49 results on '"Galan, B. E."'
Search Results
2. Correctie van substantiële hyperglykemie met insuline bij patiënten met diabetes; is controle na één uur zinvol?
- Author
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de Wit, H. M., Engwerda, E. E. C., Tack, C. J., and de Galan, B. E.
- Published
- 2018
- Full Text
- View/download PDF
3. Does the hypothalamus-pituitary-adrenal axis play a role in the difference in treatment response to GLP-1 receptor agonists in type 2 diabetes?
- Author
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Boss, M., additional, Tokgöz S, S., additional, Jansen, T. J., additional, Meijer, R., additional, de Galan, B. E., additional, Smets, N., additional, Frielink, C., additional, Tack, C. J., additional, and Gotthardt, M., additional
- Published
- 2023
- Full Text
- View/download PDF
4. Patients with type 1 diabetes mellitus have impaired IL-1β production in response to Mycobacterium tuberculosis
- Author
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Lachmandas, E., Thiem, K., van den Heuvel, C., Hijmans, A., de Galan, B. E., Tack, C. J., Netea, M. G., van Crevel, R., and van Diepen, J. A.
- Published
- 2017
- Full Text
- View/download PDF
5. Durable efficacy of liraglutide in patients with type 2 diabetes and pronounced insulin-associated weight gain: 52-week results from the Effect of Liraglutide on insulin-associated wEight GAiN in patients with Type 2 diabetesʼ (ELEGANT) randomized controlled trial
- Author
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de Wit, H. M., Vervoort, G. M., Jansen, H. J., de Galan, B. E., and Tack, C. J.
- Published
- 2016
- Full Text
- View/download PDF
6. Association between hypoglycaemia and impaired hypoglycaemia awareness and mortality in people with Type 1 diabetes mellitus
- Author
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Sejling, A.-S., Schouwenberg, B., Færch, L. H., Thorsteinsson, B., de Galan, B. E., and Pedersen-Bjergaard, U.
- Published
- 2016
- Full Text
- View/download PDF
7. Insulin administered by needle-free jet injection corrects marked hyperglycaemia faster in overweight or obese patients with diabetes
- Author
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de Wit, H. M., Engwerda, E. E. C., Tack, C. J., and de Galan, B. E.
- Published
- 2015
- Full Text
- View/download PDF
8. Prolonged effect of hypoglycaemia on circulating immune cell composition in people with type 1 diabetes
- Author
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Verhulst, E. M., Fabricius, T. W., Stienstra, R., Tack, C. J., Pedersen-Bjergaard, U., de Galan, B. E., Verhulst, E. M., Fabricius, T. W., Stienstra, R., Tack, C. J., Pedersen-Bjergaard, U., and de Galan, B. E.
- Published
- 2021
9. Association of HbA1c levels with vascular complications and death in patients with type 2 diabetes: evidence of glycaemic thresholds
- Author
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Zoungas, S., Chalmers, J., Ninomiya, T., Li, Q., Cooper, M. E., Colagiuri, S., Fulcher, G., de Galan, B. E., Harrap, S., Hamet, P., Heller, S., MacMahon, S., Marre, M., Poulter, N., Travert, F., Patel, A., Neal, B., Woodward, M., and for the ADVANCE Collaborative Group
- Published
- 2012
- Full Text
- View/download PDF
10. The effect of antecedent hypoglycaemia on β2-adrenergic sensitivity in healthy participants with the Arg16Gly polymorphism of the β2-adrenergic receptor
- Author
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Schouwenberg, B. J. J. W., Smits, P., Tack, C. J., and de Galan, B. E.
- Published
- 2011
- Full Text
- View/download PDF
11. Contribution of change in glycosylated haemoglobin to insulin-associated weight gain: results of a longitudinal study in type 2 diabetic patients
- Author
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Jansen, H. J., Hendriks, J. C., de Galan, B. E., Penders, G., Tack, C. J., and Vervoort, G.
- Published
- 2011
- Full Text
- View/download PDF
12. Cognitive function and risks of cardiovascular disease and hypoglycaemia in patients with type 2 diabetes: the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial
- Author
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de Galan, B. E., Zoungas, S., Chalmers, J., Anderson, C., Dufouil, C., Pillai, A., Cooper, M., Grobbee, D. E., Hackett, M., Hamet, P., Heller, S. R., Lisheng, L., MacMahon, S., Mancia, G., Neal, B., Pan, C. Y., Patel, A., Poulter, N., Travert, F., Woodward, M., and for the ADVANCE Collaborative group
- Published
- 2009
- Full Text
- View/download PDF
13. Reducing the burden of hypoglycaemia in people with diabetes through increased understanding: design of the Hypoglycaemia REdefining SOLutions for better liVEs (Hypo-RESOLVE) project
- Author
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de Galan, B. E., McCrimmon, R. J., Ibberson, M., Heller, S. R., Choudhary, P., Pouwer, F., Speight, Jane, Carlton, J., Pieber, T. R., Rosilio, M., Tack, C. J., Müllenborn, M., Hypo-RESOLVE Consortium, de Galan, B. E., McCrimmon, R. J., Ibberson, M., Heller, S. R., Choudhary, P., Pouwer, F., Speight, Jane, Carlton, J., Pieber, T. R., Rosilio, M., Tack, C. J., Müllenborn, M., and Hypo-RESOLVE Consortium
- Published
- 2020
14. Hyperinsulinaemic-hypoglycaemic glucose clamps in human research: a systematic review of the literature
- Author
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Fabricius, T. Wilbek, Verhulst, C., de Galan, B. E., Pedersen-Bjergaard, U., Fabricius, T. Wilbek, Verhulst, C., de Galan, B. E., and Pedersen-Bjergaard, U.
- Published
- 2020
15. Sweet dreams or bitter nightmare: A narrative review of 25 years of research on the role of sleep in diabetes and the contributions of behavioural science
- Author
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Nefs, G., Bazelmans, E., Donga, E., Tack, C. J., de Galan, B. E., Nefs, G., Bazelmans, E., Donga, E., Tack, C. J., and de Galan, B. E.
- Abstract
The aim of this review was to provide an overview of developments, clinical implications and gaps in knowledge regarding the relationship between diabetes and sleep over the past 25 years, with special focus on contributions from the behavioural sciences. Multiple prospective observational and experimental studies have shown a link between suboptimal sleep and impaired glucose tolerance, decreased insulin sensitivity and the development of type 2 diabetes. While prevalence rates of suboptimal sleep vary widely according to definition, assessment and sample, suboptimal subjective sleep quality appears to be a common reality for one-third of people with type 1 diabetes and over half of people with type 2 diabetes. Both physiological and psychosocial factors may impair sleep in these groups. In turn, suboptimal sleep can negatively affect glycaemic outcomes directly or indirectly via suboptimal daytime functioning (energy, mood, cognition) and self-care behaviours. Technological devices supporting diabetes self-care may have both negative and positive effects. Diabetes and its treatment also affect the sleep of significant others. Research on the merits of interventions aimed at improving sleep for people with diabetes is in its infancy. Diabetes and sleep appear to be reciprocally related. Discussion of sleep deserves a central place in regular diabetes care. Multi-day, multi-method studies may shed more light on the complex relationship between sleep and diabetes at an individual level. Intervention studies are warranted to examine the potential of sleep interventions in improving outcomes for people with diabetes.
- Published
- 2020
16. Body mass index and the efficacy of needle-free jet injection for the administration of rapid-acting insulin analogs, a post hoc analysis
- Author
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de Galan, B. E., Engwerda, E. E. C., Abbink, E. J., and Tack, C. J.
- Published
- 2013
- Full Text
- View/download PDF
17. Weight changes and their predictors amongst 11 140 patients with type 2 diabetes in the ADVANCE trial
- Author
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van Dieren, S., Czernichow, S., Chalmers, J., Kengne, A. P., de Galan, B. E., Poulter, N., Woodward, M., Beulens, J. W. J., Grobbee, D. E., van der Schouw, Y. T., and Zoungas, S.
- Published
- 2012
- Full Text
- View/download PDF
18. Successful treatment of severe subcutaneous insulin resistance with inhaled insulin therapy
- Author
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van Alfen-van der Velden, A AEM, Noordam, C, de Galan, B E, Hoorweg-Nijman, J JG, Voorhoeve, P G, and Westerlaken, C
- Published
- 2010
- Full Text
- View/download PDF
19. Sweet dreams or bitter nightmare: a narrative review of 25 years of research on the role of sleep in diabetes and the contributions of behavioural science
- Author
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Nefs, G., primary, Bazelmans, E., additional, Donga, E., additional, Tack, C. J., additional, and Galan, B. E., additional
- Published
- 2019
- Full Text
- View/download PDF
20. Sensitivity-enhanced 13C MR spectroscopy of the human brain at 3 Tesla
- Author
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Klomp, D. W.J., Renema, W. K.J., van der Graaf, M., de Galan, B. E., Kentgens, A. P.M., and Heerschap, A.
- Published
- 2006
- Full Text
- View/download PDF
21. Glucose counterregulation in Type 2 diabetes mellitus
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de Galan, B. E. and Hoekstra, J. B. L.
- Published
- 2001
22. Reducing the burden of hypoglycaemia in people with diabetes through increased understanding: design of the Hypoglycaemia REdefining SOLutions for better liVEs (Hypo‐RESOLVE) project.
- Author
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Galan, B. E., McCrimmon, R. J., Ibberson, M., Heller, S. R., Choudhary, P., Pouwer, F., Speight, J., Carlton, J., Pieber, T. R., Rosilio, M., Tack, C. J., and Müllenborn, M.
- Subjects
- *
DIABETES , *HYPOGLYCEMIA , *MEDICAL care costs , *PATIENT education , *RISK assessment , *DISEASE complications - Abstract
Background: Hypoglycaemia is the most frequent complication of treatment with insulin or insulin secretagogues in people with diabetes. Severe hypoglycaemia, i.e. an event requiring external help because of cognitive dysfunction, is associated with a higher risk of adverse cardiovascular outcomes and all‐cause mortality, but underlying mechanism(s) are poorly understood. There is also a gap in the understanding of the clinical, psychological and health economic impact of 'non‐severe' hypoglycaemia and the glucose level below which hypoglycaemia causes harm. Aim: To increase understanding of hypoglycaemia by addressing the above issues over a 4‐year period. Methods: Hypo‐RESOLVE is structured across eight work packages, each with a distinct focus. We will construct a large, sustainable database including hypoglycaemia data from >100 clinical trials to examine predictors of hypoglycaemia and establish glucose threshold(s) below which hypoglycaemia constitutes a risk for adverse biomedical and psychological outcomes, and increases healthcare costs. We will also investigate the mechanism(s) underlying the antecedents and consequences of hypoglycaemia, the significance of glucose sensor‐detected hypoglycaemia, the impact of hypoglycaemia in families, and the costs of hypoglycaemia for healthcare systems. Results: The outcomes of Hypo‐RESOLVE will inform evidence‐based definitions regarding the classification of hypoglycaemia in diabetes for use in daily clinical practice, future clinical trials and as a benchmark for comparing glucose‐lowering interventions and strategies across trials. Stakeholders will be engaged to achieve broadly adopted agreement. Conclusion: Hypo‐RESOLVE will advance our understanding and refine the classification of hypoglycaemia, with the ultimate aim being to alleviate the burden and consequences of hypoglycaemia in people with diabetes. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
23. Sweet dreams or bitter nightmare: a narrative review of 25 years of research on the role of sleep in diabetes and the contributions of behavioural science.
- Author
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Nefs, G.M., Bazelmans, E., Donga, E., Tack, C. J., and Galan, B. E.
- Subjects
TYPE 2 diabetes risk factors ,TYPE 2 diabetes complications ,DIABETES ,PEOPLE with diabetes ,INSULIN resistance ,TYPE 1 diabetes ,MEDICAL research ,PSYCHOLOGY ,QUALITY of life ,HEALTH self-care ,SLEEP ,SLEEP disorders ,SOCIAL sciences ,PSYCHOSOCIAL factors ,GLYCEMIC control ,SLEEP hygiene ,DISEASE complications ,DISEASE risk factors - Abstract
The aim of this review was to provide an overview of developments, clinical implications and gaps in knowledge regarding the relationship between diabetes and sleep over the past 25 years, with special focus on contributions from the behavioural sciences. Multiple prospective observational and experimental studies have shown a link between suboptimal sleep and impaired glucose tolerance, decreased insulin sensitivity and the development of type 2 diabetes. While prevalence rates of suboptimal sleep vary widely according to definition, assessment and sample, suboptimal subjective sleep quality appears to be a common reality for one‐third of people with type 1 diabetes and over half of people with type 2 diabetes. Both physiological and psychosocial factors may impair sleep in these groups. In turn, suboptimal sleep can negatively affect glycaemic outcomes directly or indirectly via suboptimal daytime functioning (energy, mood, cognition) and self‐care behaviours. Technological devices supporting diabetes self‐care may have both negative and positive effects. Diabetes and its treatment also affect the sleep of significant others. Research on the merits of interventions aimed at improving sleep for people with diabetes is in its infancy. Diabetes and sleep appear to be reciprocally related. Discussion of sleep deserves a central place in regular diabetes care. Multi‐day, multi‐method studies may shed more light on the complex relationship between sleep and diabetes at an individual level. Intervention studies are warranted to examine the potential of sleep interventions in improving outcomes for people with diabetes. What's new?: In 1994, studying suboptimal sleep in people with diabetes was highlighted as a promising new research area.Since then, a large evidence base has illustrated the myriad of ways in which sleep and diabetes are linked.Suboptimal sleep is a common reality for many people with diabetes, which may negatively impact glycaemic and psychosocial outcomes.In turn, physiological and psychosocial factors may impair sleep.Sleep deserves a more central place in regular diabetes care.Future studies may focus on clarifying the interactions of sleep and diabetes on the individual level, as well as on evaluating the merits of sleep interventions in this group. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
24. A Case of Guillain-Barré Syndrome due to Infection with Rickettsia conorii
- Author
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de Galan, B. E., van Kasteren, B. J., Wall Bake, A. W. L., and Vreugdenhil, G.
- Published
- 1999
- Full Text
- View/download PDF
25. Association between hypoglycaemia and impaired hypoglycaemia awareness and mortality in people with Type 1 diabetes mellitus
- Author
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Sejling, A-S, Schouwenberg, B, Faerch, L H, Thorsteinsson, B, de Galan, B E, Pedersen-Bjergaard, U, Sejling, A-S, Schouwenberg, B, Faerch, L H, Thorsteinsson, B, de Galan, B E, and Pedersen-Bjergaard, U
- Abstract
AIMS: To examine whether severe hypoglycaemia and impaired hypoglycaemic awareness, a principal predictor of severe hypoglycaemia, are associated with all-cause mortality or cardiovascular mortality in Type 1 diabetes mellitus.METHODS: Mortality was recorded in two cohorts, one in Denmark (n = 269, follow-up 12 years) and one in the Netherlands (n = 482, follow-up 6.5 years). In both cohorts, awareness class was characterized and numbers of episodes of severe hypoglycaemia either during lifetime (Danish cohort) or during the preceding year (Dutch cohort) were recorded. In addition, episodes of severe hypoglycaemia were prospectively recorded every month for 1 year in the Danish cohort. Follow-up data regarding mortality were obtained through medical reports and registries (Danish cohort).RESULTS: All-cause mortality was 14% (n = 39) in the Danish and 4% (n = 20) in the Dutch cohort. In either cohort, neither presence of episodes with severe hypoglycaemia nor impaired hypoglycaemia awareness were associated with increased mortality in age-truncated Cox proportional hazard regression models. Variables associated with increased risk of all-cause mortality in both cohorts were evidence of macrovascular disease and reduced kidney function.CONCLUSIONS: Severe hypoglycaemia and hypoglycaemia unawareness are not associated with increased risk of all-cause or cardiovascular mortality in people with Type 1 diabetes mellitus.
- Published
- 2016
26. The role of the hypothalamus-pituitary-adrenal axis in the difference in treatment response to GLP-1 receptor agonists in type 2 diabetes.
- Author
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Tokgöz, S., Jansen, T. J. P., Meijer, R., Frielink, C., Tack, C. J., de Galan, B. E., Gotthardt, M., and Boss, M.
- Published
- 2023
27. Daily unstructured physical activity affects mean glucose, occurrence of hypoglycaemia and glucose variability in people with type 1 diabetes.
- Author
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Drenthen, L. C. A., Ajie, M., Bakker, E. A., Abbink, E. J., Thijssen, D. H. J., Tack, C. J., and de Galan, B. E.
- Published
- 2023
28. Durable efficacy of liraglutide in patients with type 2 diabetes and pronounced insulin-associated weight gain: 52-week results from the Effect of Liraglutide on insulin-associated wEight GAiN in patients with Type 2 diabetes' (ELEGANT) randomized control
- Author
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de Wit, H. M., primary, Vervoort, G. M., additional, Jansen, H. J., additional, de Galan, B. E., additional, and Tack, C. J., additional
- Published
- 2015
- Full Text
- View/download PDF
29. Patients with type 1 diabetes mellitus have impaired IL-1β production in response to Mycobacterium tuberculosis.
- Author
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Lachmandas, E., Thiem, K., van den Heuvel, C., Hijmans, A., de Galan, B. E., Tack, C. J., Netea, M. G., van Crevel, R., and van Diepen, J. A.
- Subjects
TYPE 1 diabetes ,TREATMENT of diabetes ,INSULIN resistance ,MYCOBACTERIUM tuberculosis ,INTERLEUKIN-1 receptors ,IMMUNE response ,DIAGNOSIS ,DISEASE risk factors - Abstract
Patients with diabetes mellitus have an increased risk of developing tuberculosis. Although the underlying mechanism is unclear, evidence suggests a role for chronic hyperglycaemia. We examined the influence of hyperglycaemia on Mycobacterium tuberculosis-induced cytokine responses in patients with type 1 diabetes mellitus (T1D). Peripheral blood mononuclear cells (PBMCs) from 24 male T1D patients with sub-optimal glucose control [HbA1c > 7.0% (53 mmol/L)] and from 24 age-matched male healthy controls were stimulated with M. tuberculosis lysate. Cytokine analysis, assessment of aerobic glycolysis, receptor recognition and serum cross-over experiments were performed to explore the mechanistic differences. PBMCs from T1D patients produced less bioactive interleukin (IL)-1β in response to M. tuberculosis. IL-6 and interferon (IFN)-γ production trended towards a decrease, whilst other cytokines such as tumour necrosis factor (TNF)-α, IL-17 and IL-1Ra were normal. The decrease in cytokine production was not correlated to HbA1c or plasma glucose levels. Cross-over serum experiments did not alter the cytokine profile of T1D or control patients, arguing for an intrinsic cellular defect. Cellular metabolism and the expression of M. tuberculosis-related pattern recognition receptors (PRRs) such as TLR2, TLR4 and NOD2 did not differ between T1D patients and healthy controls. Compared to matched controls, T1D patients have a reduced capacity to produce pro-inflammatory cytokines in response to M. tuberculosis. The impaired IL-1β production in T1D patients may contribute to the increased susceptibility to tuberculosis. This effect appears not to be related to prevailing glucose levels but to an intrinsic cellular deficit. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
30. Association between hypoglycaemia and impaired hypoglycaemia awareness and mortality in people with Type 1 diabetes mellitus
- Author
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Sejling, A.-S., primary, Schouwenberg, B., additional, Faerch, L. H., additional, Thorsteinsson, B., additional, de Galan, B. E., additional, and Pedersen-Bjergaard, U., additional
- Published
- 2015
- Full Text
- View/download PDF
31. Durable efficacy of liraglutide in patients with type 2 diabetes and pronounced insulin-associated weight gain: 52-week results from the Effect of Liraglutide on insulin-associated wEight GAiN in patients with Type 2 diabetes' (ELEGANT) randomized controlled trial.
- Author
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Wit, H. M., Vervoort, G. M., Jansen, H. J., Galan, B. E., and Tack, C. J.
- Subjects
WEIGHT gain ,PEOPLE with diabetes ,INSULIN therapy ,GLYCEMIC control ,HEMOGLOBINS ,GLUCAGON-like peptide 1 ,RANDOMIZED controlled trials ,HYPOGLYCEMIC agents ,COMPARATIVE studies ,INSULIN ,RESEARCH methodology ,MEDICAL cooperation ,TYPE 2 diabetes ,RESEARCH ,TIME ,EVALUATION research ,TREATMENT effectiveness - Abstract
Background: Pronounced weight gain frequently complicates insulin therapy in patients with type 2 diabetes (T2DM). We have previously reported that addition of liraglutide for 26 weeks can reverse insulin-associated weight gain, decrease insulin dose and improve glycaemic control, as compared with continuation of standard insulin treatment.Objectives: To investigate whether the beneficial effects of liraglutide are sustained up to 52 weeks and whether similar effects could be obtained when liraglutide is added 6 months later.Methods: Adult T2DM patients with ≥ 4% weight gain within 16 months of insulin therapy completing the first 26-week trial period of open-label addition of liraglutide 1.8 mg day(-1) (n = 26) versus continuation of standard insulin therapy (n = 24) were all treated with liraglutide for another 26 weeks. Results were analysed according to the intention-to-treat principle.Results: Overall, 24 (92%) and 18 (75%) patients originally assigned to liraglutide and standard therapy, respectively, completed the study. Addition of liraglutide decreased body weight to a similar extend when given in the first 26 weeks (liraglutide group) or second 26 weeks (original standard therapy group): -4.4 vs. -4.3 kg (difference -0.32 kg, 95% confidence interval -2.2 to 1.6 kg; P = 0.74). Similar results were also seen in the two groups with regard to decrease in haemoglobin A1c (HbA1c ) (-0.77 vs. -0.66%; P = 0.23) and insulin dose (-28 vs. -26 U day(-1) ; P = 0.32). In both groups, 22% of patients could discontinue insulin. Continuation of liraglutide until 52 weeks led to sustained effects on body weight, HbA1c and insulin-dose requirements.Conclusion: In T2DM patients with pronounced insulin-associated weight gain, addition of liraglutide within 2 years leads to sustained reversal of body weight, improved glycaemic control and decrease in insulin dose. Thus, liraglutide offers a valuable therapeutic option. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
32. Body mass index and the efficacy of needle‐free jet injection for the administration of rapid‐acting insulin analogs, a post hoc analysis
- Author
-
de Galan, B. E., primary, Engwerda, E. E. C., additional, Abbink, E. J., additional, and Tack, C. J., additional
- Published
- 2012
- Full Text
- View/download PDF
33. Contribution of change in glycosylated haemoglobin to insulin-associated weight gain: results of a longitudinal study in type 2 diabetic patients
- Author
-
Jansen, H. J., primary, Hendriks, J. C., additional, de Galan, B. E., additional, Penders, G., additional, Tack, C. J., additional, and Vervoort, G., additional
- Published
- 2010
- Full Text
- View/download PDF
34. Routine blood pressure lowering and intensive glucose control in patients with Type 2 diabetes: the ADVANCE trial.
- Author
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Joshi, Rohina, de Galan, B. E., Chalmers, John, Perkovic, Vlado, and Patel, Anushka
- Subjects
BLOOD pressure ,TYPE 2 diabetes ,BLOOD sugar ,PEOPLE with diabetes ,PLACEBOS - Abstract
The Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial investigated the effects of routine blood pressure lowering and intensive blood glucose control on major vascular events in people with Type 2 diabetes. In this factorial randomized study, 11,140 individuals with Type 2 diabetes were randomly assigned to a fixed combination of perindopril and indapamide or matching placebo, and to intensive glucose control with the use of modified-release gliclazide plus other drugs required to achieve a hemoglobin A1c of 6.5% of less, or standard guideline-based glucose control. The primary outcomes were composites of major macrovascular and major microvascular events (major vascular events), analyzed jointly and separately. Active treatment in the blood pressure-lowering arm reduced blood pressure by 5.6/2.2 mmHg compared with placebo, and the relative risks of major vascular events, all deaths and cardiovascular deaths by 9% (p = 0.043), 14% (p = 0.025) and 18% (p = 0.027), respectively. These effects appeared independent of the initial blood pressure level or the use of concomitant treatments. Intensive glucose control lowered glycated hemoglobin levels to a mean of 6.5% and reduced the relative risk of major vascular events by 10% (p = 0.01 ), primarily through a 21% (p = 0.006) reduction in nephropathy. Intensive glucose control was not associated with a significant reduction in macrovascular events; however, unlike reports from the recently reported Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, there was no evidence of any increase in all-cause mortality or cardiovascular death with more intensive glucose control. This trial has provided important new evidence with direct implications for clinical management of blood pressure and blood glucose in patients with Type 2 diabetes. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
- View/download PDF
35. Expression of herpes simplex virus type 2 latency-associated transcript in neurons and nonneurons
- Author
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Tenser, R B, primary, Edris, W A, additional, Hay, K A, additional, and de Galan, B E, additional
- Published
- 1991
- Full Text
- View/download PDF
36. Body mass index and the efficacy of needle-free jet injection for the administration of rapid-acting insulin analogs, a post hoc analysis.
- Author
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Galan, B. E., Engwerda, E. E. C., Abbink, E. J., and Tack, C. J.
- Subjects
- *
BODY mass index , *INSULIN , *HYPODERMIC jet injectors , *PHARMACOKINETICS , *PHARMACODYNAMICS , *DOSE-effect relationship in pharmacology - Abstract
We recently showed in a euglycaemic glucose clamp study among 18 healthy volunteers that using jet injectors rather than conventional pens significantly improved the time-action profiles of rapid-acting insulin analogs. Here, we investigated whether such profiles were modified by body mass index ( BMI) and related weight parameters by comparing insulin administration by jet injection to that by conventional pen in subgroups defined by BMI, waist-to-hip ratio, waist circumference and insulin dose. After conventional administration, times to peak insulin levels (T- INSmax) occurred 31.1 [95% confidence interval ( CI) 13.7-48.5] min later and time to maximum glucose requirement (T- GIRmax) 56.9 (95% CI 26.6-87.3) min later in more obese ( BMI > 23.6 kg/m2) than in lean subjects ( BMI < 23.6 kg/m2). In contrast, T- INSmax and T- GIRmax were similar in subjects with high and low BMI, when insulin was administered by jet injection. We conclude that using jet injection for insulin administration may especially benefit subjects with higher body weight. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
37. 40 EASD Annual Meeting of the European Association for the Study of Diabetes : Munich, Germany, 5-9 September 2004
- Author
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Veitenhansl, M., Stegner, K., Hierl, F-X, Dieterle, C., Feldmeier, H., Gutt, B., Landgraf, R., Garrow, A. P., Vileikyte, L., Findlow, A., Waterman, C., Boulton, A. J. M., Shankhdhar, K., Shankhdhar, L., Shankhdhar, U., Petrova, N. L., Foster, A. V. M., Edmonds, M. E., Ferraresi, R., Caravaggi, C., Giglio, R., Cavaiani, P., Pogliaghi, I., Sommariva, E., Katz, I. A., Harlan, A., Miranda-Palma, B., Prieto-Sanchez, L., Armstrong, D. G., Bowker, J. H., Mizel, M. S., Cernea, S., Wohlgelernter, J., Kidron, M., Modi, P., Raz, I., Arbit, E., Nosek, L., Kapitza, C., Beckett, P., Gelfand, R., Goldberg, M., Heise, T., Testa, M. A., Turner, R. R., Hayes, J. F., Scranton, R. E., Simonson, D. C., Yang, Y-W, Hsu, Y-J, Naujok, O., Francini, F., Jorns, A., Tiedge, M., Lenzen, S., Abdel-Wahab, Y. H. A., Marenah, L., Orr, D. F., Shaw, C., Flatt, P. R., Chokkalingam, K., Mansell, P. I., Clausen, P., Ekbom, P., Damm, P., Feldt-Rasmussen, U., Nielsen, B., Mathiesen, E. R., Feldt-Rasmussen, B., Dewan, S., Da Silva, N., Ternan, P. Mc, Leong, K. S., Wilding, J. P. H., Asatiani, N., Kurashvili, R., Dundua, M., Shelestova, E., Pagava, K., Ramazashvili, M., Hod, M., Smirnov, S., Petersen, J. L. A., Justesen, T. I., Ringholm Nielsen, L., Muller, C., Hojlund, K., Wensaas, A., Kase, E. T., Aas, V., Rustan, A. C., Thoresen, G. H., Levin, K., Beck-Nielsen, H., Gaster, M., Im, S-S, Kang, S-Y, Kim, S-Y, Ahn, Y-H, Lihn, A. S., Schmoll, D., Werner, T., Kienitz, A., Meyer, M., Barthel, A., Ailett, F., Sutherland, C., Walther, R., Grempler, R., Sasson, S., Reich, R., Tenenbaum, T., Alpert, E., Anfossi, G., Russo, I., Traversa, M., Massucco, P., Mattiello, L., Doronzo, G., Trovati, M., Lally, S., Tan, C. Y., Owens, D., Tomkin, G. H., Porchay, I., Pean, F., Bellili, N., Betoulle, D., Balkau, B., Tichet, J., Marre, M., Fumeron, F., Group D.E.S.I.R., Chatellier, G., Alhenc-Gelas, F., Diabhycar, Study Group, Nichols, G. A., Brown, J. B., Hayes, R. P., Bowman, L., Drexel, H., Saely, C. H., Marte, T., Benzer, W., Langer, P., Hoefle, G., Moll, W., Aczel, S., Karagiannis, E., Lubben, G., Urquhart, R., Edwards, G., Bruce, S., Howlett, H. S. C., Cugnardey, N., Turner, K. C., Park, J-S, Fiedorek, F. T., Avogaro, A., Gallo, A., Pinton, P., Rizzuto, R., Murphy, E., Ceolotto, G., Caterson, I., Guy-Grand, B., Hill, J., Barone, M., Aiello, A., Allochis, G., Borzi, V., Cannata, F., Caronna, S., D Avanzo, A., Elli, R., Formoso, G., Paroli, A., Scardapane, R., Sorichetti, P., Tatti, P., Viviani, G., Santeusanio, F., Italian Repaglinide Study Group, Manzella, D., Grella, R., Abbatecola, A. M., Paolisso, G., Sondergaard, L. G., Monster, T. B. M., Johnsen, S. P., Olsen, M. L., Mclaughlin, J. K., Sorensen, H. T., Lervang, H. H., Rungby, J., Lyssenko, V., Fredriksson, J., Almgren, P., Anevski, D., Orho-Melander, M., Sjogren, M., Tuomi, T., Groop, L., Jaziri, R., Aubert, R., Tuomilehto, J., Hu, G., Jousilahti, P., Peltonen, M., Lindstrom, J., Laina, A., Alevizaki, M., Philippou, G., Souvatzoglou, A., Anastasiou, E., Alba, S., Metcalf, B. S., Voss, L. D., Jeffery, A. N., Wilkin, T. J., Gluimer, C., Colagiuri, S., Vistisen, D., Borch-Johnsen, K., Haynes, A., Bower, C., Bulsara, M. K., Jones, T. W., Davis, E. A., Mortensen, H. B., Hougaard, P., Holl, R., Swift, P., Pociot, F., Knip, M., Hansen, L., Szadkowska, A., Pietrzak, I., Zmyslowska, A., Wyka, K., Bodalski, J., Holl, R. W., Swift, R., Hougaard, R., Gerstl, E-M, Engelsberger, I., Rabl, W., Rosenbauer, J., Grobe, H., Hofer, S. E., Krause, U., DPV-Wiss-Study Group, Dabelea, D., Morgan, T., Pettitt, D. J., Dolan, L., Mayer-Davis, E. J., Pihoker, C., Hillier, T. A., Imperatore, G., Ruggiero, A., Hamman, R. E., Stylianou, A., Tentolouris, N., Perrea, D., Tselepis, A. D., Lourida, E., Kitsou, E., Katsilambros, N., Vedovato, M., Dodesini, A. R., Lepore, G., Tiengo, A., Trevisan, R., Penno, G., Miccoli, R., Pucci, L., Lucchesi, D., Bandinelli, S., Fotino, C., Triscornia, S., Baldassari, E., Del Prato, S., Reboldi, P., Santeusanio, E., Fuller, J., Langham, R. G., Gow, R. M., Zhang, Y., Kelly, D. J., Christensen, P. K., Parving, H-H, Gilbert, R. E., Chibalin, A. V., Zhong, Z., Kotova, O., Davidescu, A., Ehren, I., Ekberg, K., Wahren, J., Wassef, L., Buckley, A. J., Rooney, K. B., Briody, J., Thompson, M., Ozanne, S. E., Thompson, C. H., Chamson-Reig, A., Summers, K., Arany, E. J. R., Hill, D. J., Solerte, S. B., Gazzaruso, C., Locatelli, E., Precerutti, S., Schifino, N., Ferrari, E., Fioravanti, M., Phenekos, C. V., Ginis, A., Fragaki, I., Chalkiadaki, M., Tzioras, C., Powell, L. A., Mcguire, G. M., Jewhurst, V., Trimble, E. R., Rasmussen, B. M., Vessby, B., Uusitupa, M., Berglund, L., Pedersen, E., Riccardi, G., Rivellese, A. A., Tapsell, L., Hermansen, K., Kanwu, Study Group, Da Silva Xavier, G., Rutter, J., Rutter, G. A., Briaud, I. M., Lingohr, M. K., Dickson, L. M., Mccuaig, J. R., Lawrence, J. C., Rhodes, C. J., Wikstrom, J. D., Katzman, S. M., Shirihai, O. S., Yang, J., Deng, S., Wang, X., Hessner, M. J., Wu, J., Wong, R. K., Sukumvanich, S., Markman, J. F., Naji, A., Wolf, B. A., Gao, Z., Rubi, B., Del Arco, A., Satrustegui, J., Maechler, P., Del Guerra, S., Lupi, R., Bugliani, M., Sbrana, S., Torri, S., Boggi, U., Vistoli, F., Mosca, F., Marchetti, P., Rennings, A. J. M., Smits, P., Stewart, M. W., Tack, C. J. J., Li, L., Nystrom, T., Gutniak, M., Ahren, B., Holst, J., Sjoholm, A., Gomes, M. B., Cailleaux, S., Tibirica, E., Albertini, J-P, Chen, H., Mather, R., Valensi, P. E., Chisalita, S. I., Arnqvist, H. J., Kraenkel, N., Adams, V., Linke, A., Gielen, S., Schuler, G., Humbrecht, R., Cipollone, F., Iezzi, A., Fazia, M., Pini, B., Cucurullo, C., Cesare, D., Schmidt, A. M., Mazurek, T., Zang, L. F., Mannion, J., Diehl, J., Martin, J., Martella, A., Zalewski, A., Shi, Y., Otter, W., Winter, M., Doering, W., Standi, E., Schnell, O., Kragelund, C., Kober, L., Faber, J., Hildebrandt, P., Steffensen, R., Pankowska, E., Szypowska, A., Lipka, M., Herwig, J., Scholl-Schilling, G., Bohles, H., Robertson, K. J., Schonle, E., Gucev, Z., Mordhorst, L., Tamer, S. C., Gall, M-A, Ludvigsson, J., Hoogma, R. P. L., Hammond, P. J., Gomis, R., Kerr, D., Bruttomesso, D., Bouter, P., Wiefels, K. J., La Calle, H., Schweitzer, D. H., Pfohl, M., Torlone, E., Krinelke, L. G., 205-Nations Study Group, Conget, I., Storms, F., Rodriguez, J., Leperlier, C., Davies, M., At Lantus, Study Group, Peter, R., Luzio, S. D., Dunseath, G., Miles, A., Hare, B., Backx, K., Pauvaday, V., Owens, D. R., Caselli, A., Marfia, G. A., Battista, C., Veves, A., Spallone, V., Uccioli, L., Gonzalez, J. S., Peyrot, M. F., Rubin, R. R., Leventhal, H., Scheffler, N., Ulbrecht, J. S., Cavanagh, P. R., Boulton, A. J., Perrin, N. A., Oglesby, A., Bastyr, E. J., Ziegler, D., Siekierka-Kleiser, E., Meyer, B., Schweers, M., Selvarajah, D., Wilkinson, I. D., Emery, C. J., Shaw, P. J., Griffiths, P. D., Tesfaye, S., Obrosova, I. G., Arezzo, J., Phillips, K., Fidarestat Study Group, Gribble, F. M., Williams, L., Reimann, F., Iakoubov, R., Whiteside, C., Brubaker, P. L., Acitores, A., Gonzalez, N., Sancho, V., Valverde, I., Villanueva-Penacarrillo, M. L., Martin-Duce, A., Trigo, M. V., Arnes, L., Burkart, V., Ichino, N., Ohashi, A., Klein, B. S., Paxian, S., Schmid, R., Karlsen, A. E., Heding, P. E., Frobose, H., Ronn, S. G., Kruhoffer, M., Orntoft, T. F., Nerup, J., Mandrup-Poulsen, T., Billestrup, N., Cardozo, A. K., Ortis, F., Feng, Y-M, Rasschaert, J., Eylen, F., Storling, J., Herchuelz, A., Eizirik, D. L., Wang, H., Kouri, G., Wollheim, C. B., Ribaux, P., Hammar, E., Parnaud, G., Rouiller, D., Bosco, D., Halban, P., Midthjell, K., Carlsson, S., Grill, V., Lau, C., Farch, K., Glumer, C., Tetens, I., Jorgensen, T., Tillin, T., Forouhi, N., Mckeigue, P., Chaturvedi, N., Zethelius, B., Hales, C. N., Berne, C., Coleman, R. L., Stevens, R. J., Holman, R. R., Christensen, J. O., Sandbak, A., Lauritzen, T., Irwin, N., Gault, V. A., Green, B. D., Harriott, P., O Harte, F. P. M., Bouman, S. D., Urso, B., Brand, C. L., Rolin, B., Ribel, U., Schaffer, L., Maggs, D. G., Ceriello, A., Frias, J. P., Wang, Y., Ruggles, J. A., Kolterman, O. G., Piconi, L., Weyer, C., Want, L. L., Ratner, R. E., Uwaifo, G. I., Thornberry, N. A., Eiermann, G., Kim, D., Lankas, G., Leiting, B., Li, Z., Lyons, K., Petrov, A., Sinha Roy, R., Woods, A., Woods, J., Zhang, B. B., Fisher, M., Moller, D. E., Weber, A. E., Dreyer, M., Bellin, C., Schmitz, V., Roesen, R., Nescheret, A. P., Bose, A. K., Mocanu, M. M., Carr, R. D., Yellon, D. M., Manolopoulos, K., Born, S., Wagner, A., Jeziorska, M., Ben Drief, A., Bashir, M., Tomlinson, D., Malik, R. A., Zeymer, U., Schwarzmaier-D Assie, A., Petzinna, D., Chiasson, J-L, Stratton, I. M., Af Bjorkesten, C-G, Fagerudd, J., Rosengard-Barlund, M., Forsblom, C., Pettersson-Fernholm, K., Waden, J., Saraheimo, M., Ronnback, M., Thorn, L., Groop, P-H, Mollsten, A., Svensson, M., Kockum, I., Rudberg, S., Brismar, K., Dahlquist, G., Hovind, P., Hansen, T. K., Tarnow, L., Thiel, S., Jensen, B. R., Flyvbjerg, A., Kankova, K., Hertlova, M., Krusova, D., Schwenke, S., Ott, J., Thom, S. A. M., Mistry, P., Sjolie, A., Larsen, B., Witt, N., Hughes, A. D., Samira, H. H., Lahiry, S., Howlader, S. R., Parveen, S., Azad Khan, A. K., Clarke, P. M., Gray, A., Stevens, R., Holman, R., Phillips, L., Phillips, P. J., Chittleborough, C., Baldock, K., Taylor, A., North West Adelaide Health Study Team, Davis, W. A., Davis, T. M. E., Knuiman, M. W., Hendrie, D., Worthley, D., Nicolucci, A., Pellegrini, F., Berardis, G., Franciosi, M., Belfiglio, M., Rossi, M. C. E., Sacco, M., Valentini, M., Richardson, C. C., Jones, P., Persaud, S., Hussain, K., Clark, A., Christie, M. R., Gniuli, D., Hribal, M. L., Accili, D., Khan, M., Zervou, S., Cheung, L., Abouna, S., Ifandi, V., Pelengaris, S., Luco, R. F., Ferrer, J., Ma, D., Shield, J. P. H., Dean, W., Leclerc, I., Knauf, C., Burcelin, R., Kelsey, G., Powers, A. C., Shostak, A., Ferrara, N., Poffenberger, G., Jerome, W. G., Brissova, M., Geloneze, S. R., Tambascia, M. A., Pareja, J. C., Chaim, E., Silveira, H. V., Geloneze, B., Ravikumar, B., Carey, P. E., Snaar, J. E., Dheelchand, D., Cook, D. B., Neely, D., Taylor, G., Morris, P. G., Taylor, R., Stears, A. J., Masding, M. G., Wootton, S. A., Sandeman, D. D., Klimes, I., Wein, S., Gasperikova, D., Ukropec, J., Wiernsperger, N., Sebokova, E., Manco, M., Mingrone, G., Granato, L., Greco, A. V., Nanni, G., Castagneto, M., Vidal, H., Calvani, M., Ferrannini, E., Alvarsson, M., Sundkvist, G., Lager, I., Henricsson, M., Berntorp, K., Fernqvist-Forbes, E., Steen, L., Orn, T., Shutler, S., Bianchi-Biscay, M., Rosenstock, J., Sugimoto, D., Strange, P., Stewart, J., Soltes Rak, E., Dailey, G., Kloos, C., Muller, U., Samann, A., Femerling, M., Risse, A., Jecht, M., Haak, T., Garg, R., Lawrence, I. G., Akinsola, M. O., Davies, M. J., Mcnally, P. G., Garber, A. J., Kim, H., Draeger, E., Aydin, L., Sengul, A., Kurklu, A., Ucak, S., Basat, O., Seber, S., Altuntas, Y., Jin, J., Yu, Y., Yu, H., Zhang, X., Mattoo, V., Eckland, D., Widel, M., Duran, S., Fajardo, C., Strand, J., Knight, D., Oakley, D., Tan, M., Sato, A., Nagao, M., Aki, N., Nakagami, T., Iwamoto, Y., Zhou, Z., Li, X., Huang, G., Yan, X., Yang, L., Peng, J., Wang, J., Tan, S., Tang, W., Furnsinn, C., Brunmair, B., Wagner, L., Gras, F., Artwohl, M., Zierhut, B., Waldhausl, W., Shine, B. L., Hopkins, D., Anand, V., Lim, E., Raval, U., Sharp, P., Corder, R., Lipkin, D., Lahiri, A., Bartnik, M., Ryden, L., Ferrari, R., Malmberg, K., Pyorala, K., Simoons, M. L., Standl, E., Soler-Soler, J., Ohrvik, J., Euro Heart Survey Investigators, Bruce, D. G., Starkstein, S. E., Schauer, U. J. W., Astrup, A. S., Pietraszek, L., Nielsen, F. S., Rossing, P., Ali, S., Smidt, U. M., Yokoyama, H., Pavkov, M. E., Knowler, W. C., Bennett, P. H., Nelson, R. G., Lopez-Alba, A., Morcillo, L., Caballero, A., Montoya, L., Jimenez, A., Maceira, B., Lewis, J. B., Ravid, M., Wajman, A., Tadgell, C., Remuzzi, G., Hunsicker, L. G., Wessman, M., Taskinen, M-R, FinnDiane Study Group, Pugliese, G., Amadio, L., Menini, S., Oddi, G., Ricci, C., Iacobini, C., Pricci, F., Sorcini, M., Pesce, C., Migliaccio, E., Giorgio, M., Pelicci, P., Di Mario, U., Lassila, M., Jandeleit-Dahm, K., Seah, K. K., Calkin, A. C., Allen, T. J., Cooper, M. E., Lopes Faria, J. M., Cavakcanti, T. C., Silva, K. C., Ferrari, A. L., Lopes Faria, J. B., Cellek, S., Foxwell, N. A., Cotter, M. A., Cameron, N. E., Tennagels, N., Jordan, H., Stahl, P., Voss, M. D., Welte, S., Werner, U., Lehmann, R., Moeschel, K., Baumgartner, F., Oeckinghaus, A., Beck, A., Weigert, C., Hennige, A., Schleicher, E. D., Haring, H. U., Mussig, K., Staiger, H., Haring, H-U, Natalicchio, A., Laviola, L., Tullio, C., Renna, L., Giorgino, R., Giorgino, F., Falasca, M., Maffucci, T., Park, D., Kang, S., Song, J., Lee, D., Lee, Y., Hariharan, N., Kunselman, L., Gu, L., Sasseville, V., Harrity, T., Cheng, P. T. W., Pratley, R. E., Schweizer, A., Mills, D., Kim, T-H, Song, X-L, Poelje, P. D., Potter, S. C., Dang, Q., Fujitaki, J. M., Linemeyer, D. L., Landau, B. R., Erion, M. D., Pankop, M., Golay, A., Despres, J., Sjostrom, L., Lawlor, D. L., Legg, K. T., Ur, E., Houweling, S. T., Kleefstra, N., Meyboom-De Jong, B., Bilo, H. J. G., Schlomer, G. J., Meyer, G., Kasper, J., Muhlhauser, I., Young, B., Taylor, J., Friede, T., Hollis, S., Mason, J., Long, A., Gambling, T., Pauline, L., Burns, E., New, J., Gibson, M., Betteridge, D. J., Leiter, L. A., Audit, Investigators, Whitty, P. M., Eccles, M. P., Hawthorne, G., Grimshaw, J., Steen, I. N., Vanoli, A., Wood, L., Speed, C., Mcdowell, D., Rewers, M., Maahs, D., Wadwa, R., Eckel, R., Tracy, R., Pfutzner, A., Strotmann, H-J, Schulze, J., Hohberg, C., Pahler, S., Forst, T., Ambery, P. D., Sydall, H., Cooper, C., Dennison, E., Sayer, A. Aihie, Barker, D., Phillips, D., Lalic, N. M., Ostojic, M., Lalic, K., Zamaklar, M., Jotic, A., Ilic, M., Rajkovic, N., Lukic, L., Milicic, T., Verges, B., Zeller, M., Steg, P. G., Beer, J. C., Brisard, C., Brindisi, M. C., Dentan, G., Laurent, Y., Janin-Manificat, L., Makki, H., Ravisy, J., Cottin, Y., Ajjan, R. A., Grant, P. J., Futers, T. S., Brown, J. M., Carter, A. M., Rasmussen, M. S., Bruun, J. M., Pedersen, S. B., Richelsen, B., Dietze-Schroeder, D., Sell, H., Koenen, M., Eckel, J., Delporte, M-L L., Bauche, I. B., Brichard, S. M., Ait El Mkadem, S., Rezsohazy, R., Tsiotra, P. C., Tsigos, C., Gatsiou, C., Raptis, S. A., Walker, C. G., Bryson, J. M., Hancock, D. P., Caterson, I. D., Takahashi, N., Hatakeyama, H., Kasai, H., Gauthier, B. R., Iezzi, M., Fukuda, M., Duhamel, D. L., Ravier, M. A., Dufer, M., Neye, Y., Krippeit-Drews, P., Hennige, A. M., Sausbier, U., Arntz, C., Sausbier, M., Neuhuber, W., Ruth, P., Drews, G., Beauvois, M. C., Rolland, J-F, Jonas, J-C, Merezak, C., Henquin, J-C, Gilon, P., Jabin Gustafsson, A., Dzabic, M., Islam, M. S., Vaxillaire, M., Cheyssac, C., Dina, C., Vasseur-Delannoy, V., Lepretre, F., Siddiq, A., Froguel, P., Neve, B., Fernandez-Zapico, M. E., Ashkenazi-Katalan, V., Urrutia, R., Melloul, D., Froguel, R., Poulsen, P., Wojtaszewski, J., Richter, E., Vaag, A., Granhall, C., Renstrom, E., Luthman, H., Isomaa, B., Gloyn, A. L., Edghill, E. L., Pearson, E. R., Mackay, D. J. G., Temple, I. K., Noyes, K., Freedenberg, D., Gillespie, K. M., Lambert, A. P., Gale, E. A., Ellard, S., Hattersley, A. T., Fanelli, C. G., Porcellati, F., Rossetti, P., Busciantella, N. R., Billi, C., Burrin, D. G., Bolli, G. B., Bingham, E. M., Dunn, J., Sutcliffe-Goulden, J., Marsden, P., Amiel, S., Davis, R. E., Kennedy-Martin, T., Peters, J. R., Wittrup-Jensen, K. U., Mcewan, P., Morrissey, M., Currie, C. J., Akram, K., Pedersen-Bjergaard, U., Thorsteinsson, B., Pibernik-Okanovic, M., Peros, K., Begic, D., Szabo, S., Metelko, Z., Vlaiculescu, M. V., Calota, I., Busila, T., Bruckner, I., Giannakopoulou, D. F., Lindner, H. D., Hrachovinova, T., Fejfarova, V., Csemy, L., Malcomson, J., Campbell, M., Pandolfi, A., Giardinelli, A., Di Tomo, P., Di Silvestre, S., Di Fulvio, P., Capani, F., Consoli, A., Roesen, P., Patruno, A., Grilli, A., Capani, R., Felaco, M., Boner, G., Mccarroll, K., Brenner, B. M., Zeeuw, D., Kowey, P., Shahinfar, S., Crow, R. 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P., Majdrakova, I., Varbanova, T., Todorova, B., Bajo-Martinez, A., Bernal, E., Sanchez, O., Ugalde-Canitrot, A., Sanchez-Largo, E., Coca-Robinot, D., Fabregate, R., Calbacho, M., Marquez, J., Saban-Ruiz, J., Penesova, A., Cizmarova, E., Blazicek, P., Jongh, R. T., Serne, E. H., Ijzerman, R. G., Vries, G., Stehouwer, C. D. A., Poulsen, P. L., Andersen, N. H., Knudsen, S. T., Helleberg, K., Mogensen, C. E., Walus, M., Idzior-Walus, B., Sztefko, K., Cieslik, G., Fedak, D., Wozniakiewicz, E., Lin, S. D., Guo, M. Y., Lin, C. J., Liu, X. C., Francisco, M-M J., Rodriguez-Rosas, H., Peiro-Martinez, I., Macias-Batista, A., Harte, A. L., Rodriguez-Cuenca, S., Valsamakis, G., Chetty, R., Anderson, L. 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M., Sartore, G., Piarulli, F., Cantaro, S., Reitano, R., Fiore, C., Marin, R., Bassan, S., Manzato, E., Fedele, D., Solini, A., Santini, E., Thornalley, P. J., Babaei-Jadidi, R., Karachalias, N., Kupich, C., Ahmed, N., Fowler, A. E., Baker, A. R., Starczynski, J., O Hare, P., Szepietowska, B., Szelachowska, M., Puch, U., Glebocka, A., Quinn, D. W., Da Silva, N. F., Mcternan, C. L., Bonser, R. S., Mcternan, P., Dimitriou, K., Apostolou, O., Kontela, E., Devangelio, E., Gould, E. M., Serri, O., Roussin, A., Buithieu, J., Mamputu, J-C, Renier, G., Giordanetti, S., Amici, E., Poggi, G., Turpini, C., Fratino, P., Garzaniti, A., Yin, D., Banu, I., Roman, G., Negrean, M., Bala, C. G., Nita, C., Kistorp, C., Gustafsson, F., Chong, A., Lip, G., Galatius, S., Shearer, A. T., Ari, N., Sahilli, M., Ceylan-Isik, A., Ozansoy, G., Karasu-Yilmaz, C., Matteucci, E., Rosada, J., Pallini, M., Evangelista, I., Cassetti, G., Giusti, C., Giampietro, O., Capaldo, B., Galderisi, M., Cicala, S., Turco, A., Imbroinise, A., Nosso, G., D Errico, A., Divitiis, O., Klimontov, V. V., Korolyova, E. A., Jeltova, L. I., Bondar, I. A., Tarkun, I., Arslan, B., Canturk, Z., Tarkun, P., Agacdiken, A., Komsuoglu, B., Meneveau, N., Pierre-Justin, E., Alsayed, M., Sabbah, R., Paulin, S., Marcu, S., Tauveron, I., Zimmermann, C., Schiele, F., Seronde, M-E, Vautrin, P., Lusson, J-R, Thieblot, P., Bernard, Y., Mistry, A., Pye, M. P., Peovska, I., Maksimovic Pavlovic, J., Vavlukis, M., Pop Gorceva, D., Bosevski, M., Scognamiglio, R., Negut, C., Kreutzenberg, S., Madonna, R., Caterina, R., Willerson, J. T., Geng, Y-J, Vahsen, S., Ledwig, D., Ramrath, S., Frantz, S., Schmidt, I., Calvillo, L., Dienesch, C., Elbing, I., Bischoff, H., Ertl, G., Bauersachs, J., Davydov, A. L., Mkrtum Yan, A. M., Baranova, L. Y., Ikeda, Y., Suehiro, T., Osaki, F., Ota, K., Arii, K., Kumon, Y., Hashimoto, K., Doney, A. S. F., Fischer, B., Morris, A. D., Palmer, C. N. A., Ahn, Y-M, Lee, B-C, Kim, S-I, Byun, S-H, Ahn, S-Y, Doo, H-K, Pagnin, E., Calo, L. A., Fadini, G., Kubaszek, A., Chai, S., Chai, Q., Rasmussen, L., Ledet, T., Wogensen, L., Lengyel, C., Varro, A., Virag, L., Magyar, J., Biro, T., Jost, N., Skoumal, R., Nanasi, P., Toth, M., Horkay, F., Papp, J. G., Zacharopoulou, O., Athanaselis, S., Tsokos, N., Doupis, J., Psallas, M., Cokkinos, D., Pavlatos, S., Liatis, S., Akhobadze, T., Dzneladze, L., Samarguliani, I., Taskiran, M., Rasmussen, V., Rasmussen, B., Jensen, G. B., Fisher, A. A., Petrovsky, N., Davis, M. W., Srikusalanukul, W., Budge, M. M., Trifunovic-Zamaklar, D. D., Zivkovic, M., Jelic, V., Vukomanovic, G., Ristic, A. D., Seferovic, P. M., Costa, J. V., Duarte, S., Manley, S. E., Sailesh, S., Venkataraman, A., Haider, Y., Groza, I., Oprean, M., Ardelean, A., Morosanu, A., Darkow, T., Vanderplas, A., Mamas, M. A., Mcelduff, P., Burns, J., Edwards, R., Fitchet, A., Young, R. J., Gibson, J. M., New, J. P., Lichiardopol, R., Niculescu, N., Totora, A., Pencea, C., Tomescu, I., Cinteza, M., Manicardi, V., Coscelli, C., Navazio, A., Catellani, E., Michelini, M., Dall Asta, D., Guberti, A., Piazza, A., Gasparini, E., Pantaleoni, M., Guiducci, U., Manari, A., Sejil, S., Janand-Delenne, B., Avierinos, J-F, Habib, G., Labastie, N., Vague, P., Lassmann-Vague, V., Luzniak, P., Wojciechowska Luzniak, A., Zairis, M., Lyras, A., Patsourakos, N., Tsirimbis, V., Foussas, S., Lupon, J., Urrutia, A., Herreros, J., Gonzalez, B., Coll, R., Altimir, S., Prats, M., Valle, V., Abreu-Padi, C., Rabago, G., Ivanova, L. A., Brasacchio, D., Calkin, A., Jandeleit-Dahm, K. A., Harno, E., Keenan, A. K., Li, H. L., Yu, Y. R., Lu, Z. M., Zhang, X. E., Ke, L., Liu, H., Zhang, X. X., Jeong, I-K, Chae, M-K, Choi, M-H, Yoo, H-J, Kim, C. D., Yun, M. R., Na, M. A., Kang, Y. H., Kong, O. N., Son, S. M., Kim, I. J., Kim, Y. K., Tanaka, N., Hosoi, M., Matsuyama, Y., Fukumoto, M., Yamakita, T., Yoshioka, K., Ishii, T., Sato, T., Fujii, S., Aoki, T., Shibata, T., Mizutani, N., Suzuki, J-Y, Fowelin, J. H. R., Samuelsson, P., Brandrup-Wogsen, G., Okumura, K., Tokmakova, A. Y., Staroverova, D. N., Antcieferov, M. B., Shutichina, I. V., Kuntchevich, G. I., Vriesendorp, T. M., Morelis, Q. J., Legemate, D. A., Schaper, F., Mainas, E. I., Gkioulmpasanis, I., Panagiotou, I., Vassilikos, G., Skorda, L., Sidira, M., Christoforidou, M., Alaveras, A., Artikis, V., Evdemon, E., Lechleitner, M., Koch, T., Ebenbichler, C., Sturm, W., Moretti, L., Moruzzo, D., Boldrini, E., Pandolfo, C., Kameyama, M., Iwasa, R., Cho, M-H, Nam, J-Y, Kim, C-S, Kim, D-M, Ahn, C-W, Cha, B-S, Lim, S-K, Kim, K-R, Lee, H-C, Huh, K-B, Kaplar, M., Paragh, G., Erdei, A., Csongradi, E., Garai, I., Varga, J., Galuska, L., Udvardy, M., Higa, M., Kaneko, Y., Hiroi, N., Koziarska, D., Nowacki, P., Majkowska, L., Wojciechowska-Luzniak, A., Tushuizen, M. E., Nieuwland, R., Snoeck, D. P., Sturk, A., Diamant, M., Aguiar, L. G. K., Bahia, L., Villela, N., Laflor, C., Conde, C., Bottino, D., Dorigo, D., Bouskela, E., Pu, S., Yu, H. L., Luo, Z. T., Lam, K. S. L., Dan, Q., Xu, A., Shen, J., Cheng, K., Xu, J. Y. U., Thamer, C., Stefan, N., Haap, M., Heller, E., Tschritter, O., Prado, A., Ortiz, A., Ybarra, J., Gich, I., Pou, J. M., Ehren, M., Meyer, M. F., Roggenland, D., Reinsen, B., Klein, H. H., Rittig, K., Stock, J., Kocher, B., Balletshofer, B., Lee, J., Shon, H. S., Chung, D. S., Nakatani, Y., Matsuhisa, M., Kaneto, H., Hatazaki, M., Yoshiuchi, K., Katakami, N., Kawamori, D., Ohtoshi, K., Sakamoto, K., Matsuoka, T-A, Ozawa, K., Ogawa, S., Hori, M., Yamasaki, Y., Zitouni, K., Harry, D., Nourooz-Zadeh, J., Betteridge, J. D., Earle, K. A., Rasmussen, L. M., Olesen, P., Franco, L., Corvaja, C., Semplicini, A., Rosen, P., Lee, I-K, Kim, M-J, Park, K-G, Jung, E-D, Shin, D-W, Jo, S-R, Obuobie, K., Prakash, P. K., Hanna, F. W., Evans, M., Lazarus, J., Varadhan, L., Gurushankar, J., James, D., Sheikh, S., Gaede, P., Li, H., Zou, D., Lee, S. J., Choi, M. G., Kim, D. S., Kim, T. W., Vilarrasa, N., Perez-Maraver, M., Mena, E., Perez, D., Setti, G., Buckingham, R., Urbancic, V., Stefanovska, A., Bernjak, A., Azman-Juvan, K., Kocijancic, A., Glowania, A., Filters, T. S., Fosmark, D. S., Torjesen, P. A., Kilhovd, B., Berg, T. J., Sandvik, L., Hanssen, K. F., Mentink, C. J. A., Kilhovd, B. K., Kuchmerovska, T. M., Shymanskyy, I. O., Donchenko, G. V., Stepanenko, S. P., Klimenko, A. P., Park, J., Maingrette, F., Deng, H. C., Lindenmair, A., Waldhausl, W. K., Freudenthaler, A., Baumgartner-Parzer, S. M., Nizheradze, K., Khoruzhenko, A., Tronko, N., Sheu, W. H. H., Ou, H-C, Shen, H-M, Lin, T-M, Wu, H-S, Yang, C-H, Mogylnytska, L., Mankovsky, B., Schmoelzer, I., Davies, J. I., Band, M., Morris, A., Struthers, A. D., Prazny, M., Skrha, J., Kasalova, Z., Neelotpol, S., Jahan, P., Kauschke, S. G., Harrop, C. A., Schafer, A., Widder, J., Eigenthaler, M., Walter, U., Uchimura, I., Ikebukuro, M., Kaibara, M., Hirata, M., Helal, R., Pervin, F., Khan, A. K. A., Yang, X., Jansson, P-A, Nagaev, I., Jack, M. M., Carvalho, E., Sunnerhagen, K. Stibrant, Cam, M. C., Cushman, S. W., Smith, U., Creely, S. J., Farmer, J., Creely, S., Gustafson, B., Kusminski, C. M., Krusinova, E., Wohl, P., Klementova, M., Lanska, V., Mcdougall, C., Thomas, S. J., Kelly, I., Abbas, Z. G., Lutale, J. K., Archibald, L. K., Karunajeewa, H., Stingemore, N., Stuccio, G., Mcgechie, D., Muller, L. M. A., Hak, E., Goudzwaard, W. L., Montorsi, F., Homering, M., Sprenger, K., Goldstein, I., Asnaghi, V., Ferrari, G., Rastaldi, M., Gabellini, D., Antonio, G., Maestroni, A., Ruggieri, D., Luzi, L., Piemonti, L., Zerbini, G., Anafaroglu, I., Tutuncu, N. B., Sultana, M., Siddiqua, N., Iwasaki, T., Nakajima, A., Yoneda, M., Mukasa, K., Tanaka, S., and Sekihara, H.
38. Reducing the burden of hypoglycaemia in people with diabetes through increased understanding: design of the Hypoglycaemia REdefining SOLutions for better liVEs (Hypo-RESOLVE) project.
- Author
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de Galan BE, McCrimmon RJ, Ibberson M, Heller SR, Choudhary P, Pouwer F, Speight J, Carlton J, Pieber TR, Rosilio M, Tack CJ, and Müllenborn M
- Subjects
- Cost of Illness, Databases, Factual, Health Care Costs, Humans, Hypoglycemia chemically induced, Hypoglycemia economics, Hypoglycemia physiopathology, Mortality, Risk Factors, Diabetes Mellitus drug therapy, Hypoglycemia psychology, Hypoglycemic Agents adverse effects, Insulin adverse effects
- Abstract
Background: Hypoglycaemia is the most frequent complication of treatment with insulin or insulin secretagogues in people with diabetes. Severe hypoglycaemia, i.e. an event requiring external help because of cognitive dysfunction, is associated with a higher risk of adverse cardiovascular outcomes and all-cause mortality, but underlying mechanism(s) are poorly understood. There is also a gap in the understanding of the clinical, psychological and health economic impact of 'non-severe' hypoglycaemia and the glucose level below which hypoglycaemia causes harm., Aim: To increase understanding of hypoglycaemia by addressing the above issues over a 4-year period., Methods: Hypo-RESOLVE is structured across eight work packages, each with a distinct focus. We will construct a large, sustainable database including hypoglycaemia data from >100 clinical trials to examine predictors of hypoglycaemia and establish glucose threshold(s) below which hypoglycaemia constitutes a risk for adverse biomedical and psychological outcomes, and increases healthcare costs. We will also investigate the mechanism(s) underlying the antecedents and consequences of hypoglycaemia, the significance of glucose sensor-detected hypoglycaemia, the impact of hypoglycaemia in families, and the costs of hypoglycaemia for healthcare systems., Results: The outcomes of Hypo-RESOLVE will inform evidence-based definitions regarding the classification of hypoglycaemia in diabetes for use in daily clinical practice, future clinical trials and as a benchmark for comparing glucose-lowering interventions and strategies across trials. Stakeholders will be engaged to achieve broadly adopted agreement., Conclusion: Hypo-RESOLVE will advance our understanding and refine the classification of hypoglycaemia, with the ultimate aim being to alleviate the burden and consequences of hypoglycaemia in people with diabetes., (© 2020 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.)
- Published
- 2020
- Full Text
- View/download PDF
39. A cost-controlling treatment strategy of adding liraglutide to insulin in type 2 diabetes.
- Author
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de Wit HM, Vervoort GMM, de Galan BE, and Tack CJ
- Subjects
- Aged, Blood Glucose analysis, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 drug therapy, Drug Therapy, Combination economics, Female, Glycated Hemoglobin analysis, Humans, Hypoglycemic Agents administration & dosage, Insulin administration & dosage, Liraglutide administration & dosage, Male, Middle Aged, Treatment Outcome, Weight Loss drug effects, Diabetes Mellitus, Type 2 economics, Health Care Costs, Hypoglycemic Agents economics, Insulin economics, Liraglutide economics
- Abstract
Background: Addition of the GLP-1 receptor agonist liraglutide to insulin can reverse insulin-associated weight gain, improve HbA1c and decrease the need for insulin, but is expensive. From a cost perspective, such treatment should be discontinued when it is clear that treatment targets will not be achieved. Our aim was to find the best cost-controlling treatment strategy: the shortest possible trial period needed to discriminate successfully treated patients from those failing to achieve predefined targets of treatment success., Methods: We used data from the 'Effect of Liraglutide on insulin-associated wEight GAiN in patients with Type 2 diabetes' (ELEGANT) trial, comparing additional liraglutide (n = 47) and standard insulin therapy (n = 24) during 26 weeks, to calculate the costs associated with different trial periods. Treatment success after 26 weeks was defined by having achieved ≥ 2 of the following: ≥ 4% weight loss, HbA1c ≤ 53 mmol/mol (7%), and/or discontinuation of insulin., Results: The additional direct costs of adding liraglutide for 26 weeks were € 699 per patient, or € 137 per 1 kg weight loss, compared with standard therapy. The best cost-controlling treatment strategy (identifying 21 of 23 responders, treating four non-responders) was to continue treatment in patients showing ≥ 3% weight loss or ≥ 60% decrease in insulin dose at 8 weeks, with a total cost of € 246 for this t rial period, saving € 453 in case of early discontinuation., Conclusion: An 8-week trial period of adding liraglutide to insulin in patients with insulin-associated weight gain is an effective cost-controlling treatment strategy if the liraglutide is discontinued in patients not showing an early response regarding weight loss or insulin reduction.
- Published
- 2017
40. A comparison of the pharmacodynamic profiles of jet-injected regular human insulin versus conventionally administered insulin aspart in healthy volunteers.
- Author
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Engwerda EEC, Tack CJ, and de Galan BE
- Subjects
- Adolescent, Adult, Blood Glucose drug effects, Cross-Over Studies, Diabetes Mellitus blood, Dose-Response Relationship, Drug, Double-Blind Method, Female, Glucose Clamp Technique, Healthy Volunteers, Humans, Hypoglycemic Agents administration & dosage, Hypoglycemic Agents pharmacokinetics, Injections, Jet, Injections, Subcutaneous, Insulin Aspart administration & dosage, Insulin, Regular, Human administration & dosage, Male, Young Adult, Blood Glucose metabolism, Diabetes Mellitus drug therapy, Insulin Aspart pharmacokinetics, Insulin, Regular, Human pharmacokinetics
- Abstract
Aims: Rapid-acting insulin analogues are generally preferred over regular human insulin because of their more immediate onset of action and shorter time-action profile. However, these analogues may not always be tolerated by or universally available for people with insulin-requiring diabetes. Jet injection has been demonstrated to facilitate faster insulin absorption. We determined whether administration of regular human insulin by jet injection achieves the same pharmacological properties as that of a rapid-acting insulin analogue., Methods: Twenty healthy volunteers received regular human insulin (0.2units/kg) by jet injection. Glucose 20% was infused intravenously to maintain euglycaemia over six hours. The glucose infusion rates (GIR) were determined to compare pharmacological profiles. These profiles were compared with data from two other studies in which a similar dose of insulin aspart was administered by conventional pen., Results: Regular human insulin by jet injection had a faster onset of glucose-lowering effect compared to aspart by conventional pen (T-GIR
50% , 30.8±2.9 versus 43.1±3.2min, P<0.01). There were no differences in time to maximal GIR (106.1±11.9 versus 95.8±9.2min, P=0.50), maximal GIR (8.6±0.7 versus 7.7±0.7mg/kg/min, P=0.0.33), total glucose-lowering effect (101.0±9.8 versus 87.6±7.0g, P=0.28), and time until 50% of glucose disposal (144.8±5.6 versus 151.3±5.1min, P=0.39)., Conclusions: Jet-injected regular human insulin had a pharmacological profile that was essentially not dissimilar from that of aspart insulin administered by conventional pen, and can therefore be used as an alternative for conventionally administered rapid-acting insulin analogues., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)- Published
- 2016
- Full Text
- View/download PDF
41. Diabetes in patients with HIV: patient characteristics, management and screening.
- Author
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Roerink ME, Meijering R, Bosch M, de Galan BE, and van Crevel R
- Subjects
- Adult, Age Factors, Blood Glucose metabolism, Diabetes Mellitus, Type 1 diagnosis, Diabetes Mellitus, Type 1 drug therapy, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 drug therapy, Dyslipidemias complications, Dyslipidemias drug therapy, Female, Glycated Hemoglobin metabolism, Humans, Hypertension complications, Hypertension drug therapy, Male, Mass Screening methods, Mass Screening statistics & numerical data, Middle Aged, Netherlands, Retrospective Studies, Diabetes Mellitus, Type 1 complications, Diabetes Mellitus, Type 2 complications, HIV Infections complications, Hypoglycemic Agents therapeutic use
- Abstract
Background: As HIV management has become more successful during the past years, non-communicable diseases have become more prevalent among HIV-infected individuals. As a result, more HIV-infected patients die of cardiovascular diseases, with diabetes being one of the main risk factors. This study evaluates screening and management of diabetes among HIV-infected patients in a university hospital in the Netherlands., Methods: We examined clinical characteristics, glycaemic control and cardiovascular risk management of HIV-infected patients with coexisting diabetes, and determined the frequency of diabetes screening in those without., Results: Of 518 HIV-infected patients, 28 had been diagnosed with diabetes (5.4%), mostly (20÷28) after being diagnosed with HIV. Patients with coexisting diabetes were older, had a longer duration of HIV, lower CD4 cell counts and higher body mass index (BMI), and were more likely to use aspirin, statins and antihypertensive medication than those without diabetes (all p < 0.05). HbA1c values were below 7% (53 mmol÷mol) in 54% of patients. Targets for systolic blood pressure (< 140 mmHg), LDL cholesterol (< 2.5 mmol÷l) and BMI (< 25 kg÷m2) were achieved by 82%, 50% and 29% of patients, respectively. Annual ophthalmology examination, screening for microalbuminuria and foot control were rarely performed. Among the patients without known diabetes, diabetes screening during the past year had been performed using (non-fasting) plasma glucose in 56% and HbA1c in 10%, but 42% of patients had not been screened., Conclusion: For HIV-infected individuals with diabetes, glycaemic control and cardiovascular risk management were reasonable, but screening for microvascular complications was rarely performed. Annual diabetes screening of HIV-infected patients was not routine.
- Published
- 2015
42. Efficacy and safety of inhaled insulin in the treatment of diabetes mellitus.
- Author
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de Galan BE, Simsek S, Tack CJ, and Heine RJ
- Subjects
- Administration, Inhalation, Humans, Hypoglycemia chemically induced, Insulin adverse effects, Insulin pharmacokinetics, Risk Assessment, Risk Factors, Diabetes Mellitus drug therapy, Insulin administration & dosage
- Abstract
Many patients with diabetes mellitus view subcutaneous injections of insulin as a daily burden. Pulmonary delivery of insulin offers an alternative route of administration and may as such improve diabetes treatment. Inhaled insulin provides a rapid absorption of insulin, but with low bioavailability. Phase III clinical trials in type 1 and type 2 diabetes have disclosed clinical equivalence between three inhaled insulin products (Exubera, AErx idMs, and hIIp) and regular human insulin, both in terms of glycaemic control and hypoglycaemic risk. Inhaled insulin cannot be used to replace basal insulin requirements. The most commonly reported adverse effects of inhaled insulin are cough and insulin antibody formation, the clinical significance of which is uncertain. No or minimal deterioration in pulmonary function parameters have been recorded, although studies were typically of short duration. Patients participating in inhaled insulin trials generally expressed satisfaction with the product and chose to remain on it. The availability of inhaled insulin may increase willingness in type 2 diabetic patients to consider insulin therapy. More studies of longer duration are required to determine (pulmonary) safety and cost-effectiveness of inhaled insulin, and to disclose which patients may benefit the most.
- Published
- 2006
43. Pathophysiology and management of recurrent hypoglycaemia and hypoglycaemia unawareness in diabetes.
- Author
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de Galan BE, Schouwenberg BJ, Tack CJ, and Smits P
- Subjects
- Adult, Blood Glucose Self-Monitoring, Diabetes Mellitus, Type 1 blood, Dose-Response Relationship, Drug, Female, Humans, Hypoglycemia epidemiology, Hypoglycemic Agents therapeutic use, Incidence, Insulin therapeutic use, Risk Factors, Blood Glucose metabolism, Diabetes Mellitus, Type 1 drug therapy, Hypoglycemia etiology, Hypoglycemia prevention & control, Hypoglycemic Agents administration & dosage, Insulin administration & dosage
- Abstract
Iatrogenic hypoglycaemia is a well-known complication of insulin therapy in patients with diabetes mellitus and a limiting factor for glycaemic control. In a setting of endogenous insulin deficiency (type 1 and advanced type 2 diabetes), one episode of hypoglycaemia reduces both counterregulatory hormone responses to and subjective awareness of subsequent hypoglycaemia, thus impairing physiological defences against hypoglycaemia. This phenomenon may lead to a vicious cycle of recurrent hypoglycaemia and glucose counterregulatory failure, of which hypoglycaemia unawareness (i.e. the inability to perceive symptoms of hypoglycaemia) is the clinical representative. The underlying mechanism of hypoglycaemia-induced counterregulatory failure has not yet been disclosed. Patients with clinical hypoglycaemia unawareness are at high risk of severe hypoglycaemia that requires third-party assistance. Management options include avoidance of hypoglycaemic events and optimisation of insulin therapy to limit deterioration of glycaemic control associated with hypoglycaemia avoidance. Several counterregulatory-stimulating agents have been found to improve hypoglycaemic awareness in small clinical trials, but none have been tested in sufficiently large randomised studies to justify their use in daily practice. More research is required to elucidate the pathogenesis of counterregulatory failure and to develop adequate treatment strategies.
- Published
- 2006
44. [Treatment of patients with diabetes mellitus by means of inhaled insulin].
- Author
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Simsek S, de Galan BE, Tack CJ, and Heine RJ
- Subjects
- Administration, Inhalation, Clinical Trials, Phase III as Topic, Cost-Benefit Analysis, Diabetes Mellitus, Type 2 economics, Humans, Hypoglycemic Agents adverse effects, Hypoglycemic Agents economics, Insulin adverse effects, Insulin economics, Safety, Treatment Outcome, Diabetes Mellitus, Type 2 drug therapy, Hypoglycemic Agents administration & dosage, Insulin administration & dosage
- Abstract
Good glycaemic control of diabetes mellitus is still hampered by the fear of insulin injections. Particularly in patients with type 2 diabetes, inhaled insulin as a novel therapeutic option for glycaemic control could be an alternative to subcutaneous insulin. Phase III clinical studies have shown glycaemic equivalence between inhaled insulin and conventional subcutaneous insulin. However, no study comparing inhaled insulin with short-acting insulin analogues has yet been published. Thus, methodological problems preclude conclusive remarks concerning quality-of-life issues. Inhaled insulin should be reserved for selected patient groups only. Lengthier studies to evaluate the long-term (pulmonary) safety of inhaled insulin and a cost-effectiveness study are needed.
- Published
- 2006
45. Insulin pump therapy, should we consider it more often?
- Author
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de Galan BE
- Subjects
- Blood Glucose analysis, Humans, Infusion Pumps, Implantable, Quality of Life, Diabetes Mellitus drug therapy, Insulin Infusion Systems statistics & numerical data
- Abstract
Erratic blood glucose control, hypoglycaemia unawareness and optimisation of glycaemic control during pregnancy are widely recognised indications for commencing diabetic patients on continuous subcutaneous insulin infusion (CSII) using an insulin pump. In patients without such a specific condition, the benefit of CSII over other forms of intensified treatment on glycaemic control and hypoglycaemic rate is generally viewed as too modest to warrant a change of regimen. However, the impact of the treatment regimen on psychosocial parameters is often undervalued, at least in randomised trials. This is unfortunate as quality of life and treatment satisfaction probably determine the patient's preferences more than metabolic parameters. To truly appreciate all potential benefits of either strategy (CSII or injection therapy), these data are urgently required. In the meantime, doctors should keep an open eye for the specific needs of the individual patient to find the best treatment available for that person.
- Published
- 2004
46. Hypothesis: Normalisation of cytokine dysbalance explains the favourable effects of strict glucose regulation in the critically ill.
- Author
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Pickkers P, Hoedemaekers A, Netea MG, de Galan BE, Smits P, van der Hoeven JG, and van Deuren M
- Subjects
- Cytokines physiology, Glucose physiology, Humans, Insulin physiology, Blood Coagulation physiology, Blood Glucose metabolism, Critical Illness, Cytokines metabolism, Heart physiopathology, Hyperglycemia physiopathology
- Abstract
Recent trials investigating the effects of strict glucose regulation in critically ill patients have shown impressive reductions in morbidity and mortality. Although the literature focuses on the possible toxic effects of high blood glucose levels, the underlying mechanism for this improvement is unclear. We hypothesise that strict glucose regulation results in modulation of cytokine production, leading to a shift towards a more anti-inflammatory pattern. This shift in the cytokine balance accounts for the reduction in morbidity and mortality. To support our hypothesis, effects of glucose and insulin on cytokine release and effects of glucose, insulin, and cytokines on host defence, cardiac function and coagulation will be reviewed.
- Published
- 2004
47. Hypoglycaemia downregulates endotoxin-induced production of tumour necrosis factor-alpha, but does not affect IL-1beta, IL-6, or IL-10.
- Author
-
de Galan BE, Netea MG, Smits P, and van der Meer JW
- Subjects
- Adult, Cells, Cultured, Dose-Response Relationship, Drug, Down-Regulation drug effects, Female, Humans, Hypoglycemia blood, Insulin blood, Interleukin-10 blood, Interleukin-6 blood, Lipopolysaccharides pharmacology, Male, Middle Aged, Hypoglycemia metabolism, Interleukin-1 metabolism, Interleukin-10 metabolism, Interleukin-6 metabolism, Tumor Necrosis Factor-alpha metabolism
- Abstract
The aim of the present study was to investigate the effect of hypoglycaemia on the production capacity of the proinflammatory cytokines tumour necrosis factor-alpha (TNFalpha) and interleukin-1beta (IL-1beta) in subjects with and without diabetes. Hyperinsulinaemic (360 pmolm(-2) x min(-1)) stepped hypoglycaemic (5.0-3.5-2.5 mmoll(-1)) glucose clamps were performed in eight diabetic patients and in six non-diabetic subjects, and hyperinsulinaemic normoglycaemia (5.0 mmoll(-1)) control experiments were performed in four non-diabetic subjects. Circulating levels of cytokines and endotoxin-induced production of TNFalpha, IL-1beta, IL-6, and IL-10 were assessed. The effects of insulin and adrenaline were measured in separate in vitro experiments. In non-diabetic subjects, hypoglycaemia downregulated the production capacity of TNFalpha in a concentration-dependent fashion (P=0.007), but not of IL-1beta, IL-6, or IL-10. Compared to controls, the production capacity of TNFalpha in diabetic patients was already suppressed at normoglycaemia (P=0.02) and only fell in response to hypoglycaemic nadir (P=0.04). The downregulation of TNFalpha could not be explained by increased insulin or adrenaline levels. We conclude that hypoglycaemia specifically downregulates TNFalpha production capacity. Diabetic patients already have a suppressed TNFalpha production capacity at non-hypoglycaemic levels.
- Published
- 2003
- Full Text
- View/download PDF
48. Hospital-related outbreak of infection with multidrug-resistant Streptococcus pneumoniae in the Netherlands.
- Author
-
de Galan BE, van Tilburg PM, Sluijter M, Mol SJ, de Groot R, Hermans PW, and Jansz AR
- Subjects
- Aged, Carrier State epidemiology, Cross Infection microbiology, Female, Hospitals, Teaching, Humans, Lung Diseases, Obstructive complications, Lung Diseases, Obstructive microbiology, Male, Microbial Sensitivity Tests statistics & numerical data, Middle Aged, Netherlands epidemiology, Pneumococcal Infections microbiology, Sputum microbiology, Streptococcus pneumoniae isolation & purification, Cross Infection epidemiology, Disease Outbreaks statistics & numerical data, Drug Resistance, Microbial, Drug Resistance, Multiple, Pneumococcal Infections epidemiology, Streptococcus pneumoniae drug effects
- Abstract
Multidrug-resistant strains of Streptococcus pneumoniae were isolated over a two-year period (July 1995 until August 1997) from the sputum of 36 patients who were hospitalized in a Dutch medical centre. Nosocomial transmission was confirmed by typing of the bacterial isolates: all 36 multidrug-resistant isolates shared the same genotype, serotype, and displayed overlapping drug resistance profiles. Thirty-two of the 36 (89%) patients had chronic obstructive pulmonary disease (COPD). The outbreak was initiated by a 76-year old patient, who had been colonized with the same strain since 1993. Because staff screening of the hospital and pulmonary function department was negative, patient-to-patient spread was the most likely cause of this outbreak. The epidemic ceased following the commencement of barrier nursing, a treatment course of ceftriaxone, and a five-day rifampicin eradication therapy for the positive patients. The outbreak resulted from failure to recognize quickly the rapid transmission of this multidrug-resistant pneumococcal clone. We conclude that patients with COPD are at high risk of acquiring multidrug resistant pneumococci, and suggest that COPD patients who are colonized or infected with multidrug-resistant pneumococci should be isolated to prevent future transmission.
- Published
- 1999
- Full Text
- View/download PDF
49. Extremely elevated body temperature: case report and review of classical heat stroke.
- Author
-
de Galan BE and Hoekstra JB
- Subjects
- Acute Kidney Injury etiology, Aged, Cytokines immunology, Fatal Outcome, Humans, Male, Rhabdomyolysis etiology, Heat Stroke complications, Heat Stroke diagnosis, Heat Stroke immunology, Heat Stroke therapy
- Abstract
Classical heat stroke is a rare disease in moderate climates. We report a patient who demonstrated the classical triad of elevated body temperature, neurological disturbances, and anhidrosis. He developed rhabdomyolysis and acute renal failure. Eventually he died. Since manifestations of classical heat stroke appear to mimic an acute phase response, cytokines are thought to play an important role in its pathogenesis.
- Published
- 1995
- Full Text
- View/download PDF
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