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  • 1
    In: Diabetes/Metabolism Research and Reviews, Wiley, Vol. 23, No. 5 ( 2007-07), p. 386-391
    Type of Medium: Online Resource
    ISSN: 1520-7552 , 1520-7560
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2007
    detail.hit.zdb_id: 2001565-3
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  • 2
    In: Liver International, Wiley, Vol. 33, No. 3 ( 2013-03), p. 410-419
    Type of Medium: Online Resource
    ISSN: 1478-3223
    Language: English
    Publisher: Wiley
    Publication Date: 2013
    detail.hit.zdb_id: 2124684-1
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  • 3
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. Suppl_1 ( 2022-11-08)
    Abstract: Introduction: The high burden of comorbidities among patients with Type 2 Diabetes (T2D) may contribute to the low use of guideline directed medical therapies (GDMT) that improve CV outcomes, including sodium glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like-peptide-1 receptor agonists (GLP1RA). Hypothesis: The DECIDE-CV clinic at McGill University (Montreal, Canada) is a novel synchronous healthcare program whereby patients with T2D are seen at each visit simultaneously by a cardiologist, endocrinologist, and nephrologist to enable rapid GDMT implementation. We hypothesized that synchronous healthcare delivery would increase SGLT2i and GLP1RA use among multimorbid patients with T2D. Methods: We conducted a pre/post analysis of GDMT use throughout patient follow-up in the DECIDE-CV clinic. We evaluated the first 76 patients (2020-10-26 to 2022-04-18) and used Canadian diabetes/CV guidelines with Quebec medication coverage criteria to assess eligibility for SGLT2i and GLP1RA. A 2-sample test for proportions compared use of GDMT at baseline and follow-up. Results: At baseline, the mean age of patients was 68.5 years old, 79% were male, 33% were non-white minorities, 50% had CKD, 64% had HF, and 58% had ASCVD. The median eGFR was 60.1 ml/min/1.73m 2 (IQR 40.7, 93.8), median NT-proBNP was 434 (IQR 123, 1425), and median HbA1c was 7.3% (IQR 6.8, 8.7). At baseline only 37% were prescribed a SGLT2i and 3% a GLP1RA despite being guideline eligible and having medication coverage. After the first visit, the use of therapies significantly increased to 90% for SGLT2i and 39% for GLP1RA. At the end of follow-up, 98% were prescribed a SGLT2i and 57% were prescribed a GLP1RA (P-value comparing proportion GDMT 〈 0.001; Figure 1). Conclusions: Among patients eligible for GDMT, the initial use of SGLT2i and GLP1RA was low. Our model of synchronous healthcare delivery in a multi-comorbid population, significantly increased the use of SGLT2i and GLP1RA.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
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  • 4
    In: Diabetes, American Diabetes Association, Vol. 71, No. Supplement_1 ( 2022-06-01)
    Abstract: Background: In the MiTy trial [pregnant T2D randomized to metformin vs. placebo], infants exposed to metformin in-utero had a lower risk of large-for-gestational-age (LGA) but were at higher risk of small-for-gestational-age (SGA) . To date, there are limited data on the effect of in-utero exposure to metformin on infant/child growth in T2D, according to the intrauterine growth status. The MiTy Kids study followed the offspring of MiTy participants to 24 months of age to examine the effect of metformin exposure in-utero on child growth. Aim: Examine the weight and body mass index (BMI) trajectories of children of women with T2D, according to the intrauterine growth status [appropriate for gestational age (AGA) , LGA, and SGA] and metformin exposure. Methods: The study population included offspring of MiTy trial participants. Height and weight measurements were collected at 3, 6, 12, 18 and 24 months of age. Analysis of data was conducted using a fractional polynomial linear mixed effects approach to compare growth trajectories. Results: Of the 283 children who participated in MiTy Kids (46.3% female) , 194 children were AGA at birth (90 metformin and 1placebo) , 65 were LGA (29 metformin and 36 placebo) , and 24 were SGA (16 metformin and 8 placebo) . In children born AGA, both sexes in the metformin arm had a lower weight gain trajectory than those in the placebo group (p=0.008) . Treatment and sex did not have an effect on the growth trajectories of children born LGA. In SGA children, in both sexes, SGA children in the metformin group had a lower weight gain trajectory (p= & lt;0.001) and BMI trajectory (p=0.042) than children in the placebo group, and achieved a lower weight than the WHO growth standard at 24 months. Conclusion: Metformin exposure in-utero was associated with lower weight gain trajectories and BMI trajectories in children of both sexes born SGA and lower weight gain trajectory in AGA children. Further follow-up will determine subsequent growth in these children. Disclosure J. Sanchez: None. J. Hamilton: Advisory Panel; Novo Nordisk Canada Inc. Research Support; Mead Johnson & Company, LLC. G. Tomlinson: None. E. Asztalos: None. K. Murphy: None. B. Zinman: Advisory Panel; Abbott Diabetes, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck & Co., Inc., Novo Nordisk Canada Inc., Sanofi K.K. D. Simmons: Research Support; Abbott, Hitachi, Ltd., Novo Nordisk. Speaker's Bureau; Sanofi. Other Relationship; Elsevier. A. Haqq: None. I.G. Fantus: None. A. Armson: None. J.F.R. Barrett: None. L.E. Donovan: Other Relationship; Dexcom, Inc., Inner Analytics, Medtronic, Tandem Diabetes Care, Inc. P. Karanicolas: Research Support; Baxter. Y. Jiang: None. S. Tobin: None. K. Mangoff: None. G. Klein: None. D. Feig: Advisory Panel; Novo Nordisk. Research Support; Apotex. Funding Canadian Institutes of Health Research
    Type of Medium: Online Resource
    ISSN: 0012-1797
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2022
    detail.hit.zdb_id: 1501252-9
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  • 5
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Journal of the American Society of Nephrology Vol. 34, No. 11S ( 2023-11), p. 1010-1010
    In: Journal of the American Society of Nephrology, Ovid Technologies (Wolters Kluwer Health), Vol. 34, No. 11S ( 2023-11), p. 1010-1010
    Type of Medium: Online Resource
    ISSN: 1046-6673
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2029124-3
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  • 6
    Online Resource
    Online Resource
    American Diabetes Association ; 2011
    In:  Diabetes Vol. 60, No. 12 ( 2011-12-01), p. 3271-3278
    In: Diabetes, American Diabetes Association, Vol. 60, No. 12 ( 2011-12-01), p. 3271-3278
    Abstract: Rosiglitazone (RSG) is an insulin-sensitizing drug used to treat type 2 diabetes mellitus. The A Diabetes Outcome Progression Trial (ADOPT) shows that women taking RSG experienced more fractures than patients taking other type 2 diabetes drugs. These were not osteoporotic vertebral fractures but, rather, occurred in the limbs. The purpose of this study was to investigate how RSG treatment alters bone quality, which leads to fracture risk, using the Zucker fatty rat as a model. RESEARCH DESIGN AND METHODS A total of 61 female 4-month-old rats were divided into six groups. One Sham group was a control and another was administered oral RSG 10 mg/kg/day. Four ovariectomized (OVX) groups were dosed as follows: controls, RSG 10 mg/kg, alendronate (ALN, injected at 0.7 mg/kg/week), and RSG 10 mg/kg plus ALN. After 12 weeks of treatment, bone quality was evaluated by mechanical testing. Microarchitecture, bone mineral density (BMD), cortical bone porosity, and bone remodeling were also measured. RESULTS OVX RSG 10 mg/kg rats had lower vertebral BMD and compromised trabecular architecture versus OVX controls. Increased cortical bone porosity and decreased mechanical properties occurred in these rats. ALN treatment prevented decreased BMD and architectural and mechanical properties in the OVX model. Reduced bone formation, increased marrow adiposity, and excess bone resorption were observed in RSG-treated rats. CONCLUSIONS RSG decreases bone quality. An unusual finding was an increase in cortical bone porosity induced by RSG, consistent with its effect on long bones of women. ALN, an inhibitor of bone resorption, enhanced mechanical strength and may provide an approach to partially counter the deleterious skeletal effects of RSG.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2011
    detail.hit.zdb_id: 1501252-9
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  • 7
    In: Diabetes, American Diabetes Association, Vol. 71, No. Supplement_1 ( 2022-06-01)
    Abstract: Background: Offspring of mothers with T2D are at increased risk of obesity and diabetes. In the MiTy trial [pregnant T2D randomized to metformin vs. placebo], infants exposed to metformin were lighter, had lower fat-mass and risk of large-for-gestational-age, but at higher risk of small-for-gestational-age. There are questions on the long-term effects of in-utero exposure to metformin on offspring of women with T2D. Aim: To examine adiposity in children of women with T2D, with and without exposure to metformin, up to 24 months. Methods: We included infants of women who participated in MiTy. Anthropometric measurements were made at 3, 6, 12, 18 and 24 months of age. At 24 months, t-tests and linear regression were used to estimate differences in BMI z-score and sum of skinfolds by metformin group, adjusted for confounders. Comparisons over time used longitudinal models, with fractional polynomials for growth trajectories. Results: Of the 465 eligible children from MiTy, 283 (60.8%) participated in MiTy Kids. At 24 months, there was no difference in BMI z-score (0·84±1·52 in metformin vs. 0·91±1·38 in placebo (p=0.72)) or sum of skinfolds (23·0±5·2 in metformin vs. 23·8±5·3 in placebo (p=0.31)) between groups. There was no difference in BMI trajectory by treatment overall but in males, treatment had significantly different trajectories (p=0.048) ; the metformin BMI was higher from 8 to 24 months. At 24 months, reduced sleep time (p=0.0125) and increased screen time (p=0.0549) were associated with increased BMI z-score. Offspring of women with T2D were approximately 1 SD heavier than the WHO reference population. Conclusion: Offspring of women with T2D with and without exposure to metformin in-utero had similar anthropometrics overall. In males, metformin led to higher BMI growth trajectory between 8 and 24 months. Future follow-up is needed to see if these findings continue. Disclosure D.Feig: Advisory Panel; Novo Nordisk, Research Support; Apotex. A.Armson: None. J.F.R.Barrett: None. L.E.Donovan: Other Relationship; Dexcom, Inc., Inner Analytics, Medtronic, Tandem Diabetes Care, Inc. P.Karanicolas: Research Support; Baxter. G.Klein: None. S.Tobin: None. K.Mangoff: None. G.Tomlinson: None. J.Hamilton: Advisory Panel; Novo Nordisk Canada Inc., Research Support; Mead Johnson & Company, LLC. J.Sanchez: None. K.Murphy: None. E.Asztalos: None. B.Zinman: Advisory Panel; Abbott Diabetes, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck & Co., Inc., Novo Nordisk Canada Inc., Sanofi K.K. D.Simmons: Other Relationship; Elsevier, Research Support; Abbott, Hitachi, Ltd., Novo Nordisk, Speaker's Bureau; Sanofi. A.Haqq: None. I.G.Fantus: None. L.Lipscombe: n/a. Funding Canadian Health Institute for Research
    Type of Medium: Online Resource
    ISSN: 0012-1797
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2022
    detail.hit.zdb_id: 1501252-9
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