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  • 1
    In: Critical Care Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 51, No. 1 ( 2023-01), p. 312-312
    Type of Medium: Online Resource
    ISSN: 0090-3493
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2034247-0
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  • 2
    In: Diabetes Care, American Diabetes Association, Vol. 46, No. 6 ( 2023-06-01), p. 1265-1270
    Abstract: The Rare and Atypical Diabetes Network (RADIANT) will perform a study of individuals and, if deemed informative, a study of their family members with uncharacterized forms of diabetes. RESEARCH DESIGN AND METHODS The protocol includes genomic (whole-genome [WGS], RNA, and mitochondrial sequencing), phenotypic (vital signs, biometric measurements, questionnaires, and photography), metabolomics, and metabolic assessments. RESULTS Among 122 with WGS results of 878 enrolled individuals, a likely pathogenic variant in a known diabetes monogenic gene was found in 3 (2.5%), and six new monogenic variants have been identified in the SMAD5, PTPMT1, INS, NFKB1, IGF1R, and PAX6 genes. Frequent phenotypic clusters are lean type 2 diabetes, autoantibody-negative and insulin-deficient diabetes, lipodystrophic diabetes, and new forms of possible monogenic or oligogenic diabetes. CONCLUSIONS The analyses will lead to improved means of atypical diabetes identification. Genetic sequencing can identify new variants, and metabolomics and transcriptomics analysis can identify novel mechanisms and biomarkers for atypical disease.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2023
    detail.hit.zdb_id: 1490520-6
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  • 3
    In: Diabetes, American Diabetes Association, Vol. 68, No. Supplement_1 ( 2019-06-01)
    Abstract: Introduction: Diabetes mellitus (DM) remains the iceberg disease in rural areas with large number of subjects remaining undiagnosed. India is the diabetes capital with home to 72.9 million diabetic people. Methodology: Our cross-sectional observational and analytical survey studied 516 subjects with uncontrolled type 2 DM (HbA1c & gt;9%) in the 9 villages (having 35,000 population) at Rural health centre, Veleru of Dr. PSIMS and RF, Krishna district, Andhra Pradesh, South India which is a predominantly rice eating population and analyzed the socio-demographic factors influencing insulin administration. Participants were assessed through a pre-tested structured questionnaire to elicit awareness regarding insulin usage. Results: Though 40.3% were prescribed insulin at some point of time, only 10.1% subjects were taking it. Awareness of diabetes was lacking in 67.8% and that of insulin in 54.1%. Commonest reason for avoiding insulin was fear of injections (31.8%), unawareness of insulin technique in 25.8%, lack of facilities to store insulin in 19.8% subjects, lack of access to pharmacy in 9.3%, unsure about correct timing in 20.2%, concerned about proper dosage measurements in 1.9%, but only 3.9% were concerned about cost. Conclusion: Proper awareness programs can significantly increase effective and regular use of insulin in diabetes subjects. Disclosure P. Mandava: None. H.R.S. Munganda: None. V. Undavalli: None. P. Satyanarayana Chowdary: None. D. Amle: None.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2019
    detail.hit.zdb_id: 1501252-9
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  • 4
    In: Children, MDPI AG, Vol. 9, No. 12 ( 2022-11-23), p. 1797-
    Abstract: Background: asthma, a chronic respiratory disease caused by inflammation and narrowing of the small airways in the lungs, is the most common chronic childhood disease. Prevalence of childhood asthma in the United States is 5.8%. In boys, prevalence is 5.7% and it is 6% in girls. Asthma is associated with other comorbidities such as major depressive disorder and anxiety disorder. This study explores the association between asthma and depression. Methods: we conducted a retrospective cross-sectional study using NHANES data from 2013 to 2018. Asthma and childhood onset asthma were assessed using questionnaires MCQ010 and MCQ025, respectively. Sociodemographic variables were summarized, and univariate analysis was performed to determine the association between asthma and major depressive disorder and its individual symptoms. Results: there were 402,167 participants from 2013–2018 in our study: no asthma in 84.70%; asthma in 15.30%. Childhood onset asthma (COA) included 10.51% and adult-onset asthma (AOA) included 4.79%. Median age of COA is 5 years and AOA is 41 years. Among the asthma groups, most AOA were females (67.77%, p 〈 0.0001), most COA were males (52.16%, p 〈 0.0001), and ethnicity was predominantly White in AOA (42.39%, p 〈 0001) and in COA (35.24%, p 〈 0.0001). AOA mostly had annual household income from $0–24,999 (35.91%, p 〈 0.0001), while COA mostly had annual household income from $25,000–64,999 (36.66%, p 〈 0.0001). There was a significantly higher prevalence of MDD in COA (38.90%) and AOA (47.30%) compared to NOA (31.91%). Frequency of symptoms related to MDD were found to have a significantly higher prevalence and severity in the asthma groups compared to no asthma, and slightly greater and more severe in AOA than in COA. Symptoms include having little interest in doing things (COA 18.38% vs. AOA 22.50% vs. NOA 15.44%), feeling down, depressed, or hopeless (COA 20.05% vs. AOA 22.77% vs. NOA 15.85%), having trouble sleeping or sleeping too much (COA 27.38% vs. AOA 23.15% vs. NOA 22.24%), feeling tired or having little energy (COA 39.17% vs. AOA 34.24% vs. NOA 33.97%), having poor appetite or overeating (COA 19.88% vs. AOA 20.02% vs. NOA 15.11%), feeling bad about yourself (COA 13.90% vs. AOA 13.79% vs. NOA 10.78%), having trouble concentrating on things (COA 12.34% vs. AOA 14.41% vs. NOA 10.06%), moving or speaking slowly or too fast (COA 8.59% vs. AOA 9.72% vs. NOA 6.09%), thinking you would be better off dead (COA 3.12% vs. AOA 4.38% vs. NOA 1.95%) and having the difficulties these problems have caused (COA 21.66% vs. AOA 26.73% vs. NOA 19.34%, p 〈 0.0001). Conclusion: MDD and related symptoms were significantly higher and more severe in participants with asthma compared to no asthma. Between adult-onset asthma compared to childhood onset asthma, adult-onset asthma had slightly greater and more severe MDD and related symptoms compared to childhood onset asthma.
    Type of Medium: Online Resource
    ISSN: 2227-9067
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2732685-8
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  • 5
    In: Diabetes, American Diabetes Association, Vol. 72, No. Supplement_1 ( 2023-06-20)
    Abstract: Background: Degludec (D), a once-daily basal insulin, takes 2-3 days to achieve steady state. When transitioning from insulin glargine (G) to D, 1:1 conversion is recommended. We studied the off-label effects of a bridging dose of G with the first dose of D in type 1 diabetes (T1D) patients using a continuous glucose monitor (CGM) 48 hours before and after the transition. Methods: Patients with T1D on a stable G regimen and A1C & lt;9% were randomized (double-blind) to a dose of placebo or G with first dose of D. Patients transitioned to D at 80% of total baseline G dose, based on result of SWITCH 1 clinical trial of transition to D. Bridging dose of G was 50% of total daily G dose for patients on once daily (QD) regimen at baseline and 50% of evening G dose in those on twice daily (BID) G and was taken with only the first dose of D. All participants wore a study CGM (Dexcom G6) and were instructed to manage their diabetes as usual except for not administering correctional doses of insulin unless glucose was greater than 250 mg/dL in the 48 hours before and after first dose of D. Results: Forty participants were randomized and 37 completed the study. The study population was 65% male with mean age of 47 years, 22 years duration of T1D, BMI 26 kg/m2, A1C of 6.8% and total daily insulin dose of 0.7 units/kg body weight. Nineteen patients (12 QD, 7 BID) received a bridging dose of G with their first dose of D; 18 patients (12 QD, 6 BID) received placebo. Among the BID users, patients bridged with G had a mean 9% increase in time in range (70-180 mg/dL) on CGM, while placebo patients had a mean 12% decrease (p=0.003). Time above range (180-250 mg/dL) also showed a mean 11.4% decrease in the BID users bridged with G, contrasted with an 11.5% increase in BID users on placebo (p=0.002). There were no significant differences in time below ranges ( & lt;70 mg/dL, & lt;54 mg/dL). Conclusions: Well-controlled twice-daily G users transitioning to D may benefit from a 50% bridging dose of evening G with first dose of D. Disclosure A.Thirumalai: Research Support; Novo Nordisk, Fractyl Health, Inc. J.H.Chao: None. T.Kaleru: None. X.Dong: None. P.Mandava: None. D.Khakpour: None. I.B.Hirsch: Consultant; Abbott Diabetes, Lifecare, Inc., Hagar, Research Support; Beta Bionics, Inc., Insulet Corporation, Dexcom, Inc. Funding Novo Nordisk (ISS001250)
    Type of Medium: Online Resource
    ISSN: 0012-1797
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2023
    detail.hit.zdb_id: 1501252-9
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  • 6
    In: Diabetes, Obesity and Metabolism, Wiley, Vol. 26, No. 5 ( 2024-05), p. 1868-1876
    Abstract: To study the effects of a bridging dose of U‐100 glargine (U‐100G) with the first dose of degludec in type 1 diabetes (T1D) patients transitioning from glargine to degludec, by comparing the glucose metrics 48 h before and after the transition. Materials and Methods Patients with T1D on a stable U‐100G regimen and with glycated haemoglobin concentration 〈 75 mmol/mol were randomized (double‐blind) to one dose of placebo or U‐100G with first dose of degludec, administered at 9:00 pm . Patients on once‐daily U‐100G at baseline received 50% of total U‐100G dose (bridging dose), while patients on twice‐daily U‐100G received 50% of the evening U‐100G dose. Participants wore a continuous glucose monitor during the study. Results Forty participants were randomized, of whom 37 completed the study. The cohort was 65% male, the mean age was 47 years, duration of T1D 22 years, BMI 26 kg/m 2 , HbA1c 51 mmol/mol and total daily insulin dose 0.7 units/kg body weight. The bridging group included 19 participants (once‐daily U‐100G: n = 12; twice‐daily U‐100G: n = 7) and the placebo group included 18 participants (once‐daily U‐100G: n = 12; twice‐daily U‐100G: n = 6). Change in time in range (TIR) was not significantly different between the two treatment groups. In secondary analyses, among twice‐daily U‐100G users, TIR (3.9‐10 mmol/L) increased 8% in the bridging group in the 48 h after first dose of degludec compared to the preceding 48 h, while participants in the placebo group had a 9.5% decrease ( p = 0.027). Conclusions A subgroup of well‐controlled twice‐daily U‐100G users transitioning to degludec benefited from a 50% bridging dose of evening U‐100G with the first dose of degludec in a small pilot study.
    Type of Medium: Online Resource
    ISSN: 1462-8902 , 1463-1326
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2024
    detail.hit.zdb_id: 2004918-3
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