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Kawaguchi Y, Hajika Y, Rinka M, Masumoto K, Sawa J, Hamazaki K, Kumeda Y. Comparison of efficacy and safety of insulin degludec/liraglutide and insulin glargine U-100/lixisenatide in individuals with type 2 diabetes mellitus using professional continuous glucose monitoring. J Diabetes Investig 2024; 15:598-607. [PMID: 38258482 PMCID: PMC11060164 DOI: 10.1111/jdi.14151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/22/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
AIM/INTRODUCTION Insulin glargine U100/lixisenatide and insulin degludec/liraglutide are fixed-ratio combinations containing basal insulin and a glucagon-like peptide-1 receptor agonist capable of reducing both fasting and postprandial blood glucose levels with a single formulation. This study aimed to compare the time in range (TIR) and the time below range (TBR) level 1 using professional continuous glucose monitoring and to establish criteria for the differential use of the fixed-ratio combinations. MATERIALS AND METHODS Thirty-six outpatients with type 2 diabetes mellitus (24 men and 12 women; average age, 62.1 years) were randomly assigned to the groups. At 0 and 18 weeks, a device was worn to compare the TIR and TBR level 1. The correlation between the C-peptide index at baseline and TIR at 18 weeks was assessed. RESULTS The TIR and TBR level 1 showed no significant differences between the two groups. Both groups showed significant positive correlations between the C-peptide index and the TIR (P = 0.002, r = 0.679; P = 0.002, r = 0.681, respectively). The changes in glycemic variability, therapeutic indices, and body mass index were not significantly different among the groups (P > 0.05). The receiver operating curve analysis revealed that the cut-off values of the C-peptide index to achieve TIR of >70% at 18 weeks were 1.258 (sensitivity, 77.8%; specificity, 100%) and 1.099 (sensitivity, 57.1%; specificity, 90.9%) in the insulin glargine U100/lixisenatide and insulin degludec/liraglutide groups, respectively. CONCLUSIONS A TIR of >70% was achieved for both fixed-ratio combinations without significant differences.
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Affiliation(s)
- Yuji Kawaguchi
- Department of Internal MedicineMinami Osaka HospitalOsakaJapan
| | - Yuriko Hajika
- Department of Internal MedicineMinami Osaka HospitalOsakaJapan
| | - Maho Rinka
- Department of Internal MedicineMinami Osaka HospitalOsakaJapan
| | - Koji Masumoto
- Department of Internal MedicineMinami Osaka HospitalOsakaJapan
| | - Jun Sawa
- Department of Internal MedicineMinami Osaka HospitalOsakaJapan
| | - Kenji Hamazaki
- Department of Internal MedicineMinami Osaka HospitalOsakaJapan
| | - Yasuro Kumeda
- Department of Internal MedicineMinami Osaka HospitalOsakaJapan
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Chow E, Chan JCN. Targeting postprandial glucose control using ultra-rapid insulins: is faster better? Sci Bull (Beijing) 2022; 67:2392-2394. [PMID: 36566058 DOI: 10.1016/j.scib.2022.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Elaine Chow
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China; Phase 1 Clinical Trial Centre, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Juliana C N Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
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Tamez-Pérez HE, Cantú-Santos OM, Gutierrez-González D, González-Facio R, Romero-Ibarguengoitia ME. Effect of Digital-Tool-Supported Basal Insulin Titration Algorithm in Reaching Glycemic Control in Patients with Type 2 Diabetes in Mexico. J Diabetes Sci Technol 2022; 16:1513-1520. [PMID: 34323110 PMCID: PMC9631525 DOI: 10.1177/19322968211034533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND My Dose Coach (MDC) is a mobile application combined with a web portal that can suggest optimized basal insulin (BI) injection doses using Self-Measured Plasma Glucose (SMPG) and hypoglycemia data. This study aimed to evaluate its efficacy on patients reaching SMPG and Fasting blood glucose (FBG) target range 90-130 mg/dl (5-7.2 mmol/L) goals without severe hypoglycemic episodes. We also addressed the mean reduction in glycated hemoglobin (A1C), FBG, and SMPG and the improvement in the WHO's Five Well Being Index (WBI). METHODS This prospective pilot study involved the use of MDC in outpatients with type 2 diabetes (T2DM) from a Hospital in Northern Mexico. Patients on treatment with any BI were included in the study. The follow-up was of 16 weeks. Student t-tests or McNemar test were used for effect comparisons. RESULTS We included 158 patients (46.8% women), mean (SD) age 51 (10.3) years. We achieved SMPG target range in 58.9% [mean (95CI) reduction of 30.9 mg/dl (22.5-37.7; P < .001)] of the patients [66(28) days], with no severe hypoglycemia events. FBG goal was reached in 55.7% [mean (95CI) reduction of 63.4 mg/dl (49.6-77.2; P < .001)]. The mean (95CI) reduction of A1C was 1.78% (1.47-2, P < .01) with the last observation carried forward. There was a mean (95CI) increase of 2.23 (-3, -1.4, P < .01) points in WBI scale. CONCLUSIONS MDC successfully helped to achieve FBG and SMPG goals, reduced A1C, and increased WBI with no severe hypoglycemia events.
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Affiliation(s)
| | | | - Oscar Manuel Cantú-Santos
- Internal Medicine Department, Hospital
Clinica Nova de Monterrey, San Nicolas de los Garza, Nuevo Leon, Mexico
| | - Dalia Gutierrez-González
- Research Department, Hospital Clinica
Nova de Monterrey, San Nicolas de los Garza, Nuevo Leon, Mexico
| | - Rosalinda González-Facio
- Internal Medicine Department, Hospital
Clinica Nova de Monterrey, San Nicolas de los Garza, Nuevo Leon, Mexico
| | - Maria Elena Romero-Ibarguengoitia
- Research Department, Hospital Clinica
Nova de Monterrey, San Nicolas de los Garza, Nuevo Leon, Mexico
- Maria Elena Romero Ibarguengoitia, MD, MS,
PhD, Hospital Clinica Nova de Monterrey. Av. Del Bosque 139, Cuauhtémoc, San
Nicolas de los Garza, Nuevo Leon, CP 66450, Mexico.
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Motoda S, Watanabe N, Nakata S, Hayashi I, Komatsu R, Ishibashi C, Fujita S, Baden MY, Kimura T, Fujita Y, Tokunaga A, Takahara M, Fukui K, Iwahashi H, Kozawa J, Shimomura I. Motivation for Treatment Correlating Most Strongly with an Increase in Satisfaction with Type 2 Diabetes Treatment. Diabetes Ther 2022; 13:709-721. [PMID: 35267173 PMCID: PMC8908749 DOI: 10.1007/s13300-022-01235-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 02/16/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION We previously reported several factors that cross-sectionally correlate with treatment satisfaction in Japanese patients with type 2 diabetes visiting diabetes clinics. The aim of this study is to identify factors associated with longitudinal changes in treatment satisfaction in patients with type 2 diabetes. METHODS The study included 649 patients with type 2 diabetes treated with oral glucose-lowering agents who completed the first questionnaire in 2016. The collected data included scores from the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and other parameters regarding diabetes treatment. We analyzed 1-year longitudinal changes in DTSQ scores and investigated factors associated with these changes. RESULTS Univariate linear regression analyses showed that changes in body weight, adherence to diet therapy, adherence to exercise therapy, cost burden, motivation for treatment, regularity of mealtimes, and perceived hypoglycemia correlated with changes in DTSQ scores. On the basis of multiple linear regression analyses, a decrease in hypoglycemia (β ± SE = - 0.394 ± 0.134, p = 0.0034), cost burden (β ± SE = - 0.934 ± 0.389, p = 0.017), and an increase in treatment motivation (β ± SE = 1.621 ± 0.606, p = 0.0077) correlated with DTSQ score increases, suggesting that motivation for treatment had the strongest impact on score increases. Subgroup analyses revealed that an increase in motivation for treatment most significantly correlated with a DTSQ score increase in obese and poor glycemic control groups, regardless of age. CONCLUSION This is the first longitudinal study clarifying that an increase in motivation for treatment most strongly correlates with an increase in DTSQ score in patients with type 2 diabetes.
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Affiliation(s)
- Saori Motoda
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2-B5 Yamadaoka, Suita, 565-0871, Japan
| | | | | | | | | | - Chisaki Ishibashi
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2-B5 Yamadaoka, Suita, 565-0871, Japan
| | - Shingo Fujita
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2-B5 Yamadaoka, Suita, 565-0871, Japan
| | - Megu Y Baden
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2-B5 Yamadaoka, Suita, 565-0871, Japan
| | - Takekazu Kimura
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2-B5 Yamadaoka, Suita, 565-0871, Japan
| | - Yukari Fujita
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2-B5 Yamadaoka, Suita, 565-0871, Japan
- Department of Community Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Ayumi Tokunaga
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2-B5 Yamadaoka, Suita, 565-0871, Japan
| | - Mitsuyoshi Takahara
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2-B5 Yamadaoka, Suita, 565-0871, Japan
- Department of Diabetes Care Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kenji Fukui
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2-B5 Yamadaoka, Suita, 565-0871, Japan
| | - Hiromi Iwahashi
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2-B5 Yamadaoka, Suita, 565-0871, Japan
- Department of Diabetes Care Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
- Department of Internal Medicine, Toyonaka Municipal Hospital, Osaka, Japan
| | - Junji Kozawa
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2-B5 Yamadaoka, Suita, 565-0871, Japan.
- Department of Diabetes Care Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2-B5 Yamadaoka, Suita, 565-0871, Japan
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Shao C, Sun M, Liu W, Zhao S, Liu Y, Chen Y, Liang SN, Yuan H, Sui H, Wang B, Li S. Patient-Reported Outcomes Following the Use of Jiang Tang San Huang Tablets in Type 2 Diabetes Mellitus: A Retrospective Cohort Study in a Chinese Population. Diabetes Metab Syndr Obes 2022; 15:4023-4033. [PMID: 36582504 PMCID: PMC9793732 DOI: 10.2147/dmso.s388336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE We aimed to assess the efficacy of the Jiang Tang San Huang (JTSH) tablet for the treatment of patients with type 2 diabetes mellitus (T2DM). METHODS All data for this retrospective cohort study were acquired from the outpatient clinic database of our institution, and all enrolled patients received JTSH tablet for at least two months. Overall, 147 patients were included in the analysis. The primary outcome was patient-reported outcomes on the efficacy of the JTSH tablets using a questionnaire survey. Correlation analysis evaluated the duration of JTSH tablet administration and glycemic control in patients with T2DM. The secondary outcome measures included: changes in glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2-hour postprandial blood glucose, homeostasis model assessment of insulin resistance index (HOMA-IR) and homeostasis model assessment of β-cell function (HOMA-β) after 2 months of treatment with JTSH tablets. RESULTS Overall,120 patients (81.63%) reported a JTSH tablet treatment satisfaction score of ≥60 points, and believed that JTSH tablets had satisfactory hypoglycemic effects and could improve symptoms. The average duration of JTSH tablet treatment was 2.57±1.45 years. Overall, 111 patients achieved good blood glucose control, while 36 patients had poor glycemic control. Multivariate logistic regression model analysis showed that taking JTSH tablets for 1 year might reduce the risk of poor hypoglycemic effect by 17.00% (Risk ratio=0.830, 95% confidence interval:0.578, 1.021, P=0.066). Compared with the baseline data, the levels of HbA1c, FPG and HOMA-IR decreased significantly and HOMA-β levels increased significantly (P<0.05). CONCLUSION Good blood glucose control may be positively correlated with the duration of JTSH tablets administration. Patients with T2DM were satisfied with the anti-diabetic effects of JTSH tablets, which can significantly reduce blood glucose and insulin resistance, and improve the function of islet cells.
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Affiliation(s)
- Cui Shao
- Department of Endocrinology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Mengxue Sun
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Wanwen Liu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Shaoyang Zhao
- Department of Endocrinology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Yang Liu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Yuna Chen
- Department of Endocrinology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Shu-Nung Liang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Haoyu Yuan
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Huacheng Sui
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Baohua Wang
- Department of Endocrinology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
- Correspondence: Baohua Wang; Saimei Li, Department of Endocrinology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China, Tel +8613580515855; +8615818159018, Fax +86 20-36588726, Email ;
| | - Saimei Li
- Department of Endocrinology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
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