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1.
Medicina (B Aires) ; 82(5): 752-759, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-36220033

RESUMO

Fast acting aspart insulin is a faster-acting formulation of aspart insulin, having nicotinamide and Larginine added to the molecule, in order to achieve a faster absorption through the subcutaneous cellular tissue. Pharmacokinetic and pharmacodynamic studies showed a left-shifted mean serum concentration-time profile compared to the conventional formulation. Its efficacy profile is highlighted in terms of early postprandial glycemic control. In addition, fast acting aspart insulin allows a more flexible treatment schedule, as it may be administrated at mealtime, immediately before or up to 20 minutes after; this schedule represents an advantage regarding quality of life in patients with diabetes treated with prandial insulin, especially in populations such as children, pregnant women or elderly subjects. The safety and tolerability profiles are comparable to conventional aspart insulin.


La insulina aspártica de acción rápida es una formulación más rápida de la insulina aspártica convencional, a la que se adicionan nicotinamida y L-arginina para lograr una absorción más rápida en el tejido celular subcutáneo. Estudios farmacocinéticos y farmacodinámicos demostraron un desplazamiento de las curvas de concentración sérica de insulina/tiempo hacia la izquierda en comparación con la formulación convencional. Su perfil de eficacia se destaca en términos del control de la glucemia posprandial temprana. Además, la insulina aspártica de acción rápida aporta flexibilidad al tratamiento, ya que puede aplicarse al momento de la comida, inmediatamente antes o hasta 20 minutos después, lo que constituye una ventaja en cuanto a calidad de vida en los pacientes con diabetes en tratamiento con insulina prandial, especialmente en poblaciones como los niños, las embarazadas o los ancianos. El patrón de seguridad y tolerabilidad es comparable al de la insulina aspártica convencional.


Assuntos
Diabetes Mellitus Tipo 1 , Insulina Aspart , Idoso , Glicemia , Criança , Diabetes Mellitus Tipo 1/tratamento farmacológico , Método Duplo-Cego , Feminino , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Insulina Aspart/farmacocinética , Insulina Aspart/uso terapêutico , Niacinamida/uso terapêutico , Período Pós-Prandial , Gravidez , Qualidade de Vida
2.
Medicina (B.Aires) ; 82(5): 752-759, Oct. 2022. graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1405732

RESUMO

Resumen La insulina aspártica de acción rápida es una formulación más rápida de la insulina aspártica convencional, a la que se adicionan nicotinamida y L-arginina para lograr una absorción más rápida en el tejido celular subcutáneo. Estudios farmacocinéticos y farmacodinámicos demostraron un desplazamiento de las curvas de concentración sérica de insulina/tiempo hacia la izquierda en comparación con la formulación conven cional. Su perfil de eficacia se destaca en términos del control de la glucemia posprandial temprana. Además, la insulina aspártica de acción rápida aporta flexibilidad al tratamiento, ya que puede aplicarse al momento de la comida, inmediatamente antes o hasta 20 minutos después, lo que constituye una ventaja en cuanto a calidad de vida en los pacientes con diabetes en tratamiento con insulina prandial, especialmente en poblaciones como los niños, las embarazadas o los ancianos. El patrón de seguridad y tolerabilidad es comparable al de la insulina aspártica convencional.


Abstract Fast acting aspart insulin is a faster-acting formulation of aspart insulin, having nicotinamide and L-arginine added to the molecule, in order to achieve a faster absorption through the subcutaneous cellular tissue. Pharmacokinetic and pharmacodynamic studies showed a left-shifted mean serum concentration-time profile compared to the conventional formulation. Its efficacy profile is highlighted in terms of early postprandial glycemic control. In addition, fast acting aspart insulin allows a more flexible treatment schedule, as it may be administrated at mealtime, immediately before or up to 20 minutes after; this schedule represents an advantage regarding quality of life in patients with diabetes treated with prandial insulin, especially in populations such as children, pregnant women or elderly subjects. The safety and tolerability profiles are comparable to conventional aspart insulin.

3.
Medicina (B Aires) ; 82(3): 398-407, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-35639061

RESUMO

Cardiovascular disease (CVD) is the main cause of morbidity and mortality in patients with type 2 diabetes mellitus (DM2). However, scarce specific data are available about the prevalence of CVD in that population in daily clinical practice. The CAPTURE study investigated the contemporary prevalence of CVD in a representative sample of DM2 population in 13 countries, distributed over 5 continents (n = 9823). Among the 834 Argentinian participants, the CVD prevalence was 41.5% (n = 347) (95% confidence interval [95%CI]: 38.4-44.7%), while worldwide rate was 34.8% (n = 3582) (95%CI: 32.7-36.8%). In most cases, it was categorized as atherosclerotic CVD 35.3% (n = 295) (95%CI: 32.3; -38.4%). Likewise, the rate of use of antidiabetic drugs with proven cardiovascular benefits was low, both in Argentina (12.8%: n = 107) and global data (21.9%; n = 2151).


La enfermedad cardiovascular (ECV) es la principal causa de morbimortalidad en los pacientes con diabetes mellitus tipo 2 (DM2). Sin embargo, se dispone de escasos datos específicos sobre la prevalencia de ECV en esta población en la práctica clínica cotidiana. El estudio CAPTURE investigó la prevalencia contemporánea de ECV en una muestra representativa de la población con diagnóstico de DM2 en 13 países, distribuidos en 5 continentes (n = 9823). Entre los 834 participantes de Argentina, la prevalencia de ECV fue de 41.5% (n = 347) (intervalo de confianza del 95% [IC95%]: 38.4-44.7%), mientras que a nivel mundial la prevalencia fue 34.8% (n = 3582) (IC95%: 32.7-36.8%). La mayoría de los casos fue categorizada como ECV aterosclerótica: 35.3% (n = 295) (IC95%:32.3-38.4%). Asimismo, la utilización de medicamentos antidiabéticos con beneficios cardiovasculares comprobados fue baja: 12.8% (n = 107) y 21.9% (n = 2151) en Argentina y a nivel global respectivamente.


Assuntos
Aterosclerose , Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Argentina/epidemiologia , Aterosclerose/complicações , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Humanos , Prevalência
4.
Diabetes Ther ; 13(4): 761-774, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35290624

RESUMO

AIMS: To investigate the efficacy and safety of fast-acting insulin aspart (faster aspart) compared with insulin aspart (IAsp) in participants with type 2 diabetes (T2D) across different subgroups. METHODS: We report on a post hoc analysis of onset 9, a 16-week trial of participants with T2D randomised to faster aspart (n = 546) or IAsp (n = 545). Participants were grouped by baseline HbA1c (< 7.0%, ≥ 7.0%), meal test bolus insulin dose (≤ 10 units [U], > 10 U to ≤ 20 U, > 20 U), body mass index (< 30 kg/m2, ≥ 30 to < 35 kg/m2, ≥ 35 kg/m2), and age (< 65 years, ≥ 65 years). Outcomes assessed were change from baseline in HbA1c and in 1-h postprandial glucose (PPG) increment, and severe or blood glucose (BG)-confirmed hypoglycaemia. RESULTS: Faster aspart provided reductions in HbA1c comparable to IAsp across all subgroups, with improved 1-h PPG control compared with IAsp in several subgroups. Faster aspart had comparable or improved rates of severe or BG-confirmed hypoglycaemia versus IAsp, particularly in participants with good glycaemic control (HbA1c < 7.0%), the elderly (≥ 65 years old), and those with insulin resistance (> 20 U meal test bolus insulin dose). CONCLUSIONS: Faster aspart provides effective overall glycaemic control, with improved early PPG control compared with IAsp across a range of patient characteristics. CLINICAL TRIAL REGISTRATION: NCT03268005.


Fast-acting insulin aspart (faster aspart) is a type of insulin used at mealtimes to reduce the spike in blood sugar resulting from that meal. Faster aspart works in the body more quickly and more effectively than insulin aspart (IAsp), the previous version of this insulin. The properties of insulins in the body can change according to certain patient characteristics. In this study, the researchers wanted to find out if there were differences between various subgroups of patients in the effectiveness and safety of faster aspart compared with IAsp in the treatment of type 2 diabetes. Data were used from a clinical trial (onset 9), in which 546 patients were treated with faster aspart and 545 were treated with IAsp. Patients were grouped by baseline glycated haemoglobin (HbA1c), meal test actual bolus insulin dose, body mass index, and age. Faster aspart provided reductions in HbA1c comparable to IAsp across all subgroups, with improved glucose control 1 hour after a meal compared with IAsp, in several subgroups. Faster aspart had comparable or improved rates of hypoglycaemia versus IAsp, particularly in participants with good glucose control, the elderly (≥ 65 years old), and those with insulin resistance. In summary, the researchers found that faster aspart provides effective overall glucose control, with improved early mealtime glucose control compared with IAsp across patients with a range of baseline characteristics.

5.
ACS Nano ; 15(4): 7006-7020, 2021 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-33733736

RESUMO

Doping-induced solubility control (DISC) patterning is a recently developed technique that uses the change in polymer solubility upon doping, along with an optical dedoping process, to achieve high-resolution optical patterning. DISC patterning can produce features smaller than predicted by the diffraction limit; however, no mechanism has been proposed to explain such high resolution. Here, we use diffraction to spatially modulate the light intensity and determine the dissolution rate, revealing a superlinear dependence on light intensity. This rate law is independent of wavelength, indicating that patterning resolution is not dominated by an optical dedoping reaction, as was previously proposed. Instead we show here that the optical patterning mechanism is primarily controlled by the thermal profile generated by the laser. To quantify this effect, the thermal profile and dissolution rate are modeled using a finite-element model and compared against patterned line cross sections as a function of wavelength, laser intensity, and dwell time. Our model reveals that although the laser-generated thermal profile is broadened considerably beyond the profile of the laser, the highly temperature dependent dissolution rate results in selective dissolution near the peak of the thermal profile. Therefore, the key factor in achieving super-resolution patterning is a strongly temperature dependent dissolution rate, a common feature of many polymers. In addition to suggesting several routes to improved resolution, our model also demonstrates that doping is not required for optical patterning of conjugated polymers, as was previously believed. Instead, we demonstrate that superlinear resolution optical patterning should be attainable in any conjugated polymer simply by tuning the solvent quality during patterning, thus extending the applicability of our method to a wide class of materials. We demonstrate the generality of photothermal patterning by writing sub-400 nm features into undoped PffBT4T-2OD.

6.
Diabetes Care ; 43(8): 1710-1716, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32209647

RESUMO

OBJECTIVE: To evaluate the efficacy and safety of fast-acting insulin aspart (faster aspart) compared with insulin aspart (IAsp), both with insulin degludec with or without metformin, in adults with type 2 diabetes not optimally controlled with a basal-bolus regimen. RESEARCH DESIGN AND METHODS: This multicenter, double-blind, treat-to-target trial randomized participants to faster aspart (n = 546) or IAsp (n = 545). All available information, regardless of treatment discontinuation or use of ancillary treatment, was used for evaluation of effect. RESULTS: Noninferiority for the change from baseline in HbA1c 16 weeks after randomization (primary end point) was confirmed for faster aspart versus IAsp (estimated treatment difference [ETD] -0.04% [95% CI -0.11; 0.03]; -0.39 mmol/mol [-1.15; 0.37]; P < 0.001). Faster aspart was superior to IAsp for change from baseline in 1-h postprandial glucose (PPG) increment using a meal test (ETD -0.40 mmol/L [-0.66; -0.14]; -7.23 mg/dL [-11.92; -2.55]; P = 0.001 for superiority). Change from baseline in self-measured 1-h PPG increment for the mean over all meals favored faster aspart (ETD -0.25 mmol/L [-0.42; -0.09]); -4.58 mg/dL [-7.59; -1.57]; P = 0.003). The overall rate of treatment-emergent severe or blood glucose (BG)-confirmed hypoglycemia was statistically significantly lower for faster aspart versus IAsp (estimated treatment ratio 0.81 [95% CI 0.68; 0.97]). CONCLUSIONS: In combination with insulin degludec, faster aspart provided effective overall glycemic control, superior PPG control, and a lower rate of severe or BG-confirmed hypoglycemia versus IAsp in adults with type 2 diabetes not optimally controlled with a basal-bolus regimen.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Insulina Aspart , Insulina de Ação Prolongada , Metformina , Idoso , Glicemia/efeitos dos fármacos , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/sangue , Método Duplo-Cego , Combinação de Medicamentos , Quimioterapia Combinada , Feminino , Hemoglobinas Glicadas/efeitos dos fármacos , Hemoglobinas Glicadas/metabolismo , Humanos , Hipoglicemia/induzido quimicamente , Hipoglicemia/epidemiologia , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/efeitos adversos , Insulina Aspart/administração & dosagem , Insulina Aspart/efeitos adversos , Insulina de Ação Prolongada/administração & dosagem , Insulina de Ação Prolongada/efeitos adversos , Masculino , Refeições , Metformina/administração & dosagem , Metformina/efeitos adversos , Pessoa de Meia-Idade , Período Pós-Prandial/efeitos dos fármacos , Resultado do Tratamento
7.
Diabetes Care ; 41(5): 1009-1016, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29483185

RESUMO

OBJECTIVE: In patients with uncontrolled type 2 diabetes on basal insulin, prandial insulin may be initiated. We assessed the efficacy and safety of initiating insulin degludec/liraglutide fixed-ratio combination (IDegLira) versus basal-bolus insulin. RESEARCH DESIGN AND METHODS: A phase 3b trial examined patients with uncontrolled type 2 diabetes on insulin glargine (IGlar U100) 20-50 units/day and metformin, randomized to IDegLira or IGlar U100 and insulin aspart ≤4 times per day. RESULTS: Glycated hemoglobin (HbA1c) decreased from 8.2% (66 mmol/mol) to 6.7% (50 mmol/mol) with IDegLira and from 8.2% (67 mmol/mol) to 6.7% (50 mmol/mol) with basal-bolus (estimated treatment difference [ETD] -0.02% [95% CI -0.16, 0.12]; -0.2 mmol/mol [95% CI -1.7, 1.3]), confirming IDegLira noninferiority versus basal-bolus (P < 0.0001). The number of severe or blood glucose-confirmed symptomatic hypoglycemia events was lower with IDegLira versus basal-bolus (risk ratio 0.39 [95% CI 0.29, 0.51]; rate ratio 0.11 [95% CI 0.08, 0.17]). Body weight decreased with IDegLira and increased with basal-bolus (ETD -3.6 kg [95% CI -4.2, -2.9]). Fasting plasma glucose reductions were similar; lunch, dinner, and bedtime self-monitored plasma glucose measurements were significantly lower with basal-bolus. Sixty-six percent of patients on IDegLira vs. 67.0% on basal-bolus achieved HbA1c <7.0% (53 mmol/mol). Total daily insulin dose was lower with IDegLira (40 units) than basal-bolus (84 units total; 52 units basal). CONCLUSIONS: In patients with uncontrolled type 2 diabetes on IGlar U100 and metformin, IDegLira treatment elicited HbA1c reductions comparable to basal-bolus, with statistically superior lower hypoglycemia rates and weight loss versus weight gain.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/efeitos adversos , Insulina de Ação Prolongada/administração & dosagem , Insulina de Ação Prolongada/efeitos adversos , Insulina/administração & dosagem , Liraglutida/administração & dosagem , Liraglutida/efeitos adversos , Metformina/administração & dosagem , Adulto , Idoso , Glicemia/efeitos dos fármacos , Glicemia/metabolismo , Combinação de Medicamentos , Quimioterapia Combinada , Feminino , Hemoglobinas Glicadas/análise , Humanos , Insulina/efeitos adversos , Insulina Aspart/administração & dosagem , Insulina Aspart/efeitos adversos , Insulina Glargina/administração & dosagem , Insulina Glargina/efeitos adversos , Masculino , Metformina/efeitos adversos , Pessoa de Meia-Idade , Resultado do Tratamento
8.
Bol. latinoam. Caribe plantas med. aromát ; 12(4): 385-399, jul. 2013. mapas, tab, graf
Artigo em Espanhol | LILACS | ID: lil-724332

RESUMO

This work constitutes a record of vascular plant species used for therapeutic purposes on Santiago Island, located in the Rio de La Plata, southeast of the Party of Ensenada, Buenos Aires, Argentina. The island has an area of 8 km2 and consists of alluvial land, with natural and rich floristic environments. Eighty three households were sampled, plant specimens were collected “in-situ”, were identified using specific literature and binocular magnifying glass, and a digital photographic record was made. We identified 40 species of vascular plants, used by the islanders in folk medicine, mostly exotic and herbaceous. Also, 32 therapeutic uses and 11 affections were reported. The digestive and skin disorders were the most representative.


Este trabajo constituye un registro de especies de plantas vasculares utilizadas con fines terapéuticos en la Isla Santiago, ubicada en el Río de La Plata, al SE del Partido de Ensenada, provincia de Buenos Aires, Argentina. La isla, tiene una superficie de 8 km2 y está formada por tierras de origen aluvional, con ambientes naturales de gran riqueza florística. Se muestrearon 83 unidades domésticas, se recolectaron ejemplares vegetales “in-situ”, se identificaron utilizando bibliografía específica y lupa binocular y se hizo un registro fotográfico digital. Se identificaron 40 especies de plantas vasculares, utilizadas por los isleños en medicina popular, la mayoría exóticas y herbáceas. Asimismo, se reportaron 32 usos terapéuticos y 11 afecciones; los trastornos digestivos y de la piel fueron los más representativos.


Assuntos
Humanos , Etnobotânica , Extratos Vegetais/uso terapêutico , Plantas Medicinais , Argentina , Entrevistas como Assunto
9.
Medicina (B Aires) ; 72(3): 235-42, 2012.
Artigo em Espanhol | MEDLINE | ID: mdl-22763161

RESUMO

Information on starting insulin regimens in specific populations with type 2 diabetes (T2D) is limited. This analysis compared efficacy and safety of two starter insulin regimens: insulin lispro mix 25 (LM25) and basal insulin glargine (GL) in patients from Argentina. This post-hoc analysis evaluated 193 insulin-naïve patients who participated in the DURABLE trial 24-week initiation phase. Patients 30-79 years with T2D inadequately controlled (HbA1c > 7.0%) with = 2 oral antihyperglycemic medications (OAMs), were randomized to add LM25 (25% insulin lispro, 75% insulin lispro protamine suspension) twice daily or GL (basal insulin glargine) once daily to pre-study OAMs. Primary efficacy was measured by HbA1c at 24-week endpoint. Secondary measures included: proportion of patients achieving HbA1c = 6.5% and = 7.0%, body weight change, self-monitored blood glucose (BG) values, and hypoglycemia rates. LM25 demonstrated greater HbA1c reduction (- 2.4% ± 0.16 vs. -2.0% ± 0.16, P = 0.002), a higher proportion of patients achieving HbA1c = 7.0% (P = 0.012), and lower BG levels after the morning (P = 0.028) and evening (P = 0.011) meals, and at 3:00AM (P = 0.005) compared with GL. Fasting BG and proportion of patients achieving HbA1c = 6.5% were similar between groups. Both groups increased body weight, although the gain was higher at endpoint with LM25 (6.35 kg vs. 4.23 kg, P < 0.001). No differences in hypoglycemia rates were observed between groups, and no serious adverse events were reported for either group. In this subgroup from Argentina, LM25 demonstrated greater improvement in glucose control with similar risk of hypoglycemia and more weight gain than GL.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Hemoglobinas Glicadas/efeitos dos fármacos , Hipoglicemiantes/administração & dosagem , Insulina Lispro/administração & dosagem , Insulina de Ação Prolongada/administração & dosagem , Adulto , Idoso , Argentina , Glicemia/efeitos dos fármacos , Relação Dose-Resposta a Droga , Feminino , Humanos , Hipoglicemia/etiologia , Insulina Glargina , Masculino , Pessoa de Meia-Idade , Período Pós-Prandial , Aumento de Peso/efeitos dos fármacos
10.
Medicina (B.Aires) ; 72(3): 235-242, jun. 2012. ilus, graf, tab
Artigo em Espanhol | LILACS | ID: lil-657508

RESUMO

La información sobre el inicio de regímenes de insulina en poblaciones específicas con diabetes tipo 2 (DT2) es limitada. Se comparó eficacia y seguridad de dos regímenes de inicio: insulina lispro mix 25 (LM25) e insulina glargina basal (GL). Se evaluaron 193 pacientes no tratados previamente con insulina, en la fase de iniciación de 24 semanas del ensayo DURABLE; edades: 30-79 años, DT2 controlada inadecuadamente (HbA1c > 7.0%) con = 2 medicaciones orales antidiabéticas (MOAs), aleatorizados para LM25 (25% de insulina lispro, 75% de insulina lispro protamina en suspensión) dos veces/día, o GL (insulina glargina basal) una vez/ día, a las MOAs previas. La eficacia primaria se midió por HbA1c a las 24 semanas. Se midió eficacia secundaria por: proporción de pacientes que alcanzaron HbA1c= 6.5% y= 7.0%, cambio en peso corporal, valores de automonitoreo glucémico e índices de hipoglucemia. LM25 demostró mayor reducción de la HbA1c (- 2.4% ± 0.16 vs. -2.0% ± 0.16, P = 0.002), mayor proporción de pacientes alcanzaron HbA1c= 7.0% (P = 0.012) y niveles de glucemia menores después del desayuno (P = 0.028) y de la cena (P = 0.011), y a las 3 a.m. (P = 0.005) comparada con GL. La glucemia en ayunas (GA) y la proporción de pacientes que alcanzaron una HbA1c= 6.5% fueron similares. En ambos grupos hubo aumento del peso corporal, mayor en la valoración final con LM25 (6.35 kg vs. 4.23 kg, P < 0.001). No hubieron diferencias en índices de hipoglucemia entre grupos, ni eventos adversos serios en ninguno. Con LM25 fue mejor el control de glucosa, riesgo de hipoglucemia similar y mayor aumento de peso que GL.


Information on starting insulin regimens in specific populations with type 2 diabetes (T2D) is limited. This analysis compared efficacy and safety of two starter insulin regimens: insulin lispro mix 25 (LM25) and basal insulin glargine (GL) in patients from Argentina. This post-hoc analysis evaluated 193 insulin-naïve patients who participated in the DURABLE trial 24-week initiation phase. Patients 30-79 years with T2D inadequately controlled (HbA1c > 7.0%) with = 2 oral antihyperglycemic medications (OAMs), were randomized to add LM25 (25% insulin lispro, 75% insulin lispro protamine suspension) twice daily or GL (basal insulin glargine) once daily to pre-study OAMs. Primary efficacy was measured by HbA1c at 24-week endpoint. Secondary measures included: proportion of patients achieving HbA1c= 6.5% and= 7.0%, body weight change, self-monitored blood glucose (BG) values, and hypoglycemia rates. LM25 demonstrated greater HbA1c reduction (- 2.4% ± 0.16 vs. -2.0% ± 0.16, P = 0.002), a higher proportion of patients achieving HbA1c= 7.0% (P = 0.012), and lower BG levels after the morning (P = 0.028) and evening (P = 0.011) meals, and at 3:00AM (P = 0.005) compared with GL. Fasting BG and proportion of patients achieving HbA1c= 6.5% were similar between groups. Both groups increased body weight, although the gain was higher at endpoint with LM25 (6.35 kg vs. 4.23 kg, P < 0.001). No differences in hypoglycemia rates were observed between groups, and no serious adverse events were reported for either group. In this subgroup from Argentina, LM25 demonstrated greater improvement in glucose control with similar risk of hypoglycemia and more weight gain than GL.


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , /tratamento farmacológico , Hemoglobinas Glicadas/efeitos dos fármacos , Hipoglicemiantes/administração & dosagem , Insulina Lispro/administração & dosagem , Insulina de Ação Prolongada/administração & dosagem , Argentina , Glicemia/efeitos dos fármacos , Relação Dose-Resposta a Droga , Hipoglicemia/etiologia , Período Pós-Prandial , Aumento de Peso/efeitos dos fármacos
11.
Medicina (B.Aires) ; 72(3): 235-242, jun. 2012. ilus, graf, tab
Artigo em Espanhol | BINACIS | ID: bin-129330

RESUMO

La información sobre el inicio de regímenes de insulina en poblaciones específicas con diabetes tipo 2 (DT2) es limitada. Se comparó eficacia y seguridad de dos regímenes de inicio: insulina lispro mix 25 (LM25) e insulina glargina basal (GL). Se evaluaron 193 pacientes no tratados previamente con insulina, en la fase de iniciación de 24 semanas del ensayo DURABLE; edades: 30-79 años, DT2 controlada inadecuadamente (HbA1c > 7.0%) con = 2 medicaciones orales antidiabéticas (MOAs), aleatorizados para LM25 (25% de insulina lispro, 75% de insulina lispro protamina en suspensión) dos veces/día, o GL (insulina glargina basal) una vez/ día, a las MOAs previas. La eficacia primaria se midió por HbA1c a las 24 semanas. Se midió eficacia secundaria por: proporción de pacientes que alcanzaron HbA1c= 6.5% y= 7.0%, cambio en peso corporal, valores de automonitoreo glucémico e índices de hipoglucemia. LM25 demostró mayor reducción de la HbA1c (- 2.4% ± 0.16 vs. -2.0% ± 0.16, P = 0.002), mayor proporción de pacientes alcanzaron HbA1c= 7.0% (P = 0.012) y niveles de glucemia menores después del desayuno (P = 0.028) y de la cena (P = 0.011), y a las 3 a.m. (P = 0.005) comparada con GL. La glucemia en ayunas (GA) y la proporción de pacientes que alcanzaron una HbA1c= 6.5% fueron similares. En ambos grupos hubo aumento del peso corporal, mayor en la valoración final con LM25 (6.35 kg vs. 4.23 kg, P < 0.001). No hubieron diferencias en índices de hipoglucemia entre grupos, ni eventos adversos serios en ninguno. Con LM25 fue mejor el control de glucosa, riesgo de hipoglucemia similar y mayor aumento de peso que GL.(AU)


Information on starting insulin regimens in specific populations with type 2 diabetes (T2D) is limited. This analysis compared efficacy and safety of two starter insulin regimens: insulin lispro mix 25 (LM25) and basal insulin glargine (GL) in patients from Argentina. This post-hoc analysis evaluated 193 insulin-na´ve patients who participated in the DURABLE trial 24-week initiation phase. Patients 30-79 years with T2D inadequately controlled (HbA1c > 7.0%) with = 2 oral antihyperglycemic medications (OAMs), were randomized to add LM25 (25% insulin lispro, 75% insulin lispro protamine suspension) twice daily or GL (basal insulin glargine) once daily to pre-study OAMs. Primary efficacy was measured by HbA1c at 24-week endpoint. Secondary measures included: proportion of patients achieving HbA1c= 6.5% and= 7.0%, body weight change, self-monitored blood glucose (BG) values, and hypoglycemia rates. LM25 demonstrated greater HbA1c reduction (- 2.4% ± 0.16 vs. -2.0% ± 0.16, P = 0.002), a higher proportion of patients achieving HbA1c= 7.0% (P = 0.012), and lower BG levels after the morning (P = 0.028) and evening (P = 0.011) meals, and at 3:00AM (P = 0.005) compared with GL. Fasting BG and proportion of patients achieving HbA1c= 6.5% were similar between groups. Both groups increased body weight, although the gain was higher at endpoint with LM25 (6.35 kg vs. 4.23 kg, P < 0.001). No differences in hypoglycemia rates were observed between groups, and no serious adverse events were reported for either group. In this subgroup from Argentina, LM25 demonstrated greater improvement in glucose control with similar risk of hypoglycemia and more weight gain than GL.(AU)


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hemoglobinas Glicadas/efeitos dos fármacos , Hipoglicemiantes/administração & dosagem , Insulina Lispro/administração & dosagem , Insulina de Ação Prolongada/administração & dosagem , Argentina , Glicemia/efeitos dos fármacos , Relação Dose-Resposta a Droga , Hipoglicemia/etiologia , Período Pós-Prandial , Aumento de Peso/efeitos dos fármacos
12.
Acta bioquím. clín. latinoam ; 27(4): 463-70, dic. 1993. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-135777

RESUMO

Para el diagnóstico de las enfermedades renales con compromiso glomerular, se utiliza tradicionalmente el dosaje de proteínas en muestras de orina de 24 horas. En general, este tipo de muestras está sujeta a errores de recolección que influyen en los resultados. En este trabajo se evaluó la correlación del índice proteinuria-creatininuria en una muestra aislada de orina (prot/creat) aislada con la excreción diaria de proteinuria. Para ello se evaluaron 133 individuos adultos, de los cuales 21 eran normales, 65 abarcaban una amplia gama de patología renal, y el resto se excluyó por mala recolección de la muestra. Se encontró una buena correlación lineal (r:0,958) entre el contenido de la proteinuria de 24 horas y el índice (prot/creat) aislada y una mejor correlación (r:0,972) se halló entre el índice (prot/creat) de 24 horas y el índice (prot/cret) aislada. Se concluye que la determinación del índice (prot/cret) aislada es un parámetro fiable para evaluar la excreción de proteínas en orina de 24 horas y puede usarse para realizar el seguimiento del paciente proteinúrico. Se calcularon valores de corte para el índice (prot/cret) aislada de los diferentes grupos de pacientes, un valor menor de 0,145 es indicativo de normalidad, un valor mayor de 1,82 caracteriza al rango nefrótico y valores intermedios (entre 0,145 y 1,82) reflejan algún tipo de enfermedad renal


Assuntos
Humanos , Masculino , Feminino , Adulto , Creatinina/análise , Nefropatias/diagnóstico , Proteinúria/diagnóstico , Urina/química , Creatinina , Creatinina/urina , Nefropatias/urina , Proteinúria/urina
13.
Acta bioquím. clín. latinoam ; 27(4): 463-70, dic. 1993. ilus, tab
Artigo em Espanhol | BINACIS | ID: bin-24754

RESUMO

Para el diagnóstico de las enfermedades renales con compromiso glomerular, se utiliza tradicionalmente el dosaje de proteínas en muestras de orina de 24 horas. En general, este tipo de muestras está sujeta a errores de recolección que influyen en los resultados. En este trabajo se evaluó la correlación del índice proteinuria-creatininuria en una muestra aislada de orina (prot/creat) aislada con la excreción diaria de proteinuria. Para ello se evaluaron 133 individuos adultos, de los cuales 21 eran normales, 65 abarcaban una amplia gama de patología renal, y el resto se excluyó por mala recolección de la muestra. Se encontró una buena correlación lineal (r:0,958) entre el contenido de la proteinuria de 24 horas y el índice (prot/creat) aislada y una mejor correlación (r:0,972) se halló entre el índice (prot/creat) de 24 horas y el índice (prot/cret) aislada. Se concluye que la determinación del índice (prot/cret) aislada es un parámetro fiable para evaluar la excreción de proteínas en orina de 24 horas y puede usarse para realizar el seguimiento del paciente proteinúrico. Se calcularon valores de corte para el índice (prot/cret) aislada de los diferentes grupos de pacientes, un valor menor de 0,145 es indicativo de normalidad, un valor mayor de 1,82 caracteriza al rango nefrótico y valores intermedios (entre 0,145 y 1,82) reflejan algún tipo de enfermedad renal(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Proteinúria/diagnóstico , Nefropatias/diagnóstico , Urina/química , Creatinina/análise , Proteinúria/urina , Nefropatias/urina , Creatinina/urina , Creatinina/diagnóstico
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