Challenges associated with insulin therapy progression among patients with type 2 diabetes: Latin American MOSAIc study baseline data.

Background: Poor glycemic control in patients with type 2 diabetes is commonly recorded worldwide; Latin America (LA) is not an exception. Barriers to intensifying insulin therapy and which barriers are most likely to negatively impact outcomes are not completely known. The objective was to identify barriers to insulin progression in individuals with type 2 diabetes mellitus (T2DM) in LA countries (Mexico, Brazil, and Argentina).

Prandial-basal insulin regimens plus oral antihyperglycaemic agents to improve mealtime glycaemia: initiate and progressively advance insulin therapy in type 2 diabetes.

Aims: To compare two progressive approaches [once-daily insulin glargine plus ≤3 mealtime lispro (G+L) vs. insulin lispro mix 50/50 (LM50/50) progression once up to thrice daily (premix progression, PP)] of beginning and advancing insulin in patients with type 2 diabetes (T2D) and inadequate glycaemic control on oral therapy, with the aim of showing non-inferiority of PP to G+L.

Methods: Patients were randomized to PP (n = 242) or G+L (n = 242) in a 36-week, multinational, open-label trial.

An algorithm for the treatment of type 2 diabetes in Latin America.

Diabetes is a principal and growing health concern in Latin America, accounting for significant mortality and morbidities. Large, randomized, prospective trials of various interventional therapies in patients with both type 1 and type 2 diabetes have demonstrated that reductions in hyperglycaemia and management of diabetes-related risk factors can significantly reduce the micro- and macrovascular complications of diabetes. Therefore, patients with type 2 diabetes will benefit from more aggressive treatment regimens to help decrease the occurrence and rate of progression of diabetic complications.

Effects of weight loss on insulin secretion and in vivo insulin sensitivity in obese diabetic and non-diabetic subjects.

To investigate the effects of caloric restriction and weight loss program on insulin sensitivity, acute insulin secretion and glucose effectiveness in 2 obese groups with different beta-cell function, we performed a longitudinal clinical intervention study with a 60 week weight loss program (20-25 kcal/kg ideal weight/day) in 44 obese subjects, 20 with Type 2 diabetes (OD) and 24 non-diabetic (OND). Body mass index (BMI) and metabolic parameters were determined at baseline and every 15 weeks during the intervention study. Insulin sensitivity index (Si) [10(-4) min(-1) x (mU/ml)(-1)], acute insulin response to glucose (AIRg) [pm] and glucose effectiveness (Sg) [x10(-2)/min(-1)] were assessed using the Bergman's minimal model (MINMOD).