Relaxation training significantly reduced blood glucose levels in patients with type 1 diabetes mellitus

Purpose/Objective: The present study was designed to test whether adding a relaxation training technique to the medical treatment of patients with type 1 diabetes mellitus could, adjusting for the non-specific factors of therapy, lead to an improvement in the patients’ condition. Method: Forty-six participants were randomly allocated either to an experimental (intervention) group, receiving weekly sessions of relaxation training, or to a control group (placebo) receiving weekly blood circulation training exercises. Measures included the State and Trait Anxiety Inventory, blood glucose levels, high-density lipoprotein levels, cholesterol levels, body weight, HbA1c levels, the Mood Adjective Checklist (MACL), a diary checklist, and urine glucose levels. Assessment of psychological and physiological parameters was conducted before and upon completion of the intervention (8 weeks). Results: Trait anxiety and the main metabolic measurement of blood glucose levels and HbA1C revealed significant differences over time, predominantly among patients in the intervention group. Conclusions: Relaxation techniques as an adjunct to medical treatment are a useful tool for patients with type 1 diabetes mellitus. © 2020, Hellenic Endocrine Society

Improvement of metabolic control after 3-month use of real-time continuous glucose monitoring in patients with type 1 diabetes: a multicenter study in Greece

Purpose: To assess the efficacy of a real-time continuous glucose monitoring (RT–CGM) system added to insulin pump therapy for 3 months, in sub-optimally controlled adults with type 1 diabetes mellitus (T1D). Methods: This was a prospective, multicenter, non-randomized, post-market release study. A total of 43 adult patients with T1D on insulin pump therapy and inadequate glycemic control (HbA1c > 7.0%) participated in the study. The primary endpoint was the change from baseline HbA1c levels. Secondary objectives were to evaluate the impact of the RT–CGM system on glucose variability, daily insulin requirements, and the frequency of hypoglycemic and ketoacidosis events. Results: At 3 months, the baseline HbA1c values decreased from 8.0 (7.6, 8.7) to 7.1 (6.7, 8.0) % (p < 0.001). Nineteen participants (44.2%) had a posttreatment HbA1c level ≤ 7%. Average total daily insulin requirements, as well as the average number of insulin boluses per day, increased significantly after the use of the RT–CGM system. The number of hypoglycemic events recorded did not differ between the first week and last week of RT–CGM usage, while no severe hypoglycemic episodes, ketoacidosis events, or hospitalizations related to diabetes occurred during the 3-month follow-up period. Conclusion: Addition of a RT–CGM system to insulin pump therapy for 3 months in inadequately controlled patients with T1D resulted in improved HbA1c levels, without increasing the risk of hypoglycemic events. © 2019, Hellenic Endocrine Society

Annual research review, chemical pulping, March 25, 1992

"March 25, 1992."Fundamentals of bleaching chemistry: project 3728 / L.B. Sonnenberg, A.J. Ragauskas, D.R. Dimmel ; Fundamentals of brightness stability: project 3524 / Arthur J. Ragauskas ; Sulfur-free selective pulping process: project 3661 / Donald R. Dimmel, Xiaoqi Pan, and staff at the National energy renewable laboratory ; Mechanisms of dioxin formation in pulp production part II: chlorination and dioxin recations: project 3685 / Donald R. Dimmel, and Battelle ; Environmentally compatible production of bleached chemical pulp: project 3474 / Thomas J. McDonough ... [et al.] ; Effects of residual lignin structure on bleachability / Kyle R. Reed, Thomas J. McDonough ; Kinetics of cellulose degradation by ozone / Barbara I. Johnson, Thomas J. McDonough ;Gas dispersion in oxygen delignification / Edouard Benroubi, Thomas McDonough ; Biomimetic approach to pulp bleaching / Collen C. Walker ... [et al.] ; Investigation of novel bleaching agents / Arthur J. Ragauskas ; Mixing in chlorination and effluent quality / Amy R. Malcolm, Thomas J. McDonough ; Characterization of aox / Todd Schwantes, Thomas J. McDonough ; Evaluation of commercially available conductivity sensors: project 3699/3741 / Charles E. Courchene, Tanya Kubicar, Blair Carter ; Estimating yield for the prediction of end-use properties in semichemical pulping: project 3716 / Clark P. Woitkovich and Thomas J. McDonough

Liraglutide and renal outcomes in type 2 diabetes

BACKGROUND In a randomized, controlled trial that compared liraglutide, a glucagon-like peptide 1 analogue, with placebo in patients with type 2 diabetes and high cardiovascular risk who were receiving usual care, we found that liraglutide resulted in lower risks of the primary end point (nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes) and death. However, the long-term effects of liraglutide on renal outcomes in patients with type 2 diabetes are unknown. METHODS We report the prespecified secondary renal outcomes of that randomized, controlled trial in which patients were assigned to receive liraglutide or placebo. The secondary renal outcome was a composite of new-onset persistent macroalbuminuria, persistent doubling of the serum creatinine level, end-stage renal disease, or death due to renal disease. The risk of renal outcomes was determined with the use of time-to-event analyses with an intention-to-treat approach. Changes in the estimated glomerular filtration rate and albuminuria were also analyzed. RESULTS A total of 9340 patients underwent randomization, and the median follow-up of the patients was 3.84 years. The renal outcome occurred in fewer participants in the liraglutide group than in the placebo group (268 of 4668 patients vs. 337 of 4672; hazard ratio, 0.78; 95% confidence interval [CI], 0.67 to 0.92; P=0.003). This result was driven primarily by the new onset of persistent macroalbuminuria, which occurred in fewer participants in the liraglutide group than in the placebo group (161 vs. 215 patients; hazard ratio, 0.74; 95% CI, 0.60 to 0.91; P=0.004). The rates of renal adverse events were similar in the liraglutide group and the placebo group (15.1 events and 16.5 events per 1000 patient-years), including the rate of acute kidney injury (7.1 and 6.2 events per 1000 patient-years, respectively). CONCLUSIONS This prespecified secondary analysis shows that, when added to usual care, liraglutide resulted in lower rates of the development and progression of diabetic kidney disease than placebo. (Funded by Novo Nordisk and the National Institutes of Health; LEADER ClinicalTrials.gov number, NCT01179048.