Sodium-glucose cotransporter-2 inhibitors and genital and urinary tract infections in type 2 diabetes.

Coincident with the high and increasing worldwide prevalence of type 2 diabetes (T2D), a growing armamentarium of antidiabetes medications has been introduced to target different organ systems that play a role in the pathophysiology of T2D. Among these, the sodium-glucose cotransporter-2 (SGLT-2) inhibitors were introduced in the United States in 2013 as a new treatment option to address the hyperglycemia associated with T2D. SGLT-2 inhibitors decrease renal glucose reabsorption, resulting in glucosuria, alleviation of hyperglycemia, and modest weight loss and are associated with a low risk of hypoglycemia.

Recruitment of Asians and Pacific Islanders with Type 2 Diabetes into a Clinical Research Trial of Enhancing Diabetes Self-Management.

The objective of the study was to evaluate strategies and barriers to recruiting Asians and Pacific Islanders (API) with type 2 diabetes, into clinical trials. Descriptive statistics and content analysis were utilized to analyze reasons for non-participation. A "talk story" interview method was employed to recruit participants and uncover reasons for non-participation.

Psychosocial and Clinical Outcomes of a Cognitive Behavioral Therapy for Asians and Pacific Islanders with Type 2 Diabetes: A Randomized Clinical Trial.

Asian Americans and Pacific Islanders are twice as likely to be diagnosed with type 2 diabetes compared to Caucasians. The objective was to determine the effect of cognitive behavioral therapy on quality of life, general health perceptions, depressive symptoms, and glycemia in Asians and Pacific Islanders with type 2 diabetes. The design was a randomized controlled clinical trial comparing cognitive behavioral therapy to diabetes education and support for six weekly sessions.

Treatment-Induced Changes in Plasma Adiponectin Do Not Reduce Urinary Albumin Excretion in the Diabetes Prevention Program Cohort.

Background And Objectives: Molecular data suggests that adiponectin may directly regulate urinary albumin excretion. In the Diabetes Prevention Program (DPP) we measured adiponectin and albuminuria before and after intervention, and we previously reported increases in adiponectin with interventions. Here we have used the DPP dataset to test the hypothesis that treatment-related increases in adiponectin may reduce albuminuria in obesity.

TWO TREATMENT APPROACHES FOR HUMAN REGULAR U-500 INSULIN IN PATIENTS WITH TYPE 2 DIABETES NOT ACHIEVING ADEQUATE GLYCEMIC CONTROL ON HIGH-DOSE U-100 INSULIN THERAPY WITH OR WITHOUT ORAL AGENTS: A RANDOMIZED, TITRATION-TO-TARGET CLINICAL TRIAL.

Objective: To compare the efficacy and safety of 2 dosing regimens for human regular U-500 insulin (U-500R, 500 units/mL) replacing high-dose U-100 insulins with or without oral antihyperglycemic drugs in patients with inadequately controlled type 2 diabetes (T2D).

Methods: We conducted a 24-week, open-label, parallel trial in 325 patients (demographics [means]: age, 55.4 years; diabetes duration, 15.

Toxic multinodular goiter in a patient with end-stage renal disease and hemodialysis.

The management of symptomatic hyperthyroidism in patients with end stage renal disease (ESRD) is challenging because of altered clearance of medications and iodine with dialysis; moreover, many patients meeting these criteria are medically fragile. A 77-year-old man with type 2 diabetes and ESRD requiring hemodialysis, with dilated cardiomyopathy and paroxysmal atrial fibrillation, was found to have subclinical hyperthyroidism. Over a 2-year period he became clinically hyperthyroid with serum TSH level of <0.

Efficacy and safety of dulaglutide added onto pioglitazone and metformin versus exenatide in type 2 diabetes in a randomized controlled trial (AWARD-1).

Objective: To compare the efficacy and safety of dulaglutide, a once-weekly GLP-1 receptor agonist, with placebo and exenatide in type 2 diabetic patients. The primary objective was to determine superiority of dulaglutide 1.5 mg versus placebo in HbA1c change at 26 weeks.

Impact of race/ethnicity on efficacy and safety of two starter insulin regimens in patients with type 2 diabetes: a posthoc analysis of the DURABLE trial.

Objective: To explore the impact of race/ethnicity on efficacy and safety of twice-daily insulin lispro mix 75/25 (LM75/25; 75% lispro protamine suspension, 25% insulin lispro) and once daily insulin glargine (GL).

Design, Setting, Patients: More than 2,000 Patients with type 2 diabetes enrolled in the 24-week initiation phase of the DURABLE Trial.

Main Outcome Measures: Efficacy and safety variables at endpoint, including hemoglobin A1c (HbA1c), self-monitored plasma glucose (SMPG), and hypoglycemia, in each racial/ethnic group were compared to Caucasians within treatment groups.

Associations between Psychosocial and Physiological Factors and Diabetes Health Indicators in Asian and Pacific Islander Adults with Type 2 Diabetes.

The associations between psychosocial and physiological factors and diabetes' health indicators have not been widely investigated among Asians and Pacific Islanders. We hypothesize that health behaviour and depression are directly or indirectly associated with diabetes' health indicators such as BMI, glycemic control, general health, and diabetes quality of life. Our hypothesis was tested through a structural equation modelling (SEM) approach.

Diabetic Ketoacidosis in Acromegaly: A Case Report.

Objective: To report an uncommon case of diabetic ketoacidosis in a patient with acromegaly, and present the clinical response to treatment.

Methods: Patient evaluation and literature review.

Results: A 23-year-old Japanese male with no prior medical history, presented with diabetic ketoacidosis (DKA) and found to have acromegaly.

Effects of genetic variants previously associated with fasting glucose and insulin in the Diabetes Prevention Program.

Common genetic variants have been recently associated with fasting glucose and insulin levels in white populations. Whether these associations replicate in pre-diabetes is not known. We extended these findings to the Diabetes Prevention Program, a clinical trial in which participants at high risk for diabetes were randomized to placebo, lifestyle modification or metformin for diabetes prevention.

A randomized, controlled study of once-daily LY2605541, a novel long-acting basal insulin, versus insulin glargine in basal insulin-treated patients with type 2 diabetes.

Objective: To evaluate whether LY2605541 results in lower fasting blood glucose (FBG) versus insulin glargine (GL).

Research Design And Methods: This 12-week, randomized, open-label, Phase 2 study enrolled patients with type 2 diabetes (hemoglobin A(1c) [A1C] ≤ 10.5%), taking metformin and/or sulfonylurea with GL or NPH insulin once daily.

Changes in fasting plasma glucose levels with ribavirin and pegylated interferon treatment in normal and impaired glucose tolerant patients with chronic hepatitis C.

Background: Patients with Hepatitis C Virus (HCV) infection have increased rates of glucose intolerance, and studies have shown the improvement of fasting plasma glucose (FPG) levels after clearance of HCV infection with standard ribavirin plus pegylated interferon treatment. The purpose of this study was to examine glycemic changes with standard HCV treatment in patients with impaired fasting glucose (IFG) and normal fasting glucose (NFG).

Methods: A retrospective study of FPG changes in HCV patients with IFG and NFG treated with standard HCV therapy was conducted.

Potential for use of 1,5-anhydroglucitol when initiating insulin therapy in people with type 2 diabetes and suboptimal control with oral antidiabetic drugs.

Endpoint HbA(1c) <7.0% was achieved by 80 (73.4%) lispro mix 25 (LM25)-treated patients and 67 (60.

Perceptions related to diet and exercise among Asians and Pacific Islanders with diabetes.

The purpose of this study was to explore the perceptions of Asians and Pacific Islanders (API) with Type 2 diabetes related to diet and exercise. A descriptive content analysis was conducted on verbalized responses from 15 participants in focus groups who were asked "What role does your culture play in what, when, and how much you eat?" and "If and/or how much you exercise and what type of exercise you do?" The participants recorded responses were transcribed verbatim and analyzed for themes utilizing the social ecological framework.The families, environment, and the local culture in Hawai'i greatly affect the dietary and physical activities of the participants.

Concomitant oral antihyperglycemic agent use and associated treatment outcomes after initiation of insulin therapy.

Objective: To compare outcomes in patients with type 2 diabetes initiating insulin lispro mix 75/25 (75% insulin lispro protamine suspension and 25% lispro) or insulin glargine therapy, stratified by baseline oral antihyperglycemic agent (OHA) use.

Methods: We performed a post hoc analysis of 6-month data from the DURABLE clinical trial, which enrolled patients with hemoglobin A1c (A1C) levels >7.0% treated with 2 or more OHAs (metformin, sulfonylurea, and thiazolidinedione), and randomly assigned them to treatment with twice-daily insulin lispro 75/25 or once-daily glargine.

A 47, XXY patient and Xq21.31 duplication with features of Prader-Willi syndrome: results of array-based comparative genomic hybridization.

A man diagnosed with 47, XXY during childhood presents an appearance similar to that of Prader-Willi syndrome with hypogonadism and gynecomastia, developmental delay, and short stature and obesity. Array-based comparative genomic hybridization revealed duplication at Xq21.31 in addition to his abnormal karyotype.

Randomized, open-label, parallel-group evaluations of basal-bolus therapy versus insulin lispro premixed therapy in patients with type 2 diabetes mellitus failing to achieve control with starter insulin treatment and continuing oral antihyperglycemic drugs: a noninferiority intensification substudy of the DURABLE trial.

Background: Insulin glargine and lispro mix 75/25 (75% insulin lispro protamine suspension and 25% insulin lispro injection [LM75/25]) represent 2 common starter insulin regimen classes: basal and premixed. After initiation of starter insulin therapy, if patients with type 2 diabetes mellitus (DM) are unable to achieve a glycosylated hemoglobin (HbA1c) level <7.0%, insulin intensification may be indicated.

Ketoconazole enantiomer for the treatment of diabetes mellitus.

The impact of hypercortisolism on multiple metabolic conditions is well recognized; the metabolic manifestations of Cushing's syndrome overlap with those seen in type 2 diabetes and the metabolic syndrome. Ketoconazole (KTZ), a widely used antifungal agent that inhibits various enzymes in adrenal cortisol synthesis, is effective in treating hypercortisolemia, but its use is limited by toxicities. KTZ is a racemic compound of two cis-enantiomers: (2R,4S)-(+)-KTZ and (2S,4R)-(-)-KTZ.

The association of ENPP1 K121Q with diabetes incidence is abolished by lifestyle modification in the diabetes prevention program.

Context: Insulin resistance is an important feature of type 2 diabetes. Ectoenzyme nucleotide pyrophosphatase phosphodiesterase 1 (ENPP1) inhibits insulin signaling, and a recent meta-analysis reported a nominal association between the Q allele in the K121Q (rs1044498) single nucleotide polymorphism in its gene ENPP1 and type 2 diabetes. OBJECTIVE AND INTERVENTION: We examined the impact of this polymorphism on diabetes incidence as well as insulin secretion and sensitivity at baseline and after treatment with a lifestyle intervention or metformin vs.

Clinical experience with exenatide in predominantly Asian and Pacific Islander patients with type 2 diabetes.

Exenatide is a new injectable medication for the treatment of hyperglycemia in type 2 diabetes. Due to limited information of exenatide use in Asians and Pacific Islanders (API), we retrospectively reviewed API patients' responses to exenatide treatment and compared the efficacy and safety of treatment to Caucasian patients. A total of 92 patients (70 API, 21 Caucasians, and 1 Hispanic) with type 2 diabetes were treated with exenatide.