In patients with T2DM, intensification following A1c ≥7.0% on 2OADs was associated with a significant improvement in glycemic control. Patients intensified with insulin had a higher baseline A1c but greater A1c reduction than those intensified with a non‐insulin agent. However, A1c remained above 8.0% overall (Diabetes, Obesity and Metabolism)
Diabetes News
Tag: insulin
Association Between Triglyceride Level and Glycemic Control Among Insulin-Treated Patients With Type 2 Diabetes
Elevated triglyceride levels were strongly associated with inadequate glycemic control; thus, suppressing triglyceride levels may attain more optimal glycemic control in patients with type 2 diabetes (Journal of Clinical Endocrinology & Metabolism)
Automated insulin dosing guidance to optimise insulin management in patients with type 2 diabetes: a multicentre, randomised controlled trial
The combination of automated insulin titration guidance with support from health-care professionals offers superior glycaemic control compared with support from health-care professionals alone (The Lancet)
Efficacy and safety of oral basal insulin versus subcutaneous insulin glargine in type 2 diabetes: a randomised, double-blind, phase 2 trial
I338 can safely improve glycaemic control in insulin-naive patients with type 2 diabetes with no evidence of a difference compared with insulin glargine, a widely used subcutaneously administered basal insulin (The Lancet Diabetes & Endocrinology)
Perceptions of insulin therapy in people with type 2 diabetes and physicians: a cross-sectional survey conducted in France
Most people with T2D reported that transitioning to insulin therapy was less difficult than they had feared. People with T2D and physicians exhibited differing perceptions regarding the transition (Patient Preference and Adherence)
The effect of short-term intensive insulin therapy on circulating T cell subpopulations in patients with newly diagnosed type 2 diabetes mellitus
Short-term intensive insulin therapy could modulate circulating T cell subpopulations in patients with T2DM, which might alleviate inflammatory responses caused by hyperglycemia
Association of Insulin Dose, Cardiometabolic Risk Factors, and Cardiovascular Disease in Type 1 Diabetes During 30 Years of Follow-up in the DCCT/EDIC Study
During DCCT/EDIC, higher insulin doses were associated with adverse trends in several cardiometabolic risk factors, even after multivariable adjustment, but not with incident CVD outcomes (Diabetes Care)
Heart failure among people with Type 2 diabetes mellitus: real‐world data of 289 954 people from a diabetes database
Heart failure is common in diabetes mellitus, but the prevalence in the DPV is lower frequent than expected. The reason for improved metabolic control in heart failure may be intensified therapy with insulin, lipid‐lowering medication and anti‐hypertensives in this cohort (Diabetic Medicine)
The prevalence of retinopathy in patients with type 1 diabetes treated with education-based intensified insulin therapy and its association with parameters of glucose control
In type 1 diabetes EBIIT is associated with good diabetes control and a low prevalence of DR. The cumulative glucose exposure over time given as HbA1c years is the best predictor for development of DR (Diabetes Research and Clinical Practice)
Insulin Bolus Administration in Insulin Pump Therapy: Effect of Bolus Delivery Speed on Insulin Absorption from Subcutaneous Tissue
Results suggest that insulin bolus delivery with fast delivery speed may result in more rapid insulin absorption and, thus, may provide a better control of meal-related glucose excursions than that obtained with bolus delivery using slow delivery speeds. Our findings may have important implications for the future design of the bolus delivery unit of insulin pumps (Diabetes Technology and Therapeutics)
A Multinational Observational Study Assessing Insulin Use: Understanding the Determinants Associated with Progression of Therapy
Among insulin‐treated patients with T2D, treatment changes were common; however only approximately one‐fourth of individuals achieved their HbA1c target (Dibetes, Obesity and Metabolism)
Cost‐effectiveness of intensification with SGLT2i in Type 2 Diabetes patients on metformin and sitagliptin compared to direct intensification with insulin in the United Kingdom
For UK T2D patients not at goal on metformin and sitagliptin therapy, treatment intensification with SGLT2i prior to NPH insulin is cost‐neutral or cost‐effective compared to immediate NPH insulin intensification (Diabetes, Obesity and Metabolism)
Investigating the Association Between Baseline Characteristics (HbA1c and Body Mass Index) and Clinical Outcomes of Fast-Acting Insulin Aspart in People with Diabetes
In participants with T1D and T2D, treatment differences (for change in HbA1c and overall hypoglycaemia) between mealtime faster aspart and insulin comparators were similar to the corresponding overall analysis across baseline HbA1c and BMI subgroups. The finding of a lower total daily insulin dose in participants with obesity (BMI > 30 kg/m2) and T1D treated with faster aspart, versus those treated with IAsp, may warrant further investigation (Diabetes Therapy)
Commencing insulin glargine 100 U/mL therapy in people with type 2 diabetes: Determinants of achievement of HbA1c goal <7.0%
Baseline HbA1c was the strongest determinant for achieving target HbA1c <7.0% by supplementary Gla‐100 therapy while sex and BMI were also useful indicators. However, age and C‐peptide levels at baseline did not predict glycaemic response to the introduction of basal insulin (Diabetes, Obesity and Metabolism)
Sliding scale insulin for non‐critically ill hospitalised adults with diabetes mellitus
Based on low‐ to very low‐certainty evidence, our results for non‐critically ill hospitalised adults with diabetes mellitus in the medical and surgical in‐hospital setting showed that a basal‐bolus insulin strategy that applied higher total daily doses of insulin than the sliding scale insulin regimen might result in better short‐term glycaemic control but might also cause an increase in severe hypoglycaemic episodes (Cochrane Systematic Review)
Fasting Plasma Glucose Indicates Reversibility of the Acute Insulin Response after Short-Term Intensive Insulin Therapy in Patients with Various Duration of Type 2 Diabetes
We concluded that recovery of the AIR could be obtained in T2DM patients of varying disease duration by short-term intensive insulin therapy and it could be conveniently estimated using posttreatment fasting plasma glucose and other fasting indicators (Journal of Diabetes Research)
Asymptomatic hypoglycaemia in Type 1 diabetes: incidence and risk factors
Asymptomatic hypoglycaemia constitutes the majority of hypoglycaemic events in Type 1 diabetes. Reduced hypoglycaemia awareness and high insulin dose are risk factors for asymptomatic hypoglycaemia, but other conventional risk factors for severe hypoglycaemia do not correlate with risk of asymptomatic episodes (Diabetic Medicine)
A Randomized Trial of Insulin Glargine plus Oral Hypoglycemic Agents versus Continuous Subcutaneous Insulin Infusion to Treat Newly Diagnosed Type 2 Diabetes
In conclusion, short-term intensive therapy with basal insulin plus OHAs showed comparable benefits to CSII in terms of overall glycemic control and improvement in β-cell function in newly diagnosed patients with type 2 diabetes mellitus and is a possible option for treating newly diagnosed patients with type 2 diabetes (Journal of Diabetes Research)
Time to Treatment Intensification After Monotherapy Failure and Its Association With Subsequent Glycemic Control Among 93,515 Patients With Type 2 Diabetes
Earlier treatment intensification is associated with shorter time to subsequent glycemic control, independent of whether patients initiate first-line treatment with metformin or a sulfonylurea (Diabetes Care)
Five-Year Predictors of Insulin Initiation in People with Type 2 Diabetes under Real-Life Conditions
In conclusion, even if patients with T2DM are characterized by different rates of disease progression and the clinical presentation of the disease could lead to insulin treatment initiation per se, the analysis of the collected data allows us to partly respond to typical patient’s question “will I need insulin?,” which originated in this paper (Journal of Diabetes Research)
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