Switching from neutral protamine Hagedorn insulin to insulin glargine 300?U/mL improves glycaemic control and reduces hypoglycaemia risk : results of a multicentre, prospective, observational study

Type 2 diabetes mellitus (T2DM) is a major cause of morbidity and mortality worldwide and is an important public health issue. A significant proportion of insulin-treated patients with T2DM do not reach target glycated haemoglobin (HbA1c) values, which ultimately increases their risk of long-term microvascular and macrovascular complications. One potential option to improve diabetes control in these patients may be the use of new insulin formulations including second-generation basal insulin analogues such as insulin glargine 300 U/mL (Gla-300). Several published randomised controlled trials have assessed the clinical effectiveness of Gla-300, mostly versus insulin glargine 100 U/mL as well as insulin degludec. However, there is limited information about the real-world effectiveness of Gla-300 when patients are transitioned directly from neutral protamine Hagedorn (NPH) human basal insulin. The primary objective of this study was to evaluate the effectiveness of Gla-300, defined as the percentage of participants with an HbA1c reduction of ≥0.5%, 6 months after switching from NPH insulin, in participants with T2DM. Secondary objectives included the safety assessment based on the percentage of patients experiencing ≥1 episodes and the number of hypoglycaemic episodes by category: severe, symptomatic, symptomatic confirmed, diurnal or nocturnal, change in body weight, and insulin dose. A total of 469 participants completed the 6-month observation period. Mean baseline HbA1c was 9.19%. The percentage of participants with a ≥0.5% improvement in HbA1c from baseline was 71.7% at 6 months. Mean HbA1c decreased at 3 and 6 months by 0.77% (±0.98) and 1.01% (±1.12), respectively (p<0.00001 versus baseline), while fasting glycaemia decreased by 32 mg/dL and 37 mg/dL, respectively (p<0.00001 versus baseline). There were moderate increases in the doses of both Gla-300 and, if used, short-acting insulins during the 6 months of observation. The percentage of participants with ≥1 hypoglycaemia event during the preceding 4 weeks decreased significantly from baseline to 3 and 6 months, as did the proportion with symptomatic hypoglycaemia at night (p<0.00001 versus baseline). No participants had severe hypoglycaemia after a switch to Gla-300. Body mass, waist and hip circumferences, and waist : hip ratio did not change significantly. In conclusion, this large, prospective, observational study demonstrated that switching from NPH insulin to Gla-300 resulted in a significant improvement in HbA1c, with only a moderate increase in insulin dose, a decreased risk of hypoglycaemia, and no increase in body weight

A comparison of different approaches to detect the transitions from regular to chaotic motions in SMA oscillator

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Controlled cholesterol efflux from the aortic smooth muscle cells triggers microheterogeneity of plasma membrane lipids and induces modification of the mitochondrial topology

It is generally accepted that phospholipids of plasma membrane display lateral segregation into small microdomains commonly known as lipid rafts. Such lateral lipid organization is under the control of cholesterol. Cholesterol depletion evolved by methyl-&#946;-cyclodextrin (MCD) has been found to induce further marked perturbation in lateral lipid organization, evidenced in the high field part of electron paramagnetic resonance spectra of plasma membranes labelled with a spectroscopic probe, namely 5-doxyl-stearic acid (5DOXS). Such perturbation of surface lipid topo-logy has been found to induce distinct changes in the mitochondrial morpho-logy, i.e. switch from filamentous form into small granular form

Multiple solutions and corresponding power output of a nonlinear bistable piezoelectric energy harvester

We examine multiple responses of a vibrational energy harvester composed of a vertical beam and a tip mass. The beam is excited horizontally by a harmonic inertial force while mechanical vibrational energy is converted to electrical power through a piezoelectric patch. The mechanical resonator can be described by single or double well potentials depending on the gravity force from the tip mass. By changing the tip mass we examine the appearance of various solutions and their basins of attraction. Identification of particular solutions of the energy harvester is important as each solution may provide a different level of power output

Experimental analysis of the dynamical response of energy harvesting devices based on bistable laminated plates

The use of bistable laminates is a potential approach to realize broadband piezoelectric based energy harvesting systems. In this paper the dynamic response of a piezoelectric material attached to a bistable laminate plate is examined based on the experimental generated voltage time series. The system was subjected to harmonic excitations and exhibited single-well and snap-through vibrations of both periodic and chaotic character. To identify the dynamics of the system response we examined the frequency spectrum, bifurcation diagrams, phase portraits, and the 0–1 test

4-OH-TEMPO prevents the morphological alteration of rat thymocytes primed to apoptosis by oxidative stress inducer ButOOH

Thymocytes exposed to the pro-oxidant tert&#8211;butyl-hydroperoxide (ButOOH) display a number of dramatic changes in morphology similar to those observed in the case of dexamethasone-treated cells. Both reagents induce nuclear chromatin peripheral aggregation below the nuclear membrane. Some nuclei themselves break up producing two or more fragments. ButOOH-treated cells are morphologically characterised by cell shrinkage, extensive surface blebbing and, finally, fragmentation into membrane&#8211;bound apoptotic bodies composed of cytoplasm and tightly packed with or without nuclear fragments. An increased level of lipid hydroxyperoxides was detected after exposure of thymocytes to ButOOH. Both oxidative stress markers and morphological damage to cells were prevented by the antioxidant 4-OH-TEMPO

Regular and chaotic vibration in a piezoelectric energy harvester

We examine regular and chaotic responses of a vibrational energy harvester composed of a vertical beam and a tip mass. The beam is excited horizontally by a harmonic inertial force while mechanical vibrational energy is converted to electrical power through a piezoelectric patch. The mechanical resonator can be described by single or double well potentials depending on the gravity force from the tip mass. By changing the tip mass we examine bifurcations from single well oscillations, to regular and chaotic vibrations between the potential wells. The appearance of chaotic responses in the energy harvesting system is illustrated by the bifurcation diagram, the corresponding Fourier spectra, the phase portraits, and is confirmed by the 0–1 test. The appearance of chaotic vibrations reduces the level of harvested energy