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17 results on '"Klonoff, D"'

1. Towards the standardisation of adult person-reported outcome domains in diabetes research: A Consensus Statement development panel.

Author

Barnard-Kelly K, Marrero D, de Wit M, Pouwer F, Khunti K, Hermans N, Pierce JS, Laffel L, Holt RIG, Battelino T, Naranjo D, Fosbury J, Fisher L, Polonsky W, Weissberg-Benchell J, Hood KK, Schnell O, Messer LH, Danne T, Nimri R, Skovlund SE, Mader JK, Sherr JL, Schatz D, O'Neill S, Doble E, Town M, Lange K, de Beaufort C, Gonder-Frederick L, Jaser SS, Liberman A, Klonoff D, ElSayed NA, Bannuru RR, Parkin CG, and Snoek F

Subjects
Humans, Adult, Consensus, Health Status, Patient Reported Outcome Measures, Quality of Life, Diabetes Mellitus therapy, Diabetes Mellitus psychology
Abstract

Diabetes is unique among chronic diseases because clinical outcomes are intimately tied to how the person living with diabetes reacts to and implements treatment recommendations. It is further characterised by widespread social stigma, judgement and paternalism. This physical, social and psychological burden collectively influences self-management behaviours. It is widely recognised that the individual's perspective about the impact of trying to manage the disease and the burden that self-management confers must be addressed to achieve optimal health outcomes. Standardised, rigorous assessment of mental and behavioural health status, in interaction with physical health outcomes is crucial to aid understanding of person-reported outcomes (PROs). Whilst tempting to conceptualise PROs as an issue of perceived quality of life (QoL), in fact health-related QoL is multi-dimensional and covers indicators of physical or functional health status, psychological and social well-being. This complexity is illuminated by the large number of person reported outcome measures (PROMs) that have been developed across multiple psychosocial domains. Often measures are used inappropriately or because they have been used in the scientific literature rather than based on methodological or outcome assessment rigour. Given the broad nature of psychosocial functioning/mental health, it is important to broadly define PROs that are evaluated in the context of therapeutic interventions, real-life and observational studies. This report summarises the central themes and lessons derived in the assessment and use of PROMs amongst adults with diabetes. Effective assessment of PROMs routinely in clinical research is crucial to understanding the true impact of any intervention. Selecting appropriate measures, relevant to the specific factors of PROs important in the research study will provide valuable data alongside physical health data., (© 2024 Diabetes UK.)

Published
2024
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2. Digital Diabetes Congress 2019.

Author

Han J, King F, Klonoff D, Drincic A, Crosby KP, Robinson T, Gabbay RA, Oley L, Ahn D, Evans B, Salber P, Cruz M, Ginsberg B, Adi S, Armstrong D, and Kerr D

Subjects
Humans, Software trends, Diabetes Mellitus, Smartphone trends, Wearable Electronic Devices trends
Abstract

New applications of digital health software and sensors for diabetes are rapidly becoming available. The link between healthcare, wearable or carryable devices, and the use of smartphones is increasingly being used by patients for timely information and by healthcare professionals to deliver information and personalized advice and to encourage healthy behavior. To assemble stakeholders from academia, industry, and government, Diabetes Technology Society and Sansum Diabetes Research Institute hosted the 3rd Annual Digital Diabetes Congress on May 14-15, 2019 in San Francisco. Physicians, entrepreneurs, attorneys, psychologists, and other leaders in the diabetes technology field came together to discuss current and future trends and applications of digital tools in diabetes. The meeting focused on eight topics: 1) User Interface/User Experience (UI/UX) for Digital Health, 2) clinical aspects, 3) marketing, 4) investment, 5) regulation, 6) who owns the data, 7) engagement, and 8) the future of digital health. This meeting report contains summaries of the meeting's eight plenary sessions and eight panel discussions, which were all focused on an important aspect of the development, use, and regulation of diabetes digital tools.

Published
2019
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3. Diabetes and technology in 2030: a utopian or dystopian future?

Author

Kerr D, Axelrod C, Hoppe C, and Klonoff DC

Subjects
Artificial Intelligence, Blood Glucose Self-Monitoring instrumentation, Blood Glucose Self-Monitoring trends, Diabetes Mellitus blood, Forecasting, Glycated Hemoglobin metabolism, Humans, Inventions trends, Machine Learning, Biomedical Technology trends, Diabetes Mellitus therapy
Abstract

The ability of an individual living with diabetes to have human-to-human contact with their healthcare provider is not keeping pace with the number of people developing diabetes. From a futurist perspective, however, this dichotomy of diabetes care represents an opportunity for digital healthcare. The focus of technological innovation is unlikely to be the replacement of the multidisciplinary diabetes team but rather the provision of meaningful individual and family support between clinic visits and, on a larger scale, the facilitation of population health management for diabetes. We can also expect to see new therapies, including implantable drug delivery systems, automated closed-loop systems and miniaturized non-invasive glucose monitoring systems. New digital health technologies will create a 'digital diabetes ecosystem' to enhance rather than devolve care from humans. Concerns related to data privacy and ownership will inevitably rise, thus a future for diabetes care relying heavily on technology is not inevitably utopian. Nevertheless, revolutions in the development of novel sensors, accumulation of 'big data', and use of artificial intelligence will provide exciting opportunities for preventing, monitoring and treating diabetes in the near future., (© 2018 Diabetes UK.)

Published
2018
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4. Pathways to quality inpatient management of hyperglycemia and diabetes: a call to action.

Author

Draznin B, Gilden J, Golden SH, Inzucchi SE, Baldwin D, Bode BW, Boord JB, Braithwaite SS, Cagliero E, Dungan KM, Falciglia M, Figaro MK, Hirsch IB, Klonoff D, Korytkowski MT, Kosiborod M, Lien LF, Magee MF, Masharani U, Maynard G, McDonnell ME, Moghissi ES, Rasouli N, Rubin DJ, Rushakoff RJ, Sadhu AR, Schwartz S, Seley JJ, Umpierrez GE, Vigersky RA, Low CC, and Wexler DJ

Subjects
Adult, Blood Glucose drug effects, Diabetes Mellitus drug therapy, Humans, Hyperglycemia drug therapy, Hypoglycemic Agents therapeutic use, Inpatients, Diabetes Mellitus blood, Hyperglycemia blood
Abstract

Currently patients with diabetes comprise up to 25-30% of the census of adult wards and critical care units in our hospitals. Although evidence suggests that avoidance of hyperglycemia (>180 mg/dL) and hypoglycemia (<70 mg/dL) is beneficial for positive outcomes in the hospitalized patient, much of this evidence remains controversial and at times somewhat contradictory. We have recently formed a consortium for Planning Research in Inpatient Diabetes (PRIDE) with the goal of promoting clinical research in the area of management of hyperglycemia and diabetes in the hospital. In this article, we outline eight aspects of inpatient glucose management in which randomized clinical trials are needed. We refer to four as system-based issues and four as patient-based issues. We urge further progress in the science of inpatient diabetes management. We hope this call to action is supported by the American Diabetes Association, The Endocrine Society, the American Association of Clinical Endocrinologists, the American Heart Association, the European Association for the Study of Diabetes, the International Diabetes Federation, and the Society of Hospital Medicine. Appropriate federal research funding in this area will help ensure high-quality investigations, the results of which will advance the field. Future clinical trials will allow practitioners to develop optimal approaches for the management of hyperglycemia in the hospitalized patient and lessen the economic and human burden of poor glycemic control and its associated complications and comorbidities in the inpatient setting.

Published
2013
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6. FDA approves new glucose test for adult diabetics.

Author

Klonoff DC

Subjects
Adult, Equipment Design, Humans, United States, Blood Glucose Self-Monitoring instrumentation, Blood Glucose Self-Monitoring methods, Diabetes Mellitus metabolism, Glucose metabolism, United States Dept. of Health and Human Services, United States Food and Drug Administration
Published
2001
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7. An economic analysis of interventions for diabetes.

Author

Klonoff DC and Schwartz DM

Subjects
Costs and Cost Analysis, Diabetic Nephropathies economics, Diabetic Nephropathies prevention & control, Diabetic Retinopathy economics, Diabetic Retinopathy prevention & control, Female, Humans, Pregnancy, Pregnancy in Diabetics economics, Pregnancy in Diabetics therapy, Prenatal Care economics, Self Care economics, United States, Diabetes Mellitus economics, Diabetes Mellitus therapy
Abstract

The objective of this article is to stratify interventions for diabetes according to their economic impact. We conducted a review of the literature to select articles that performed a cost-benefit analysis for 17 widely practiced interventions for diabetes. A scale for categorizing interventions according to their economic impact was defined. The 17 interventions were classified as follows: 1) clearly cost-saving, 2) clearly cost-effective, 3) possibly cost-effective, 4) non-cost-effective, or 5) unclear. Clearly cost-saving interventions included eye care and pre-conception care. Clearly cost-effective interventions included nephropathy prevention in type 1 diabetes and improved glycemic control. Possibly cost-effective interventions included nephropathy prevention in type 2 diabetes and self-management training. Non-cost-effective interventions were not identified. Interventions with unclear economic impact included case management, medical nutrition therapy, self-monitoring of blood glucose, foot care, blood pressure control, blood lipid control, smoking cessation, exercise, weight loss, HbA1c measurement, influenza vaccination, and pneumococcus vaccination. Widely practiced interventions for patients with diabetes can be clearly cost-saving and clearly cost-effective. These practices are attractive from both a medical and an economic perspective.

Published
2000
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9. The promise of optical sensing strategies for glucose.

Author

Klonoff DC

Subjects
Aqueous Humor chemistry, Extracellular Space chemistry, Humans, Spectrophotometry methods, Spectrum Analysis, Raman methods, Blood Glucose analysis, Blood Glucose Self-Monitoring methods, Diabetes Mellitus blood, Glucose analysis
Published
1999
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10. Inhaled insulin.

Author

Klonoff DC

Subjects
Aerosols, Equipment Design, Humans, Insulin therapeutic use, Lung physiology, Administration, Inhalation, Diabetes Mellitus drug therapy, Insulin administration & dosage
Abstract

Inhalation is a potentially viable route of insulin administration. This treatment is being tested but has not been approved by the United States Food and Drug Administration (FDA). The lung airways contain bronchial tubes, which are impermeable to insulin and alveoli, from which insulin can be absorbed into the circulation. Inhaled asthma medications deposit before reaching the alveoli. Novel devices can deliver insulin particles via slow even breaths into the alveoli. An aerosol of either powdered or solubilized insulin can be released mechanically or electronically. Pulmonary toxicity due to inhaled insulin has not been reported, but no chronic use studies have been conducted. The efficiency of insulin delivery by inhalation may be compromised by: (1) losses within the device and the environment; (2) deposition onto the throat and bronchial tubes; and (3) incomplete absorption from the alveoli. With current delivery technology, the maximum possible delivery efficiency is approximately 30%. The peak activity of inhaled regular insulin occurs at 60 minutes, which is similar to that of subcutaneous lispro insulin. Inhaled long-acting insulin is in early development. Studies comparing sequentially administered subcutaneous and inhaled regular insulins have demonstrated significantly reproducible glucose-lowering effects of inhaled insulin. In type 1 and insulin-treated type 2 patients, substitution of premeal inhaled insulin for subcutaneous insulin has resulted in no significant change in control. In a series of patients with type 2 diabetes failing oral agents, addition of premeal inhaled insulin resulted in significantly improved control. Inhaled insulin will become established if ongoing studies continue to demonstrate this technology to be safe and effective.

Published
1999
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13. FDA approves new Glucose Monitoring System.

Author

Klonoff DC

Subjects
Adult, Blood Glucose analysis, Blood Glucose Self-Monitoring instrumentation, Humans, Monitoring, Ambulatory instrumentation, United States, United States Food and Drug Administration, Blood Glucose metabolism, Blood Glucose Self-Monitoring standards, Diabetes Mellitus blood, Monitoring, Ambulatory standards
Published
1999
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15. Noninvasive blood glucose monitoring.

Author

Klonoff DC

Subjects
Humans, Blood Glucose analysis, Blood Glucose Self-Monitoring methods, Diabetes Mellitus blood
Abstract

The concentration of glucose in the blood may soon be measured noninvasively, without puncturing the finger to obtain a drop of blood. Current prototype devices for this purpose require greater accuracy and miniaturization to be commercially viable. No such device has been approved for marketing by the U.S. Food and Drug Administration. The technology used for noninvasive blood glucose monitoring involves either radiation or fluid extraction. With radiation technology, an energy beam is 1) applied to the body, 2) modified proportionate to the concentration of glucose in the blood, and 3) measured. The blood glucose concentration is then calculated. With fluid extraction technology, a body fluid containing glucose in a concentration proportionate to the blood glucose concentration is extracted and measured. The blood glucose concentration is then calculated. The most promising technologies are 1) near-infrared light spectroscopy, 2) far-infrared radiation spectroscopy, 3) radio wave impedance, 4) optical rotation of polarized light, 5) fluid extraction from skin, and 6) interstitial fluid harvesting. Each method has features predictive of commercial viability, as well as technical problems to overcome.

Published
1997
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16. Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes

Author

Holman, Rr, Bethel, Ma, Mentz, Rj, Thompson, Vp, Lokhnygina, Y, Buse, Jb, Chan, Jc, Choi, J, Gustavson, Sm, Iqbal, N, Maggioni, Ap, Marso, Sp, Öhman, P, Pagidipati, Nj, Poulter, N, Ramachandran, A, Zinman, B, Hernandez, Af, EXSCEL Study Group, : Califf RM, Patel, R, George, J, Sourij, H, Wong, Yw, Hannan, K, Sellers, Ma, Gottlieb, P, Lavender, P, Leloudis, D, Meadows, Y, Larson, D, Anderson, H, Elkins, M, Stone, A, Tisch, A, Perkins, L, Sanders, K, Campbell, C, Kennedy, I, Heal, P, Masterson, M, Darbyshire, J, Mumtaz, L, Athwal, R, Ferch, A, Batra, P, Durborow, L, Vincent, J, Woodall, A, Flanagan, T, Katona, B, Reicher, B, Pozzi, E, Oulhaj, A, Coleman, R, Rouleau, Jl, Pocock, Sj, Gorelick, F, Mcmurray, J, Riddle, M, Gagel, R, Collier, T, Markovic, T, Kong, Aps, Hian, Sk, Scott, R, Panelo, A, Yoon, Kh, Sheu, W, Sritara, P, Linong, J, Pan, C, Yong, H, Schernthaner, G, Mathieu, C, Tankova, T, Widimsky, P, Hanefeld, M, Keltai, M, Wainstein, J, del Prato, S, Pirags, V, Jakuboniene, N, Kooy, A, Dziemidok, P, Veresiu, Ia, Dreval, Av, Murin, J, Torello, Al, Sattar, N, Parkhomenko, O, Omar, M, Diaz, R, Lopes, R, Lanas, F, Urina Triana, M, Leiva-Pons, Jl, Aguliera, D, Bergenstal, R, Goodman, S, Yale, Jf, Caterson, I, Weng, J, Hu, D, Junbo, G, Zannad, F, Anoop, M, Ambrish, M, Gallegos, Ja, Green, Jb, Akerblom, A, Alexander, K, Al-Khatib, S, Armaganijan, L, Barros, P, Batit, M, Bernacki, G, Bernandez, S, Bloomfield, G, Clausen, E, De Souza Brito, F, Devore, A, Dombrowski, K, Eapen, Z, Gellad, Z, George, D, Guimaraes, P, Halim, S, Harrison, R, Hawes, J, Hess, C, Hyland, K, Jackson, L, Jones, S, Jordan, D, Katz, M, Kong, D, Koshizaka, M, Lakey, W, Leblanc, T, Leonardi, S, Luo, N, Mahaffey, K, Mandawat, A, Mehta, R, Melloni, C, Morse, M, Pagidpati, N, Patel, C, Patel, K, Pokorney, S, Posvic, T, Rao, M, Roe, M, Shah, B, Tillmann, H, Truffa, A, Zazula, A, Zeitler, E, Sicer, M, Ulla, Mr, Maffei, L, Klyver, Mi, Calella, P, Alvarisqueta, A, De La Fuente RL, Aizenberg, D, Roque, F, Cruciani, A, Frechtel, G, Gelersztein, E, Villarino, A, Mallagray, M, Nardone, L, Zaidman, C, Novaretto, L, Bartolacci, I, de Salvo, M, Delcourt, C, Crimmins, D, Jackson, R, O’Neal, D, Colman, P, Jeffries, W, Mah, Pm, Wittert, G, Proietto, J, Amerena, J, Marks, S, Tan, R, Colquhoun, D, Pieber, T, Drexel, H, Prager, R, Schnack, C, Hoppichler, F, Fasching, P, Francesconi, C, Luger, A, Schoenherr, Hr, Ebenbichler, C, Paulweber, B, Shernthaner, G, Verhaegen, A, Vanuytsel, J, Thissen, Jp, e Silva P, Barros, Gonzaga, C, Borges, J, Hissa, M, Rea, R, Rossi, P, Chacra, A, Eliaschewitz, F, Garbelini, B, Felicio, J, Rassi, N, Rossi, F, Nunes dos Santos, M, e Farias F, Bandeira, Lisboa, H, e Forti A, Costa, Saraiva, Jk, Kovacheva, S, Levterov, G, Sheinkova, G, Ilieva, E, Lyubenova, L, Damyanova, V, Gushterova, V, Mincheva, L, Illiev, D, Ivanov, V, Bobeva, R, Nikitov, Z, Shumkova, R, Lefterov, In, Zaharieva, S, Videva, V, Yakov, A, Cheung, S, Elliott, T, Mehta, P, Ross, S, Sigal, R, Woo, V, Jaffer, S, Kuritsky, R, Bell, A, Dumas, R, Gosselin, G, Robitaille, Y, Greenspoon, A, Lochnan, H, Tytus, R, Leiter, L, Pandey, A, Punthakee, Z, Dube, F, Sigalas, J, Pearce, M, Woodford, T, Paul, P, Bourgeois, R, Conway, R, Mazza, G, Hatheway, R, Misterski, J, Raffo, C, Olivares, C, Godoy, J, Potthoff, S, Santibañez, C, Larenas Yanez GJ, Gu, W, Shen, F, Ma, J, Guo, X, Li, Q, Du, Y, Hu, J, Ji, L, Li, Y, Deng, H, Feng, Y, Liu, L, Mu, Y, Ma, C, Qu, S, Wang, J, Wang, Y, Yuan, Z, Zhang, L, Zhou, S, Yang, T, Dong, Y, Liu, D, Coronel Arroyo, J, Perez Amador, G, Botero Lopes, R, Jaramilo, C, Orozco Linares, A, Cure Cure CA, Hernandez Triana, E, Molina de Salazar DI, Marin, Cr, Jaramilo Gomez CJ, Kellinerova, I, Adamkova, V, Krami, P, Brychta, T, Havelkova, J, Pantikova, K, Schoper, F, Pohl, W, Schumm-Draeger, Pm, Julius, U, Tschöpe, D, Hamann, A, Seissler, J, Schellong, S, Rose, L, Becker, B, Linn, T, Oerter, Em, Strotmann, Hj, Mölle, A, Pfutzner, A, Forst, T, Schäufele, T, Mugge, A, Lehrke, M, Meyer-Pannwitt, U, Mehling, H, Simon-Wagner, I, Schenkenberger, I, Busch, K, Hermes, S, Milek, K, Landers, B, Grueneberg, M, Braun, M, Nothroff, J, Kamke, W, Hergdt, G, Duengen, Hd, Kleinertz, K, Kuesters, D, Boenninghoff, Ah, Appel, Kf, Schaefer, A, Bieler, T, Ozaki, R, Luk, Aoy, Chu, Dw, Cheung-Wong, Mm, Siu, Dc, Yan, Bpy, Kung, K, Wong, Sys, Tsang, Cc, Yeung, Vt, Cheung, Bm, Tse, Hf, Hodi, G, Nagy, K, Lippai, J, Takacs, J, Fulop, T, Gaal, Z, Pauker, Z, Foldesi, I, Simon, J, Oroszan, T, Futo, L, Bezzegh, K, Nagy, A, Vandorfi, G, Kiss, J, Kesmarki, N, Kis, E, Papp, A, Kovacs, A, Szakal, I, Palinkas, A, Czegany, Z, Voros, P, Reiber, I, Kerenyi, Z, Dezso, E, Wittman, I, Penzes, J, Ples, Z, Taller, A, Farago, K, Kis, Jt, Zilahi, Z, Molnar, M, Barkai, L, Mileder, M, Szentpeteri, I, Peterfai, E, Lovasz, O, Mosenzon, O, Minuchin, O, Jaffe, A, Vishlitsky, V, Shimon, I, Bashkin, A, Stern, N, Elias, N, Bental, T, Butnaru, A, Lewis, B, Adawi, F, Nseir, W, Klainman, E, Herskovits, T, Cignarelli, M, Rotella, Cm, Ambrosio, G, Pozzilli, P, Genovese, S, Cavarape, A, Salvioni, A, Sokolova, J, Strautina, I, Teterovska, D, Stalte, V, Pastare, S, Leitane, I, Lagzdina, L, Andersone, I, Eglite, R, Stelmane, I, Levinger, A, Barsiene, L, Sulskiene, M, Varanauskiene, E, Danyte, E, Urbanaviciene, E, Urbanavicius, V, Zabuliene, L, Juskiene, R, Velaviciene, A, Kakariekiene, V, Augusteniene, A, Velickiene, D, Lasiene, J, Dauksiene, D, Caponis, J, Tan, At, Ramanathan, L, Hassan, Mra, Tan, F, Ong, Tk, Foo, Sh, Ghani, Ra, Cheah, Wk, Sanchez Mijangos JH, Cabrera Jardines, R, Barrientos Perez, M, Sauque Reyna, L, Alcocer Gamba MA, Villeda Espinosa, E, Tamez Perez HE, De La Garza Hernandez NE, Lopes, Sm, Ramirez Diaz SP, Reyes Sanchez, R, Márquez-Rodriguez, E, Köse, V, Voors-Pette, C, Oldenburg-Ligtenberg, Pc, van Kempen WW, Cox, K, Hoogendyk, J, Swinkels-Diepenmaat, L, Rojas-Lingan, G, Kentgens, S, Schipperen, S, de Valk HW, Swart, H, van Bemmel, B, Hoogslag, Pam, Diamant, M, Serné, Eh, Hamer, A, Wilson, S, Fisher, N, Dixon, P, Chaudhri, O, Crawford, V, Quinn, D, Nirmalaraj, K, Dunn, P, Gillies, J, Cutfield, R, Krebs, J, Helm, C, Kerr, J, Pryke, J, Ebo, G, Denopol, M, Ang, E, Uy, N, Jimeno, C, Mirasoi, R, Paz Pacheco, E, Custodio, M, Nicodemus, N Jr, Catindig, Ea, Magno, M, Tirador, L, Cylkowska, B, Stasinksa, T, Silwinska, T, Sroka, M, Piepiorka, M, Korzeniak, R, Mirecka, H, Zaluska, R, Pupek-Musialik, D, Homenda, W, Grabowska, A, Okopien, B, Niegowska, J, Pogorzelska, H, Mikolajczyk-Swatko, A, Sikorski, M, Sowinski, D, Tahk, Sj, Kim, Yn, Nam, Cw, Rim, Sj, Kim, Cj, Choi, Km, Lee, Ik, Kim, Ij, Namgung, J, Moon, Kw, Kim, Ks, Oh, Bh, Lee, Wy, Choi, Sh, Kim, Es, Moon, S, Mindrescu, Nm, Aron, G, Graur, M, Hancu, N, Mlitaru, C, Nafornita, V, Szilagyi, I, Popa, Ar, Angelescu, Lm, Negrisanu, Gd, Zaharie, Dg, Culman, Mi, Vacaru, G, Munteanu, M, Constantinescu, S, Tivadar, S, Dreval, A, Barbarash, O, Strongin, L, Dogadin, S, Suplotova, L, Izmozherova, N, Marasaev, V, Khokhlov, A, Repin, A, Turova, E, Bondar, I, Samoylova, Y, Sherenkov, A, Smolenskaya, O, Zrahevskiy, K, Koshelskaya, O, Obrezan, A, Dzupina, A, Stevlik, J, Buganova, I, Pella, D, Vinanska, D, Jascur, J, Micko, K, Sosovec, D, Philippiova, A, Olexa, P, Fedacko, J, Selecky, J, Nicolau, J, Mediavilla Garcia, J, Botella Serrano, M, Lecube, A, Arguelles, I, Sabán, J, Gómez Cerezo, F, Soto, A, Bellido, D, Sucunza Alfonso, N, Vendrell Ortega, J, Alvarez, L, Garcia Puig, J, Angustias Quesada, M, Contreras Gilbert, J, Almeida, Ca, Tinahones, Fj, Garcia Ortiz, L, Gómez Marcos MA, Aomar, I, Fernández Balsells, M, Distiller, L, Padayachee, T, Badat, A, Ebrahim, I, Naiker, P, Ranjith, N, Kelfkens, Y, Makan, H, Mogashoa, S, Fulat, M, Carim-Ganey, N, Coetzee, K, Govender, T, Nortje, H, Wilhase, A, Seedat, S, Gani, M, Ellis, G, Rheeder, P, Wing, J, Blignaut, S, Kaplan, H, Lottering, H, Pillai, P, Louw, C, Coetzer, T, Sheu, Whh, Chen, Jf, Yang, Cy, Tseng, St, Wang, Cy, Lai, Wt, Hung, Yj, Hsieh, Ic, Su, Sl, Pei, D, Benjasuratwong, Y, Purewal, T, Milward, A, Dimitropoulos, I, Kumar, S, Barber, T, Wiles, P, Dang, C, Adler, A, Philip, S, Bellary, S, Price, D, Oelbaum, R, Heller, S, Sathayapalan, T, Clark, J, Leese, G, Simpson, H, Kilvert, A, Dawson, A, Hall, T, Takhar, A, Bundy, C, Harvey, P, Maxwell, S, Asamoah-Owusu, Nj, Mcknight, J, Chatterjee, S, Calvert, J, Wright, A, Macrury, S, Macfarlane, D, Johnson, A, Litchfield, J, Field, B, Koval, O, Larin, O, Levchenko, O, Martynyuk, L, Maslyanko, V, Rudyk, I, Suprun, Y, Tseluyko, V, Botsyurko, V, Vatutin, M, Fushtey, I, Grishyna, O, Kuskalo, P, Panina, S, Pererva, L, Prysupa, L, Teliatnikova, Z, Sokolova, L, Vlasenko, M, Berenfus, V, Gyrina, O, Kopytsya, M, Vizir, V, Vayda, M, Shanik, M, Headapohl, D, Pahl, J, Aronoff, S, Bartkowiak, A Jr, Chang, A, Gaudiani, L, Kayne, D, Look, M, Patel, N, Moran, J, Stout, E, Tsao, J, Struble, R, Fishman, N, Rodbard, H, Lucas, K, Dugano-Daphnis, P, Merrick, B, Nadar, V, Severa, L, Sorli, C, Chang, M, Reed, J III, Grunberger, G, Bain, C, Bestermann, W Jr, Morawski, E, White, J, Azizad, M, Ukwade, P, Anekwe, A, Jimenez, A, Weiss, D, Green, S, Overcash, J, Eaton, C, Roseman, H, Soler, N, Mikell, F, Manos, P, Levinson, L, Claxton, E Jr, Weiss, R, Argoud, G, Bickel, L, Wilson, J, Short, B, Webster, B, Mcneill, R, Schnall, A, Force, R, Phillips, L, Bybee, K, Forker, A, Denham, D, Vonderhaar, T, Pullman, J, Kruger, D, Whitehouse, F, Wysham, C, Baron, M, Kravitz, A, Dushkin, H, Manning, Mb, Wine, A, Jaffrani, N, Chadha, C, Sperl-Hillen, J, Busch, R, Estevez, R, Robbins, D, Rassouli, N, Garvey, T, Oparil, S, Eckel, R, Mcdermott, M, Rasouli, N, Mcgill, J, Corder, C, Klonoff, D, Mills, R, Earl, J, Kessel, J, Cuddihy, R, Zimmerman, R, Dayamani, P, Oral, E, Zimering, M, Marks, J, Farnsworth, K, Sugimoto, D, Toth, P, Bhargava, A, Mcguire, D, Rohatgi, A, Davies, M, Peden, E, Wyne, K, Alfonso, L, Seyoum, B, Akpunonu, B, Feinglos, M, Reaven, P, Soule, J, Luttrell, L, Schactman, B, Canadas, R, Boggs, B, Abbott, L, Herring, C, Roberts, L, Hage-Korban, E, Schubart, U, Taylon, A, Tannenbaum, A, Kingsley, J, Lenhard, J, Biscoveanu, M, Cohen, J, Donovan, D, Laferrere, B, Thompson, N, Wade, T, Detweiler, R, Henson, B, White, A, Cavale, A, Ravi, C, Thomas, A, Goodman, H, Kalen, V, Fox, D, Dauber, I, Rizvi, S, Marcus, A, Mulford, M, Higgins, A, Chane, M, Bland, V, Osunkoya, A, Suresh, D, Khan, S, Anastasi, L, Bajaj, M, Eisen, H, Mudaliar, Sr, Powell, S, Carr, K, Tripathy, D, Azad, N, Wakefield, P, Acheatel, R, Bressler, P, Dean, J, El Shahawy, M, Gilbert, J, Haque, I, Humiston, D, Ison, R, Karounos, D, Lillestol, M, Ferrier, N, Labroo, A, Vo, A, D’Agostino, R, Dulin, M, Mcwilliams, A, Hargrove, J, Blumberg, E, Jackson, B, Staniloae, C, Salacata, A, Hidalgo, H Jr, Nicol, P, Digiovanna, M, Soufer, J, Mahabadi, V, Akinboboye, O, Arauz-Pacheco, C, Neutel, J, Dungan, K, Benson, M, Powell, T, Gandy, W, Rovner, S, Berk, M, Khan, A, Ledesma, G, Madu, I, Erickson, B, Radbill, M, Graves, M, Kaczmarek, G, Giep, S, Baldauf, C, Golden, G, Lesh, K, Davis, C, Godbole, N, Kirby, W, Razzaque, N, Bhatt, B, Wilson, M., Internal medicine, ACS - Diabetes & metabolism, and ACS - Microcirculation

Subjects
Male, medicine.medical_specialty, EXSCEL Study Group, Injections, Subcutaneous, 030209 endocrinology & metabolism, Type 2 diabetes, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Placebo, Article, Drug Administration Schedule, GLP1-agonists, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Interquartile range, Internal medicine, Diabetes mellitus, General & Internal Medicine, medicine, Humans, Hypoglycemic Agents, Least-Squares Analysis, Aged, Glycated Hemoglobin, business.industry, Venoms, Semaglutide, Incidence, Type 2 diabetes, GLP1-agonists, exenatide, cardiovascular effects, General Medicine, 11 Medical And Health Sciences, Middle Aged, medicine.disease, Surgery, Albiglutide, Editorial, Diabetes Mellitus, Type 2, Cardiovascular Diseases, Exenatide, Dulaglutide, Female, business, Peptides, cardiovascular effects, medicine.drug
Abstract

BACKGROUND: The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. METHODS: We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy. RESULTS: In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P

Published
2017
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17. Efficacy and safety of a fixed-ratio combination of insulin degludec and liraglutide (IDegLira) compared with its components given alone: results of a phase 3, open-label, randomised, 26-week, treat-to-target trial in insulin-naive patients with type 2 diabetes

Author

Gough, S. C., Bode, B., Woo, V., Rodbard, H. W., Linjawi, S., Poulsen, P., Damgaard, L. H., Buse, J. B., NN9068 3697 trial investigators, Donnelly, T, Gerstman, M, Linjawi, S, Park, K, Roberts, A, Shaw, Je, Wu, T, Aggarwal, N, Bowering, K, Chouinard, G, Deyoung, P, Dumas, R, Elliott, Tg, Frechette, A, Giguere, N, Gottesman, I, Ho, K, Kohli, S, Teitelbaum, I, Tytus, R, Wharton, S, Woo, V, Hellsten, T, Kuusela, M, Sarti, C, Strand, J, Valli, K, Erlinger, R, Goelz, S, Hauser, Kh, Hilgenberg, J, Kaiser, M, Marck, C, Merfort, F, Milek, K, Paschen, B, Rose, L, Schlecht, K, Wenzl Bauer, V, Dudas, M, Fulop, G, Harcsa, E, Kerenyi, Z, Szőcs, A, Takacs, R, Babu, T, Bandgar, Tr, Bantwal, G, Bhagwat, Nm, Chatterjee, S, Jain, Sm, John, M, Kale, S, Kanungo, Ak, Kumar, A, Kumar, H, Kumar, Sn, Lodha, S, Majumder, A, Mithal, A, Murthy, S, Sethi, Bk, Shah, P, Sharma, Sk, Sivagnanam, N, Velu, S, Viswanathan, V, Yajnik, Cs, Byrne, M, O'Brien, T, Aimaretti, G, Baroni, Mg, D'Amico, E, Dotta, Francesco, Giordano, C, Sforza, A, Tonolo, G, Bebakar, Wm, Kamaruddin, Na, Hussein, Z, Mumtaz, M, Sothiratnam, R, Gonzalez Galvez, G, Hernandez, Pa, Grineva, E, Kalashnikova, Mf, Kulkova, P, Krasilnikova, Ee, Kondrachenko, S, Kunitsyna, Ma, Poley, M, Sardinov, R, Vorokhobina, Nv, Yurievna, M, Zhdanova, Ea, Zhukova, La, Dalan, R, Khoo, Ey, Sum, Cf, Cizova, M, Martinka, E, Schroner, Z, Teplanova, M, Tomasova, L, Biermann, E, Dulabh, R, Khutsoane, Dt, Komati, Sm, Makan, Ha, Mayet, L, Mitha, Ea, Padayachee, T, Pillay, S, Reddy, J, Snyman, Hh, Siddique, N, Trokis, J, Bobillo, Er, de la Cuesta, C, Fernández, Mr, González, As, De Teresa Parreño, L, Raya, Pm, de la Torre ML, Torres, Jf, Sheu, Wh, Sun, Jh, Yang, Cy, Deerochanawong, C, Phornphutkul, M, Suwanwalaikorn, S, Sriwijitkamol, A, Clark, J, Downie, P, Evans, P, Furlong, N, Gough, S, Harper, R, Harvey, Jn, Khan, A, Leese, G, Mckinnon, C, Narendran, P, Patterson, C, Raymond, F, Singhal, P, Smith, P, Viljoen, A, Willis, T, Acampora, M, Agaiby, Jm, Ahmed, I, Allison, Jr, Altamirano, D, Anderson, Mw, Andrawis, N, Aroda, Vr, Ballard, Tv, Beavins, J, Bedel, Gw, Bernstein, R, Blaze, K, Bode, Bw, Bononi, Pl, Broker, Re, Buse, Jb, Butuk, Dj, Camiscoli, Dj, Canadas, R, Castorino, K, Cathcart, H, Cha, G, Chang, A, Chappel, Cm, Cheema, C, Chenore, M, Cheung, D, Christensen, J, Chu, Jw, Chuck, L, Cohen, Cd, Cohen, K, Cho, Mh, Rivera Colon, L, Condit, J, Corbett, B, Pearlstein, R, Cox, Wr, Daboul, Ny, Deatkine, D, Dunn, Lj, Ellison, Hs, Feldman, Bn, Fidelholtz, J, First, B, Fishman, N, Fogarty, Cm, Fraser, Nj, Gabra, N, Gaona, Re, Gerety, G, Gilman, Rm, Gonte, Ws, Gottschlich, Gm, Grant, Dm, Hewitt, M, Hollander, P, House, Ba, Huffman, D, Jain, Rk, Johnson, G, Jones, Sw, Kayne, Dm, Kimmel, Ma, Klonoff, D, Knight, H, Koontz, D, Kutner, Me, Lenhard, Jm, Liss, Jl, Litchfield, Wr, Lubin, B, Lucas, Kj, Lynn, L, Lyons, Tj, Macadams, Mr, Mach, Mq, Maletz, L, Mariano, Hg, Mayeda, So, Pratley, Re, Madder, R, Martinez, Gj, Mcgarity WC Jr, Mckenzie, Wc, Meisner, Cr, Montenegro, C, Moran, Je, Morawski, Ej, Moretto, Tj, Mudaliar, Sr, Murray, Av, Myers, L, Odugbesan, Ao, Olivarez, E, Pangtay, D, Patel, Mb, Patel, Nr, Patel, R, Perdomo, A, Pritchett, Kl, Rasmussen, B, Reed, Jc, Reeves, Ml, Reichman, A, Rhee, C, Rice, Lc, Risser, J, Rodbard, Hw, Rosen, R, Rosenstock, J, Ryan, Eh, Schreiman, Rc, Scott, Rb, Selagamsetty, Mr, Shaughnessy, J, Silver, R, Simon, Hj, Snyder, B, Soufer, J, Stegemoller, Rk, Sugimoto, D, Thurman, J, Tolia, Kk, Wagner, R, Wahlen, J, Webster, De, Weisbrot, Aj, Whittier, F, Winkle, Pj, Woolley, Jh, Yeoman, G, Zemel, Lr, Smith, Bp, Philis Tsimikas, A, Weissman, P, and Kurland Wise, J.

Subjects
Insulin degludec, Blood Glucose, Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Urology, Type 2 diabetes, law.invention, Endocrinology, Randomized controlled trial, law, Glucagon-Like Peptide 1, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Humans, Hypoglycemic Agents, Glycated Hemoglobin, Liraglutide, business.industry, Insulin, Middle Aged, medicine.disease, Metformin, Insulin, Long-Acting, Drug Combinations, Treatment Outcome, Diabetes Mellitus, Type 2, Female, business, Pioglitazone, medicine.drug
Abstract

A fixed-ratio combination of the basal insulin analogue insulin degludec and the glucagon-like peptide-1 (GLP-1) analogue liraglutide has been developed as a once-daily injection for the treatment of type 2 diabetes. We aimed to compare combined insulin degludec-liraglutide (IDegLira) with its components given alone in insulin-naive patients.In this phase 3, 26-week, open-label, randomised trial, adults with type 2 diabetes, HbA1c of 7-10% (inclusive), a BMI of 40 kg/m(2) or less, and treated with metformin with or without pioglitazone were randomly assigned (2:1:1) to daily injections of IDegLira, insulin degludec, or liraglutide (1·8 mg per day). IDegLira and insulin degludec were titrated to achieve a self-measured prebreakfast plasma glucose concentration of 4-5 mmol/L. The primary endpoint was change in HbA1c after 26 weeks of treatment, and the main objective was to assess the non-inferiority of IDegLira to insulin degludec (with an upper 95% CI margin of 0·3%), and the superiority of IDegLira to liraglutide (with a lower 95% CI margin of 0%). This study is registered with ClinicalTrials.gov, number NCT01336023.1663 adults (mean age 55 years [SD 10], HbA1c 8·3% [0·9], and BMI 31·2 kg/m(2) [4·8]) were randomly assigned, 834 to IDegLira, 414 to insulin degludec, and 415 to liraglutide. After 26 weeks, mean HbA1c had decreased by 1·9% (SD 1·1) to 6·4% (1·0) with IDegLira, by 1·4% (1·0) to 6·9% (1·1) with insulin degludec, and by 1·3% (1·1) to 7·0% (1·2) with liraglutide. IDegLira was non-inferior to insulin degludec (estimated treatment difference -0·47%, 95% CI -0·58 to -0·36, p0·0001) and superior to liraglutide (-0·64%, -0·75 to -0·53, p0·0001). IDegLira was generally well tolerated; fewer participants in the IDegLira group than in the liraglutide group reported gastrointestinal adverse events (nausea 8·8 vs 19·7%), although the insulin degludec group had the fewest participants with gastrointestinal adverse events (nausea 3·6%). We noted no clinically relevant differences between treatments with respect to standard safety assessments, and the safety profile of IDegLira reflected those of its component parts. The number of confirmed hypoglycaemic events per patient year was 1·8 for IDegLira, 0·2 for liraglutide, and 2·6 for insulin degludec. Serious adverse events occurred in 19 (2%) of 825 patients in the IDegLira group, eight (2%) of 412 in the insulin degludec group, and 14 (3%) of 412 in the liraglutide group.IDegLira combines the clinical advantages of basal insulin and GLP-1 receptor agonist treatment, resulting in improved glycaemic control compared with its components given alone.Novo Nordisk.

Published
2014

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