共查询到20条相似文献,搜索用时 0 毫秒
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Simon Heller MD Tadej Battelino MD Timothy S. Bailey MD Thomas R. Pieber MD Ulrike Hövelmann MD Leona Plum-Mörschel MD Anita E. Melgaard MSc Ronnie Aronson MD Linda A. DiMeglio MD Thue Johansen MD Thomas Danne MD 《Diabetes, obesity & metabolism》2023,25(5):1351-1360
Aims
To perform an integrated analysis of the safety and efficacy of dasiglucagon, a glucagon analogue available in a ready-to-use aqueous formulation, to treat severe hypoglycaemia (SH) in type 1 diabetes (T1D).Materials and Methods
An integrated analysis of dasiglucagon safety was conducted on data from two placebo-controlled trials (placebo-controlled pool) and two placebo-controlled and four non-placebo-controlled trials (broad pool) in adults with T1D. An integrated analysis of dasiglucagon efficacy was conducted of pooled data and within demographic subgroups from the two placebo-controlled and two non-placebo-controlled trials in adults with T1D.Results
Dasiglucagon had a similar safety and tolerability profile to that of reconstituted glucagon. In the placebo-controlled datasets, no serious adverse events (AEs), AEs leading to withdrawal from the trial, or deaths were reported. The most common causally related AEs were nausea (56.5%) and vomiting (24.6%). The broad pool safety analysis showed similar results. Dasiglucagon efficacy in time to plasma glucose recovery from insulin-induced SH was similar to that of reconstituted glucagon (median 10.0 and 12.0 minutes, respectively) and superior to placebo (median 40.0 minutes; P < 0.0001). The median recovery time was consistent across all placebo-controlled trial subgroups.Conclusions
Dasiglucagon was well tolerated and effective as a rapid rescue agent for insulin-induced SH in people with T1D. 相似文献2.
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Vivian T. Thieu PhD Beth D. Mitchell MPH Oralee J. Varnado PhD Brian M. Frier MD 《Diabetes, obesity & metabolism》2020,22(4):469-479
Some therapies for diabetes increase the risk of hypoglycaemia, in particular all insulins and insulin secretagogues, including the glinides and sulfonylureas. Hypoglycaemia remains a major limiting factor to successful glycaemic management, despite the availability of prevention options such as insulin analogues, continuous glucose monitoring, insulin pumps, and dogs that have been trained to detect hypoglycaemia. Non-severe (self-treated) and severe (requiring assistance for recovery) hypoglycaemia rates are higher in people with type 1 diabetes, but those with insulin-treated type 2 diabetes are also at risk. Education and regular review are essential between people with diabetes and their caregivers and healthcare professionals about symptoms, prevention and treatment. Awareness of the potential dangers of hypoglycaemia is fundamental to the optimal management of diabetes. When therapy is intensified to achieve glycaemic targets, it is important that people at risk of severe hypoglycaemia, and particularly their caregivers, have ready access to effective treatment for hypoglycaemia emergencies. The current and potential formulations of glucagon available for treatment of severe hypoglycaemia are reviewed. 相似文献
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Aims Impaired awareness of hypoglycaemia (IAH) is thought to affect approximately 25% of people with Type 1 diabetes. While this estimate was based on retrospective information from patients in several small studies performed several years ago, validated methods of assessment have not been used in a large hospital clinic-based population to ascertain the prevalence in the present era. Methods Five hundred and eighteen people with Type 1 diabetes were recruited by random selection over a 2-year period. Participants completed a questionnaire documenting baseline characteristics and assessment of their awareness status using the method described by Gold et al. The number of episodes of severe hypoglycaemia they had experienced in the preceding year was recorded retrospectively. Results IAH was present in 19.5% of the cohort. Compared to those with normal awareness of hypoglycaemia, those with IAH were significantly older [mean ± standard deviation (sd ); 39.3 ± 12.9 vs. 45.9 ± 13.5 years, P < 0.001], had a longer duration of diabetes [median (interquartile range) 14 (8–22) vs. 23 (14–32) years, P < 0.001], and had a six-fold higher frequency of severe hypoglycaemia in the previous year [0.38 ± 1.04 (25th–75th centile 0–0) vs. 2.36 ± 4.81 (25th–75th centile 0–2) episodes per person, P < 0.001]. Conclusions The present survey of a large hospital-based clinic population has confirmed that a significant proportion of people with Type 1 diabetes (19.5%) continue to have IAH. Despite improvements in insulin therapies, intensification of insulin regimens and innovative patient education, the prevalence of IAH remains high in Type 1 diabetes. 相似文献
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Christian Laugesen MD Signe Schmidt MD Jens Juul Holst MD Kirsten Nørgaard MD Ajenthen G. Ranjan MD 《Diabetes, obesity & metabolism》2021,23(4):1057-1062
Identifying determinants of low-dose glucagon efficacy is important to optimise its utilization for prevention and treatment of hypoglycaemia in individuals with type 1 diabetes. The study objective was to investigate whether the preceding glucose decline rate affects glucose response to low-dose glucagon administration. Ten adults with insulin pump-treated type 1 diabetes were included in this randomized, single-blind, two-way crossover study. Using a hyperinsulinaemic clamp technique, plasma glucose levels were reduced with either a rapid or slow decline rate while maintaining fixed insulin levels. When the plasma glucose level reached 3.9 mmoL/L, insulin and glucose infusions were discontinued and 150 μg subcutaneous glucagon was administered, followed by 120 minutes of plasma glucose monitoring. The positive incremental area under the glucose curve after administration of low-dose glucagon did not differ between the rapid-decline and slow-decline visits (mean ± SEM: 220 ± 49 vs. 174 ± 31 mmoL/L x min; P = 0.21). Similarly, no differences in total area under the glucose curve, peak plasma glucose, incremental peak plasma glucose, time-to-peak plasma glucose or end plasma glucose were observed. Thus, preceding glucose decline rate did not significantly affect the glucose response to low-dose glucagon. 相似文献
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Summary The aim of the present study was to compare intranasal glucagon with subcutaneous glucagon as a treatment of insulin-induced
hypoglycaemia in 11 children, 7–12 years old, with Type 1 (insulin-dependent) diabetes mellitus. Hypoglycaemia (1.6±0.1 vs
1.8±0.2 mmol/l) was induced twice in each child by continuous insulin and variable glucose infusions. One milligram of intranasal
glucagon or 0.5 mg of subcutaneous glucagon was given in a randomized order. At 15 min after the administrations of either
intranasal or subcutaneous glucagon, the blood glucose concentration increased by 1.5±0.2 mmol/l or 1.7±0.2 mmol/l above the
glucose nadir, respectively. After nasal administration, the maximal rise in blood glucose was seen after 25 min. Subcutaneous
injections induced higher and more sustained plasma glucagon concentrations but the children suffered more often from nausea
than when they were treated intranasally. In conclusion, treatment with intranasal glucagon seems to be efficient and results
in a rapid correction of insulin-induced hypoglycaemia with few side-effects. 相似文献
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Namam Ali MD Anna W. M. Janssen MD Martin Jaeger PhD Lisa Van de Wijer MSc Wouter van der Heijden MSc Rob ter Horst MSc Priya Vart PhD Alain van Gool PhD Leo A. B. Joosten PhD Mihai G. Netea MD Rinke Stienstra PhD Bastiaan E. De Galan MD Cees J. Tack MD 《Diabetes, obesity & metabolism》2020,22(12):2427-2436
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Liraglutide as adjunct to insulin treatment in type 1 diabetes does not interfere with glycaemic recovery or gastric emptying rate during hypoglycaemia: A randomized,placebo‐controlled,double‐blind,parallel‐group study 下载免费PDF全文
Christian S. Frandsen PhD MD Thomas F. Dejgaard MD Henrik U. Andersen DMSc Jens J. Holst DMSc Bolette Hartmann PhD Birger Thorsteinsson DMSc Sten Madsbad DMSc 《Diabetes, obesity & metabolism》2017,19(6):773-782
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Non‐severe hypoglycaemia is associated with weight gain in patients with type 1 diabetes: Results from the Diabetes Control and Complication Trial 下载免费PDF全文
Anisoara Bumbu MD Abdul Moutairou MSc Odette Matar MD Frédéric Fumeron PhD Gilberto Velho PhD Jean‐Pierre Riveline MD Jean‐François Gautier MD Michel Marre MD Ronan Roussel MD Louis Potier MD 《Diabetes, obesity & metabolism》2018,20(5):1289-1292
It is unclear whether the frequent non‐severe episodes of hypoglycaemia observed during intensive glucose control in individuals with type 1 diabetes (T1D) are associated with subsequent weight gain. We analysed the association between non‐severe hypoglycaemia and weight gain in 1441 Diabetes Control and Complication Trial (DCCT) participants. Non‐severe hypoglycaemia was assessed by hypo‐score (ie, number of blood glucose values <70 mg/dL divided by the total number of measurements during the DCCT quarterly visits). Significant associations were observed between the hypo‐score and annual and total weight gain. The annual weight gain by hypo‐score tertiles was 0.8 ± 1.2 (T1), 1.3 ± 1.5 (T2) and 1.4 ± 1.3 kg/y (T3), P < .001 for T2 and T3 vs T1, and for T3 vs T2. The odds ratio for a weight gain of 1.8 kg/y was 2.14 (95% CI, 1.56‐2.93) for T2, and 2.53 (95%CI, 1.85‐3.45) for T3 vs T1. These differences in weight gain and in risk of weight gain remained significant after adjustment for sex, age, duration of diabetes, HbA1c at baseline and treatment arms. In conclusion, our analysis shows a significant association between non‐severe hypoglycaemia and weight gain in individuals with T1D from the DCCT. 相似文献
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Othmar Moser PhD James Rafferty Max L. Eckstein Faisal Aziz Stephen C. Bain Richard Bergenstal Harald Sourij Rebecca L. Thomas 《Diabetes, obesity & metabolism》2023,25(8):2243-2254