Fulminant type 1 diabetes is defined as a subtype of type 1 diabetes with a remarkably acute onset. A nationwide survey identified that this variant accounts for approximately 20% of acute-onset type 1 diabetic patients in Japan. Recent studies indicate that this is not a minor subtype in other East ...

We present an update of knowledge on diabetes MODY (maturity onset diabetes of the young), including the recent molecular discoveries, and new diagnostic strategies. Considerable progress has been made in understanding the different molecular abnormalities that cause MODY and the phenotypic consequences resulting therefrom. MODY diabetes is very heterogeneous and ...

ABSTRACT: BACKGROUND: There has been no systematic evaluation of the association between genetic variants of type 2 receptor for TNFalpha (TNFR2) and type 2 diabetes, despite strong biological evidence for the role of this receptor in the pathogenesis of this complex disorder. In view of this, we performed a comprehensive ...

Even though autoantibodies to pancreatic islet cells are normally found in type 1 diabetes and insulin-resistance due to overweight is more reminiscent of type 2 diabetes, some studies have described β-cell antibodies also in maturity-onset diabetes of the young (MODY) and in type 2 diabetes. A 7-year-old girl was referred ...

Abstract Background: Several articles describing within-subject biological variation of fasting glucose and HbA(1c) in healthy populations have been published, but information about biological variation of glucose and HbA(1c) in patients with type 1 diabetes is scarce. It is reasonable to assume that type 1 diabetics differ from their healthy counterparts ...

The aim of this study was to evaluate the effect of diabetes on the function and distribution of vascular α(1)-adrenoceptors in the abdominal aorta and distal mesenteric artery from streptozotocin (STZ)-induced diabetic rats at the level of the α(1)-adrenoceptor subtypes. Diabetes was induced by a single intravenous injection of STZ ...

With current hypoglycemic therapies, only half of type 2 diabetes mellitus (T2DM) patients achieve optimal glycemic control and even fewer maintain it. Therefore, there is an unmet need for novel antidiabetic agents. Dapagliflozin, a selective inhibitor of sodium glucose transporter 2 (SGLT2), targets hyperglycemia independently of insulin, via decreasing renal ...

To investigate the contribution of glycosylated haemoglobin change (HbA1c) on body weight in patients with type 2 diabetes after start of insulin therapy. We analysed 122 individual weight-profiles in relation to the change in HbA1c per se in these patients up to 36 months after the start of insulin therapy. Data ...

To estimate the switching rate and to identify factors that predict switch from non-insulin to insulin therapy in patients with type 2 diabetes using routinely collected data from a clinical information system at Isfahan Endocrine and Metabolism Research Centre, Iran. During the mean (SD) follow-up period of 9.3 (3.4) years, ...

Hyperglycemia is highly prevalent in the acute-care setting and is associated with an increased risk of morbidity and mortality. Evidence suggests that glycemic control in this population is suboptimal, due in part to continued use of nonphysiologic sliding-scale insulin strategies without scheduled basal insulin doses or prandial insulin with concomitant ...

Subjects (n = 46) with type 2 diabetes who responded inadequately to two and three oral medications (HbA₁(C) > 8.0%) were consecutively recruited for treatment with premixed insulin 30/70 two times a day in order to investigate whether previous oral therapies may predict insulin requirements. In this prospective study, men ...

We conducted a study to examine the efficacy, effectiveness, and harms of pramlintide as adjunct therapy in adults and children with type 1 or type 2 diabetes. We searched multiple bibliographic databases to January 2010, the US Food and Drug Administration Web site, and other sources to identify randomized controlled ...

Alogliptin (Nesina®) is a dipeptidyl peptidase-4 inhibitor that is approved in Japan for the treatment of adult patients with type 2 diabetes mellitus that is inadequately controlled by diet and exercise alone or by diet plus treatment with an α-glucosidase inhibitor. Alogliptin plus diet and exercise is also approved in ...

Advanced glycation end products (AGEs) and their receptor (RAGE) have been shown to play a role in insulin resistance. We have previously shown that combination therapy with nateglinide (NAT) and telmisartan (TEL) improves postprandial metabolic derangements in Zucker fatty (ZF) rats, an animal model of insulin resistance with obesity. However, ...

Stress electrocardiogram(ECG)-gated single photon emission computed tomography (SPECT) imaging is highly effective in risk stratification of diabetic patients for adverse cardiac events. While patients with diabetes are predisposed to a more aggressive progression of vascular disease, the impact of its duration and type of therapy on risk stratification are unknown. ...

The effectiveness of insulin therapy to lower blood glucose levels in patients with type 2 diabetes (T2D) may depend on a variety of factors. This study aims to determine baseline parameters including body mass index (BMI) threshold that might predict responders to insulin therapy. This was a retrospective UK population-based ...

Diabetes mellitus is the most common endocrine disease in childhood. The global incidence of diabetes emphasizes the health, social and financial magnitude of this disease and the importance of optimizing disease management and prevention. This article reviews the treatments options for type 1 and 2 diabetes in children, focusing on ...

The current basal and bolus insulin pump therapy is dependent on user intervention; because of its open-loop nature, the therapy does not accommodate insulin variability and unmeasured meal disturbances. To conquer these challenges, an automatic bolus and adaptive basal (ABAB) therapy is proposed to regulate glucose levels for people with ...

This study assessed patient-reported outcomes (PRO) for patients with type 2 diabetes treated by insulin pump therapy. This 16-week, open-label, multicenter study was conducted with adults (averaging 57 years old, 50% women, 68% white non-Hispanic, with duration of diabetes of 13 years) treated at baseline with oral antidiabetes agents (OAD) ...

Scleredema diabeticorum is an uncommon condition. It is one of the cutaneous manifestations in diabetes mellitus that mainly occurs in obese middle-aged men with insulin-resistant diabetes. This condition is generally recalcitrant to therapy. Various treatments have been tried with inconsistent results. Here, we describe two cases of scleredema diabeticorum with ...

Patients with chronic hepatitis C infection are 2- to 3-fold more likely to develop type 2 diabetes, which reduces their chances of achieving a sustained virologic response (SVR). To identify differences in predictors of SVR in patients with and without diabetes who received combination antiviral therapy, we conducted a retrospective ...

To review the pharmacology, pharmacokinetics, efficacy, and safety of mitiglinide, a rapid-acting insulin secretion-stimulating agent to determine its potential role in therapy for the treatment of type 2 diabetes mellitus. A MEDLINE search (1966-May 2010) was conducted for English-language, human studies using the terms mitiglinide, KAD 1229, S 21403, and ...

Effectiveness of Sensor-Augmented Insulin-Pump Therapy in Type 1 Diabetes Original Article, N Engl J Med 2010:363;311-320. In first paragraph of the Primary and Secondary Outcomes subsection of Results (page 315), there were two instances in which the upper limit of the 95% confidence interval should have been -0.4, rather than ...

Objective: To explore the impact of race/ethnicity on the efficacy and safety of commonly used insulin regimens in patients with type 2 diabetes mellitus.Methods: In this post hoc analysis, pooled data from 11 multinational clinical trials involving 1455 patients with type 2 diabetes were used to compare specific insulin treatments ...

Glycemic variability is suggested to be a predictor for the risk of complications of diabetes. A multitude of parameters to express glycemic variability have been described, but no gold standard exists. The easy measurable parameter SD has been shown to be strongly related to other parameters in a group of ...

BACKGROUND/AIMS: Based on the results of well designed clinical studies, intensive insulin therapy has been established to improve glycemic control in newly diagnosed diabetes. However, discrepancies exist between the findings of clinical trials and experiences in general practice. Furthermore, the efficacy of an early insulin therapy (EIT) - commonly used ...

Diabetes mellitus (DM) results from defects in insulin secretion (type 1) or insulin resistance (type 2). Insulin is used to manage type 1 DM, and oral hypoglycemic agents are used to manage type 2 DM. These therapies are inconsistent in maintaining glycemic control and cause some severe adverse effects such ...

The objective of this research is to gain a greater understanding of the cause of fasting and postprandial hyperglycemia in people with type 2 diabetes. Endogenous glucose production is excessive before eating and fails to appropriately suppress after eating in people with type 2 diabetes. This is due in part ...

Type 2 diabetes usually occurs in the context of obesity and associated insulin resistance. Current treatment recommendations are based on lifestyle modifications and incremental drug therapy. However, this approach could lead to inappropriate priorities upon ageing, when diabetes may be compounded by malnutrition and reduced insulin resistance. We prospectively evaluated ...

Many patients with type 2 diabetes need to progress to insulin use when oral glucose lowering therapies fail to maintain adequate glycaemic control. To suggest when and how to initiate insulin therapy for patients with type 2 diabetes in the primary care setting. In general, initiation of insulin should be ...

HISTORY, ADMISSION FINDINGS AND TREATMENT: In a 35-year-old pregnant woman (pat. 1) with type 1 diabetes, insulin pump therapy was initiated because of very fluctuating blood glucose levels with severe hypoglycaemias and worsening hypoglycaemia unawareness during pregnancy. In a 45-year-old female (pat. 2) with type 1 diabetes, severe hypoglycemia with ...

BACKGROUND: This study assessed insulin dose and dosing patterns required to optimize glycemic control with an insulin pump in patients with type 2 diabetes. METHODS: In this 16-week, open-label, multicenter, pilot study, 56 insulin pump-naive patients treated at baseline with two or more oral antidiabetes agents (OADs), basal insulin with ...

Intensive insulin therapy in type 1 diabetes is based on the well-established practice of adjusting basal and bolus insulin independently. Basal insulin delivery is designed to optimize glucose concentrations between meals and overnight, while bolus insulin delivery is designed to optimize postprandial glucose concentrations. However, this strategy shows some limitations ...

Postprandial metabolic derangements are one of the risk factors of cardiovascular disease in humans. Insulin resistance and/or impaired early-phase insulin secretion are major determinants of postprandial metabolic derangements. In this study, we investigated the potential utility of combination therapy with vildagliptin, a dipeptidyl peptidase IV (DPP-IV) inhibitor and nateglinide, a ...

Choreoathetosis is a rare neurologic complication of the diabetic disease. The purpose of this case report is to increase the knowledge of such occurrence by describing the case of an elderly woman who was admitted to our institution for an over 20-day history of choreic movement in the left side ...

This pedagogical review illustrates the differences between pharmacokinetic (PK) and pharmacodynamic (PD) measures, using insulin therapy as the primary example. The main conclusion is that PD parameters are of greater clinical significance for insulin therapy than PK parameters. The glucose-clamp technique, the optimal method for determining insulin PD, is explained ...

BACKGROUND: Emerging technology, such as an artificial pancreatic beta-cell, is not likely to be affordable to people who live in developing nations in the next 20-30 years. However, multiple-daily injection (MDI) therapy can be improved using similar advanced control algorithms designed for continuous glucose monitoring and continuous insulin infusion pumps. ...

The following illustrative case presentation was introduced by Jeffrey S. Freeman, DO, at the symposium titled "Incretin-Based Therapies: Bridging the Gap Between Clinical Experiences and Emerging Applications in Type 2 Diabetes." The program was conducted Thursday, November 5, 2009, at the American Osteopathic Association's 114th Annual Osteopathic Medical Conference and ...

OBJECTIVE: This report illustrates the treatment progression of a patient with rapidly decompensating type 2 diabetes. METHODS: The patient had to transition to insulin therapy within 2 years of her initial diagnosis, following only a brief period of glycemic control with diet management, weight loss, and oral agents. This relatively ...

Nadeau DA. Partnering with patients to improve therapeutic outcomes: incretin-based therapy for type 2 diabetes. Postgrad Med. 2010;122(3):7-15.

OBJECTIVES: To identify predictors of nonadherence to angiotensin-converting enzyme inhibitors (ACEIs) and/or angiotensin II receptor blockers (ARBs) and to assess the association between nonadherence to ACEIs/ARBs and potentially avoidable hospitalizations (PAHs) among elderly high-risk patients with diabetes. METHODS: Medicare Part D enrollees from six states who had diabetes and coexisting ...

This report highlights a roundtable discussion that occurred during the annual meeting of the International Diabetes Federation (IDF) in November 2009, in Montreal, Quebec, Canada. Participants included Bernard Zinman, MD, Michael A. Nauck, MD, PhD, Jorge Plutzky, MD, and Allison B. Goldfine, MD. The roundtable was chaired by Vivian A. ...

A total of 856 diabetic patients were evaluated for pharmacotherapy-based problems like for possible drug interactions, adverse drug reactions, and other mismatches, if any. Poor correlation between the advised insulin therapy and patients' fasting blood glucose levels (12%, n=103) was observed. To most of the patients (41.66%, n= 357), insulin ...

Recently developed technologies for the treatment of type 1 diabetes mellitus include a variety of pumps and pumps with glucose sensors. In this 1-year, multicenter, randomized, controlled trial, we compared the efficacy of sensor-augmented pump therapy (pump therapy) with that of a regimen of multiple daily insulin injections (injection therapy) ...

We describe the case of a 66-year-old man with chronic hepatitis C who developed type 1 diabetes mellitus (T1DM) and thyroid autoimmunity during Interferon alpha (INFalpha) therapy and then stiff-person syndrome (SPS). This is the first reported case in which SPS has appeared as complication of IFNalpha therapy.

Oral insulin therapy has great potential benefits over conventional therapy for diabetic patients as well as mimicking the physiological fate of insulin. Here we evaluated the characteristics of insulin and deoxycholate-based synthetic N(alpha)-deoxycholyl-L-lysyl-methylester (DCK) complex, and diabetes correction in pancreatectomized canines after oral administration. After the insulin/DCK complexation was made, ...

There is a growing body of evidence to suggest that the autoimmunity observed in type 1 diabetes mellitus (T1DM) is the result of an imbalance between autoaggressive and regulatory cell subsets. Therapeutics that supplement or enhance the existing regulatory subset are therefore a much sought after goal in this indication. ...

Although European groups have initiated innovative clinical research in the field of insulin pump therapy, insulin pump use remains currently limited in many European countries, and well behind that in the United States. The main reason is the late approval of cost coverage by most national healthcare insurance systems, which ...

The increasing prevalence of diabetes among elderly patients underscores the importance of matching the most effective therapy for diabetes self-management with patients' cognitive and motor skills, as these diminish with advancing age. Although many geriatric patients state interest in insulin pump therapy for tight glycemic control, few studies have examined ...

The use of insulin pump therapy (continuous subcutaneous insulin infusion) has increased dramatically in youth with type 1 diabetes (T1D) in the past decade. In this review we provide background and practical clinical advice on insulin basal rates and bolus doses and on the advantages of pump therapy with exercise. ...