Diabetes technology & therapeutics
-
Diabetes Technol. Ther. · Sep 2019
Multicenter StudySotagliflozin Added to Optimized Insulin Therapy Leads to Lower Rates of Clinically Relevant Hypoglycemic Events at Any HbA1c at 52 Weeks in Adults with Type 1 Diabetes.
Background: Hypoglycemia rates usually increase when insulin treatment is intensified to improve glycemic control. We evaluated (post hoc) hypoglycemic rates in adult patients with type 1 diabetes (T1D) on sotagliflozin (a dual sodium-glucose cotransporter [SGLT] 1 and 2 inhibitor) in two phase 3, 52-week clinical trials (inTandem 1 and 2; NCT02384941 and NCT02421510). Materials and Methods: We analyzed rates of documented hypoglycemia (level 1, blood glucose ≥54 to <70 mg/dL) and clinically important hypoglycemia (level 2, glucose <54 mg/dL) in a patient-level pooled analysis (n = 1362) using a negative binomial model adjusted for hemoglobin A1c (HbA1c) at 52 weeks in patients receiving placebo, sotagliflozin 200 mg, and sotagliflozin 400 mg. ⋯ The difference in rates of hypoglycemia with sotagliflozin versus placebo became more pronounced as HbA1c decreased. Conclusions: At week 52, level 1 and 2 hypoglycemia events were 22% to 30% less frequent with sotagliflozin added to optimized insulin therapy versus placebo in adults with T1D at any HbA1c level, with greater differences at lower HbA1c values. These findings support the use of sotagliflozin as an insulin adjunct in T1D.
-
Diabetes Technol. Ther. · Jun 2017
Multicenter Study Comparative StudyComparison of Insulin Pump Therapy and Multiple Daily Injections Insulin Regimen in Patients with Type 1 Diabetes During Ramadan Fasting.
Fasting Ramadan carries a high risk for patients with type 1 diabetes (T1DM). Data on the optimum insulin regimen in these patients are limited. ⋯ In patients with T1DM who fast Ramadan, there was no difference in rates of hypoglycemia or hyperglycemia between CSII and MDI. However, CSII was associated with less glucose variability.
-
Diabetes Technol. Ther. · Jul 2016
Multicenter StudyAssociation of Diabetic Microvascular Complications and Parameters of Obstructive Sleep Apnea in Patients with Type 2 Diabetes.
Obstructive sleep apnea (OSA) is prevalent in patients with type 2 diabetes, but the influence of OSA on diabetes complications is not clear. We aimed to investigate the association of OSA with chronic diabetes complications in Chinese patients with type 2 diabetes. ⋯ Parameters of nocturnal hypoxemia are associated with DN and renal function of patients with type 2 diabetes. The parameters of hypoxemia may more sensitively reflect the association of OSA and diabetic microvascular complications than AHI.
-
Diabetes Technol. Ther. · Dec 2015
Randomized Controlled Trial Multicenter StudyRandomized Evaluation of Glycemic Control in the Medical Intensive Care Unit Using Real-Time Continuous Glucose Monitoring (REGIMEN Trial).
Hyperglycemia occurs commonly in patients admitted to medical intensive care units (MICUs). Whether real-time (RT) continuous glucose monitoring (CGM) improves glycemic control and variability and reduces hypoglycemia in severely ill MICU patients with an Acute Physiology and Chronic Health Evaluation II (APACHE-II) score of ≥20 has not been studied. ⋯ RT-CGM did not ameliorate glucose control or variability; neither did it reduce the number of hypoglycemic events, but our insulin infusion protocol led to overall good glucose control without a significant hypoglycemia risk, making further improvement difficult.
-
Diabetes Technol. Ther. · Jun 2015
Multicenter Study Clinical TrialGlycemic Variability Is Associated with Frequency of Blood Glucose Testing and Bolus: Post Hoc Analysis Results from the ProAct Study.
The ProAct study has shown that a pump switch to the Accu-Chek(®) Combo system (Roche Diagnostics Deutschland GmbH, Mannheim, Germany) in type 1 diabetes patients results in stable glycemic control with significant improvements in glycated hemoglobin (HbA1c) in patients with unsatisfactory baseline HbA1c and shorter pump usage time. ⋯ Pump users who perform frequent daily glucose readings have a better glycemic control with lower glycemic variability.