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38 results on '"Diabetes Mellitus/drug therapy"'

1. Risk of diabetes and the impact on preexisting diabetes in patients with lymphoma treated with steroid-containing immunochemotherapy

Author: Joachim Baech, Marianne Tang Severinsen, Andreas K. Øvlisen, Henrik Frederiksen, Peter Vestergaard, Christian Torp-Pedersen, Judit Jørgensen, Michael Roost Clausen, Christian B. Poulsen, Peter Brown, Anne Ortved Gang, Robert Schou Pedersen, Karin Ekström Smedby, Sandra Eloranta, Lasse Hjort Jakobsen, and Tarec Christoffer El-Galaly
Subjects: Lymphoma, Non-Hodgkin, Prednisone/adverse effects, Insulins, Hematology, Diabetes Mellitus/drug therapy, Insulins/therapeutic use, Cohort Studies, Cardiovascular Diseases, hemic and lymphatic diseases, Diabetes Mellitus, Prednisone, Humans, Cardiovascular Diseases/etiology, Lymphoma, Non-Hodgkin/complications
Abstract: First-line treatments for lymphomas often include high doses of prednisolone, but the risks of new-onset diabetes mellitus (DM) or worsening of preexisting DM following treatment with cyclic high dose corticosteroids is unknown. This cohort study matched non-Hodgkin lymphoma (NHL) patients treated with steroid-containing immunochemotherapy (ie, R-CHOP[-like] and R-CVP) between 2002 and 2015 to individuals from the Danish population to investigate the risks of new-onset DM. For patients with preexisting DM, the risks of insulin dependency and anthracycline-associated cardiovascular diseases (CVDs) were assessed. In total, 5672 NHL patients and 28 360 matched comparators were included. Time-varying incidence rate ratios (IRRs) showed increased risk of DM in the first year after treatment compared with matched comparators, with the highest IRR being 2.7. The absolute risks were higher among patients in the first 2 years, but the difference was clinically insignificant. NHL patients with preexisting DM had increased risks of insulin prescriptions with 0.5-, 5-, and 10-year cumulative risk differences of insulin treatment of 15.3, 11.8, and 6.0 percentage units as compared with the DM comparators. In a landmark analysis at 1 year, DM patients with lymphoma had decreased risks of insulin dependency compared with comparators. Time-varying IRRs showed a higher CVD risk for NHL patients with DM as compared with comparators in the first year after treatment. NHL patients treated with steroid-containing immunochemotherapy regimens have a clinically insignificant increased risk of DM in the first year following treatment, and patients with preexisting DM have a temporary increased risk of insulin prescriptions and CVD.
Published: 2022
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2. Simultaneous determination of anti-diabetic drugs

Author: Nawab Sher, Nasreen Fatima, Shahnaz Perveen, and Farhan Ahmed Siddiqui
Subjects: Metformin/pharmacokinetics, High Pressure Liquid Chromatography, Urine/Plasma methods, Determination/prevention, Diabetes Mellitus/drug therapy, Drug Liberation/drug effects, Pharmacy and materia medica, RS1-441
Abstract: A novel reverse phase, isocratic HPLC method is described to separate five anti-diabetic drugs i.e., glimepiride, metformin, sitagliptin, rosiglitazone and pioglitazone. Nucleosil C18 analytical column was used as stationary phase, while mobile phase consisted of acetonitrile:phosphate buffer: methanol (40/40/20, v/v) pH 2.0. Effluent was monitored at a flow rate 1 mL/min and detected at wavelength of 240 nm. This research produced excellent chromatography over a wide concentration range of 25-10000 ng/mL. Sepprated and well resolved quantifiable peaks were obtained and test results were linear in this range. Correlation coefficient of more than 0.9990 was witnessed as well as Low %RSD values i.e., maximum 2.0% documented excellent precision of the method. Good recoveries from pharmaecutical (99-101%), urine and plasma samples (>96%) in a range of concentrtion granted very good linearity, accuracy and precision. The projected method has satisfactory applications in quality control of these molecules as well as quantification of these molecules in urine and plasma samples.
Published: 2019
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3. Report from the CVOT Summit 2021:new cardiovascular, renal, and glycemic outcomes

Author: Schnell, Oliver, Battelino, Tadej, Bergenstal, Richard, Blüher, Matthias, Böhm, Michael, Brosius, Frank, Carr, Richard D, Ceriello, Antonio, Forst, Thomas, Giorgino, Francesco, Guerci, Bruno, Heerspink, Hiddo J L, Itzhak, Baruch, Ji, Linong, Kosiborod, Mikhail, Lalić, Nebojša, Lehrke, Michael, Marx, Nikolaus, Nauck, Michael, Rodbard, Helena W, Rosano, Giuseppe M C, Rossing, Peter, Rydén, Lars, Santilli, Francesca, Schumm-Draeger, Petra-Maria, Vandvik, Per Olav, Vilsbøll, Tina, Wanner, Christoph, Wysham, Carol, Standl, Eberhard, Schnell, Oliver, Battelino, Tadej, Bergenstal, Richard, Blüher, Matthias, Böhm, Michael, Brosius, Frank, Carr, Richard D, Ceriello, Antonio, Forst, Thomas, Giorgino, Francesco, Guerci, Bruno, Heerspink, Hiddo J L, Itzhak, Baruch, Ji, Linong, Kosiborod, Mikhail, Lalić, Nebojša, Lehrke, Michael, Marx, Nikolaus, Nauck, Michael, Rodbard, Helena W, Rosano, Giuseppe M C, Rossing, Peter, Rydén, Lars, Santilli, Francesca, Schumm-Draeger, Petra-Maria, Vandvik, Per Olav, Vilsbøll, Tina, Wanner, Christoph, Wysham, Carol, and Standl, Eberhard
Abstract: The 7th Cardiovascular Outcome Trial (CVOT) Summit on Cardiovascular, Renal, and Glycemic Outcomes, was held virtually on November 18-19, 2021. Pursuing the tradition of the previous summits, this reference congress served as a platform for in-depth discussion and exchange on recently completed CVOTs. This year's focus was placed on the outcomes of EMPEROR-Preserved, FIGARO-DKD, AMPLITUDE-O, SURPASS 1-5, and STEP 1-5. Trial implications for diabetes and obesity management and the impact on new treatment algorithms were highlighted for endocrinologists, diabetologists, cardiologists, nephrologists, and general practitioners. Discussions evolved from outcome trials using SGLT2 inhibitors as therapy for heart failure, to CVOTs with nonsteroidal mineralocorticoid receptor antagonists and GLP-1 receptor agonists. Furthermore, trials for glycemic and overweight/obesity management, challenges in diabetes management in COVID-19, and novel guidelines and treatment strategies were discussed.Trial registration The 8th Cardiovascular Outcome Trial Summit will be held virtually on November 10-11, 2022 ( http://www.cvot.org ).
Published: 2022

4. Report from the CVOT Summit 2021:new cardiovascular, renal, and glycemic outcomes

Author: Oliver Schnell, Tadej Battelino, Richard Bergenstal, Matthias Blüher, Michael Böhm, Frank Brosius, Richard D. Carr, Antonio Ceriello, Thomas Forst, Francesco Giorgino, Bruno Guerci, Hiddo J. L. Heerspink, Baruch Itzhak, Linong Ji, Mikhail Kosiborod, Nebojša Lalić, Michael Lehrke, Nikolaus Marx, Michael Nauck, Helena W. Rodbard, Giuseppe M. C. Rosano, Peter Rossing, Lars Rydén, Francesca Santilli, Petra-Maria Schumm-Draeger, Per Olav Vandvik, Tina Vilsbøll, Christoph Wanner, Carol Wysham, Eberhard Standl, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), and Groningen Kidney Center (GKC)
Subjects: Blood Glucose, Clinical Trials as Topic, GLP-1 receptor agonist, Mineralocorticoid receptor antagonist, Endocrinology, Diabetes and Metabolism, Sodium-Glucose Transporter 2 Inhibitors/therapeutic use, education, Diabetes, COVID-19, Heart failure, SGLT2 inhibitor, 7. Cardiovascular Outcome Trial (CVOT) Summit on Cardiovascular, Renal, and Glycemic Outcomes, online, 2021-11-18 - 2021-11-19, Hypoglycemic Agents/therapeutic use, Cardiovascular disease, Tirzepatide, Diabetes Mellitus/drug therapy, Living guidelines, Treatment Outcome, Chronic kidney disease, Humans, Obesity, Cardiovascular Diseases/drug therapy, Cardiology and Cardiovascular Medicine
Abstract: Cardiovascular diabetology 21, 50 (2022). doi:10.1186/s12933-022-01481-0, Published by BioMed Central, London
Published: 2022
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5. Health status and quality of life in patients with diabetes in Switzerland

Author: Anne Zanchi, Chantal Arditi, and Isabelle Peytremann-Bridevaux
Subjects: Male, Gerontology, Time Factors, Social Determinants of Health, Cross-sectional study, Health Status, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, 03 medical and health sciences, 0302 clinical medicine, Cost of Illness, Quality of life, Risk Factors, Diabetes mellitus, Diabetes Mellitus, Internal Medicine, Humans, Hypoglycemic Agents, Insulin, Medicine, In patient, 030212 general & internal medicine, Social determinants of health, Lower income, Aged, Nutrition and Dietetics, business.industry, Age Factors, Middle Aged, medicine.disease, Mental health, humanities, Cross-Sectional Studies, Diabetes Mellitus/diagnosis, Diabetes Mellitus/drug therapy, Diabetes Mellitus/physiopathology, Diabetes Mellitus/psychology, Female, Hypoglycemic Agents/adverse effects, Insulin/adverse effects, Mental Health, Quality of Life, Switzerland, ADDQoL, Diabetes, Health status, SF-12, Sex life, Family Practice, business
Abstract: Aims We aimed to assess the health status and quality of life (QoL) of patients with diabetes and explore the associated factors in a French-speaking region of Switzerland. Methods This cross-sectional study analyzed self-reported data from 585 patients with diabetes. We ran univariate and multivariate regressions analyses on health status (Physical and Mental Component Summary scores (PCS, MCS) of the SF-12) and diabetes-specific QoL (ADDQoL score). Results Mean PCS was 43.1 ± 10.4 and mean MCS was 46.7 ± 11.1. The overall ADDQoL score was −1.6 ± 1.6; the life domains of the ADDQoL with the lowest scores were freedom to eat, sex life and freedom to drink. Being older was independently and significantly associated with higher mental health and QoL, while lower income was associated with lower physical health, mental health, and QoL. Having diabetes for over 10 years was associated with lower QoL, while insulin treatment and complications were correlated with lower physical health and QoL. Conclusions This study provides key information on the health status and QoL of patients with diabetes in Switzerland and their associated factors, which can help healthcare providers to identify patients at higher risk of lower health and QoL.
Published: 2019
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6. Diabète secondaire aux nouvelles thérapies ciblées contre le cancer [New-onset diabetes and novel targeted therapies against cancer]

Author: Zordan, A., Kosinski, C., Zaman, K., and Wojtusciszyn, A.
Subjects: Blood Glucose, Diabetes Mellitus/drug therapy, Diabetes Mellitus/epidemiology, Diabetes Mellitus, Type 2, Homeostasis, Humans, Neoplasms/drug therapy
Abstract: New systemic cancer therapies are increasingly oriented towards specific signaling pathways involved in carcinogenesis. However, these new treatments may lead to disorders of glycemic homeostasis ranging from glucose intolerance, diabetes or the occurrence of severe acute hyperglycemic syndrome due to blockade of certain pathways common to glucose metabolism. This article discusses the estimated frequency of new-onset diabetes, the pathophysiological mechanisms as well as the diagnostic, therapeutic, monitoring and prognostic management of glycemic dysfunction in patients treated with these novel systemic cancer therapies.
Published: 2021

7. Polypharmacy difference between older people with and without diabetes: Evidence from the English longitudinal study of ageing

Author: Yun-Ting Huang, Andrew Steptoe, Paola Zaninotto, and Li Wei
Subjects: Gerontology, Male, Longitudinal study, Aging, Glycated Hemoglobin A/metabolism, Endocrinology, Diabetes and Metabolism, Prevalence, Hypoglycemic Agents/therapeutic use, 030209 endocrinology & metabolism, Comorbidity, Diabetes Mellitus/drug therapy, Diabetes Complications, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Risk Factors, Diabetes mellitus, Internal Medicine, medicine, Diabetes Mellitus, Humans, Hypoglycemic Agents, 030212 general & internal medicine, Longitudinal Studies, Obesity, England/epidemiology, Risk factor, Aged, Polypharmacy, Aged, 80 and over, Glycated Hemoglobin, business.industry, General Medicine, Pharmacoepidemiology, Middle Aged, medicine.disease, Aging/physiology, Cross-Sectional Studies, England, Relative risk, Diabetes Complications/drug therapy, Female, Obesity/complications, business
Abstract: AIM: To study the association between diabetes and the prevalence of and risk factors for polypharmacy among adults aged 50 and older in England.METHODS: A cross-sectional study (2012-2013) of the English Longitudinal Study of Ageing. Polypharmacy was defined as taking 5-9 long-term medications a day and heightened polypharmacy as 10 or more. Diabetes included diagnosed and undiagnosed cases (glycated haemoglobin ≥ 6.5% (48 mmol/mol)).RESULTS: Of 7729 participants, 1100 people had diabetes and showed higher prevalence rates of polypharmacy (41.1% vs 14.8%) and heightened polypharmacy (5.8% vs 1.7%) than those without diabetes, even when antihyperglycemic medications were excluded. Risk factors for polypharmacy also differed according to diabetes status. Among people with diabetes, risk factors for polypharmacy and heightened polypharmacy were having more long-term conditions (relative risk ratio (RRR) = 1.86; 3.51) and being obese (RRR = 1.68; 3.68), while females were less likely to show polypharmacy (RRR = 0.51) and heightened polypharmacy (RRR = 0.51) than males. Older age (RRR = 1.04) was only related to polypharmacy among people without diabetes.CONCLUSIONS: Adults with diabetes had higher prevalence rates of polypharmacy and heightened polypharmacy than those without diabetes, regardless of including antihyperglycemic drugs. Early detection of polypharmacy among older people with diabetes needs to focus on co-morbidities and obesity.
Published: 2020
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8. Diabète post-transplantation rénale: le point de vue du diabétologue [Post-transplantation diabetes in kidney transplant: from the diabetologist point of view]

Author: Pauchet, A., Schwotzer, N., Lamine, F., Perrottet, N., Zanchi, A., Golshayan, D., and Wojtusciszyn, A.
Subjects: Diabetes Mellitus/drug therapy, Diabetes Mellitus/etiology, Diabetes Mellitus/metabolism, Diabetic Ketoacidosis/drug therapy, Diabetic Ketoacidosis/metabolism, Dipeptidyl-Peptidase IV Inhibitors/therapeutic use, Humans, Hypoglycemic Agents/therapeutic use, Insulin/metabolism, Insulin/therapeutic use, Kidney Transplantation/adverse effects, Metformin/therapeutic use, Postoperative Complications/drug therapy, Postoperative Complications/etiology, Postoperative Complications/metabolism, Risk Factors
Abstract: Post-transplantation diabetes (PTDM) exposes to increased morbidity (cardiovascular or infectious complications, early graft dysfunction) and to a risk of premature death. Recognition of risk factors is essential for early and individualized care. The management of a PTDM requires the use of oral antidiabetic treatments (metformin or DPP4 inhibitors) or GLP1 receptor agonists for their favorable effects on weight and kidney that seem ideal in this context. Corticosteroid-induced diabetes or the rare occurrence of diabetic ketoacidosis require insulin therapy. In the long term, the main objective remains to integrate PTDM treatment in a more comprehensive management, targeting the reduction of cardiovascular risk of vulnerable transplant patients.
Published: 2020

9. Diabète et infection à COVID-19 [Diabetes and COVID-19 infection]

Author: Kosinski, C., Zanchi, A., and Wojtusciszyn, A.
Subjects: Aged, Betacoronavirus, Blood Glucose, Coronavirus Infections/complications, Coronavirus Infections/epidemiology, Diabetes Complications, Diabetes Mellitus/drug therapy, Humans, Hypoglycemic Agents/therapeutic use, Pandemics, Pneumonia, Viral/complications, Pneumonia, Viral/epidemiology
Abstract: Based on the epidemiological data currently available, diabetes does not seem to be a risk factor for infection with SARS-CoV-2 but may be associated with a more severe course. Diabetes is extremely common in older patients with co-morbidities who are at risk of unfavorable outcomes. As with any other infection, poorly controlled pre-existing diabetes can promote secondary infections and lead to acute complications related to hyperglycemia, worsened itself by the infection. It is important to advise patients to have enough diabetic equipment and supplies at home, to make regular blood glucose self-tests, and to contact a caregiver immediately in case of glycemic imbalance or signs of infection. Antidiabetic therapy may need adjustments following usual sick day rules. Insulin therapy should be considered to treat any persistent hyperglycemia in patients hospitalized for an acute infection.
Published: 2020

10. Medication self-management support for people with diabetes and low health literacy: A needs assessment

Author: Visscher, Boudewijn B, Steunenberg, Bas, Heerdink, Eibert R, Rademakers, Jany, Visscher, Boudewijn B, Steunenberg, Bas, Heerdink, Eibert R, and Rademakers, Jany
Abstract: INTRODUCTION: An adequate level of health literacy is regarded as a prerequisite for adequate medication self-management. Low health literacy skills are relatively more common in people with Diabetes Mellitus type 2. The aim of this study was to explore the needs regarding medication self-management of people with type 2 diabetes and low (functional, communicative and critical) health literacy, and their preferences for medication self-management support.MATERIALS AND METHODS: A two-stage qualitative needs assessment study was performed using in-depth individual interviews and focus groups.RESULTS: The participants preferred to be supported with reliable and easily understandable information, adequate interactive communication with health care professionals and fellow people with diabetes and tools for medication self-management support.DISCUSSION: Future interventions should be created in co-creation with people with low health literacy and fulfill the expressed needs on information, communication and tools to improve self-management.
Published: 2020

11. Continuous Insulin Infusion Improves Postoperative Glucose Control in Patients with Diabetes Mellitus.

Author: Jiun-Yi Li, Shen Sun, and Shye-Jao Wu
Subjects: *INSULIN, *BLOOD sugar, *PEOPLE with diabetes, *DIABETES, *CORONARY disease
Abstract: Postoperative glucose control directly affects the incidence of deep sternal wound infection and death after patients with diabetes have undergone coronary artery bypass grafting. We compared the effect upon glucose control of continuous insulin infusion with that of glucometer-guided insulin injection after coronary artery bypass. Our prospective, randomized, controlled study involved patients with diabetes mellitus who underwent coronary artery bypass grafting in our hospital from January 2001 through January 2003. Immediately after surgery, patients were randomly assigned to receive continuous insulin infusion or conventional glucometer-guided injection to maintain blood glucose at a level between 150 and 200 mg/dL. The adequacy of postoperative blood glucose control and clinical outcome were evaluated. Of 93 patients studied, the incidence of sternal wound infection was 3.9% among infusion patients and 4.8% among injection patients (P=0.587). There was no significant difference in mortality rates (infusion, 3.9%; injection, 2.4%; P=0.573). Satisfactory blood glucose levels were achieved in significantly more patients undergoing infusion than injection (64.7% vs 28.6%, P <0.001). In the injection group, significantly more blood glucose measurements were required to achieve control (23.4 vs 16.5, P=0.001), and good control was attained much sooner in the infusion group (21.4 vs 30.5 hr, P=0.013). We conclude that continuous insulin infusion provides better control of postoperative blood glucose levels after coronary artery bypass grafting in patients with diabetes than does glucometer-guided insulin injection. [ABSTRACT FROM AUTHOR]
Published: 2006

12. Simultaneous determination of anti-diabetic drugs

Author: Nasreen Fatima, Shahnaz Perveen, Farhan Ahmed Siddiqui, and Nawab Sher
Subjects: Accuracy and precision, Correlation coefficient, Urine/Plasma methods, Urine, 030226 pharmacology & pharmacy, 01 natural sciences, High-performance liquid chromatography, Diabetes Mellitus/drug therapy, Drug Liberation/drug effects, 03 medical and health sciences, chemistry.chemical_compound, Pharmacy and materia medica, 0302 clinical medicine, medicine, High Pressure Liquid Chromatography, Acetonitrile, High Pressure Liquid Chromatography, Urine/Plasma methods, Determination/prevention, Chromatography, Chemistry, 0104 chemical sciences, RS1-441, 010404 medicinal & biomolecular chemistry, Glimepiride, Metformin/pharmacokinetics, Sitagliptin, Pioglitazone, medicine.drug
Abstract: A novel reverse phase, isocratic HPLC method is described to separate five anti-diabetic drugs i.e., glimepiride, metformin, sitagliptin, rosiglitazone and pioglitazone. Nucleosil C18 analytical column was used as stationary phase, while mobile phase consisted of acetonitrile:phosphate buffer: methanol (40/40/20, v/v) pH 2.0. Effluent was monitored at a flow rate 1 mL/min and detected at wavelength of 240 nm. This research produced excellent chromatography over a wide concentration range of 25‑10000 ng/mL. Sepprated and well resolved quantifiable peaks were obtained and test results were linear in this range. Correlation coefficient of more than 0.9990 was witnessed as well as Low %RSD values i.e., maximum 2.0% documented excellent precision of the method. Good recoveries from pharmaecutical (99-101%), urine and plasma samples (>96%) in a range of concentrtion granted very good linearity, accuracy and precision. The projected method has satisfactory applications in quality control of these molecules as well as quantification of these molecules in urine and plasma samples.
Published: 2019

13. Medication self-management support for people with diabetes and low health literacy: A needs assessment

Author: Visscher, Boudewijn B, Steunenberg, Bas, Heerdink, Eibert R, Rademakers, Jany, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, RS: CAPHRI - R6 - Promoting Health & Personalised Care, Family Medicine, Afd Pharmacoepi & Clinical Pharmacology, and Pharmacoepidemiology and Clinical Pharmacology
Subjects: Male, Health Knowledge, Attitudes, Practice, Health Literacy/methods, Physiology, Psychological intervention, Social Sciences, Pharmacists, Biochemistry, Diabetes Mellitus/drug therapy, 0302 clinical medicine, Endocrinology, Sociology, Health care, Medicine and Health Sciences, Insulin, Psychology, 030212 general & internal medicine, Medical Personnel, Qualitative Research, Language, Practice, education, Multidisciplinary, Health Knowledge, Communication, Social Communication, Focus Groups, Middle Aged, Blood Sugar, Body Fluids, Professions, Blood, Health Education and Awareness, Needs assessment, Medicine, Female, Anatomy, Needs Assessment, Self-medication, Research Article, Adult, Endocrine Disorders, Science, MEDLINE, 030209 endocrinology & metabolism, Health literacy, Medication Adherence, 03 medical and health sciences, ADHERENCE, Diabetes Mellitus, Humans, interventions, Diabetic Endocrinology, Medical education, business.industry, Self-Management, Cognitive Psychology, Biology and Life Sciences, Focus group, Communications, Hormones, Health Literacy, MODEL, Self Care, Health Care, Medication Adherence/psychology, Attitudes, Metabolic Disorders, People and Places, Self-Management/methods, Cognitive Science, Population Groupings, business, Qualitative research, Neuroscience
Abstract: IntroductionAn adequate level of health literacy is regarded as a prerequisite for adequate medication self-management. Low health literacy skills are relatively more common in people with Diabetes Mellitus type 2. The aim of this study was to explore the needs regarding medication self-management of people with type 2 diabetes and low (functional, communicative and critical) health literacy, and their preferences for medication self-management support.Materials and methodsA two-stage qualitative needs assessment study was performed using in-depth individual interviews and focus groups.ResultsThe participants preferred to be supported with reliable and easily understandable information, adequate interactive communication with health care professionals and fellow people with diabetes and tools for medication self-management support.DiscussionFuture interventions should be created in co-creation with people with low health literacy and fulfill the expressed needs on information, communication and tools to improve self-management.
Published: 2019

14. Parenteral nutrition and insulin per protocol improve diabetes management after total pancreatectomy

Author: Andersen, Sakshi, Andersen, Andreas, Ringholm, Lene, Hansen, Carsten Palnæs, Storkholm, Jan, Lillpers, Kerstin, Schiøtz, Charlotte, Mathiesen, Elisabeth Reinhardt, Andersen, Sakshi, Andersen, Andreas, Ringholm, Lene, Hansen, Carsten Palnæs, Storkholm, Jan, Lillpers, Kerstin, Schiøtz, Charlotte, and Mathiesen, Elisabeth Reinhardt
Abstract: INTRODUCTION: Pancreatogenic diabetes develops in patients undergoing total pancreatectomy and complicates post-surgical management. The aim of this study was to compare parenteral nutrition (PN) with protocolled insulin treatment to intravenous glucose treatment after total pancreatectomy.METHODS: This was a retrospective study of 97 patients undergoing total pancreatectomy between 2009 and 2014. Patients were divided into a PN cohort (n = 57) and a glucose cohort (n = 40). The PN cohort was given PN with one international unit (IU) rapid-acting insulin per 10 g of carbohydrate. The glucose cohort was given a continuous 5% glucose infusion with 2 IU rapid-acting insulin per 10 g of carbohydrate. Both cohorts were given insulin detemir 0.2 IU/kg/day.RESULTS: Within the first 13 post-operative days, plasma glucose values were within the target range (4.0-10.0 mmol/l) in the PN cohort more frequently than in the glucose cohort (46% versus 42%, p = 0.01) without any increase in hypoglycaemia. Non-infectious complications occurred less frequently in the parenteral cohort than in the glucose cohort (23% versus 43%, p = 0.04). Infectious complications occurred in 19% versus 33% of patients, respectively (p = 0.14). The mean length of hospitalisation was 19.8 ± 12.7 versus 25.0 ± 21.5 days, p = 0.14.CONCLUSIONS: After total pancreatectomy, PN with insulin treatment per protocol improves glycaemic control compared with glucose infusion and reduces the number of non-infectious post-operative complications without increasing hypoglycaemia.FUNDING: none.TRIAL REGISTRATION: not relevant.
Published: 2018

15. Choice and Outcomes of Rate Control versus Rhythm Control in Elderly Patients with Atrial Fibrillation: A Report from the REPOSI Study

Author: Paciullo, Francesco, Proietti, Marco, Bianconi, Vanessa, Nobili, Alessandro, Pirro, Matteo, Mannucci, Pier Mannuccio, Lip, Gregory Y. H., Lupattelli, Graziana, Tettamanti, Mauro, Pasina, Luca, Franchi, Carlotta, Perticone, Francesco, Salerno, Francesco, Corrao, Salvatore, Marengoni, Alessandra, Licata, Giuseppe, Violi, Francesco, Corazza, Gino Roberto, Marcucci, Maura, Eldin, Tarek Kamal, Di Blanca, Maria Pia Donatella, Lanzo, Giovanna, Astuto, Sarah, Ardoino, Ilaria, Cortesi, Laura, Prisco, Domenico, Silvestri, Elena, Cenci, Caterina, Emmi, Giacomo, Biolo, Gianni, Guarnieri, Gianfranco, Zanetti, Michela, Fernandes, Giovanni, Chiuch, Massimiliano, Vanoli, Massimo, Grignani, Giulia, Casella, Gianluca, Pulixi, Edoardo Alessandro, Bernardi, Mauro, Bassi, Silvia Li, Santi, Luca, Zaccherini, Giacomo, Mannarino, Elmo, Nuti, Ranuccio, Valenti, Roberto, Ruvio, Martina, Cappelli, Silvia, Palazzuoli, Alberto, Salvatore, Teresa, Sasso, Ferdinando Carlo, Girelli, Domenico, Olivieri, Oliviero, Matteazzi, Thomas, Barbagallo, Mario, Plances, Lidia, Alcamo, Roberta, Calvo, Luigi, Valenti, Maria, Zoli, Marco, Arnò, Raffaella, Pasini, Franco Laghi, Capecchi, Pier Leopoldo, Bicchi, Maurizio, Palasciano, Giuseppe, Modeo, Maria Ester, Peragine, Maria, Pappagallo, Fabrizio, Pugliese, Stefania, Di Gennaro, Carla, Postiglione, Alfredo, Barbella, Maria Rosaria, de Stefano, Francesco, Cappellini, Maria Domenica, Fabio, Giovanna, Seghezzi, Sonia, de Amicis, Margherita Migone, Mancarella, Marta, Mari, Daniela, Rossi, Paolo Dionigi, Damanti, Sarah, Ottolini, Barbara Brignolo, Bonini, Giulia, Miceli, Emanuela, Lenti, Marco Vincenzo, Padula, Donatella, Murialdo, Giovanni, Marra, Alessio, Cattaneo, Federico, Secchi, Maria Beatrice, Ghelfi, Davide, Anastasio, Luigi, Sofia, Lucia, Carbone, Maria, Davì, Giovanni, Guagnano, Maria Teresa, Sestili, Simona, Mancuso, Gerardo, Calipari, Daniela, Bartone, Mosè, Meroni, Maria Rachele, Perin, Paolo Cavallo, Lorenzati, Bartolomeo, Gruden, Gabriella, Bruno, Graziella, Amione, Cristina, Fornengo, Paolo, Tassara, Rodolfo, Melis, Deborah, Rebella, Lara, Delitala, Giuseppe, Pretti, Vincenzo, Masala, Maristella Salvatora, Pes, Chiara, Bolondi, Luigi, Rasciti, Leonardo, Serio, Ilaria, Fanelli, Filippo Rossi, Amoroso, Antonio, Molfino, Alessio, Petrillo, Enrico, Zuccalà, Giuseppe, Franceschi, Francesco, de Marco, Guido, Chiara, Cordischi, Marta, Sabbatini, D’Aurizio, Gabriella, Romanelli, Giuseppe, Amolini, Claudia, Chiesa, Deborah, Picardi, Antonio, Gentilucci, Umberto Vespasiani, Gallo, Paolo, Annoni, Giorgio, Corsi, Maurizio, Zazzetta, Sara, Bellelli, Giuseppe, Szabo, Hajnalka, Arturi, Franco, Succurro, Elena, Rubino, Mariangela, Sesti, Giorgio, Loria, Paola, Becchi, Maria Angela, Martucci, Gianfranco, Fantuzzi, Alessandra, Maurantonio, Mauro, Serra, Maria Grazia, Bleve, Maria Antonietta, Gasbarrone, Laura, Sajeva, Maria Rosaria, Brucato, Antonio, Ghidoni, Silvia, Di Corato, Paola, Agnelli, Giancarlo, Marchesini, Emanuela, Fabris, Fabrizio, Carlon, Michela, Turatto, Francesca, Baritusso, Aldo, Amabile, Annalisa, Omenetto, Elisabetta, Scarinzi, Paolo, Manfredini, Roberto, Molino, Christian, Pala, Marco, Fabbian, Fabio, Boari, Benedetta, de Giorgi, Alfredo, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Laieta, Maria Teresa, Rini, Giovanbattista, Mansueto, Pasquale, Pepe, Ilenia, Borghi, Claudio, Strocchi, Enrico, de Sando, Valeria, Pareo, Ilaria, Sabbà, Carlo, Vella, Francesco Saverio, Suppressa, Patrizia, Valerio, Raffaella, Agosti, Pasquale, Fontana, Flavia, Loparco, Francesca, Capobianco, Caterina, Fenoglio, Luigi, Bracco, Christian, Giraudo, Alessia Valentina, Testa, Elisa, Serraino, Cristina, Fargion, Silvia, Bonara, Paola, Periti, Giulia, Porzio, Marianna, Tiraboschi, Slivia, Peyvandi, Flora, Tedeschi, Alberto, Rossio, Raffaella, Ferrari, Barbara, Monzani, Valter, Savojardo, Valeria, Folli, Christian, Magnini, Maria, Conca, Alessio, Gobbo, Giulia, Pallini, Giada, Valenti, Miriam, Balduini, Carlo L., Bertolino, Giampiera, Provini, Stella, Quaglia, Federica, Dallegri, Franco, Ottonello, Luciano, Liberale, Luca, Chin, Wu Sheng, Carassale, Laura, Caporotundo, Silvia, Traisci, Giancarlo, de Feudis, Lucrezia, Di Carlo, Silvia, Liberato, Nicola Lucio, Buratti, Alberto, Tognin, Tiziana, Bianchi, Giovanni Battista, Giaquinto, Sabrina, Purrello, Francesco, Di Pino, Antonino, Piro, Salvatore, Rozzini, Renzo, Falanga, Lina, Spazzini, Elena, Montrucchio, Giuseppe, Greco, Elisabetta, Tizzani, Pietro, Petitti, Paolo, Perciccante, Antonio, Coralli, Alessia, Salmi, Raffaella, Gaudenzi, Piergiorgio, Gamberini, Susanna, Semplicini, Andrea, Gottardo, Lucia, Vendemiale, Gianluigi, Serviddio, Gaetano, Forlano, Roberta, Masala, Cesare, Mammarella, Antonio, Raparelli, Valeria, Basili, Stefania, Perri, Ludovica, Landolfi, Raffaele, Montalto, Massimo, Mirijello, Antonio, Vallone, Carla, Bellusci, Martino, Setti, Donatella, Pedrazzoli, Filippo, Guasti, Luigina, Castiglioni, Luana, Maresca, Andrea, Squizzato, Alessandro, Molaro, Marta, Bertolotti, Marco, Mussi, Chiara, Libbra, Maria Vittoria, Miceli, Andrea, Pellegrini, Elisa, Carulli, Lucia, Veltri, Francesca, Sciacqua, Angela, Quero, Michele, Bagnato, Chiara, Colangelo, Lidia, Falbo, Tania, de Giorgio, Roberto, Serra, Mauro, Grasso, Valentina, Ruggeri, Eugenio, Ilaria, Benzoni, Salvi, Andrea, Leonardi, Roberto, Grassini, Chiara, Mascherona, Ilenia, Minelli, Giorgio, Maltese, Francesca, Damiani, Giampaolo, Capeci, William, Mattioli, Massimo, Martino, Giuseppe Pio, Biondi, Lorenzo, Ormas, Monica, Pettinari, Pietro, Romiti, Roberto, Messina, Silvia, Cavallaro, Federica, Ghio, Riccardi, Favorini, Serena, Col, Anna Dal, Minisola, Salvatore, Colangelo, Luciano, Afeltra, Antonella, Alemanno, Pamela, Marigliano, Benedetta, Pipita, Maria Elena, Castellino, Pietro, Blanco, Julien, Zanoli, Luca, Cattaneo, Marco, Fracasso, Paola, Amoruso, Maria Valentina, Saracco, Valter, Fogliati, Marisa, Bussolino, Carlo, Durante, Vittorio, Eusebi, Giovanna, Tirotta, Daniela, Mete, Francesca, Gino, Miriam, Cittadini, Antonio, Vigorito, Carlo, Arcopinto, Michele, Salzano, Andrea, Bobbio, Emanuele, Marra, Alberto Maria, Sirico, Domenico, Moreo, Guido, Scopelliti, Francesco, Gasparini, Francesca, Cocca, Melissa, Ballestrero, Alberto, Ferrando, Fabio, Berra, Sergio, Dassi, Simonetta, Nava, Maria Cristina, Graziella, Bruno, Baldassarre, Stefano, Fragapani, Salvatore, Galanti, Giorgio, Mascherini, Gabriele, Petri, Cristian, Stefani, Laura, Girino, Margherita, Piccinelli, Valeria, Nasso, Francesco, Gioffrè, Vincenza, Pasquale, Maria, Scattolin, Giuseppe, Martinelli, Sergio, Turrin, Mauro, Sechi, Leonardo, Catena, Cristina, Colussi, Gianluca, Nieves, Ramirez Duque, Alberto, Muela Molinero, Pedro, Abad Requejo, Vanessa, Lopez Pelaez, Lara, Tamargo, Xavier, Corbella Viros, Francesc, Formiga, Jesus, Diez Manglano, Esperanza, Bejarano Tello, Esther, Del Corral Behamonte, Maria, Sevil Puras, Romero, Manuel, Blanca, Pinilla Llorente, Cristina, Lopez Gonzalez-Cobos, Victoria, Villalba Garcia M., Saez, Lopez, Bosco, Juan, Susana, Sanz Baena, Marta, Arroyo Gallego, Concepcion, Gonzalez Becerra, Antonio, Fernandez Moyano, Hernandez, Mercedes Gomez, Borrego, Manuel Poyato, Raquel, Pacheco Cuadros, Florencia, Perez Rojas, Beatriz, Garcia Olid, Sara, Carrascosa Garcia, Alfonso, Gonzalez-Cruz Cervellera, Marta, Peinado Martinez, Garcia, Sara Carrascosa, Alberto, Ruiz Cantero, Antonio, Albarracín Arraigosa, Montserrat, Godoy Guerrero, Ángel, Barón Ramos Miguel, Manuel, Machin Jose, Ignacio, Novo Veleiro, Lucía, Alvela Suarez, Alfonso, Lopez, David, Rubal Bran, Iria, Iñiguez Vazquez, Monica, Rios Prego, Paciullo F., Proietti M., Bianconi V., Nobili A., Pirro M., Mannucci P.M., Lip G.Y.H., Lupattelli G., Tettamanti M., Pasina L., Franchi C., Perticone F., Salerno F., Corrao S., Marengoni A., Licata G., Violi F., Corazza G.R., Marcucci M., Eldin T.K., Di Blanca M.P.D., Lanzo G., Astuto S., Ardoino I., Cortesi L., Prisco D., Silvestri E., Cenci C., Emmi G., Biolo G., Guarnieri G., Zanetti M., Fernandes G., Chiuch M., Vanoli M., Grignani G., Casella G., Pulixi E.A., Bernardi M., Bassi S.L., Santi L., Zaccherini G., Mannarino E., Nuti R., Valenti R., Ruvio M., Cappelli S., Palazzuoli A., Salvatore T., Sasso F.C., Girelli D., Olivieri O., Matteazzi T., Barbagallo M., Plances L., Alcamo R., Calvo L., Valenti M., Zoli M., Arno R., Pasini F.L., Capecchi P.L., Bicchi M., Palasciano G., Modeo M.E., Peragine M., Pappagallo F., Pugliese S., Di Gennaro C., Postiglione A., Barbella M.R., De Stefano F., Cappellini M.D., Fabio G., Seghezzi S., De Amicis M.M., Mancarella M., Mari D., Rossi P.D., Damanti S., Ottolini B.B., Bonini G., Miceli E., Lenti M.V., Padula D., Murialdo G., Marra A., Cattaneo F., Secchi M.B., Ghelfi D., Anastasio L., Sofia L., Carbone M., Davi G., Guagnano M.T., Sestili S., Mancuso G., Calipari D., Bartone M., Meroni M.R., Perin P.C., Lorenzati B., Gruden G., Bruno G., Amione C., Fornengo P., Tassara R., Melis D., Rebella L., Delitala G., Pretti V., Masala M.S., Pes C., Bolondi L., Rasciti L., Serio I., Fanelli F.R., Amoroso A., Molfino A., Petrillo E., Zuccala G., Franceschi F., De Marco G., Chiara C., Marta S., D'Aurizio G., Romanelli G., Amolini C., Chiesa D., Picardi A., Gentilucci U.V., Gallo P., Annoni G., Corsi M., Zazzetta S., Bellelli G., Szabo H., Arturi F., Succurro E., Rubino M., Sesti G., Loria P., Becchi M.A., Martucci G., Fantuzzi A., Maurantonio M., Serra M.G., Bleve M.A., Gasbarrone L., Sajeva M.R., Brucato A., Ghidoni S., Di Corato P., Agnelli G., Marchesini E., Fabris F., Carlon M., Turatto F., Baritusso A., Amabile A., Omenetto E., Scarinzi P., Manfredini R., Molino C., Pala M., Fabbian F., Boari B., De Giorgi A., Paolisso G., Rizzo M.R., Laieta M.T., Rini G., Mansueto P., Pepe I., Borghi C., Strocchi E., De Sando V., Pareo I., Sabba C., Vella F.S., Suppressa P., Valerio R., Agosti P., Fontana F., Loparco F., Capobianco C., Fenoglio L., Bracco C., Giraudo A.V., Testa E., Serraino C., Fargion S., Bonara P., Periti G., Porzio M., Tiraboschi S., Peyvandi F., Tedeschi A., Rossio R., Ferrari B., Monzani V., Savojardo V., Folli C., Magnini M., Conca A., Gobbo G., Pallini G., Balduini C.L., Bertolino G., Provini S., Quaglia F., Dallegri F., Ottonello L., Liberale L., Chin W.S., Carassale L., Caporotundo S., Traisci G., De Feudis L., Di Carlo S., Liberato N.L., Buratti A., Tognin T., Bianchi G.B., Giaquinto S., Purrello F., Di Pino A., Piro S., Rozzini R., Falanga L., Spazzini E., Montrucchio G., Greco E., Tizzani P., Petitti P., Perciccante A., Coralli A., Salmi R., Gaudenzi P., Gamberini S., Semplicini A., Gottardo L., Vendemiale G., Serviddio G., Forlano R., Masala C., Mammarella A., Raparelli V., Basili S., Perri L., Landolfi R., Montalto M., Mirijello A., Vallone C., Bellusci M., Setti D., Pedrazzoli F., Guasti L., Castiglioni L., Maresca A., Squizzato A., Molaro M., Bertolotti M., Mussi C., Libbra M.V., Miceli A., Pellegrini E., Carulli L., Veltri F., Sciacqua A., Quero M., Bagnato C., Colangelo L., Falbo T., De Giorgio R., Serra M., Grasso V., Ruggeri E., Ilaria B., Salvi A., Leonardi R., Grassini C., Mascherona I., Minelli G., Maltese F., Damiani G., Capeci W., Mattioli M., Martino G.P., Biondi L., Ormas M., Pettinari P., Romiti R., Messina S., Cavallaro F., Ghio R., Favorini S., Col A.D., Minisola S., Afeltra A., Alemanno P., Marigliano B., Pipita M.E., Castellino P., Blanco J., Zanoli L., Cattaneo M., Fracasso P., Amoruso M.V., Saracco V., Fogliati M., Bussolino C., Durante V., Eusebi G., Tirotta D., Mete F., Gino M., Cittadini A., Vigorito C., Arcopinto M., Salzano A., Bobbio E., Marra A.M., Sirico D., Moreo G., Scopelliti F., Gasparini F., Cocca M., Ballestrero A., Ferrando F., Berra S., Dassi S., Nava M.C., Graziella B., Baldassarre S., Fragapani S., Galanti G., Mascherini G., Petri C., Stefani L., Girino M., Piccinelli V., Nasso F., Gioffre V., Pasquale M., Scattolin G., Martinelli S., Turrin M., Sechi L., Catena C., Colussi G., Nieves R.D., Alberto M.M., Pedro A.R., Vanessa L.P., Lara T., Xavier C.V., Francesc F., Jesus D.M., Esperanza B.T., Esther D.C.B., Maria S.P., Romero M., Blanca P.L., Cristina L.G.-C., Victoria V.G.M., Saez L., Bosco J., Susana S.B., Marta A.G., Concepcion G.B., Antonio F.M., Hernandez M.G., Borrego M.P., Raquel P.C., Florencia P.R., Beatriz G.O., Sara C.G., Alfonso G.-C.C., Marta P.M., Garcia S.C., Alberto R.C., Antonio A.A., Montserrat G.G., Angel B.R.M., Manuel M.J., Ignacio N.V., Lucia A.S., Alfonso L., David R.B., Iria I.V., Monica R.P., Paciullo, Francesco, Proietti, Marco, Bianconi, Vanessa, Nobili, Alessandro, Pirro, Matteo, Mannucci, Pier Mannuccio, Lip, Gregory Y. H., Lupattelli, Graziana, Tettamanti, Mauro, Pasina, Luca, Franchi, Carlotta, Perticone, Francesco, Salerno, Francesco, Corrao, Salvatore, Marengoni, Alessandra, Licata, Giuseppe, Violi, Francesco, Corazza, Gino Roberto, Marcucci, Maura, Eldin, Tarek Kamal, Di Blanca, Maria Pia Donatella, Lanzo, Giovanna, Astuto, Sarah, Ardoino, Ilaria, Cortesi, Laura, Prisco, Domenico, Silvestri, Elena, Cenci, Caterina, Emmi, Giacomo, Biolo, Gianni, Guarnieri, Gianfranco, Zanetti, Michela, Fernandes, Giovanni, Chiuch, Massimiliano, Vanoli, Massimo, Grignani, Giulia, Casella, Gianluca, Pulixi, Edoardo Alessandro, Bernardi, Mauro, Bassi, Silvia Li, Santi, Luca, Zaccherini, Giacomo, Mannarino, Elmo, Nuti, Ranuccio, Valenti, Roberto, Ruvio, Martina, Cappelli, Silvia, Palazzuoli, Alberto, Salvatore, Teresa, Sasso, Ferdinando Carlo, Girelli, Domenico, Olivieri, Oliviero, Matteazzi, Thoma, Barbagallo, Mario, Plances, Lidia, Alcamo, Roberta, Calvo, Luigi, Valenti, Maria, Zoli, Marco, Arnò, Raffaella, Pasini, Franco Laghi, Capecchi, Pier Leopoldo, Bicchi, Maurizio, Palasciano, Giuseppe, Modeo, Maria Ester, Peragine, Maria, Pappagallo, Fabrizio, Pugliese, Stefania, Di Gennaro, Carla, Postiglione, Alfredo, Barbella, Maria Rosaria, de Stefano, Francesco, Cappellini, Maria Domenica, Fabio, Giovanna, Seghezzi, Sonia, de Amicis, Margherita Migone, Mancarella, Marta, Mari, Daniela, Rossi, Paolo Dionigi, Damanti, Sarah, Ottolini, Barbara Brignolo, Bonini, Giulia, Miceli, Emanuela, Lenti, Marco Vincenzo, Padula, Donatella, Murialdo, Giovanni, Marra, Alessio, Cattaneo, Federico, Secchi, Maria Beatrice, Ghelfi, Davide, Anastasio, Luigi, Sofia, Lucia, Carbone, Maria, Davì, Giovanni, Guagnano, Maria Teresa, Sestili, Simona, Mancuso, Gerardo, Calipari, Daniela, Bartone, Mosè, Meroni, Maria Rachele, Perin, Paolo Cavallo, Lorenzati, Bartolomeo, Gruden, Gabriella, Bruno, Graziella, Amione, Cristina, Fornengo, Paolo, Tassara, Rodolfo, Melis, Deborah, Rebella, Lara, Delitala, Giuseppe, Pretti, Vincenzo, Masala, Maristella Salvatora, Pes, Chiara, Bolondi, Luigi, Rasciti, Leonardo, Serio, Ilaria, Fanelli, Filippo Rossi, Amoroso, Antonio, Molfino, Alessio, Petrillo, Enrico, Zuccalà, Giuseppe, Franceschi, Francesco, de Marco, Guido, Chiara, Cordischi, Marta, Sabbatini, D’Aurizio, Gabriella, Romanelli, Giuseppe, Amolini, Claudia, Chiesa, Deborah, Picardi, Antonio, Gentilucci, Umberto Vespasiani, Gallo, Paolo, Annoni, Giorgio, Corsi, Maurizio, Zazzetta, Sara, Bellelli, Giuseppe, Szabo, Hajnalka, Arturi, Franco, Succurro, Elena, Rubino, Mariangela, Sesti, Giorgio, Loria, Paola, Becchi, Maria Angela, Martucci, Gianfranco, Fantuzzi, Alessandra, Maurantonio, Mauro, Serra, Maria Grazia, Bleve, Maria Antonietta, Gasbarrone, Laura, Sajeva, Maria Rosaria, Brucato, Antonio, Ghidoni, Silvia, Di Corato, Paola, Agnelli, Giancarlo, Marchesini, Emanuela, Fabris, Fabrizio, Carlon, Michela, Turatto, Francesca, Baritusso, Aldo, Amabile, Annalisa, Omenetto, Elisabetta, Scarinzi, Paolo, Manfredini, Roberto, Molino, Christian, Pala, Marco, Fabbian, Fabio, Boari, Benedetta, de Giorgi, Alfredo, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Laieta, Maria Teresa, Rini, Giovanbattista, Mansueto, Pasquale, Pepe, Ilenia, Borghi, Claudio, Strocchi, Enrico, de Sando, Valeria, Pareo, Ilaria, Sabbà, Carlo, Vella, Francesco Saverio, Suppressa, Patrizia, Valerio, Raffaella, Agosti, Pasquale, Fontana, Flavia, Loparco, Francesca, Capobianco, Caterina, Fenoglio, Luigi, Bracco, Christian, Giraudo, Alessia Valentina, Testa, Elisa, Serraino, Cristina, Fargion, Silvia, Bonara, Paola, Periti, Giulia, Porzio, Marianna, Tiraboschi, Slivia, Peyvandi, Flora, Tedeschi, Alberto, Rossio, Raffaella, Ferrari, Barbara, Monzani, Valter, Savojardo, Valeria, Folli, Christian, Magnini, Maria, Conca, Alessio, Gobbo, Giulia, Pallini, Giada, Valenti, Miriam, Balduini, Carlo L., Bertolino, Giampiera, Provini, Stella, Quaglia, Federica, Dallegri, Franco, Ottonello, Luciano, Liberale, Luca, Chin, Wu Sheng, Carassale, Laura, Caporotundo, Silvia, Traisci, Giancarlo, de Feudis, Lucrezia, Di Carlo, Silvia, Liberato, Nicola Lucio, Buratti, Alberto, Tognin, Tiziana, Bianchi, Giovanni Battista, Giaquinto, Sabrina, Purrello, Francesco, Di Pino, Antonino, Piro, Salvatore, Rozzini, Renzo, Falanga, Lina, Spazzini, Elena, Montrucchio, Giuseppe, Greco, Elisabetta, Tizzani, Pietro, Petitti, Paolo, Perciccante, Antonio, Coralli, Alessia, Salmi, Raffaella, Gaudenzi, Piergiorgio, Gamberini, Susanna, Semplicini, Andrea, Gottardo, Lucia, Vendemiale, Gianluigi, Serviddio, Gaetano, Forlano, Roberta, Masala, Cesare, Mammarella, Antonio, Raparelli, Valeria, Basili, Stefania, Perri, Ludovica, Landolfi, Raffaele, Montalto, Massimo, Mirijello, Antonio, Vallone, Carla, Bellusci, Martino, Setti, Donatella, Pedrazzoli, Filippo, Guasti, Luigina, Castiglioni, Luana, Maresca, Andrea, Squizzato, Alessandro, Molaro, Marta, Bertolotti, Marco, Mussi, Chiara, Libbra, Maria Vittoria, Miceli, Andrea, Pellegrini, Elisa, Carulli, Lucia, Veltri, Francesca, Sciacqua, Angela, Quero, Michele, Bagnato, Chiara, Colangelo, Lidia, Falbo, Tania, de Giorgio, Roberto, Serra, Mauro, Grasso, Valentina, Ruggeri, Eugenio, Ilaria, Benzoni, Salvi, Andrea, Leonardi, Roberto, Grassini, Chiara, Mascherona, Ilenia, Minelli, Giorgio, Maltese, Francesca, Damiani, Giampaolo, Capeci, William, Mattioli, Massimo, Martino, Giuseppe Pio, Biondi, Lorenzo, Ormas, Monica, Pettinari, Pietro, Romiti, Roberto, Messina, Silvia, Cavallaro, Federica, Ghio, Riccardi, Favorini, Serena, Col, Anna Dal, Minisola, Salvatore, Colangelo, Luciano, Afeltra, Antonella, Alemanno, Pamela, Marigliano, Benedetta, Pipita, Maria Elena, Castellino, Pietro, Blanco, Julien, Zanoli, Luca, Cattaneo, Marco, Fracasso, Paola, Amoruso, Maria Valentina, Saracco, Valter, Fogliati, Marisa, Bussolino, Carlo, Durante, Vittorio, Eusebi, Giovanna, Tirotta, Daniela, Mete, Francesca, Gino, Miriam, Cittadini, Antonio, Vigorito, Carlo, Arcopinto, Michele, Salzano, Andrea, Bobbio, Emanuele, Marra, Alberto Maria, Sirico, Domenico, Moreo, Guido, Scopelliti, Francesco, Gasparini, Francesca, Cocca, Melissa, Ballestrero, Alberto, Ferrando, Fabio, Berra, Sergio, Dassi, Simonetta, Nava, Maria Cristina, Graziella, Bruno, Baldassarre, Stefano, Fragapani, Salvatore, Galanti, Giorgio, Mascherini, Gabriele, Petri, Cristian, Stefani, Laura, Girino, Margherita, Piccinelli, Valeria, Nasso, Francesco, Gioffrè, Vincenza, Pasquale, Maria, Scattolin, Giuseppe, Martinelli, Sergio, Turrin, Mauro, Sechi, Leonardo, Catena, Cristina, Colussi, Gianluca, Nieves, Ramirez Duque, Alberto, Muela Molinero, Pedro, Abad Requejo, Vanessa, Lopez Pelaez, Lara, Tamargo, Xavier, Corbella Viro, Francesc, Formiga, Jesus, Diez Manglano, Esperanza, Bejarano Tello, Esther, Del Corral Behamonte, Maria, Sevil Pura, Romero, Manuel, Blanca, Pinilla Llorente, Cristina, Lopez Gonzalez-Cobo, Victoria, Villalba Garcia M., Saez, Lopez, Bosco, Juan, Susana, Sanz Baena, Marta, Arroyo Gallego, Concepcion, Gonzalez Becerra, Antonio, Fernandez Moyano, Hernandez, Mercedes Gomez, Borrego, Manuel Poyato, Raquel, Pacheco Cuadro, Florencia, Perez Roja, Beatriz, Garcia Olid, Sara, Carrascosa Garcia, Alfonso, Gonzalez-Cruz Cervellera, Marta, Peinado Martinez, Garcia, Sara Carrascosa, Alberto, Ruiz Cantero, Antonio, Albarracín Arraigosa, Montserrat, Godoy Guerrero, Ángel, Barón Ramos Miguel, Manuel, Machin Jose, Ignacio, Novo Veleiro, Lucía, Alvela Suarez, Alfonso, Lopez, David, Rubal Bran, Iria, Iñiguez Vazquez, Monica, Rios Prego, De Stefano, Francesco, De Amicis, Margherita Migone, De Marco, Guido, De Giorgi, Alfredo, De Sando, Valeria, De Feudis, Lucrezia, De Giorgio, Roberto, Mannucci, Pm, Nobili, A, Tettamanti, M, Pasina, L, Franchi, C, Perticone, F, Salerno, F, Corrao, S, Marengoni, A, Licata, G, Violi, F, Corazza, Gr, Marcucci, M, Eldin, Tk, Di Blanca, Mpd, Lanzo, G, Astuto, S, Ardoino, I, Cortesi, L, Prisco, D, Silvestri, E, Cenci, C, Emmi, G, Biolo, G, Guarnieri, G, Zanetti, M, Fernandes, G, Chiuch, M, Vanoli, M, Grignani, G, Casella, G, Pulixi, Ea, Bernardi, M, Bassi, Sl, Santi, L, Zaccherini, G, Mannarino, E, Lupattelli, G, Bianconi, V, Paciullo, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Salvatore, T, Sasso, Fc, Girelli, D, Olivieri, O, Matteazzi, T, Barbagallo, M, Plances, L, Alcamo, R, Calvo, L, Valenti, M, Zoli, M, Arnò, R, Pasini, Fl, Capecchi, Pl, Bicchi, M, Palasciano, G, Modeo, Me, Peragine, M, Pappagallo, F, Pugliese, S, Di Gennaro, C, Postiglione, A, Barbella, Mr, De Stefano, F, Cappellini, Md, Fabio, G, Seghezzi, S, De Amicis, Mm, Mancarella, M, Mari, D, Rossi, Pd, Damanti, S, Ottolini, Bb, Bonini, G, Miceli, E, Lenti, Mv, Padula, D, Murialdo, G, Marra, A, Cattaneo, F, Secchi, Mb, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Davì, G, Guagnano, Mt, Sestili, S, Mancuso, G, Calipari, D, Bartone, M, Meroni, Mr, Perin, Pc, Lorenzati, B, Gruden, G, Bruno, G, Amione, C, Fornengo, P, Tassara, R, Melis, D, Rebella, L, Delitala, G, Pretti, V, Masala, M, Pes, C, Bolondi, L, Rasciti, L, Serio, I, Fanelli, Fr, Amoroso, A, Molfino, A, Petrillo, E, Zuccalà, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, D'Aurizio, G, Romanelli, G, Amolini, C, Chiesa, D, Picardi, A, Gentilucci, Uv, Gallo, P, Annoni, G, Corsi, M, Zazzetta, S, Bellelli, G, Szabo, H, Arturi, F, Succurro, E, Rubino, M, Sesti, G, Loria, P, Becchi, Ma, Martucci, G, Fantuzzi, A, Maurantonio, M, Serra, Mg, Bleve, Ma, Gasbarrone, L, Sajeva, Mr, Brucato, A, Ghidoni, S, Di Corato, P, Agnelli, G, Marchesini, E, Fabris, F, Carlon, M, Turatto, F, Baritusso, A, Amabile, A, Omenetto, E, Scarinzi, P, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Boari, B, De Giorgi, A, Paolisso, G, Rizzo, Mr, Laieta, Mt, Rini, G, Mansueto, P, Pepe, I, Borghi, C, Strocchi, E, De Sando, V, Pareo, I, Sabbà, C, Vella, F, Suppressa, P, Valerio, R, Agosti, P, Fontana, F, Loparco, F, Capobianco, C, Fenoglio, L, Bracco, C, Giraudo, Av, Testa, E, Serraino, C, Fargion, S, Bonara, P, Periti, G, Porzio, M, Tiraboschi, S, Peyvandi, F, Tedeschi, A, Rossio, R, Ferrari, B, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Conca, A, Gobbo, G, Pallini, G, Balduini, Cl, Bertolino, G, Provini, S, Quaglia, F, Dallegri, F, Ottonello, L, Liberale, L, Chin, W, Carassale, L, Caporotundo, S, Traisci, G, De Feudis, L, Di Carlo, S, Liberato, Nl, Buratti, A, Tognin, T, Bianchi, Gb, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Montrucchio, G, Greco, E, Tizzani, P, Petitti, P, Perciccante, A, Coralli, A, Salmi, R, Gaudenzi, P, Gamberini, S, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Masala, C, Mammarella, A, Raparelli, V, Basili, S, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Vallone, C, Bellusci, M, Setti, D, Pedrazzoli, F, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Molaro, M, Bertolotti, M, Mussi, C, Libbra, Mv, Miceli, A, Pellegrini, E, Carulli, L, Veltri, F, Sciacqua, A, Quero, M, Bagnato, C, Colangelo, L, Falbo, T, De Giorgio, R, Serra, M, Grasso, V, Ruggeri, E, Ilaria, B, Salvi, A, Leonardi, R, Grassini, C, Mascherona, I, Minelli, G, Maltese, F, Damiani, G, Capeci, W, Mattioli, M, Martino, Gp, Biondi, L, Ormas, M, Pettinari, P, Romiti, R, Messina, S, Cavallaro, F, Ghio, R, Favorini, S, Col, Ad, Minisola, S, Afeltra, A, Alemanno, P, Marigliano, B, Pipita, Me, Castellino, P, Blanco, J, Zanoli, L, Cattaneo, M, Fracasso, P, Amoruso, Mv, Saracco, V, Fogliati, M, Bussolino, C, Durante, V, Eusebi, G, Tirotta, D, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Marra, Am, Sirico, D, Moreo, G, Scopelliti, F, Gasparini, F, Cocca, M, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, Mc, Graziella, B, Baldassarre, S, Fragapani, S, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffrè, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Nieves, Rd, Alberto, Mm, Pedro, Ar, Vanessa, Lp, Lara, T, Xavier, Cv, Francesc, F, Jesus, Dm, Esperanza, Bt, Esther, Dcb, Maria, Sp, Romero, M, Blanca, Pl, Cristina, Lg, Victoria, Vgm, Saez, L, Bosco, J, Susana, Sb, Marta, Ag, Concepcion, Gb, Antonio, Fm, Hernandez, Mg, Borrego, Mp, Raquel, Pc, Florencia, Pr, Beatriz, Go, Sara, Cg, Alfonso, Gc, Marta, Pm, Garcia, Sc, Alberto, Rc, Antonio, Aa, Montserrat, Gg, Ángel, Brm, Manuel, Mj, Ignacio, Nv, Lucía, A, Alfonso, L, David, Rb, Iria, Iv, Monica, Rp., Paciullo, F., Proietti, M., Bianconi, V., Nobili, A., Pirro, M., Mannucci, P. M., Lip, G. Y. H., Lupattelli, G., Tettamanti, M., Pasina, L., Franchi, C., Perticone, F., Salerno, F., Corrao, S., Marengoni, A., Licata, G., Violi, F., Corazza, G. R., Marcucci, M., Eldin, T. K., Di Blanca, M. P. D., Lanzo, G., Astuto, S., Ardoino, I., Cortesi, L., Prisco, D., Silvestri, E., Cenci, C., Emmi, G., Biolo, G., Guarnieri, G., Zanetti, M., Fernandes, G., Chiuch, M., Vanoli, M., Grignani, G., Casella, G., Pulixi, E. A., Bernardi, M., Bassi, S. L., Santi, L., Zaccherini, G., Mannarino, E., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Palazzuoli, A., Salvatore, T., Sasso, F. C., Girelli, D., Olivieri, O., Matteazzi, T., Barbagallo, M., Plances, L., Alcamo, R., Calvo, L., Valenti, M., Zoli, M., Arno, R., Pasini, F. L., Capecchi, P. L., Bicchi, M., Palasciano, G., Modeo, M. E., Peragine, M., Pappagallo, F., Pugliese, S., Di Gennaro, C., Postiglione, A., Barbella, M. R., De Stefano, F., Cappellini, M. D., Fabio, G., Seghezzi, S., De Amicis, M. M., Mancarella, M., Mari, D., Rossi, P. D., Damanti, S., Ottolini, B. B., Bonini, G., Miceli, E., Lenti, M. V., Padula, D., Murialdo, G., Marra, A., Cattaneo, F., Secchi, M. B., Ghelfi, D., Anastasio, L., Sofia, L., Carbone, M., Davi, G., Guagnano, M. T., Sestili, S., Mancuso, G., Calipari, D., Bartone, M., Meroni, M. R., Perin, P. C., Lorenzati, B., Gruden, G., Bruno, G., Amione, C., Fornengo, P., Tassara, R., Melis, D., Rebella, L., Delitala, G., Pretti, V., Masala, M. S., Pes, C., Bolondi, L., Rasciti, L., Serio, I., Fanelli, F. R., Amoroso, A., Molfino, A., Petrillo, E., Zuccala, G., Franceschi, F., De Marco, G., Chiara, C., Marta, S., D'Aurizio, G., Romanelli, G., Amolini, C., Chiesa, D., Picardi, A., Gentilucci, U. V., Gallo, P., Annoni, G., Corsi, M., Zazzetta, S., Bellelli, G., Szabo, H., Arturi, F., Succurro, E., Rubino, M., Sesti, G., Loria, P., Becchi, M. A., Martucci, G., Fantuzzi, A., Maurantonio, M., Serra, M. G., Bleve, M. A., Gasbarrone, L., Sajeva, M. R., Brucato, A., Ghidoni, S., Di Corato, P., Agnelli, G., Marchesini, E., Fabris, F., Carlon, M., Turatto, F., Baritusso, A., Amabile, A., Omenetto, E., Scarinzi, P., Manfredini, R., Molino, C., Pala, M., Fabbian, F., Boari, B., De Giorgi, A., Paolisso, G., Rizzo, M. R., Laieta, M. T., Rini, G., Mansueto, P., Pepe, I., Borghi, C., Strocchi, E., De Sando, V., Pareo, I., Sabba, C., Vella, F. S., Suppressa, P., Valerio, R., Agosti, P., Fontana, F., Loparco, F., Capobianco, C., Fenoglio, L., Bracco, C., Giraudo, A. V., Testa, E., Serraino, C., Fargion, S., Bonara, P., Periti, G., Porzio, M., Tiraboschi, S., Peyvandi, F., Tedeschi, A., Rossio, R., Ferrari, B., Monzani, V., Savojardo, V., Folli, C., Magnini, M., Conca, A., Gobbo, G., Pallini, G., Balduini, C. L., Bertolino, G., Provini, S., Quaglia, F., Dallegri, F., Ottonello, L., Liberale, L., Chin, W. S., Carassale, L., Caporotundo, S., Traisci, G., De Feudis, L., Di Carlo, S., Liberato, N. L., Buratti, A., Tognin, T., Bianchi, G. B., Giaquinto, S., Purrello, F., Di Pino, A., Piro, S., Rozzini, R., Falanga, L., Spazzini, E., Montrucchio, G., Greco, E., Tizzani, P., Petitti, P., Perciccante, A., Coralli, A., Salmi, R., Gaudenzi, P., Gamberini, S., Semplicini, A., Gottardo, L., Vendemiale, G., Serviddio, G., Forlano, R., Masala, C., Mammarella, A., Raparelli, V., Basili, S., Perri, L., Landolfi, R., Montalto, M., Mirijello, A., Vallone, C., Bellusci, M., Setti, D., Pedrazzoli, F., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Molaro, M., Bertolotti, M., Mussi, C., Libbra, M. V., Miceli, A., Pellegrini, E., Carulli, L., Veltri, F., Sciacqua, A., Quero, M., Bagnato, C., Colangelo, L., Falbo, T., De Giorgio, R., Serra, M., Grasso, V., Ruggeri, E., Ilaria, B., Salvi, A., Leonardi, R., Grassini, C., Mascherona, I., Minelli, G., Maltese, F., Damiani, G., Capeci, W., Mattioli, M., Martino, G. P., Biondi, L., Ormas, M., Pettinari, P., Romiti, R., Messina, S., Cavallaro, F., Ghio, R., Favorini, S., Col, A. D., Minisola, S., Afeltra, A., Alemanno, P., Marigliano, B., Pipita, M. E., Castellino, P., Blanco, J., Zanoli, L., Cattaneo, M., Fracasso, P., Amoruso, M. V., Saracco, V., Fogliati, M., Bussolino, C., Durante, V., Eusebi, G., Tirotta, D., Mete, F., Gino, M., Cittadini, A., Vigorito, C., Arcopinto, M., Salzano, A., Bobbio, E., Marra, A. M., Sirico, D., Moreo, G., Scopelliti, F., Gasparini, F., Cocca, M., Ballestrero, A., Ferrando, F., Berra, S., Dassi, S., Nava, M. C., Graziella, B., Baldassarre, S., Fragapani, S., Galanti, G., Mascherini, G., Petri, C., Stefani, L., Girino, M., Piccinelli, V., Nasso, F., Gioffre, V., Pasquale, M., Scattolin, G., Martinelli, S., Turrin, M., Sechi, L., Catena, C., Colussi, G., Nieves, R. D., Alberto, M. M., Pedro, A. R., Vanessa, L. P., Lara, T., Xavier, C. V., Francesc, F., Jesus, D. M., Esperanza, B. T., Esther, D. C. B., Maria, S. P., Romero, M., Blanca, P. L., Cristina, L. G. -C., Victoria, V. G. M., Saez, L., Bosco, J., Susana, S. B., Marta, A. G., Concepcion, G. B., Antonio, F. M., Hernandez, M. G., Borrego, M. P., Raquel, P. C., Florencia, P. R., Beatriz, G. O., Sara, C. G., Alfonso, G. -C. C., Marta, P. M., Garcia, S. C., Alberto, R. C., Antonio, A. A., Montserrat, G. G., Angel, B. R. M., Manuel, M. J., Ignacio, N. V., Lucia, A. S., Alfonso, L., David, R. B., Iria, I. V., Monica, R. P., Proietti, M, Pirro, M, Mannucci, P, Lip, G, Corazza, G, Eldin, T, Di Blanca, M, Pulixi, E, Bassi, S, Sasso, F, Pasini, F, Capecchi, P, Modeo, M, Barbella, M, de Stefano, F, Cappellini, M, de Amicis, M, Rossi, P, Ottolini, B, Lenti, M, Secchi, M, Guagnano, M, Meroni, M, Perin, P, Fanelli, F, de Marco, G, D’Aurizio, G, Gentilucci, U, Becchi, M, Bleve, M, Sajeva, M, de Giorgi, A, Rizzo, M, Laieta, M, de Sando, V, Giraudo, A, Balduini, C, de Feudis, L, Liberato, N, Bianchi, G, Libbra, M, de Giorgio, R, Martino, G, Col, A, Pipita, M, Amoruso, M, Nava, M, Nieves, R, Alberto, M, Pedro, A, Vanessa, L, Xavier, C, Jesus, D, Esperanza, B, Esther, D, Maria, S, Blanca, P, Cristina, L, Victoria, V, Susana, S, Marta, A, Concepcion, G, Antonio, F, Hernandez, M, Borrego, M, Raquel, P, Florencia, P, Beatriz, G, Sara, C, Alfonso, G, Marta, P, Garcia, S, Alberto, R, Antonio, A, Montserrat, G, Ángel, B, Manuel, M, Ignacio, N, David, R, Iria, I, and Monica, R
Subjects: Male, Anti-Arrhythmia Agents/therapeutic use, antiarrhythmic agent, Comorbidity, Aged, Aged, 80 and over, Anti-Arrhythmia Agents, Atrial Fibrillation, Diabetes Mellitus, Female, Heart Failure, Heart Rate, Hospitalization, Humans, Odds Ratio, Polypharmacy, Prevalence, Geriatrics and Gerontology, Pharmacology (medical), 030204 cardiovascular system & hematology, anticoagulant agent, Diabetes Mellitus/drug therapy, 0302 clinical medicine, 80 and over, 030212 general & internal medicine, LS4_4, antiarrhythmic agent, anticoagulant agent, antithrombocytic agent, calcium channel blocking agent, digoxin, Heart Rate/drug effects, Diabetes Mellitu, Atrial fibrillation, antithrombocytic agent, digoxin, Anti-Arrhythmia Agent, Human, medicine.medical_specialty, Socio-culturale, 03 medical and health sciences, Internal medicine, Diabetes mellitus, Heart rate, calcium channel blocking agent, medicine, business.industry, Atrial Fibrillation/drug therapy, Odds ratio, medicine.disease, Heart Failure/drug therapy, Confidence interval, Heart failure, business
Abstract: Background: Among rate-control or rhythm-control strategies, there is conflicting evidence as to which is the best management approach for non-valvular atrial fibrillation (AF) in elderly patients. Design: We performed an ancillary analysis from the ‘Registro Politerapie SIMI’ study, enrolling elderly inpatients from internal medicine and geriatric wards. Methods: We considered patients enrolled from 2008 to 2014 with an AF diagnosis at admission, treated with a rate-control-only or rhythm-control-only strategy. Results: Among 1114 patients, 241 (21.6%) were managed with observation only and 122 (11%) were managed with both the rate- and rhythm-control approaches. Of the remaining 751 patients, 626 (83.4%) were managed with a rate-control-only strategy and 125 (16.6%) were managed with a rhythm-control-only strategy. Rate-control-managed patients were older (p=0.002), had a higher Short Blessed Test (SBT; p=0.022) and a lower Barthel Index (p=0.047). Polypharmacy (p=0.001), heart failure (p=0.005) and diabetes (p=0.016) were more prevalent among these patients. Median CHA2DS2-VASc score was higher among rate-control-managed patients (p=0.001). SBT [odds ratio (OR) 0.97, 95% confidence interval (CI) 0.94–1.00, p=0.037], diabetes (OR 0.48, 95% CI 0.26–0.87, p=0.016) and polypharmacy (OR 0.58, 95% CI 0.34–0.99, p=0.045) were negatively associated with a rhythm-control strategy. At follow-up, no difference was found between rate- and rhythm-control strategies for cardiovascular (CV) and all-cause deaths (6.1 vs. 5.6%, p=0.89; and 15.9 vs. 14.1%, p=0.70, respectively). Conclusion: A rate-control strategy is the most widely used among elderly AF patients with multiple comorbidities and polypharmacy. No differences were evident in CV death and all-cause death at follow-up.
Published: 2018
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16. Determinants of change in polypharmacy status in Switzerland: the population-based CoLaus study

Author: Pedro Marques-Vidal, Julien Castioni, Gérard Waeber, Peter Vollenweider, and Nazanin Abolhassani
Subjects: Adult, Male, Pediatrics, medicine.medical_specialty, Population, Population based, 030204 cardiovascular system & hematology, Overweight, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Diabetes mellitus, medicine, Diabetes Mellitus, Prevalence, Humans, Hypoglycemic Agents, Pharmacology (medical), 030212 general & internal medicine, education, Life Style, Aged, Dyslipidemias, Pharmacology, Polypharmacy, education.field_of_study, Analgesics, Psychotropic Drugs, business.industry, Smoking, Cardiovascular Agents, General Medicine, Middle Aged, medicine.disease, Analgesics/therapeutic use, Cardiovascular Agents/therapeutic use, Diabetes Mellitus/drug therapy, Diabetes Mellitus/epidemiology, Dyslipidemias/drug therapy, Dyslipidemias/epidemiology, Female, Hypertension/drug therapy, Hypertension/epidemiology, Hypoglycemic Agents/therapeutic use, Overweight/drug therapy, Overweight/epidemiology, Psychotropic Drugs/therapeutic use, Smoking/drug therapy, Smoking/epidemiology, Switzerland/epidemiology, Determinants, General population, Switzerland, Trends, Obesity, Cardiovascular agent, Hypertension, medicine.symptom, business, Dyslipidemia, Demography
Abstract: This study aimed to assess the prevalence, the change, and the determinants of change in polypharmacy in a population-based sample. Baseline (2003–2006) and follow-up (2009–2012) data are from 4679 participants aged between 35 and 75 years (53.5% women, mean age 52.6 ± 10.6 years) from the population of Lausanne, Switzerland. Polypharmacy was defined by the regular use of ≥5 drugs. Four categories of change were defined: never (no polypharmacy at baseline and follow-up), initiating (no polypharmacy at baseline but at follow-up), maintaining, or quitting. Polypharmacy increased from 7.7% at baseline to 15.3% at follow-up. Cardiovascular drugs were the most prescribed medicines at baseline and follow-up. Gender, age, obesity, smoking, previously diagnosed hypertension, or diabetes or dyslipidemia were significantly and independently associated with initiating and maintaining polypharmacy. In a population-based sample, prevalence of polypharmacy doubled over a 5.6-year period. The main determinants of initiating polypharmacy were age, overweight and obesity, smoking status, and previously diagnosed cardiovascular risk factors.
Published: 2017

17. Design and rationale of a large, international, prospective cohort study to evaluate the occurrence of malformations and perinatal/neonatal death using insulin detemir in pregnant women with diabetes in comparison with other long-acting insulins

Author: Sofia I. I. Kring, Henning F. Andersen, Peter Damm, and Elisabeth R. Mathiesen
Subjects: Adult, medicine.medical_specialty, medicine.medical_treatment, Perinatal Death, Insulin Detemir/adverse effects, Pregnancy in Diabetics, 030209 endocrinology & metabolism, Type 2 diabetes, Diabetes Mellitus/drug therapy, Hypoglycemic Agents/adverse effects, Pregnancy in Diabetics/drug therapy, 03 medical and health sciences, Study Protocol, 0302 clinical medicine, Insulin Detemir, Pregnancy, Diabetes mellitus, Obstetrics and Gynaecology, medicine, Diabetes Mellitus, Abnormalities, Drug-Induced/epidemiology, Humans, Hypoglycemic Agents, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Insulin detemir, Obstetrics, business.industry, Insulin, Diabetes, Infant, Newborn, Obstetrics and Gynecology, Abnormalities, Drug-Induced, medicine.disease, Basal (medicine), Research Design, Perinatal Death/etiology, Female, business, Cohort study, medicine.drug
Abstract: Background There are a lack of data regarding the effect of basal insulin analogues on rates of events like congenital malformation and perinatal mortality in diabetic pregnancy. Methods The present study is a prospective, non-interventional, multicentre cohort study conducted in seven countries, designed to assess the safety of insulin detemir during pregnancy, and to monitor the health status of resulting infants (exposed in utero) up to 1 year of age. The study population includes women with type 1 or type 2 diabetes, who are pregnant and being treated with insulin. Data will be collected in the context of routine practice. The primary endpoint is the proportion of pregnancies in women treated with insulin detemir, compared with other basal insulin regimens, which do not result in any of the following events: major congenital malformations, perinatal death or neonatal death. A sample size of 3075 pregnancies was calculated to provide an 80% power to detect a difference of 3.5% between groups in the primary endpoint at a 5% level. Discussion The study will also examine other important maternal endpoints (e.g., incidences of severe hypoglycaemia and pre-eclampsia) and perinatal outcomes such as overweight neonates, as well as infant outcomes at 1 year of age. It has a fixed recruitment period from 2013 to 2018, enrolling all eligible patients, and is expected to inform future prescribing with basal insulins in diabetic pregnancy. Trial registration ClinicalTrials.gov: NCT01892319 (date registered: 27.06.2013). Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-1177-4) contains supplementary material, which is available to authorized users.
Published: 2017
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18. Artemisinins Target GABA A Receptor Signaling and Impair α Cell Identity

Author: Sara Sdelci, Tibor Harkany, Keiryn L. Bennett, Kilian Huber, Patrick Collombat, Christian Honoré, Florian M. Pauler, Matthias Farlik, Ekaterine Berishvili, Monica Courtney, Igor Baburin, Stefan Kubicek, Nicole Schmitner, Jin Li, Steffen Hering, Peter Májek, Jacob Hecksher-Sørensen, Thierry Sulpice, Martin Distel, Robin A. Kimmel, Charles-Hugues Lardeau, Manuela Gridling, Johanna Klughammer, Camilla Ingvorsen, Alexey Stukalov, Christoph Bock, Andhira Vieira, François Briand, Giulio Superti-Furga, Roman A. Romanov, Thomas Frogne, Dirk Meyer, Caterina Sturtzel, Thomas Penz, Fabio Avolio, Katja Parapatics, Jacques Colinge, Andreas Spittler, Charlotte Barbieux, Tamara Casteels, Harbin Engineering University (HRBEU), Research Center for Molecular Medicine of the Austrian Academy of Sciences [Vienna, Austria] (CeMM ), Austrian Academy of Sciences (OeAW), CeMM Research Center for Molecular Medicine [Vienna, Austria], Novo Nordisk A/S , Danemark, Novo Nordisk, Institut de Biologie Valrose (IBV), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Institute for Research on Cancer and Aging, Nice (IRCAN), INSERM, U1081, CNRS UMR 7284, Nice, Innsbruck Medical University [Austria] (IMU), Leopold Franzens Universität Innsbruck - University of Innsbruck, Medizinische Universität Wien = Medical University of Vienna, Karolinska Institutet [Stockholm], Tumor Immunology [Vienna, Austria] (Children’s Cancer Research Institute), St. Anna Kinderkrebsforschung e.V. [Vienna, Austria], CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, 1090 Vienna, Austria, Physiological Chemistry, Biocenter, Am Hubland, Julius-Maximilians-Universität Würzburg [Wurtzbourg, Allemagne] (JMU), IBM PSSC Montpellier - Innovation Lab., IBM PSSC Montpellier, Physiogenex, University of Geneva [Switzerland], Geneva University Hospital (HUG), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Children’s Cancer Research Institute [Vienna, Austria], University of Vienna [Vienna], Cancer Center Karolinska [Karolinska Institutet] (CCK), Directors's Laboratory, Novo Nordisk Foundation Center for Biosustainability, and Technical University of Denmark [Lyngby] (DTU)
Subjects: 0301 basic medicine, insulin secretion, Artemisinins/administration & dosage/pharmacology, β cell, Carrier Proteins/metabolism, Diabetes Mellitus/drug therapy, Mice, Single-cell analysis, Insulin-Secreting Cells, GABA-receptor signaling, Insulin, artemisinins, gamma-Aminobutyric Acid/metabolism, Cells, Cultured, Zebrafish, gamma-Aminobutyric Acid, pancreatic endocrine transdifferentiation, ddc:617, biology, diabetes, Protein Stability, Receptors, GABA-A/metabolism, Transdifferentiation, Diabetes Mellitus, Type 1/drug therapy/pathology, 3. Good health, Cell biology, medicine.anatomical_structure, Biochemistry, ARX translocation, Artemether, MESH: Animals, Disease models, animal, Insulin/Genetics, Signal transduction, Artemisinins/Pharmacology, Single-Cell Analysis, Signal Transduction, Cell type, regenerative medicine, chemical biology, [SDV.CAN]Life Sciences [q-bio]/Cancer, Cell Transdifferentiation/drug effects, Article, General Biochemistry, Genetics and Molecular Biology, Diabetes Mellitus, Experimental, Islets of Langerhans, 03 medical and health sciences, Genetic model, Protein Stability/drug effects, Diabetes Mellitus, medicine, Homeodomain Proteins/metabolism, Regeneration, Animals, Humans, Transcription Factors/metabolism, Transcription factor, Homeodomain Proteins, Insulin/genetics/metabolism, Gephyrin, Biochemistry, Genetics and Molecular Biology(all), Gene Expression Profiling, Pancreatic islets, Membrane Proteins, Islets of Langerhans/drug effects, Receptors, GABA-A, gephyrin, Rats, Disease Models, Animal, Diabetes Mellitus, Type 1, 030104 developmental biology, Cell Transdifferentiation, biology.protein, Membrane Proteins/metabolism, Carrier Proteins, Transcription Factors
Abstract: Summary Type 1 diabetes is characterized by the destruction of pancreatic β cells, and generating new insulin-producing cells from other cell types is a major aim of regenerative medicine. One promising approach is transdifferentiation of developmentally related pancreatic cell types, including glucagon-producing α cells. In a genetic model, loss of the master regulatory transcription factor Arx is sufficient to induce the conversion of α cells to functional β-like cells. Here, we identify artemisinins as small molecules that functionally repress Arx by causing its translocation to the cytoplasm. We show that the protein gephyrin is the mammalian target of these antimalarial drugs and that the mechanism of action of these molecules depends on the enhancement of GABAA receptor signaling. Our results in zebrafish, rodents, and primary human pancreatic islets identify gephyrin as a druggable target for the regeneration of pancreatic β cell mass from α cells., Graphical Abstract, Highlights • Artemisinins inhibit ARX function and impair α cell identity • Compounds act by stabilizing gephyrin, thus enhancing GABAA receptor signaling • Artemisinins increase β cell mass in zebrafish and rodent models • Functional and transcriptional data indicate a conserved phenotype in human islets, The anti-malarial drug Artemisinin can drive the in vivo conversion of pancreatic α cells into functional β-like cells through enhanced GABA signaling and may have potential as a therapeutic for diabetes.
Published: 2017
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19. Insulin analogues in pregnancy and specific congenital anomalies:a literature review

Author: de Jong, Josta, Garne, Ester, Wender-Ozegowska, Ewa, Morgan, Margery, de Jong-van den Berg, Lolkje T. W., and Wang, Hao
Subjects: Insulin/adverse effects, Congenital anomalies, Insulin analogues, Pregnancy, Diabetes, Humans, Female, Review, Congenital Abnormalities/etiology, reproductive and urinary physiology, Diabetes Mellitus/drug therapy, Hypoglycemic Agents/adverse effects
Abstract: BACKGROUND: Insulin analogues are commonly used in pregnant women with diabetes. It is not known if the use of insulin analogues in pregnancy is associated with any higher risk of congenital anomalies in the offspring compared with use of human insulin. METHODS: We performed a literature search for studies of pregnant women with pregestational diabetes using insulin analogues in the first trimester and information on congenital anomalies. The studies were analyzed to compare the congenital anomaly rate among fetuses of mothers using insulin analogues with fetuses of mothers using human insulin. RESULTS: Of 29 studies we included 1286 fetuses of mothers using short-acting insulin analogues with 1089 references of mothers using human insulin and 768 fetuses of mothers using long-acting insulin analogues with 685 references of mothers using long-acting human insulin (Neutral Protamine Hagedorn; NPH). The congenital anomaly rate was 4.84% and 4.29% among the fetuses of mothers using lispro and aspart. For glargine and detemir the congenital anomaly rate was 2.86% and 3.47% respectively. No studies on the use of insulin glulisine and degludec in pregnancy were found. There was no statistically significant difference in the congenital anomaly rate among fetuses exposed to insulin analogues (lispro, aspart, glargine or detemir) compared to those exposed to human insulin or NPH insulin. CONCLUSION: The total prevalence of congenital anomalies was not increased for fetuses exposed to insulin analogues. The small samples in the included studies provided insufficient statistical power to identify a moderate increased risk of specific congenital anomalies. This article is protected by copyright. All rights reserved.
Published: 2016
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20. Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants

Author: NCD Risk Factor Collaboration (NCD-RisC), Zhou, B., Lu, Y., Hajifathalian, K., Bentham, J., Di Cesare, M., Danaei, G., Bixby, H., Cowan, M.J., Ali, M.K., Taddei, C., Lo, W.C., Reis-Santos, B., Stevens, G.A., Riley, L.M., Miranda, J.J., Bjerregaard, P., Rivera, J.A., Fouad, H.M., Ma, G., Mbanya, J.C., McGarvey, S.T., Mohan, V., Onat, A., Pilav, A., Ramachandran, A., Romdhane, H.B., Paciorek, C.J., Bennett, J.E., Ezzati, M., Abdeen, Z.A., Abdul Kadir, K., Abu-Rmeileh, N.M., Acosta-Cazares, B., Adams, R., Aekplakorn, W., Aguilar-Salinas, C.A., Agyemang, C., Ahmadvand, A., Al-Othman, A.R., Alkerwi, A., Amouyel, P., Amuzu, A., Andersen, L.B., Anderssen, S.A., Anjana, R.M., Aounallah-Skhiri, H., Aris, T., Arlappa, N., Arveiler, D., Assah, F.K., Avdicová, M., Azizi, F., Balakrishna, N., Bandosz, P., Barbagallo, C.M., Barceló, A., Batieha, A.M., Baur, L.A., Benet, M., Bernabe-Ortiz, A., Bharadwaj, S., Bhargava, S.K., Bi, Y., Bjertness, E., Bjertness, M.B., Björkelund, C., Blokstra, A., Bo, S., Boehm, B.O., Boissonnet, C.P., Bovet, P., Brajkovich, I., Breckenkamp, J., Brenner, H., Brewster, L.M., Brian, G.R., Bruno, G., Bugge, A., Cabrera de León, A., Can, G., Cândido, A.P., Capuano, V., Carlsson, A.C., Carvalho, M.J., Casanueva, F.F., Casas, J.P., Caserta, C.A., Castetbon, K., Chamukuttan, S., Chaturvedi, N., Chen, C.J., Chen, F., Chen, S., Cheng, C.Y., Chetrit, A., Chiou, S.T., Cho, Y., Chudek, J., Cifkova, R., Claessens, F., Concin, H., Cooper, C., Cooper, R., Costanzo, S., Cottel, D., Cowell, C., Crujeiras, A.B., D'Arrigo, G., Dallongeville, J., Dankner, R., Dauchet, L., de Gaetano, G., De Henauw, S., Deepa, M., Dehghan, A., Deschamps, V., Dhana, K., Di Castelnuovo, A.F., Djalalinia, S., Doua, K., Drygas, W., Du, Y., Dzerve, V., Egbagbe, E.E., Eggertsen, R., El Ati, J., Elosua, R., Erasmus, R.T., Erem, C., Ergor, G., Eriksen, L., Escobedo-de la Peña, J., Fall, C.H., Farzadfar, F., Felix-Redondo, F.J., Ferguson, T.S., Fernández-Bergés, D., Ferrari, M., Ferreccio, C., Feskens, E.J., Finn, J.D., Föger, B., Foo, L.H., Forslund, A.S., Francis, D.K., Franco, M.do C., Franco, O.H., Frontera, G., Furusawa, T., Gaciong, Z., Garnett, S.P., Gaspoz, J.M., Gasull, M., Gates, L., Geleijnse, J.M., Ghasemian, A., Ghimire, A., Giampaoli, S., Gianfagna, F., Giovannelli, J., Giwercman, A., Gross, M.G., González Rivas, J.P., Gorbea, M.B., Gottrand, F., Grafnetter, D., Grodzicki, T., Grøntved, A., Gruden, G., Gu, D., Guan, O.P., Guerrero, R., Guessous, I., Guimaraes, A.L., Gutierrez, L., Hambleton, I.R., Hardy, R., Hari Kumar, R., Hata, J., He, J., Heidemann, C., Herrala, S., Hihtaniemi, I.T., Ho, S.Y., Ho, S.C., Hofman, A., Hormiga, C.M., Horta, B.L., Houti, L., Howitt, C., Htay, T.T., Htet, A.S., Htike, M.M., Hu, Y., Hussieni, A.S., Huybrechts, I., Hwalla, N., Iacoviello, L., Iannone, A.G., Ibrahim, M.M., Ikeda, N., Ikram, M.A., Irazola, V.E., Islam, M., Iwasaki, M., Jacobs, J.M., Jafar, T., Jamil, K.M., Jasienska, G., Jiang, C.Q., Jonas, J.B., Joshi, P., Kafatos, A., Kalter-Leibovici, O., Kasaeian, A., Katz, J., Kaur, P., Kavousi, M., Keinänen-Kiukaanniemi, S., Kelishadi, R., Kengne, A.P., Kersting, M., Khader, Y.S., Khalili, D., Khang, Y.H., Kiechl, S., Kim, J., Kolsteren, P., Korrovits, P., Kratzer, W., Kromhout, D., Kujala, U.M., Kula, K., Kyobutungi, C., Laatikainen, T., Lachat, C., Laid, Y., Lam, T.H., Landrove, O., Lanska, V., Lappas, G., Laxmaiah, A., Leclercq, C., Lee, J., Lehtimäki, T., Lekhraj, R., León-Muñoz, L.M., Li, Y., Lim, W.Y., Lima-Costa, M.F., Lin, H.H., Lin, X., Lissner, L., Lorbeer, R., Lozano, J.E., Luksiene, D., Lundqvist, A., Lytsy, P., Machado-Coelho, G.L., Machi, S., Maggi, S., Magliano, D.J., Makdisse, M., Mallikharjuna Rao, K., Manios, Y., Manzato, E., Margozzini, P., Marques-Vidal, P., Martorell, R., Masoodi, S.R., Mathiesen, E.B., Matsha, T.E., McFarlane, S.R., McLachlan, S., McNulty, B.A., Mediene-Benchekor, S., Meirhaeghe, A., Menezes, A.M., Merat, S., Meshram, I.I., Mi, J., Miquel, J.F., Mohamed, M.K., Mohammad, K., Mohammadifard, N., Mohd Yusoff, M.F., Møller, N.C., Molnár, D., Mondo, C.K., Morejon, A., Moreno, L.A., Morgan, K., Moschonis, G., Mossakowska, M., Mostafa, A., Mota, J., Motta, J., Mu, T.T., Muiesan, M.L., Müller-Nurasyid, M., Mursu, J., Nagel, G., Námešná, J., Nang, E.E., NangThetia, V.B., Navarrete-Muñoz, E.M., Ndiaye, N.C., Nenko, I., Nervi, F., Nguyen, N.D., Nguyen, Q.N., Nieto-Martínez, R.E., Ning, G., Ninomiya, T., Noale, M., Noto, D., Nsour, M.A., Ochoa-Avilés, A.M., Oh, K., Ordunez, P., Osmond, C., Otero, J.A., Owusu-Dabo, E., Pahomova, E., Palmieri, L., Panda-Jonas, S., Panza, F., Parsaeian, M., Peixoto, S.V., Peltonen, M., Peters, A., Peykari, N., Pham, S.T., Pitakaka, F., Piwonska, A., Piwonski, J., Plans-Rubió, P., Porta, M., Portegies, M.L., Poustchi, H., Pradeepa, R., Price, J.F., Punab, M., Qasrawi, R.F., Qorbani, M., Radisauskas, R., Rahman, M., Raitakari, O., Rao, S.R., Ramke, J., Ramos, R., Rampal, S., Rathmann, W., Redon, J., Reganit, P.F., Rigo, F., Robinson, S.M., Robitaille, C., Rodríguez-Artalejo, F., Rodriguez-Perez, M.del C., Rodríguez-Villamizar, L.A., Rojas-Martinez, R., Ronkainen, K., Rosengren, A., Rubinstein, A., Rui, O., Ruiz-Betancourt, B.S., Russo Horimoto, R.V., Rutkowski, M., Sabanayagam, C., Sachdev, H.S., Saidi, O., Sakarya, S., Salanave, B., Salonen, J.T., Salvetti, M., Sánchez-Abanto, J., Santos, D., dos Santos, R.N., Santos, R., Saramies, J.L., Sardinha, L.B., Sarrafzadegan, N., Saum, K.U., Scazufca, M., Schargrodsky, H., Scheidt-Nave, C., Sein, A.A., Sharma, S.K., Shaw, J.E., Shibuya, K., Shin, Y., Shiri, R., Siantar, R., Sibai, A.M., Simon, M., Simons, J., Simons, L.A., Sjostrom, M., Slowikowska-Hilczer, J., Slusarczyk, P., Smeeth, L., Snijder, M.B., So, H.K., Sobngwi, E., Söderberg, S., Solfrizzi, V., Sonestedt, E., Soumare, A., Staessen, J.A., Stathopoulou, M.G., Steene-Johannessen, J., Stehle, P., Stein, A.D., Stessman, J., Stöckl, D., Stokwiszewski, J., Stronks, K., Strufaldi, M.W., Sun, C.A., Sundström, J., Sung, Y.T., Suriyawongpaisal, P., Sy, R.G., Tai, E.S., Tamosiunas, A., Tang, L., Tarawneh, M., Tarqui-Mamani, C.B., Taylor, A., Theobald, H., Thijs, L., Thuesen, B.H., Tolonen, H.K., Tolstrup, J.S., Topbas, M., Torrent, M., Traissac, P., Trinh, O.T., Tulloch-Reid, M.K., Tuomainen, T.P., Turley, M.L., Tzourio, C., Ueda, P., Ukoli, F.A., Ulmer, H., Uusitalo, H.M., Valdivia, G., Valvi, D., van Rossem, L., van Valkengoed, I.G., Vanderschueren, D., Vanuzzo, D., Vega, T., Velasquez-Melendez, G., Veronesi, G., Verschuren, W.M., Verstraeten, R., Viet, L., Vioque, J., Virtanen, J.K., Visvikis-Siest, S., Viswanathan, B., Vollenweider, P., Voutilainen, S., Vrijheid, M., Wade, A.N., Wagner, A., Walton, J., Wan Mohamud, W.N., Wang, F., Wang, M.D., Wang, Q., Wang, Y.X., Wannamethee, S.G., Weerasekera, D., Whincup, P.H., Widhalm, K., Wiecek, A., Wijga, A.H., Wilks, R.J., Willeit, J., Wilsgaard, T., Wojtyniak, B., Wong, T.Y., Woo, J., Woodward, M., Wu, F.C., Wu, S.L., Xu, H., Yan, W., Yang, X., Ye, X., Yoshihara, A., Younger-Coleman, N.O., Zambon, S., Zargar, A.H., Zdrojewski, T., Zhao, W., Zheng, Y., and Zuñiga Cisneros, J.
Subjects: Adult, Age Distribution, Age of Onset, Bayes Theorem, Blood Glucose/metabolism, Cost of Illness, Developing Countries/statistics & numerical data, Diabetes Mellitus/blood, Diabetes Mellitus/drug therapy, Diabetes Mellitus/epidemiology, Female, Global Health, Health Surveys, Humans, Hypoglycemic Agents/therapeutic use, Incidence, Insulin/therapeutic use, Male, Prevalence, Research Report/standards, Sex Distribution
Abstract: One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes. We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence-defined as fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs-in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue. We used data from 751 studies including 4,372,000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-7.0) in 1980 to 9.0% (7.2-11.1) in 2014 in men, and from 5.0% (2.9-7.9) to 7.9% (6.4-9.7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28.5% due to the rise in prevalence, 39.7% due to population growth and ageing, and 31.8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target. Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults affected, has increased faster in low-income and middle-income countries than in high-income countries. Wellcome Trust.
Published: 2016

21. Polypharmacy and specific comorbidities in university primary care settings

Author: Carole E. Aubert, Bruno R. da Costa, Sven Streit, Jacques Cornuz, Nicolas Rodondi, Drahomir Aujesky, Tinh-Hai Collet, Jean-Michel Gaspoz, and Doug C. Bauer
Subjects: Male, Pediatrics, Databases, Factual, Cross-sectional study, Inappropriate Prescribing, Comorbidity, 030204 cardiovascular system & hematology, Diabetes Mellitus/drug therapy, Hospitals, University, 0302 clinical medicine, 80 and over, Renal Insufficiency, 030212 general & internal medicine, Aged, 80 and over, Hypertension/drug therapy, Pharmacoepidemiology, Middle Aged, Hospitals, 3. Good health, Cardiovascular Diseases, Hypertension, symbols, Female, Switzerland, medicine.medical_specialty, Chronic/drug therapy, Aged, Cardiovascular Diseases/drug therapy, Cross-Sectional Studies, Humans, Inappropriate Prescribing/statistics & numerical data, Logistic Models, Multivariate Analysis, Polypharmacy, Primary Health Care, Renal Insufficiency, Chronic/drug therapy, Comorbidities, Inappropriate prescribing, Multimorbidity, Databases, 03 medical and health sciences, symbols.namesake, Internal medicine, mental disorders, Internal Medicine, medicine, Diabetes Mellitus, Poisson regression, Renal Insufficiency, Chronic, Factual, ddc:613, University, business.industry, Odds ratio, medicine.disease, business, Body mass index, Kidney disease
Abstract: Aims Polypharmacy is associated with adverse events and multimorbidity, but data are limited on its association with specific comorbidities in primary care settings. We measured the prevalence of polypharmacy and inappropriate prescribing, and assessed the association of polypharmacy with specific comorbidities. Methods We did a cross-sectional analysis of 1002 patients aged 50–80 years followed in Swiss university primary care settings. We defined polypharmacy as ≥ 5 long-term prescribed drugs and multimorbidity as ≥ 2 comorbidities. We used logistic mixed-effects regression to assess the association of polypharmacy with the number of comorbidities, multimorbidity, specific sets of comorbidities, potentially inappropriate prescribing (PIP) and potential prescribing omission (PPO). We used multilevel mixed-effects Poisson regression to assess the association of the number of drugs with the same parameters. Results Patients (mean age 63.5 years, 67.5% ≥ 2 comorbidities, 37.0% ≥ 5 drugs) had a mean of 3.9 (range 0–17) drugs. Age, BMI, multimorbidity, hypertension, diabetes mellitus, chronic kidney disease, and cardiovascular diseases were independently associated with polypharmacy. The association was particularly strong for hypertension (OR 8.49, 95%CI 5.25–13.73), multimorbidity (OR 6.14, 95%CI 4.16–9.08), and oldest age (75–80 years: OR 4.73, 95%CI 2.46–9.10 vs.50–54 years). The prevalence of PPO was 32.2% and PIP was more frequent among participants with polypharmacy (9.3% vs. 3.2%, p Conclusions Polypharmacy is common in university primary care settings, is strongly associated with hypertension, diabetes mellitus, chronic kidney disease and cardiovascular diseases, and increases potentially inappropriate prescribing. Multimorbid patients should be included in further trials for developing adapted guidelines and avoiding inappropriate prescribing.
Published: 2016

22. Treatment Intensification and Risk Factor Control

Author: Connie S. Uratsu, Nicolas Rodondi, Bruce Fireman, Julie A. Schmittdiel, Joseph V. Selby, Tiffany Peng, Eve A. Kerr, and Andrew J. Karter
Subjects: medicine.medical_specialty, business.industry, Treatment intensification, media_common.quotation_subject, Public Health, Environmental and Occupational Health, Aged, Antihypertensive Agents/administration & dosage, Antihypertensive Agents/therapeutic use, Antilipemic Agents/administration & dosage, Antilipemic Agents/therapeutic use, California, Cardiovascular Diseases/prevention & control, Chronic Disease/drug therapy, Diabetes Mellitus/drug therapy, Drug Therapy/methods, Drug Therapy/standards, Female, Humans, Hyperlipidemias/drug therapy, Hypertension/drug therapy, Hypoglycemic Agents/administration & dosage, Hypoglycemic Agents/therapeutic use, Male, Managed Care Programs, Middle Aged, Outcome and Process Assessment (Health Care), Quality Indicators, Health Care/standards, Risk Factors, Pharmacotherapy, Chronic disease, Physical therapy, Medicine, Quality (business), Risk factor, business, Intensive care medicine, media_common
Abstract: BACKGROUND: Intensification of pharmacotherapy in persons with poorly controlled chronic conditions has been proposed as a clinically meaningful process measure of quality. OBJECTIVE: To validate measures of treatment intensification by evaluating their associations with subsequent control in hypertension, hyperlipidemia, and diabetes mellitus across 35 medical facility populations in Kaiser Permanente, Northern California. DESIGN: Hierarchical analyses of associations of improvements in facility-level treatment intensification rates from 2001 to 2003 with patient-level risk factor levels at the end of 2003. PATIENTS: Members (515,072 and 626,130; age >20 years) with hypertension, hyperlipidemia, and/or diabetes mellitus in 2001 and 2003, respectively. MEASUREMENTS: Treatment intensification for each risk factor defined as an increase in number of drug classes prescribed, of dosage for at least 1 drug, or switching to a drug from another class within 3 months of observed poor risk factor control. RESULTS: Facility-level improvements in treatment intensification rates between 2001 and 2003 were strongly associated with greater likelihood of being in control at the end of 2003 (P < or = 0.05 for each risk factor) after adjustment for patient- and facility-level covariates. Compared with facility rankings based solely on control, addition of percentages of poorly controlled patients who received treatment intensification changed 2003 rankings substantially: 14%, 51%, and 29% of the facilities changed ranks by 5 or more positions for hypertension, hyperlipidemia, and diabetes, respectively. CONCLUSIONS: Treatment intensification is tightly linked to improved control. Thus, it deserves consideration as a process measure for motivating quality improvement and possibly for measuring clinical performance.
Published: 2009
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23. Emphysematous perinephric abscess with diabetes mellitus: a case report

Author: Suzuki, Kenichi, Hagisawa, Shigeru, Mitsuzuka, Koji, and Takeuchi, Mutsuo
Subjects: Diabetic Nephropathies/etiology/therapy, Abscess/etiology/therapy, Escherichia coli Infections/etiology/therapy, Middle Aged, Diabetes Mellitus/drug therapy, Diabetes Complications, Anti-Bacterial Agents/therapeutic use, Kidney Diseases/etiology/therapy, Insulin/therapeutic use, Emphysema/etiology/therapy, Drainage, Humans, Female, 494.9
Abstract: 48歳女.主訴は発熱, 左側腹部痛.重篤な糖尿病であり, CTでは左腎周囲の多量の気腫と膿瘍と思われる液体貯留を認めた.DIPにては左腎を取り囲む多量のガス像を認め, 左腸腰筋の輪郭が不明瞭であったが結石や尿路の通過障害は認めなかった.入院時より抗生剤(セフォゾプラン)及びγグロブリン投与を行い, 食事は1200kcal/日とし, インスリンを用いた糖尿病の治療を開始した.入院後5日間保存的治療にても, 39℃台の発熱が軽快しない為, 全身麻酔下に左肋骨弓下に約5cmの切開を行いドレナージを行った.ドレナージ約2ヵ月後のCTでは, 左腎周囲の膿瘍は殆ど認められなくなった, A 48-year-old woman was referred to our hospital with high fever and left flank pain. She was diagnosed with diabetes mellitus (DM), and abdominal computed tomography (CT) revealed left perinephric abscess with much emphysema. She underwent drainage of the abscess by left flank incision after treatment with antibiotics and insulin. The pus culture revealed Escherichia coli. Immediately after drainage, the symptoms began to subside. At three months after drainage, abdominal CT revealed no emphysema around the left kidney. At 18 months after the discharge, left perinephric abscess was not seen and DM was well controlled with insulin.
Published: 2002

24. Use of metformin and survival of diabetic women with breast cancer

Author: Paul J.H.L. Peeters, Marloes T Bazelier, Marjanka K. Schmidt, Frank de Vries, Hubert G. M. Leufkens, Peter Vestergaard, and Marie L. De Bruin
Subjects: Research design, Survival, type 2 diabetes mellitus, Denmark, Comorbidity, Toxicology, Diabetes Mellitus/drug therapy, Cohort Studies, Breast cancer, 0302 clinical medicine, Risk Factors, 80 and over, Pharmacology (medical), Registries, Young adult, Cause of death, Aged, 80 and over, 0303 health sciences, Middle Aged, Metformin, 3. Good health, Treatment Outcome, 030220 oncology & carcinogenesis, Female, Cohort study, medicine.drug, Adult, medicine.medical_specialty, Breast Neoplasms/complications, Adolescent, Breast Neoplasms, Hypoglycemic Agents/therapeutic use, Article, Young Adult, 03 medical and health sciences, Internal medicine, Diabetes Mellitus, medicine, Hypoglycemic Agents, Humans, Metformin/therapeutic use, Aged, 030304 developmental biology, Pharmacology, Gynecology, business.industry, medicine.disease, mortality, Denmark/epidemiology, Discontinuation, business, Follow-Up Studies
Abstract: OBJECTIVE: This study was set out to determine whether metformin use influences survival in breast cancer patients treated with antidiabetic drugs as compared to non-users.RESEARCH DESIGN AND METHODS: We used data from the Danish national registries (1996-2008) to identify adult female patients diagnosed with breast cancer who were prescribed antidiabetic medication. We performed multivariate Coxproportional hazard regression to assess all-cause and breast cancer-specific mortality risks associated with metformin exposure. In a secondary analysis, we stratified use of metformin according to the cumulative number of prescriptions.RESULTS: Of the 1058 breast cancer patients 349 died during follow-up, with breast cancer listed as the primary cause of death for 152 cases. Compared to non-use, current metformin treatment was associated with a significant reduction in overall mortality (adjusted HR 0.74, 95% CI, 0.58-0.96). For breast cancer-specific mortality, a non-significant risk reduction (adjusted HR 0.88, 95% CI, 0.59-1.29) was observed, which became significant after stratification according to cumulative number of prescriptions. An increased risk of both overall and breast cancer-specific mortality was observed in the first 12 months after discontinuation of metformin.CONCLUSIONS: We observed a nonsignificant reduction in breast cancer-specific mortality associated with metformin exposure among breast cancer patients treated with antidiabetic drugs. However, our findings suggest that long-term metformin use may have a beneficial effect on survival in patients with breast cancer. Further confirmation of these findings is needed.
Published: 2013
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25. Endothelial small-conductance and intermediate-conductance KCa channels:An Update on Their Pharmacology and Usefulness as Cardiovascular Targets

Author: Heike Wulff and Ralf Köhler
Subjects: Endothelium, Vascular/drug effects, Ataxia, Vascular smooth muscle, Small-Conductance Calcium-Activated Potassium Channels, Biological Factors/metabolism, Pharmacology, Biology, Apamin, KCa3.1, KCa2.3, Article, Diabetes Mellitus/drug therapy, Bursting, chemistry.chemical_compound, Biological Factors, action potential, medicine, Diabetes Mellitus, endothelium-derived hyperpolarization, Humans, Animals, Molecular Targeted Therapy, B cell, lymphocyte activation, small/intermediate-conductance calcium-activated K+ channel, blood pressure, Afterhyperpolarization, Hyperpolarization (biology), Small-Conductance Calcium-Activated Potassium Channels/drug effects, Intermediate-Conductance Calcium-Activated Potassium Channels, Intermediate-Conductance Calcium-Activated Potassium Channels/drug effects, gating modulation, medicine.anatomical_structure, chemistry, Cardiovascular Diseases, Drug Design, afterhyperpolarizatin, Neuron, Endothelium, Vascular, medicine.symptom, Cardiovascular Diseases/drug therapy, Cardiology and Cardiovascular Medicine
Abstract: Most cardiovascular researchers are familiar with intermediate-conductance KCa3.1 and small-conductance KCa2.3 channels because of their contribution to endothelium-derived hyperpolarization. However, to immunologists and neuroscientists, these channels are primarily known for their role in lymphocyte activation and neuronal excitability. KCa3.1 is involved in the proliferation and migration of T cells, B cells, mast cells, macrophages, fibroblasts, and dedifferentiated vascular smooth muscle cells and is, therefore, being pursued as a potential target for use in asthma, immunosuppression, and fibroproliferative disorders. In contrast, the 3 KCa2 channels (KCa2.1, KCa2.2, and KCa2.3) contribute to the neuronal medium afterhyperpolarization and, depending on the type of neuron, are involved in determining firing rates and frequencies or in regulating bursting. KCa2 activators are accordingly being studied as potential therapeutics for ataxia and epilepsy, whereas KCa2 channel inhibitors like apamin have long been known to improve learning and memory in rodents. Given this background, we review the recent discoveries of novel KCa3.1 and KCa2.3 modulators and critically assess the potential of KCa activators for the treatment of diabetes and cardiovascular diseases by improving endothelium-derived hyperpolarizations.
Published: 2013
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26. Hypoglycémie chez des patients porteurs de pompe a insuline [Hypoglycemia in patients treated with an external insulin pump]

Author: Laurent, J.C., Waeber, G., Ruiz, J., and Carron, P.N.
Subjects: Diabetes Mellitus/drug therapy, Humans, Hypoglycemia/chemically induced, Hypoglycemia/prevention & control, Hypoglycemic Agents/administration & dosage, Hypoglycemic Agents/adverse effects, Insulin/administration & dosage, Insulin/adverse effects, Insulin Infusion Systems/adverse effects
Abstract: Hypoglycemia is a potentially serious complication of insulin therapy. Some insulin-dependent diabetic patients can benefit from continuous subcutaneous insulin infusion therapy (an "insulin pump"), which in most case improves glycemia control and decreases the occurrence of hypoglycemic episodes. However, such events may occur, particularly during initial treatment phases or pregnancy. Severe hypoglycemia is mainly managed by stopping the insulin pump and insuring an adequate carbohydrate intake. Patients with insulin pumps and their entourage should receive specific instruction in the adjustment of pump flow in the presence of dysglycemia-inducing circumstances (illness, physical exertion), as well as in anticipation of high-risk situations, such as motor-vehicle driving.
Published: 2011

27. Comment minimiser la prise de poids secondaire au traitement d'insuline?

Author: Philippe, Jacques
Subjects: ddc:616, Hypoglycemia/chemically induced/prevention & control, Insulin/*adverse effects/therapeutic use, Hypoglycemic Agents/*adverse effects/therapeutic use, Humans, Exercise, Life Style, Weight Gain/*drug effects, Caloric Restriction, Diabetes Mellitus/drug therapy
Abstract: Insulin treatment is associated with two important and frequent side effects: hypoglycemia and weight gain. Weight gain is in contradiction with the physiological central effect of insulin which leads to decreased food intake like leptin. However, decreased urinary caloric loss due to better glycemic control, prevention and correction of hypoglycemia, the anabolic effect of insulin and the possible central resistance to insulin explain the observed weight gain. Insulin is often necessary when oral antidiabetic treatment fails; the physician and the patient need to remain alert to minimize the side effects through adequate insulin regimen and life style.
Published: 2010

28. Insuline et cancer: mythe ou realité?

Author: Tran, Christel, Gariani, Karim, and Philippe, Jacques
Subjects: ddc:616, Insulin, Long-Acting, Risk, Hypoglycemic Agents/administration & dosage/*adverse effects, Insulin/administration & dosage/adverse effects/*analogs & derivatives, Evidence-Based Medicine, Incidence, Humans, Neoplasms/*chemically induced, Diabetes Mellitus/drug therapy
Abstract: Several insulin analogues have been developed in recent years and are increasingly being used in the treatment of diabetes. However, modifying the insulin molecule not only changes its metabolic effects, but can also alter its mitogenic potency. In vitro experiments had previously suggested a potential association between insulin analogues and cancer. In 2009 several articles were published in Diabetologia describing an association between administration of glargine (Lantus) and higher incidence of cancer rates. The present article aims at briefly presenting the state of the art based upon currently available data on insulin and cancer. We will summarize the mechanisms by which insulin can increase cell proliferation, the observations reported in recent publications and finally conclude with some practical recommendations.
Published: 2010

29. The PPAR-gamma activator rosiglitazone fails to lower plasma growth hormone and insulin-like growth factor-1 levels in patients with acromegaly

Author: Bastemir M, Akin F, and Yaylali GF
Subjects: Acromegaly/blood/*drug therapy, Adenoma/blood/drug therapy, Adult, Diabetes Mellitus/drug therapy, Female, Growth Hormone-Secreting Pituitary Adenoma/blood/drug therapy, Human Growth Hormone/*blood, Humans, Hypoglycemic Agents/*administration & dosage, Insulin-Like Growth Factor I/*metabolism, Male, Middle Aged, PPAR gamma/agonists/*metabolism, Prospective Studies, Rosiglitazone, Thiazolidinediones/*administration & dosage, Treatment Failure
Abstract: BACKGROUND/AIM: Despite combined therapy consisting of surgery, external X-ray, and medical therapy, a significant number of acromegaly patients continue to have uncontrolled growth hormone (GH) secretion and active disease. These patients, particularly those with large or invasive tumors, require additional therapy to decrease their GH levels. Our aim was to investigate whether patients with documented GH-secreting pituitary adenomas leading to acromegaly would respond with attenuation of GH and insulin-like growth factor-1 (IGF-1) levels after treatment with a peroxisome proliferator-activated receptor gamma (PPAR-gamma) agonist. METHODS: We conducted prospective analyses in the Endocrinology Clinic of the Pamukkale University. Acromegaly patients who had active disease participated in two admissions: before and after 6 weeks of daily treatment with 8 mg of oral rosiglitazone. Four male and 3 female patients have completed the study. Basal and nadir GH levels during an oral glucose tolerance test were determined, and the IGF-1 and IGF-binding protein-3 levels were also measured both before and 6 weeks after the rosiglitazone treatment. RESULTS: Treatment with rosigitazone did not reduce basal and nadir GH levels during the oral glucose tolerance test and the IGF-1 levels in the patient population as a whole (p > 0.05). CONCLUSIONS: The PPAR-gamma activator rosiglitazone, used at maximum approved dosage, did not reduce plasma GH and IGF-1 levels in patients with acromegaly. Further studies with higher doses and longer duration of PPAR-gamma agonist administration would be required to determine its usefulness in the treatment in this group of patients.
Published: 2007

30. Amiodarone protects diabetics and non-diabetics undergoing coronary artery bypass grafting equally

Author: Zebis, Lars R, Christensen, Thomas D, Thomsen, Henrik F, Hjortdal, Vibeke E, Zebis, Lars R, Christensen, Thomas D, Thomsen, Henrik F, and Hjortdal, Vibeke E
Abstract: OBJECTIVE: To evaluate amiodarone prophylaxis in diabetics and non-diabetics. Further to clarify whether the risk of developing atrial fibrillation is higher for diabetics than non-diabetic patients, and to evaluate whether the diabetic status has any influence on the length of in-hospital stay.DESIGN: Subgroup analysis within a randomized, controlled, double-blinded trial.RESULTS: At 30 days of follow-up atrial fibrillation was equally frequent among diabetics (22%) and non-diabetics (17%) (p =0.41). The length of in-hospital stay for diabetics was prolonged with 25% (9%; 45%). The prophylactic amiodarone was found equally efficient in diabetics and non-diabetics, as the relative risk ratios were 1.2 (0.4-5.4) and 2.0 (0.3-12.5), respectively.CONCLUSIONS: Diabetics and non-diabetics had the same effect of the amiodarone prophylaxis regime. Atrial fibrillation developed equally among diabetics and non-diabetics, but the length of stay was prolonged for diabetics.
Published: 2008

31. This title is unavailable for guests, please login to see more information.

Author: Suzuki, Kenichi, Hagisawa, Shigeru, Mitsuzuka, Koji, Takeuchi, Mutsuo, Suzuki, Kenichi, Hagisawa, Shigeru, Mitsuzuka, Koji, and Takeuchi, Mutsuo
Abstract: A 48-year-old woman was referred to our hospital with high fever and left flank pain. She was diagnosed with diabetes mellitus (DM), and abdominal computed tomography (CT) revealed left perinephric abscess with much emphysema. She underwent drainage of the abscess by left flank incision after treatment with antibiotics and insulin. The pus culture revealed Escherichia coli. Immediately after drainage, the symptoms began to subside. At three months after drainage, abdominal CT revealed no emphysema around the left kidney. At 18 months after the discharge, left perinephric abscess was not seen and DM was well controlled with insulin.
Published: 2002

32. Signal transduction : multiple pathways, multiple options for therapy

Author: Heldin, Carl-Henrik and Heldin, Carl-Henrik
Abstract: Many aspects of cell behavior, such as growth, motility, differentiation, and apoptosis, are regulated by signals cells receive from their environment. Such signals are important, e.g., during embryonal development, wound healing, hematopoiesis, and in the regulation of the immune response, and may come from interactions with other cells or components of the extracellular matrix, or from binding of soluble signaling molecules to specific receptors at the cell membrane. Hereby different signaling pathways are initiated inside the cell. Perturbations of such signaling pathways are seen in several types of diseases, e.g., cancer, inflammatory conditions, and atherosclerosis. Thus, antagonists of several signaling pathways have potential clinical utility. Several such compounds are currently used or are in clinical trials; others are currently being analyzed in animal models.
Published: 2001
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33. Trends in self-reported prevalence and management of hypertension, hypercholesterolemia and diabetes in Swiss adults, 1997-2007

Author: Peter Vollenweider, Fred Paccaud, Pedro Marques-Vidal, and Daniel Estoppey
Subjects: Adult, Male, Pediatrics, medicine.medical_specialty, Adolescent, Cross-sectional study, Population, Hypercholesterolemia, Aged, Cross-Sectional Studies, Diabetes Mellitus/drug therapy, Diabetes Mellitus/epidemiology, Female, Humans, Hypercholesterolemia/drug therapy, Hypercholesterolemia/epidemiology, Hypertension/drug therapy, Hypertension/epidemiology, Mass Screening/statistics & numerical data, Middle Aged, Self Care, Switzerland/epidemiology, Young Adult, Diabetes mellitus, Epidemiology, medicine, Diabetes Mellitus, Mass Screening, Young adult, education, Mass screening, education.field_of_study, business.industry, Mortality rate, lcsh:Public aspects of medicine, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, medicine.disease, Hypertension, Biostatistics, business, Switzerland, Research Article
Abstract: Background Switzerland has a low mortality rate from cardiovascular diseases, but little is known regarding prevalence and management of cardiovascular risk factors (CV RFs: hypertension, hypercholesterolemia and diabetes) in the general population. In this study, we assessed 10-year trends in self-reported prevalence and management of cardiovascular risk factors in Switzerland. Methods data from three national health interview surveys conducted between 1997 and 2007 in representative samples of the Swiss adult population (49,261 subjects overall). Self-reported CV RFs prevalence, treatment and control levels were computed. The sample was weighted to match the sex - and age distribution, geographical location and nationality of the entire adult population of Switzerland. Results self-reported prevalence of hypertension, hypercholesterolemia and diabetes increased from 22.1%, 11.9% and 3.3% in 1997 to 24.1%, 17.4% and 4.8% in 2007, respectively. Prevalence of self-reported treatment among subjects with CV RFs also increased from 52.1%, 18.5% and 50.0% in 1997 to 60.4%, 38.8% and 53.3% in 2007 for hypertension, hypercholesterolemia and diabetes, respectively. Self-reported control levels increased from 56.4%, 52.9% and 50.0% in 1997 to 80.6%, 75.1% and 53.3% in 2007 for hypertension, hypercholesterolemia and diabetes, respectively. Finally, screening during the last 12 months increased from 84.5%, 86.5% and 87.4% in 1997 to 94.0%, 94.6% and 94.1% in 2007 for hypertension, hypercholesterolemia and diabetes, respectively. Conclusion in Switzerland, the prevalences of self-reported hypertension, hypercholesterolemia and diabetes have increased between 1997 and 2007. Management and screening have improved, but further improvements can still be achieved as over one third of subjects with reported CV RFs are not treated.
Published: 2011

34. Use of insulin and insulin analogs and risk of cancer - systematic review and meta-analysis of observational studies

Author: Morten Andersen, Jari Haukka, Jacob Starup-Linde, Anssi Auvinen, Peter Vestergaard, Øystein Karlstad, Marloes T Bazelier, Kari Furu, Marie L. De Bruin, Marjanka K. Schmidt, Frank de Vries, and Vidar Hjellvik
Subjects: Oncology, Colorectal cancer, medicine.medical_treatment, Insulin Glargine, VDP::Medisinske fag: 700::Helsefag: 800::Epidemiologi medisinsk og odontologisk statistikk: 803, Toxicology, Diabetes Mellitus/drug therapy, Hypoglycemic Agents/adverse effects, Cohort Studies, Cancer risk, 0302 clinical medicine, Neoplasms, Insulin, Pharmacology (medical), Registries, Breast Neoplasms/chemically induced, 2. Zero hunger, 3. Good health, Insulin, Long-Acting, Insulin/adverse effects, Observational Studies as Topic, Research Design, 030220 oncology & carcinogenesis, Meta-analysis, diabetes mellitus, Female, VDP::Midical sciences: 700::Health sciences: 800::Epidemiology, medical and dental statistics: 803, systematic review, Colorectal Neoplasms, medicine.drug, medicine.medical_specialty, Breast Neoplasms, Long-Acting/adverse effects, 030209 endocrinology & metabolism, Article, 03 medical and health sciences, Breast cancer, Colorectal Neoplasms/chemically induced, Internal medicine, Diabetes mellitus, medicine, Hypoglycemic Agents, Humans, Pharmacology, business.industry, Insulin glargine, Case-control study, Cancer, medicine.disease, meta-analysis, Endocrinology, Case-Control Studies, business, Neoplasms/epidemiology, Publication Bias, neoplasm
Abstract: Background: An association of insulin use and risk of cancer has been reported but evidence is conflicting and methodological issues have been identified. Objective: To summarize results regarding insulin use and cancer risk by a systematic review and meta-analysis of cohort and case-control studies examining risk of cancer associated with insulin use in patients with diabetes. Data Sources: Systematic literature search in 5 databases: PubMed, Embase, Web of Science, Scopus and Cochrane Library. Study Eligibility Criteria (PICOS): Population: diabetes patients. Exposure: Users of any exogenous insulin. Comparison: Diabetes patients with or without use of antidiabetic drugs. Outcome: Any incident cancer. Study Design: Cohort and case-control studies. Results: 42 eligible studies examined risk of any cancer and 27 site-specific cancers. Results of individual studies were heterogeneous. Meta-analyses were significant for: Insulin vs No Insulin: Increased risk for pancreas, liver, kidney, stomach and respiratory cancer, decreased risk for prostate cancer. Insulin vs Non-Insulin Antidiabetics: Increased risk for any, pancreatic and colorectal cancer. Glargine vs Non-Glargine Insulin: Increased risk for breast cancer, decreased risk for colon cancer. Limitations: Few studies available for most cancer sites and exposure contrasts, and few assess effect of dose and duration of exposure. Methodological issues in several studies. Availability of confounders. Conclusions: Insulin use was associated with risk of cancer at several sites. Cautious interpretation of results is warranted as methodological issues and limitations in several of the included studies have been identified. Choice of study design may have a profound effect on estimated cancer risk.
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35. Health systems research for policy change: lessons from the implementation of rapid assessment protocols for diabetes in low- and middle-income settings

Author: David Beran, María Kathia Cárdenas, Maryam Bigdeli, and J. Jaime Miranda
Subjects: Program evaluation, Asia, International Cooperation, Decision Making, Developing country, Context (language use), Nicaragua, Computer-assisted web interviewing, Health systems research, World Health Organization, Trust, Health Services Accessibility, Health administration, Diabetes Mellitus/drug therapy, Health Services Research/methods, Health systems, Nursing, purl.org/pe-repo/ocde/ford#3.03.02 [https], Surveys and Questionnaires, Credibility, Diabetes Mellitus, Insulin, Medicine, Humans, Cooperative Behavior, Policy Making, Developing Countries, Health policy, ddc:613, business.industry, Research, Health Policy, Diabetes, Health services research, Administrative Personnel, Public relations, Policy, Attitude, Insulin/therapeutic use, Africa, Income, Health Services Research, business, Program Evaluation
Abstract: BACKGROUND: As many challenges exist for access to diabetes care in developing countries, the International Insulin Foundation developed a Rapid Assessment tool and implemented this approach to identify barriers to care and propose concrete recommendations for decision makers. The objective of this paper is to identify the factors that contributed to informing and influencing policymakers with regards to this work. METHODS: A documentary review comprised Stage 1. Stage 2 used an online questionnaire to gain insight from users of the Rapid Assessment results. Based on Stages 1 and 2, Stage 3 comprised in-depth interviews with a total of nine individuals (one individual each from the six participating countries; two individuals from the World Health Organization; one "Global Diabetes Advocate"). Interviews were analyzed based on a list of themes developed from Stage 2. RESULTS: Stage 1 led to the identification of various types of documents referring to the results. The online questionnaire had a response rate of 33%. Respondents directly involved in the assessment had a "Good" or "Very Good" appreciation of most aspects and scored these higher than those not directly involved. From the interviews, formalized methods and close collaboration between the international team and local partners were strengths. Trust and a relationship with local partners were also seen as assets. All stakeholders valued the results and the credibility of the data generated. Local partners felt that more could have been done for dissemination. CONCLUSION: This study shows the importance of specific results from the different assessments. In addressing complex issues having external experts involved was seen as an advantage. The uptake of results was due to the credibility of the research which was influenced by a mix of the people involved, past assessments, trusted local partners, and the use of the results by knowledge brokers, such as the World Health Organization. Through these brokers, others gained ownership of the data. The methods used and the fact that this data was grounded in a local context also reinforced its value. Despite limitations, this study offers a unique perspective where a similar research approach was taken in six countries.
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36. Parenteral nutrition and insulin per protocol improve diabetes management after total pancreatectomy

Author: Andersen, Sakshi, Andersen, Andreas, Ringholm, Lene, carsten palnæs hansen, Storkholm, Jan, Lillpers, Kerstin, Schiotz, Charlotte, and Mathiesen, Elisabeth Reinhardt
Subjects: Male, Chi-Square Distribution, Blood Glucose/metabolism, Adenocarcinoma, Middle Aged, Hypoglycemic Agents/administration & dosage, Statistics, Nonparametric, Diabetes Mellitus/drug therapy, Postoperative Complications/drug therapy, Length of Stay/statistics & numerical data, Parenteral Nutrition/methods, Pancreatectomy/adverse effects, Pancreatic Neoplasms/surgery, Humans, Female, Infusions, Intravenous, Insulin/administration & dosage, Insulin Aspart, Aged, Retrospective Studies
Abstract: INTRODUCTION: Pancreatogenic diabetes develops in patients undergoing total pancreatectomy and complicates post-surgical management. The aim of this study was to compare parenteral nutrition (PN) with protocolled insulin treatment to intravenous glucose treatment after total pancreatectomy.METHODS: This was a retrospective study of 97 patients undergoing total pancreatectomy between 2009 and 2014. Patients were divided into a PN cohort (n = 57) and a glucose cohort (n = 40). The PN cohort was given PN with one international unit (IU) rapid-acting insulin per 10 g of carbohydrate. The glucose cohort was given a continuous 5% glucose infusion with 2 IU rapid-acting insulin per 10 g of carbohydrate. Both cohorts were given insulin detemir 0.2 IU/kg/day.RESULTS: Within the first 13 post-operative days, plasma glucose values were within the target range (4.0-10.0 mmol/l) in the PN cohort more frequently than in the glucose cohort (46% versus 42%, p = 0.01) without any increase in hypoglycaemia. Non-infectious complications occurred less frequently in the parenteral cohort than in the glucose cohort (23% versus 43%, p = 0.04). Infectious complications occurred in 19% versus 33% of patients, respectively (p = 0.14). The mean length of hospitalisation was 19.8 ± 12.7 versus 25.0 ± 21.5 days, p = 0.14.CONCLUSIONS: After total pancreatectomy, PN with insulin treatment per protocol improves glycaemic control compared with glucose infusion and reduces the number of non-infectious post-operative complications without increasing hypoglycaemia.FUNDING: none.TRIAL REGISTRATION: not relevant.

37. CARING (CAncer Risk and INsulin analoGues): The association of diabetes mellitus and cancer risk with focus on possible determinants - a systematic review and a meta-analysis

Author: Peter Vestergaard, Morten Andersen, Anthonius de Boer, Kari Furu, Frank de Vries, Jakob Starup-Linde, Vidar Hjellvik, Marloes T Bazelier, Øystein Karlstad, Anssi Auvinen, Stine Aistrup Eriksen, Jari Haukka, Heleen K Bronsveld, and Marie L. De Bruin
Subjects: Cochrane Library, Diabetes Complications/epidemiology, Toxicology, Diabetes Mellitus/drug therapy, Hypoglycemic Agents/adverse effects, Cancer risk, 0302 clinical medicine, systematic review, Neoplasms, 80 and over, Insulin, Pharmacology (medical), 030212 general & internal medicine, Young adult, Child, 2. Zero hunger, Aged, 80 and over, education.field_of_study, Middle Aged, 3. Good health, Insulin/adverse effects, 030220 oncology & carcinogenesis, Meta-analysis, Child, Preschool, diabetes mellitus, Regression Analysis, Adult, Risk, medicine.medical_specialty, Adolescent, Population, Article, Diabetes Complications, 03 medical and health sciences, Young Adult, Internal medicine, Diabetes mellitus, medicine, Humans, Hypoglycemic Agents, education, Preschool, Aged, Pharmacology, business.industry, Cancer, Infant, Publication bias, medicine.disease, Surgery, meta-analysis, business, Body mass index, Neoplasms/epidemiology, Publication Bias, neoplasm
Abstract: Background: Patients suffering from diabetes mellitus (DM) may experience an increased risk of cancer; however, it is not certain whether this effect is due to diabetes per se. Objective: To examine the association between DM and cancers by a systematic review and meta-analysis according to the PRISMA guidelines. Data Sources: The systematic literature search includes Medline at PubMed, Embase, Cinahl, Bibliotek.dk, Cochrane library, Web of Science and SveMed+ with the search terms: “Diabetes mellitus”, “Neoplasms”, and “Risk of cancer”. Study Eligibility Criteria: The included studies compared the risk of cancer in diabetic patients versus non-diabetic patients. All types of observational study designs were included. Results: Diabetes patients were at a substantially increased risk of liver (RR=2.1), and pancreas (RR=2.2) cancer. Modestly elevated significant risks were also found for ovary (RR=1.2), breast (RR=1.1), cervix (RR=1.3), endometrial (RR=1.4), several digestive tract (RR=1.1-1.5), kidney (RR=1.4), and bladder cancer (RR=1.1). The findings were similar for men and women, and unrelated to study design. Meta-regression analyses showed limited effect modification of body mass index, and possible effect modification of age, gender, with some influence of study characteristics (population source, cancer- and diabetes ascertainment). Limitations: Publication bias seemed to be present. Only published data were used in the analyses. Conclusions: The systematic review and meta-analysis confirm the previous results of increased cancer risk in diabetes and extend this to additional cancer sites. Physicians in contact with patients with diabetes should be aware that diabetes patients are at an increased risk of cancer.

38. RESISTANCE AGAINST SUBCUTANEOUS INSULIN SUCCESSFULLY MANAGED WITH APROTININ

Author: PhilippeA. Halban, Robin E. Offord, Michael F. Berger, W. A. Muller, Jacques Philippe, Claude Taillens, and Serge Léreret
Subjects: medicine.medical_specialty, business.industry, Injections, Subcutaneous, General Medicine, Middle Aged, Pharmacology, Insulin/administration & dosage/metabolism, Diabetes Mellitus/drug therapy, Surgery, Subcutaneous insulin, Aprotinin/ pharmacology, Humans, Medicine, ddc:576.5, Female, Aprotinin, Insulin Resistance, business, medicine.drug
Published: 1980
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