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Projected long‐term outcomes in patients with type 1 diabetes treated with fast‐acting insulin aspart vs conventional insulin aspart in the UK setting 下载免费PDF全文
David Russell‐Jones MD Simon R. Heller MD Sarah Buchs MSc Anna Sandberg MSc William J. Valentine PhD Barnaby Hunt MSc 《Diabetes, obesity & metabolism》2017,19(12):1773-1780
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Use and effectiveness of a fixed‐ratio combination of insulin degludec/liraglutide (IDegLira) in a real‐world population with type 2 diabetes: Results from a European,multicentre, retrospective chart review study 下载免费PDF全文
Hermione Price MBChB Matthias Blüher MD Rudolf Prager MD Tra‐Mi Phan MD Brian L. Thorsted MSc Bernd Schultes MD for the EXTRA study group 《Diabetes, obesity & metabolism》2018,20(4):954-962
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Rates of hypoglycaemia are lower in patients treated with insulin degludec/liraglutide (IDegLira) than with IDeg or insulin glargine,regardless of the hypoglycaemia definition used 下载免费PDF全文
Paul Norwood MD FACE Roger Chen MB BS PhD FRACP Elmar Jaeckel MD Ildiko Lingvay MD MPH MSCS Henrik Jarlov MD Lucine Lehmann MD Simon Heller MD FRCP 《Diabetes, obesity & metabolism》2017,19(11):1562-1569
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Switching from sitagliptin to liraglutide to manage patients with type 2 diabetes in the UK: A long‐term cost‐effectiveness analysis 下载免费PDF全文
Anthony H. Barnett MD Simon Arnoldini PhD Barnaby Hunt MSc Gowri Subramanian MBChB Christina Stentoft Hoxer BSc 《Diabetes, obesity & metabolism》2018,20(8):1921-1927
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Impact of baseline glycated haemoglobin,diabetes duration and body mass index on clinical outcomes in the LixiLan‐O trial testing a titratable fixed‐ratio combination of insulin glargine/lixisenatide (iGlarLixi) vs insulin glargine and lixisenatide monocomponents 下载免费PDF全文
Melanie J. Davies MD Lawrence A. Leiter MD Bruno Guerci MD George Grunberger MD F. Javier Ampudia‐Blasco MD Christine Yu MD William Stager PhD Elisabeth Niemoeller MD Elisabeth Souhami MD Julio Rosenstock MD 《Diabetes, obesity & metabolism》2017,19(12):1798-1804
To determine whether baseline characteristics had an impact on clinical outcomes in the LixiLan‐O trial (N = 1170), we compared the efficacy and safety of iGlarLixi, a titratable fixed‐ratio combination of insulin glargine 100 U (iGlar) and lixisenatide (Lixi) with iGlar or Lixi alone in patients with uncontrolled type 2 diabetes mellitus (T2DM) on oral therapy. Subgroups according to baseline glycated haemoglobin (HbA1c; <8% or ≥8% [<64 or ≥64 mmol/mol]), T2DM disease duration (<7 or ≥7 years) and body mass index (BMI; <30 or ≥30 kg/m2) were investigated. In all subpopulations, iGlarLixi was consistently statistically superior to iGlar and Lixi alone in reducing HbA1c from baseline to week 30; higher proportions of patients achieved HbA1c <7% (<53 mmol/mol) with iGlarLixi vs iGlar and Lixi alone. Compared with iGlar, iGlarLixi resulted in a substantial decrease in 2‐hour postprandial plasma glucose levels, and mitigation of weight gain, with no differences among subpopulations in incidence of symptomatic hypoglycaemia. iGlarLixi consistently improved glycaemic control compared with iGlar and Lixi alone, without weight gain or increase in hypoglycaemic risk compared with iGlar in the subpopulations tested, regardless of baseline HbA1c, disease duration and BMI. 相似文献
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Consistent findings in glycaemic control,body weight and hypoglycaemia with iGlarLixi (insulin glargine/lixisenatide titratable fixed‐ratio combination) vs insulin glargine across baseline HbA1c,BMI and diabetes duration categories in the LixiLan‐L trial 下载免费PDF全文
Carol Wysham MD Riccardo C. Bonadonna MD Vanita R. Aroda MD Manuel Puig Domingo MD PhD Christoph Kapitza MD William Stager PhD Christine Yu MD Elisabeth Niemoeller MD Elisabeth Souhami MD Richard M. Bergenstal MD 《Diabetes, obesity & metabolism》2017,19(10):1408-1415
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I. B. Hirsch J. B. Buse J. Leahy J. B. McGill A. Peters H. W. Rodbard J. S. Skyler C. A. Verderese M. C. Riddle 《Diabetes, obesity & metabolism》2014,16(3):206-214
Integrating patient‐centered diabetes care and algorithmic medicine poses particular challenges when optimized basal insulin fails to maintain glycaemic control in patients with type 2 diabetes. Multiple entwined physiological, psychosocial and systems barriers to insulin adherence are not easily studied and are not adequately considered in most treatment algorithms. Moreover, the limited number of alternatives to add‐on prandial insulin therapy has hindered shared decision‐making, a central feature of patient‐centered care. This article considers how the addition of a glucagon‐like peptide 1 (GLP‐1) analogue to basal insulin may provide new opportunities at this stage of treatment, especially for patients concerned about weight gain and risk of hypoglycaemia. A flexible framework for patient–clinician discussions is presented to encourage development of decision‐support tools applicable to both specialty and primary care practice. 相似文献
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More patients reach glycaemic control with a fixed‐ratio combination of insulin glargine and lixisenatide (iGlarLixi) than with basal insulin at 12 weeks of treatment: A post hoc time‐to‐control analysis of LixiLan‐O and LixiLan‐L 下载免费PDF全文
Juan Frias MD Manuel Puig Domingo MD Luigi Meneghini MD Raffaele Napoli MD Minzhi Liu PhD Erika Soltes Rak PhD Vanita R. Aroda MD 《Diabetes, obesity & metabolism》2018,20(9):2314-2318
The present post hoc analysis of two 30‐week clinical trials compared efficacy and hypoglycaemia outcomes at early study visits with iGlarLixi (insulin glargine U100 [iGlar] and lixisenatide) vs iGlar alone in patients with type 2 diabetes (T2D) uncontrolled on oral antidiabetic drugs (OADs; LixiLan‐O trial) or basal insulin (LixiLan‐L trial). Time to control, defined as days to achieve glycated haemoglobin (HbA1c) <53 mmol/mol (<7%) or fasting plasma glucose (FPG) ≤7.2 mmol/L, was estimated using the Kaplan–Meier method. In the LixiLan‐O and LixiLan‐L trials, 60% and 46% of patients, respectively, reached HbA1c <53 mmol/mol (<7%) with iGlarLixi at 12 weeks, vs 45% and 24%, respectively, with iGlar. In the LixiLan‐O trial, the median time to target HbA1c was approximately half with iGlarLixi vs iGlar (85.0 vs 166.0 days; P < .0001). In the LixiLan‐L trial, the median time to target HbA1c was 153.0 days with iGlarLixi, while target HbA1c was never reached by 50% of patients with iGlar (P < .0001). Time‐to‐target FPG and hypoglycaemia outcomes were similar between treatments. In T2D uncontrolled on OADs or basal insulin, iGlarLixi resulted in glycaemic control in more patients than did iGlar at early treatment time points. 相似文献
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C. Pratoomsoot H. T. Smith A. Kalsekar K. S. Boye J. Arellano W. J. Valentine 《Diabetic medicine》2009,26(8):803-814
Aims To determine the long‐term health economic benefits associated with lispro vs. regular human insulin (RHI) in UK Type 1 diabetic (T1DM) patients using the previously published and validated CORE Diabetes Model. Methods A literature review designed to capture clinical benefits associated with lispro and T1DM cohort characteristics specific to UK was undertaken. Clinical benefits were derived from a Cochrane meta‐analysis. The estimated difference (weighted mean) in glycated haemoglobin (HbA1c) was ?0.1% (95% confidence interval ?0.2 to 0.0%) for lispro vs. RHI. Severe hypoglycaemia rates for lispro and RHI were 21.8 and 46.1 events per 100 patient years, respectively. Costs and disutilities were accounted for severe hypoglycaemia rates. All costs were accounted in 2007 £UK from a National Health Service (NHS) perspective. Future costs and clinical benefits were discounted at 3.5% annually. Results In the base‐case analysis, lispro was projected to be dominant compared with RHI. Lispro was associated with improvements in quality‐adjusted life expectancy (QALE) of approximately 0.10 quality‐adjusted life years (QALYs) vs. RHI (7.60 vs. 7.50 QALYs). Lifetime direct medical costs per patient were lower with lispro treatment, £70 576 vs. £72 529. Severe hypoglycaemia rates were the key driver in terms of differences in QALE and lifetime costs. Sensitivity analyses with assumptions around time horizon, discounting rates and benefits in terms of glycaemic control or hypoglycaemic event rates revealed that lispro remained dominant. Conclusions Our findings suggest that lispro is likely to improve QALE, reduce frequency of diabetes‐related complications and lifetime medical costs compared with RHI. 相似文献
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Julie Maria Bøggild Brøsen MD Rikke Mette Agesen PhD Peter Lommer Kristensen PhD Amra Ciric Alibegovic PhD Henrik Ullits Andersen DMSc Henning Beck-Nielsen DMSc Peter Gustenhoff MD Troels Krarup Hansen DMSc Christoffer Hedetoft PhD Tonny Jensen DMSc Charlotte Røn Stolberg PhD Claus Bogh Juhl DMSc Susanne Søgaard Lerche PhD Kirsten Nørgaard DMSc Hans-Henrik Parving DMSc Lise Tarnow DMSc Birger Thorsteinsson DMSc Ulrik Pedersen-Bjergaard DMSc 《Diabetes, obesity & metabolism》2023,25(6):1557-1565
Aim
To compare nocturnal glucose profiles according to hourly plasma glucose measurements during treatment with insulin degludec and insulin glargine U100 in a cohort of people with type 1 diabetes prone to nocturnal severe hypoglycaemia.Materials and methods
The HypoDeg trial is a 2-year investigator-initiated, randomized, controlled crossover trial in 149 participants randomized to treatment with insulin degludec and insulin glargine U100 for 12 months each. The 51 participants in this predefined substudy stayed at least one night in hospital during each treatment arm for plasma glucose samples to be taken. Endpoints were glucose profiles, including mean plasma glucose, glycaemic variability and risk of hypoglycaemia.Results
There were no differences between treatments regarding mean plasma glucose. We saw a flatter glucose profile during insulin degludec compared with insulin glargine U100 treatment, which had a nadir at 4:00 AM, with a subsequent rise. During treatment with insulin degludec, the participants had lower glycaemic variability, with an estimated treatment difference of −4.3% (95% confidence interval [CI] −8.1 to −0.5; P < 0.05). Participants treated with insulin degludec were less likely to experience nocturnal hypoglycaemia below 3.0 mmol/L (hazard ratio 0.36 [95% CI 0.17-0.73; P < 0.05]).Conclusion
Based on nocturnal plasma glucose measurements, treatment with insulin degludec compared with insulin glargine U100 administered in the evening results in lower glycaemic variability and lower risk of nocturnal hypoglycaemia without differences in mean plasma glucose. 相似文献17.
Richard E. Pratley MD Scott S. Emerson MD Edward Franek MD Matthew P. Gilbert DO Steven P. Marso MD Darren K. McGuire MD Thomas R. Pieber MD Bernard Zinman MD Charlotte T. Hansen MD Melissa V. Hansen MD Thomas Mark PhD Alan C. Moses MD John B. Buse MD 《Diabetes, obesity & metabolism》2019,21(7):1625-1633
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Comparison of insulin degludec with insulin detemir in type 1 diabetes: a 1‐year treat‐to‐target trial 下载免费PDF全文
M. Davies T. Sasaki J. L. Gross G. Bantwal Y. Ono T. Nishida D. Tojjar H. Seino 《Diabetes, obesity & metabolism》2016,18(1):96-99
The long‐term safety and tolerability of insulin degludec (IDeg) was compared with that of insulin detemir (IDet), as basal treatment in participants with type 1 diabetes mellitus (T1DM). In the present multinational, 26‐week core + 26‐week extension, controlled, open‐label, parallel‐group trial, adults with T1DM were randomized to IDeg or IDet as basal insulin treatment combined with meal‐time bolus insulin aspart. IDeg was administered once daily, whilst IDet was administered once or twice daily depending on patients' glycaemic control. After 1 year, IDeg provided a 33% lower rate of nocturnal hypoglycaemia compared with IDet: estimated rate ratio (IDeg : IDet) 0.67 [95% confidence interval (CI) 0.51; 0.88]; p < 0.05. IDeg improved glycated haemoglobin after 1 year of treatment, similarly to IDet, but IDeg also provided a significantly greater reduction in fasting plasma glucose compared with IDet: estimated difference (IDeg ? IDet) ?1.11 (95% CI ?1.83; ?0.40) mmol/l; p < 0.05. The present study confirmed the long‐term safety and tolerability profile of IDeg in patients with T1DM. IDeg provided a lower risk of nocturnal confirmed hypoglycaemia than IDet. 相似文献
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Free and fixed‐ratio combinations of basal insulin and GLP‐1 receptor agonists versus basal insulin intensification in type 2 diabetes: A systematic review and meta‐analysis of randomized controlled trials 下载免费PDF全文
Maria Ida Maiorino PhD Paolo Chiodini Msc Giuseppe Bellastella PhD Lorenzo Scappaticcio MD Miriam Longo MD Katherine Esposito PhD Dario Giugliano PhD 《Diabetes, obesity & metabolism》2018,20(9):2309-2313
A meta‐analysis is presented of randomized controlled trials (RCTs) comparing free or fixed combinations of a glucagon‐like peptide‐1 receptor agonist plus basal insulin versus insulin intensification on metabolic control in patients with type 2 diabetes. Electronic databases were searched for RCTs assessing changes in HbA1c, proportion of patients at HbA1c target of <7% (53 mmol/mol), hypoglycaemia and body weight. A random‐effect model was used to calculate the weighted mean difference (WMD) or relative risk (RR) with 95% CI. Eleven RCTs were identified, lasting 24–30 weeks and involving 6176 patients. In the overall analysis, the combination therapy led to a mean HbA1c decrease significantly greater than insulin up‐titration (WMD ?0.53%, 95% CI, ?0.66, ?0.40%, P < 0.001), more patients at HbA1c target (RR 1.69, 95% CI, 1.42, 2.00, P < 0.001), similar hypoglycaemic events (RR 0.97, 95% CI, 0.84, 1.12, P = 0.114), and reduction in body weight (WMD ?1.9, 95% CI ?2.3, ?1.4, P < 0.001), with heterogeneity (I2 > 71%, P < 0.001). Results did not differ in either the free or fixed combination subgroups. Combination strategies, either free or fixed, represent a good option for intensifying basal insulin therapy in patients with type 2 diabetes who need amelioration of glycaemic control. 相似文献