Self-Reported Frequency and Impact of Hypoglycemic Events in Spain

INTRODUCTION: Hypoglycemia is a common side effect of insulin therapy and has negative implications for quality of life and healthcare resources. The authors investigated the self-reported frequency of non-severe and severe hypoglycemic events (NSHEs and SHEs), hypoglycemia awareness, patient–physician communication, health-related effects and economic impact on people with insulin-treated diabetes (Type-1 and Type-2) in Spain. METHODS: People with Type-1 (T1DM) or insulin-treated Type-2 (T2DM) diabetes older than 15 years of age completed up to 4 questionnaires at weekly intervals. NSHE was an event which respondents could manage without assistance. SHE needed help from a third party to manage. RESULTS: In total, 630 respondents completed questionnaires covering 2,235 weeks. Mean self-reported NSHEs per respondent-week were 1.7 (T1DM) and 0.4–0.8 (T2DM). Impaired hypoglycemia awareness or unawareness was reported by 55% of T1DM and 39% of T2DM respondents. Overall, 31% of T1DM and 20% of T2DM respondents rarely/never informed their physician about NSHEs. Respondents reported feeling tired/fatigued after 67% of NSHE and less alert after 45% of NSHE. Over the week following an NSHE, blood glucose measurement test-strip use increased by 5.3 (mean). In employed respondents (43%), 18% of NSHEs were reported to lead to lost work time (mean 1.5 h per event). After an SHE, 49% of respondents required emergency visits and/or hospital admission. CONCLUSION: NSHE are a common occurrence with T1DM and insulin-treated T2DM in Spain and are associated with a cost burden and negative impact on well-being. Patient–physician communication is higher in Spain than Europe overall; however, many patients expressed reluctance to discuss their hypoglycemia. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s13300-014-0057-z) contains supplementary material, which is available to authorized users

Extraction of valuable compounds from granadilla (Passiflora ligularis Juss) peel using pressurized fluids technologies

Valuable products, including carotenoids, phenolic compounds, and pectin were obtained from granadilla peel using green technologies based on pressurized fluids. The processes of pressurized liquid extraction (PLE) and CO2-expanded ethanol (GXE) were evaluated to recover the carotenoids and phenolic compounds, while pressurized hot water extraction (PHWE) was evaluated to extract pectin from the granadilla peel. The results demonstrated that although PLE and GXE had no significant difference in the carotenoids yield and antioxidant activity of the extracts obtained, PLE was faster than GXE to achieve the highest extraction yield. The pectin yield obtained by PHWE was affected by the process temperature with the highest value obtained at 160 °C. Further studies are needed to characterize the chemical composition of the pectin obtained, but the present results enable establishing a biorefinery for the complete use of granadilla wastes (seeds and peel).The authors thank the financial support of the Ministry of Education (MECESUP) through the Program Strengthening Featuring MECESUP-ANT 1999 (Attraction of Advanced Human Capital from Abroad short-term visits) and the FONDEQUIP EQM160073 Project of the National Agency for Research and Development (ANID) ex-National Commission for Scientific and Technological Research(CONICYT) of Chile. Renata Vardanegathanks Horizon 2020 MSCA grant agreement No 101062938 for the postdoctoral fellowship.info:eu-repo/semantics/publishedVersio

Cost-effectiveness analysis of insulin degludec compared with insulin glargine u100 for the management of type 1 and type 2 diabetes mellitus - from the Spanish National Health System perspective

The objective of this study was to assess the cost-effectiveness of insulin degludec versus insulin glargine, from the Spanish NHS in three groups of patients. Methods: A short-term cost utility model was developed to estimate effectiveness results in terms of the total number of hypoglycaemic events and their disutility impact throughout the year on the initial level of quality of life for patients in each treatment

Supercritical Fluid Extraction of Fucoxanthin from the Diatom Phaeodactylum tricornutum and Biogas Production through Anaerobic Digestion

Phaeodactylum tricornutum is the marine diatom best known for high-value compounds that are useful in aquaculture and food area. In this study, fucoxanthin was first extracted from the diatom using supercritical fluid extraction (SFE) and then using the extracted diatom-like substrate to produce bioenergy through anaerobic digestion (AD) processes. Factors such as temperature (30 °C and 50 °C), pressure (20, 30, and 40 MPa), and ethanol (co-solvent concentration from 10% to 50% v/v) were optimized for improving the yield, purity, and recovery of fucoxanthin extracted using SFE. The highest yield (24.41% w/w) was obtained at 30 MPa, 30 °C, and 30% ethanol but the highest fucoxanthin purity and recovery (85.03mg/g extract and 66.60% w/w, respectively) were obtained at 30 MPa, 30 °C, and 40%ethanol. Furthermore, ethanol as a factor had the most significant effect on the overall process of SFE. Subsequently, P.tricornutum biomass and SFE-extracted diatom were used as substrates for biogas production through AD. The effect of fucoxanthin was studied on the yield of AD, which resulted in 77.15 ± 3.85 LSTP CH4/kg volatile solids (VS) and 56.66 ± 1.90 LSTP CH4/kg VS for the whole diatom and the extracted P.tricornutum, respectively. Therefore, P.tricornutuman can be considered a potential source of fucoxanthin and methane and both productions will contribute to the sustainability of the algae-biorefinery processes

Clinical Effects of Liraglutide in a Real-World Setting in Spain: eDiabetes-Monitor SEEN Diabetes Mellitus Working Group Study

Introduction: A limitation with randomized controlled trials is that, while they provide unbiased evidence of the efficacy of interventions, they do so under unreal conditions and in a very limited and highly selected patient population. Our aim was to provide data about the effectiveness of liraglutide treatment in a real-world and clinical practice setting. Methods: In a retrospective and observational study, data from 753 patients with type 2 diabetes were recorded through an online tool (eDiabetes-Monitor). Results: Mean baseline glycated hemoglobin (HbA1c) was 8.4 ± 1.4% and mean body mass index (BMI) was 38.6 ± 5.4 kg/m2. After 3–6 months of treatment with liraglutide, we observed a change in HbA1c of -1.1 ± 1.2%, -4.6 ± 5.3 kg in weight and -1.7 ± 2.0 kg/m

Clinical Recommendations to Manage Gastrointestinal Adverse Events in Patients Treated with Glp-1 Receptor Agonists: A Multidisciplinary Expert Consensus

Gastrointestinal adverse events; Obesity; Type 2 diabetesEsdeveniments adversos gastrointestinals; Obesitat; Diabetis tipus 2Eventos adversos gastrointestinales; Obesidad; Diabetes tipo 2Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are indicated in type 2 diabetes and obesity for their high efficacy in controlling glycaemia and inducing body weight loss, respectively. Patients may develop gastrointestinal adverse events (GI AEs), namely nausea, vomiting, diarrhoea and/or constipation. To minimize their severity and duration, healthcare providers (HCPs) and patients must be aware of appropriate measures to follow while undergoing treatment. An expert panel comprising endocrinologists, nephrologists, primary care physicians, cardiologists, internists and diabetes nurse educators convened across virtual meetings to reach a consensus regarding these compelling recommendations. Firstly, specific guidelines are provided about how to reach the maintenance dose and how to proceed if GI AEs develop during dose-escalation. Secondly, specific directions are set about how to avoid/minimize nausea, vomiting, diarrhoea and constipation symptoms. Clinical scenarios representing common situations in daily practice, and infographics useful to guide both HCPs and patients, are included. These recommendations may prevent people with T2D and/or obesity from withdrawing from GLP-1 RAs treatment, thus benefitting from their superior effect on glycaemic control and weight loss.This work has been funded by Novo-Nordisk

Influence of Physicochemical Characteristics of Bean Crop Soil in Trichoderma spp. Development

[EN] Spain has ranked 6th on the harvested bean area and 8th in bean production in the European Union (EU). The soils of this area have mixed silt loam and sandy loam texture, with moderate clay content, neutral or acidic pH, rich in organic matter and low carbonate levels, providing beans with high water absorption capacity and better organoleptic qualities after cooking. Similar to other crops, it is attacked by some phytopathogens. Hitherto, chemical methods have been used to control these organisms. However, with the Reform of the Community Agrarian Policy in the EU, the number of authorized plant protection products has been reduced to prevail food security, as well as to be sustainable in the long term, giving priority to the non-chemical methods that use biological agents, such as Trichoderma. This study aimed to investigate the relative importance of various crop soil parameters in the adaptation of Trichoderma spp. autoclaved soils (AS) and natural soils (NS) from the Protected Geographical Indication (PGI) “Alubia La Bañeza—León” that were inoculated with Trichoderma velutinum T029 and T. harzianum T059 and incubated in a culture chamber at 25◦C for 15 days. Their development was determined by quantitative PCR. Twelve soil samples were selected and analyzed from the productive zones of Astorga, La Bañeza, La Cabrera, Esla-Campos and Páramo. Their physicochemical characteristics were different by zone, as the texture of soils ranged between sandy loam and silt loam and the pH between strongly acid and slightly alkaline, as well as the organic matter (OM) concentration between low and remarkably high. Total C and N concentrations and their ratio were between medium and high in most of the soils and the rest of the micronutrients had an acceptable concentration except for Paramo’s soil. Both Trichoderma species developed better in AS than in NS, T. velutinum T029 grew better with high levels of OM, total C, ratio C:N, P, K, Fe, and Zn than T. harzianum T059 in clay soils, with the highest values of cation exchange capacity (CEC), pH, Ca, Mg and Mn. These effects were validated by Canonical Correlation Analysis (CCA), texture, particularly clay concentration, OM, electrical conductivity (EC), and pH (physical parameters) and B and Cu (soil elements) are the main factors explaining the influence in the Trichoderma development. OM, EC, C:N ratio and Cu are the main soil characteristics that influence in T. velutinum T029 development and pH in the development of T. harzianum T059.SIThis research was funded by Junta de Castilla y León, Consejería de Educación for the project “Application of Trichoderma strains in sustainable quality bean production” (LE251P18

Comprehensive approach to people with type 2 diabetes. Diabetes Knowledge Area of the Spanish Society of Endocrinology and Nutrition

[ES] Objetivo: Proporcionar recomendaciones prácticas para el abordaje integral de las personas con diabetes tipo 2 según la medicina basada en la evidencia. Participantes: Miembros del Área de Conocimiento de Diabetes de la Sociedad Española de Endocrinología y Nutrición. Métodos: Las recomendaciones se formularon según los grados de evidencia de los Standards of Medical Care in Diabetes—2022. Tras la revisión de la evidencia disponible y la formulación de recomendaciones por los autores de cada apartado, se desarrollaron varias rondas de comentarios con incorporación de las aportaciones y votación de los puntos controvertidos. Por último, el documento final se remitió al resto de los miembros del área para revisión e incorporación de aportaciones, para, finalmente, realizar el mismo proceso con los miembros de la Junta Directiva de la Sociedad Española de Endocrinología y Nutrición. Conclusiones: El documento establece unas recomendaciones prácticas basadas en la última evidencia disponible para el manejo de las personas con diabetes tipo 2.[EN] Objective. To provide practical recommendations for the comprehensive approach of people with type 2 diabetes according to evidence-based medicine. Participants. Members of the Diabetes Knowledge Area of the Spanish Society of Endocrinology and Nutrition. Methods. The recommendations were formulated according to the degrees of evidence of the Standards of Medical Care in Diabetes—2022. After reviewing the available evidence and formulating recommendations by the authors of each section, several rounds of comments were developed incorporating the contributions and voting on controversial points. Finally, the final document was sent to the rest of the members of the area for review and incorporation of contributions, to finally carry out the same process with the members of the Spanish Society of Endocrinology and Nutrition Board of Directors. Conclusions. The document establishes practical recommendations based on the latest available evidence for the management of people with type 2 diabetes.Peer reviewe

Report from Working Group 3: Beyond the standard model physics at the HL-LHC and HE-LHC

This is the third out of five chapters of the final report [1] of the Workshop on Physics at HL-LHC, and perspectives on HE-LHC [2]. It is devoted to the study of the potential, in the search for Beyond the Standard Model (BSM) physics, of the High Luminosity (HL) phase of the LHC, defined as $3$ ab$^{-1}$ of data taken at a centre-of-mass energy of 14 TeV, and of a possible future upgrade, the High Energy (HE) LHC, defined as $15$ ab$^{-1}$ of data at a centre-of-mass energy of 27 TeV. We consider a large variety of new physics models, both in a simplified model fashion and in a more model-dependent one. A long list of contributions from the theory and experimental (ATLAS, CMS, LHCb) communities have been collected and merged together to give a complete, wide, and consistent view of future prospects for BSM physics at the considered colliders. On top of the usual standard candles, such as supersymmetric simplified models and resonances, considered for the evaluation of future collider potentials, this report contains results on dark matter and dark sectors, long lived particles, leptoquarks, sterile neutrinos, axion-like particles, heavy scalars, vector-like quarks, and more. Particular attention is placed, especially in the study of the HL-LHC prospects, to the detector upgrades, the assessment of the future systematic uncertainties, and new experimental techniques. The general conclusion is that the HL-LHC, on top of allowing to extend the present LHC mass and coupling reach by $20-50\%$ on most new physics scenarios, will also be able to constrain, and potentially discover, new physics that is presently unconstrained. Moreover, compared to the HL-LHC, the reach in most observables will, generally more than double at the HE-LHC, which may represent a good candidate future facility for a final test of TeV-scale new physics