Diabetes technology & therapeutics
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Diabetes Technol. Ther. · Jan 2012
The cost-effectiveness of saxagliptin versus NPH insulin when used in combination with other oral antidiabetes agents in the treatment of type 2 diabetes mellitus in Poland.
This study compared the health and economic benefits of saxagliptin versus insulin as second-line therapy with either metformin (MET) or sulfonylurea (SU) after failure of the respective monotherapies for patients with type 2 diabetes in Poland. ⋯ Saxagliptin in combination with MET or SU is likely to represent a cost-effective treatment option in Polish patients with type 2 diabetes failing first-line treatment.
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Diabetes Technol. Ther. · Dec 2011
ReviewRecent advances in the prevention of hypoglycemia in type 1 diabetes.
Iatrogenic hypoglycemia is one of the chief barriers to optimal glycemic control in people with type 1 diabetes (T1D). As a common contributor to morbidity and mortality in T1D, severe hypoglycemia (SH) is also a major fear for people with T1D and their families. Consequently, fear of hypoglycemia and hypoglycemia-avoidant behaviors are predominant limiting factors in achieving euglycemia in people with T1D. ⋯ Various strategies and technologies have already been developed to help detect and prevent hypoglycemia, including improved patient education, frequent self-monitoring of blood glucose levels, the use of rapid-acting and basal insulin analogs, continuous subcutaneous insulin infusion therapy, exercise-related insulin modifications, and continuous glucose monitors. The efficacy of these methods is well established, but further advances are still needed. The purpose of this review is to describe these currently available methods and to emphasize recent progress related to the prevention of hypoglycemia in T1D.
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Diabetes Technol. Ther. · Nov 2011
Relationship between interstitial and blood glucose during hypoglycemia in subjects with type 2 diabetes.
Continuous glucose monitoring devices measure interstitial glucose and are commonly used to investigate hypoglycemia. The relationship between interstitial glucose and blood glucose is not completely understood, particularly at low blood glucose concentrations. Interstitial glucose during hypoglycemia is generally lower than blood glucose in young subjects without diabetes and those with type 1 diabetes, but the effect of insulin resistance and obesity in type 2 diabetes on this relationship has not been examined previously. We studied the relationship between blood and interstitial glucose during experimental hypoglycemia in subjects with type 2 diabetes treated with insulin or sulfonylureas and matched controls without diabetes. ⋯ In older subjects with or without type 2 diabetes, interstitial glucose is significantly higher than blood glucose, and this difference increases with increasing severity of hypoglycemia. Continuous glucose monitors may underestimate hypoglycemia in this group, and this should be taken into account when interpreting results obtained using this technology.
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Diabetes Technol. Ther. · Sep 2011
Effects of sleep apnea severity on glycemic control in patients with type 2 diabetes prior to continuous positive airway pressure treatment.
Obstructive sleep apnea (OSA), a highly prevalent condition, is independently associated with increased risks of developing type 2 diabetes mellitus (T2D) and metabolic syndrome. It is unclear, however, if the severity of OSA has any impact on glycemic control among patients with T2D. We therefore aimed to determine the independent association between OSA severity and glycosylated hemoglobin (HbA1c) in patients with T2D. ⋯ Increased severity of OSA is independently associated with worsening glycemic control following adjustment of various confounders, including insulin dosage. We would hypothesize therefore that identification and treating OSA among patients with T2D may confer benefits in improving glycemic control.
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Diabetes Technol. Ther. · Aug 2011
Increased accumulation of skin advanced glycation end products is associated with microvascular complications in type 1 diabetes.
Skin autofluorescence (AF) measured with an AF reader device is a noninvasive tool to measure the tissue accumulation of advanced glycation end products (AGEs). The aim of the study was to assess the association between AF and microvascular complications in type 1 diabetes mellitus (DM1). ⋯ The tissue accumulation of AGE is significantly associated with microvascular complications in DM1.