Publications by authors named "Michael Joubert"

Introduction: Glycated haemoglobin (HbA1c) is currently the gold standard for assessing glycaemic control in diabetes, given the established relationship with microvascular and macrovascular complications in this condition. However, HbA1c is affected by non-glycaemic factors, while also failing to provide data on hypoglycaemic exposure and glucose variability, which are associated with adverse vascular outcomes. Continuous glucose monitoring (CGM)-derived glucose metrics provide a more comprehensive assessment of glycaemia, but their role in predicting future vascular complications remains unclear.

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Introduction: The MiniMed™ 780G system uses an advanced hybrid closed loop algorithm to improve outcomes in people with type 1 diabetes (T1D). The MiniMed™ 780G Glycemic Control and Quality of Life (EQOL) study aimed to provide routine clinical practice data on system effectiveness and associated patient-reported outcomes (PROs) in France.

Methods: Individuals aged ≥ 7 years with T1D were enrolled.

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Sleep is a key biological mechanism in promoting wellbeing and resilience to stress. This cross-sectional study examined connections between sleep, autonomic function, wellbeing, and stress reactivity in healthy individuals. Demographic, lifestyle, sleep, and psychological well-being information were collected from 85 healthy university students.

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Objectives: Carrying out a pregnancy to term in a patient with a paraganglioma or pheochromocytoma (PPGL) results from a multidisciplinary challenge. The objective was to compare our therapeutic attitude with the existing literature and to identify optimal treatment.

Methods: Description of a case of paraganglioma treated during pregnancy at the University Hospital Center of Caen (France) in 2024 and comparison with the literature.

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Context: Renin is a marker of blood volume. There is no consensus on the validity of plasma renin measurement for adjusting mineralocorticoid (MC) substitution in patients with primary adrenal insufficiency (PAI).

Objective: This work aimed to investigate if plasma renin could be used to adjust MC substitution in patients with PAI.

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  • - Pheochromocytoma and paraganglioma (PPGL) are rare tumors with a significant genetic component, leading to the need for genetic screening for specific variants.
  • - Over 21 years (2001-2022), an endocrine oncogenetic lab studied 606 PPGL cases, using both traditional Sanger sequencing and modern next-generation sequencing (NGS) to identify genetic variants in patients and their relatives.
  • - The study found that 27.2% of index cases had pathogenic variants, with variability in symptoms and tumor characteristics among different families, emphasizing the importance of genetic screening for tailored patient management.
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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.*
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Objective: To evaluate the association of insulin injection adherence, smart insulin pen engagement, and glycemic control using real-world data from 16 countries from adults self-administering basal insulin degludec and bolus insulin with a smart insulin pen (NovoPen 6 or NovoPen Echo Plus) alongside continuous glucose monitoring (CGM).

Research Design And Methods: Data were aggregated over 14-day periods. Treatment adherence was defined according to the number of missed basal and missed bolus insulin doses and smart pen engagement according to the number of days with data uploads.

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TOMORROW, WHAT EVOLUTIONS IN DIABETES ? Diabetes care has undergone a major digital nutation over the past decade. The devices used to treat and monitor patients with diabetes are increasingly "connected", generating large amounts of data. These data, hosted in clouds, facilitate the development of remote monitoring and teleconsultations in diabetology.

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Context: The amount of consumed carbohydrates is the strongest factor influencing glucose levels during the four hours following a meal. Our aim was to evaluate the association between carbohydrate counting knowledge and continuous glucose monitoring (CGM) parameters in patients with type 1 diabetes (T1D) using different insulin regimens.

Method: In this multicenter prospective study, the GluciQuizz questionnaire was used to evaluate carbohydrate knowledge.

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Clinical trials and real-world data for Type II diabetes both show that glycated hemoglobin (HbA1c) levels and hypoglycemia occurrence can be reduced by real-time continuous glucose monitoring (rt-CGM) versus self-monitoring of blood glucose (SMBG). The present cost-utility study investigated the long-term health economic outcomes associated with using rt-CGM versus SMBG in people with insulin-treated Type II diabetes in France. Effectiveness data were obtained from a real-world study, which showed rt-CGM reduced HbA1c by 0.

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Article Synopsis
  • * Results showed significant improvements in key measures: time in range (TIR) increased by 9.1%, HbA1c decreased by 0.5%, and notable reductions in time spent below and above target levels.
  • * The majority of patients (92.7%) continued using the system, and more achieved glycemic goals after one year, although there were some reported cases of severe hypoglycemia and ketoacidosis.
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  • The study investigated the incidence and costs associated with cardiovascular renal diseases (CVRD) among people with type 2 diabetes who did not have a history of CVRD, using a cohort of over 2 million individuals in France for 5 years.
  • Results showed that 15.3% of participants developed a CVRD manifestation within 5 years, with chronic kidney disease (CKD) being the most common (40.6%), followed by heart failure (HF) and peripheral arterial disease (PAD).
  • The total hospitalization costs for CVRD over the 5 years were estimated at 3.9 billion euros, with CKD accounting for the largest share of the costs (2 billion euros), indicating a significant economic burden in
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The morbidity and mortality of pancreatic cancer surgery has seen substantial improvement due to the standardization of surgical techniques, the optimization of perioperative multidisciplinary management and the organization of specialized care systems. The identification and treatment of postoperative functional and nutritional sequelae have thereby become major issues in patients who undergo pancreatic surgery. This review addresses the functional sequelae of pancreatic resection for cancerous and pre-cancerous lesions (excluding chronic pancreatitis).

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Aims: Glycemic variability has been suggested as a risk factor for diabetes complications but the precise deleterious mechanisms remain poorly understood. Since mitochondria are the main source of energy in heart and cardiovascular diseases remain the first cause of death in patients with diabetes, the aim of the study was to evaluate the impact of glucose swings on mitochondrial functions in the cardiomyocyte cell line HL-1.

Methods: HL-1 cells were exposed to low (LG, 2.

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  • A study evaluated the safety and effectiveness of automated insulin delivery (AID) in adults with type 1 diabetes (T1D) who are at a high risk of hypoglycemia, enrolling 72 participants who had a history of severe hypoglycemic events.
  • Participants were randomly assigned to use either AID technology or traditional continuous glucose monitoring (CGM) and insulin pump therapy for 12 weeks, measuring changes in time below range (TBR) and other glucose metrics.
  • Results showed that AID significantly reduced TBR by 3.7% and increased time in target range (TIR) by 8.6%, leading to the conclusion that AID is highly recommended for adults with T1D at
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Introduction: The use of devices to connect insulin pens could facilitate management and improve glycaemic control in people with type 1 (PwT1D) and type 2 diabetes (PwT2D). However, their acceptance seems little studied. We conducted an online survey with the main objective of assessing the level of interest among insulin-treated people with diabetes (PwD) in a device connected to a disposable pen and secondary objectives of assessing the perceived benefits and important features expected of a connected device and identifying factors associated with interest scores.

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Postprandial hyperglycaemia (PPH) may sometimes be relegated to the background in the treatment of diabetic patients, while its control seems important if not essential to reach an adequate overall glycaemic control. PPH is correlated with glycated haemoglobin and diabetic complications. It is also identified as a cardiovascular risk factor.

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Introduction: The use of predictive low-glucose suspend (PLGS) sensor-augmented pumps has been shown to lead to a significant reduction in hypoglycemic episodes in patients with type 1 diabetes (T1D), but their effects on hyperglycemia exposure are heterogeneous. The aim of this study was to determine the settings of the Medtronic 640G system to obtain the optimal balance between occurrence of both hypoglycemia and hyperglycemia.

Methods: The hypo- and hyperglycemia area under the curve (AUC), as well as system settings [hypoglycemic threshold, mean insulin total daily dose (TDD), mean basal insulin percentage, and mean daily duration of PLGS] were collected between 2 and 12 times during 1 year in patients from four university hospital centers.

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Background: A composite metric for the quality of glycemia from continuous glucose monitor (CGM) tracings could be useful for assisting with basic clinical interpretation of CGM data.

Methods: We assembled a data set of 14-day CGM tracings from 225 insulin-treated adults with diabetes. Using a balanced incomplete block design, 330 clinicians who were highly experienced with CGM analysis and interpretation ranked the CGM tracings from best to worst quality of glycemia.

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Background: To evaluate the impact of switching from U-100 to U-500 insulin in patients with type 2 diabetes mellitus (T2DM) uncontrolled with continuous subcutaneous insulin infusion (CSII) by pump.

Methods: We retrospectively collected data from patients with T2DM, treated by U-100 CSII, who were switched to U-500 regular insulin where haemoglobin A1c (Hb) was >8% and/or insulin total daily dose (TDD) was >100 UI/d. Data collection from patient medical records included Hb, lipid levels, liver biomarkers, weight, TDD, declared hypoglycaemic episodes and measured by continuous glucose monitoring (CGM).

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Introduction: Smartphone applications (apps) have been designed that help patients to accurately count their carbohydrate intake in order to optimize prandial insulin dose matching. Our aim was to evaluate the accuracy of two carbohydrate (carb) counting apps.

Methods: Medical students, in the role of mock patients, evaluated meals using two smartphone apps: Foodvisor (which uses automatic food photo recognition technology) and Glucicheck (which requires the manual entry of carbohydrates with the help of a photo gallery).

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Article Synopsis
  • The study aimed to investigate the effects of prior metformin use on the health outcomes of type 2 diabetes patients hospitalized for COVID-19.
  • An analysis of 2,449 patients showed that metformin users generally had better survival rates and lower mortality compared to non-users, particularly noted at days 7 and 28 after admission.
  • The conclusion suggests that metformin may reduce the risk of death in diabetes patients with COVID-19, indicating its potential beneficial effects during hospitalization.
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Aim: To assess the safety and efficacy of the short-acting glucagon-like peptide-1 receptor agonist exenatide on a population of patients with type 2 diabetes (T2D) mostly treated with continuous subcutaneous insulin injection (CSII).

Materials And Methods: A phase 2/3, multicentre, randomized, parallel-group, double-blind, placebo-controlled, 6-month trial was conducted. Patients were randomized to receive subcutaneous (SC) injections of exenatide (10 μg BID) or matched placebo.

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