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Background: The V-Go is a once-daily disposable device that allows coverage of basal and prandial insulin requirements over a period of 24 hours. The aim of this proof-of-concept study was to evaluate the clinical functionality, safety, and pharmacodynamics of the V-Go delivering insulin aspart and redistributing a single basal dose of insulin glargine as a constant basal infusion supplemented with prandial insulin in subjects with type 2 diabetes mellitus., Methods: In six subjects receiving once-daily subcutaneous (SC) injections of insulin glargine (> or =15 U/day) with or without concomitant oral antidiabetic drugs, glargine was discontinued following a 3-day baseline phase. The V-Go was then applied to the lower abdomen of the subjects once daily for 7 days (days 1-3 inpatient, days 4-7 outpatient). Each V-Go provided a continuous 24-hour preset basal infusion rate of insulin aspart (0.6 U/h) and up to three daily prandial doses at mealtimes. Capillary blood glucose concentrations were measured at 11 time points per day during the baseline and inpatient phases and at 4 time points per day during the outpatient phase. Additionally, glucose profiles were measured continuously on all days., Results: The V-Go was well tolerated and operated as anticipated. The mean +/- SEM prestudy daily dose of SC insulin glargine was 33.3 +/- 13.8 U; the mean daily total insulin aspart dose infused with the V-Go was 31.5 +/- 7.5 and 32.3 +/- 7.8 U for the inpatient and outpatient periods, respectively. Fasting blood glucose values were similar to those observed at baseline throughout the study, with nonsignificant (NS) reductions in readings collected during the outpatient phase before lunch (-35 +/- 27 mg/dl) and before dinner (-38 +/- 25 mg/dl). The 2-hour postprandial glucose trended lower from 231 to 195 mg/dl (NS) at breakfast, 234 to 166 mg/dl (NS) at lunch, and 222 to 171 mg/dl (NS) at dinner. Bedtime blood glucose decreased (mean change from baseline -52 +/- 21 mg/dl; P = 0.0313), as did nighttime (3:00 AM) measurements (-20 +/- 9 mg/dl; P = 0.0313). Overall glycemic control tended to improve, as shown by continuous glucose monitoring changing from 173 to 157 mg/dl (P = 0.063, NS) and 156 mg/dl (P = 0.219) during inpatient and outpatient periods, respectively. Glycemic variability assessed by the M value similarly tended to decrease from 33 +/- 9 to 25 +/- 4 (NS) and 21 +/- 4 (NS) for inpatient and outpatient periods, respectively., Conclusions: These first data suggest that use of the V-Go is an attractive alternative to SC insulin injection therapy because metabolic control appears to be maintained or even improved without increasing daily insulin doses.

In this study, different tap water handling strategies were investigated to evaluate the effects on two principal chlorinated DBPs, trihalomethanes (THMs) and haloacetic acids (HAAs). Tap water samples collected in the Quebec City (Canada) distribution system on a spatio-temporal basis were subjected to diverse indoor handling scenarios: storing water in the refrigerator, boiling water followed by storage and, finally, filtering water with a point-of-use commercial pitcher also followed by storage. In the first two cases, the use of covered and uncovered pitchers was investigated separately, while in the last case, both the use of new and used filters was compared. In all cases, maximum storage time was 48h. Results demonstrated that in some cases, water handling scenarios have considerable effect, and in other cases, little or no effect. Removal of THM concentrations by simple storage was high (on average 30%) and very high by boiling and filtering with subsequent storage in the refrigerator (on average, 87% and 92%, respectively). In scenarios where water was stored in uncovered pitchers (with or without previous boiling and filtering), the THM decrease was higher for increased storage times. However, storage did not have any effect on HAAs, whereas boiling decreased levels of trichloroacetic acid (TCAA) (on average 42%) and increased levels of dichloroacetic acid (DCAA) (on average 35%), resulting in unchanged average levels of total HAAs. The use of the filtration pitcher decreased HAA levels dramatically (on average 66%). Percentages of change in chlorinated DBPs in the different scenarios varied according to initial concentrations in tap water (baseline water), that is, according to the spatio-temporal variations of these substances in the distribution system. On the basis of these results, the paper discusses implications regarding public health protection and exposure assessment for epidemiological studies.