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1.
Diabetes Care ; 44(9): 2069-2077, 2021 09.
Article in English | MEDLINE | ID: mdl-34330786

ABSTRACT

OBJECTIVE: To compare the risk of severe adverse pregnancy complications in women with preexisting diabetes. RESEARCH DESIGN AND METHODS: Multinational, prospective cohort study to assess the prevalence of newborns free from major congenital malformations or perinatal or neonatal death (primary end point) following treatment with insulin detemir (detemir) versus other basal insulins. RESULTS: Of 1,457 women included, 727 received detemir and 730 received other basal insulins. The prevalence of newborns free from major congenital malformations or perinatal or neonatal death was similar between detemir (97.0%) and other basal insulins (95.5%) (crude risk difference 0.015 [95% CI -0.01, 0.04]; adjusted risk difference -0.003 [95% CI -0.03, 0.03]). The crude prevalence of one or more congenital malformations (major plus minor) was 9.4% vs. 12.6%, with a similar risk difference before (-0.032 [95% CI -0.064, 0.000]) and after (-0.036 [95% CI -0.081, 0.009]) adjustment for confounders. Crude data showed lower maternal HbA1c during the first trimester (6.5% vs. 6.7% [48 vs. 50 mmol/mol]; estimated mean difference -0.181 [95% CI -0.300, -0.062]) and the second trimester (6.1% vs. 6.3% [43 vs. 45 mmol/mol]; -0.139 [95% CI -0.232, -0.046]) and a lower prevalence of major hypoglycemia (6.0% vs. 9.0%; risk difference -0.030 [95% CI -0.058, -0.002]), preeclampsia (6.4% vs. 10.0%; -0.036 [95% CI -0.064, -0.007]), and stillbirth (0.4% vs. 1.8%; -0.013 [95% CI -0.024, -0.002]) with detemir compared with other basal insulins. However, differences were not significant postadjustment. CONCLUSIONS: Insulin detemir was associated with a similar risk to other basal insulins of major congenital malformations, perinatal or neonatal death, hypoglycemia, preeclampsia, and stillbirth.


Subject(s)
Diabetes Mellitus , Perinatal Death , Blood Glucose , Female , Glycated Hemoglobin/analysis , Humans , Hypoglycemic Agents/adverse effects , Infant, Newborn , Insulin Detemir/adverse effects , Insulin, Long-Acting , Pregnancy , Pregnant Women , Prospective Studies
3.
Med Clin (Barc) ; 141 Suppl 2: 14-9, 2013 Sep.
Article in Spanish | MEDLINE | ID: mdl-24444519

ABSTRACT

In this article, we review the results that can be expected after significant weight loss in patients with type 2 diabetes mellitus. We provide consensus-based documentation supported by the American Diabetes Association, the European Association for the Study of Diabetes, and the International Diabetes Federation on the importance of physical exercise, metabolic-bariatric surgery, and drug therapy. Lastly, we report the results of studies published in the last few years on glucagon-like peptide-1 analogs and the new family of oral drugs known as gliflozins, specifically studies published on dapagliflozin.


Subject(s)
Diabetes Mellitus, Type 2/complications , Obesity/complications , Bariatric Surgery , Benzhydryl Compounds , Causality , Comorbidity , Diabetes Mellitus, Type 2/metabolism , Diabetes Mellitus, Type 2/therapy , Diet, Diabetic , Diet, Reducing , Disease Management , Evidence-Based Medicine , Exercise Therapy , Glucagon-Like Peptide 1/agonists , Glucosides/therapeutic use , Humans , Hyperinsulinism/complications , Hyperinsulinism/metabolism , Hypoglycemic Agents/classification , Hypoglycemic Agents/pharmacology , Hypoglycemic Agents/therapeutic use , Insulin Resistance , Metabolic Syndrome/therapy , Obesity/metabolism , Obesity/therapy , Practice Guidelines as Topic , Sodium-Glucose Transporter 2 , Sodium-Glucose Transporter 2 Inhibitors , Weight Loss
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