113 research outputs found
Glucose variability does not contribute to the development of peripheral and autonomic neuropathy in type 1 diabetes: data from the DCCT
Acceptance of the Artificial Pancreas:Comparing the Effect of Technology Readiness, Product Characteristics and Social Influence between Invited and Self-Selected Respondents
Efficacy and safety of two 5 day insulin dosing regimens to achieve strict glycaemic control in patients with acute ischaemic stroke
Nocturnal hypoglycaemia in type 1 diabetic patients, assessed with continuous glucose monitoring: frequency, duration and associations
WSTĘP. W niniejszej pracy określono ilościowo częstość występowania i czas trwania epizodów nocnej
hipoglikemii u chorych na cukrzycę typu 1, leczonych
ciągłym podskórnym wlewem insuliny (CSII) lub za
pomocą wielokrotnych wstrzyknięć insuliny (MIT),
wykorzystując ciągły podskórny pomiar glukozy
z zastosowaniem czujnika.
METODY. Czujnik mikrodializacyjny był noszony
w warunkach domowych przez 24 pacjentów leczonych
CSII (średnie stężenie HbA1c 7,8 ± 0,9%) oraz
przez 33 pacjentów, u których stosowano MIT (średnie
stężenie HbA1c 8,7 ± 1,3%) przez 48 godzin. Oceniano
częstość występowania i czas trwania epizodów hipoglikemii oraz związek między stężeniem
HbA1c, czasem trwania cukrzycy, sposobem jej leczenia
(CSII vs. MIT), wartościami glikemii na czczo oraz
przed spoczynkiem nocnym, całkowitą dobową
dawką insuliny, a także średnimi wartościami glikemii
w nocy a częstością występowania i czasem trwania
epizodów hipoglikemii.
WYNIKI. Epizody nocnej hipoglikemii z wartościami
glikemii ≤ 3,9 mmol/l wystąpiły u 33,3% pacjentów
w obu grupach - zarówno w grupie leczonej CSII
(8/24), jak i stosującej MIT (11/33). średni czas trwania
hipoglikemii (± SD; mediana, przedział międzykwartylowy)
wynosił 78 min na noc (± 76; 57, 23-120) u chorych poddanych CSII oraz 98 min na noc
(± 80; 81, 32-158) u pacjentów stosujących MIT.
W analizie metodą regresji wieloczynnikowej wykazano,
że glikemia przed spoczynkiem nocnym najsilniej
wiąże się z częstoœcią (p = 0,026) oraz czasem
trwania (p = 0,032) epizodów nocnej hipoglikemii.
WNIOSKI. Ciągłe monitorowanie glikemii z wykorzystaniem
metody mikrodializy umożliwiło bardziej
precyzyjne określenie ilościowe częstoœci występowania
i czasu trwania epizodów nocnej hipoglikemii
u chorych na cukrzycę typu 1. Parametry te wiążą
się głównie z wartościami glikemii przed spoczynkiem
nocnym.AIMS. We quantified the occurrence and duration
of nocturnal hypoglycaemia in individuals with type 1
diabetes treated with continuous subcutaneous insulin
infusion (CSII) or multiple-injection therapy (MIT)
using a continuous subcutaneous glucose sensor.
METHODS. A microdialysis sensor was worn at home
by 24 patients on CSII (mean HbA1c 7.8 ± 0.9%) and
33 patients on MIT (HbA1c 8.7 ± 1.3%) for 48 h.
Occurrence and duration of nocturnal hypoglycaemia
were assessed and using multivariate regression
analysis, the association between HbA1c, diabetes
duration, treatment type (CSII vs. MIT), fasting
and bedtime blood glucose values, total daily insulin
dose and mean nocturnal glucose concentrations,
and hypoglycaemia occurrence and duration was
investigated.
RESULTS. Nocturnal hypoglycaemia ≤ 3.9 mmol/l occurred
in 33.3% of both the CSII- (8/24) and MITtreated patients (11/33). Mean (± SD; median, interquartile
range) duration of hypoglycaemia ≤ 3.9
mmol/l was 78 (± 76; 57, 23-120) min per night for
the CSII- and 98 (± 80; 81, 32-158) min per night
for the MIT-treated group. Multivariate regression
analysis showed that bedtime glucose value had the
strongest association with the occurrence (p = 0.026)
and duration (p = 0.032) of nocturnal hypoglycaemia.
CONCLUSIONS. Microdialysis continuous glucose
monitoring has enabled more precise quantification
of nocturnal hypoglycaemia occurrence and duration
in type 1 diabetic patients. Occurrence and duration
of nocturnal hypoglycaemia were mainly
associated with bedtime glucose value
Lower rates of hypoglycaemia in older individuals with type 2 diabetes using insulin degludec versus insulin glargine U100 : results from SWITCH 2
Aim
This study aimed to investigate the safety of insulin degludec (degludec) in relation to age and risk of hypoglycaemia post hoc in individuals with type 2 diabetes (T2D) (SWITCH 2 trial).
Methods
In this crossover study, individuals with T2D who were at risk of hypoglycaemia were randomized to double‐blind treatment with degludec or insulin glargine 100 units/mL (glargine U100) ± oral antidiabetic drugs. After 32 weeks, patients crossed over to the other treatment. Primary endpoint was number of overall severe (positively adjudicated) or glucose‐confirmed (plasma glucose <56 mg/dL; 3.1 mmol/L) symptomatic hypoglycaemia events during the two 16‐week maintenance periods.
Results
For individuals ≤65 (n = 450) and >65 (n = 270) years, baseline median (range) duration of diabetes was 12 (1–40) vs 15 (1–54) years, mean HbA1c was 7.7% vs 7.4% and mean estimated glomerular filtration rate was 87.0 vs 63.7 mL/min/1.73 m2, respectively. No significant differences in HbA1c reduction were seen in individuals ≤65 or >65 years. During both maintenance periods, treatment with degludec lowered rates of hypoglycaemia (overall/nocturnal symptomatic) vs those with glargine U100 in individuals ≤65 (31% vs 43%) and >65 (30% vs 41%) years. With degludec and glargine U100, respectively, six vs nine severe hypoglycaemic events occurred in individuals ≤65 years and four vs eight events occurred in those >65 years. Adverse event rates were 3.2 and 3.3 events/patient‐year for individuals ≤65 years and were 3.5 and 4.1 events/patient‐year for individuals >65 years with degludec and glargine U100, respectively.
Conclusion
Treatment with degludec was safe and effective, with a frequency of hypoglycaemia lower than that with glargine U100 in both younger and older individuals (>65 years) with T2D
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