المؤلفون: Ingmar Schäfer, Daniel Tajdar, Laura Walther, Lasse Bittner, Dagmar Lühmann, Martin Scherer

المصدر: Frontiers in Public Health, Vol 11 (2024)

مصطلحات موضوعية: COVID-19 lockdown, HbA1c, glycemic control, atherosclerotic cardiovascular disease, insulin treatment, Public aspects of medicine, RA1-1270

الوصف: IntroductionGlycemic effects of COVID-19 lockdowns on patients with type 2 diabetes (T2D) are controversial. In this long-term observation, we aimed (1) to analyze changes in HbA1c levels during lockdowns in Germany, and (2) to investigate whether diabetes medication, comorbidities, and sociodemographic data influenced these changes.Materials and methodsThis cohort study observed 1,089 patients aged ≥18 years over the years 2019 to 2021. Patients were recruited from 14 physicians specialized on diabetes. As dependent variable, 7,987 HbA1c values were analyzed by multivariable linear regression adjusted for random effects of physicians and patients.ResultsPatients had a median age of 68 (60/76) years and 623 (57.2%) were male. Before the pandemic, median HbA1c level (in %) was 6.9 (6.3/7.7). Average HbA1c level increased during first lockdown (0.21,0.11/0.31,p

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fpubh.2023.1272769/fullTest; https://doaj.org/toc/2296-2565Test

الوصول الحر: https://doaj.org/article/933d71e2eff54c0698bd82c1e20fb298Test

المؤلفون: Wahyudi Wahyudi, Ade Risma, Feby Ayu Putri, Munanda Andin, Juhri Panjaitan, Sultan Faqih

مصطلحات موضوعية: Direct medical costs, insulin treatment, T2DM, outpatients

الوصف: Type 2 diabetes mellitus (T2DM) is a global health issue that affect around 643 million people in 2030. Estimated prevalence of T2DM in adults aged 20–79 years has more than tripled, from an estimated 151 million (4.6% of the global population at the time) to 537 million (10.5%) today. This study analyze direct medical costs of insulin treatment with in T2DM outpatients. This retrospective descriptive economic evaluation was conducted in April 2023 on the basis of payer (called as Badan Penyelenggara Jaminan Sosial abbreviated as BPJS) perspective, then only direct costs were included in this study. Component of direct medical cost of this research include drug acquisition costs, physician service, laboratory examination, medical execution and administration. 58 T2DM outpatients met inclusion criteria in Universitas Sumatera Utara was recruited by simple random sampling. Result of this study show that most of respondent were aged 56-65 years (58.89%). Cost/year/patient of drug acquisition costs was ...

العلاقة: https://dx.doi.org/10.5281/zenodo.11213911Test

الإتاحة: https://doi.org/10.5281/zenodo.1121391010.5281/zenodo.11213911Test

المؤلفون: Hong Liu, Hongying Peng, Chunxia Cheng, Meng Wang, Chunmei Mi, Guo Feng, Jinru Wu, Hao Nie, Jiaoyang Wu, Yufang Luo, Min Liu

المصدر: Clinical and Experimental Obstetrics & Gynecology, Vol 51, Iss 3, p 71 (2024)

مصطلحات موضوعية: gestational diabetes mellitus (gdm), oral glucose tolerance test, postpartum period, wechat platform, insulin treatment, Gynecology and obstetrics, RG1-991

الوصف: Background: The prevalence of gestational diabetes mellitus (GDM) has been increasing globally, which has led to substantial implications for long-term maternal health including diabetes. The present study aimed to explore the rate of postpartum glucose screening (PGS) of women with GDM based on WeChat management and explore factors affecting the rate of PGS and impaired glucose regulation (IGR). Methods: In this prospective trial, GDM patients were enrolled in our WeChat platform groups. Demographic and medical data were collected at the baseline surveys and follow-up visits. GDM patients were managed throughout their pregnancies via the WeChat platform. We sent messages, involving multidisciplinary care, medical nutritional therapy, and glucose monitoring every three days in the chat groups, and reminded them to go to the hospital to complete PGS. Questionnaires about PGS via the WeChat platform were sent to those women who had delivered within 4 to 12 weeks postpartum. Answers to the questionnaires [understanding the necessity of postpartum oral glucose tolerance testing (OGTT) screening, and the results of 42-day postpartum OGTT screening, as well as the reasons for failing to finish postpartum screening, and the ways to get nutrition knowledge for GDM patients] were collected. Results: From 1 January 2016 to 31 August 2019, 490 participants were included in our WeChat groups, 375 of whom completed questionnaires. Among the 375 participants, 277 (73.9%) had completed post-partum 75 g OGTT, 202 (72.9%) had normal glucose levels, and 75 (27.1%) had impaired glucose regulation (IGR). Univariable logistic analysis and stepwise regression analysis demonstrated that a previous history of GDM and cesarean delivery were the two variables influencing PGS (odds ratio (OR): 0.44, 95% confidence interval (95% CI): 0.20–0.94; OR: 1.88, 95% CI: 1.04–3.39, respectively). Insulin treatment during pregnancy and cesarean delivery were found to have a significant association with postpartum IGR (OR: 3.74, 95% CI: 1.97–7.08; OR: 1.83, 95% CI: 1.02–3.28, respectively). Conclusions: The WeChat messaging platform may be a useful tool to promote postpartum OGTT screening in women with GDM. Women who failed to return for PGS were more likely to have prior GDM than those who returned for PGS. Women who had postpartum IGR were more likely to use insulin treatment during pregnancy and more likely to deliver by cesarean delivery compared to those who had normal postpartum glucose results. Clinical Trial Registration: The present study was registered at ClinicalTrials.gov Protocol Registration and Results System https://classic.clinicaltrials.govTest/ (No. NCT02893072).

وصف الملف: electronic resource

العلاقة: https://www.imrpress.com/journal/CEOG/51/3/10.31083/j.ceog5103071Test; https://doaj.org/toc/0390-6663Test

الوصول الحر: https://doaj.org/article/7050c267b50d4015af9fdfb31e8395cbTest

المؤلفون: Junnosuke Miura, Yasuko Uchigata

المصدر: Journal of Diabetes Investigation, Vol 14, Iss 4, Pp 531-534 (2023)

مصطلحات موضوعية: Advances in medical engineering, Insulin treatment, Type 1 diabetes, Diseases of the endocrine glands. Clinical endocrinology, RC648-665

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2040-1116Test; https://doaj.org/toc/2040-1124Test

الوصول الحر: https://doaj.org/article/a2ff330879ac42aabdceb33bb150499aTest

المؤلفون: Sharon Kuzi, Michal Mazaki‐Tovi, Shai Hershkovitz, Einat Yas, Rebecka S. Hess

المصدر: Veterinary Medicine and Science, Vol 9, Iss 2, Pp 704-711 (2023)

مصطلحات موضوعية: basal‐bolus insulin treatment, canine, hypoglycaemia, post‐prandial hyperglycaemia, Veterinary medicine, SF600-1100

الوصف: Abstract Background The long‐term clinical and biofhemical effects of basal‐bolus insulin treatment with lispro and NPH in dogs with diabetes mellitus are undocumented. Objectives To perform a prospective pilot field study of the long‐term effects of lispro and NPH on clinical signs and serum fructosamine concentrations (SFC) in dogs with diabetes mellitus. Methods Twelve dogs received combined lispro and NPH insulins treatment twice a day and were examined every 2 weeks for 2 months (visits 1–4), and every 4 weeks for up to 4 additional months (visits 5–8). Clinical signs and SFC were recorded at each visit. Polyuria and polydipsia (PU/PD) were scored as absent (0) or present (1). Results Median (range) PU/PD scores of combined visits 5–8 (0, 0–1) were significantly lower than median scores of combined visits 1–4 (1, 0–1, p = 0.03) and at enrolment (1, 0–1, p = 0.045). Median (range) SFC of combined visits 5–8 (512 mmol/L, 401–974 mmol/L) was significantly lower than SFC of combined visits 1–4 (578 mmol/L, 302–996 mmol/L, p = 0.002) and at enrolment (662 mmol/L, 450–990 mmol/L, p = 0.03). Lispro insulin dose was significantly and negatively, albeit weakly, correlated with SFC concentration during visits 1 through 8 (r = –0.3, p = 0.013). Median duration of follow up was 6 months (range 0.5–6) and most dogs (8, 66.7%) were followed for 6 months. Four dogs withdrew from the study within 0.5–5 months because of documented or suspected hypoglycaemia, short NPH duration or sudden unexplained death. Hypoglycaemia was noted in 6 dogs. Conclusions Long‐term lispro and NPH combination therapy may improve clinical and biochemical control of some diabetic dogs with comorbidities. Risk of hypoglycaemia should be addressed with close monitoring.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2053-1095Test

الوصول الحر: https://doaj.org/article/d24583396df04cb087ca6e5362f9cfd6Test

المؤلفون: Chae-Gwan Kong, Jong-Beom Park, Seung Hyo Kim

المصدر: Asian Spine Journal, Vol 17, Iss 1, Pp 1-7 (2023)

مصطلحات موضوعية: inhibitory effect, insulin treatment, apoptosis, disc cells, diabetes, Medicine

الوصف: Study Design Experimental study using a streptozotocin (STZ)-induced diabetic rat model. Purpose This study aims to investigate whether insulin treatment could attenuate disc cell apoptosis and matrix degradation in a STZ-induced diabetic rat model. Overview of Literature Diabetes is a significant risk factor for disc degeneration due to excessive apoptosis of disc cells and matrix degradation. However, no studies were noted to demonstrate the inhibitory effect of insulin treatment on the apoptosis of disc cells and matrix degradation in diabetic patients. Methods Rats were allocated randomly into one of three groups: control, STZ, and STZ-insulin. Diabetes was induced by a single intraperitoneal injection of STZ (65 mg/kg) in the STZ and STZ-insulin groups. The blood glucose level was consistently above 400 mg/dL in the STZ and STZ-insulin groups 2 weeks after STZ injection. After 2 weeks of STZ injection, the STZ-insulin group was administered insulin treatment (1.5 unit/100 g) daily for up to 4 weeks. Blood glucose of the STZ-insulin rats significantly decreased to normal levels 4 weeks after insulin treatment. The rats were sacrificed 6 weeks after STZ injection, and disc cells and tissues were harvested to investigate the expression of apoptosis markers and matrix metalloproteinases (MMPs). Results Fas and caspase-8, -9, and -3 expressions were significantly increased in the STZ group, along with increased expressions of MMP-2 and -3. On the contrary, insulin treatment significantly decreased the expressions of Fas, caspase-8, -9, and -3 as well as MMP-2 and -3 in the STZ-insulin group. Conclusions The results of the current study demonstrated that insulin treatment attenuates excessive apoptosis of disc cells and matrix degradation in the diabetic rat model. Accordingly, strict blood glucose control should be recommended to prevent disc degeneration in diabetic patients.

وصف الملف: electronic resource

العلاقة: http://www.asianspinejournal.org/upload/pdf/asj-2021-0514.pdfTest; https://doaj.org/toc/1976-1902Test; https://doaj.org/toc/1976-7846Test

الوصول الحر: https://doaj.org/article/2f2ca1cb193d4b32b5348ab111e077bfTest

المؤلفون: Baoling Bai, Kang Gao, Kexin Zhang, Lingyun Liu, Xiaobo Chen, Qin Zhang

المصدر: Frontiers in Endocrinology, Vol 14 (2023)

مصطلحات موضوعية: type 1 diabetes, exosome, proteomics, TMT6, insulin treatment, Diseases of the endocrine glands. Clinical endocrinology, RC648-665

الوصف: IntroductionType 1 diabetes (T1D) is a serious autoimmune disease with high morbidity and mortality. Early diagnosis and treatment remain unsatisfactory. While the potential for development of T1D biomarkers in circulating exosomes has attracted interest, progress has been limited. This study endeavors to explore the molecular dynamics of plasma exosome proteins in pediatric T1D patients and potential mechanisms correlated with T1D progressionMethodsLiquid chromatography-tandem mass spectrometry with tandem mass tag (TMT)6 labeling was used to quantify exosomal protein expression profiles in 12 healthy controls and 24 T1D patients stratified by age (≤ 6 years old and > 6 years old) and glycated hemoglobin (HbA1c) levels (> 7% or > 7%). Integrated bioinformatics analysis was employed to decipher the functions of differentially expressed proteins, and Western blotting was used for validation of selected proteins' expression levels. ResultsWe identified 1035 differentially expressed proteins (fold change > 1.3) between the T1D patients and healthy controls: 558 in those ≤ 6-year-old and 588 in those > 6-year-old. In those who reached an HbA1c level < 7% following 3 or more months of insulin therapy, the expression levels of most altered proteins in both T1D age groups returned to levels comparable to those in the healthy control group. Bioinformatics analysis revealed that differentially expressed exosome proteins are primarily related to immune function, hemostasis, cellular stress responses, and matrix organization. Western blotting confirmed the alterations in RAB40A, SEMA6D, COL6A5, and TTR proteins. DiscussionThis study delivers valuable insights into the fundamental molecular mechanisms contributing to T1D pathology. Moreover, it proposes potential therapeutic targets for improved T1D management.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fendo.2023.1271929/fullTest; https://doaj.org/toc/1664-2392Test

الوصول الحر: https://doaj.org/article/91c9e2f438ed448e8d90df0ff167f90fTest

المؤلفون: Min Ma, Xiquan Ma, Jingzhi Chang, Feiyan Yin, Sha Ma, Yuan Zhang, Zhidao Shi

المصدر: Frontiers in Endocrinology, Vol 14 (2023)

مصطلحات موضوعية: type 2 diabetes mellitus, barriers to insulin treatment, psychological resistance to insulin therapy, adherence, scale revision, reliability, Diseases of the endocrine glands. Clinical endocrinology, RC648-665

الوصف: AimThe objective of this study was to translate the Barriers to Insulin Treatment Questionnaire (BIT) into Chinese and test its psychometric properties in middle-aged and elderly type 2 diabetes mellitus (T2D) patients using insulin in the Han people of urban China.MethodsWe established the Barriers to Insulin Treatment Questionnaire in Chinese (BIT-C). We selected 296 patients with T2D for testing BIT-C's the reliability and validity, of which 120 patients were retested four weeks later. Another 200 patients with T2D were selected to perform the confirmatory factor analysis (CFA).ResultsThe final BIT-C consisted of 11 items (BIT-C-11) and four factors. The explained variances of the BIT-C-11 and its four factors were 90.153%, 51.308%, 18.810%, 10.863%, and 9.173%. CFA validated that the four-factor model fit with the data of the BIT-C-11. Standardized factor loadings ranged between 0.77 and 0.90. The Cronbach’s α coefficients of the BIT-C-11 and its four factors were 0.903, 0.952, 0.927, 0.938, and 0.917. Correlation analysis was performed between the BIT-C-11 and General Adherence Scale in Chinese (GAS-C) to calculate the criterion-related validity (r = 0.598, p < 0.001). The correlation coefficient r of the BIT-C-11’s test–retest reliability was 0.810 (p < 0.001).ConclusionThe BIT-C-11 has good reliability and validity. It can be used for psychological resistance to insulin therapy studies of middle-aged and elderly patients with T2D using insulin in the Han people of Chinese cities.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fendo.2023.1192108/fullTest; https://doaj.org/toc/1664-2392Test

الوصول الحر: https://doaj.org/article/33c82c883ae74bef9a960883472ae09bTest

المؤلفون: Lingli Zhou, Yingying Luo, Yan Wang, Yao Cheng, Rui Zhang, Simin Zhang, Siqian Gong, Xueyao Han, Linong Ji

المصدر: Frontiers in Clinical Diabetes and Healthcare, Vol 4 (2023)

مصطلحات موضوعية: fasting insulin levels, insulin resistance, insulin antibodies, type 2 diabetes, hyperinsulinemia, insulin treatment, Diseases of the endocrine glands. Clinical endocrinology, RC648-665

الوصف: ObjectiveThis study aimed to investigate the clinical implications of fasting serum insulin (FINS) levels in subjects with type 2 diabetes who were receiving insulin therapy.MethodsA total of 1,553 subjects with type 2 diabetes [774 subjects who had never received insulin treatment (N-INS) and 779 subjects who were receiving insulin therapy (constant insulin treatment, C-INS)] admitted to the Department of Endocrinology and Metabolism of Peking University People’s Hospital were enrolled in this study. Their FINS levels were measured and those with hyperinsulinemia were identified. The underlying mechanisms of hyperinsulinemia were revealed by measuring insulin antibodies (IAs) and analyzing changes in FINS levels before and after polyethylene glycol (PEG) precipitation. In addition, the clinical characteristics of patients with different types of hyperinsulinemia were compared.ResultsHigher FINS levels and a higher incidence (43.8%, 341/779) of hyperinsulinemia (FINS > 15μIU/mL) were observed in subjects with C-INS than in subjects with N-INS. Among subjects with C-INS and hyperinsulinemia, 66.9% (228/341) were IAs positive, and the incidence of IAs was found to be positively associated with FINS level. By performing PEG precipitation, we found that all subjects without IAs (i.e., those with real hyperinsulinemia) and 31.1% of subjects (71/228) with IAs (i.e., those with both real and IAs-related hyperinsulinemia) still had hyperinsulinemia after PEG precipitation, whereas FINS levels in the other 68.9% of subjects (157/228) with IAs were normal (IAs-related hyperinsulinemia) after PEG precipitation. Comparisons between the groups showed that subjects with real hyperinsulinemia showed more obvious insulin resistance characteristics, including higher lipid levels, BMIs, and homoeostasis model assessment2-estimated insulin resistance (HOMA2-IR) index, and were more likely to have hypertension, obesity, and metabolic syndromes (p

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fcdhc.2023.1172208/fullTest; https://doaj.org/toc/2673-6616Test

الوصول الحر: https://doaj.org/article/b2eebc30db944fefb03a8346747d8e72Test

المؤلفون: Masao Toyoda, Nobumichi Saito, Moritsugu Kimura, Nobuo Hatori, Kouichi Tamura, Masaaki Miyakawa, Kazuyoshi Sato, Akira Kanamori, Kazuo Kobayashi

المصدر: Journal of Diabetes Investigation, Vol 13, Iss 9, Pp 1520-1527 (2022)

مصطلحات موضوعية: Insulin treatment, Renal composite outcome, Sodium–glucose cotransporter 2 inhibitors, Diseases of the endocrine glands. Clinical endocrinology, RC648-665

الوصف: ABSTRACT Aims/Introduction We previously reported that sodium–glucose cotransporter 2 inhibitor (SGLT2i) treatment was associated with an improvement of the albumin‐to‐creatinine ratio in Japanese patients with type 2 diabetes mellitus and chronic kidney disease. The present study clarified how concomitant insulin treatment (IT) with SGLT2i therapy influences the renal composite outcome (RCO). Materials and Methods We retrospectively evaluated 624 Japanese patients with type 2 diabetes mellitus and chronic kidney disease who underwent SGLT2i treatment. The renal composite outcome was set as progression of the stage of albuminuria or a ≥15% decrease in the estimated glomerular filtration rate per year. We developed a cohort model of patients managed with and without IT (Ins [+], Ins [−]) using propensity score matching methods. Furthermore, all patients in our study population were stratified into quintiles according to their propensity score. Results The incidence of the RCO was in Ins (+) patients significantly higher than that in Ins (−) (P = 0.033). The estimated hazard ratio for the RCO was 1.55 (P = 0.035) in Ins (+) patients. The change in the estimated glomerular filtration rate and albumin‐to‐creatinine ratio in the groups was not statistically significant. The analysis, which was based on the quintiles, showed a statistically significant difference between the Ins (+) and Ins (−) groups (P = 0.01); the odds ratio for the RCO in patients managed with IT was 2.20 (P = 0.01). Conclusions Concomitant administration of IT with SGLT2is influenced the RCO in Japanese patients with type 2 diabetes mellitus and chronic kidney disease. We might need to consider the influence of concomitant agents on the renoprotective effects of SGLT2i therapy.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2040-1116Test; https://doaj.org/toc/2040-1124Test

الوصول الحر: https://doaj.org/article/9d29947443064f66a7b0e820db4c0a8bTest