Publications by authors named "Jean Pierre Riveline"
Aims/hypothesis: COMBINE 2 assessed the efficacy and safety of once-weekly IcoSema (a combination therapy of basal insulin icodec and semaglutide) vs once-weekly semaglutide (a glucagon-like peptide-1 analogue) 1.0 mg in individuals with type 2 diabetes inadequately managed with GLP-1 receptor agonist (GLP-1 RA) therapy, with or without additional oral glucose-lowering medications.
Methods: This 52 week, randomised, multicentre, open-label, parallel group, Phase IIIa trial was conducted across 121 sites in 13 countries/regions.
Aims: Diabetes distress (DD) is prevalent among people with diabetes. While automated insulin delivery systems (AIDs) improve glycaemic control, their impact on DD is unclear. We aimed to investigate the effect of AIDs on DD in people with diabetes and their caregivers.
View Article and Find Full Text PDFExperience of People with Diabetes Treated with Insulin Delivery Systems in France: A Comparative Analysis of Multiple Daily Injections, Tubeless Pumps, Tubed Pumps, and Hybrid Closed Loops.
Diabetes Ther
December 2024
Introduction: While people with diabetes (PWD)'s experiences with their insulin delivery systems (IDS) are frequently reported in clinical trials, few real-world data exist on the subject. This study aimed to assess the real-world experience and satisfaction with IDS in PWD.
Methods: This cross-sectional survey of PWD treated with tubed or tubeless insulin pumps, hybrid closed loop (HCL) systems, or multiple daily injections (MDI) for at least 3 months ran from 4 to 16 May 2023.
The pressing need to reduce undiagnosed type 2 diabetes (T2D) globally calls for innovative screening approaches. This study investigates the potential of using a voice-based algorithm to predict T2D status in adults, as the first step towards developing a non-invasive and scalable screening method. We analyzed pre-specified text recordings from 607 US participants from the Colive Voice study registered on ClinicalTrials.
View Article and Find Full Text PDFThe DERMIS Study: Methodologies, Results, and Implications for the Future.
J Diabetes Sci Technol
December 2024
Ongoing innovation in diabetes technologies has led to the development of advanced tools such as automated insulin delivery (AID) systems that adjust insulin delivery in response to current and predicted glucose levels, residual insulin action, and other inputs (eg, meal and exercise announcements). However, infusion sets continue to be the "Achilles heel" of accurate and precise insulin delivery and continued device use. A recent study by Kalus et al (DERMIS Study) revealed higher vessel density and signals of inflammation by optical coherence tomography (OCT), in addition to increased inflammation, fat necrosis, fibrosis, and eosinophilic infiltration by histopathology.
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- Diabetes mellitus increases the risk of severe respiratory diseases like influenza and COVID-19, primarily due to glycemic variability rather than average blood glucose levels.
- A study used blood samples and continuous glucose monitoring from individuals with type 1 diabetes to examine how glycemic variability affects T cell responses to influenza.
- Higher glycemic variability was linked to a decreased proportion of specific T cells responding to the influenza virus, indicating the importance of monitoring glycemic variability for understanding immune responses in diabetic individuals.
Objective: To examine the efficacy and safety of the tubeless Omnipod 5 automated insulin delivery (AID) system compared with pump therapy with a continuous glucose monitor (CGM) in adults with type 1 diabetes with suboptimal glycemic outcomes.
Research Design And Methods: In this 13-week multicenter, parallel-group, randomized controlled trial performed in the U.S.
Introduction & Objectives: To evaluate whether cardiovascular risk factors and their management differ in primary prevention between adult males and females with type 1 diabetes (T1D) in two European countries in 2020-2022 and sex inequalities in achievement of standards of care in diabetes.
Methods: We used 2020-2022 data of patients without a cardiovascular history in the Prospective Diabetes Follow-up registry (DPV) centres, in Germany, and the Société Francophone du Diabète- Cohorte Diabète de Type 1 cohort (SFDT1), in France.
Results: We included 2,657 participants from the DPV registry and 1,172 from the SFDT1 study.
Glycemic management in people with type 2 diabetes mellitus (T2DM) on insulin-secretagogue regimens without insulin is of importance, as this group still represents a significant proportion of patients. Risks for acute diabetes events (ADEs), including diabetic ketoacidosis (DKA) or hypoglycemia, using insulin-secretagogue drugs are well established. Few studies have suggested that continuous glucose monitoring (CGM) could be useful for monitoring glucose dynamics associated with the use of such therapies.
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- The study investigates the varying glycaemic profiles in individuals with type 1 diabetes to better understand their complexities.
- Using a unique methodology and the DDRTree algorithm, researchers identified seven distinct glycaemic phenotypes among 618 participants.
- The findings suggest that relying solely on traditional metrics may overlook important subtleties of glycaemic management, emphasizing the need for more tailored strategies in treatment.*
Assessment of the Impact of Subcutaneous Catheter Change on Glucose Control in Patients with Type 1 Diabetes Treated by Insulin Pump in Open- and Closed-Loop Modes.
Diabetes Technol Ther
July 2024
Article Synopsis
- Most insulin catheters are changed every 3 days, and this study evaluates how these changes affect glucose control in type 1 diabetes patients using two different insulin delivery methods: open-loop (OL) and automated insulin delivery (AID).
- Researchers analyzed data from 134 patients who used the Tandem t:slim x2 insulin pump and Dexcom G6 sensor over a 3-month period, focusing on the percentage of time their glucose levels were above 180 mg/dL (%TAR180) on the day of the catheter change and the following two days.
- Results indicated that there was a significant increase in time spent in hyperglycemia on the day of catheter change for both OL and AID modes,
Article Synopsis
- Diabetes significantly increases the risk of cardiovascular diseases, particularly among individuals with type 2 diabetes (T2D), where circulating monocytes play a crucial role in inflammation related to both diabetes and atherosclerosis.* -
- A study involving 672 T2D patients found a positive correlation between blood monocyte counts and coronary artery calcium scores, which are indicators of cardiovascular risk, revealing distinct monocyte subtypes associated with varying cardiovascular risk levels.* -
- The research indicates that analyzing monocyte frequency and profiles can serve as valuable predictors for cardiovascular events in T2D patients, highlighting potential mitochondrial dysfunction in these individuals' immune responses.*
Article Synopsis
- Sudomotor dysfunction is a problem with the nerve fibers that help control sweating, which can be linked to a condition called small fiber neuropathy (SFN).
- This study compared a new home device called Body Scan with a hospital device called Sudoscan, to see which one better measures sweat gland activity in patients, especially those with diabetes.
- The Body Scan performed really well in detecting SFN, showing good results in terms of sensitivity and specificity, which means it was accurate in identifying patients who have this nerve issue.
Article Synopsis
- People with type 1 diabetes who use insulin pumps often experience changes in their blood sugar levels, which may be due to how insulin spreads under their skin.
- A new method was developed to study how insulin moves in the skin by using special imaging and measuring pressure in real-time.
- The study found that most insulin was delivered under the skin correctly, but some errors occurred, like air bubbles forming, and this method can help improve how insulin is given in the future.
Article Synopsis
- The study aimed to assess how practical, safe, and effective automated insulin delivery (AID) is for people with type 2 diabetes who need help managing multiple daily insulin injections (MDI) at home, supported by home health care (HHC) services.
- A total of 30 adults were randomly assigned to either AID or their usual therapy for 12 weeks, measuring their time within the target glucose range and other health metrics.
- Results showed that AID significantly improved the time in the target glucose range and HbA1c levels, with high satisfaction among patients and caregivers, indicating AID is a safe and effective option for managing diabetes.
High-dose corticosteroids adjusted to oxygen requirement and monitoring of serum C-reactive protein to improve outcome of non-critically ill COVID-19 patients: the CocAA-CoLa Plus Study.
Minerva Med
May 2023
Older people with type 2 diabetes (T2DM) on insulin are at increased risk of hypoglycemia and associated morbidity. Management of T2DM in older people must optimize glycemic control, while minimizing risks for hypoglycemia and diabetic ketoacidosis (DKA). In France, the FreeStyle Libre (FSL) system has been reimbursed since June 2017 for T2DM on intensive insulin therapy.
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- * Among 851 adult diabetes patients, 28% reported skin reactions with CGM, and 29% with CSII, with higher incidence among women and type 1 diabetes patients.
- * Common reactions included redness and itching, usually occurring within the first day or after several months of use, but only a small percentage stopped using the devices due to these reactions, indicating irritation rather than allergies.
Initiation of insulin therapy in people with type 2 diabetes (T2DM) may be necessary to achieve glycemic targets but is associated with acute diabetes events (ADEs), including severe hypoglycemia (SH) or diabetic ketoacidosis (DKA). We assessed the impact of initiating FreeStyle Libre system (FSL) on hospitalizations for ADEs in people with T2DM on basal insulin only regimen±noninsulin antidiabetic drugs. A retrospective study of the French national Système National des Données de Santé reimbursement claims database (≈66 million French people) identified people with T2DM on basal insulin therapy receiving a first reimbursement of FSL between August 1, 2017 and December 31, 2018.
View Article and Find Full Text PDFContext: Some women living with type 1 diabetes complain of changes in glucose values according to the different phases of menstruation.
Objective: To evaluate this variability through continuous glucose monitoring (CGM) data in type 1 diabetes patients.
Design: Observational study.
Article Synopsis
- The study aims to evaluate the prevalence of diabetes and its complications in France as of 2017, highlighting the rising health concern surrounding the disease.
- A total of 29,288 patients were analyzed, with 93% having type 2 diabetes (DT2) and 6.7% on insulin treatment (DTi), revealing a prevalence rate of 4.9% that varied geographically.
- It was found that diabetes-related complications and hospital admissions were significantly more common in patients treated with insulin than those on other anti-diabetic medications, yet many patients did not follow recommended healthcare guidelines.
Article Synopsis
- The study investigates how different glucose metrics from flash glucose monitoring can indicate the ability to consistently meet glycaemic targets, focusing on total (t-CV) and within-day coefficient of variation (wd-CV) for assessing glucose variability and hypoglycaemia risk.!* -
- By analyzing data from over 1 million flash glucose readers, researchers found a clear link between lower estimated A1c (eA1c) levels and better glucose management, including time in range and reduced hypoglycaemia.!* -
- The findings suggest that a t-CV under 40% or a wd-CV under 34% should be used to identify patients more likely to meet the target of less than 1
Background: Support programs are provided to people with diabetes to help them manage their disease. However, adherence to and persistence in support programs are often low, making it difficult to demonstrate their effectiveness.
Aim: To identify the determinants of patients' perceived interest in diabetes support programs because it may be a powerful determinant of effective participation in such programs.
The RELIEF study has previously shown a fall in the rate of acute diabetes events (ADEs) in people living with type 1 diabetes (PwDT1) or people living with type 2 diabetes (PwDT2) in the 12 months after initiation of flash glucose monitoring (FLASH) in France. The 2-year follow-up has provided new insights on the frequency of ADEs, including severe hypoglycemia and diabetic ketoacidosis (DKA), during use of FLASH. The RELIEF study included 31,446 PwDT1 and 41,027 PwDT2 with a first delivery of FreeStyle Libre (FSL) between August 1 and December 31, 2017.
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