Journal of Diabetes and its Complications,
Год журнала:
2024,
Номер
38(8), С. 108795 - 108795
Опубликована: Июнь 12, 2024
Aim
The
efficacy
of
hybrid
closed-loop
systems
(HCLs)
in
managing
glycemic
control
pregnant
women
with
type
1
diabetes
remains
inadequately
characterized.
We
evaluated
the
use
Medtronic
Minimed
780G
HCLs.
Nature Medicine,
Год журнала:
2024,
Номер
30(6), С. 1689 - 1695
Опубликована: Апрель 16, 2024
Abstract
Reduced
insulin
sensitivity
(insulin
resistance)
is
a
hallmark
of
normal
physiology
in
late
pregnancy
and
also
underlies
gestational
diabetes
mellitus
(GDM).
We
conducted
transcriptomic
profiling
434
human
placentas
identified
positive
association
between
insulin-like
growth
factor
binding
protein
1
gene
(
IGFBP1
)
expression
the
placenta
at
~26
weeks
gestation.
Circulating
levels
rose
over
course
declined
postpartum,
which,
together
with
high
our
samples,
suggests
placental
or
decidual
source.
Higher
circulating
were
associated
greater
(lesser
gestation
same
cohort
two
additional
cohorts.
In
addition,
low
early
predicted
subsequent
GDM
diagnosis
cohorts
pregnant
women.
These
results
implicate
glycemic
suggest
role
for
deficiency
pathogenesis.
Scientific Reports,
Год журнала:
2024,
Номер
14(1)
Опубликована: Март 14, 2024
Gestational
diabetes
mellitus
(GDM)
is
a
known
risk
factor
for
gestational
hypertension
which
further
progress
toward
conditions
like
proteinuria,
dyslipidemia,
thrombocytopenia,
pulmonary
edema
leading
to
Preeclampsia
(PE).
Pregnancy
can
be
challenging
time
many
women,
especially
those
diagnosed
with
GDM
and
PE.
Thus,
the
current
prospective
study
investigates
association
of
OGTT
glucose
levels
systolic
diastolic
blood
pressure
lipid
profile
parameters
in
pregnant
women
A
total
140
were
stratified
into
(n
=
50),
PE
40)
controls
50).
Two
hour
75
g
oral
tolerance
test
(OGTT)
was
performed
screening
GDM.
Biochemical
analysis
OGTT,
cholesterol
(TC),
triglyceride
(Tg),
high
density
lipoprotein-cholesterol
(HDL-C),
low
(LDL-C),
urinary
albumin
creatinine
tested
find
ratio
(uACR).
Statistical
using
ANOVA
followed
by
post
hoc
regression
analysis.
Among
studied
groups,
groups
showed
no
significant
difference
age
increased
BMI.
Increased
2
h
&
TC
group;
elevated
uACR,
systolic/diastolic
pressure,
Tg,
HDL-C,
LDL-C
group
observed
differ
significantly
(p
<
0.0001)
other
groups.
positive
effect
on
(R
Diabetes/Metabolism Research and Reviews,
Год журнала:
2024,
Номер
40(6)
Опубликована: Сен. 1, 2024
ABSTRACT
Aims
To
compare
the
efficacy
and
safety
of
different
hybrid
closed
loop
(HCL)
systems
in
people
with
diabetes
through
a
network
meta‐analysis.
Methods
We
searched
MEDLINE,
EMBASE,
CENTRAL
PubMed
for
randomised
clinical
trials
(RCTs)
enrolling
children,
adolescents
and/or
adults
type
1
or
2
diabetes,
evaluating
Minimed
670G,
780G,
Control‐IQ,
CamAPS
Fx,
DBLG‐1,
DBLHU,
Omnipod
5
HCL
against
other
types
insulin
therapy,
reporting
time
target
range
(TIR)
as
outcome.
Results
A
total
28
RCTs,
all
were
included.
significantly
increased
TIR
compared
subcutaneous
therapy
without
continuous
glucose
monitoring
(SIT).
780G
achieved
highest
ahead
Control
IQ
(mean
difference
(MD)
5.1%,
95%
confidence
interval
(95%
CI)
[0.68;
9.52],
low
certainty),
670G
(MD
7.48%,
CI
[4.27;
10.7],
moderate
Fx
8.94%,
[4.35;
13.54],
DBLG1
10.69%,
[5.73;
15.65],
certainty).
All
decreased
below
range,
−3.69%,
[−5.2;
−2.19],
high
−2.9%,
[−3.77;
−2.04],
certainty)
−2.79%,
[−3.94;
−1.64],
exhibiting
largest
reductions
to
SIT.
The
risk
severe
hypoglycaemia
diabetic
ketoacidosis
was
similar
therapy.
Conclusions
show
hierarchy
among
thus
providing
support
decision‐making.
Trial
Registration:
PROSPERO
CRD42023453717
Frontiers in Endocrinology,
Год журнала:
2024,
Номер
15
Опубликована: Март 14, 2024
Insulin
is
an
essential
drug
in
the
treatment
of
diabetes,
often
necessary
for
managing
hyperglycemia
type
2
diabetes
mellitus
(T2DM).
It
should
be
considered
cases
severe
requiring
hospitalization,
after
failure
other
treatments,
advanced
chronic
kidney
disease,
liver
cirrhosis,
post-transplant
or
during
pregnancy.
Moreover,
specific
patient
subgroups,
early
initiation
insulin
crucial
control
and
prevention
complications.
Clinical
guidelines
recommend
initiating
when
treatments
fail,
although
there
are
barriers
that
may
delay
its
initiation.
The
timing
depends
on
individual
characteristics.
Typically,
insulinization
starts
by
adding
basal
to
patient’s
existing
and,
if
necessary,
progresses
gradually
introducing
prandial
insulin.
Several
have
been
identified
hinder
insulin,
including
fear
hypoglycemia,
lack
adherence,
need
glucose
monitoring,
injection
method
administration,
social
rejection
associated
with
stigma
injections,
weight
gain,
a
sense
therapeutic
at
initiation,
experience
among
some
healthcare
professionals,
delayed
reactive
positioning
recent
clinical
guidelines.
These
contribute,
factors,
inertia
intensifying
patients’
non-adherence.
In
this
context,
development
once-weekly
formulations
could
improve
initial
acceptance,
satisfaction,
consequently,
quality
life
patients.
Currently,
two
insulins,
icodec
BIF,
which
different
stages
development,
help.
Their
longer
half-life
translates
lower
variability
reduced
risk
hypoglycemia.
This
review
addresses
T2DM,
under
circumstances,
current
treatment,
potential
role
as
solution
facilitate
timely
insulinization,
would
reduce
achieve
better
people
T2DM.
EClinicalMedicine,
Год журнала:
2024,
Номер
71, С. 102610 - 102610
Опубликована: Апрель 24, 2024
BackgroundA
recently
undertaken
multicenter
randomized
controlled
trial
(RCT)
"Treatment
Of
BOoking
Gestational
diabetes
Mellitus"
(TOBOGM:
2017–2022)
found
that
the
diagnosis
and
treatment
of
pregnant
women
with
early
gestational
mellitus
(GDM)
improved
pregnancy
outcomes.
Based
on
data
from
trial,
this
study
aimed
to
assess
cost-effectiveness
GDM
(from
<20
weeks')
among
risk
factors
for
hyperglycemia
in
compared
usual
care
(no
until
24–28
a
healthcare
perspective.MethodsParticipants'
resource
utilization
were
collected
their
self-reported
questionnaires
hospital
records,
valued
using
unit
costs
obtained
standard
Australian
national
sources.
Costs
reported
US
dollars
($)
purchasing
power
parity
(PPP)
estimates
facilitate
comparison
across
countries.
Intention-to-treat
(ITT)
principle
was
followed.
Missing
cost
replaced
multiple
imputations.
Bootstrapping
method
used
estimate
uncertainty
around
mean
difference
results.
Bootstrapped
cost–effect
pairs
plot
(CE)
plane
acceptability
curve
(CEAC).FindingsDiagnosis
more
effective
tended
be
less
costly,
i.e.,
dominant
(cost-saving)
[−5.6%
composite
adverse
outcome
(95%
CI:
−10.1%,
−1.2%),
−$1373
−$3,749,
$642)]
care.
Our
findings
confirmed
by
both
CE
(88%
bootstrapped
fall
south-west
quadrant),
CEAC
(the
probability
intervention
being
cost-effective
ranged
84%
at
willingness-to-pay
(WTP)
threshold
value
$10,000–99%
WTP
$100,000
per
prevented).
Sub-group
analyses
demonstrated
higher
glycemic
range
(fasting
blood
glucose
95–109
mg/dl
[5.3–6.0
mmol/L],
1-h
≥191
[10.6
mmol/L]
and/or
2-h
162–199
[9.0–11.0
mmol/L])
costly
(dominant)
[−7.8%
−14.6%,
−0.9%),
−$2795
−$6,638,
−$533)];
[−8.9%
−15.1%,
−2.6%),
−$5548
−$16,740,
$1547)]
diagnosed
before
14
weeks'
gestation
as
well.InterpretationOur
highlight
potential
health
economic
benefits
supports
its
implementation.
Long-term
follow-up
studies
are
recommended
key
future
area
research
long-term
consequences
intervention.FundingNational
Health
Medical
Research
Council
(grants
1104231
2009326),
Region
O¨rebro
Committee
Dnr
OLL-970566
OLL-942177),
Scientific
Fund
Mayor
Vienna
(project
15,205
project
23,026),
South
Western
Sydney
Local
District
Academic
Unit
(grant
2016),
University
Ainsworth
Trust
Grant
(2019).
Nutrients,
Год журнала:
2024,
Номер
16(3), С. 399 - 399
Опубликована: Янв. 30, 2024
Gestational
diabetes
mellitus
(GDM)
is
a
common
metabolic
disorder
that
often
develops
during
pregnancy,
characterized
by
glucose
intolerance
and
insulin
resistance
(IR).
To
ensure
the
well-being
of
both
mother
fetus,
body
undergoes
multiple
immunological
changes
result
in
peripheral
IR
and,
under
certain
hereditary
or
acquired
abnormalities,
GDM
predisposed
women.
The
adverse
short-
long-term
effects
impact
fetus.
Nutrition
seems
to
play
an
important
role
prevent
improve
its
evolution.
An
emphasis
has
been
given
proportion
carbohydrates
(CHO)
relative
protein
lipids,
as
well
dietary
patterns,
GDM.
CHO
on
postprandial
concentrations
are
reflected
glycemic
index
(GI)
load
(GL).
Diets
rich
GI
GL
may
induce
exacerbate
IR,
whereas
diets
low
appear
enhance
sensitivity
control.
These
positive
outcomes
be
attributed
direct
interactions
with
homeostasis
indirect
through
improved
composition
weight
management.
This
comprehensive
narrative
review
aims
explore
significance
nutrition,
focus
critical
evaluation
management
women
EBioMedicine,
Год журнала:
2024,
Номер
101, С. 105008 - 105008
Опубликована: Фев. 17, 2024
Gestational
diabetes
mellitus
(GDM)
is
one
of
the
most
common
metabolic
complications
during
pregnancy,
threatening
both
maternal
and
fetal
health.
Prediction
diagnosis
GDM
not
unified.
Finding
effective
biomarkers
for
particularly
important
achieving
early
prediction,
accurate
timely
intervention.
Urine,
due
to
its
accessibility
in
large
quantities,
noninvasive
collection
easy
preparation,
has
become
a
good
sample
biomarker
identification.
In
recent
years,
number
studies
using
metabolomics
proteomics
approaches
have
identified
differential
expressed
urine
metabolites
proteins
patients.
this
review,
we
summarized
these
potential
prediction
elucidated
their
role
development
GDM.
Obesity
and
pre-diabetes
are
metabolic
disorders
associated
with
insulin
resistance
(IR).
Excess
epicardial
adipose
tissue
is
also
increased
IR.
The
triglyceride-glucose
index
(TyG)
has
been
evaluated
as
an
alternative
measure
of
the
IR
in
a
variety
cardiovascular
disorders.
However,
its
relationship
EAT
thickness
not
studied
yet.
study
included
176
prediabetic
obese
patients.
was
assessed
using
echocardiography.
thickness,
TyG
index,
anthropometric
obesity
indices
(body
mass
(BMI),
waist
circumference
(WC),
waist-hip
ratio
(WHR)),
homeostatic
model
assessment
(HOMA-IR),
biochemical
parameters
were
compared.
following
correlations
between
related
observed:
WC
(
r
=
.529),
BMI
.514),
ALT
.358),
.338),
HOMA-IR
.322;
P
<
.001
for
all).
Multiple
regression
analysis
showed
that
(Beta
.428;
.004),
age
.223;
.001),
.196;
.029),
.168;
.012),
.128;
.049)
strongest
independent
variables
correlated
thickness.
A
based
on
WC,
BMI,
age,
provided
best
R-square
(.387)
estimating
.001).
significant
EAT,
suggesting
it
may
be
useful
indicator