Available data points to an important insulin participation in renal glucose handling, including tubular glucose transport, but human studies with reproducible and comparable method are still needed (Journal of Diabetes Research)
Diabetes News
Tag: insulin
Effectiveness and Safety of Insulin Glargine 300 U/mL in Insulin‐Naïve Patients with Type 2 Diabetes after Failure of Oral Therapy in a Real World Setting
Starting a BOT regimen with Gla‐300 allowed about 60% of 721 German and Swiss patients with inadequately controlled type 2 diabetes to achieve glycaemic control within 12 months in daily clinical practice. Glycaemic control was achieved without weight gain or increased risk of nocturnal or severe hypoglycaemia (Diabetes, Obesity and Metabolism)
Strategies to reduce insulin prescribing errors in UK hospitals: results from a national survey
There is potential to optimize the functionality of both electronic and paper‐based prescribing systems to improve the safe prescribing of insulin in hospitals in the UK (Diabetic Medicine)
A review of the NG17 recommendations for the use of basal insulin in type 1 diabetes
Many of the trials used in this analysis were treat‐to‐target, which minimize differences in HbA1c. In the NMAs, statistical significance was severely undermined by the wide credible intervals. Despite these limitations, point estimates of HbA1c were used to rank the insulins and formed the basis of NG17 guidance. This study queries whether such analyses should be used to make specific clinical recommendations (Diabetic Medicine)
Effects of Gender-Affirming Hormone Therapy on Insulin Sensitivity and Incretin Responses in Transgender People
In this cohort of transgender persons, insulin sensitivity but also post-OGTT incretin responses tend to increase with masculinization and to decrease with feminization (Diabetes Care)
Switching Patients with Type 1 Diabetes to Insulin Degludec from Other Basal Insulins: Real-World Data of Effectiveness and Safety
Switching patients with type 1 diabetes to IDeg from other basal insulins was associated with relevant improvements in metabolic control and glycemic variability without weight gain; the risk of hypoglycemic episodes also significantly declined (Diabetes Therapy)
Improving Type 2 Diabetes Management in General Practice Using a Second-Generation Basal Insulin Analogue Insulin Glargine 300 U/mL: A Practical Guide
The clinical application of the use of Gla-300 include advantages such as less intra- and interpatient variability in glucose control resulting in rather less hypoglycaemia, longer duration of action and greater flexibility in the timing of administration thus suiting a wide range of patient presentations (Diabetes Therapy)
Efficacy, Safety and Tolerability of Oral Semaglutide Versus Placebo Added to Insulin ± Metformin in Patients with Type 2 Diabetes: the PIONEER 8 Trial
Oral semaglutide was superior to placebo in reducing HbA1c and body weight when added to insulin ± metformin in patients with type 2 diabetes. The safety profile was consistent with other glucagon-like peptide-1 receptor agonists (Diabetes Care)
Exploring Patient Preferences for Adjunct-to-Insulin Therapy in Type 1 Diabetes
Low-dose SGLTi profile was the favored adjunct-to-insulin therapy by persons with T1D (Diabetes Care)
Post-Basal Insulin Intensification and Healthcare Resource Use in Type 2 Diabetes: A Web-Based Physician Survey in the United States and United Kingdom
Less complex regimens for intensification following basal insulin may help reduce the time and healthcare resources required for intensification and address some of the challenges T2D patients face when intensifying to basal–bolus or basal with GLP-1 (Diabetes Therapy)
Investigating optimal β‐cell‐preserving treatment in latent autoimmune diabetes in adults: Results from a 21‐month randomized trial
β‐cell function after intervention was similar in patients with insulin‐ and sitagliptin‐treated LADA, regardless of the strength of autoimmunity. Further, participants with low levels of GAD antibodies did not experience progressive deterioration of β‐cell function over a 21‐month period. Taken together, these findings could be useful for clinicians’ choices of treatment in people with LADA (Diabetes, Obesity and Metabolism)
A randomized trial comparing the efficacy and safety of treating patients with very elevated hba1c levels with basal‐bolus insulin or a glp‐1 receptor agonist plus basal insulin
In patients with HbA1c≥10% treatment with GLP1RA plus basal insulin, compared with basal‐bolus insulin, resulted in better glycemic control and weight, lower insulin dosage and hypoglycemia, and improved quality of life. This treatment strategy is an effective and safe alternative to basal‐bolus insulin regimen (Diabetes, Obesity and Metabolism)
Use of sensor‐integrated pump therapy to reduce hypoglycaemia in people with Type 1 diabetes: a real‐world study in the UK
Real‐world UK data show that increasing automation of insulin suspension reduces hypoglycaemia exposure in people with Type 1 diabetes (Diabetic Medicine)
Glycaemic benefit of iGlarLixi in insulin‐naive type 2 diabetes patients with high HbA1c or those with inadequate glycaemic control on two oral antihyperglycaemic drugs in the LixiLan‐O randomized trial
These results suggest that iGlarLixi achieves superior glycaemic control compared with iGlar or Lixi alone in T2DM patients with HbA1c ≥9% or those inadequately controlled on two OADs (Diabetes, Obesity and Metabolism)
Role of diabetes and insulin use in the risk of stroke and acute myocardial infarction in patients with atrial fibrillation
There is an incremental risk of ischemic stroke and MI from non-diabetics to non-insulin diabetics with the highest risk in insulin users. Protective effect of anticoagulation is attenuated with insulin use (American Heart Journal)
Implementation of Basal–Bolus Therapy in Type 2 Diabetes
Bolus insulin delivered by patch and pen using an algorithm-based weekly insulin dose titration significantly improved HbA1c in adults with type 2 diabetes, with improved subject and health care provider experience and preference for the patch (Diabetes Technology and Therapeutics)
Interventions to improve insulin prescribing practice for people with diabetes in hospital: a systematic review
Implementing strategies that are sensitive to local context and designed to increase adherence to insulin prescribing guidelines are associated with a reduction in prescribing errors. Future implementation should build on effective approaches including multifaceted interventions involving multiple stakeholders at various institutional levels (Diabetic Medicine)
Efficacy and safety of dual SGLT 1/2 inhibitor sotagliflozin in type 1 diabetes: meta-analysis of randomised controlled trials
In type 1 diabetes, sotagliflozin improves glycaemic and non-glycaemic outcomes and reduces hypoglycaemia rate and severe hypoglycaemia. The risk of diabetic ketoacidosis could be minimised by appropriate patient selection and down-titration of the basal insulin dose (BMJ)
Double‐blind, randomized clinical trial comparing the efficacy and safety of continuing or discontinuing the dipeptidyl peptidase‐4 inhibitor sitagliptin when initiating insulin glargine therapy in patients with type 2 diabetes
When initiating insulin glargine therapy, continuation of sitagliptin, compared with discontinuation, resulted in a clinically meaningful greater reduction in HbA1c without an increase in hypoglycaemia (Diabetes, Obesity and Metabolism)
Safer insulin prescribing
This document summarises the evidence base on safer insulin prescribing. It is a key therapeutic topic that has been identified to support medicines optimisation. It is not formal NICE guidance
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