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Background: Carotenoids have various physiological functions, such as immune regulation and cancer prevention. Germination could further improve the content of carotenoids in maize seeds. In this study, yellow maize seeds (Suyu 29) were soaked and germinated with different concentrations of 24‐epibrassinolide. The changes of germination percentage, sprout length, bioactive components, antioxidant capacity and carotenoid content of the maize seeds were analyzed. Additionally, the relative expression of key genes in the carotenoid synthesis pathway was investigated. Results: The results showed that the sprout length, germination percentage, soluble protein, free amino acids, proline, endogenous abscisic acid, vitamin C, total phenolics and carotenoids displayed a significant increasing trend compared with the control group (P < 0.05). The activity of superoxide dismutase and peroxidase increased by 55.1% and 58.5% versus the control group, and the antioxidant capacity of 2,2‐diphenyl‐1‐picrylhydrazyl, 2,2‐azinobis(3‐ethylbenzothiazoline‐6‐sulfonic acid) and ferric reducing antioxidant power was 19.8%, 13.4% and 44.1% higher than that of the control group (P < 0.05). Compared with the control group, the expression of genes was significantly up‐regulated (P < 0.05). Under the treatment of 0.1 mg L−1 of 24‐epibrassinolide, carotenoid content reached the highest value. The carotenoids showed a positive correspondence with antioxidant enzyme activity, antioxidant capacity and total phenolics content (P < 0.05). Conclusion: This study showed that 0.1 mg L−1 of exogenous 24‐epibrassinolide promoted the accumulation of carotenoids and improved the antioxidant capacity and the quality of germinated maize seeds. It could provide a method for the development of germinated maize products enriched in carotenoids. © 2024 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Aim: This study assessed the efficacy and safety of co‐administering retagliptin and henagliflozin versus individual agents at corresponding doses in patients with type 2 diabetes mellitus who were inadequately controlled with metformin. Methods: This multicentre, phase 3 trial consisted of a 24‐week, randomized, double‐blind, active‐controlled period. Patients with glycated haemoglobin (HbA1c) levels between 7.5% and 10.5% were randomized to receive once‐daily retagliptin 100 mg (R100; n = 155), henagliflozin 5 mg (H5; n = 156), henagliflozin 10 mg (H10; n = 156), co‐administered R100/H5 (n = 155), or R100/H10 (n = 156). The primary endpoint was the change in HbA1c from baseline to week 24. Results: Based on the primary estimand, the least squares mean reductions in HbA1c at week 24 were significantly greater in the R100/H5 (−1.51%) and R100/H10 (−1.54%) groups compared with those receiving the corresponding doses of individual agents (−0.98% for R100, −0.86% for H5 and −0.95% for H10, respectively; p <.0001 for all pairwise comparisons). Achievement of HbA1c <7.0% at week 24 was observed in 27.1% of patients in the R100 group, 21.2% in the H5 group, 24.4% in the H10 group, 57.4% in the R100/H5 group and 56.4% in the R100/H10 group. Reductions in fasting plasma glucose and 2‐h postprandial glucose were also more pronounced in the co‐administration groups compared with the individual agents at corresponding doses. Decreases in body weight and systolic blood pressure were greater in the groups containing henagliflozin than in the R100 group. The incidence rates of adverse events were similar across all treatment groups, with no reported episodes of severe hypoglycaemia. Conclusions: For patients with type 2 diabetes mellitus inadequately controlled by metformin monotherapy, the co‐administration of retagliptin and henagliflozin yielded more effective glycaemic control through 24 weeks compared with the individual agents at their corresponding doses. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effect of age and disease duration on the efficacy and safety of iGlarLixi versus insulin glargine 100 units/ml (iGlar) or lixisenatide (Lixi) alone in Asian people with type 2 diabetes (T2D) uncontrolled on oral antidiabetic drugs (LixiLan‐O‐AP) or basal insulin ± oral antidiabetic drugs (LixiLan‐L‐CN). Materials and Methods: In this post hoc analysis, the glycated haemoglobin (HbA1c) changes were assessed from baseline to week 24 (LixiLan‐O‐AP) or 30 (LixiLan‐L‐CN) in subgroups defined by baseline age (<65, ≥65 years) and duration of T2D. The proportion who achieved the composite of HbA1c <7% (<53.0 mmol/mol) without weight gain and without symptomatic hypoglycaemia (plasma glucose ≤3.9 mmol/L) and the incidences of hypoglycaemia and gastrointestinal disorders were also analysed. Results: HbA1c reductions were consistently greater with iGlarLixi versus iGlar or Lixi across all subgroups, including participants aged ≥65 years and those with T2D for ≥15 or ≥20 years. Greater proportions of participants achieved HbA1c <7% (<53.0 mmol/mol) without weight gain or hypoglycaemia with iGlarLixi versus iGlar or Lixi, regardless of age or T2D duration. Hypoglycaemia incidence was similar with iGlarLixi versus iGlar across most subgroups; the incidence of gastrointestinal disorders was lower with iGlarLixi versus Lixi in all subgroups. Conclusions: iGlarLixi showed consistent efficacy and safety across all age and disease duration subgroups in Asian people with uncontrolled T2D, including older individuals and those with longstanding disease. [ABSTRACT FROM AUTHOR]

Aim: To investigate the effect of improving early phase insulin secretion function for glycaemic control in patients with type 2 diabetes mellitus treated with a new class of antidiabetic drug dorzagliatin. Materials and Methods: Early insulin secretion function was studied in 726 participants of which 414 were treated with dorzagliatin in the SEED and DAWN study. The early insulinogenic index (IGI30min) and disposition index (DI) were used to assess early‐phase insulin secretion function in this study. Logistic regression analysis was performed to verify the importance of IGI30min and DI indices for achieving effective glycaemic control. Results: The reduction in HbA1c has a significant correlation with the improvement of IGI30min for patients that received 24 weeks of dorzagliatin treatment (p <.001), and this correlation was not observed in the placebo group (p =.364). In the dorzagliatin treatment group, the responders showed significant improvements in homeostasis model assessment 2‐β, IGI30min and DI compared with the non‐responders. Logistic regression analysis revealed that the odds ratio (OR) for achieving glycaemic control was 1.28 (95% CI 1.14‐1.43) for baseline IGI30min, and 1.24 (95% CI 1.14‐1.35) for the 24‐week incremental IGI30min from baseline. The OR for baseline DI and 24‐week changes in DI from baseline were 1.39 (95% CI 1.2‐1.6) and 1.30 (95% CI 1.19‐1.43) respectively. The timing of insulin secretion analysis showed the significant contribution of early‐phase insulin secretion, rather than late‐phase insulin secretion, to postprandial glucose control with the OR for the incremental IGI30min and IGI2h to postprandial glucose control were 1.3 (95% CI 1.19‐1.42) and 1 (95% CI 1‐1.01) respectively. Conclusions: Restoring the impaired early‐phase insulin secretion function in patients with type 2 diabetes mellitus is a critical factor for improving the glycaemic control by dorzagliatin treatment. [ABSTRACT FROM AUTHOR]

Background: This study investigated the effects of early‐onset type 2 diabetes (EOD) vs late‐onset type 2 diabetes (LOD) on nonfatal cardiovascular diseases (CVD) in China. Methods: We conducted a cross‐sectional survey of 46 239 participants from 14 provinces in China from 2007 to 2008, selecting 4949 participants with type 2 diabetes for analysis. Participants were categorized as EOD (<40 years) or LOD (≥40 years) based on age at diabetes diagnosis. Sociodemographic and nonfatal CVD information was collected through an interviewer‐assisted questionnaire and clinical examination. Logistic regression analysis was used to investigate the nonfatal CVD risk. Results: Out of 4949 participants with type 2 diabetes, 390 (7.88%) had nonfatal CVD. Participants with EOD had a higher age‐standardized prevalence of nonfatal CVD than those with LOD (11.4% vs 4.4%). Compared to LOD patients, EOD patients tended to be males and had a higher family history of diabetes, unhealthy lifestyle behaviors, and lower blood pressure levels. After adjustment for age and sex, EOD patients had a higher risk of nonfatal CVD than LOD patients (odds ratio [OR] 2.3, 95% CI 1.5–3.5). After further adjustment for diabetes duration, use of drugs, and other risk factors, the OR of nonfatal CVD was reduced but significant (OR 1.8, 95% CI 1.1–2.9). Sensitivity analysis revealed that EOD patients with metabolic syndrome had an increased nonfatal CVD risk compared to LOD patients (OR 2.0, 95% CI 1.2–3.5). Conclusions: EOD patients are at increased risk of nonfatal CVD. Individualized intervention and management measures for EOD patients are necessary. [ABSTRACT FROM AUTHOR]

Introduction: To examine changes in the prevalence of diabetes and the control of risk factors for diabetes over 10 years among adults in China. Methods: Two population‐based cross‐sectional surveys were used to obtain a nationally representative sample of adults aged 20 years and older in mainland China in 2007 (n = 46 239) and 2017 (n = 73 340). Changes in the prevalence of diabetes, impaired fasting glucose, impaired glucose tolerance, and prediabetes, as diagnosed by the World Health Organization criteria, were assessed over time. Results: The weighted prevalence of diagnosed diabetes (3.8% vs 6.3%, p =.0001) and total diabetes (9.7% vs 11.7%, p =.005) increased among the overall population between 2007 and 2017. The weighted prevalence of undiagnosed diabetes (5.9% vs 5.4%, p =.7), impaired fasting glucose (2.7% vs 2.6%, p =.68), impaired glucose tolerance (12.7% vs 12.5%, p =.95), prediabetes (15.4% vs 15.1%, p =.79), the treatment of diabetes (34.1% vs 32.5%, p =.44), and the control of diabetes (31.1% vs 32.8%, p =.73) did not significantly change over this period. The awareness of diabetes (39.4% vs 53.6%, p =.0004) increased over 10 years among the overall population. The proportion of achieved high‐density lipoprotein cholesterol targets increased (p =.005), but the proportion of achieved body mass index (p =.01) and waist circumference (p =.0002) targets decreased significantly. Conclusions: Between 2007 and 2017, the prevalence of total diabetes (diagnosed by the World Health Organization criteria), especially diagnosed diabetes, increased among adults in China. Although awareness of diabetes improved, effective interventions and clinical strategies are urgently required. [ABSTRACT FROM AUTHOR]

Minimax optimization (MMO), which aims at pursuing the solutions with the best performances in the worst case, is widely used in the robust design. However, there are still fundamental limitations for MMO to converge to the optimum when solving asymmetric problems. Moreover, when MMO is employed in robust design where the objective function is evaluated through costly simulations, the efficiency of the optimization becomes crucial. To address these issues, in this paper, A novel efficient global optimization algorithm based on co‐evolutionary strategy is proposed to solve the asymmetry MMO problem with satisfactory efficiency. Furthermore, the new algorithm is tested on eight analytical benchmark problems and compared with the state‐of‐the‐art methods. Lastly, the methodology has been successfully applied to the robust design of a practical engineering product. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the efficacy of iGlarLixi in the Asian Pacific (AP) population with type 2 diabetes (T2D) using derived time‐in‐ranges calculated from seven‐point self‐measured blood glucose. Methods: Two phase III trials were analysed. LixiLan‐O‐AP was performed in insulin‐naive T2D patients (n = 878) randomized to iGlarLixi, glargine 100 units/mL (iGlar) or lixisenatide (Lixi). LixiLan‐L‐CN was performed in insulin‐treated T2D patients (n = 426) randomized to iGlarLixi or iGlar. Changes in derived time‐in‐ranges from baseline to end‐of‐treatment (EOT) and estimated treatment differences (ETDs) were analysed. The proportions of patients achieving 70% or higher derived time‐in‐range (dTIR), 5% or higher dTIR improvement, and the composite triple target (≥ 70% dTIR, < 4% derived time‐below‐the‐range [dTBR] and < 25% derived time‐above‐the‐range [dTAR]) were calculated. Results: The changes from baseline to EOT in dTIR with iGlarLixi were greater versus iGlar (ETD1: 11.45% [95% CI, 7.66% to 15.24%]) or Lixi (ETD2: 20.54% [95% CI, 15.74% to 25.33%]) in LixiLan‐O‐AP, and versus iGlar (ETD: 16.59% [95% CI, 12.09% to 21.08%]) in LixiLan‐L‐CN. In LixiLan‐O‐AP, the proportions of patients achieving 70% or higher dTIR or 5% or higher dTIR improvement at EOT with iGlarLixi were 77.5% and 77.8%, respectively, higher than with iGlar (61.1% and 75.3%) or Lixi (47.0% and 53.0%). In LixiLan‐L‐CN, the proportions of patients achieving 70% or higher dTIR or 5% or higher dTIR improvement at EOT were 71.4% and 59.8% with iGlarLixi, greater than with iGlar (45.4% and 39.5%). More patients achieved the triple target with iGlarLixi compared with iGlar or Lixi. Conclusion: iGlarLixi achieved greater improvements in dTIR parameters versus iGlar or Lixi in insulin‐naïve and insulin‐experienced AP people with T2D. [ABSTRACT FROM AUTHOR]

Metformin is the first‐line drug for type 2 diabetes (T2D) while acarbose is suggested as a viable alternative in Chinese patients with newly diagnosed T2D. However, few biomarkers have been established to guide the choice between these two agents. Mitochondrial DNA (mtDNA) copy number (mtDNA‐CN) is a biomarker of mitochondrial function, which is associated with various metabolic outcomes. Using data from the trial of Metformin and Acarbose in Chinese as the Initial Hypoglycaemic Treatment (MARCH) (metformin n = 214; acarbose n = 198), we examined whether mtDNA‐CN was associated with response to the drugs in terms of glycemic response and β‐cell function protection response. The glycemic response is defined as the maximum glucose reduction of glycated hemoglobin A1c, fasting plasma glucose, or postprandial blood glucose during 48 weeks. β‐cell function protection response is defined as the maximum increment of insulinogenic index (IGI) or disposition index (DI). For all three glycemic responses, mtDNA‐CN was not significantly associated with either metformin or acarbose. Importantly, for β‐cell function protection response, we found the increased mtDNA‐CN was significantly associated with more IGI increment (beta: 0.84; 95% confidence interval (CI), 0.02 to 1.66) in the metformin group, but less IGI increment (beta: −1.38; 95% CI, −2.52 to −0.23) in the acarbose group. A significant interaction (P = 0.008) between mtDNA‐CN and the treatment group was observed. Consistent results were also obtained when DI increment was used as a measure of β‐cell function response. This study demonstrated the potential application of mtDNA‐CN in guiding the treatment choice between metformin and acarbose based on β‐cell protection. [ABSTRACT FROM AUTHOR]

Aim: To assess the efficacy and safety of a dipeptidyl peptidase‐4 (DPP‐4) inhibitor combined respectively with three oral antihyperglycaemic agents in Chinese patients with newly diagnosed type 2 diabetes mellitus (T2DM) with high levels of glycated haemoglobin (HbA1c). Materials and methods: Between 30 December 2014 and 1 November 2017, a 24‐week, multicentre, parallel‐controlled study was performed on drug‐naive T2DM patients. In total, 648 patients with 8.0% ≤ HbA1c ≤ 11.0%, aged 18‐80 years and body mass index (BMI) 19‐40 kg/m2 were randomly assigned 1:1:1 to receive saxagliptin (Saxa) combined with metformin (Met), acarbose (Aca) or gliclazide (Gli) modified release (MR) tablets (Saxa + Met, Saxa + Aca and Saxa + Gli). The primary outcome was the absolute change in HbA1c from baseline; secondary outcome was the percentage of patients achieving HbA1c <7.0% and ≤6.5%. Results: Each treatment arm contained 216 patients; overall, 583 completed the 24‐week trial. At 24 weeks, the mean (95% confidence interval) change in HbA1c from baseline in Saxa + Met, Saxa + Aca and Saxa + Gli were, respectively: –2.9% [–3.1, –2.8]; –2.6% [–2.8, –2.5]; and –2.8% [–2.9, –2.6] (overall p =.04, Saxa + Aca vs. Saxa + Met, p =.010, Saxa + Gli vs. Saxa + Met, p = 0.18). At 24 weeks, 84.9%, 74.7% and 80.3% of participants were at HbA1c <7.0% (overall p =.05); and 72.6%, 59.8% and 63.3% were HbA1c ≤6.5% (overall p = 0.10). The rates of minor or symptomatic hypoglycaemia were very low. Conclusions: Initial treatment with a DPP‐4 inhibitor combined with Metform, alpha‐glycosidase inhibitor or sulphonylurea was safe and effective for patients with newly diagnosed T2DM and high HbA1c. DPP‐4 inhibitor combined with Met showed the best efficacy for this population. [ABSTRACT FROM AUTHOR]

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Cobalt‐rich materials have generally been recognized as the prevailing candidates of cathodes for low‐temperature solid oxide fuel cells (LT‐SOFCs, 400–600 °C). Regrettably, their instability and high cost are the major concerns for future commercialization. In response to these drawbacks, here, an A‐site‐deficient low‐cobalt‐containing perovskite‐type oxide, Ba0.95Fe0.7Co0.2Sc0.1O3‐δ (BFCS0.95), as an efficient bifunctional electrode with triple‐conducting (H+|O2−|e−) nature for oxygen‐ion conducting SOFCs (O‐SOFCs) and proton conducting SOFCs (H‐SOFCs) is proposed. BFCS0.95 electrode exhibits impressive versatility in catalyzing oxygen reduction reaction, i.e., ultralow area‐specific resistances (0.072 Ω cm2 for O‐SOFCs and 0.4 Ω cm2 for H‐SOFCs at 550 °C, respectively), extraordinarily high power outputs (1092 mW cm−2 for O‐SOFCs and 419 mW cm−2 for H‐SOFCs at 550 °C, respectively), excellent long‐term durability (>100 h for O‐SOFCs and H‐SOFCs at 600 °C), remarkable reversibility between pure air and CO2‐containing air, and superior resistance against temperature fluctuations. The combined experimental and computational studies elucidate the roles of A‐site deficient state and triple‐conducting behavior, both of which are essential to overall electrochemical performance. Low‐cobalt‐containing feature also makes BFCS0.95 cathode economically competitive among all cobalt‐containing analogues. Overall, the finding paves a highly efficient route to develop bifunctional electrodes for LT‐SOFCs toward a sustainable energy future. [ABSTRACT FROM AUTHOR]

Aims: To compare the efficacy and safety of iGlarLixi with insulin glargine 100 units/mL (iGlar) and lixisenatide (Lixi), in Asian Pacific people with suboptimally controlled type 2 diabetes (T2D) on metformin with or without a second oral antihyperglycaemic drug (OAD). Materials and Methods: LixiLan‐O‐AP (NCT03798054) was a 24‐week multicentre study in adults (n = 878, mean age 56.0 years, mean body mass index 26.0 kg/m2) with glycated haemoglobin (HbA1c) levels ≥53 mmol/mol (7%) and ≤97 mmol/mol (11%) on OAD(s), randomized (2:2:1) to open‐label once‐daily iGlarLixi, iGlar or Lixi while on continued metformin ± sodium‐glucose cotransporter‐2 inhibitors. The primary efficacy endpoint was change in HbA1c. Results: After 24 weeks, greater reductions in HbA1c from baseline (67 mmol/mol; 8.3%) were seen with iGlarLixi (−21 mmol/mol; −1.9%) compared with iGlar (−16 mmol/mol; −1.4%; P < 0.0001) and Lixi (−10 mmol/mol; −0.9%; P < 0.0001). Greater proportions of participants achieved HbA1c <53 mmol/mol (<7%) with iGlarLixi versus iGlar or Lixi (79%, 60% and 30%, respectively), overall and as composite endpoints including weight and hypoglycaemia. iGlarLixi improved 2‐hour postprandial glucose versus iGlar and Lixi and mitigated the weight gain seen with iGlar (least squares mean difference −1.1 kg; P < 0.0001). Documented ≤3.9 mmol/L (≤70 mg/dL) hypoglycaemia was similar between iGlarLixi and iGlar (both 3.38 events per participant‐year). The incidence rates of nausea and vomiting were lower with iGlarLixi (14% and 6%) than Lixi (21% and 11%). Conclusions: iGlarLixi achieved significant HbA1c reductions, to near‐normoglycaemic levels, compared with iGlar or Lixi, with no meaningful additional risk of hypoglycaemia and mitigated body weight gain versus iGlar, with fewer gastrointestinal adverse events versus Lixi. iGlarLixi with specifically adapted ratios may provide an efficacious and well‐tolerated treatment option for Asian Pacific people with T2D. [ABSTRACT FROM AUTHOR]

Summary: The rational design of effective and specific catalysts for oxygen evolution reaction (OER) is of vital importance for the implementation of electrochemical water oxidation as a sustainable route to produce hydrogen. Perovskite oxides have attracted considerable interests in view of the highly tunable structural, electronic, and catalytic properties associated with their compositions. Herein, an efficient Sn‐incorporated nominal perovskite nanocomposite, SrCo0.7Sn0.3O3−δ (SCS), derived from a facile one‐pot self‐assembly process, is designed as an outstanding electrocatalyst to catalyze OER in alkaline conditions. Benefiting from the unique structure, increased active oxygen intermediates, and favorable electrical conductivity, the optimized SCS exhibits superior OER electrocatalytic performance, including low overpotential of only 309 mV at 10 mA cm−2, fast kinetics with a small Tafel slope of 56 mV dec−1, and 72‐fold improvement in mass activity and 108‐fold enhancement in specific activity relative to the pristine SrCoO3−δ catalyst. The SCS catalyst also demonstrates excellent OER durability with negligible potential fluctuation for 30 hours continuous operation. This work highlights a promising strategy to develop high‐performance perovskite nanocomposites to perform efficient OER electrocatalysis. [ABSTRACT FROM AUTHOR]

Objective. To explore the effect of eye movement training on sleep quality of patients with advanced lung cancer based on the Pittsburgh Sleep Quality Index (PSQI). Methods. 120 advanced lung cancer patients admitted to our hospital from January 2019 to January 2020 were selected as the research object and divided into group A (PSQI scores ≥ 10 points, n = 60) and group B (PSQI < 10 points, n = 60). Routine nursing was performed to both groups, and patients in group A received the eye movement training additionally, so as to compare their PSQI scores, negative emotion scores, adverse reaction rate (ARR), Cancer Coping Modes Questionnaire (CCMQ) scores, and pain scores. Results. After training, group A obtained significantly better sleep quality (P < 0.05), lower negative emotion scores (P < 0.001), lower ARR (P < 0.05), better CCMQ scores (P < 0.05), and lower pain scores (P < 0.001) than group B. Conclusion. Eye movement training should be promoted in practice because it can reduce negative emotions, alleviate pain sensation, improve sleep quality and body condition, and lower the ARR for advanced lung cancer patients. [ABSTRACT FROM AUTHOR]

Aims/Introduction: To investigate the differential effects of maternal versus paternal history of diabetes on the risks for diabetes and prediabetes, as well as on insulin secretion and resistance in Chinese individuals. Materials and Methods: From the 2007 to 2008 China National Diabetes and Metabolism Disorders Study, 39,244 participants were included and divided into four categories: negative parental history, paternal history only (PH), maternal history only (MH), and both paternal and maternal history. Results: The age‐ and sex‐standardized prevalence rates of diabetes in the negative parental history, PH, MH, and both paternal and maternal history groups were 8.59, 12.56, 15.86 and 29.81%, respectively. The prevalence rates of impaired glucose metabolism were 24.13, 25.41, 31.13 and 50.80%, with the prevalence in the MH group being significantly higher than that in the PH group. Compared with that in the FH0 group, the risks of diabetes in the PH, MH, and both paternal and maternal history groups were 2.01‐, 2.67‐ and 6.37‐fold greater, and the risks of impaired glucose metabolism were 1.28‐, 1.65‐ and 3.45‐fold greater. In addition, MH had a significantly greater impact on impaired glucose metabolism than PH (PMHvsPH = 0.0292). Regression analyses suggested MH was associated with homeostatic model assessment for β‐cell function (β[SE] = −0.0910[0.0334], P = 0.0065), insulinogenic index (−0.1866[0.0550], P = 0.0007), homeostatic model assessment for insulin resistance (0.0662[0.0227], P = 0.0036) and Matsuda Index [−0.0716(0.0203), P = 0.0004]. PH was specifically associated with homeostatic model assessment for insulin resistance (0.1343[0.0267], P < 0.0001) and Matsuda Index (−0.1566[0.0243], P < 0.0001), but the effects were stronger than those of MH (PMHvsPH = 0.0431, 0.0054). Conclusions: MH and PH differentially influence the risks for diabetes, insulin secretion, and insulin resistance in the Chinese population, suggesting they participate in the pathogenesis of diabetes through different mechanisms. [ABSTRACT FROM AUTHOR]

This 24‐week, double‐blind, placebo‐controlled, phase III trial evaluated the efficacy and safety of linagliptin in 206 Chinese patients with inadequately controlled (glycated haemoglobin [HbA1c] 7.5%–10.0%) type 2 diabetes mellitus (T2DM) receiving insulin (basal or premixed) ± metformin. Patients were randomized (1:1) to receive linagliptin 5 mg/d or placebo. The decrease from baseline in HbA1c (primary endpoint) was greater with linagliptin than with placebo (−0.61% vs. −0.20%, adjusted mean difference −0.40%; P = 0.0016). Linagliptin demonstrated significantly greater improvement in 2‐hour postprandial glucose (−1.77 mmol/L [−31.95 mg/dL]; P < 0.001), and a numerical reduction in fasting plasma glucose (−0.34 mmol/L [−6.2 mg/dL]; P = 0.2241) versus placebo. Proportionally more patients on linagliptin achieved a HbA1c reduction of ≥0.5% versus those on placebo (odds ratio 2.293, P < 0.01). Adverse events in both groups were similar, with no new safety findings or clinically relevant changes in body weight. Among investigator‐defined hypoglycaemic events (linagliptin: 17.3%; placebo: 12.7%; odds ratio 1.48, P = 0.337), none were severe. In Chinese patients with T2DM, linagliptin add‐on to insulin improved glycaemic control and was well tolerated, without increased risk of hypoglycaemia or weight gain. [ABSTRACT FROM AUTHOR]

Aims. The current study aims to explore if a family history of diabetes can influence the efficiency of lifestyle intervention on insulin secretion and study the insulin resistance in Chinese men and women with metabolic syndrome in a cohort with a 2-year follow-up. Methods. 151 individuals (90 individuals did not have a family history of diabetes (DMFH (-)) and 61 with a family history of diabetes (DMFH (+)) with metabolic syndrome participated in the lifestyle intervention program at baseline and finished with 1-year follow-up. 124 individuals have two-year follow-up data. A family history of diabetes was ascertained by self-report. Lifestyle interventions were individual sessions on lifestyle changes. Results. During the 1-year follow-up, Ln Insulinogenic index ( Δ baseline − 1 year = 0.29 ± 0.65 , P = 0.001) and 30-min glucose ( Δ baseline − 1 year = − 0.41 ± 1.71 , P = 0.024) changed significantly in the DMFH(-) group; in the DMFH(+) group, Ln ISIm ( Δ baseline − 1 year = − 0.22 ± 0.60 , P = 0.022) and 30-min glucose ( Δ baseline − 1 year = 0.53 ± 1.89 , P = 0.032) changed significantly, and there was no significant change of other parameters. The change of 30 min glucose during a 1-year intervention has shown a significant difference between the two groups (P = 0.002). During the 2 years intervention, Ln Insulinogenic index changed significantly in the DMFH(-) group ( Δ baseline − 1 year = 0.33 ± 0.66 , P < 0.001 and Δ baseline − 2 year = 0.43 ± 1.17 , P = 0.034). Fasting insulin ( Δ baseline − 2 year = 2.95 ± 8.69 , P = 0.034), 2 h insulin ( Δ baseline − 2 year = 23.75 ± 44.89 , P = 0.002), Ln HOMA-B ( Δ baseline − 2 year = 0.43 ± 1.02 , P = 0.009), Ln HOMA-IR ( Δ baseline − 2 year = 0.53 ± 1.04 , P = 0.002), Ln ISIm ( Δ baseline − 2 year = 0.52 ± 0.95 , P = 0.004), and Ln Insulinogenic index ( Δ baseline − 2 year = 0.66 ± 1.18 , P = 0.047) changed significantly after 2 years of intervention, compared to the baseline in the DMFH(+) group. The change of Ln ISIm (P = 0.023), fasting (P = 0.030), and 2 h insulin (P = 0.007) during the 2-year intervention has shown a significant difference between the two groups. Family history of diabetes was related with a 0.500 unit increase in 2-year ISIm (P = 0.020) modified by lifestyle intervention adjusted for age, baseline BMI, sex, and baseline waist circumference and a 0.476 unit increase in 2-year ISIm (P = 0.027) with extra adjustment for weight change. Conclusions. Patients with a family history of diabetes benefit more from lifestyle intervention in regard to insulin resistance than those without a family history of diabetes adjusting for age, baseline BMI, sex, baseline waist circumference, and weight change. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the efficacy and safety of polyethylene glycol loxenatide (PEX168) monotherapy in type 2 diabetes (T2D) patients in China. Materials and Methods: In a multicentred, randomized, double‐blinded, placebo‐controlled phase 3a clinical trial, 361 patients with inadequate glycaemic control (HbA1c 7.0%‐10.5%, fasting plasma glucose <13.9 mmol/L) were randomized (1:1:1) for weekly subcutaneous injections: placebo, PEX168/100 μg or PEX168/200 μg. The 24‐week treatment was followed by a 28‐week extension, during which placebo‐treated patients were randomly assigned to PEX168/100 μg or PEX168/200 μg. The primary efficacy endpoint was the HbA1c change from baseline to week 24. Results: The three groups had similar demographics and baseline characteristics. The HbA1c least‐square mean (95% CI) change from baseline to week 24 was greater for PEX168/100 μg (−1.02% [−1.21%, −0.83%]) and PEX168/200 μg (−1.34% [−1.54%, −1.15%]) than for placebo (−0.17% [−0.36%, 0.02%]); (superiority: P <.0001). The proportions of patients with less than 7% HbA1c in the placebo, PEX168/100 μg and PEX168/200 μg groups were 15.7%, 34.7% and 46.6%, respectively. Common gastrointestinal adverse events (AEs) were nausea (5.6%, 10.0% and 0% for PEX168/100 μg, PEX168/200 μg and placebo, respectively) and vomiting (2.4%, 8.3% and 0% for PEX168/100 μg, PEX168/200 μg and placebo, respectively). Six (1.6%) patients (PEX168/100 μg: N = 2 [1.6%], PEX168/200 μg: N = 3 [2.5%] and placebo: N = 1 [0.8%]) discontinued treatment because of AEs. Four (1.2%) patients (PEX168/100 μg: N = 3 [2.5%] and PEX168/200 μg: N = 1 [0.9%]) developed PEX168 antidrug antibodies. Conclusion: PEX168 monotherapy significantly improved glycaemic control in T2D patients with a safety profile resembling that of other glucagon‐like peptide‐1 receptor agonists. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Diabetes is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Soybean [Glycine max (L.) Merr.] is a photoperiod‐sensitive crop, and the photoperiod response determines the ecological adaptability of soybean genotypes. Critical photoperiod is the dividing daylength between photoperiod sensitivity and photoperiod insensitivity phases and is one of the most important indicators of photoperiod sensitivity. However, the appropriate experimental treatment and calculation method for quantifying the critical photoperiod are poorly documented. To characterize the photoperiod response of genotypes, 72 soybean genotypes belonging to 14 different maturity groups (MG 0000–MG X) were included, and five photoperiod treatments of 12‐, 14‐, 16‐, 18‐, and 20‐h daylength were conducted in the consecutive 3 yr from 2015 to 2017. The piecewise linear regression model based on the median function was used to determine the critical photoperiod. The results showed that the photoperiodic responses of soybean genotypes were significantly different among various MGs. The critical photoperiod of MG 0000 was 16.4 h d−1, whereas those of MG 000 to MG I, MG II to MG III, MG IV, MG V to MG VIII, and MG IX to MG X were 15.7 to 15.8, 15.3, 14.7, 13.4 to 13.7, and ≤12 h d−1, respectively. A significant negative linear relationship between the critical photoperiod and relative maturity group (RMG) was found. It is of particular importance for the quantification of soybean photoperiod response and precise prediction of the developmental process. More importantly, the critical photoperiod obtained in this study will help breeders to synchronize the flowering time of parents from distant geographic origins and break the reproductive isolation among different ecotype cultivars. [ABSTRACT FROM AUTHOR]

The optimal fasting blood glucose (FBG) target of achieving HbA1c less than 7.0% in type 2 diabetes (T2D) patients remains controversial. This open‐label trial randomized (1:3:3) 947 adults with uncontrolled T2D (HbA1c >7% to ≤10.5%) who were using one to three oral antidiabetic drugs to achieve an FBG target of 3.9 < FBG ≤5.6 mmol/L (Group 1), 3.9 < FBG ≤6.1 mmol/L (Group 2) or of 3.9 < FBG ≤7.0 mmol/L (Group 3). Targets were achieved using a pre‐defined insulin glargine 100 U/mL titration scheme. The primary endpoint was proportion of patients achieving HbA1c <7.0% at 24 weeks. At 24 weeks, 44.4%, 46.1% and 37.7% of patients achieved HbA1c <7.0% in Groups 1, 2 and 3, respectively (P = 0.017; Group 2 vs Group 3). Alert hypoglycaemia (glucose ≤3.9 mmol/L) was significantly more frequent in Group 1 than in Group 3 (38.9 vs 23.3%; P < 0.001) but was not in Group 2 vs Group 3 (27.5% vs 23.3%; P = 0.177). Clinically important hypoglycaemia (glucose ≤3.0 mmol/L) was reported in 4.8%, 2.0% and 3.8% of patients in Groups 1, 2 and 3, respectively. In conclusion, the optimal FBG target for most Chinese patients with T2D appears to be 3.9‐6.1 mmol/L. [ABSTRACT FROM AUTHOR]

Aims: To assess the efficacy and safety of twice‐daily insulin degludec/insulin aspart (IDegAsp) versus biphasic insulin aspart 30 (BIAsp 30) twice daily, both ± metformin, in Chinese adults (N = 543) with type 2 diabetes (T2D) inadequately controlled on premixed/self‐mixed or basal insulin ± metformin. Materials and methods: We conducted a 26‐week, phase III, open‐label, treat‐to‐target, 2:1 randomized trial. Hierarchical testing was used with non‐inferiority of glycated haemoglobin (HbA1c) change from baseline to week 26 as the primary endpoint and superiority for the confirmatory secondary endpoints which were as follows: change from baseline in fasting plasma glucose (FPG); nocturnal confirmed hypoglycaemic episodes (12:01–5:59 am, inclusive); total confirmed hypoglycaemic episodes (severe or plasma glucose <3.1 mmol/L with/without symptoms); body weight; and percentage of responders (HbA1c <53 mmol/mol [<7.0%]) without confirmed hypoglycaemic episodes. Results: Non‐inferiority for change from baseline to week 26 in HbA1c and superiority of IDegAsp twice daily versus BIAsp 30 twice daily for change in FPG, nocturnal confirmed and total confirmed hypoglycaemic episodes, was demonstrated. Estimated rates of nocturnal confirmed and total confirmed hypoglycaemic episodes were 47% and 43% lower, respectively, with IDegAsp twice daily versus BIAsp 30 twice daily. Superiority for change in body weight was not confirmed. Participants were more likely to reach the HbA1c goal of <53 mmol/mol (<7.0%) without confirmed hypoglycaemia with IDegAsp twice daily versus BIAsp 30 twice daily by trial end. No new safety signals were identified. Conclusions: The efficacy and safety of IDegAsp in Chinese patients with T2D was demonstrated, confirming results from international trials. [ABSTRACT FROM AUTHOR]

Abstract: Background: This 24‐week Phase 3 double‐blind placebo‐controlled study assessed the safety and efficacy of dapagliflozin as add‐on to insulin, with or without oral antihyperglycemic drugs (OADs), in Asian patients with inadequately controlled type 2 diabetes mellitus. Methods: Adult patients with HbA1c between ≥7.5% and ≤10.5%, body mass index ≤45 kg/m2, and on insulin doses ≥20 IU daily were randomized to dapagliflozin 10 mg (n = 139) or placebo (n = 133) to assess 24‐week changes in HbA1c (primary outcome), fasting plasma glucose (FPG), body weight, total daily dose of insulin (TDDI), and seated systolic blood pressure (SeSBP; exploratory outcome). Results: Baseline characteristics were similar in both groups. At Week 24, compared with placebo, dapagliflozin significantly improved HbA1c (mean [95% confidence interval] 0.03% [−0.11, 0.17] for placebo vs −0.87% [−1.00, −0.74] for dapagliflozin; between‐group difference − 0.90% [−1.09, −0.71], P < 0.0001]), FPG, body weight, TDDI, and SeSBP. The incidence of adverse events (AEs) in the dapagliflozin and placebo groups was 80.5% and 71.2%, respectively, with few patients discontinuing due to AEs (dapagliflozin, 2.2%; placebo, 4.2%). The occurrence of hypoglycemia was similar in the dapagliflozin and placebo groups (23.7% and 22.6%, respectively; no major events). The frequency of urinary tract and genital infections was low; no deaths were reported. Conclusions: Dapagliflozin as add‐on to insulin, with or without OADs, significantly improved glycemic control and reduced body weight and blood pressure in Asian patients. Dapagliflozin was well tolerated, with a similar frequency of hypoglycemia in both groups. These results support the use of dapagliflozin as add‐on to insulin, with or without OADs, in this population. [ABSTRACT FROM AUTHOR]

Contactors are important components in circuits. To solve the multiobjective optimization problems (MOPs) of contactors, a niching multiobjective particle swarm optimization (NMOPSO) with the entropy weight ideal point theory is proposed in this paper. The new algorithm selecting and archiving the nondominated solutions based on the niching theory to ensure the diversity of the nondominated solutions. To avoid missing the extreme solutions of each objective during the multiobjective optimization process, extra particle swarms used to search the independent optimal solution of each objective are supplemented in this algorithm. In order to determine the best compromise solution, a method to select the compromise solution based on entropy weight ideal point theory is also proposed in this paper. Using the algorithm to optimize the characteristics of a typical direct-acting contactor, the results show that the proposed algorithm can obtain the best compromise solution in MOPs. [ABSTRACT FROM AUTHOR]

Aims: To assess the effects on glycaemic control of lixisenatide vs placebo as add‐on treatment to basal insulin (BI) ± metformin and effects on glycated haemoglobin (HbA1c) reduction in patients with insufficiently controlled type 2 diabetes (T2D). Methods: Patients (n = 448) with inadequately controlled T2D were randomized (1:1) to lixisenatide or placebo as add‐on to BI ± metformin for 24 weeks after an 8‐week run‐in phase, during which BI was titrated to a target self‐monitored plasma glucose (SMPG; 4.4‐5.6 mmol/L). The primary endpoint was absolute change in HbA1c from baseline to week 24. Secondary efficacy endpoints included: percentage of responders; changes in 2‐hour postprandial plasma glucose (PPG); 7‐point SMPG (daily average); body weight (BW); total daily BI dose; fasting plasma glucose; and safety assessments. Results: Baseline demographics were similar in the two treatment groups. After insulin optimization during run‐in, lixisenatide was superior to placebo in mean change from baseline (7.9% [standard deviation {s.d.}, 0.66] and 7.9% [0.70], respectively) to week 24 in HbA1c (least squares mean [standard error {s.e.}] change −0.62% [0.09] vs −0.11% [0.09]; P < .0001, respectively) and higher proportions of patients achieved HbA1c targets. Two‐hour PPG, daily mean SMPG and mean BW were reduced further and daily BI dose was lower with lixisenatide than placebo (−1.12 kg vs 0.04 kg [P < .0001]; −3.0 U vs −1.9 U [P = .0033], respectively). Treatment‐emergent adverse events were greater with lixisenatide than placebo (63.8% vs 40.8%, respectively). The incidence of symptomatic hypoglycaemia was similar (lixisenatide 15.6% vs placebo 13.5%). Conclusions: In Asian patients insufficiently controlled on BI ± metformin, lixisenatide was superior to placebo in glycaemic control, with a tolerability profile in line with other glucagon‐like peptide‐1 receptor agonists. Clinical trial number: NCT01632163 ( clinicaltrials.gov). [ABSTRACT FROM AUTHOR]

Background: It is important to characterize distribution of cardiometabolic disease (CMD) based on different body mass index (BMI) levels in a population. This information remains scarce in China, so we investigated the proportions and related factors of cardiometabolic disease stages based on different BMI levels in Chinese adults.Methods: We included 45 093 participants aged ≥20 years from the National Diabetes and Metabolic Disorders Survey. Cardiometabolic disease (central obesity, elevated triglycerides, elevated blood pressure, elevated plasma glucose, reduced high-density lipoprotein cholesterol, and cardiovascular disease) was classified as stage 0 (no CMD), stage 1 (mild-to-moderate CMD), or stage 2 (severe CMD). Overweight/obesity was defined as BMI ≥25 kg/m2 .Results: The standardized proportions of stage 0, stage 1, and stage 2 were 32.6%, 36.4%, and 30.9% in normal-weight men, 29.9%, 42.5%, and 27.7% in normal-weight women, 4.9%, 31.7%, and 63.4% in overweight/obese men, and 6.9%, 31.4%, and 61.7% in overweight/obese women, respectively. Multinomial regression showed that regardless of gender or region, the probability of severe cardiometabolic disease rapidly increased with increasing BMI. Severe cardiometabolic disease risk was positively associated with ageing, family history of diabetes, hypertension, or cardiovascular disease, but was inversely associated with higher levels of education and increased physical activity.Conclusions: Of Chinese men and women with normal weight, more than one third had mild-to-moderate cardiometabolic disease, and less than one third had severe cardiometabolic disease, while of these with overweight or obesity, nearly one third had mild-to-moderate cardiometabolic disease, and nearly two thirds had severe cardiometabolic disease. [ABSTRACT FROM AUTHOR]

Background The efficacy and safety of dapagliflozin, a sodium-glucose cotransporter 2 inhibitor, has been demonstrated predominantly in Western populations. This study examined the efficacy and safety of dapagliflozin in Asian patients with type 2 diabetes mellitus ( T2DM) from eight Phase IIb/ III double-blind trials of up to 24 weeks, treated with placebo ( n = 497) or dapagliflozin 5 mg ( n = 491) or 10 mg ( n = 465). Methods Efficacy was assessed in the pooled population receiving dapagliflozin 5, 10 mg or placebo over 24 weeks. Safety and tolerability were assessed by collating data for overall adverse events ( AEs) and AEs of special interest over the 24-week period. Results Demographic and baseline characteristics were comparable across treatment groups. Placebo-corrected adjusted mean changes from baseline at 24 weeks in the dapagliflozin 5 and 10 mg groups, respectively, were −0.52% and −0.58% for HbA1c and −1.34 and −1.80 kg for body weight. Modest reductions in blood pressure were also noted with dapagliflozin. Overall, 56.5%, 53.6%, and 58.7% of patients in the placebo and dapagliflozin 5 and 10 mg groups, respectively, experienced AEs, compared with 2.8%, 4.1%, and 2.4% experiencing serious AEs. Genital infections were more frequent with dapagliflozin 10 mg than placebo, whereas the pattern for urinary tract infections was less clear. A transient reduction in mean estimated glomerular filtration rate was noted with dapagliflozin, but was not associated with an increased frequency of serious renal AEs. In contrast, placebo-corrected reductions in urinary albumin : creatinine ratio in patients with albuminuria at baseline suggest a potential renoprotective effect of dapagliflozin. Conclusion Dapagliflozin was efficacious and well tolerated in Asian patients with T2DM. [ABSTRACT FROM AUTHOR]

In some circumstances, the premixed insulin should be switched to alternative therapy. The effectiveness and the safety of switching from premixed insulin to insulin glargine plus oral antidiabetic drugs (OADs) in Chinese patients with type 2 diabetes mellitus (T2DM) have not been clarified and, hence, will be assessed in this study. Chinese patients with T2DM (2013 men and women aged 18-75 years) who had received premixed insulin ± OADs for ≥3 months with glycated hemoglobin (HbA1c) ≤ 10% were enrolled in a prospective, observational study conducted at 53 hospitals across China. At baseline and at the discretion of the physician, patients switched from premixed insulin to insulin glargine plus OADs. Changes in HbA1c, fasting plasma glucose (FPG), 2-hour postprandial glucose (PPG), treatment satisfaction, and the incidence of hypoglycemia were assessed for 16 weeks. In total, 1850 patients completed the study. Mean HbA1c level for the group decreased significantly (from 7.8% ± 1.2% at week 1 to 7.0% ± 1.0% at week 16; P < .0001), and 55.2% of patients achieved HbA1c < 7% at week 16. Mean FPG and 2-hour PPG decreased significantly (-1.4 ± 2.2 and -2.1 ± 3.9 mmol/L, respectively; both P < .0001), whereas patient satisfaction improved significantly. Adverse events were reported in 18.7% of patients. Chinese patients with T2DM who switched from premixed insulin to insulin glargine plus OADs achieved significantly improved glycemic control and treatment satisfaction with a low incidence of hypoglycemia. Patients who are most likely to achieve the HbA1c target less than 7% are younger, have shorter disease duration, and have lower baseline HbA1c and FPG levels. [ABSTRACT FROM AUTHOR]

Background Dapagliflozin, a highly selective sodium-glucose cotransporter 2 inhibitor, reduces hyperglycemia, body weight, and blood pressure in patients with type 2 diabetes (T2D). Methods This randomized double-blind placebo-controlled parallel-group 24-week study assessed the efficacy, safety, and tolerability of dapagliflozin added to metformin in Asian patients with inadequately controlled T2D (HbA1c 7.5%-10.5%). Patients were randomized to receive placebo ( n = 145) or dapagliflozin 5 ( n = 147) or 10 mg ( n = 152). Results Most participants were Chinese (86.0%), with a mean age of 53.8 years and mean T2D duration of 4.9 years; 92.1% completed the study. Adjusted mean HbA1c changes from baseline at Week 24 (primary endpoint) were −0.23%, −0.82%, and −0.85% in the placebo, dapagliflozin 5 and 10 mg groups, respectively, resulting in dapagliflozin 5 and 10 mg versus placebo differences of −0.59% and −0.62%, respectively (both P < 0.0001). Dapagliflozin 5 and 10 mg differences versus placebo were, respectively: -1.2 and −1.5 mmol/L for fasting plasma glucose; −1.1 and −1.8 kg for weight; and −2.3 and −2.7 mmol/L for 2-h postprandial glucose (all P <0.0001). In the placebo, dapagliflozin 5 and 10 mg groups, respectively: adverse events (AEs) occurred in 52.4%, 52.4%, and 55.3% of patients; serious AEs occurred in 4.1%, 2.0%, and 2.0%; urinary tract infections occurred in 4.8%, 4.1%, and 6.6%; and genital infections occurred in 0%, 2.0%, and 1.3%. No AEs of pyelonephritis or renal failure occurred. Conclusions Dapagliflozin 5 or 10 mg as add-on to metformin was well tolerated in Asian patients with T2D and significantly improved glycemic control with the additional benefit of weight reduction. [ABSTRACT FROM AUTHOR]

Aims/Introduction: The present study was to compare the efficacy and safety of subject- driven and investigator-driven titration of biphasic insulin aspart 30 (BIAsp 30) twice daily (BID). Materials and Methods: In this 20-week, randomized, open-label, two-group parallel, multicenter trial, Chinese patients with type 2 diabetes inadequately controlled by premixed/ self-mixed human insulin were randomized 1:1 to subject-driven or investigatordriven titration of BIAsp 30 BID, in combination with metformin and/or α-glucosidase inhibitors. Dose adjustment was decided by patients in the subject-driven group after training, and by investigators in the investigator-driven group. Results: Eligible adults (n = 344) were randomized in the study. The estimated glycated hemoglobin (HbA1c) reduction was 14.5 mmol/mol (1.33%) in the subject-driven group and 14.3 mmol/mol (1.31%) in the investigator-driven group. Non-inferiority of subjecttitration vs investigator-titration in reducing HbA1c was confirmed, with estimated treatment difference -0.26 mmol/mol (95% confidence interval -2.05, 1.53) (-0.02%, 95% confidence interval -0.19, 0.14). Fasting plasma glucose, postprandial glucose increment and self-measured plasma glucose were improved in both groups without statistically significant differences. One severe hypoglycemic event was experienced by one subject in each group. A similar rate of nocturnal hypoglycemia (events/patient-year) was reported in the subject-driven (1.10) and investigator-driven (1.32) groups. There were 64.5 and 58.1% patients achieving HbA1c <53.0 mmol/mol (7.0%), and 51.2 and 45.9% patients achieving the HbA1c target without confirmed hypoglycemia throughout the trial in the subject-driven and investigator-driven groups, respectively. Conclusions: Subject-titration of BIAsp 30 BID was as efficacious and well-tolerated as investigator-titration. The present study supported patients to self-titrate BIAsp 30 BID under physicians' supervision. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Diabetes is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Short-term intensive insulin therapy is unique amongst therapies for type 2 diabetes because it offers the potential to preserve and improve beta-cell function without additional pharmacological treatment. On the basis of clinical experience and the promising results of a series of studies in newly diagnosed patients, mostly in Asian populations, an expert workshop was convened to assess the available evidence and the potential application of short-term intensive insulin therapy should it be advocated for inclusion in clinical practice. Participants included primary care physicians and endocrinologists. We endorse the concept of short-term intensive insulin therapy as an option for some patients with type 2 diabetes at the time of diagnosis and have identified the following six areas where additional knowledge could help clarify optimal use in clinical practice: (1) generalizability to primary care, (2) target population and biomarkers, (3) follow-up treatment, (4) education of patients and providers, (5) relevance of ethnicity, and (6) health economics. [ABSTRACT FROM AUTHOR]

Objective The aim of the present study was to assess the efficacy and safety of vildagliptin as add-on to sulfonylurea therapy in Chinese patients with type 2 diabetes mellitus ( T2DM) inadequately controlled on sulfonylurea monotherapy. Methods The 24-week randomized double-blind placebo-controlled study compared vildagliptin 50 mg, q.d., with placebo as add-on to glimepiride in T2DM patients who were inadequately controlled ( HbA1c 7.5%-11.0% [58-97 mmol/mol]) on a stable dose of sulfonylurea for ≥12 weeks before study entry. Results In all, 279 patients were randomized to receive either vildagliptin ( n = 143) or placebo ( n = 136). At baseline, overall mean age was 58.5 years, body weight 68.1 kg, duration of diabetes 6.9 years and daily glimepiride dose 3.3 mg. After 24 weeks, the adjusted mean change ( AMΔ) in HbA1c was −0.7% (−8 mmol/mol; baseline 8.6%, 70 mmol/mol) in the vildagliptin group and −0.2% (−2 mmol/mol; baseline 8.7%, 72 mmol/mol) in the placebo group, with a treatment difference of −0.5% (−5 mmol/mol; P < 0.001). The between-group difference in AMΔ in fasting plasma glucose was −0.4 mmol/L ( P = 0.160). There was a slight, but not significant, decrease in body weight in both groups. No hypoglycemic events were reported in either group, including those patients reaching HbA1c <7.0%. Patients in the vildagliptin and placebo groups reported low and comparable incidences of adverse events (14.0% vs 17.8%) and serious adverse events (0.7% in each group). Conclusion Vildagliptin 50 mg, q.d., added to sulfonylurea monotherapy is effective in Chinese patients with T2DM, without increasing the risk of hypoglycemia and weight gain. [ABSTRACT FROM AUTHOR]

Epidemiology is now well recognized as the foundation of public health. The Da Qing study in 1986 was the first milestone study to show that lifestyle intervention can prevent or delay the onset of diabetes. The lead investigator of that study, Professor Xiaoren Pan, is regarded as the forerunner epidemiologist for diabetes in China and even in Asia. In 2006, study participants were followed up to assess the long-term effects of the interventions after 20 years. As compared with the control group, those in the combined lifestyle intervention group had a 51% lower incidence of diabetes during the active intervention period and a 43% lower incidence over the 20-year period, adjusted by age. Recently, the National Diabetes Prevalence Survey in China was carried out from 2007 to 2008. The data from that study showed that the prevalence of diabetes in Chinese adults was 9.7%, and the increased rate of diabetes prevalence in China exceeded the International Diabetes Federation estimation. Very recently, we have reported that acarbose is a viable choice for initial therapy in Chinese patients newly diagnosed with type 2 diabetes who have a lower body mass index and exaggerated postprandial glucose excursion compared with Caucasian patients. We are expecting more contributions from epidemiology to the study of diabetes. [ABSTRACT FROM AUTHOR]

Aims/Introduction To investigate the prevalence and associated risk factors of microalbuminuria, and to explore the relationship between albuminuria and cardiovascular disease ( CVD). Materials and Methods A nationally representative sample of 38,203 Chinese participants was categorized by different levels of urinary albumin-to-creatinine ratio ( ACR; 0 -10 mg/g, 10 -20 mg/g, 20 -30 mg/g, 30 -300 mg/g). The prevalence of albuminuria was compared by using a single urinary ACR cut-off point and by sex-specific ACR cut-off points. Factors associated with the presence of albuminuria, and the relationship between albuminuria and CVD were analyzed by logistic regression. Results Prevalence of albuminuria as measured by a single ACR cut-point was significantly lower for men compared with women (13.9% vs 19.1% in the normal glucose tolerance group; 20.8% vs 26.8% in the impaired glucose tolerance group, P < 0.01). The prevalence of albuminuria, as measured by sex-specific ACR cut-points, was higher for men than women (31.4% vs 29.6% in the normal glucose tolerance group; 42.2% vs 39.3% in the impaired glucose tolerance group, P < 0.01). The independent risk factors for the presence of albuminuria were aging, female sex, hypertension, hyperglycemia, obesity, dyslipidemia, insulin resistance and metabolic syndrome. The subdivided normal ACR group did not show a linear or statistically significant relationship with CVD after adjusting for conventional CVD risk factors ( P > 0.05). Conclusions The prevalence of albuminuria was high in the general Chinese population. Aging, female sex, hypertension, hyperglycemia, dyslipidemia, insulin resistance, obesity and metabolic syndrome were all independent risk factors for albuminuria. The causal relationship between ACR and CVD might require further follow-up investigation. [ABSTRACT FROM AUTHOR]

A genome-wide association study in the Chinese Han population has identified several novel genetic variants of the serine racemase ( SRR) gene in type 2 diabetes. Our purpose was to systematically evaluate the contribution of SRR variants in the Chinese Han population. rs391300 and rs4523957 in SRR were genotyped respectively in the two independent populations. A meta-analysis was used to estimate the effects of SRR in 21,305 Chinese Han individuals. Associations between single-nucleotide polymorphisms and diabetes-related phenotypes were analyzed among 2,615 newly diagnosed type 2 diabetes patients and 5,029 controls. Neither rs391300 nor rs4523957 were associated with type 2 diabetes in populations. Furthermore, meta-analysis did not confirm an association between type 2 diabetes and SRR. In the controls, rs391300-A and rs4523957-G were associated with higher 30-min plasma glucose in an oral glucose tolerance test. The present study did not confirm that SRR was associated with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background: The present study was conducted to evaluate the efficacy, safety and tolerability of sitagliptin added to ongoing metformin therapy in Chinese patients with type 2 diabetes (T2DM) who failed to achieve adequate glycemic control with metformin monotherapy. Methods: After a metformin titration/stabilization period and a 2-week, single-blind, placebo run-in period, 395 Chinese patients with T2DM aged 25-77 years (baseline HbA1c 8.5%) were randomized (1:1) to double-blind placebo or sitagliptin 100 mg q.d. added to ongoing open-label metformin (1000 or 1700 mg/day) for 24 weeks. Results: Significant ( P < 0.001) changes from baseline in HbA1c (−0.9%), fasting plasma glucose (−1.2 mmol/L), and 2-h post-meal plasma glucose (−1.9 mmol/L) were seen with sitagliptin compared with placebo. There were no significant differences between sitagliptin and placebo in the incidence of hypoglycemia or gastrointestinal adverse events. A small decrease from baseline body weight was observed in the placebo group compared with no change in the sitagliptin group (between-group difference 0.5 kg; P = 0.018). Conclusions: The addition of sitagliptin 100 mg to ongoing metformin therapy significantly improved glycemic control and was generally well tolerated in Chinese patients with T2DM who had inadequate glycemic control on metformin alone. [ABSTRACT FROM AUTHOR]

BACKGROUND: Few studies have assessed the use of new oral anti-diabetic agents in Asian populations. This study assesses the efficacy and safety of saxagliptin versus placebo in Asian patients with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: Five hundred sixty-eight drug-naïve adult patients with T2DM and glycated haemoglobin levels (HbA(1c)) of 7.0-10.0% (53-86 mmol/mol) were randomized 1 : 1 to receive saxagliptin 5 mg daily or placebo. Efficacy endpoints included changes from baseline to week 24 in HbA(1c) , fasting plasma glucose (FPG), post-prandial glucose area under the curve from 0 to 180 min (PPG AUC(0-180)), and the proportion of patients achieving HbA(1c) <7.0% (53 mmol/mol). Adverse events (AEs) and serious AEs (SAEs) were evaluated. RESULTS: Saxagliptin provided statistically significant adjusted mean decreases from baseline to week 24 compared with placebo, respectively, in HbA(1c) (-0.84% [-9 mmol/mol] versus -0.34% [-4 mmol/mol]; p < 0.0001), FPG (-0.90 versus -0.17 mmol/L; p < 0.0001), and PPG AUC(0-180) (-417 versus -235 mmol · min/L; p = 0.0010). A significantly greater proportion of patients achieved a therapeutic glycaemic response (HbA(1c) <7.0% [53 mmol/mol]) with saxagliptin (45.8%) versus placebo (28.8%; p < 0.0001). The proportions of patients who experienced >=1 AE (excluding hypoglycaemia) was 43.3% for saxagliptin and 35.6% for placebo. Few patients in either treatment group experienced an SAE (2.8%, saxagliptin; 1.4%, placebo). A low proportion of patients reported hypoglycaemic events (1.8%, saxagliptin; 0.7%, placebo). CONCLUSIONS: Saxagliptin improved glycaemic control and was well tolerated in drug-naïve Asian patients with T2DM. [ABSTRACT FROM AUTHOR]

Aims Materials and Methods Results Conclusions This study aimed to build a model‐based predictive approach to evaluate the gastrointestinal side effects following an initial metformin medication.The model was developed from data from four randomised clinical cohorts. A prediction model was established using integrated or simplified indicators. Ten machine learning models were used for the construction of predictive models. The Shapley values were used to report the features' contribution.Four randomised clinical trial cohorts, including 1736 patients with type 2 diabetes, were first included in the analysis. Seventy percent of participants (1216) were allocated to the training set, 15% (260) were assigned to the internal validation set and 15% (260) were assigned to the test set. The Extra Tree model had the highest area under curve (AUC) (0.87) in the validation and test set. The top five crucial indicators were blood urea nitrogen (BUN), sex, triglyceride (TG), high‐density lipoprotein‐cholesterol (HDL‐C) and total cholesterol (TC), and these five indicators were selected for constructing a simplified predictive model (AUC = 0.76). An online web‐based tool was established based on the predictive model with integrated 17 features and top five indicators.To predict gastrointestinal side effects in diabetic patients for initial use of metformin, a few easily obtained features are needed to establish the model. The model can be applied to the Chinese population in clinical practice. [ABSTRACT FROM AUTHOR]

Aims: To investigate the genetic factors contributing to early-onset type 2 diabetes (EOD) in the Chinese Hans populations.Materials and Methods: For 2734 newly diagnosed type 2 diabetes patients and 4041 normal glycemic controls, 25 single nucleotide polymorphisms from 24 genomic loci linked to diabetes were successfully genotyped. Three genetic risk scores (GRSs) were constructed, including the weighted type 2 diabetes-related GRS (wT-GRS), the weighted β-cell function-related GRS (wB-GRS), and the weighted GRS constructed by risk alleles not related to β-cell function (wNB-GRS). For patients with diabetes, EOD, middle-age-onset type 2 diabetes (MOD), and late-onset type 2 diabetes (LOD) were defined by onset ages ≤40, 40 to 60, and ≥60 years, respectively.Results: From single marker analysis, different gene profiles were identified between EOD and LOD patients. EOD patients had greater wT-GRS and wB-GRS values than LOD patients. After adjustment for sex, elevated wT-GRS and wB-GRS values were significantly associated with an increased risk for EOD by 1.11- and 1.21-fold per allele (P = 1.69 × 10-7 ; 6.07 × 10-8 ). The wT-GRS and wNB-GRS were nominally related to an increased risk of LOD by 1.03-fold per allele (P = 1.03 × 10-2 , 1.78 × 10-2 ). In patients with diabetes, higher wT-GRS and wB-GRS were associated with younger onset age [wT-GRS: β (SE) = -0.0033(0.0016), P = 3.74 × 10-2 ; wB-GRS: -0.0076(0.0028), 7.45 × 10-3 ] and decreased insulinogenic index [wT-GRS: -0.0384(0.0098), 9.39 × 10-5 ; wB-GRS: -0.0722(0.0176), 4.21 × 10-5 ].Conclusion: Our findings indicate a strong genetic predisposition for EOD, which can be mainly attributed to genetic variants linked to β-cell function, suggesting the β-cell dysfunction plays a key role in the pathogenesis of EOD in Chinese Han individuals. [ABSTRACT FROM AUTHOR]

Branched‐chain amino acids (BCAAs) have generated the most research interest as they have emerged as potential biomarkers of metabolic disease. BCAAs metabolic pathways may also serve as potential targets for the treatment of type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Aims To compare glucose control and safety of different basal insulin therapies ( BI, including Insulin NPH, glargine and detemir) in real-world clinical settings based on a large-scale registry study. Methods In this multi-center 6-month prospective observational study, patients with type 2 diabetes ( HbA1c ≥ 7%) who were uncontrolled by oral anti-diabetic drugs ( OADs) and were willing to initiate BI therapy were enrolled from 209 hospitals within 8 regions of China. Type and dose of BI were at the physician's discretion and the patients' willingness. Interviews were conducted at 0 months (visit 1), 3 months (visit 2) and 6 months (visit 3). Outcomes included change in HbA1c, hypoglycemia rate and body weight from baseline at 6 months. Results A total of 16 341 and 9002 subjects were involved in Intention- To- Treat ( ITT) and per-protocol ( PP) analysis, respectively. After PS regression adjustment, ITT analysis showed that reduction in HbA1c in glargine (2.2% ± 2.1%) and detemir groups (2.2% ± 2.1%) was higher than that in the NPH group (2.0% ± 2.2%) ( P < .01). The detemir group had the lowest weight gain (−0.1 ± 2.9 kg) compared with the glargine (+0.1 ± 3.0 kg) and NPH (+0.3 ± 3.1 kg) groups ( P < .05). The glargine group had the lowest rate of minor hypoglycaemia, while there was no difference in severe hypoglycaemia among the 3 groups. The results observed in PP analyses were consistent with those in ITT analysis. Conclusion In a real-world clinical setting in China, treatment with long-acting insulin analogues was associated with better glycaemic control, as well as less hypoglycaemia and weight gain than treatment with NPH insulin in type 2 diabetes patients. However, the clinical relevance of these observations must be interpreted with caution. [ABSTRACT FROM AUTHOR]

Aims To examine treatment patterns following basal insulin ( BI) introduction in type 2 diabetes mellitus ( T2DM) patients under real-world conditions across China. Materials and methods Overall, 18 995 patients inadequately controlled ( HbA1c ≥ 53 mmol/mol [7%]) with oral antihyperglycaemic drugs ( OADs) and willing to receive BI treatment were registered at 209 hospitals and followed at baseline (visit 1), 3 months (visit 2) and 6 months (visit 3). Type of BI was initiated at physicians' discretion. Results Retention with BI therapy at 6 months was 75.6%. Use of long-acting BI predominated, with insulin glargine accounting for 71%, detemir 13% and Neutral Protamine Hagedorn ( NPH) insulin 16%. Over 70% of long-acting users maintained the same initial BI at visit 3, while 40% of NPH users switched treatment and 24.4% of participants initiated BI with prandial insulin. The initial mean (± SD) dose of BI and total insulin was 0.18 ± 0.07 and 0.25 ± 0.19 IU/kg, respectively, with a mean increase of daily dose by 0.03 and 0.02 IU/kg after 6 months, respectively. Only 56.6% of insulin users reported dose titration at visit 3. Mean HbA1c was 81 mmol/mol (9.6%) at baseline and 57 mmol/mol (7.4%) at 6 months. The frequency of hypoglycaemia was 1.61 and 2.07 episodes/patient-year at baseline and 6 months, respectively. Conclusions In real-world clinical settings, add-on BI therapy in T2DM patients is associated with significant improvement in glycaemic control without overtly compromising safety related to hypoglycaemia and weight gain. Evolution of insulin treatment regimens varied among patients, but dose titration was suboptimal. More active BI dose titration might further improve glycaemic outcome in patients receiving BI therapy. Video Abstract A free Video Abstract to accompany this article is available at [ABSTRACT FROM AUTHOR]

Background The aim of the present study was to evaluate the efficacy and safety of polyethylene glycol loxenatide (PEX168) injections in Chinese type 2 diabetic (T2D) patients. Methods The present multicenter randomized double-blind parallel placebo-controlled clinical trial enrolled patients who had been treated with a stable dose of metformin (≥1500 mg/day) for ≥12 weeks and had an HbA1c level between 7% and 11%. Subjects were randomly divided into three groups (1: 1: 1) and were treated with once weekly subcutaneous injections of either placebo or 100 or 200 μg PEX168 for 12 weeks. All subjects continued to receive metformin daily. Results After 12 weeks treatment, the adjusted least-squares mean of HbA1c reductions from baseline values in the 100 and 200 μg PEX168 groups were significantly higher than in the placebo group (−1.02% [95% confidence interval {CI} -1.33, −0.71), −1.36% [95% CI -1.68, −1.04], and 0.13% [95% CI -0.20, 0.45], respectively; P < 0.05). After treatment, 50% and 60.5% of subjects in the 100 and 200 μg PEX168 groups, respectively, achieved HbA1c levels <7% ( P < 0.01 for both vs placebo [HbA1c 11.1%]). The most frequent adverse reactions in the PEX168 groups were mild to moderate dose-dependent gastrointestinal reactions. There were no reports of hypoglycemia or pancreatitis in any of the groups. Conclusions Continuous 12 week treatment with PEX168 showed excellent safety and efficacy in T2D patients whose glucose was not well controlled with metformin alone. [ABSTRACT FROM AUTHOR]

The author reflects on the changing characteristics of type 2 diabetes in China and other Asian countries. The author says that the number of individuals with diabetes has been predicted by the International Diabetes Federation (IDF) to increase from 366 million in 2011 to 552 million in 2030. The author adds that urbanization and low education level in urbanized areas in China and other developing Asian countries are some of the reason behind the change of diabetes epidemic in these countries.

Aims: To investigate the prevalence of adult-onset autoimmune diabetes (ADM) and predisposition to autoimmune diseases by quantifying serum organ-specific autoantibodies in people with phenotype of type 2 diabetes (T2D)., Materials and Methods: We included a nationally representative sample of 46 239 adults aged ≥20 years from 14 provinces, of whom 4671 had diabetes, plus 1000 control subjects with normal glucose tolerance (NGT). Participants were screened centrally for autoantibodies to glutamic acid decarboxylase (GAD), islet antigen 2 (IA2) and zinc transporter isoform-8 (Znt8) and were defined as having ADM where positive for these antibodies. We then assayed thyroid peroxidase (TPO), tissue transglutaminase (tTG) and 21-hydroxylase (21-OH) autoantibodies in randomly selected participants with ADM and in age-matched, sex-matched and non-ADM controls with T2D plus controls with NGT., Results: Post-normalization, the standardized prevalence rate of ADM was 6.0% (95% confidence interval [CI] 5.3-6.8) in initially non-insulin-requiring participants with ADM, corresponding to six million adults in China, in whom adjusted antibody positivity was: TPO autoantibodies 16.3% (95% CI 10.8-21.8), tTG autoantibodies 2.1% (95% CI 0.0-4.2), and 21-OH autoantibodies 1.8% (95% CI -0.2 to 3.8). Those participants with ADM who were GAD autoantibody-positive had high risk of TPO autoantibody positivity (odds ratio [OR] 2.39, P = 0.0031) and tTG autoantibody positivity (OR 6.98, P = 0.027), while those positive for IA2 autoantibodies had a high risk of tTG autoantibody positivity (OR 19.05, P = 0.001)., Conclusions: A proportion of people with phenotype of T2D in China have ADM, with diabetes-associated autoantibodies, and may be at risk of developing other organ-specific autoimmune diseases; therefore, it may be clinically relevant to consider screening such Chinese populations., (© 2018 John Wiley & Sons Ltd.)