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4. Challenges in Type 1 diabetes management in South East Asia: Descriptive situational assessment

Author

Jothydev Kesavadev, Shaukat M Sadikot, Banshi Saboo, Dina Shrestha, Fatema Jawad, Kishwar Azad, Mahendra Arunashanthi Wijesuriya, Tint Swe Latt, and Sanjay Kalra

Subjects
Challenges, South East Asia, type 1 diabetes, Diseases of the endocrine glands. Clinical endocrinology, RC648-665, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Treatment of type 1 diabetes is a challenging issue in South East Asia. Unlike in the developed countries, patients have to procure insulin, glucometer strips and other treatment facilities from their own pockets. Coupled with poor resources are the difficulties with diagnosis, insulin initiation, insulin storage, marital and emotional challenges. Being a disease affecting only a minority of people, it is largely ignored by the governments and policy makers. Comprehensive diagnostic, treatment and team based educational facilities are available only in the speciality diabetes centers in the private sector whereas majority of the subjects with type 1 diabetes are from a poor socio-economic background. Unlike in the Western world, being known as a diabetes patient is a social sigma and poses huge emotional burden living with the disease and getting married. Even with best of the resources, long-term treatment of type 1 diabetes still remains a huge challenge across the globe. In this review, authors from India, Pakistan, Nepal, Sri Lanka, Myanmar and Bangladesh detail the country-specific challenges and discuss the possible solutions.

Published
2014
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5. Towards Measuring Ethicality of an Intelligent Assistive System

Author

Shaukat, M. Salman, Põder, J. -C., Bader, Sebastian, and Kirste, Thomas

Subjects
Computer Science - Computers and Society, Computer Science - Artificial Intelligence
Abstract

Artificial intelligence (AI) based assistive systems, so called intelligent assistive technology (IAT) are becoming increasingly ubiquitous by each day. IAT helps people in improving their quality of life by providing intelligent assistance based on the provided data. A few examples of such IATs include self-driving cars, robot assistants and smart-health management solutions. However, the presence of such autonomous entities poses ethical challenges concerning the stakeholders involved in using these systems. There is a lack of research when it comes to analysing how such IAT adheres to provided ethical regulations due to ethical, logistic and cost issues associated with such an analysis. In the light of the above-mentioned problem statement and issues, we present a method to measure the ethicality of an assistive system. To perform this task, we utilised our simulation tool that focuses on modelling navigation and assistance of Persons with Dementia (PwD) in indoor environments. By utilising this tool, we analyse how well different assistive strategies adhere to provided ethical regulations such as autonomy, justice and beneficence of the stakeholders., Comment: In the 1st AITHICS workshop (Artificial Intelligence and Ethics) held at 44th German Conference on Artificial Intelligence (KI-2021)

Published
2023

8. Phonon-mediated quantum discord in dark solitons

Author

Shaukat, M. I., Slaoui, A., Terças, H., and Daoud, M.

Subjects
Quantum Physics, Condensed Matter - Quantum Gases
Abstract

We investigate the quantum correlation dynamics in a dark-soliton qubits with special attention to quantum discord. Recently, dark-soliton qubit exhibiting appreciably long lifetime are proved to be an excellent candidate for information processing. Depending on the precise distance between the dark-soliton qubits, the decay rate of Dicke symmetric and antisymmetric state is suppressed or enhanced. With the Renyi-2 entropy, we derive a simple analytical expression for the quantum discord, and explore the generation and decay of correlation for different initial states. We believe the present work could pave the stage for a new generation of quantum discord based purely on matter-wave phononics., Comment: 9 Pages, 7 Figures

Published
2019

9. Universal evolution of non-classical correlations due to collective spontaneous emission

Author

Slaoui, A., Shaukat, M. I., Daoud, M., and Laamara, R. Ahl

Subjects
Quantum Physics
Abstract

We explore the spontaneous generation and decay of quantum correlations between two identical atoms coupled to a common Markovian environment in the presence of electromagnetic field modes. For this purpose, we analyze the dynamics of quantum correlations by employing the concurrence, the trace quantum discord and the local quantum uncertainty, for collective Dicke states. It is shown that the collective damping and dipole-dipole interaction plays a key role in enhancing non-classical correlations during the process of intrinsic decoherence. The quantum correlations can be maintained over a long time but for small distance between the two atoms., Comment: 10 Pages, 12 Figures

Published
2019
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12. Administrative Satisfaction and the Regulatory Climate at Public Institutions. AIR 1997 Annual Forum Paper.

Author

Volkwein, James Fredericks, Malik, Shaukat M., and Napierski-Prancl, Michelle

Abstract

This study examined the effects of state regulation of financial, personnel, and academic resources on the administrative flexibility granted to universities, and tested the hypothesis that state regulatory climate influences levels of managerial satisfaction. Data were gathered through two surveys. The first covered management flexibility and state regulation issues; responses were received from 122 public universities. A second survey of administrative satisfaction and stress was administered to 12 managers on each campus; replies were received from 995 respondents at 100 universities. Survey questions were grouped in five sets of variables: state characteristics, campus characteristics, administrator characteristics, perceived administrative work climate, and overall satisfaction. The study found: (1) that administrative teamwork and interpersonal stress, respectively, had the strongest positive and negative influences on administrative satisfaction; (2) that academic and administrative dimensions of campus autonomy were relatively independent; (3) that there was only a slight relationship between the economic, demographic, social, and political characteristics of the state and the regulatory climate for state universities or managerial satisfaction levels, (4) that there was little correlation between state control and campus characteristics, and (5) that there was little direct relationship between administrator satisfaction and state and/or campus characteristics. Four figures summarize some of the data. (Contains approximately 65 references.) (CH)

Published
1997

14. State Regulation and Administrative Flexibility at Public Universities. AIR 1996 Annual Forum Paper.

Author

Volkwein, James Fredericks and Malik, Shaukat M.

Abstract

This study investigated apsects of state regulation of public research or doctoral universities in all states and territories of the United States. The study examined: (1) dimensions of state control and administrative flexibility, and changes occurring between 1983 and 1995; (2) the extent to which state regulation of public universities is a product of the economic, political, and social characteristics of the particular state; (3) whether particular organizational characteristics of the universities attract different amounts and types of regulation; and (4) whether varying degrees of regulation and autonomy exert influences on measures of university quality. Campus and state characteristics data were assembled for 226 universities, 144 of them publicly controlled; 37 state characteristics and four broad campus dimensions were identified. Management flexibility and state regulation data were obtained for 122 public universities in 50 states; 47 flexibility and control variables were identified. Findings indicated: the strength and independence of both academic and administrative campus segments; increased flexibility of campuses in many states in their academic, financial, and personnel transactions; little evidence of a connection between state control and campus characteristics; and no evidence that flexibility exerts a significant influence on measures of faculty and student quality. Substantial data tables summarizing the results are appended. (Contains 24 references.) (MSE)

Published
1996

15. Evidence-based recommendations for insulin intensification strategies after basal insulin in type 2 diabetes

Author

Ghosh, Sujoy, Unnikrishnan, A.G., Saboo, Banshi, Kesavadev, Jothydev, Aravind, S.R., Bajaj, Sarita, Rajput, Rajesh, Seshadri, Krishna, Verma, Narsingh, Gupta, Arvind, Makkar, Brij Mohan, Saikia, Mihir, Kale, Shailaja, Damodaran, Suresh, Dengra, Ashish, Eashwar, T.K.M., Maheshwari, Anuj, Pendsey, Sharad, Phatak, Sanjeev R., Sharma, Surendra Kumar, Singh, Surya Kumar, Ramachandran, A., Zargar, Abdul H., Joshi, Shashank R., and Sadikot, Shaukat M.

Published
2017
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19. Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: a Joint Statement by International Diabetes Organizations

Author

Rubino, Francesco, Nathan, David M., Eckel, Robert H., Schauer, Philip R., Alberti, K. George M. M., Zimmet, Paul Z., Del Prato, Stefano, Ji, Linong, Sadikot, Shaukat M., Herman, William H., Amiel, Stephanie A., Kaplan, Lee M., Taroncher-Oldenburg, Gaspar, Cummings, David E., and on behalf of the Delegates of the 2nd Diabetes Surgery Summit

Published
2017
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20. Prognostic impact of hypochromic erythrocytes in patients with pulmonary arterial hypertension

Author

Theobald, V, primary, Xanthouli, P, additional, Benjamin, N, additional, Marra, A, additional, D’Agostino, A, additional, Egenlauf, B, additional, Shaukat, M, additional, Ding, C, additional, Cittadini, A, additional, Bossone, E, additional, Kögler, M, additional, Grünig, E, additional, Muckenthaler, M, additional, and Eichstaedt, C, additional

Published
2022
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22. Effect of foliar application of water soluble fertilizer on growth, yield and quality attributes of tomato (Solanum lycopersicum Mill.)

Author

Liaqat, Bakhatawar, Ashraf, M, Shaukat, M, Kiran, Shazia, Khalid, Waqar, Anam, Laraib, Kaleem, Zohaib, and Abdullah, M

Subjects
Yield, innspub, Nitrogen, fungi, Potassium, Phosphorus, Potassium, Tomato, Yield, Quality, food and beverages, Phosphorus, Quality, Tomato, ijaar
Abstract

The tomato is the one of the most famous crops in Pakistan. It is used and consumed as fresh as well as in processed form. Its botanical name is Solanum lycopersicon Mill. The proposed study had been conducted in the year 2017-2018 in order to find the best combination of water-soluble NPK fertilizers as compared to control. Five different types of water soluble fertilizers were collected from different sources and were applied at 5% concentration during the entire growing period of the tomato crop. The experiment was designed using Randomized Complete Block Design (RCBD) with five treatments and three replications of each. Different vegetative, reproductive and bio-chemical parameters were recorded and analyzed statistically at 5% level of significance. The treatments were compared using LSD test. It was concluded that different NPK water soluble fertilizers showed variation in physical and bio chemical parameters in tomato plants as compared to control. The plants showed variation in plant height, No. of fruit per plant, fruit yield per hectare, Individual fruit weight, fruit weight per plant, No. of diseased fruit per plant, date of first harvest, Fruit color Fruit length (cm), fruit size (cm), fruit firmness, total NPK contents, vitamincmg Chlorophyll concentration, pH, (TSS), Electricity conductivity (EC) and Titratable acidity Among all the water soluble treatments, the T3 treatment (WSF 20:20:20) yielded the comparatively better results as compared to other WSF treatments. So it was concluded that T3 was the recommended water-soluble fertilizer for tomatoes. Source: INNSPUB.NET, {"references":["Ali A, Hussain I, Gul H, Masoud S, Khan A, Wahab F, Khan J. 2015. Effect of different doses of foliar fertilizer on yield and physiochemical characteristics of tomato (Solanum lycopersicum Mill.) cultivars under the agro climatic condition of Peshawar. International Journal of Biosciences 7(1), 58-65.","Ali W, Jillani MS, Naeem N, Waseem K, Khan J, Ahmad MJ, Ghazanfarullah. 2012. Evaluation of different hybrids of tomato under the climatic conditions of Peshawar. Sarhad Journal of Agriculture 28(2), 207-212.","Anand N. 1973. Studies on leaf analysis and an index of fertilizer needs in tomato M.Sc. (Ag) Dissertation, Tamil Nadu Agricultural University, Coimbatore, T.N. (India).","Anoop K, Indiresh KM. 2015. Effect of water soluble fertilizers on qualitative parameters of tomato. Asian Journal of Horticulture sciences 10(1), 41-44.","Batra VK, Makhan L, Kampoj OP, Arora SK, Suthar MR. 2006. Effect of foliar application of micro nutrients on quality and shelf-life of tomato. Haryana Journal of Horticulture sciences 35(2), 140-142.","Bhatt L, Srivastava BK. 2005. Effect of foliar application of micronutrients on physical characteristics and quality attributes of tomato (Lycopersicon esculentum Mill.) fruits. Indian Journal of Agricultural Sciences 75(9), 591-592.","Chaurasia SNS, Singh KP, Rai M. 2005. Effect of foliar application of water soluble fertilizers on growth, yield and quality of tomato (Lycopersicon esculentum L.). Sri Lankan Journal of Agricultural Sciences 42, 66-70.","Chaurasia SNS, Singh KP, Rai M. 2006. Response of tomato to foliar application of water soluble fertilizers. Vegetable Science 33(1), 96-97.","Ejaz M, Rehman SU, Waqas R, Manan A, Imran M, Bukhari MA. 2011. Combined efficacy of macronutrients and micronutrients as a foliar application on growth and yield of tomato grown by vegetable forcing. International Journal of Agronomy Veternity and Medicine Sciences 5(3), 327-335.","Government of Pakistan. 2015. Fruits, Vegetables and Condiments statistics of Pakistan. Government of Pakistan, Ministry of food and Agriculture. (Economic Wing), Islambad.","Government of Pakistan. 2016. Pre-feasibility study (offseason vegetable farming–high tunnel).","Guvence I, Badem H. 2000. Effect of foliar application of different sources and levels of nitrogen on growth and yield of tomato (Lycopersicon esculentum L.). Indian Journal of Agruicultural sciences 72(2), 104-105.","Jeybal A, Murlidhar RM, Palanippam SP, Helliah SC. 1998. Technical Bulletin on specialty Fertilizers. Agriculture Research Development Institute Secunderabad.","Karpagam R, Kannan M, Natarajan S, Sriniva K. 2004. Studies on the efficacy of foliar feeding of water soluble fertilizers on growth parameters and yield of Brinjal hybrid COBH. Journal of Horticulture 52(6), 139-142.","Kumar U, Chandra G, Raghav M. 2017. Nitrogen management in potato for maximum tuber yield, quality and environmental conservation. Vegetable Science 44(2), 43-418.","Lester GE, Jifon JL, and Makus DJ. 2010. Impact of potassium nutrition on postharvest fruit quality: Melon (Cucumis melo L) case study. Plant and soil 335(1), 117-131.","Narayanamma M, Chiranjeevi C, Reddy CS. 2006. Influence of water soluble fertilizers on yield of brinjal. Journal of vegetable sciences 33, 94-95.","Naz FI, Haq U, Asghar S, Shah AS, Rahman A. 2011. Studies on growth, yield and nutritional composition of different tomato cultivars in Battal Valley of district Mansehra, Khyber Pakhtunkhwa, Pakistan. Sarhad Journal of Agriculture 27(4), 569-571.","Rab A, Haq IU. 2012. Foliar application of calcium chloride and borax influences plant growth, yield and quality of tomato (Solanum lycopersicon Mill.) fruit. Turkey Journal of Agriculture and Forest 36, 695-701.","Souri MK, Dehnavard S. 2018. Tomato plant growth, leaf nutrient concentrations and fruit quality under nitrogen foliar applications. Advances Horticulture Sciences 32(1), 41-47.","Takahashi N, Maki H, Nishina H, Takayama K. 2013. Evaluation of tomato fruit color change with different maturity stages and storage temperatures using image analysis. IFAC Proceedings 46(4), 147-149."]}

Published
2022
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25. Prognostic impact of hypochromic erythrocytes in patients with pulmonary arterial hypertension

Author

Theobald, V, additional, Xanthouli, P, additional, Benjamin, N, additional, Marra, A, additional, D'Agostino, A, additional, Egenlauf, B, additional, Shaukat, M, additional, Ding, C, additional, Cittadini, A, additional, Bossone, E, additional, Koegler, M, additional, Grünig, E, additional, Muckenthaler, M, additional, and Eichstaedt, C, additional

Published
2022
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26. The Virginia State University Herbarium (VSUH)

Author

Shaukat M Siddiqui, B.L. Sayre, Raghava Rao, and Satya S Narina

Subjects
Herbarium, Geography, Complementary and alternative medicine, State (polity), media_common.quotation_subject, Pharmaceutical Science, Pharmacology (medical), Archaeology, media_common
Published
2019

27. Administrative Satisfaction and the Regulatory Climate at Public Universities.

Author

Volkwein, James Fredericks, Malik, Shaukat M., and Napierski-Prancl, Michelle

Abstract

A study measured the financial, personnel, and academic dimensions of state regulation at 122 public universities, and examined how university and state characteristics affect regulatory climate and administrative flexibility. It also analyzed the dimensions of administrator satisfaction in 12 specific administrative positions in relation to various organizational, individual, and work climate variables. (Author/MSE)

Published
1998

28. State Regulation and Administrative Flexibility at Public Universities.

Author

Volkwein, James Fredericks and Malik, Shaukat M.

Abstract

This study examined the academic, personnel, and financial dimensions of state regulation, including changes since 1983; the relationship between state regulation, various state characteristics, and level of flexibility afforded universities; and the relationship between state regulation flexibility and campus characteristics, including institutional quality. (Author/MSE)

Published
1997

36. CLEAN DRINKING WATER AND FUTURE PROSPECTIVE.

Author

Ali, S., Farooq, F. H., Abbas, G., Hussain, Z., Anwar, M. S., Ahmad, R. I., Naz, F., Hussain, M., Nawaz, H., Shaukat, M., Shaukat, H., Sindhu, M. W., and Sindhu, M. A.

Subjects
DRINKING water, SANITATION, CONTAMINATION of drinking water, WATER quality, WATER utilities, BOTTLED water
Abstract

Water is one of the most important and vital substance on earth. Without water, there would be no life on this planet (earth). Around 20% of the human population planet has access to quality drinking water. Pakistan is listed 6th highly populated country on the earth having about 207.81 million individuals. Punjab is the most populated province of Pakistan with 110 million people. Contamination of drinking water is the most burning issue of the country. Industrialization, increase in population, intermixing of sewer in pipelines of drinking water and improper utilization of water compromise the quality and decrease the quantity of water. The physical, chemical and biological parameters of water have great detrimental effects on health. Water borne diseases in Pakistan are typhoid, diarrhea, cholera etc. The impact of poor sanitation and hygiene also have adverse effect on tourism, thereby affecting the economy of the country. Government Departments and Agencies are actively working through different interventions like chlorination to ensure facility of clean and quality drinking water to people. Chlorination is a process which is adopted to inactivate pathogens in water. Pakistan Council of Research in Water Resources (PCRWR) and Punjab Food Authority (PFA) conduct sampling and testing of the bottled water companies on periodical basis. Government of Punjab has established Aab-e-Pak Authority under Punjab Aab-e-Pak Act, 2019 for the provision of clean, safe and quality drinking water. Punjab Water Act, 2019, a comprehensive law on the subject has been passed but not implemented. Pakistan is also facing water insufficiency, water quality deterioration and demolition of freshwater resources. The world best practices regarding clean drinking water have also been analyzed. Keeping this in view, the short term, medium term and long term plans have been devised for the provision of clean and quality drinking water and improved sanitation facilities to the masses. [ABSTRACT FROM AUTHOR]

Published
2022

40. 1279-P: Socioeconomic Factors Associated with Poor Glycemic Control in People with Type 2 Diabetes: The DISCOVER Study

Author

Marilia B. Gomes, Shaukat M. Sadikot, Iichiro Shimomura, Hungta Chen, Antonio Nicolucci, Stuart Pocock, Gabriela Luporini Saraiva, Jesus Medina, Peter Fenici, Fengming Tang, Wolfgang Rathmann, Marina V. Shestakova, Javier Cid-Ruzafa, Kamlesh Khunti, Filip Surmont, and Hirotaka Watada

Subjects
Hba1c level, Kyowa hakko, Endocrinology, Diabetes and Metabolism, Poor glycemic control, Internal Medicine, In patient, Business, Management
Abstract

Background: DISCOVER is a 3-year, observational study of patients with type 2 diabetes (T2D) initiating second-line glucose-lowering therapy in 38 countries. We assessed socioeconomic factors associated with poor glycemic control (HbA1c ≥ 9.0%) at baseline. Methods: In total, 15 342 participants from 36 countries were evaluated. HbA1c levels were recorded in 12 261 participants (79.9%). Factors associated with an increased likelihood of having HbA1c ≥ 9.0% were assessed using a hierarchical logistic regression model. Results: The mean HbA1c level was 8.4% (SD: 1.7%); 48.9%, 23.4% and 27.7% of patients had HbA1c < 8.0%, ≥ 8.0 to < 9.0%, and ≥ 9.0%, respectively. Socioeconomic factors associated with an increased likelihood of having HbA1c ≥ 9.0% (Figure) included living in lower middle-income (vs. high-income) countries, being treated at a site with public/governmental or mixed (vs. private) funding, having public or no (vs. private) health insurance and having primary or no formal (vs. secondary or higher) education. Male sex and being younger than 50 years of age were also associated with an increased likelihood of having HbA1c ≥ 9.0%. Conclusions: Lower socioeconomic status is associated with an increased likelihood of having HbA1c ≥ 9.0% in people with T2D initiating second-line therapy. Efforts are needed to address social determinants of health in patients with T2D. Disclosure M.B. Gomes: Advisory Panel; Self; AstraZeneca. Consultant; Self; Merck KGaA. Research Support; Self; CNPq, FAPERJ. F. Tang: Employee; Self; Mid America Heart Institute. Research Support; Self; AstraZeneca. H. Chen: Employee; Self; AstraZeneca. J. Cid-Ruzafa: Employee; Self; Evidera. P. Fenici: Employee; Self; AstraZeneca. K. Khunti: Advisory Panel; Self; Amgen Inc., AstraZeneca, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis, Servier, Takeda Pharmaceutical Company Limited. Research Support; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis. Speaker's Bureau; Self; AstraZeneca, Berlin-Chemie AG, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Menarini Group, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi, Servier, Takeda Pharmaceutical Company Limited. S. Pocock: Consultant; Self; AstraZeneca. W. Rathmann: Advisory Panel; Self; AstraZeneca. Consultant; Self; Boehringer Ingelheim International GmbH. Research Support; Self; Novo Nordisk A/S. Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Novo Nordisk A/S. M.V. Shestakova: Advisory Panel; Self; AstraZeneca. Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi, Servier. Research Support; Self; Novo Nordisk A/S, Sanofi. F. Surmont: Employee; Self; AstraZeneca. H. Watada: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kissei Pharmaceutical Co., Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novartis Pharmaceuticals Corporation, Novo Nordisk A/S, Pfizer Inc., Sanofi, Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. Speaker's Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novo Nordisk A/S, Ono Pharmaceutical Co., Ltd., Sanofi, Takeda Pharmaceutical Company Limited, Terumo Medical Corporation. Other Relationship; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Kowa Pharmaceutical Europe Co. Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Ono Pharmaceutical Co., Ltd., Sanwa Chemical Industry Co. Ltd., Takeda Pharmaceutical Company Limited. J. Medina: Employee; Self; AstraZeneca. S.M. Sadikot: Consultant; Self; AstraZeneca. I. Shimomura: Advisory Panel; Self; AstraZeneca, Novo Nordisk Pharma Ltd., Sanwa Kagaku Kenkyusho. Consultant; Self; MSD K.K., Novo Nordisk Pharma Ltd., Taisho Pharmaceutical Co., Ltd. Research Support; Self; Astellas Pharma Inc., AstraZeneca, Daiichi Sankyo Company, Limited, Eli Lilly Japan K.K., Kaken Pharmaceutical Co., Ltd., Kowa Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Mitsubishi Tanabe Pharma Corporation, MSD K.K., Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Shionogi & Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. Speaker's Bureau; Self; Astellas Pharma Inc., AstraZeneca, Daiichi Sankyo Company, Limited, Eli Lilly Japan K.K., Kowa Pharmaceutical Co., Ltd., Lotte Co., Ltd., Mitsubishi Tanabe Pharma Corporation, MSD K.K., Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Sanwa Kagaku Kenkyusho, Taisho Toyama Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. G. Luporini Saraiva: Employee; Self; AstraZeneca. A. Nicolucci: Consultant; Self; AstraZeneca, Eli Lilly and Company, Medtronic, Novo Nordisk A/S. Research Support; Self; Artsana S.p.A., Dexcom, Inc., Novo Nordisk A/S, Sanofi-Aventis. Funding AstraZeneca

Published
2019

41. 1448-P: Potential Overtreatment of Older Patients with T2D: The Global DISCOVER Study

Author

Bernard Charbonnel, Brenda Bongaerts, Mikhail N. Kosiborod, Suzanne V. Arnold, Peter Fenici, Wolfgang Rathmann, Marilia B. Gomes, Jesus Medina, Shaukat M. Sadikot, Stuart Pocock, Kamlesh Khunti, Hungta Chen, Iichiro Shimomura, Marina V. Shestakova, Linong Ji, Fengming Tang, Javier Cid-Ruzafa, Antonio Nicolucci, Gabriela Luporini Saraiva, Filip Surmont, and Hirotaka Watada

Subjects
Hba1c level, Kyowa hakko, Older patients, Endocrinology, Diabetes and Metabolism, Internal Medicine, Business, Management
Abstract

Background: Guidelines endorse a target HbA1c of < 7% for most people with T2D, but less stringent goals (e.g., HbA1c < 8%) and medications with a low risk of causing hypoglycemia are recommended for older patients. We examined the prevalence of potential overtreatment in a global cohort of older patients with T2D. Methods: DISCOVER is an ongoing, observational study of 15 992 patients with T2D initiating second-line glucose-lowering therapy in 38 countries. HbA1c levels and glucose-lowering therapies were recorded at baseline (initiation of second-line therapy), 6, 12 and 24 months. The analysis includes patients aged ≥ 65 years with a recorded baseline HbA1c level. Insulin, sulfonylureas, and meglitinides are medications associated with risk of hypoglycemia. Results: Among 3492 older patients, 2110 (60.4%) and 812 (23.3%) had an HbA1c level of < 8% and < 7% at baseline, respectively. The proportions of patients with HbA1c < 7% increased to more than 50% during follow-up (Figure). A third or more of these patients received medications associated with risk of hypoglycemia at baseline and during follow-up. Conclusions: In this global cohort, including patients from both lower-middle- and higher-income countries, many older patients with good glycemic control (HbA1c < 7%) received medications that are associated with increased risk of hypoglycemia. A more tailored management of hyperglycemia may be needed in this population. Disclosure B. Bongaerts: Advisory Panel; Self; AstraZeneca. S.V. Arnold: None. B. Charbonnel: Consultant; Self; AstraZeneca, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi, Servier. Speaker's Bureau; Self; AstraZeneca, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi, Takeda Pharmaceutical Company Limited. H. Chen: Employee; Self; AstraZeneca. J. Cid-Ruzafa: Employee; Self; Evidera. P. Fenici: Employee; Self; AstraZeneca. M.B. Gomes: Advisory Panel; Self; AstraZeneca. Consultant; Self; Merck KGaA. Research Support; Self; CNPq, FAPERJ. L. Ji: Advisory Panel; Self; AstraZeneca. Consultant; Self; AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Bristol-Myers Squibb Company, Eli Lilly and Company, Merck KGaA, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi, Takeda Pharmaceutical Company Limited. Research Support; Self; AstraZeneca, Bristol-Myers Squibb Company, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novartis AG, Roche Pharma, Sanofi. K. Khunti: Advisory Panel; Self; Amgen Inc., AstraZeneca, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis, Servier, Takeda Pharmaceutical Company Limited. Research Support; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis. Speaker's Bureau; Self; AstraZeneca, Berlin-Chemie AG, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Menarini Group, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi, Servier, Takeda Pharmaceutical Company Limited. M.N. Kosiborod: Consultant; Self; Amgen Inc., AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Eisai Co., Ltd., GlaxoSmithKline plc., Glytec, LLC, Intarcia Therapeutics, Inc., Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Novartis AG, Novo Nordisk A/S, Sanofi. Research Support; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc. G. Luporini Saraiva: Employee; Self; AstraZeneca. J. Medina: Employee; Self; AstraZeneca. A. Nicolucci: Consultant; Self; AstraZeneca, Eli Lilly and Company, Medtronic, Novo Nordisk A/S. Research Support; Self; Artsana S.p.A., Dexcom, Inc., Novo Nordisk A/S, Sanofi-Aventis. S. Pocock: Consultant; Self; AstraZeneca. S.M. Sadikot: Consultant; Self; AstraZeneca. M.V. Shestakova: Advisory Panel; Self; AstraZeneca. Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi, Servier. Research Support; Self; Novo Nordisk A/S, Sanofi. I. Shimomura: Advisory Panel; Self; AstraZeneca, Novo Nordisk Pharma Ltd., Sanwa Kagaku Kenkyusho. Consultant; Self; MSD K.K., Novo Nordisk Pharma Ltd., Taisho Pharmaceutical Co., Ltd. Research Support; Self; Astellas Pharma Inc., AstraZeneca, Daiichi Sankyo Company, Limited, Eli Lilly Japan K.K., Kaken Pharmaceutical Co., Ltd., Kowa Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Mitsubishi Tanabe Pharma Corporation, MSD K.K., Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Shionogi & Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. Speaker's Bureau; Self; Astellas Pharma Inc., AstraZeneca, Daiichi Sankyo Company, Limited, Eli Lilly Japan K.K., Kowa Pharmaceutical Co., Ltd., Lotte Co., Ltd., Mitsubishi Tanabe Pharma Corporation, MSD K.K., Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Sanwa Kagaku Kenkyusho, Taisho Toyama Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. F. Surmont: Employee; Self; AstraZeneca. F. Tang: Employee; Self; Mid America Heart Institute. Research Support; Self; AstraZeneca. H. Watada: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kissei Pharmaceutical Co., Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novartis Pharmaceuticals Corporation, Novo Nordisk A/S, Pfizer Inc., Sanofi, Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. Speaker's Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novo Nordisk A/S, Ono Pharmaceutical Co., Ltd., Sanofi, Takeda Pharmaceutical Company Limited, Terumo Medical Corporation. Other Relationship; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Kowa Pharmaceutical Europe Co. Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Ono Pharmaceutical Co., Ltd., Sanwa Chemical Industry Co. Ltd., Takeda Pharmaceutical Company Limited. W. Rathmann: Advisory Panel; Self; AstraZeneca. Consultant; Self; Boehringer Ingelheim International GmbH. Research Support; Self; Novo Nordisk A/S. Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Novo Nordisk A/S. Funding AstraZeneca

Published
2019

42. 207-LB: Type 2 Diabetes and Heart Failure: Insights from the DISCOVER Study

Author

Filip Surmont, Hirotaka Watada, Marilia B. Gomes, Javier Cid-Ruzafa, Linong Ji, Stuart Pocock, Iichiro Shimomura, Bernard Charbonnel, Hungta Chen, Shaukat M. Sadikot, Suzanne V. Arnold, Peter Fenici, Mikhail N. Kosiborod, Fabrice Bonnet, Marina V. Shestakova, Kamlesh Khunti, Jesus Medina, Gabriela Luporini Saraiva, Jiten Vora, and Fengming Tang

Subjects
Kyowa hakko, Endocrinology, Diabetes and Metabolism, Internal Medicine, Outpatient setting, Mean age, In patient, Known Coronary Artery Disease, Business, Short duration, Management
Abstract

Background: Heart failure (HF) is one of the most morbid complications of T2D, but the role of T2D in the development of HF has been under-appreciated. We assessed the incidence and prevalence of HF in a global cohort of patients with T2D. Methods: DISCOVER is a global, observational study of patients with T2D enrolled at initiation of second-line glucose-lowering therapy. Outcomes have been prospectively collected for 2 years. Results: Among 15,359 patients from 37 countries (mean age 57 y, mean T2D duration 5.6 y, mean HbA1c 8.3%), 290 patients (1.9%) had HF at enrollment (range across countries of 0-9%), of whom 129 (45%) had known coronary artery disease (CAD). Patients with HF were older, had a longer duration of T2D, had a greater prevalence of atherosclerosis, and were less likely to be treated with metformin and thiazolidinediones (Table). Incidence of HF was 0.4% in year 1 and 0.2% in year 2; the prevalence of HF after 2 years was 2.5%. Among incident HF events, 74% were diagnosed in the outpatient setting and 56% occurred in the absence of CAD. Conclusion: Although HF is not highly prevalent in patients with a relatively short duration of T2D, it is more common with increasing age and longer T2D duration. Most patients with T2D who develop HF do not have clinically evident CAD. These findings highlight the need for greater awareness of HF risk independent of CAD and a deeper understanding of how to prevent and optimally manage HF in patients with T2D. Disclosure S.V. Arnold: None. H. Chen: Employee; Self; AstraZeneca. J. Cid-Ruzafa: Employee; Self; Evidera. P. Fenici: Employee; Self; AstraZeneca. M.B. Gomes: Advisory Panel; Self; AstraZeneca. Consultant; Self; Merck KGaA. Research Support; Self; CNPq, FAPERJ. K. Khunti: Advisory Panel; Self; Amgen Inc., AstraZeneca, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis, Servier, Takeda Pharmaceutical Company Limited. Research Support; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis. Speaker’s Bureau; Self; AstraZeneca, Berlin-Chemie AG, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Menarini Group, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi, Servier, Takeda Pharmaceutical Company Limited. G. Luporini Saraiva: Employee; Self; AstraZeneca. J. Medina: Employee; Self; AstraZeneca. S. Pocock: Consultant; Self; AstraZeneca. S.M. Sadikot: Consultant; Self; AstraZeneca. M.V. Shestakova: Advisory Panel; Self; AstraZeneca. Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi, Servier. Research Support; Self; Novo Nordisk A/S, Sanofi. I. Shimomura: Advisory Panel; Self; AstraZeneca, Novo Nordisk Pharma Ltd., Sanwa Kagaku Kenkyusho. Consultant; Self; MSD K.K., Novo Nordisk Pharma Ltd., Taisho Pharmaceutical Co., Ltd. Research Support; Self; Astellas Pharma Inc., AstraZeneca, Daiichi Sankyo Company, Limited, Eli Lilly Japan K.K., Kaken Pharmaceutical Co., Ltd., Kowa Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Mitsubishi Tanabe Pharma Corporation, MSD K.K., Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Shionogi & Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. Speaker’s Bureau; Self; Astellas Pharma Inc., AstraZeneca, Daiichi Sankyo Company, Limited, Eli Lilly Japan K.K., Kowa Pharmaceutical Co., Ltd., Lotte Co., Ltd., Mitsubishi Tanabe Pharma Corporation, MSD K.K., Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Sanwa Kagaku Kenkyusho, Taisho Toyama Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. F. Surmont: Employee; Self; AstraZeneca. F. Tang: Employee; Self; Mid America Heart Institute. Research Support; Self; AstraZeneca. J. Vora: Employee; Self; AstraZeneca. Research Support; Self; Abbott, AstraZeneca, Boehringer Ingelheim International GmbH, Bristol-Myers Squibb Company, Eli Lilly and Company, GlaxoSmithKline plc., Merck KGaA, Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi, Takeda Pharmaceutical Company Limited. H. Watada: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kissei Pharmaceutical Co., Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novartis Pharmaceuticals Corporation, Novo Nordisk A/S, Pfizer Inc., Sanofi, Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. Speaker’s Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novo Nordisk A/S, Ono Pharmaceutical Co., Ltd., Sanofi, Takeda Pharmaceutical Company Limited, Terumo Medical Corporation. Other Relationship; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Kowa Pharmaceutical Europe Co. Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Ono Pharmaceutical Co., Ltd., Sanwa Chemical Industry Co. Ltd., Takeda Pharmaceutical Company Limited. L. Ji: Advisory Panel; Self; AstraZeneca. Consultant; Self; AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Bristol-Myers Squibb Company, Eli Lilly and Company, Merck KGaA, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi, Takeda Pharmaceutical Company Limited. Research Support; Self; AstraZeneca, Bristol-Myers Squibb Company, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novartis AG, Roche Pharma, Sanofi. B. Charbonnel: Consultant; Self; AstraZeneca, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi, Servier. Speaker’s Bureau; Self; AstraZeneca, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi, Takeda Pharmaceutical Company Limited. F. Bonnet: Advisory Panel; Self; AstraZeneca. Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi, Takeda Pharmaceutical Company Limited. M.N. Kosiborod: Consultant; Self; Amgen Inc., AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Eisai Co., Ltd., GlaxoSmithKline plc., Glytec, LLC, Intarcia Therapeutics, Inc., Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Novartis AG, Novo Nordisk A/S, Sanofi. Research Support; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc. Funding AstraZeneca

Published
2019

43. 1628-P: Changes in HbA1c and Treatment in the Second Year following Initiation of Second-Line Therapy in People with T2D—The Global DISCOVER Study

Author

Jiten Vora, Kamlesh Khunti, Stuart Pocock, Fengming Tang, Jesus Medina, Marilia B. Gomes, Iichiro Shimomura, Peter Fenici, Javier Cid-Ruzafa, Hungta Chen, Antonio Nicolucci, Filip Surmont, Marina V. Shestakova, Gabriela Luporini Saraiva, Hirotaka Watada, Bernard Charbonnel, and Shaukat M. Sadikot

Subjects
Hba1c level, Second-line therapy, Kyowa hakko, Endocrinology, Diabetes and Metabolism, Treatment intensification, Internal Medicine, In patient, Business, Oral retinoid, Management
Abstract

Background: DISCOVER is an ongoing, observational study of people with T2D initiating second-line glucose-lowering therapy in 38 countries in six regions. We report changes in glucose-lowering therapies and HbA1c levels from the first to the second year of follow-up. Methods: HbA1c levels and changes in therapies were recorded at baseline, 1 and 2 years; 15 988 patients were included in the analysis. Results: Mean HbA1c levels at baseline, 1 and 2 years were 8.3%, 7.2% and 7.3%, respectively. At 1 and 2 years, mean HbA1c levels were close to 7.0% in patients receiving one or two oral drugs at 1 year, but were higher than 7.0% for those receiving more than two oral drugs or an injectable drug (Figure). The proportion of patients with HbA1c ≥ 8.0% was similar at 1 and 2 years (19.8% vs. 19.1%). Overall, 16.7% of patients changed therapy during the second year of follow-up. Treatment was intensified by the addition of an oral drug in 6.2% of patients receiving one or two oral drugs, and 3.2% of patients receiving oral therapies initiated an injectable drug. Results were consistent across regions. Conclusions: Glycemic levels were well controlled after 1 and 2 years of follow-up in participants receiving oral therapies, and treatment intensification occurred in a small proportion of people in this group. By contrast, glycemic control was suboptimal in people receiving injectable drugs. Disclosure B. Charbonnel: Consultant; Self; AstraZeneca, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi, Servier. Speaker's Bureau; Self; AstraZeneca, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi, Takeda Pharmaceutical Company Limited. H. Chen: Employee; Self; AstraZeneca. J. Cid-Ruzafa: Employee; Self; Evidera. P. Fenici: Employee; Self; AstraZeneca. M.B. Gomes: Advisory Panel; Self; AstraZeneca. Consultant; Self; Merck KGaA. Research Support; Self; CNPq, FAPERJ. G. Luporini Saraiva: Employee; Self; AstraZeneca. J. Medina: Employee; Self; AstraZeneca. A. Nicolucci: Consultant; Self; AstraZeneca, Eli Lilly and Company, Medtronic, Novo Nordisk A/S. Research Support; Self; Artsana S.p.A., Dexcom, Inc., Novo Nordisk A/S, Sanofi-Aventis. S. Pocock: Consultant; Self; AstraZeneca. M.V. Shestakova: Advisory Panel; Self; AstraZeneca. Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi, Servier. Research Support; Self; Novo Nordisk A/S, Sanofi. I. Shimomura: Advisory Panel; Self; AstraZeneca, Novo Nordisk Pharma Ltd., Sanwa Kagaku Kenkyusho. Consultant; Self; MSD K.K., Novo Nordisk Pharma Ltd., Taisho Pharmaceutical Co., Ltd. Research Support; Self; Astellas Pharma Inc., AstraZeneca, Daiichi Sankyo Company, Limited, Eli Lilly Japan K.K., Kaken Pharmaceutical Co., Ltd., Kowa Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Mitsubishi Tanabe Pharma Corporation, MSD K.K., Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Shionogi & Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. Speaker's Bureau; Self; Astellas Pharma Inc., AstraZeneca, Daiichi Sankyo Company, Limited, Eli Lilly Japan K.K., Kowa Pharmaceutical Co., Ltd., Lotte Co., Ltd., Mitsubishi Tanabe Pharma Corporation, MSD K.K., Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Sanwa Kagaku Kenkyusho, Taisho Toyama Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. S.M. Sadikot: Consultant; Self; AstraZeneca. F. Surmont: Employee; Self; AstraZeneca. F. Tang: Employee; Self; Mid America Heart Institute. Research Support; Self; AstraZeneca. J. Vora: Employee; Self; AstraZeneca. Research Support; Self; Abbott, AstraZeneca, Boehringer Ingelheim International GmbH, Bristol-Myers Squibb Company, Eli Lilly and Company, GlaxoSmithKline plc., Merck KGaA, Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi, Takeda Pharmaceutical Company Limited. H. Watada: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kissei Pharmaceutical Co., Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novartis Pharmaceuticals Corporation, Novo Nordisk A/S, Pfizer Inc., Sanofi, Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. Speaker's Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novo Nordisk A/S, Ono Pharmaceutical Co., Ltd., Sanofi, Takeda Pharmaceutical Company Limited, Terumo Medical Corporation. Other Relationship; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Kowa Pharmaceutical Europe Co. Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Ono Pharmaceutical Co., Ltd., Sanwa Chemical Industry Co. Ltd., Takeda Pharmaceutical Company Limited. K. Khunti: Advisory Panel; Self; Amgen Inc., AstraZeneca, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis, Servier, Takeda Pharmaceutical Company Limited. Research Support; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis. Speaker's Bureau; Self; AstraZeneca, Berlin-Chemie AG, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Menarini Group, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi, Servier, Takeda Pharmaceutical Company Limited. Funding AstraZeneca

Published
2019

44. 420-P: Micro- and Macrovascular Events in Patients with T2D—Results from the Global DISCOVER Study

Author

Suzanne V. Arnold, Mikhail N. Kosiborod, Iichiro Shimomura, Jesus Medina, Marilia B. Gomes, Shaukat M. Sadikot, Javier Cid-Ruzafa, Hungta Chen, Kamlesh Khunti, Marina V. Shestakova, Stuart Pocock, Peter Fenici, Antonio Nicolucci, Gabriela Luporini Saraiva, Jiten Vora, Fengming Tang, Hirotaka Watada, and Filip Surmont

Subjects
Kyowa hakko, business.industry, Endocrinology, Diabetes and Metabolism, Internal Medicine, Medicine, In patient, business, Management
Abstract

Background: Micro- and macrovascular complications are a major cause of morbidity and mortality in patients with T2D. We sought to understand the global pattern and predictors of these complications. Methods: Incidence of non-adjudicated complications was examined over 2 years of follow-up of DISCOVER, a global, observational study of patients with T2D initiating second-line glucose-lowering therapy. Hierarchical logistic regression models examined factors associated with development of complications during follow-up. Results: In 10 718 patients from 33 countries, median T2D duration was 4.1 years (interquartile range [IQR] 2.0-7.7) and median HbA1c was 8.1% (IQR 7.3-9.2). Prevalent micro- and macrovascular complications at baseline were noted in 18.2% and 12.7% of patients, respectively. Over 2 years of follow-up, 12.2% and 4.8% of patients had new micro- and macrovascular complications, respectively (Figure). Male sex, higher blood pressure and longer T2D duration were associated with a greater odds of incident microvascular disease whereas older age and known atherosclerosis were associated with greater odds of incident macrovascular disease. Conclusion: Both the prevalence and the 2-year incidence of vascular complications were remarkably high in patients with relatively short T2D duration, highlighting opportunities for early aggressive risk-factor modification. Disclosure S.V. Arnold: None. H. Chen: Employee; Self; AstraZeneca. J. Cid-Ruzafa: Employee; Self; Evidera. P. Fenici: Employee; Self; AstraZeneca. M.B. Gomes: Advisory Panel; Self; AstraZeneca. Consultant; Self; Merck KGaA. Research Support; Self; CNPq, FAPERJ. K. Khunti: Advisory Panel; Self; Amgen Inc., AstraZeneca, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis, Servier, Takeda Pharmaceutical Company Limited. Research Support; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis. Speaker's Bureau; Self; AstraZeneca, Berlin-Chemie AG, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Menarini Group, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi, Servier, Takeda Pharmaceutical Company Limited. G. Luporini Saraiva: Employee; Self; AstraZeneca. J. Medina: Employee; Self; AstraZeneca. A. Nicolucci: Consultant; Self; AstraZeneca, Eli Lilly and Company, Medtronic, Novo Nordisk A/S. Research Support; Self; Artsana S.p.A., Dexcom, Inc., Novo Nordisk A/S, Sanofi-Aventis. S. Pocock: Consultant; Self; AstraZeneca. S.M. Sadikot: Consultant; Self; AstraZeneca. M.V. Shestakova: Advisory Panel; Self; AstraZeneca. Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi, Servier. Research Support; Self; Novo Nordisk A/S, Sanofi. I. Shimomura: Advisory Panel; Self; AstraZeneca, Novo Nordisk Pharma Ltd., Sanwa Kagaku Kenkyusho. Consultant; Self; MSD K.K., Novo Nordisk Pharma Ltd., Taisho Pharmaceutical Co., Ltd. Research Support; Self; Astellas Pharma Inc., AstraZeneca, Daiichi Sankyo Company, Limited, Eli Lilly Japan K.K., Kaken Pharmaceutical Co., Ltd., Kowa Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Mitsubishi Tanabe Pharma Corporation, MSD K.K., Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Shionogi & Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. Speaker's Bureau; Self; Astellas Pharma Inc., AstraZeneca, Daiichi Sankyo Company, Limited, Eli Lilly Japan K.K., Kowa Pharmaceutical Co., Ltd., Lotte Co., Ltd., Mitsubishi Tanabe Pharma Corporation, MSD K.K., Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Sanwa Kagaku Kenkyusho, Taisho Toyama Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. F. Surmont: Employee; Self; AstraZeneca. F. Tang: Employee; Self; Mid America Heart Institute. Research Support; Self; AstraZeneca. J. Vora: Employee; Self; AstraZeneca. Research Support; Self; Abbott, AstraZeneca, Boehringer Ingelheim International GmbH, Bristol-Myers Squibb Company, Eli Lilly and Company, GlaxoSmithKline plc., Merck KGaA, Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi, Takeda Pharmaceutical Company Limited. H. Watada: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kissei Pharmaceutical Co., Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novartis Pharmaceuticals Corporation, Novo Nordisk A/S, Pfizer Inc., Sanofi, Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. Speaker's Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Eli Lilly and Company, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novo Nordisk A/S, Ono Pharmaceutical Co., Ltd., Sanofi, Takeda Pharmaceutical Company Limited, Terumo Medical Corporation. Other Relationship; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Kowa Pharmaceutical Europe Co. Ltd., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Ono Pharmaceutical Co., Ltd., Sanwa Chemical Industry Co. Ltd., Takeda Pharmaceutical Company Limited. M.N. Kosiborod: Consultant; Self; Amgen Inc., AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Eisai Co., Ltd., GlaxoSmithKline plc., Glytec, LLC, Intarcia Therapeutics, Inc., Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Novartis AG, Novo Nordisk A/S, Sanofi. Research Support; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc. Funding AstraZeneca

Published
2019

45. PHYSICOCHEMICAL PARAMETERS OF MILK AT DIFFERENT STAGES OF LACTATION IN NILI RAVI BUFFALO.

Author

Abrar, Y., Mushtaq, A., Riaz, R., Ali, S., Rafique, R., Naz, T., Zaheer, R., Awan, M. H., Khan, A. R., Shaukat, M., Shaukat, H., and Sindhu, M. W.

Subjects
FAT content of milk, LACTATION, DECANOIC acid, LAURIC acid, LINOLENIC acids, FATTY acids, STEARIC acid, FATTY acid analysis
Abstract

Among the established breeds of buffalo in Pakistan, the Nili-Ravi breed is dominant in the Punjab Province. The purpose of the study is to determine the chemical composition and fatty acid profile of buffalo milk. Milk is a complete food and contains all the nutritional components in balanced form. It helps to meet important nutritional needs of the human body. The buffaloes were divided into 3 groups on the basis of lactation period i.e. early, middle and late lactation. A total of 90 milk samples were obtained for analysis. Buffalo milk samples were analyzed for proximate analysis, parameters like fat, crude protein, lactose, ash, solids not fat (SNF), total solids (TS), pH and acidity were determined. Fatty acid profile of buffalo milk was determined by the method, Association of Office of Agricultural Chemists (AOAC, 2000). Milk fat content (%) was found to be significantly (p<0.05) lower in the early (6.52) and mid lactation (6.61) stages than the late lactation stage (6.85). The content of TS (%) was found to be significantly (p<0.05) higher in the late lactation (14.62 and 15.45) stage than the early (12.94 and 13.65)) and mid lactation (13.76 and 14.14) stages. In contrast, the content of total protein (4.31% to 4.78%), Solid not fat (8.40% to 8.70%), lactose (4.36% to 4.74%) and ash (0.18% to 0.19%) did not vary significantly among the different lactation stages. The values of Butyric acid, Caproic acid, Myristic acid, Stearic acid and Oleic acid showed significant increase towards end of lactation. These values of fatty acids also revealed that there is significant difference among the animals and lactation stages of Nili Ravi buffalo milk. Results showed that Capric acid, Lauric acid, Palmitic acid, Linoleic acid and Linolenic acid decreased in early to middle and increased towards end of lactation. [ABSTRACT FROM AUTHOR]

Published
2021

46. 1628-P: Changes in HbA1c and Treatment in the Second Year following Initiation of Second-Line Therapy in People with T2D—The Global DISCOVER Study

Author

CHARBONNEL, BERNARD, primary, CHEN, HUNGTA, additional, CID-RUZAFA, JAVIER, additional, FENICI, PETER, additional, GOMES, MARILIA B., additional, SARAIVA, GABRIELA LUPORINI, additional, MEDINA, JESUS, additional, NICOLUCCI, ANTONIO, additional, POCOCK, STUART, additional, SHESTAKOVA, MARINA V., additional, SHIMOMURA, IICHIRO, additional, SADIKOT, SHAUKAT M., additional, SURMONT, FILIP, additional, TANG, FENGMING, additional, VORA, JITEN, additional, WATADA, HIROTAKA, additional, and KHUNTI, KAMLESH, additional

Published
2019
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47. 1279-P: Socioeconomic Factors Associated with Poor Glycemic Control in People with Type 2 Diabetes: The DISCOVER Study

Author

GOMES, MARILIA B., primary, TANG, FENGMING, additional, CHEN, HUNGTA, additional, CID-RUZAFA, JAVIER, additional, FENICI, PETER, additional, KHUNTI, KAMLESH, additional, POCOCK, STUART, additional, RATHMANN, WOLFGANG, additional, SHESTAKOVA, MARINA V., additional, SURMONT, FILIP, additional, WATADA, HIROTAKA, additional, MEDINA, JESUS, additional, SADIKOT, SHAUKAT M., additional, SHIMOMURA, IICHIRO, additional, SARAIVA, GABRIELA LUPORINI, additional, and NICOLUCCI, ANTONIO, additional

Published
2019
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48. 420-P: Micro- and Macrovascular Events in Patients with T2D—Results from the Global DISCOVER Study

Author

ARNOLD, SUZANNE V., primary, CHEN, HUNGTA, additional, CID-RUZAFA, JAVIER, additional, FENICI, PETER, additional, GOMES, MARILIA B., additional, KHUNTI, KAMLESH, additional, SARAIVA, GABRIELA LUPORINI, additional, MEDINA, JESUS, additional, NICOLUCCI, ANTONIO, additional, POCOCK, STUART, additional, SADIKOT, SHAUKAT M., additional, SHESTAKOVA, MARINA V., additional, SHIMOMURA, IICHIRO, additional, SURMONT, FILIP, additional, TANG, FENGMING, additional, VORA, JITEN, additional, WATADA, HIROTAKA, additional, and KOSIBOROD, MIKHAIL N., additional

Published
2019
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49. Life Cycle Assessment (LCA) of Welded of AISI 304 Stainless Steel Using Laser Beam Welding (LBW), Friction Stir Welding (FSW) and Gas Tungsten Arc Welding (GTAW).

Author

AFZAL, A. A., SHAUKAT, M. MOBEEN, YILBAS, B. S., AKHTAR, S. S., and AL-BADOUR, F.

Subjects
*LASER welding, *FRICTION stir welding, *GAS tungsten arc welding, *STAINLESS steel welding, *STAINLESS steel, *TROPOSPHERIC ozone
Abstract

This paper analyses the environmental impacts of three different welding processes using life cycle assessment (LCA). Thin sheets of AISI 304 stainless steel are welded using friction stir welding (FSW), laser beam welding (LBW) and gas tungsten arc welding (GTAW). Data is collected for energy, material, and shielding gas consumption during welding of AISI 304 sheets using these welding processes. Then LCA is used to quantify environmental impacts of these processes using following six impact categories: acidification potential, abiotic depletion potential, eutrophication potential, global warming potential, photochemical ozone creation potential, and ozone depletion potential. The results of the study reveal that of the three processes LBW causes the least environmental impacts whereas FSW causes the highest environmental impacts in all six categories. The relationship between sheet thickness and environmental impacts of welding is also reported. This study can help in selection of environment friendly welding process for thin sheets of steel. [ABSTRACT FROM AUTHOR]

Published
2021

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