Pregestational diabetes is described when a woman with diabetes before the onset of pregnancy becomes pregnant and consequently she is vulnerable to higher risk for adverse outcomes in the embryo/foetus. Strict glycaemic control, with minimal glucose variability, starting from before conception and maintained throughout pregnancy decreases significantly adverse foetal and maternal outcomes; maternal hypoglycaemic episodes are the major barrier in achieving this goal. Insulin degludec is an ultralong-acting analogue, which has half-life of over 25 h and full duration of effect of more than 42 h, reaching a steady-state serum concentration after 2-3 days of its administration. It promotes flat, steady, peakless and predictable insulin concentrations, with minor intra-individual and inter-individual variability. It also exerts a low mitogenic/metabolic potency ratio. This review examines thoroughly all current evidence of the administration of insulin degludec in pregestational diabetes as well as its future role in this population.
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http://dx.doi.org/10.5114/amsad/188092 | DOI Listing |
Indian J Crit Care Med
January 2025
Department of Anaesthesia, ICU and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Aim And Background: Hyperglycemia is a serious condition and associated with an increased risk of complications and mortality in both critically ill and non-critically ill people. Improvement in the glycemic level reduces the length of hospital stay, systemic infections and short- and long-term mortality. The aim was to test the effectiveness of insulin degludec vs insulin glargine and regular insulin in controlling blood sugar in patients with critical hyperglycemia.
View Article and Find Full Text PDFEndocrinol Diabetes Metab Case Rep
January 2025
Summary: Palmoplantar keratoderma (PPK), characterised by excessive epidermal thickening of the skin on the palms and/or plantar surfaces of the feet, can be hereditary or acquired. Here, we report a case of a 53-year-old woman with a history of sub-optimally controlled diabetes mellitus presenting with fevers and decreased Glasgow Coma Scale (GCS) to a tertiary hospital. She was diagnosed with diabetic ketoacidosis (DKA), with blood glucose at 40 mmol/L and ketones at 7 mmol/L, in the setting of a methicillin-sensitive Staphylococcus aureus necrotising soft tissue back infection.
View Article and Find Full Text PDFCureus
November 2024
Department of Pharmacology, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND.
Diabetes mellitus represents a significant and growing global health challenge, with its prevalence steadily increasing. Insulin therapy remains a cornerstone of diabetes management. Since its discovery in 1921, insulin has undergone substantial advancements, evolving from crude animal extracts to highly refined recombinant formulations and biosimilars.
View Article and Find Full Text PDFEndocr Pract
December 2024
Department of Medicine, McMaster University, 1280 Main St W, Hamilton, Ontario L8S 4L8, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St W, Hamilton, Ontario L8S 4L8, Canada. Electronic address:
Objective: Dysglycemia has deleterious outcomes on critically ill patients with diabetes mellitus (DM). Insulin degludec, an ultra-long-acting insulin, is associated with lower rates of hypoglycemia and blood glucose (BG) variability in non-critically ill patients. The experience with insulin degludec in the intensive care units is lacking.
View Article and Find Full Text PDFDiabetes Obes Metab
December 2024
Novo Nordisk India Private Limited, Bangalore, India.
Aims: To investigate glycaemic control in Chinese adults with type 2 diabetes (T2D) initiating, or switching to insulin degludec/insulin aspart (IDegAsp), a co-formulation of basal, and bolus insulin, in a real-world setting.
Materials And Methods: A 20-week, prospective, single-arm, open-label, non-interventional study was conducted in Chinese adults with T2D initiating, or switching to IDegAsp after anti-hyperglycaemic treatment with oral antidiabetic drugs (OADs), other insulins, or glucagon-like peptide-1 receptor agonists. The primary endpoint was a change in HbA from baseline to end of the study; the secondary endpoints included a change in fasting plasma glucose and Diabetes Treatment Satisfaction Questionnaire (DTSQ) score.
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