant: A Review of the Literature.
    Adv Neonatal Care 2017 Apr 24. Epub 2017 Apr 24.
    Department of Pediatrics, NorthBay Medical Center, Fairfield, California (Ms Quinn); College of Nursing, The University of Arizona, Tucson, Arizona (Ms Sparks and Dr Gephart).
    Background: Standardized late preterm infant (LPI) discharge criteria ensure best practice and help guide the neonatal provider to determine the appropriate level of care following birth. However, the location can vary from the well newborn setting to the neonatal intensive care unit (NICU).

    Purpose: The purpose of this review is to examine differences in LPI discharge criteria between the well newborn setting and the NICU by answering the clinical questions, "What are the recommended discharge criteria for the LPI and do they differ if admitted to the well newborn setting versus the NICU?"

    Search Strategy: Databases searched include CINAHL, TRIP, PubMed, and the Cochrane Library. Read More

    Social vulnerability and hypoglycemia among patients with diabetes.
    Endocrinol Diabetes Nutr 2017 Feb 9;64(2):92-99. Epub 2017 Feb 9.
    Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States.
    Lower-income populations are hit harder by the diabetes epidemic as regards both prevalence and the risk of complications. Food Insecurity is one of the mechanisms through which poverty may predispose people with low socio-economic status to poorer control and higher complication rates. The United Nations Food and Agriculture Organization defined food security as "the right to have access to sufficient nutritional and culturally acceptable food choices. Read More

    A cluster randomised trial, cost-effectiveness analysis and psychosocial evaluation of insulin pump therapy compared with multiple injections during flexible intensive insulin therapy for type 1 diabetes: the REPOSE Trial.
    Health Technol Assess 2017 Apr;21(20):1-278
    Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
    Background: Insulin is generally administered to people with type 1 diabetes mellitus (T1DM) using multiple daily injections (MDIs), but can also be delivered using infusion pumps. In the UK, pumps are recommended for patients with the greatest need and adult use is less than in comparable countries. Previous trials have been small, of short duration and have failed to control for training in insulin adjustment. Read More

    Sodium-glucose co-transporter 2 inhibitors for type 2 diabetes mellitus: An overview for the primary care physician.
    Int J Clin Pract 2017 Apr 24. Epub 2017 Apr 24.
    Department of Medicine, State University of New York at Buffalo, Buffalo, NY, USA.
    Aims: Sodium-glucose co-transporter type 2 (SGLT2) inhibitors are a new class of anti-hyperglycaemic agents in type 2 diabetes mellitus (T2DM). This review examines their mechanism of action and provides an overview of safety and efficacy from the main studies of SGLT2 inhibitors marketed in the United States and Europe, namely, canagliflozin, dapagliflozin and empagliflozin.

    Methods: We searched the PubMed database to identify relevant publications on the mechanism of action of SGLT2 inhibitors and clinical trial reports. Read More

    Diabetes, adult neurogenesis and brain remodeling: New insights from rodent and zebrafish models.
    Neurogenesis (Austin) 2017 31;4(1):e1281862. Epub 2017 Jan 31.
    Université de La Réunion, INSERM, UMR Diabète athérothrombose Réunion Océan Indien (DéTROI), Saint-Denis de La Réunion, France.
    The prevalence of diabetes rapidly increased during the last decades in association with important changes in lifestyle. Diabetes and hyperglycemia are well-known for inducing deleterious effects on physiologic processes, increasing for instance cardiovascular diseases, nephropathy, retinopathy and foot ulceration. Interestingly, diabetes also impairs brain morphology and functions such as (1) decreased neurogenesis (proliferation, differentiation and cell survival), (2) decreased brain volumes, (3) increased blood-brain barrier leakage, (4) increased cognitive impairments, as well as (5) increased stroke incidence and worse neurologic outcomes following stroke. Read More

    Congenital Hyperinsulinism Caused by a De Novo Mutation in the ABCC8 Gene - A Case Report.
    EJIFCC 2017 Mar 8;28(1):85-91. Epub 2017 Mar 8.
    Department of Laboratory Medicine, University of Debrecen, Debrecen, Hungary.
    Congenital hyperinsulinism (CHI) is a rare genetic disorder characterized by inappropriate insulin secretion and severe hypoglycaemia. There are two histological subtypes: diffuse and focal form. Diffuse form is most common in autosomal recessive mutations in ABCC8/KCNJ11 gene, while focal CHI is caused a paternally inherited mutation and a somatic maternal allele loss. Read More

    Exploration of glycaemic states in children with type 1 diabetes.
    Psicothema 2017 May;29(2):211-216
    Universidad de Almería.
    Background: The prevention of severe hypoglycaemia is based in art on accurately anticipating its occurrence. The aim of the study was to analyse the effect of a feedback procedure on the glycaemic state of children with type 1 diabetes, aswell as the associated symptoms and estimated BGL.

    Method: For 7 days, 17 participants performed both scheduled capillary blood tests, and an estimate and self-analysis whenever they thought that there were changes in their BGL. Read More

    Reactive Rather than Proactive Diabetes Management in the Perioperative Period.
    Horm Metab Res 2017 Apr 24. Epub 2017 Apr 24.
    Department of General Internal Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
    As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care. Read More

    Mean Levels and Variability in Affect, Diabetes Self-Care Behaviors, and Continuously Monitored Glucose: A Daily Study of Latinos with Type 2 Diabetes.
    Psychosom Med 2017 Apr 21. Epub 2017 Apr 21.
    Division of Behavioral Sciences and Community Health and Department of Psychiatry, UConn Schools of Medicine and Dental Medicine Department of Psychology, Farleigh Dickinson University Department of Community Medicine, UConn School of Medicine Division of Behavioral Sciences and Community Health, UConn Schools of Medicine and Dental Medicine Joslin Diabetes Center/Harvard Medical School Yale School of Public Health.
    Objective: This study investigated between-person and within-person associations among mean levels and variability in affect, diabetes self-care behaviors, and continuously monitored glucose in Latinos with type 2 diabetes.

    Methods: Fifty participants (mean age=57.8 [SD=11. Read More

    Glucagon-like peptide-1 receptor agonists: a systematic review of comparative effectiveness research.
    Diabetes Metab Syndr Obes 2017 4;10:123-139. Epub 2017 Apr 4.
    Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
    Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) act by increasing insulin secretion, decreasing glucagon secretion, slowing gastric emptying, and increasing satiety.

    Objective: Published evidence directly comparing GLP-1RAs with other approved treatments for type 2 diabetes (T2D) was systematically reviewed.

    Methods: A literature search was performed using MEDLINE and Embase databases to identify papers comparing GLP-1RAs with other classes of glucose-lowering therapy in patients with T2D. Read More

    Global motion perception is related to motor function in 4.5-year-old children born at risk of abnormal development.
    Vision Res 2017 Apr 20. Epub 2017 Apr 20.
    School of Optometry and Vision Science, University of Auckland, New Zealand; School of Optometry and Vision Science, University of Waterloo, Canada. Electronic address:
    Global motion perception is often used as an index of dorsal visual stream function in neurodevelopmental studies. However, the relationship between global motion perception and visuomotor control, a primary function of the dorsal stream, is unclear. We measured global motion perception (motion coherence threshold; MCT) and performance on standardized measures of motor function in 606 4. Read More

    Evidence-based recommendations for insulin intensification strategies after basal insulin in type 2 diabetes.
    Diabetes Metab Syndr 2017 Apr 5. Epub 2017 Apr 5.
    Diabetes India, Mumbai, India.
    Over the time due to progressive nature of diabetes, proactive intensification of the existing insulin therapy becomes imminent as it minimizes patients' exposure to chronic hypo/hyperglycaemia and reduces weight gain while achieving individualized glycaemic targets. This review focuses on the strength of evidence behind various options for intensification, primarily the insulins as also the GLP-1 analogues. The recommendations presented here are meant to serve as a guide for the physician managing type 2 diabetes patients requiring insulin intensification upon failing of basal insulin therapy. Read More

    Glycaemic control and hypoglycaemia with insulin glargine 300 U/mL compared with glargine 100 U/mL in Japanese adults with type 2 diabetes using basal insulin plus oral anti-hyperglycaemic drugs (EDITION JP 2 randomised 12-month trial including 6-month extension).
    Diabetes Metab 2017 Apr 19. Epub 2017 Apr 19.
    Toho University School of Medicine, 5 Chome-21-16 Omorinishi, Ota, 143-8540 Tokyo, Japan. Electronic address:
    Aims: To compare insulin glargine 300 U/mL (Gla-300) with glargine 100 U/mL (Gla-100) in Japanese adults with uncontrolled type 2 diabetes on basal insulin and oral anti-hyperglycaemic drugs over 12 months.

    Methods: EDITION JP 2 was a randomised, open-label, phase 3 study. Following a 6-month treatment period, participants continued receiving previously assigned once daily Gla-300 or Gla-100, plus oral anti-hyperglycaemic drugs, in a 6-month extension period. Read More

    Cost-effectiveness of sensor-augmented pump therapy versus standard insulin pump therapy in patients with type 1 diabetes in Denmark.
    Diabetes Res Clin Pract 2017 Feb 16;128:6-14. Epub 2017 Feb 16.
    Lund University, Skåne University Hospital, Malmö, Sweden.
    Aims: The use of continuous subcutaneous insulin infusion (CSII) in type 1 diabetes (T1D) has increased in recent years. Sensor-augmented pump therapy (SAP) with low glucose suspend (LGS) (allowing temporary suspension of insulin delivery if blood glucose level falls below a pre-defined threshold level) provides additional benefits over CSII alone, but is associated with higher acquisition costs. Therefore, a cost-effectiveness analysis of SAP+LGS versus CSII in patients with T1D was performed. Read More

    Future challenges and therapeutic opportunities in type 2 diabetes: changing the paradigm of current therapy.
    Diabetes Obes Metab 2017 Apr 21. Epub 2017 Apr 21.
    Diabetes and Endocrine Centre, Heart of England NHS Foundation Trust, Birmingham Heartlands Hospital, B9 5SS and University of Birmingham, UK.
    Most algorithms for type 2 diabetes mellitus (T2DM) do not recommend treatment escalation until glycated haemoglobin (HbA1c) fails to reach the recommended target of 7% (53 mmol/mol) within approximately 3 months on any treatment regimen ('treat to failure'). Clinical inertia and/or poor adherence to therapy contribute to patients not reaching glycaemic targets when managed according to this paradigm. Clinical inertia exists across the entire spectrum of anti-diabetes therapies, although it is most pronounced when initiating and optimizing insulin therapy. Read More

    Impact of baseline HbA1c, diabetes duration and BMI on clinical outcomes in the LixiLan-O trial testing iGlarLixi (insulin glargine/lixisenatide titratable fixed-ratio combination) versus insulin glargine and lixisenatide monocomponents.
    Diabetes Obes Metab 2017 Apr 22. Epub 2017 Apr 22.
    Dallas Diabetes Research Center at Medical City, Dallas, TX, USA.
    To determine whether baseline characteristics impact clinical outcomes in the LixiLan-O trial (N = 1170), the efficacy and safety of iGlarLixi, a titratable fixed-ratio combination of insulin glargine 100 U (iGlar) and lixisenatide (Lixi) was compared with iGlar or Lixi alone in patients with uncontrolled type 2 diabetes mellitus (T2DM) on oral therapy. Subgroups according to baseline glycated haemoglobin (HbA1c; <8%, ≥8% [<64, ≥64 mmol/mol]); T2DM disease duration (<7, ≥7 years) and body mass index (BMI; <30, ≥30 kg/m(2) ) were investigated. In all subpopulations, iGlarLixi was consistently statistically superior to iGlar and Lixi alone in reducing HbA1c from baseline to week 30; higher proportions of patients achieved HbA1c <7% (<53 mmol/mol) with iGlarLixi versus iGlar and Lixi alone. Read More

    Safety of Sitagliptin in Patients with Type 2 Diabetes and Chronic Kidney Disease: Outcomes from TECOS.
    Diabetes Obes Metab 2017 Apr 22. Epub 2017 Apr 22.
    Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK.
    Aims: To characterize the incidence of diabetes-associated complications and assess the safety of sitagliptin in participants with chronic kidney disease (CKD) in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS).

    Materials And Methods: For participants with baseline eGFR measurements (n = 14,528), baseline characteristics and safety outcomes were compared for the CKD cohort (eGFR <60 mL/min per 1.73 m(2) ) versus those without CKD. Read More

    Effect of oral contraceptives and/or metformin on GLP-1 secretion and reactive hypoglycemia in PCOS.
    Endocr Connect 2017 Apr 21. Epub 2017 Apr 21.
    M Andersen, Odense C, Denmark.
    Context: Insulin resistance in polycystic ovary syndrome (PCOS) may increase the risk of reactive hypoglycaemia (RH) and decrease glucagon-like peptide-1 (GLP-1) secretion. The possible effects of treatment with oral contraceptives (OCP) and/or metformin on GLP-1 secretion and risk of RH in PCOS is undetermined.

    Setting: Outpatient clinic. Read More

    Continuous subcutaneous insulin infusion (CSII) therapy at Derby Teaching Hospitals: sustained benefits in glucose control.
    Diabet Med 2017 Apr 21. Epub 2017 Apr 21.
    Diabetes Unit, Royal Derby Hospital, Derby, UK.
    Aim: In the short term, continuous subcutaneous insulin infusion (CSII) has been associated with improved glycaemic control, reduced hypoglycaemia and improved quality of life (QOL). However, limited data are available on its long-term benefits, particularly in the UK. We aimed to assess the impact of CSII on longer term outcomes. Read More

    An Outpatient Methadone Weaning Program by a Neonatal Intensive Care Unit for Neonatal Abstinence Syndrome.
    Popul Health Manag 2017 Apr 21. Epub 2017 Apr 21.
    2 Department of Pediatrics, Lehigh Valley Health Network , Allentown, Pennsylvania.
    Through retrospective chart review, this study described characteristics and length of stay for a cohort of newborns discharged on methadone following an inpatient weaning for neonatal abstinence syndrome (NAS). Data were assessed for all term infants born between January 1, 2010, and December 31, 2014, admitted to the hospital with a co-diagnosis of NAS at discharge, for gestational age, length of stay, days on treatment protocol before discharge, time to once-daily interval methadone dosing, and hospital charges, as well as for categorical characteristics. The 53 patients were predominantly male (58%), white (71%), and covered by Medicaid insurance (72%). Read More

    Safety, tolerability, and efficacy of lixisenatide in combination with oral antidiabetic treatment in Japanese patients with type 2 diabetes: An open-label, multicenter study.
    J Diabetes Investig 2017 Apr 21. Epub 2017 Apr 21.
    Sanofi, Tokyo, Japan.
    Aim/introduction: To assess overall safety and efficacy of lixisenatide in combination with background oral antidiabetic drug treatment in Japanese patients with type 2 diabetes, as required by Japanese guidelines.

    Materials And Methods: A Phase 3, multicenter, uncontrolled, open-label, four-arm, parallel-group study in Japanese outpatients with type 2 diabetes; patients received once-daily lixisenatide in combination with biguanide, thiazolidinedione, alpha-glucosidase inhibitors, or glinide (NCT01940965). Primary endpoint was safety over 52 weeks; secondary endpoints included absolute change from baseline in glycated hemoglobin A1c at Weeks 24 and 52. Read More

    Insulin analogues in type 1 diabetes mellitus: getting better all the time.
    Nat Rev Endocrinol 2017 Apr 21. Epub 2017 Apr 21.
    Clinical and Experimental Endocrinology, University of Leuven, Herestraat 49, Leuven 3000, Belgium.
    The treatment of type 1 diabetes mellitus consists of external replacement of the functions of β cells in an attempt to achieve blood levels of glucose as close to the normal range as possible. This approach means that glucose sensing needs to be replaced and levels of insulin need to mimic physiological insulin-action profiles, including basal coverage and changes around meals. Training and educating patients are crucial for the achievement of good glycaemic control, but having insulin preparations with action profiles that provide stable basal insulin coverage and appropriate mealtime insulin peaks helps people with type 1 diabetes mellitus to live active lives without sacrificing tight glycaemic control. Read More

    Consensus Statement on Inpatient Use of Continuous Glucose Monitoring.
    J Diabetes Sci Technol 2017 Apr 1:1932296817706151. Epub 2017 Apr 1.
    8 Mayo Clinic Arizona, Scottsdale, AZ, USA.
    In June 2016, Diabetes Technology Society convened a panel of US experts in inpatient diabetes management to discuss the current and potential role of continuous glucose monitoring (CGM) in the hospital. This discussion combined with a literature review was a follow-up to a meeting, which took place in May 2015. The panel reviewed evidence on use of CGM in 3 potential inpatient scenarios: (1) the intensive care unit (ICU), (2) non-ICU, and (3) transitioning outpatient CGM use into the hospital setting. Read More

    Nighttime is the worst time: Parental fear of hypoglycemia in young children with type 1 diabetes.
    Pediatr Diabetes 2017 Apr 21. Epub 2017 Apr 21.
    Yale School of Medicine, New Haven, Connecticut.
    Background: Fear of hypoglycemia is common in parents of young children with type 1 diabetes (T1D), but little is known about the specific fears that parents most often experience. Hypoglycemia fear has been associated with poorer glycemic control in older children, though not yet studied in a large cohort of very young children.

    Materials And Methods: Parents of 549 children <7 years (mean 5. Read More

    Glycemic Control During Continuous Subcutaneous Insulin Infusion Versus Multiple Daily Insulin Injections in Type 2 Diabetes: Individual Patient Data Meta-analysis and Meta-regression of Randomized Controlled Trials.
    Diabetes Care 2017 May;40(5):715-722
    Department of Health Sciences, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, U.K.
    Objective: To compare glycemic control during continuous subcutaneous insulin infusion (CSII) and multiple daily insulin injections (MDI) in people with type 2 diabetes to identify patient characteristics that determine those best treated by CSII.

    Research Design And Methods: Randomized controlled trials were selected comparing HbA1c during CSII versus MDI in people with type 2 diabetes. Data sources included Cochrane database and Ovid Medline. Read More

    MECHANISMS IN ENDOCRINOLOGY: The multiple facets of GH: lessons from lifetime, untreated isolated GH deficiency due to GHRH receptor mutation.
    Eur J Endocrinol 2017 Apr 20. Epub 2017 Apr 20.
    R Salvatori, Endocrinology, Johns Hopkins University, Baltimore, 21287, United States.
    Twenty years ago, we described a kindred of 105 individuals with isolated GH deficiency (IGHD) in Itabaianinha County, in Brazilian northeast, due to a homozygous mutation in the GH-releasing hormone receptor gene. These subjects exhibit markedly reduced GH responsiveness to stimulatory tests, and anterior pituitary hypoplasia. Serum concentrations of IGF-I, IGF binding protein type 3, and the acid-labile subunit are markedly reduced, with a lesser reduction of IGF-II. Read More

    Hypoglycemia identified by a continuous glucose monitoring system in a second-trimester pregnant woman with insulinoma: a case report.
    J Med Case Rep 2017 Apr 21;11(1):117. Epub 2017 Apr 21.
    Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Zaloška 7, Ljubljana, 1525, Slovenia.
    Background: Insulinoma associated with pregnancy is a very rare condition and can be difficult to diagnose. Here, we present an interesting case of insulinoma occurring during pregnancy with special attention paid to the use of a continuous glucose monitoring system to detect hypoglycemia.

    Case Presentation: A 36-year-old white woman in the second trimester of pregnancy presented with recurrent episodes of hypoglycemia associated with neuroglycopenic symptoms. Read More

    Pharmacokinetics and Pharmacodynamics of Tofogliflozin (a Selective SGLT2 Inhibitor) in Healthy Male Subjects.
    Drug Res (Stuttg) 2017 Apr 20. Epub 2017 Apr 20.
    Clinical Science and Strategy Department, Chugai Pharmaceutical Co., Ltd., Tokyo, Japan.
    Tofogliflozin is a selective oral inhibitor of sodium-glucose co-transporter 2 for treatment of type 2 diabetes mellitus. The pharmacokinetics, pharmacodynamics, and safety of tofogliflozin were investigated in healthy male subjects. Three studies were conducted: single-ascending dose study (10-640 mg) in 56 Japanese and 24 Caucasian subjects; multiple-ascending dose study (2. Read More

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