Incidence of hypoglycaemia in the South African population with diabetes: Results from the IDMPS Wave 7 study

Objectives: Management of diabetes is a balancing act of preventing a state of hyperglycaemia while avoiding episodes of hypoglycaemia. Limited information is currently available on the incidence of hypoglycaemia in South African people diagnosed with diabetes. Data regarding the management of diabetes and incidence of hypoglycaemia in the South African population was collected as part of Wave 7 of the International Diabetes Management Practices Study (IDMPS).Design and methods: During this observational study the first 10 adult individuals with type 2 diabetes and the first five adult individuals with type 1 diabetes presenting to a study site during the two-week study period were enrolled.Setting: Patients were enrolled from the private healthcare sector in South Africa only.Subjects: A total of 445 individuals (49 diagnosed with T1D, 396 diagnosed with T2D) were included.Outcome measures: Glycated haemoglobin and hypoglycaemia data were recorded for each patient.Results: Of the patients who reported experiencing hypoglycaemia, 48.6% (17/35) among T1D individuals and 67.8% (40/71) among T2D individuals experienced hypoglycaemia over a four-week period. Furthermore, in patients who discontinued insulin treatment (n = 11), fear of hypoglycaemia was reported to influence adherence to insulin treatment by 27.3% in T1D and T2D individuals. Of the 148 patients not achieving their HbA1c target, 23.0% reported fear of hypoglycaemia as a reason.Conclusions: This report demonstrates the need to address hypoglycaemia and fear of hypoglycaemia in the South African diabetes population

Taxonomy of prokaryotic viruses : 2017 update from the ICTV Bacterial and Archaeal Viruses Subcommittee

Peer reviewe

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Corticolimbic changes in acetylcholine and cyclic guanosine monophosphate in the Flinders Sensitive Line rat: a genetic model of depression

Objective: Depression is suggested to involve disturbances in cholinergic as well as glutamatergic pathways, particularly the N-methyl-d-aspartate receptor-mediated release of nitric oxide (NO) and cyclic guanosine monophosphate (cGMP). The aim of this study was to determine whether the Flinders Sensitive Line (FSL) rat, a genetic model of depression, presents with corticolimbic changes in basal acetylcholine (ACh) levels and NO/cGMP signalling. Methods: Basal levels of nitrogen oxides (NOx) and both basal and l-arginine-stimulated nitric oxide synthase (NOS) formation of l-citrulline were analysed in hippocampus and frontal cortex in FSL and control Flinders resistant line (FRL) rats by fluorometric and electrochemical high-performance liquid chromatography, respectively. In addition, ACh and cGMP levels were analysed by liquid chromatography tandem mass spectrometry and radioimmunoassay, respectively. Results: Significantly elevated frontal cortical but reduced hippocampal ACh levels were observed in FSL versus FRL rats. Basal cGMP levels were significantly reduced in the frontal cortex, but not hippocampus, of FSL rats without changes in NOx and l-citrulline, suggesting that the reduction of cGMP follows through an NOS-independent mechanism. Conclusions: These data confirm a bidirectional change in ACh in the frontal cortex and hippocampus of the FSL rat, as well as provide evidence for a frontal cortical ACh-cGMP interaction in the depressive-like behaviour of the FSL rat

SMAP Handbook–Soil Moisture Active Passive: Mapping Soil Moisture and Freeze/Thaw from Space

nrpages: 182status: publishe

Whole Earth Telescope observations of BPM 37093 : a seismological test of crystallization theory in white dwarfs

BPM 37093 is the only hydrogen-atmosphere white dwarf currently known which has sufficient mass (~1.1 Mʘ) to theoretically crystallize while still inside the ZZ Ceti instability strip (Teff ~ 12 000 K). As a consequence, this star represents our first opportunity to test crystallization theory directly. If the core is substantially crystallized, then the inner boundary for each pulsation mode will be located at the top of the solid core rather than at the center of the star, affecting mainly the average period spacing. This is distinct from the “mode trapping” caused by the stratified surface layers, which modifies the pulsation periods more selectively. In this paper we report on Whole Earth Telescope observations of BPM 37093 obtained in 1998 and 1999. Based on a simple analysis of the average period spacing we conclude that a large fraction of the total stellar mass is likely to be crystallized

Whole Earth Telescope observations of BPM 37093 : a seismological test of crystallization theory in white dwarfs

BPM 37093 is the only hydrogen-atmosphere white dwarf currently known which has sufficient mass (~1.1 Mʘ) to theoretically crystallize while still inside the ZZ Ceti instability strip (Teff ~ 12 000 K). As a consequence, this star represents our first opportunity to test crystallization theory directly. If the core is substantially crystallized, then the inner boundary for each pulsation mode will be located at the top of the solid core rather than at the center of the star, affecting mainly the average period spacing. This is distinct from the “mode trapping” caused by the stratified surface layers, which modifies the pulsation periods more selectively. In this paper we report on Whole Earth Telescope observations of BPM 37093 obtained in 1998 and 1999. Based on a simple analysis of the average period spacing we conclude that a large fraction of the total stellar mass is likely to be crystallized