Littérature scientifique sur le sujet « Insulina basale »
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Articles de revues sur le sujet "Insulina basale"
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Valenzano, M. « Insulin : 100 years but not over the hill ! A treatment with potential for renewal ». Journal of AMD 25, no 2 (juillet 2022) : 97. http://dx.doi.org/10.36171/jamd22.25.2.
Texte intégralRésumé :
L’insulina è ancora un trattamento fondamentale per molti pazienti con diabete. A un secolo dalla sua scoperta, nuovi analoghi sono in procinto di essere disponibili così da potenziare ulteriormente la farmacocinetica e la farmacodinamica della molecola, sia in termini di effetto sostenuto (per l’insulina basale settimanale) che di velocità d’azione (per gli analoghi ultrarapidi). Inoltre, penne intelligenti e nuovi dispositivi agevoleranno la somministrazione di insulina, fornendo anche supporto digitale per il calcolo della dose, il monitoraggio e l’analisi delle iniezioni e, si spera, saranno utili per l’economia e l’ecosistema del pianeta. Infine, la ricerca futura è orientata allo sviluppo dell’insulina orale e dell’insulina intelligente e glucosensibile. La storia dell’insulina è tuttora in fieri e riserverà ancora molte novità. PAROLE CHIAVE insulina; insulina basale settimanale; insulina ultrarapida; penna intelligente; insulina intelligente.
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Monda, V. M. « Association of GLP-1 RA once weekly and basal insulin : a valid therapeutic option from the complications of SARS-CoV-2 infection too ? » Journal of AMD 24, no 4 (février 2022) : 295. http://dx.doi.org/10.36171/jamd21.24.4.5.
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Gli agonisti recettoriali del glucagon like peptide-1 (GLP1-RAs) sono un gruppo di farmaci antidiabetici con una rilevante azione sul controllo glicemico, basata sull’aumento della secrezione di insulina glucosio-dipendente con concomitante riduzione della secrezione di glucagone e ritardato svuotamento gastrico. I GLP1-RA hanno inoltre attività pleiotropiche come proprietà antinfiammatorie, antitrombotiche e antiobesogeniche, con evidenti benefici su eventi cardiovascolari maggiori, mortalità cardiovascolare e danno renale. Tutto ciò rende questa classe di farmaci un elemento chiave nella gestione dei pazienti con diabete tipo 2 e potenzialmente utile nei soggetti con COVID-19 (2019nCoV – Coronavirus disease 2019, COVID-19). Per le proprietà antinfiammatorie è stato ipotizzato che le terapie a base di incretino-mimetici esercitino effetti benefici sugli esiti di COVID-19. Qui riportiamo un caso di una donna di 82 anni con diabete tipo 2 scarsamente controllato, che utilizzava un regime insulinico basal-bolus più metformina. Il miglioramento del controllo glicemico ottenuto passando dal trattamento con insulina basale al GLP-1RA aggiunto al regime insulinico basale, con la sospensione dell’insulina prandiale (trattamento di de-escalation) in questo caso è risultato associato agli effetti benefici sugli esiti di COVID-19. PAROLE CHIAVE GLP1-RAs; DMT2; SARS-CoV-2; COVID-19.
3
Giorgino, Francesco, Sergio Di Molfetta et Irene Caruso. « Gestione iniziale della terapia con insulina basale nel paziente diabetico ». L'Endocrinologo 21, no 5 (octobre 2020) : 370–72. http://dx.doi.org/10.1007/s40619-020-00780-6.
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Jermendy, György. « Intensive conservative insulin treatment in patients with type 2 diabetes mellitus ». Orvosi Hetilap 153, no 38 (septembre 2012) : 1487–93. http://dx.doi.org/10.1556/oh.2012.29451.
Texte intégralRésumé :
In the last couple of years, the intensive conservative insulin treatment (basal-bolus regime) became more and more popular even in patients with type 2 diabetes. Using this insulin treatment, continuous patient education, co-operation between the medical team (diabetologist, dietician and diabetes-nurses) and the patient as well as the availability of modern insulins, pens and glucometers are of great importance. Clearly, the basal-bolus treatment with human insulin has advantages over the conservative (conventional) treatment with twice daily premix insulins. Moreover, the basal-bolus treatment with insulin-analogues proved to be superior in some aspects as compared to human insulins. The intensive insulin treatment (basal-bolus regime with insulin-analogues) approaches the optimal insulin substitution and, with its use the adequate correction of each element of the glucose triad (fasting blood glucose, postprandial blood glucose, HbA1c) should be considered feasible even in patients with type 2 diabetes. Orv. Hetil., 2012, 153, 1487–1493.
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Goldman, Jennifer, et John R. White. « Advances in Basal Insulin Therapy ». Journal of Pharmacy Technology 32, no 6 (22 septembre 2016) : 260–68. http://dx.doi.org/10.1177/8755122516667128.
Texte intégralRésumé :
Objective: To review 2 new basal insulin analogs that have been approved in the United States for use in type 1 and type 2 diabetes—insulin glargine 300 units/mL and insulin degludec 100 units/mL and 200 units/mL. Data Sources: PubMed was searched using the terms “insulin glargine 300 units/mL,” “Gla-300,” “insulin degludec,” “IDeg,” “insulin degludec 200 units/mL,” and “insulin degludec 100 units/mL” for articles published between 1995 and May 2016. Study Selection and Data Extraction: Clinical trials, meta-analyses and subanalyses were identified; review articles were excluded. Relevant citations from identified articles were also reviewed. Data Synthesis: The new basal insulins, insulin glargine 300 units/mL and insulin degludec 100 units/mL and 200 units/mL, have improved pharmacokinetic and pharmacodynamic profiles compared to insulin glargine 100 units/mL. All demonstrate longer durations of action, beyond 24 hours, and less variability. These improved profiles translate into comparable A1C reductions and comparable, or improved, levels of hypoglycemia compared to insulin glargine 100 units/mL. Conclusions: These benefits may lead to improved glycemic control in a range of patients with type 1 and type 2 diabetes with true once-daily dosing.
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Demidova, Tatiana Y., et Olga V. Balutina. « Special aspects of concentrated insulins : basic characteristics and research findings ». Diabetes mellitus 22, no 5 (17 janvier 2020) : 481–90. http://dx.doi.org/10.14341/dm10334.
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The appearance of concentrated insulins in clinical practice determines the need to analyze product priorities in appropriate groups of patients with diabetes. The aim of this article is to summarize the literature on concentrated insulins (i.e. insulin lispro 200 units/mL, insulin degludec 200 units/mL, insulin glargine 300 units/mL) from randomized controlled trials, derive guidance on appropriate and safe use of these agents and demonstrate experience in real clinical practice. Severe hypoglycemia in all studies was generally low (though higher with prandial plus concentrated basal analogue therapy), and statistical improvements in other hypoglycemia categories were observed for concentrated basal insulins versus insulin glargine 100 units/mL. In all analyzed data hypoglycemic effect of insulin glargine 300 units/mL was equitable to insulin glargine 100 units/mL. Other important findings demonstrate more constant and prolonged insulin action with low within-subject/ between-day variability for insulin glargine 300 units/mL versus insulin glargine 100 units/mL, therefore, more physiological treatment might prevent from diabetic microvascular complications. The results of randomized trials are comparable with our clinical practice experience and indicate efficacious and safe glucose-lowering properties without risk of severe hypoglycemia.
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Inman, Taylor R., Erika Plyushko, Nicholas P. Austin et Jeremy L. Johnson. « The role of basal insulin and GLP-1 receptor agonist combination products in the management of type 2 diabetes ». Therapeutic Advances in Endocrinology and Metabolism 9, no 5 (23 avril 2018) : 151–55. http://dx.doi.org/10.1177/2042018818763698.
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The prevalence of type 2 diabetes necessitates the development of new treatment options to individualize therapy. Basal insulin has been a standard treatment option for years, while glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have grown in use over the past decade due to glucose-lowering efficacy and weight loss potential. There are two new combination injectable products that have recently been approved combining basal insulins with GLP-1 RAs in single pen-injector devices. United States guidelines recently emphasize the option to use combination injectable therapy with GLP-1 RAs and basal insulin once the basal insulin has been optimally titrated as a second- or third-line agent in addition to metformin without reaching the goal A1c. Insulin glargine/lixisenatide 100/33 (IGlarLixi) can be dosed between 15 and 60 units once daily from a single pen-injector device. Insulin degludec/liraglutide 100/3.6 (IDegLira) can be dosed between 10 and 50 units once daily, also from a single pen-injector device. Maximum doses, while measured in units, correspond to limits defined by each individual GLP-1 RA. The dual use of basal insulin plus GLP-1 RA is non-inferior compared with basal insulin plus a single injection of prandial insulin at the largest meal and compared with twice daily-dosed premixed insulins; and this combination is associated with weight loss and less hypoglycemia. These new combination products could help providers effectively and efficiently follow clinical practice guidelines while enhancing patient adherence with injectable medications.
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Dzhavakhishvili, T. S., T. I. Romantsova et O. V. Roik. « Influence of the dynamics of body weight on the risk factors of cardiovascular disease in patients with type 2 diabetes during the first year of insulin treatment ». Obesity and metabolism 10, no 1 (15 mars 2013) : 22–25. http://dx.doi.org/10.14341/2071-8713-5067.
Texte intégralRésumé :
The aim of the present study was to investigate whether insulin treatment-induced weight gain had an adverse impact on cardiovascular risk factors in insulin-treated type 2 diabetic patients during the first year after initiating insulin therapy when insulin analogues or human insulins are used. A total of 157 patients with newly insulinized type 2 diabetes were included in the study. The patients were divided in two groups. First group consisted of subjects (mean age 57 [45; 73], duration of diabetes of 10 years [4; 16]) who had received long-acting basal (glargine, detemir), premixed (biphasic insulin aspart 30, Humalog Mix 25) or short-acting (aspart, lispro) insulin analogues. Patients from second group (mean age 59 [46; 75], duration of diabetes of 10 years [5; 15]) were treated with intermediate-acting basal (Protophane, Humulin NPH insulin), premixed (biphasic human insulin 30, Humulin M3) and regular (Actrapid, Humulin R) human insulins. Our study has shown that insulin-induced weight gain may not adversely affect cardiovascular risk factors, particularly, lipid profile, in insulin-treated type 2 diabetic patients during the first year after initiating insulin therapy. Use of insulin analogues for treatment of type 2 diabetes patients results in better glycaemic control, significant declines in blood lipid concentrations, less increase in waist circumference compared with human insulins during the first year after initiating insulin therapy.
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Liebl, Andreas. « Praktische Umsetzung einer Insulintherapie bei Typ-2-Diabetes ». Diabetes aktuell 19, no 05 (septembre 2021) : 204–12. http://dx.doi.org/10.1055/a-1576-9316.
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ZUSAMMENFASSUNGIn Deutschland sind eine Vielzahl basaler und prandialer Insuline auf dem Markt, die sich erheblich in ihrer Pharmakokinetik und in ihrem Einsatzbereich unterscheiden. Der Start einer Insulintherapie bei Typ-2-Diabetes erfolgt im Allgemeinen in Form einer basalunterstützten oralen Therapie (BOT). Moderne, lang und gleichmäßig wirksame Insulinanaloga verringern das Hypoglykämierisiko und erlauben eine freie Wahl des Injektionszeitpunkts. Absolut entscheidend für das Gelingen ist die konsequente Titration der Dosis. Eine basale Überinsulinisierung ist dabei unbedingt zu vermeiden. In einem späteren Schritt kann die schrittweise Zugabe von prandialem Insulin erfolgen. Das Zählen von Broteinheiten (BEs) zur Insulindosisanpassung ist bei Typ-2-Diabetes fast nie sinnvoll. Die häufigsten Probleme bei der Insulintherapie sind Hypoglykämien, Gewichtszunahme, initiale Sehstörungen sowie schwer beherrschbare Insulinresistenzen. Für all diese Probleme gibt es erprobte Strategien und zahlreiche Tipps und Tricks, die im Einzelfall zu erstaunlichen Erfolgen führen können.
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Levien, Terri L., Danial E. Baker, John R. White et R. Keith Campbell. « Insulin Glargine : A New Basal Insulin ». Annals of Pharmacotherapy 36, no 6 (juin 2002) : 1019–27. http://dx.doi.org/10.1345/aph.1a301.
Texte intégralRésumé :
OBJECTIVE: To review the pharmacology, pharmacokinetics, dosing guidelines, adverse effects, drug interactions, and clinical efficacy of insulin glargine. DATA SOURCES: Primary and review articles regarding insulin glargine were identified by MEDLINE search (1966–July 2001); abstracts were identified through Institute for Scientific Information Web of Science (1995–July 2001) and the American Diabetes Association. Additional information was obtained from the insulin glargine product information. STUDY SELECTION AND DATA EXTRACTION: All of the articles and meeting abstracts identified from the data sources were evaluated, and all information deemed relevant was included in this review. Priority was placed on data from the primary medical literature. DATA SYNTHESIS: Insulin glargine is a long-acting, recombinant human insulin analog that is given once daily as a basal source of insulin in patients with type 1 or type 2 diabetes mellitus. Modification of the basic insulin structure has produced a new insulin that is soluble at an acidic pH, but precipitates in the subcutaneous tissue and is slowly released from a depot. Insulin glargine has a slower onset of action than NPH insulin and a longer duration of action with no peak activity. Once-daily administration of insulin glargine has comparable efficacy to that of NPH insulin administered once or twice daily in basal-bolus regimens when used in combination with intermittent doses of regular insulin or insulin lispro in patients with type 1 and type 2 diabetes, and in conjunction with oral antidiabetic agents in patients with type 2 diabetes. Overall, insulin glargine has an incidence of hypoglycemia comparable to or less than that of NPH insulin, with a reduced incidence of nocturnal hypoglycemia compared with NPH insulin seen in some studies. CONCLUSIONS: Insulin glargine is a long-acting insulin analog capable of providing 24-hour basal insulin coverage when administered once daily at bedtime. Its activity profile, which lacks a pronounced peak, more closely resembles that of endogenous basal insulin than that of other intermediate- or long-acting insulins and appears more likely to be associated with a reduced incidence of hypoglycemia, particularly nocturnal hypoglycemia. Insulin glargine physiologically provides basal insulin but, for most patients, the addition of a rapid-acting insulin, like insulin lispro, before or with meals will need to be included in the treatment regimen to achieve optimal management of blood glucose concentrations.
Thèses sur le sujet "Insulina basale"
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PEROTTI, MARIO. « EFFICACIA DEL PASSAGGIO A DEGLUDEC DA UN’ALTRA INSULINA BASALE (GLARGINE/ DETEMIR) IN UNA COORTE DI PAZIENTI CON DIABETE MELLITO TIPO 1 ( DMT1) IN CONDIZIONI DI REALE PRATICA CLINICA ». Doctoral thesis, Università degli Studi di Milano-Bicocca, 2019. http://hdl.handle.net/10281/241121.
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La terapia del diabete tipo 1 può oggi essere più flessibile e personalizzata grazie alla disponibilità di numerosi tipi di insulina che differiscono tra loro per la farmacocinetica (inizio, picco e durata di azione). Il miglior controllo glicometabolico può essere ottenuto attraverso una terapia multiniettiva secondo uno schema basal-bolus, il quale prevede 3 somministrazioni preprandiali di un analogo rapido, che esprime meglio la fisiologica secrezione insulinica determinata dai pasti e da 1 iniezione di insulina ad azione lenta, necessaria per rispondere al fabbisogno insulinico nei periodi di digiuno (interprandiale e notturno).
Il raggiungimento di un controllo glicemico ottimale mediante trattamento insulinico intensivo determina un riduzione del rischio di complicanze micro e macrovascolari, ma conduce inevitabilmente a un incremento dell’incidenza di ipoglicemie, con conseguenze potenzialmente negative per il sistema cardiovascolare e neurologico.
Ottimizzare la terapia farmacologica mediante l’utilizzo di nuovi analoghi dell’insulina ad azione lenta in grado di offrire un minore rischio di ipoglicemia rappresenta un punto di fondamentale importanza.
Insulina degludec presenta molte delle caratteristiche che definiscono il profilo ideale di un’insulina basale. Dopo la somministrazione nel sottocute, grazie alla particolare ingegneria chimica, degludec viene assorbita in modo continuo e uniforme con un effetto ipoglicemizzante stabile e una durata di azione che supera le 42 ore. Dopo circa tre giorni di terapia è possibile raggiungere lo steady state condizione farmacocinetica in cui i livelli circolanti di insulina si mantengano stabili riducendo così la variabilità day-to day
L'utilizzo di degludec è stato ampiamente analizzato nel corso di studi clinici randomizzati ( RCT) sia in pazienti con diabete mellito tipo I sia in pazienti con diabete mellito tipo II. I risultati mostrano una non inferiorità di degludec rispetto a glargine in termine di target glicemici, ma una superiorità di degludec rispetto a glargine in termini di riduzione degli episodi di ipoglicemia soprattutto notturni. Tuttavia il contesto clinico di uno studio randomizzato può non essere completamente riproducibile nella pratica clinica quotidiana. Obiettivo di questo studio retrospettivo è la valutazione dell’efficacia clinica di degludec in una coorte di pazienti affetti da diabete mellito tipo 1 precedentemente trattati con diverso analogo lento ( glargine o detemir) nella pratica clinica quotidiana di real-life.
I risultati di questo studio mostrano un impatto positivo di degludec nella gestione terapeutica di pazienti con diabete mellito tipo 1 in linea con precedenti studi clinici randomizzati . Il passaggio a degludec da un altro analogo basale ( glargine o detemir) è in grado di migliorare il controllo glicemico, con una riduzione media dei valori di HbA1c di 0,20 % [-0,24;-0.17] a 6 mesi rispetto al basale (p <0.001). Inoltre i dati descritti in questo lavoro hanno evidenziato una riduzione del rischio di ipoglicemia sia totale ( rate ratio 0,79 [0,69: 0,89]), sia notturna (rate ratio 0,54 [0,42; 0,69]) sia grave (rate ratio 0,15 [0,09; 0,24]) a 6 mesi dalla modifica di terapia (p <0.001). Tale significatività rimane per tutto il periodo di follow-up di 12 mesi. Infine dopo 6 mesi di terapia con degludec, la dose totale di insulina giornaliera è diminuita del 11% rispetto al basale (p <0,001). Sulla base di questi dati, possiamo affermare che la terapia insulinica con degludec rappresenta un valido strumento terapeutico nella pratica clinica quotidiana, in grado di migliorare il compenso glicemico e la qualità di vita dei pazienti, favorendo così il raggiungimento di obiettivi glicemici più ambiziosi.Type 1 diabetes (DMT1) leads to absolute insulin deficiency due to immunologic destruction of the islet cells. Therefore affected patients need lifelong insulin treatment. Newer therapies for type 1 diabetes are aimed at developing insulin delivery systems that mimick normal physiology, identifying newer insulins that mimick endogenous insulin. To reproduce physiologic insulin secretion, both long- and short-acting insulins are used. Long-acting insulin, given at bedtime, suppresses glucose output from the liver overnight and provides basal insulin between meals; bolus doses of short-acting insulin modulate glucose excursions associated with carbohydrate consumption. Optimal glycemic control is necessary to reduce the risk for diabetes complications. However, tight glucose control carries a risk for hypoglycemia. Hypoglycemia may accelerate the vascular complications of diabetes by increasing platelet aggregation, leading to higher cardiovascular risk and all-cause mortality. Even brief hypoglycemia can cause profound dysfunction of the brain. Insulin administration by subcutaneous route has intrinsic limitations that, together with the pharmacokinetic (PK) profile of insulin formulations, do not reproduce the physiological patterns of insulin secretion. Insulin degludec (IDeg) is an ultra-long insulin analog that has unique pharmacokinetic and pharmacodynamic properties with a half-life of more than 24 h and a duration of action of more than 42 h. Compared to insulin glargine , the insulin degludec glucose-lowering action at steady state shows four time lower day-to day variability. Randomized clinical studies of degludec have shown a reduction in nocturnal hypoglycemia compared to insulin glargine. Given this background, IDeg is an ultra-long insulin analog that exhibits low intra-individual variability and whose efficacy is comparable to IGlar, but which presents as advantages flexibility in dose timing and lower risk of hypoglycemia, benefits that may impact quality of life and adherence to therapy. In Europe data on the use or effect of degludec in the general diabetes population not exist yet. Thus collection of data under routine clinical practice is highly warranted in order to access the effectiveness of degludec in real-life clinical setting. Aim of this retrospective non interventional study is to evaluate the clinical effectiveness of switching to IDeg in insulin treated patients with DMT1 under condition of routine clinical care. In all patients (n: 900), basal insulin was switched to IDeg at least 6 months before the start of data collection. Baseline was defined as the most recent recording during the 3-month period before first prescription of IDeg. Values are presented as mean [95%CI]. HbA1c decreased by -0.20 % [-0.24; -0.17%] at 6 months vs baseline (P < .001). Rate ratio of overall (0.79 [0.69; 0.89]), non-severe nocturnal (0.54 [0.42; 0.69]) and severe (0.15 [0.09; 0.24]) hypoglycaemia was significantly lower in the 6-month post-switch period vs the pre-switch period (P < .001 for all). Total daily insulin dose decreased by -4.88 [-5.52; -4.24] U (-11%) at 6 months vs baseline (P < .001). This study demonstrates that switching patients to IDeg from other basal insulins improves glycaemic control and significantly reduces the risk of hypoglycaemia in routine clinical practice.
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Conterato, Elisabete Viera. « Níveis de leptina, taxa metabólica basal e resistência insulínica em crianças obesas púberes ». reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2015. http://hdl.handle.net/10183/129680.
Texte intégralRésumé :
Introdução: A obesidade infanto-juvenil é um problema de saúde pública, com alta endemia e prevalência crescente no mundo todo. É uma doença associada a significativos problemas de saúde na população pediátrica, que afeta principalmente os sistemas cardiovascular e o endócrino, com risco elevado de desenvolvimento de diabetes mellitus tipo 2, hipertensão arterial, aterosclerose e dislipidemias. Objetivo: Investigar a relação entre os níveis séricos de leptina, a taxa metabólica basal e a resistência insulínica com o escore Z do índice de massa corporal de crianças púberes com obesidade. Métodos: Trata-se de um estudo transversal, realizado com 37 crianças obesas púberes de 7 a 12 anos de idade, atendidas pela primeira vez no Ambulatório de Obesidade Infantil, entre junho/2013 a abril/2014. Os participantes foram submetidos à avaliação antropométrica, aferição da pressão arterial, auto-classificação da maturação sexual, testes laboratoriais e bioimpedância. Resultados: O peso, o índice de massa corporal e a leptina diferiram de modo significativo entre os grupos (grupo 1 indivíduos com obesidade (2 Introduction: Childhood and adolescent obesity is a public health problem that presents high endemic and growing prevalence worldwide. It is a disease associated with important health problems in the population of children, that affects mainly the cardiovascular and endocrine systems, with high risck of developing type 2 diabetes mellitus, arterial hypertension, atherosclerosis and dyslipidemia. Objective: This study aims to investigate the relationship between the serum levels of leptin, the basal metabolic rate and the insulin resistance, with the Z score of the body mass index of children with obesity. Methods: This is a transversal study and 37 obese children, aged between 7 to 12 years old, were treated for the first time in the outpatient care unit specialized in childhood obesity, from June/2013 to April/2014. The participants were submitted to anthropometric evaluation, blood pressure measurement, selfclassification of sexual maturity, laboratory tests and bioimpedance. Results: Weight, body mass index and leptin differed significantly between the groups (Group 1 - individuals as obese (2
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Jaén, Sitges Maria Luisa. « Terapia génica para la diabetes tipo I basada en la administración intramuscular de AAV1 insulina-glucoquinasa ». Doctoral thesis, Universitat Autònoma de Barcelona, 2017. http://hdl.handle.net/10803/458687.
Texte intégralRésumé :
La diabetes tipo 1 es una enfermedad metabólica compleja para la cual actualmente no hay cura y está asociada con complicaciones secundarias graves, causadas en gran parte por un control glucémico deficiente. El logro de la normoglucemia con el tratamiento exógeno con insulina requiere el uso de altas dosis de la hormona, lo que aumenta el riesgo de episodios hipoglucémicos potencialmente mortales. En nuestro laboratorio se ha demostrado previamente que una única administración intramuscular de dos vectores AAV de serotipo 1 (AAV1) que expresaban insulina y glucoquinasa produjo corrección de la enfermedad en perros diabéticos durante 4 años. La primera parte de este trabajo se centró en la evaluación de la eficacia y seguridad tras 8 años de tratamiento. Los perros tratados contrarrestaron la hiperglucemia sin necesidad de insulina exógena durante un período de al menos 8 años después de una única administración de los vectores terapéuticos. La normalización metabólica sostenida se demostró mediante la cuantificación plurianual de los niveles séricos de proteínas glucosiladas (fructosamina), triglicéridos y colesterol y la buena respuesta de los animales tratados a la prueba oral de tolerancia a la glucosa. La persistencia de los genomas virales así como la expresión y actividad de los transgenes terapéuticos se atestiguaron en múltiples muestras de los músculos tratados. Además, no se observaron signos de patología en el análisis histopatológico de los mismos. En la segunda parte, se generaron vectores AAV duales que codificaban conjuntamente insulina y glucoquinasa. La generación de un vector dual, permitirá incrementar la eficacia terapéutica de la aproximación ya que todas las células modificadas genéticamente expresarán los dos componentes del “sensor de glucosa”. Asimismo, permite disminuir la dosis viral lo que, por un lado, minimiza la potencial toxicidad, y por otro, facilita los procesos de producción y regulatorios requeridos para una futura aplicación clínica. Los vectores duales mostraron mayor eficacia que la combinación de sus respectivos controles individuales. De entre los diferentes vectores duales con diversas conformaciones y combinaciones de secuencias codificantes y reguladoras generados, el vector con las dos unidades transcripcionales en conformación opuesta medió mayor expresión de los transgenes terapéuticos. Además, entre los vectores generados, el vector “L” (AAV1-miniCMV-hIns-RSV-hGck) fue el que mostró una expresión in vitro más alta tanto de insulina como de glucoquinasa. Los datos en los estudios realizados en ratones diabéticos tratados con el vector dual confirmaron una eficacia superior a la obtenida en los ratones tratados con los vectores individuales. Por tanto, los datos obtenidos en esta tesis doctoral demuestran la eficacia y seguridad a largo plazo de la administración intramuscular de los vectores AAV que codifican para insulina y glucoquinasa para contrarrestar la diabetes y sientan las bases para la futura translación a la clínica de esta estrategia terapéutica.Diabetes is a complex metabolic disease for which there is currently no cure and is associated with severe secondary complications, caused largely by poor glycaemic control. Achievement of normoglycemia with exogenous insulin treatment requires the use of high doses of hormone, which increases the risk of life-threatening hypoglycemic episodes. We previously demonstrated that a single intramuscular administration of two AAV serotype 1 (AAV1) vectors expressing insulin and glucokinase produce 4 years of disease correction in diabetic dogs. The first part of this study focused on the evaluation of efficacy and safety after 8 years of treatment. It is demonstrated how these dogs maintain glycemic control without the need of exogenous insulin for a period of up to 8 years after a single administration of the therapeutic vectors. Long term metabolic normalization was demonstrated by the multi-annual quantification of serum levels of glycosylated proteins (fructosamine), triglycerides and cholesterol and the correct response of the treated animals to the oral glucose tolerance test. The persistence of the viral genomes and the expression and activity of the therapeutic transgenes were confirmed in multiple samples of the treated muscles. In addition, no signs of pathology were observed in the histopathological analysis of the same muscles. In the second part of the study, dual AAV1 vectors were generated that encoded together insulin and glucokinase. The generation of a dual vector will allow to increase the therapeutic efficacy since all the genetically modified cells will express the two components of the "glucose sensor", while a reduced viral dose with minimize potential toxicity, and simplify both the production and regulatory processes required for future clinical application. The design of the modular system allowed for the generation and evaluation of conformations and combinations of coding and regulatory sequences. These were evaluated in vitro to demonstrate that the dual vectors with the two units in opposite conformation mediated a greater expression of both transgenes. The data in the studies performed in healthy and diabetic mice administered with the dual vectors confirmed that efficacy was superior to that obtained in the mice treated with the individual vectors. Therefore, the data obtained in both parts of this work demonstrate the long-term functionality and safety of intramuscular administration of AAV1 vectors encoding insulin and glucokinase to counteract diabetes while providing the basis for future clinical translation of a this type of gene therapy strategy, using a single dual AAV1 vector expressing both genes.
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Oak, Mayura Arvind. « Controlled Delivery of Basal Level of Insulin ». Diss., North Dakota State University, 2013. https://hdl.handle.net/10365/26761.
Texte intégralRésumé :
The present study was aimed at developing a delivery system for controlled release of insulin at basal level from chitosan-zinc-insulin complex incorporated into thermosensitive polymer, poly(lactic acid)-poly(ethylene glycol)-poly(lactic acid) (PLA-PEG-PLA). Chitosan-zinc-insulin complex was optimized to restrict the insulin diffusion from the delivery system by complex formation and thereby reducing initial burst release. Polymer concentration, insulin loading, chitosan and ZincNational Institutes of Health (NIH)
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Ashwell, Simon Guy. « New approaches to basal insulin therapy in diabetes ». Thesis, University of Newcastle upon Tyne, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.413268.
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Capel, Flores Ismael. « Validación clínica inicial de un sistema de páncreas artificial con controlador basado en reglas ». Doctoral thesis, Universitat Autònoma de Barcelona, 2017. http://hdl.handle.net/10803/457142.
Texte intégralRésumé :
La diabetes mellitus tipo 1 implica una deficiencia completa de la secreción nativa de insulina y su tratamiento fundamental, hasta la fecha, es la sustitución de esta secreción con insulina exógena de la forma más fisiológica posible. Los tratamientos actuales son imperfectos y necesitan ser optimizados. En este sentido, la integración de sensores continuos de glucosa con algoritmos que decidan la dosis óptima de insulina a administrar y bombas de infusión continua subcutánea de insulina, constituyendo un sistema de páncreas artificial, puede suponer una mejoría muy significativa de las opciones terapéuticas disponibles hasta el momento. Se han propuesto diferentes algoritmos de control para páncreas artificial pero no existe un gold standard. El Grupo de Bioingeniería y Telemedicina de la Universidad Politécnica de Madrid junto al Servicio de Endocrinología del Hospital Universitari Parc Taulí han desarrollado un algoritmo para páncreas artificial denominado Predictive Rule-Based Algorithm (pRBA). Este algoritmo parte de la pauta de insulina habitual, con bomba de infusión continua, del paciente y le aplica una serie de reglas que optimizan continuamente la dosis en base a la predicción que realiza una red neuronal artificial. Se trata de un sistema híbrido que automatiza totalmente el control basal o nocturno pero que requiere de aviso de las ingestas.
El objetivo principal de la investigación expuesta en esta tesis doctoral fue la validación clínica inicial, en medio hospitalario, del controlador pRBA. Para ello se ha llevado a cabo un ensayo clínico aleatorizado y cruzado en el que 10 pacientes con diabetes tipo 1 han pasado 2 noches no consecutivas en el hospital; una con su pauta habitual de bomba (noche control) y otra bajo el control del pRBA (noche experimental). El periodo de control automatizado fue de las 22:00 a las 10:00h del día siguiente, incluyendo el control nocturno y el control prandial del desayuno. El contralador pRBA ha demostrado que es capaz de mantener a los pacientes mayor tiempo en glucemia objetivo (3,9-8,0 mmol/l) durante el periodo nocturno (00:00-08:00h) que la pauta de tratamiento habitual (95,8 % [73-100] versus 66.6% [8,3-75]; p<0,05). Así mismo ha demostrado conseguir un menor porcentaje de tiempo en hipoglucemia (<3,9 mmol/l) en el mismo periodo (0,0 [0,0-0,0] versus 4,2 [0,0-21]; p<0,05) y reducir la variabilidad glucémica (HBGI 1,60 versus 3,95; p<0,05). En relación al control prandial del desayuno no se han observado diferencias significativas entre el periodo experimental y control (porcentaje de tiempo entre 3,9-10 mmol/l en el periodo 08:00-10:00h 50,0% [50,0-100] versus 58,3% [29,1-87,5]; p n.s.).
Como conclusión de la investigación expuesta en esta tesis podemos establecer que el controlador pRBA se muestra eficaz y seguro para el control nocturno de pacientes con diabetes tipo 1, pero que no muestra ventajas evidentes para el control prandial. Debe optimizarse el controlador prandial y poder testar el algoritmo en condiciones más reales antes de plantear su uso clínico ordinario.Type 1 diabetes mellitus implies a complete deficiency of native insulin secretion and its fundamental treatment, to date, is the replacement of this secretion with exogenous insulin as physiologically as possible. Current treatments are imperfect and need to be optimized. Integration of continuous glucose sensors with algorithms that decide the optimal dose of insulin to be administered and continuous subcutaneous insulin infusion pumps, constituting an artificial pancreas system, may imply a very significant improvement in the therapeutic options available until the moment. Different control algorithms have been proposed for artificial pancreas but there is no gold standard. Our research team, integrated by Grupo de Bioingeniería y Telemedicina (GBT) - Universidad Politécnica de Madrid, together with the Endocrinology Department of Parc Taulí University Hospital-UAB, has developed an artificial pancreas algorithm called Predictive Rule-Based Algorithm (pRBA). This algorithm starts from the patient's usual insulin regimen, with a continuous infusion pump, and applies a series of rules that continuously optimize the dose based on the prediction of an artificial neural network. It is a hybrid system that fully automates basal or night control but requires notification of intakes. The main objective of the research presented in this doctoral thesis was the initial clinical validation, in hospital setting, of the pRBA controller. For this, a randomized and cross-over trial has been carried out in which 10 patients with type 1 diabetes have spent 2 non consecutive nights in the hospital; one with his/her usual pump pattern (night control) and another under the control of pRBA (experimental night). The automated control period lasted from 22:00 to 10:00 on the following day, including night control and prandial breakfast control. pRBA algorithm has been shown to be able to keep patients longer on target glycemia (3.9-8.0 mmol/l) during the night time period (00:00-08:00) than the usual treatment regimen (95.8% [73-100] versus 66.6% [8.3-75], p <0.05). It has also been shown to achieve a lower percentage of time in hypoglycemia (<3.9 mmol/l) in the same period (0.0 [0.0-0.0] versus 4.2 [0.0-21]; p <0.05) and reduced glycemic variability (HBGI 1.60 versus 3.95, p <0.05). Regarding to breakfast prandial control, no significant differences were observed between the experimental and control periods (percentage of time between 3.9-10 mmol/l in the period 08:00-10:00h 50,0% [50,0- 100] versus 58.3% [29.1-87.5]; p ns). As a conclusion of the research exposed in this thesis we can establish that the pRBA controller is shown to be effective and safe for the nocturnal control of patients with type 1 diabetes, but does not show significant advantages for the prandial control. The prandial controller must be optimized and the algorithm should be tested under more real conditions before its usual clinical use is raised.
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Gludsted, Emil Brohl. « A study of value transitions in the basal insulin regimen for treatment of type 2 diabetes ». reponame:Repositório Institucional do FGV, 2016. http://hdl.handle.net/10438/17639.
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Type 2 diabetes is a progressive disease projected to grow tremendously in prevalence. Basal insulin analogues used to be the most efficacious treatment and last step in therapeutic intensification. Today, demographic, economic and epidemiologic transitions have placed pressure on healthcare systems and payers’ budgets. Three imminent threats require the basal insulin regimen to rethink how value can be addressed in the market: mounting institutional pricing pressure, biosimilar competition and, new innovative anti-diabetic drug classes with the potential to delay insulinization. Products aspiring to compete in the basal insulin regimen must avoid commoditization and steer clear of new threats. This paper identifies seven strategies and tactics to successfully address value in the diabetes market and particularly in the basal insulin regimen: 1) cost-based advantage and price competition; 2) value-based pricing; 3) risk-sharing agreements; 4) redifferentiation and post-approval evidence generation; 5) combination products carrying complementary mechanisms of action; 6) treating comorbidities and adjacent diseases; and, 7) indicating for patient sub-populations.
A diabetes tipo 2 é uma doença progressiva cuja projeção é crescer tremendamente em prevalência. Análogos de insulina basal eram considerados o tratamento mais eficaz, e utilizados em último instância durante a intensificação terapêutica. Hoje, transições demográficas, econômicas e epidemiológicas tem colocado pressão nos sistemas de saúde e no orçamento dos usuários. Três iminentes ameaças levam o regime de insulina basal à necessidade de repensar a maneira como seu valor é apresentado ao mercado: crescente pressão institucional sobre os preços, competição de biosimilares e novas classes medicamentos inovadores anti-diabetes com o potencial de atrasar a insulinização. Produtos que buscam competir no regime de insulina basal devem evitar a comoditização e esquivar-se de novas ameaças. Este trabalho identifica sete estratégias e táticas para apresentar de maneira bem sucedida valor no mercado de diabetes e particularmente no regime de insulina basal: 1) vantagem baseada em custo e competição por preço; 2) precificação baseada em valor; 3) acordos de compartilhamento de riscos; 4) rediferenciação e geração de evidencias pós-aprovação; 5) produtos combinados que apresentam mecanismos complementares de ação; 6) tratamento de co-morbidades e doenças adjacentes; e, 7) indicação para pacientes de determinados sub-grupos da população.
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Barrault, Valérie. « Les protéines kinases C : mise au point du dosage et valeurs basales dans divers modèles expérimentaux ». Paris 5, 1992. http://www.theses.fr/1992PA05P083.
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Sharma, Divya. « Drug Delivery Systems for Treatment of Diabetes Mellitus ». Diss., North Dakota State University, 2019. https://hdl.handle.net/10365/31745.
Texte intégralRésumé :
Daily injections for basal insulin therapy are far from ideal resulting in hypo/hyperglycemic episodes associated with fatal complications in type-1 diabetes patients. The purpose of this study was to develop a thermosensitive copolymer-based in situ depot forming delivery system to provide controlled release of insulin for extended duration following a single subcutaneous injection, closely mimicking physiological basal insulin requirement. Size and nature of the incorporated therapeutic were observed to affect the release profile of insulin. Modification with zinc and chitosan preserved thermal, conformational, and chemical stability of insulin during the entire duration of storage (up to 9 months at 4 °C) and release (up to 3 months at 37 °C). In vivo, daily administration of long-acting insulin, glargine, resulted in fluctuating blood glucose levels between 91 – 443 mg/dL in type 1 diabetic rats. However, single administration of oleic acid-grafted-chitosan-zinc-insulin complexes incorporated in copolymer formulation demonstrated slow diffusion of insulin complexes maintaining peak-free basal insulin level of 21 mU/L for 91 days. Sustained release of basal insulin also correlated with efficient glycemic control (blood glucose <120 mg/dL), prevention of diabetic ketoacidosis and absence of cataract development, unlike other treatment groups. The suggested controlled basal insulin delivery system has the potential to significantly improve patient compliance by improving glycemic control and eliminating life-threatening diabetes complications.
Furthermore, oleic acid-grafted-chitosan (CO) nanomicelles were investigated as a non-viral vector to deliver plasmid DNA encoding short hairpin RNA (shRNA) against pro-inflammatory cytokines to adipose tissue macrophages and adipocytes for the treatment of insulin resistance. Nanomicelles modified using mannose (COM) and adipose homing peptide (AHP) (COA) showed significantly higher uptake and transfection efficiency in inflamed macrophages- adipocytes co culture owing to glucose transporter-1 and prohibitin receptor mediated internalization, respectively. Ligand modified nanomicelles loaded with shRNA against tumor necrosis factor alpha (COM-TNFα) and monocyte chemoattractant protein-1 (COA-MCP1) demonstrated significant attenuation of pro-inflammatory cytokines and improved insulin sensitivity and glucose tolerance in obese-diabetic mice for six weeks post treatment with single dose of optimized formulation. Overall, chitosan nanomicelles mediated targeted gene therapy can help attenuate inflammation, the chief underlying cause of insulin resistance, thereby helping reverse the progression of diabetes.National Institutes of Health (NIH) grant R15GM114701
ND EPSCoR seed award FAR0030636
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Fujimoto, Shinpei. « Augmentation of basal insulin release from rat islets by preexposure to a high concentration of glucose ». Kyoto University, 2001. http://hdl.handle.net/2433/150511.
Texte intégralLivres sur le sujet "Insulina basale"
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R, Owens D., dir. Basal insulin therapy in type 2 diabetes mellitus. London : Aesculapium Ltd., 2004.
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Hunnisett, Douglas J. Leptin demonstrates no significant effect on basal or insulin-stimulated 2-deoxyglucose uptake and C14-labelled glucose incorporation into glycogen in L6 myotubes. Ottawa : National Library of Canada, 2000.
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Journals, Wellness with Spirit. Diabetes Insulin Pump Tracker : Diary Notebook to Log and Track Blood Sugar, Boluses. Basal Rates and Activity. Independently Published, 2019.
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Journals, Wellness with Spirit. Diabetes Insulin Pump Tracker : Diary Notebook to Log and Track Blood Sugar, Boluses. Basal Rates and Activity. Independently published, 2019.
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Publishing, Medihealth. My Insulin Pump And Blood Glucose Tracker : Continuous Monitoring of your programmed small doses of Insulin of continuous Basal rates and mealtime ... accurate readings all throughout the day. Independently published, 2019.
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Publishing, Medihealth. My Insulin Pump And Blood Glucose Tracker : Keep Track of your programmed small doses of Insulin of continuous Basal rates and mealtime blood sugar. ... accurate readings all throughout the day. Independently published, 2019.
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Publishing, Medihealth. My Insulin Pump and Blood Glucose Tracker : Keep Track of Your Programmed Small Doses of Insulin of Continuous Basal Rates and Mealtime Blood Sugar. Great Gift for Any Diabetic for Portable Accurate Readings All Throughout the Day. Independently Published, 2019.
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Publishing, Medihealth. My Insulin Pump and Blood Glucose Tracker : Continuous Monitoring Track of Your Programmed Small Doses of Insulin of Continuous Basal Rates and Mealtime Blood Sugar. Great Gift for Any Diabetic for Portable Accurate Readings All Throughout the Day. Independently Published, 2019.
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City, Cloud. Basal Bolus Blood Book : Daily Diabetes Journal for Insulin Calculation with Before and after Meal Blood Glucose Tracking, Food / Nutrition / Carb Counter, Activity Log and Medication / Symptom Diary. Independently Published, 2022.
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Hatfield, Anthea. Metabolism. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199666041.003.0024.
Texte intégralRésumé :
This chapter tells you how homeostasis in the body is achieved. Contributing factors such as stress, hormones, and the automatic nervous system are integrated into the discussion in a thoughtful way. The problem of cold postoperative patients is thoroughly referenced to modern investigation. Diabetes, how surgery destabilizes diabetics, and how to use insulin is explained. Malignant hyperthermia, thyroid storm, and acid—base disorders are all problems that can occur in the recovery room and guidelines for the management of these patients are outlined. Hydrogen ions affect haemoglobin and biochemical reactions and can cause acidosis and alkalosis—this chapter outlines how to interpret the blood gas results. How to distinguish between respiratory and metabolic causes of acid—base disorders is simply and clearly explained.
Chapitres de livres sur le sujet "Insulina basale"
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Hofmann, H. M. H., P. A. M. Weiss et F. Kainer. « Insulin Treatment of Gestational Diabetes. The Basal Bolus Concept ». Dans Gestational Diabetes, 142–49. Vienna : Springer Vienna, 1988. http://dx.doi.org/10.1007/978-3-7091-8925-2_13.
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Li, Ming. « Role of T-Type Ca2+ Channels in Basal Insulin Release ». Dans T-type Calcium Channels in Basic and Clinical Science, 137–50. Vienna : Springer Vienna, 2014. http://dx.doi.org/10.1007/978-3-7091-1413-1_10.
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Ghimpeteanu, G., G. Roman, D. Ciobanu et A. Alionescu. « Age-Specific Basal Rate Profile Characteristics at Initiation of Insulin Pump Therapy ». Dans International Conference on Advancements of Medicine and Health Care through Technology ; 5th – 7th June 2014, Cluj-Napoca, Romania, 69–72. Cham : Springer International Publishing, 2014. http://dx.doi.org/10.1007/978-3-319-07653-9_14.
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Schrezenmeir, J., F. Tatò, S. Tatò, C. Laue et J. Beyer. « Differences between Basal and Postprandial Circadian Variation of Insulin Sensitivity in Healthy Subjects and Type 1 Diabetics ». Dans Recent Developments in Lipid and Lipoprotein Research, 45–64. Berlin, Heidelberg : Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-84855-1_7.
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Piemonte, G., A. Bolner, P. Moghetti, E. Bonora, V. Cacciatori, M. Querena et M. Muggeo. « Measurement of Plasma Catecholamines — Study at Basal and during Insulin-Induced Hypoglycemia in Normal and Diabetic Subjects ». Dans Developments in Analytical Methods in Pharmaceutical, Biomedical, and Forensic Sciences, 257–70. Boston, MA : Springer US, 1987. http://dx.doi.org/10.1007/978-1-4899-3526-7_29.
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Wilson, Helen, Diana Calcraft, Cai Neville, Susan Lanham-New et Louise R. Durrant. « Bone Health, Fragility and Fractures ». Dans Perspectives in Nursing Management and Care for Older Adults, 115–34. Cham : Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-63892-4_9.
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AbstractAchieving and maintaining skeletal health throughout the life trajectory is essential for the prevention of bone diseases such as rickets, osteomalacia and osteoporosis. Rickets and osteomalacia are usually a result of calcium and/or vitamin D deficiency, causing softening of bones and bone pain, and both conditions are treatable with calcium and vitamin D supplementation. Osteoporosis is a multifaceted disease mainly affecting older people, and its pathogenesis (and hence treatment) is more complex. Untreated osteoporosis results in fragility fractures causing morbidity and increased mortality.Nutrition is one of many factors that influence bone mass and risk of bone disease. Developing a nutritional sciences approach is a feasible option for improving bone health.The importance of adequate calcium and vitamin D in ensuring skeletal integrity throughout the life course has a sound evidence base. Poor vitamin D status in population groups of all ages is widespread across many countries (including affluent and non-affluent areas). Public health approaches are required to correct this given the fact that vitamin D is not just required for musculoskeletal health but also for other health outcomes.Dietary protein may be beneficial for bone due to its effect of increasing insulin-like growth-factor-1 (IGF-1). Recent meta-analyses show that dietary protein has a beneficial role to play in bone health at all ages.Other nutritional factors and nutrients (such as potassium, magnesium, vitamin K and acid-base balance) are also likely to have an important role in bone health, though the literature is less clear in terms of the association/relationship and more research is required.
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Fonseca, Maria Carmela Kneip Lopes, Jhessika Rosa Soprani, Christianne Tolêdo de Souza Leal et Bárbara Oliveira Reis. « CONFIGURAÇÃO DA INSULINA BASAL ». Dans BOMBA DE INSULINA, 32–34. Editora Pasteur, 2021. http://dx.doi.org/10.29327/542788.1-6.
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Prakash, Anupam, Yash Munjal et Ghan Pangtey. « Basal Insulins ». Dans RSSDI Update–2015, 228. Jaypee Brothers Medical Publishers (P) Ltd., 2017. http://dx.doi.org/10.5005/jp/books/12963_47.
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Madhu, SV. « Basal Insulin ». Dans ESI Manual of Clinical Endocrinology, 105. Jaypee Brothers Medical Publishers (P) Ltd., 2015. http://dx.doi.org/10.5005/jp/books/12535_18.
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« Basal Bolus Insulin Calculations ». Dans Active Learning Exercises. 2215 Constitution Avenue, N.W. Washington, DC 20037-2985 : The American Pharmacists Association, 2013. http://dx.doi.org/10.21019/ale.2000.174.
Texte intégralActes de conférences sur le sujet "Insulina basale"
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Pfliegler, G., J. Arnout, J. Kienast, K. Wittevrongel et J. Vermylen. « INSULIN RECEPTORS ARE NOT COUPLED TO THE PHOSPHOINOSITIDE OR ADENYLCYCLASE MESSENGER SYSTEMS IN HUMAN PLATELETS ». Dans XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644523.
Texte intégralRésumé :
Insulin receptors have been found not only on its “target Cells” but also on several other cell-types, including human platelets. From studies on adipocytes and liver cells it seems that they are coupled both to the adenylate cyclase-cyclic AMP and the polyphosphoinositide messenger systems. Circulating blood cells might faithfully reflect the insulin receptor state of target organ tissues. Impaired platelet function has an important role in the pathogenesis of vascular and thrombotic complications in diabetes mellitus, and insulin seems to act directly on platelets. A reduction in the number and binding capacity of platelet insulin receptors in diabetic patients (Udvardy et al. 1986) suggested a (patho)physiological role for these receptors. In our studies, insulin (1 × 10-9 - 1 × 10-6 M) did not affect basal platelet cyclic AMP levels, as measured following incorporation of [3H] adenine. Insulin did not prevent PGI2 (25-75 nmol/L) induced cyclic AMP formation in platelets. Insulin did not modify the basal levels of inositol phosphate (IP), IP2 or IP3 in platelets, as measured following incorporation of [3H] inositol. Insulin did not affect formation of IP, IP2 or IP3 by thrombin. No changes in cytosolic free Ca2+ (Quin 2 method) were detected in the presence of insulin. Sodium nitroprusside on the other hand, which is known to mimic several effects of insulin on adipocytes, inhibited IP formation induced by threshold concentrations of thrombin.On the basis of our results the insulin receptors in human platelets seem to be “non-functional” insofar as their occupancy is not accompanied by the stimulation or inhibition of phospho-inositide breakdown or cyclic AMP formation. Similarly, “silent” muscarinic-cholinergic receptors have recently been reported in human erythrocytes (Sehar et al. 1986).
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Prudencio, Patricia Barbosa de Castro, et Renata Heinen Corrêa. « ALTERAÇÕES NOS NÍVEIS DE TRIGLICERÍDEOS E HDL OBSERVADOS NA RESISTÊNCIA À INSULINA ». Dans II Congresso Brasileiro de Bioquímica Humana On-line. Revista Multidisciplinar em Saúde, 2022. http://dx.doi.org/10.51161/conbraqui/22.
Texte intégralRésumé :
Introdução: A resistência à insulina é um estado patológico comum de etiologia genética e ambiental na qual os tecidos periféricos não respondem aos níveis normais de insulina circulante. Ela tem sido considerada a base fisiopatológica entre as diversas alterações presentes na síndrome metabólica, como a hipertensão arterial, a intolerância à glicose, o diabetes, as dislipidemias e a presença de estados pró-inflamatórios. O tecido adiposo, quando resistente à insulina, não responde ao efeito antilipolítico deste hormônio e aumenta a hidrólise dos triglicerídeos armazenados, sob a ação catalítica de diversos tipos de lipases, com consequente liberação de quantidades excessivas de ácidos graxos livres na circulação, o que pode vir a desencadear uma série de distúrbios lipídicos. Objetivo: Este trabalho tem por objetivo descrever, por meio de revisão da literatura, a relação entre alterações de triglicerídeos e HDL e a resistência à insulina. Material e métodos: Foi realizada uma pesquisa bibliográfica nas seguintes bases de dados científicos Google acadêmico, Scielo, BIREME e Pubmed, utilizando os seguintes ;descritores: “Triglicerídeos”; “HDL-Colesterol”; “Resistência à insulina”;“Dislipidemias”; “Síndrome metabólica”. Resultados: Alguns autores observaram que os portadores de resistência à insulina apresentam maior predisposição para desenvolver, posteriormente, síndrome metabólica, diabetes mellitus tipo 2 e doenças cardiovasculares. Para tanto, foram avaliados dados bioquímicos, clínicos, estilo de vida e composição corporal de indivíduos, de ambos os sexos, cujos resultados apontaram para resistência à insulina e síndrome metabólica. Segundo esses dados, o sexo feminino apresentou maior prevalência de dislipidemia, excesso de gordura corporal e resistência à insulina, em contrapartida, o masculino demonstrou maior prevalência de HDL baixo, hiperuricemia e pressão arterial alterada. Conclusão: A relação Triglicerídeos/colesterol HDL foi indicador bioquímico promissor para estabelecer o perfil lipídico na avaliação dos níveis mais elevados da resistência a insulina, parecendo ser mais eficiente que a determinação do HDL-colesterol ou hipertrigliceridemia isolados.
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Oroojeni Mohammad Javad, Mahsa, Stephen Agboola, Kamal Jethwani, Ibrahim Zeid et Sagar Kamarthi. « Reinforcement Learning Algorithm for Blood Glucose Control in Diabetic Patients ». Dans ASME 2015 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2015. http://dx.doi.org/10.1115/imece2015-53420.
Texte intégralRésumé :
In this paper a reinforcement learning algorithm is applied to regulating the blood glucose level of Type I diabetic patients using insulin pump. In this approach the agent learns from its exploration and experiences to selects its actions. In the current reinforcement learning algorithm, body weight, A1C level, and physical activity define the state of a diabetic patient. For the agent, insulin dose levels constitute the actions. There are five alternative actions for the agent: (1) raising the insulin infusion rate during 24 hours, (2) keeping it the same, (3) decreasing insulin infusion rate, (4) adjusting basal rate two times during 24 hours, and (5) adjusting basal rate three times during 24 hours. As a result of a patient’s treatment, after each time step t, the reinforcement learning agent receives a numerical reward depending on the response of the patient’s health condition. At each stage the reward is calculated as a function of the deviation of the A1C from its target value. Since reinforcement learning algorithm can select actions that improve patient condition by taking into account delayed effects it has tremendous potential to control blood glucose level in diabetic patients. This research will utilize ten years of clinical data obtained from a hospital.
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CABRAL, AYARA ALMEIDA SOUZA, FILIPE COSTA, JULIANA BOTELHO ARAÚJO, KAMILA LEAL CORREA et IVALDO DE JESUS ALMEIDA BELÉM FILHO. « EVOLUÇÃO NO TRATAMENTO FARMACOLÓGICO DE DIABETES MELLITUS TIPO II NO BRASIL ». Dans I Congresso Brasileiro de Doenças Crônicas On-line. Revista Multidisciplinar em Saúde, 2022. http://dx.doi.org/10.51161/cronics/6611.
Texte intégralRésumé :
Introdução: Diabetes Mellitus (DM) é uma doença crônica caracterizada como uma síndrome metabólica, resultante da falta de atividade da insulina em realizar seus efeitos e/ou também pela inexistência da mesma. Apresenta-se de várias formas, dentre está a DM tipo II (DM2), que promove a perda gradual da secreção insulínica pelo pâncreas associada à resistência desse hormônio. Atualmente o Brasil é o 6º país em incidência de diabetes no mundo e o tratamento primário para DM2 é dieta balanceada e exercícios físicos, no entanto, com a falha da terapia, é adotada uma abordagem farmacológica fundamental para controlar a glicemia, que vem evoluindo com o desenvolvimento de substâncias e novos alvos terapêuticos. Objetivo: Descrever e analisar a evolução do tratamento farmacológico de DM2 no Brasil. Material e métodos: É um estudo de revisão bibliográfica integrativa com abordagem qualitativa, a partir da base de dados Pubmed, Google acadêmico e Scielo, selecionados 21 artigos. Resultados: No tratamento inicial, utiliza-se a metformina, sendo um hipoglicemiante oral que reduz a gliconeogênese, a absorção de glicose e aumenta a sensibilidade à insulina nos tecidos muscular e adiposo, e melhora a resposta da célula beta à glicose, por mecanismos ainda desconhecidos. Em seguida o uso de sulfonilureias, estimulando a secreção de insulina através de um receptor específico das células beta pancreáticas; a pioglitazona, um agonista seletivo para os receptores gama ativados pelo proliferador de peroxissomos, em que a insulina exerce ação, no tecido adiposo e o fígado reduzindo a glicemia, e a insulinoterapia atuando diretamente à insulina endógena. Outros fármacos com ação promissora vêm sendo utilizados como os inibidores da dipeptidil peptidase 4, os agonistas do receptor do peptídeo tipo 1 e os inibidores do cotransportador sódio- glicose 2 que propõem novos alvos moleculares ao tratamento em pacientes com DM2. Conclusão: Constata-se, portanto, que a evolução no tratamento de DM 2 no Brasil passou por diversas modernizações e modificações moleculares para alvos seletivos na tentativa de conter a progressão da doença uma vez que, estima-se que em 2045 o Brasil tenha em média 23,2 milhões de adultos doentes com DM, gerando muitas complicações à saúde, alta morbidade e custos aos sistemas públicos.
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Barcellos, Cristiano, Monica Palmanhani et Rodrigo de Carvalho. « Switch from Basal Insulin to Ideglira : Why Hyperglycemia Does Not Occur at The Beginning of Ideglira Titration Despite The Great Amount Reduction of Dose from Basal Insulin ? Case Report ». Dans XXI I Congresso Brasileiro de Nutrologia. Thieme Revinter Publicações Ltda, 2018. http://dx.doi.org/10.1055/s-0038-1675040.
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Oliveira, Roberta Helena Marques, Joanna Lara Castelo Rodrigues, Amanda Almeida de Souza et Vitória Regina Nunes Maia. « A INFLUÊNCIA DA HEMOCROMATOSE HEREDITÁRIA NO DESENVOLVIMENTO DE DIABETES ». Dans I Congresso Brasileiro de Hematologia Clínico-laboratorial On-line. Revista Multidisciplinar em Saúde, 2021. http://dx.doi.org/10.51161/rems/613.
Texte intégralRésumé :
Introdução: A hemocromatose é uma doença em que o corpo pode acumular ferro na pele, coração, fígado, pâncreas, glândula pituitária e articulações. O excesso de ferro é tóxico para o corpo e, com o tempo, os altos níveis de ferro podem danificar tecidos e órgãos, ocasionando um fator de risco para o desenvolvimento de diabetes mellitus, uma vez que a elevação dos níveis de ferritina, promove o stress oxidativo nas células beta das ilhotas pancreáticas, as destruindo e, portanto, diminuindo a síntese de insulina. Objetivo: Analisar a relação entre a hemocromatose hereditária e a diabetes mellitus, com enfoque na patogênese e prognóstico do paciente, relacionando com o tipo de hemocromatose hereditária e de diabetes mellitus. Material e métodos: Foram utilizados a base de dados Pubmed e os descritores "hereditary hemochromatosis" e "diabetes mellitus", encontrando-se 35 artigos dos últimos 10 anos. Após análise e aplicação dos critérios de inclusão e exclusão, selecionaram-se 5 artigos. Resultados: Embora a fisiopatologia da diabetes na HH seja controversa, é amplamente aceito que os principais mecanismos são: dano às células β com deficiência de insulina e resistência à insulina, devido a dano hepático. Além disso, há indícios de que ocorre deposição severa de hemossiderina e fibrose induzida por ferro nas ilhotas de Langerhans e nos ácinos pancreáticos. Ademais, o coração e as glândulas endócrinas são mais suscetíveis ao acúmulo de ferro, justificando assim o desenvolvimento de problemas endócrinos e cardiovasculares. Conclusão: Visto que a hemocromatose hereditária possui uma tendência a lesões hepáticas, cardiovasculares e em glândulas endócrinas, é de grande importância o diagnóstico precoce da doença, para que haja um tratamento adequado no caso de diabetes mellitus e evitar a progressão de complicações hepáticas e cardiovasculares, melhorando o prognóstico do paciente.
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Klimontov, V. V., E. A. Koroleva et O. N. Fazullina. « Switching to insulin glargine 300 U/mL from other basal insulin analogues provides less 24-hour glucose variability in hospitalized patients with type 1 diabetes ». Dans 2018 11th International Multiconference Bioinformatics of Genome Regulation and Structure\Systems Biology (BGRS\SB). IEEE, 2018. http://dx.doi.org/10.1109/csgb.2018.8544728.
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Razak, N. N., J. Lin, A. Le Compte, G. M. Shaw, U. Jamaludin, C. G. Pretty, J. G. Chase et F. M. Suhaimi. « Glargine as a basal insulin supplement in recovering critically Ill patients : an in silico study ». Dans UKACC International Conference on CONTROL 2010. Institution of Engineering and Technology, 2010. http://dx.doi.org/10.1049/ic.2010.0394.
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Boschetti, C., A. Vicari, E. Cofrancesco, A. Della Volpe, G. Moreo, E. Po-gliani, G. Pozza et E. Polli. « HEPARIN-RELEASED PLATELET FACTOR 4 (HR-PF4) IN DIABETIC MICR0VAS-CULAR DISEASE ». Dans XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643498.
Texte intégralRésumé :
When heparin is injected i.v. as a bolus, PF4 but not (β-throm boglobulin ((βTG) is released immediately. HR-PF4 is not liberated from platelets but from the endothelial cells of vessels which serve as storage sites. The role of platelet activation in diabetic microvascular disease is still controversial, however there is experimental evidence of vascular injury and hemostatic activation preceding the appearance of microvascular disease. The contradictory results so far obtained in man may be partly attributed to the heterogeneity of the diabetic patients studied. We studied 20 insulin-dependent diabetics (age 21-40) in stable metabolic equilibrium (mean HbAlc=7.6%). 10 without fluoroangiographic evidence of retinopathy (Group l) and 10 with retinopathy (Group 2). None had signs or symptoms of macrovascular disease. The control group consisted of 10 healthy volunteers (age 22-39). No medication except insulin was taken for at least 10 days preceding the study. 12 h before the study all subjects received aspirin 500 mg p.o. Plasma (βTG and PF4 were determined before (basal) and 5,30,90 min after a heparin bolus i.v. (5000 U). Protein C, factor VIIIR:Ag and tissue plasminogen activator were also measured in plasma.
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Goldschmidt, Ezequiel, David Gau, Aidan Dadey, Zhipeng Li, Meghan Schneck, Carl Snyderman, Eric Wang, Partha Roy, Sally Wenzel et Paul Gardner. « Insulin Promotes Cellular Growth in an In Vitro Model of Mucosal Healing after Endoscopic Endonasal Approaches ». Dans 29th Annual Meeting North American Skull Base Society. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1679495.
Texte intégralRapports d'organisations sur le sujet "Insulina basale"
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Silva, Rodrigo Ribeiro e., Mateus de Miranda Gauza, Julia Opolski Nunes da Silva Opolski et Maria Eduarda Schramm Guisso. Once-Weekly Insulin Icodec vs Once-Daily Insulin Glargine U100 for Type 2 Diabetes : A Meta-analysis of Phase 2 Randomized Controlled Trials. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, mai 2022. http://dx.doi.org/10.37766/inplasy2022.5.0102.
Texte intégralRésumé :
Review question / Objective: To compare Once-Weekly Insulin Icodec and Once-Daily Insulin Glargine U100 in patients with Type 2 Diabetes Mellitus using oral hypoglycemic drugs in need of insulin therapy. Condition being studied: Patients with Diabetes Mellitus Type 2 using oral hypoglycemic drugs in need for basal insulin. Eligibility criteria: Inclusion in this meta-analysis was restricted to studies that met all the following criteria: (1) randomized trials; (2) comparing the use once weekly insulin icodec to once daily insulin glargine; (3) enrolling patients with type 1 or type 2 diabetes mellitus; (4) evaluating any of the desired outcomes; (4) articles in written on english language. We excluded studies with (1) no control group; (2) overlapping studies population; clinical trial register entry only; (3) non-human studies and (4) studies reported only as abstracts.
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ZHU, Dongshan. The lifestyle changes after initiating basal insulin in insulin naive patients with type 2 diabetes : Results from the ORBIT study. Science Repository, juin 2019. http://dx.doi.org/10.31487/j.jicoa.2019.02.04.
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Hernández Gamboa, Adriana Elena. Seguridad del Paciente en la Administración de Medicamentos de Alto Riesgo. Ediciones Universidad Cooperativa de Colombia, octobre 2020. http://dx.doi.org/10.16925/gcnc.14.
Texte intégralRésumé :
Esta nota de clase presenta al enfermero en formación la importancia y la responsabilidad de su quehacer en el día a día en relación con el cuidado de los pacientes ante una situación de emergencia o un estado de salud complejo, que requiera la administración de medicamentos de alto riesgo tales como inotrópicos, vasopresores, vasodilatadores, antiarrítmicos, insulinas, potasio, etc. Ese compromiso enfermero-paciente implica conocimiento científico basado en la evidencia, capacitación continua y adquisición de habilidades para realizar cálculos matemáticos sencillos, preparación de mezclas, programación de equipos o bombas de infusión y, desde luego, la atención cálida y humana que distingue a nuestra profesión, basada en los principios éticos y valores fundamentales de la sociedad. Los medicamentos anteriormente mencionados, no solo pueden salvar la vida de los enfermos, sino que también pueden poderla en riesgo, si se cometen errores en la preparación de la mezcla, en la programación de la velocidad o dosis de la infusión o debido a la falta de conocimiento del enfermero acerca del tipo y características del medicamento que está manejando.
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Meidan, Rina, et Robert Milvae. Regulation of Bovine Corpus Luteum Function. United States Department of Agriculture, mars 1995. http://dx.doi.org/10.32747/1995.7604935.bard.
Texte intégralRésumé :
The main goal of this research plan was to elucidate regulatory mechanisms controlling the development, function of the bovine corpus luteum (CL). The CL contains two different sterodigenic cell types and therefore it was necessary to obtain pure cell population. A system was developed in which granulosa and theca interna cells, isolated from a preovulatory follicle, acquired characteristics typical of large (LL) and small (SL) luteal cells, respectively, as judged by several biochemical and morphological criteria. Experiments were conducted to determine the effects of granulosa cells removal on subsequent CL function, the results obtained support the concept that granulosa cells make a substaintial contribution to the output of progesterone by the cyclic CL but may have a limited role in determining the functional lifespan of the CL. This experimental model was also used to better understand the contribution of follicular granulosa cells to subsequent luteal SCC mRNA expression. The mitochondrial cytochrome side-chain cleavage enzyme (SCC), which converts cholesterol to pregnenolone, is the first and rate-limiting enzyme of the steroidogenic pathway. Experiments were conducted to characterize the gene expression of P450scc in bovine CL. Levels of P450scc mRNA were higher during mid-luteal phase than in either the early or late luteal phases. PGF 2a injection decreased luteal P450scc mRNA in a time-dependent manner; levels were significantly reduced by 2h after treatment. CLs obtained from heifers on day 8 of the estrous cycle which had granulosa cells removed had a 45% reduction in the levels of mRNA for SCC enzymes as well as a 78% reduction in the numbers of LL cells. To characterize SCC expression in each steroidogenic cell type we utilized pure cell populations. Upon luteinization, LL expressed 2-3 fold higher amounts of both SCC enzymes mRNAs than SL. Moreover, eight days after stimulant removal, LL retained their P4 production capacity, expressed P450scc mRNA and contained this protein. In our attempts to establish the in vitro luteinization model, we had to select the prevulatory and pre-gonadotropin surge follicles. The ratio of estradiol:P4 which is often used was unreliable since P4 levels are high in atretic follicles and also in preovulatory post-gonadotropin follicles. We have therefore examined whether oxytocin (OT) levels in follicular fluids could enhance our ability to correctly and easily define follicular status. Based on E2 and OT concentrations in follicular fluids we could more accurately identify follicles that are preovulatory and post gonadotropin surge. Next we studied OT biosynthesis in granulosa cells, cells which were incubated with forskolin contained stores of the precursor indicating that forskolin (which mimics gonadotropin action) is an effective stimulator of OT biosynthesis and release. While studying in vitro luteinization, we noticed that IGF-I induced effects were not identical to those induced by insulin despite the fact that megadoses of insulin were used. This was the first indication that the cells may secrete IGF binding protein(s) which regonize IGFs and not insulin. In a detailed study involving several techniques, we characterized the species of IGF binding proteins secreted by luteal cells. The effects of exogenous polyunsaturated fatty acids and arachidonic acid on the production of P4 and prostanoids by dispersed bovine luteal cells was examined. The addition of eicosapentaenoic acid and arachidonic acid resulted in a dose-dependent reduction in basal and LH-stimulated biosynthesis of P4 and PGI2 and an increase in production of PGF 2a and 5-HETE production. Indomethacin, an inhibitor of arachidonic acid metabolism via the production of 5-HETE was unaffected. Results of these experiments suggest that the inhibitory effect of arachidonic acid on the biosynthesis of luteal P4 is due to either a direct action of arachidonic acid, or its conversion to 5-HETE via the lipoxgenase pathway of metabolism. The detailed and important information gained by the two labs elucidated the mode of action of factors crucially important to the function of the bovine CL. The data indicate that follicular granulosa cells make a major contribution to numbers of large luteal cells, OT and basal P4 production, as well as the content of cytochrome P450 scc. Granulosa-derived large luteal cells have distinct features: when luteinized, the cell no longer possesses LH receptors, its cAMP response is diminished yet P4 synthesis is sustained. This may imply that maintenance of P4 (even in the absence of a Luteotropic signal) during critical periods such as pregnancy recognition, is dependent on the proper luteinization and function of the large luteal cell.