[ { "key": "2M7NMTDE", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/2M7NMTDE", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/2M7NMTDE", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "lastModifiedByUser": { "id": 192482, "username": "drnasirmahgoub", "name": "Abdelnasir", "links": { "alternate": { "href": "https://www.zotero.org/drnasirmahgoub", "type": "text/html" } } }, "creatorSummary": "DeFronzo et al.", "parsedDate": "2009-09", "numChildren": 0 }, "data": { "key": "2M7NMTDE", "version": 1, "itemType": "journalArticle", "title": "The efficacy and safety of saxagliptin when added to metformin therapy in patients with inadequately controlled type 2 diabetes with metformin alone", "creators": [ { "creatorType": "author", "firstName": "Ralph A", "lastName": "DeFronzo" }, { "creatorType": "author", "firstName": "Miguel N", "lastName": "Hissa" }, { "creatorType": "author", "firstName": "Alan J", "lastName": "Garber" }, { "creatorType": "author", "firstName": "Jorge", "lastName": "Luiz Gross" }, { "creatorType": "author", "firstName": "Raina", "lastName": "Yuyan Duan" }, { "creatorType": "author", "firstName": "Shoba", "lastName": "Ravichandran" }, { "creatorType": "author", "firstName": "Roland S", "lastName": "Chen" } ], "abstractNote": "OBJECTIVE: This 24-week trial assessed the efficacy and safety of saxagliptin as add-on therapy in patients with type 2 diabetes with inadequate glycemic control with metformin alone. RESEARCH DESIGN AND METHODS: This was a randomized, double-blind, placebo-controlled study of saxagliptin (2.5, 5, or 10 mg once daily) or placebo plus a stable dose of metformin (1,500-2,500 mg) in 743 patients (A1C > or =7.0 and < or =10.0%). Efficacy analyses were performed using an ANCOVA model using last observation carried forward methodology on primary (A1C) and secondary (fasting plasma glucose [FPG] and postprandial glucose [PPG] area under the curve [AUC]) end points. RESULTS: Saxagliptin (2.5, 5, and 10 mg) plus metformin demonstrated statistically significant adjusted mean decreases from baseline to week 24 versus placebo in A1C (-0.59, -0.69, and -0.58 vs. +0.13%; all P < 0.0001), FPG (-14.31, -22.03, and -20.50 vs. +1.24 mg/dl; all P < 0.0001), and PPG AUC (-8,891, -9,586, and -8,137 vs. -3,291 mg . min/dl; all P < 0.0001). More than twice as many patients achieved A1C <7.0% with 2.5, 5, and 10 mg saxagliptin versus placebo (37, 44, and 44 vs. 17%; all P < 0.0001). beta-Cell function and postprandial C-peptide, insulin, and glucagon AUCs improved in all saxagliptin treatment groups at week 24. Incidence of hypoglycemic adverse events and weight reductions were similar to those with placebo. CONCLUSIONS: Saxagliptin once daily added to metformin therapy was generally well tolerated and led to statistically significant improvements in glycemic indexes versus placebo added to metformin in patients with type 2 diabetes inadequately controlled with metformin alone.", "publicationTitle": "Diabetes Care", "publisher": "", "place": "", "date": "Sep 2009", "volume": "32", "issue": "9", "section": "", "partNumber": "", "partTitle": "", "pages": "1649-1655", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Diabetes Care", "DOI": "10.2337/dc08-1984", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/19478198", "accessDate": "2009-11-22T15:26:20Z", "PMID": "", "PMCID": "", "ISSN": "1935-5548", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "0209", "rights": "", "extra": "PMID: 19478198", "tags": [ { "tag": "Adamantane", "type": 1 }, { "tag": "Adolescent", "type": 1 }, { "tag": "Adult", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Blood Glucose", "type": 1 }, { "tag": "Diabetes Mellitus, Type 2", "type": 1 }, { "tag": "Dipeptides", "type": 1 }, { "tag": "Double-Blind Method", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Hypoglycemic Agents", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Metformin", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Placebos", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 }, { "tag": "Young Adult", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2013-01-25T00:47:15Z" } }, { "key": "2HMEINHS", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/2HMEINHS", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/2HMEINHS", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "lastModifiedByUser": { "id": 192482, "username": "drnasirmahgoub", "name": "Abdelnasir", "links": { "alternate": { "href": "https://www.zotero.org/drnasirmahgoub", "type": "text/html" } } }, "creatorSummary": "Bonds et al.", "parsedDate": "2010", "numChildren": 0 }, "data": { "key": "2HMEINHS", "version": 1, "itemType": "journalArticle", "title": "The association between symptomatic, severe hypoglycaemia and mortality in type 2 diabetes: retrospective epidemiological analysis of the ACCORD study", "creators": [ { "creatorType": "author", "firstName": "Denise E", "lastName": "Bonds" }, { "creatorType": "author", "firstName": "Michael E", "lastName": "Miller" }, { "creatorType": "author", "firstName": "Richard M", "lastName": "Bergenstal" }, { "creatorType": "author", "firstName": "John B", "lastName": "Buse" }, { "creatorType": "author", "firstName": "Robert P", "lastName": "Byington" }, { "creatorType": "author", "firstName": "Jeff A", "lastName": "Cutler" }, { "creatorType": "author", "firstName": "R James", "lastName": "Dudl" }, { "creatorType": "author", "firstName": "Faramarz", "lastName": "Ismail-Beigi" }, { "creatorType": "author", "firstName": "Angela R", "lastName": "Kimel" }, { "creatorType": "author", "firstName": "Byron", "lastName": "Hoogwerf" }, { "creatorType": "author", "firstName": "Karen R", "lastName": "Horowitz" }, { "creatorType": "author", "firstName": "Peter J", "lastName": "Savage" }, { "creatorType": "author", "firstName": "Elizabeth R", "lastName": "Seaquist" }, { "creatorType": "author", "firstName": "Debra L", "lastName": "Simmons" }, { "creatorType": "author", "firstName": "William I", "lastName": "Sivitz" }, { "creatorType": "author", "firstName": "Joann M", "lastName": "Speril-Hillen" }, { "creatorType": "author", "firstName": "Mary Ellen", "lastName": "Sweeney" } ], "abstractNote": "OBJECTIVE: To determine whether there is a link between hypoglycaemia and mortality among participants in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. DESIGN: Retrospective epidemiological analysis of data from the ACCORD trial. Setting Diabetes clinics, research clinics, and primary care clinics. PARTICIPANTS: Patients were eligible for the ACCORD study if they had type 2 diabetes, a glycated haemoglobin (haemoglobin A(1C)) concentration of 7.5% or more during screening, and were aged 40-79 years with established cardiovascular disease or 55-79 years with evidence of subclinical disease or two additional cardiovascular risk factors. Intervention Intensive (haemoglobin A(1C) <6.0%) or standard (haemoglobin A(1C) 7.0-7.9%) glucose control. OUTCOME MEASURES: Symptomatic, severe hypoglycaemia, manifest as either blood glucose concentration of less than 2.8 mmol/l (<50 mg/dl) or symptoms that resolved with treatment and that required either the assistance of another person or medical assistance, and all cause and cause specific mortality, including a specific assessment for involvement of hypoglycaemia. RESULTS: 10 194 of the 10 251 participants enrolled in the ACCORD study who had at least one assessment for hypoglycaemia during regular follow-up for vital status were included in this analysis. Unadjusted annual mortality among patients in the intensive glucose control arm was 2.8% in those who had one or more episodes of hypoglycaemia requiring any assistance compared with 1.2% for those with no episodes (53 deaths per 1924 person years and 201 deaths per 16 315 person years, respectively; adjusted hazard ratio (HR) 1.41, 95% CI 1.03 to 1.93). A similar pattern was seen among participants in the standard glucose control arm (3.7% (21 deaths per 564 person years) v 1.0% (176 deaths per 17 297 person years); adjusted HR 2.30, 95% CI 1.46 to 3.65). On the other hand, among participants with at least one hypoglycaemic episode requiring any assistance, a non-significantly lower risk of death was seen in those in the intensive arm compared with those in the standard arm (adjusted HR 0.74, 95% 0.46 to 1.23). A significantly lower risk was observed in the intensive arm compared with the standard arm in participants who had experienced at least one hypoglycaemic episode requiring medical assistance (adjusted HR 0.55, 95% CI 0.31 to 0.99). Of the 451 deaths that occurred in ACCORD up to the time when the intensive treatment arm was closed, one death was adjudicated as definitely related to hypoglycaemia. CONCLUSION: Symptomatic, severe hypoglycaemia was associated with an increased risk of death within each study arm. However, among participants who experienced at least one episode of hypoglycaemia, the risk of death was lower in such participants in the intensive arm than in the standard arm. Symptomatic, severe hypoglycaemia does not appear to account for the difference in mortality between the two study arms up to the time when the ACCORD intensive glycaemia arm was discontinued. TRIAL REGISTRATION: NCT00000620.", "publicationTitle": "BMJ (Clinical Research Ed.)", "publisher": "", "place": "", "date": "2010", "volume": "340", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "b4909", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "BMJ", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/20061358", "accessDate": "2010-02-05T20:45:22Z", "PMID": "", "PMCID": "", "ISSN": "1468-5833", "archive": "", "archiveLocation": "", "shortTitle": "The association between symptomatic, severe hypoglycaemia and mortality in type 2 diabetes", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "0192", "rights": "", "extra": "PMID: 20061358", "tags": [ { "tag": "Aged", "type": 1 }, { "tag": "Antihypertensive Agents", "type": 1 }, { "tag": "Antilipemic Agents", "type": 1 }, { "tag": "Diabetes Mellitus, Type 2", "type": 1 }, { "tag": "Diabetic Angiopathies", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Hemoglobin A, Glycosylated", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Hyperlipidemias", "type": 1 }, { "tag": "Hypertension", "type": 1 }, { "tag": "Hypoglycemia", "type": 1 }, { "tag": "Hypoglycemic Agents", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Retrospective Studies", "type": 1 }, { "tag": "Risk Factors", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2013-01-25T00:47:14Z" } }, { "key": "28UXMXA2", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/28UXMXA2", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/28UXMXA2", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "lastModifiedByUser": { "id": 192482, "username": "drnasirmahgoub", "name": "Abdelnasir", "links": { "alternate": { "href": "https://www.zotero.org/drnasirmahgoub", "type": "text/html" } } }, "creatorSummary": "Diamant et al.", "parsedDate": "2010-06-26", "numChildren": 0 }, "data": { "key": "28UXMXA2", "version": 1, "itemType": "journalArticle", "title": "Once weekly exenatide compared with insulin glargine titrated to target in patients with type 2 diabetes (DURATION-3): an open-label randomised trial", "creators": [ { "creatorType": "author", "firstName": "Michaela", "lastName": "Diamant" }, { "creatorType": "author", "firstName": "Luc", "lastName": "Van Gaal" }, { "creatorType": "author", "firstName": "Stephen", "lastName": "Stranks" }, { "creatorType": "author", "firstName": "Justin", "lastName": "Northrup" }, { "creatorType": "author", "firstName": "Dachuang", "lastName": "Cao" }, { "creatorType": "author", "firstName": "Kristin", "lastName": "Taylor" }, { "creatorType": "author", "firstName": "Michael", "lastName": "Trautmann" } ], "abstractNote": "BACKGROUND: Diabetes treatments are needed that are convenient, provide effective glycaemic control, and do not cause weight gain. We aimed to test the hypothesis that improvement in haemoglobin A(1c) (HbA(1c)) achieved with once weekly exenatide was superior to that achieved with insulin glargine titrated to glucose targets. METHODS: In this 26-week, open-label, randomised, parallel study, we compared exenatide with insulin glargine in adults with type 2 diabetes who had suboptimum glycaemic control despite use of maximum tolerated doses of blood-glucose-lowering drugs for 3 months or longer. Patients were randomly assigned to add exenatide (2 mg, once-a-week injection) or insulin glargine (once-daily injection, starting dose 10 IU, target glucose range 4.0-5.5 mmol/L) to their blood-glucose-lowering regimens. Randomisation was with a one-to-one allocation and block size four, stratified according to country and concomitant treatment (70% metformin only; 30% metformin plus sulphonylurea). Participants and clinical investigators were not masked to assignment, but investigators analysing data were. The primary endpoint was change in HbA(1c) from baseline, and analysis of this outcome was by modified intention to treat for all patients who received at least one dose of study drug. This trial is registered at ClinicalTrials.gov, number NCT00641056. FINDINGS: 456 patients were randomly allocated to treatment and were included in the modified intention-to-treat analysis (233 exenatide, 223 insulin glargine). Participants who received at least one dose of study drug and for whom baseline and at least one postbaseline measurement of HbA(1c) were available were included in the primary efficacy analysis. Change in HbA(1c) at 26 weeks was greater in patients taking exenatide (n=228; -1.5%, SE 0.05) than in those taking insulin glargine (n=220; -1.3%, 0.06; treatment difference -0.16%, 0.07, 95% CI -0.29 to -0.03). 12 (5%) of 233 patients allocated to exenatide and two (1%) of 223 taking insulin glargine discontinued participation because of adverse events (p=0.012). A planned extension period (up to 2.5 years' duration) is in progress. INTERPRETATION: Once weekly exenatide is an important therapeutic option for patients for whom risk of hypoglycaemia, weight loss, and convenience are particular concerns. FUNDING: Amylin Pharmaceuticals; Eli Lilly and Company.", "publicationTitle": "Lancet", "publisher": "", "place": "", "date": "Jun 26, 2010", "volume": "375", "issue": "9733", "section": "", "partNumber": "", "partTitle": "", "pages": "2234-2243", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Lancet", "DOI": "10.1016/S0140-6736(10)60406-0", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/20609969", "accessDate": "2010-10-13T21:04:21Z", "PMID": "", "PMCID": "", "ISSN": "1474-547X", "archive": "", "archiveLocation": "", "shortTitle": "Once weekly exenatide compared with insulin glargine titrated to target in patients with type 2 diabetes (DURATION-3)", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "0135", "rights": "", "extra": "PMID: 20609969", "tags": [ { "tag": "Blood Glucose", "type": 1 }, { "tag": "Diabetes Mellitus, Type 2", "type": 1 }, { "tag": "Drug Administration Schedule", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Glucagon-Like Peptide 1", "type": 1 }, { "tag": "Hemoglobin A, Glycosylated", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Hypoglycemic Agents", "type": 1 }, { "tag": "Injections, Subcutaneous", "type": 1 }, { "tag": "Insulin", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Peptides", "type": 1 }, { "tag": "Venoms", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2013-01-25T00:47:13Z" } }, { "key": "TFN6FGSN", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/TFN6FGSN", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/TFN6FGSN", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/7612/items/GZ9VI4XB", "type": "application/json" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "TFN6FGSN", "version": 1, "parentItem": "GZ9VI4XB", "itemType": "note", "note": "", "tags": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "9A5C7GAJ", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/9A5C7GAJ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/9A5C7GAJ", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/7612/items/X2V3WCUM", "type": "application/json" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "9A5C7GAJ", "version": 1, "parentItem": "X2V3WCUM", "itemType": "note", "note": "

The authors discuss QALY as part of a sensitivity analysis but say there is no change in the relative difference of prompt revascularisation vs. initial medical therapy.

", "tags": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "UABWWQ3B", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/UABWWQ3B", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/UABWWQ3B", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/7612/items/X2V3WCUM", "type": "application/json" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "UABWWQ3B", "version": 1, "parentItem": "X2V3WCUM", "itemType": "note", "note": "", "tags": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "QNWSTA62", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/QNWSTA62", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/QNWSTA62", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/7612/items/563V5RQA", "type": "application/json" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "QNWSTA62", "version": 1, "parentItem": "563V5RQA", "itemType": "note", "note": "

Hypoglycaemia may not be as strong a predictor of death in acute MI when compared with hyperglycaemia.

", "tags": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "W7PASG6F", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/W7PASG6F", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/W7PASG6F", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/7612/items/UJXN4KIA", "type": "application/json" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "W7PASG6F", "version": 1, "parentItem": "UJXN4KIA", "itemType": "note", "note": "

Description of two type os diabetes - insulin sensitive and insulin insensitive.

", "tags": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "MJQ7E5RD", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/MJQ7E5RD", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/MJQ7E5RD", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/7612/items/9J73K2R8", "type": "application/json" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "MJQ7E5RD", "version": 1, "parentItem": "9J73K2R8", "itemType": "note", "note": "

Small reduction in HbAc (0.58%) when added to insulin.

", "tags": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "BNQFJDDZ", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/BNQFJDDZ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/BNQFJDDZ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "creatorSummary": "Reaven", "parsedDate": "2005-01", "numChildren": 0 }, "data": { "key": "BNQFJDDZ", "version": 1, "itemType": "journalArticle", "title": "Why Syndrome X? From Harold Himsworth to the Insulin Resistance Syndrome", "creators": [ { "creatorType": "author", "firstName": "Gerald M.", "lastName": "Reaven" } ], "abstractNote": "", "publicationTitle": "Cell Metabolism", "publisher": "", "place": "", "date": "January 2005", "volume": "1", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "9-14", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "10.1016/j.cmet.2004.12.001", "citationKey": "", "url": "http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B7MFH-4F8SPMH-5&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=d18241e3fc6f1a7ceb8404bff66a9129", "accessDate": "2009-10-23T18:04:25Z", "PMID": "", "PMCID": "", "ISSN": "", "archive": "", "archiveLocation": "", "shortTitle": "Why Syndrome X?", "language": "", "libraryCatalog": "ScienceDirect", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "QP6SJWG6", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/QP6SJWG6", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/QP6SJWG6", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "creatorSummary": "Bouillon et al.", "parsedDate": "2008", "numChildren": 0 }, "data": { "key": "QP6SJWG6", "version": 1, "itemType": "journalArticle", "title": "Vitamin D and Human Health: Lessons from Vitamin D Receptor Null Mice", "creators": [ { "creatorType": "author", "firstName": "R.", "lastName": "Bouillon" }, { "creatorType": "author", "firstName": "G.", "lastName": "Carmeliet" }, { "creatorType": "author", "firstName": "L.", "lastName": "Verlinden" }, { "creatorType": "author", "firstName": "E.", "lastName": "van Etten" }, { "creatorType": "author", "firstName": "A.", "lastName": "Verstuyf" }, { "creatorType": "author", "firstName": "H. F.", "lastName": "Luderer" }, { "creatorType": "author", "firstName": "L.", "lastName": "Lieben" }, { "creatorType": "author", "firstName": "C.", "lastName": "Mathieu" }, { "creatorType": "author", "firstName": "M.", "lastName": "Demay" } ], "abstractNote": "", "publicationTitle": "Endocrine Reviews", "publisher": "", "place": "", "date": "07/2008", "volume": "29", "issue": "6", "section": "", "partNumber": "", "partTitle": "", "pages": "726-776", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Endocrine Reviews", "DOI": "10.1210/er.2008-0004", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2583388/?tool=pubmed", "accessDate": "2009-12-10T15:34:00Z", "PMID": "", "PMCID": "", "ISSN": "0163-769X", "archive": "", "archiveLocation": "", "shortTitle": "Vitamin D and Human Health", "language": "", "libraryCatalog": "CrossRef", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "IVTZDTSI", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/IVTZDTSI", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/IVTZDTSI", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "creatorSummary": "Ryan and Germsheid", "parsedDate": "2009-10", "numChildren": 0 }, "data": { "key": "IVTZDTSI", "version": 1, "itemType": "journalArticle", "title": "Use of continuous glucose monitoring system in the management of severe hypoglycemia", "creators": [ { "creatorType": "author", "firstName": "Edmond A", "lastName": "Ryan" }, { "creatorType": "author", "firstName": "Judy", "lastName": "Germsheid" } ], "abstractNote": "BACKGROUND: Severe hypoglycemia can have a dramatic impact on daily life for people with diabetes. Hypoglycemia is quantifiable by the HYPO-Score derived from the frequency of severe hypoglycemia over a year and a component based on 4 weeks of glucose records. The latter gives a modified HYPO-Score as a short-term measure of hypoglycemia. We used a continuous glucose monitoring system (CGMS) in patients with severe hypoglycemia to assess if we could decrease hypoglycemia as measured by the modified HYPO-Score. METHODS: Sixteen type 1 diabetes subjects, 52.0 +/- 2.3 years old with a diabetes duration of 29.4 +/- 2.8 years having problematic hypoglycemia were enrolled. All used multiple daily insulin injections, and the glycosylated hemoglobin level was 8.4 +/- 0.3%. After a month of gathering hypoglycemia information for baseline modified HYPO-Score, subjects wore the CGMS for 2 months, and a modified HYPO-Score was repeated. To assess long-term benefit, CGMS was then discontinued for 3 months, and a final modified HYPO-Score was determined. RESULTS: The modified HYPO-Score decreased from 857 +/- 184 to 444 +/- 92 (P = 0.055) (intention-to-treat basis). Further analysis of the modified HYPO-Score when the CGMS was actually functioning showed it decreased from 857 +/- 184 to 366 +/- 86 (P = 0.023). Severe hypoglycemia episodes dropped from 16 at baseline to three when wearing the CGMS. The number of hypoglycemia episodes <3.0 mmol/L dropped from 8.6 +/- 1.5 to 4.7 +/- 0.9 (P = 0.01). Subjects expressed less fear of hypoglycemia with CGMS. In 11 who completed modified Final Month HYPO-Scores, the number of severe hypoglycemic events rose to six. At study end, 13 of 16 subjects elected to continue using the CGMS. CONCLUSIONS: When the CGMS was worn and functioning there was a significant decrease in the modified HYPO-Score and number of hypoglycemic values <3.0 mmol/L.", "publicationTitle": "Diabetes Technology & Therapeutics", "publisher": "", "place": "", "date": "Oct 2009", "volume": "11", "issue": "10", "section": "", "partNumber": "", "partTitle": "", "pages": "635-639", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Diabetes Technol. Ther", "DOI": "10.1089/dia.2009.0042", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/19821755", "accessDate": "2010-01-10T12:07:24Z", "PMID": "", "PMCID": "", "ISSN": "1557-8593", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 19821755", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Blood Glucose", "type": 1 }, { "tag": "Blood Glucose Self-Monitoring", "type": 1 }, { "tag": "Diabetes Mellitus, Type 1", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Glucose", "type": 1 }, { "tag": "Hemoglobin A, Glycosylated", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Hypoglycemia", "type": 1 }, { "tag": "Insulin", "type": 1 }, { "tag": "Longitudinal Studies", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Quality of Life", "type": 1 }, { "tag": "Time Factors", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "MPZURNVC", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/MPZURNVC", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/MPZURNVC", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "creatorSummary": "Monnier et al.", "parsedDate": "2008-06", "numChildren": 0 }, "data": { "key": "MPZURNVC", "version": 1, "itemType": "journalArticle", "title": "Type 2 diabetes: a well-characterised but suboptimally controlled disease. Can we bridge the divide?", "creators": [ { "creatorType": "author", "firstName": "L", "lastName": "Monnier" }, { "creatorType": "author", "firstName": "C", "lastName": "Colette" }, { "creatorType": "author", "firstName": "D R", "lastName": "Owens" } ], "abstractNote": "From a pathophysiological point of view, type 2 diabetes is a well-characterised disease, since the glycaemic disorders result from three main mechanisms (the De Fronzo's triumvirate): a defect of beta-cell function, decreased disposal of glucose in peripheral tissues and overproduction of glucose by the liver. Each defect is subject to 24-h circadian variations and to inevitable worsening with time. As a consequence, therapeutic strategies should reflect whether patients retain sufficient insulin secretion or suffer from a more severe secretory defect that progresses from being responsive to oral diabetic agents to the insulin-requiring stage. Identifying the different pathophysiological stages is a prerequisite for successful therapeutic strategies. This assessment can be done by considering on the one hand the HbA(1c) and on the other the glycaemic profiles. For the latter, either discontinuous (self-monitoring of blood glucose) or continuous glucose monitoring can be used. However, many difficulties remain for bridging the divide between well-understood pathophysiological concepts and suboptimal glycaemic control achieved in clinical practice. The main drawback is the difficulty in providing therapies at recommended doses to stochastic phenomena such as either intestinal absorption of carbohydrates or fluctuations in both pharmacokinetics and pharmacodynamics of hypoglycaemic agents.", "publicationTitle": "Diabetes & Metabolism", "publisher": "", "place": "", "date": "Jun 2008", "volume": "34", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "207-216", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Diabetes Metab", "DOI": "10.1016/j.diabet.2008.01.011", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/18511324", "accessDate": "2009-11-15T21:55:33Z", "PMID": "", "PMCID": "", "ISSN": "1262-3636", "archive": "", "archiveLocation": "", "shortTitle": "Type 2 diabetes", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 18511324", "tags": [ { "tag": "Administration, Oral", "type": 1 }, { "tag": "Blood Glucose", "type": 1 }, { "tag": "Diabetes Mellitus, Type 2", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Hypoglycemic Agents", "type": 1 }, { "tag": "Insulin", "type": 1 }, { "tag": "Insulin-Secreting Cells", "type": 1 }, { "tag": "Metformin", "type": 1 }, { "tag": "Reference Values", "type": 1 }, { "tag": "Thiazolidinediones", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "4AGCU63F", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/4AGCU63F", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/4AGCU63F", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "creatorSummary": "DAFNE Study Group", "parsedDate": "2002-10-05", "numChildren": 0 }, "data": { "key": "4AGCU63F", "version": 1, "itemType": "journalArticle", "title": "Training in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes: dose adjustment for normal eating (DAFNE) randomised controlled trial", "creators": [ { "creatorType": "author", "firstName": "", "lastName": "DAFNE Study Group" } ], "abstractNote": "Objectives: To evaluate whether a course teaching flexible intensive insulin treatment combining dietary freedom and insulin adjustment can improve both glycaemic control and quality of life in type 1 diabetes. Design: Randomised design with participants either attending training immediately (immediate DAFNE) or acting as waiting list controls and attending \"delayed DAFNE\" training 6 months later. Setting: Secondary care diabetes clinics in three English health districts. Participants: 169 adults with type 1 diabetes and moderate or poor glycaemic control. Main outcome measures: Glycated haemoglobin (HbA1c), severe hypoglycaemia, impact of diabetes on quality of life (ADDQoL). Results: At 6 months, HbA1c was significantly better in immediate DAFNE patients (mean 8.4%) than in delayed DAFNE patients (9.4%) (t=6.1, P<0.0001). The impact of diabetes on dietary freedom was significantly improved in immediate DAFNE patients compared with delayed DAFNE patients (t=[-]5.4, P<0.0001), as was the impact of diabetes on overall quality of life (t=2.9, P<0.01). General wellbeing and treatment satisfaction were also significantly improved, but severe hypoglycaemia, weight, and lipids remained unchanged. Improvements in \"present quality of life\" did not reach significance at 6 months but were significant by 1 year. Conclusion: Skills training promoting dietary freedom improved quality of life and glycaemic control in people with type 1 diabetes without worsening severe hypoglycaemia or cardiovascular risk. This approach has the potential to enable more people to adopt intensive insulin treatment and is worthy of further investigation. What is already known on this topic Current treatment of type 1 diabetes fails to engage many patients in intensive self management and is associated with poor glycaemic outcomes and impaired quality of lifeAn approach to intensive insulin treatment in which participants match insulin dose to unrestricted food choices has been developed in GermanyThis approach has been shown to lead to sustained improvements in glycaemic control but has not been widely adopted elsewhereWhat this study adds Training in flexible, intensive insulin treatment can improve glycaemic control in the United KingdomThis approach also leads to significant improvements in treatment satisfaction, psychological wellbeing, and quality of life measures", "publicationTitle": "BMJ", "publisher": "", "place": "", "date": "October 5, 2002", "volume": "325", "issue": "7367", "section": "", "partNumber": "", "partTitle": "", "pages": "746", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "10.1136/bmj.325.7367.746", "citationKey": "", "url": "http://www.bmj.com/cgi/content/abstract/325/7367/746", "accessDate": "2009-10-24T12:19:32Z", "PMID": "", "PMCID": "", "ISSN": "", "archive": "", "archiveLocation": "", "shortTitle": "Training in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes", "language": "", "libraryCatalog": "HighWire", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "X3ET8QZ8", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/X3ET8QZ8", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/X3ET8QZ8", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "creatorSummary": "Holman et al.", "parsedDate": "2009-10-29", "numChildren": 0 }, "data": { "key": "X3ET8QZ8", "version": 1, "itemType": "journalArticle", "title": "Three-year efficacy of complex insulin regimens in type 2 diabetes", "creators": [ { "creatorType": "author", "firstName": "Rury R", "lastName": "Holman" }, { "creatorType": "author", "firstName": "Andrew J", "lastName": "Farmer" }, { "creatorType": "author", "firstName": "Melanie J", "lastName": "Davies" }, { "creatorType": "author", "firstName": "Jonathan C", "lastName": "Levy" }, { "creatorType": "author", "firstName": "Julie L", "lastName": "Darbyshire" }, { "creatorType": "author", "firstName": "Joanne F", "lastName": "Keenan" }, { "creatorType": "author", "firstName": "Sanjoy K", "lastName": "Paul" } ], "abstractNote": "BACKGROUND: Evidence supporting the addition of specific insulin regimens to oral therapy in patients with type 2 diabetes mellitus is limited. METHODS: In this 3-year open-label, multicenter trial, we evaluated 708 patients who had suboptimal glycated hemoglobin levels while taking metformin and sulfonylurea therapy. Patients were randomly assigned to receive biphasic insulin aspart twice daily, prandial insulin aspart three times daily, or basal insulin detemir once daily (twice if required). Sulfonylurea therapy was replaced by a second type of insulin if hyperglycemia became unacceptable during the first year of the study or subsequently if glycated hemoglobin levels were more than 6.5%. Outcome measures were glycated hemoglobin levels, the proportion of patients with a glycated hemoglobin level of 6.5% or less, the rate of hypoglycemia, and weight gain. RESULTS: Median glycated hemoglobin levels were similar for patients receiving biphasic (7.1%), prandial (6.8%), and basal (6.9%) insulin-based regimens (P=0.28). However, fewer patients had a level of 6.5% or less in the biphasic group (31.9%) than in the prandial group (44.7%, P=0.006) or in the basal group (43.2%, P=0.03), with 67.7%, 73.6%, and 81.6%, respectively, taking a second type of insulin (P=0.002). Median rates of hypoglycemia per patient per year were lowest in the basal group (1.7), higher in the biphasic group (3.0), and highest in the prandial group (5.7) (P<0.001 for the overall comparison). The mean weight gain was higher in the prandial group than in either the biphasic group or the basal group. Other adverse event rates were similar in the three groups. CONCLUSIONS: Patients who added a basal or prandial insulin-based regimen to oral therapy had better glycated hemoglobin control than patients who added a biphasic insulin-based regimen. Fewer hypoglycemic episodes and less weight gain occurred in patients adding basal insulin. (Current Controlled Trials number, ISRCTN51125379.)", "publicationTitle": "The New England Journal of Medicine", "publisher": "", "place": "", "date": "Oct 29, 2009", "volume": "361", "issue": "18", "section": "", "partNumber": "", "partTitle": "", "pages": "1736-1747", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "N. Engl. J. Med", "DOI": "10.1056/NEJMoa0905479", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/19850703", "accessDate": "2009-11-10T13:47:32Z", "PMID": "", "PMCID": "", "ISSN": "1533-4406", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 19850703", "tags": [ { "tag": "insulin" } ], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "THQAGCWH", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/THQAGCWH", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/THQAGCWH", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "creatorSummary": "Vella et al.", "parsedDate": "2010-01-08", "numChildren": 0 }, "data": { "key": "THQAGCWH", "version": 1, "itemType": "journalArticle", "title": "The use of metformin in type 1 diabetes: a systematic review of efficacy", "creators": [ { "creatorType": "author", "firstName": "S", "lastName": "Vella" }, { "creatorType": "author", "firstName": "L", "lastName": "Buetow" }, { "creatorType": "author", "firstName": "P", "lastName": "Royle" }, { "creatorType": "author", "firstName": "S", "lastName": "Livingstone" }, { "creatorType": "author", "firstName": "H M", "lastName": "Colhoun" }, { "creatorType": "author", "firstName": "J R", "lastName": "Petrie" } ], "abstractNote": "AIMS/HYPOTHESIS: As adding metformin to insulin therapy has been advocated in type 1 diabetes, we conducted a systematic review of published clinical trials and clinical trial databases to assess the effects on HbA(1c), weight, insulin-dose requirement and adverse effects. METHODS: We constructed evidence tables and fitted a fixed-effects model (inverse variance method) in order to assess heterogeneity between studies and give a crude measure of each overall treatment effect. RESULTS: Of 197 studies identified, nine involved randomisation with informed consent of patients with type 1 diabetes to metformin (vs placebo or comparator) in either a parallel or crossover design for at least 1 week. We noted marked heterogeneity in study design, drug dose, age of participants and length of follow-up. Metformin was associated with reductions in: (1) insulin-dose requirement (5.7-10.1 U/day in six of seven studies); (2) HbA(1c) (0.6-0.9% in four of seven studies); (3) weight (1.7-6.0 kg in three of six studies); and (4) total cholesterol (0.3-0.41 mmol/l in three of seven studies). Metformin was well tolerated, albeit with a trend towards increased hypoglycaemia. Formal estimates of combined effects from the five trials which reported appropriate data indicated a significant reduction in insulin dose (6.6 U/day, p < 0.001) but no significant reduction in HbA(1c) (absolute reduction 0.11%, p = 0.42). No reported trials included cardiovascular outcomes. CONCLUSIONS/INTERPRETATION: Metformin reduces insulin-dose requirement in type 1 diabetes but it is unclear whether this is sustained beyond 1 year and whether there are benefits for cardiovascular and other key clinical outcomes.", "publicationTitle": "Diabetologia", "publisher": "", "place": "", "date": "Jan 8, 2010", "volume": "", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Diabetologia", "DOI": "10.1007/s00125-009-1636-9", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/20057994", "accessDate": "2010-02-08T11:06:03Z", "PMID": "", "PMCID": "", "ISSN": "1432-0428", "archive": "", "archiveLocation": "", "shortTitle": "The use of metformin in type 1 diabetes", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 20057994", "tags": [], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "RTXEUAT3", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/RTXEUAT3", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/RTXEUAT3", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "creatorSummary": "Stevens et al.", "parsedDate": "2001-12", "numChildren": 0 }, "data": { "key": "RTXEUAT3", "version": 1, "itemType": "journalArticle", "title": "The UKPDS risk engine: a model for the risk of coronary heart disease in Type II diabetes (UKPDS 56)", "creators": [ { "creatorType": "author", "firstName": "R J", "lastName": "Stevens" }, { "creatorType": "author", "firstName": "V", "lastName": "Kothari" }, { "creatorType": "author", "firstName": "A I", "lastName": "Adler" }, { "creatorType": "author", "firstName": "I M", "lastName": "Stratton" } ], "abstractNote": "A definitive model for predicting absolute risk of coronary heart disease (CHD) in male and female people with Type II diabetes is not yet available. This paper provides an equation for estimating the risk of new CHD events in people with Type II diabetes, based on data from 4540 U.K. Prospective Diabetes Study male and female patients. Unlike previously published risk equations, the model is diabetes-specific and incorporates glycaemia, systolic blood pressure and lipid levels as risk factors, in addition to age, sex, ethnic group, smoking status and time since diagnosis of diabetes. All variables included in the final model were statistically significant (P<0.001, except smoking for which P=0.0013) in likelihood ratio testing. This model provides the estimates of CHD risk required by current guidelines for the primary prevention of CHD in Type II diabetes.", "publicationTitle": "Clinical Science (London, England: 1979)", "publisher": "", "place": "", "date": "Dec 2001", "volume": "101", "issue": "6", "section": "", "partNumber": "", "partTitle": "", "pages": "671-679", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Clin. Sci", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/11724655", "accessDate": "2009-10-24T13:01:00Z", "PMID": "", "PMCID": "", "ISSN": "0143-5221", "archive": "", "archiveLocation": "", "shortTitle": "The UKPDS risk engine", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 11724655", "tags": [], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "JXBTZZB7", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/JXBTZZB7", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/JXBTZZB7", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "creatorSummary": "Prochaska and Velicer", "parsedDate": "1997-10", "numChildren": 0 }, "data": { "key": "JXBTZZB7", "version": 1, "itemType": "journalArticle", "title": "The transtheoretical model of health behavior change", "creators": [ { "creatorType": "author", "firstName": "J O", "lastName": "Prochaska" }, { "creatorType": "author", "firstName": "W F", "lastName": "Velicer" } ], "abstractNote": "The transtheoretical model posits that health behavior change involves progress through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. Ten processes of change have been identified for producing progress along with decisional balance, self-efficacy, and temptations. Basic research has generated a rule of thumb for at-risk populations: 40% in precontemplation, 40% in contemplation, and 20% in preparation. Across 12 health behaviors, consistent patterns have been found between the pros and cons of changing and the stages of change. Applied research has demonstrated dramatic improvements in recruitment, retention, and progress using stage-matched interventions and proactive recruitment procedures. The most promising outcomes to data have been found with computer-based individualized and interactive interventions. The most promising enhancement to the computer-based programs are personalized counselors. One of the most striking results to date for stage-matched programs is the similarity between participants reactively recruited who reached us for help and those proactively recruited who we reached out to help. If results with stage-matched interventions continue to be replicated, health promotion programs will be able to produce unprecedented impacts on entire at-risk populations.", "publicationTitle": "American Journal of Health Promotion: AJHP", "publisher": "", "place": "", "date": "1997 Sep-Oct", "volume": "12", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "38-48", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Am J Health Promot", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/10170434", "accessDate": "2009-10-24T13:30:44Z", "PMID": "", "PMCID": "", "ISSN": "0890-1171", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 10170434", "tags": [], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "WQWRKTKZ", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/WQWRKTKZ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/WQWRKTKZ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "creatorSummary": "Klupa et al.", "parsedDate": "2005-05", "numChildren": 0 }, "data": { "key": "WQWRKTKZ", "version": 1, "itemType": "journalArticle", "title": "The identification of a R201H mutation in KCNJ11, which encodes Kir6.2, and successful transfer to sustained-release sulphonylurea therapy in a subject with neonatal diabetes: evidence for heterogeneity of beta cell function among carriers of the R201H mutation", "creators": [ { "creatorType": "author", "firstName": "T", "lastName": "Klupa" }, { "creatorType": "author", "firstName": "E L", "lastName": "Edghill" }, { "creatorType": "author", "firstName": "J", "lastName": "Nazim" }, { "creatorType": "author", "firstName": "J", "lastName": "Sieradzki" }, { "creatorType": "author", "firstName": "S", "lastName": "Ellard" }, { "creatorType": "author", "firstName": "A T", "lastName": "Hattersley" }, { "creatorType": "author", "firstName": "M T", "lastName": "Malecki" } ], "abstractNote": "", "publicationTitle": "Diabetologia", "publisher": "", "place": "", "date": "May 2005", "volume": "48", "issue": "5", "section": "", "partNumber": "", "partTitle": "", "pages": "1029-1031", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Diabetologia", "DOI": "10.1007/s00125-005-1731-5", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/15838686", "accessDate": "2009-10-24T11:41:00Z", "PMID": "", "PMCID": "", "ISSN": "0012-186X", "archive": "", "archiveLocation": "", "shortTitle": "The identification of a R201H mutation in KCNJ11, which encodes Kir6.2, and successful transfer to sustained-release sulphonylurea therapy in a subject with neonatal diabetes", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 15838686", "tags": [], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "UWJSPX4D", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/UWJSPX4D", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/UWJSPX4D", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "UWJSPX4D", "version": 1, "itemType": "webpage", "title": "The Glycemic Index", "creators": [], "abstractNote": "The Official Website of the Glycemic Index and GI Database by Professor Jenny Brand-Miller", "websiteTitle": "", "websiteType": "", "date": "", "publisher": "", "place": "", "DOI": "", "citationKey": "", "url": "http://www.glycemicindex.com/", "accessDate": "2009-10-24T12:30:33Z", "shortTitle": "", "language": "", "rights": "", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "QPSRRIT5", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/QPSRRIT5", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/QPSRRIT5", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "creatorSummary": "Miller et al.", "parsedDate": "2010", "numChildren": 0 }, "data": { "key": "QPSRRIT5", "version": 1, "itemType": "journalArticle", "title": "The effects of baseline characteristics, glycaemia treatment approach, and glycated haemoglobin concentration on the risk of severe hypoglycaemia: post hoc epidemiological analysis of the ACCORD study", "creators": [ { "creatorType": "author", "firstName": "Michael E", "lastName": "Miller" }, { "creatorType": "author", "firstName": "Denise E", "lastName": "Bonds" }, { "creatorType": "author", "firstName": "Hertzel C", "lastName": "Gerstein" }, { "creatorType": "author", "firstName": "Elizabeth R", "lastName": "Seaquist" }, { "creatorType": "author", "firstName": "Richard M", "lastName": "Bergenstal" }, { "creatorType": "author", "firstName": "Jorge", "lastName": "Calles-Escandon" }, { "creatorType": "author", "firstName": "R Dale", "lastName": "Childress" }, { "creatorType": "author", "firstName": "Timothy E", "lastName": "Craven" }, { "creatorType": "author", "firstName": "Robert M", "lastName": "Cuddihy" }, { "creatorType": "author", "firstName": "George", "lastName": "Dailey" }, { "creatorType": "author", "firstName": "Mark N", "lastName": "Feinglos" }, { "creatorType": "author", "firstName": "Farmarz", "lastName": "Ismail-Beigi" }, { "creatorType": "author", "firstName": "Joe F", "lastName": "Largay" }, { "creatorType": "author", "firstName": "Patrick J", "lastName": "O'Connor" }, { "creatorType": "author", "firstName": "Terri", "lastName": "Paul" }, { "creatorType": "author", "firstName": "Peter J", "lastName": "Savage" }, { "creatorType": "author", "firstName": "Ulrich K", "lastName": "Schubart" }, { "creatorType": "author", "firstName": "Ajay", "lastName": "Sood" }, { "creatorType": "author", "firstName": "Saul", "lastName": "Genuth" } ], "abstractNote": "OBJECTIVES: To investigate potential determinants of severe hypoglycaemia, including baseline characteristics, in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial and the association of severe hypoglycaemia with levels of glycated haemoglobin (haemoglobin A(1C)) achieved during therapy. DESIGN: Post hoc epidemiological analysis of a double 2x2 factorial, randomised, controlled trial. SETTING: Diabetes clinics, research clinics, and primary care clinics. PARTICIPANTS: 10 209 of the 10 251 participants enrolled in the ACCORD study with type 2 diabetes, a haemoglobin A(1C) concentration of 7.5% or more during screening, and aged 40-79 years with established cardiovascular disease or 55-79 years with evidence of significant atherosclerosis, albuminuria, left ventricular hypertrophy, or two or more additional risk factors for cardiovascular disease (dyslipidaemia, hypertension, current smoker, or obese). Interventions Intensive (haemoglobin A(1C) <6.0%) or standard (haemoglobin A(1C) 7.0-7.9%) glucose control. MAIN OUTCOME MEASURES: Severe hypoglycaemia was defined as episodes of \"low blood glucose\" requiring the assistance of another person and documentation of either a plasma glucose less than 2.8 mmol/l (<50 mg/dl) or symptoms that promptly resolved with oral carbohydrate, intravenous glucose, or glucagon. RESULTS: The annual incidence of hypoglycaemia was 3.14% in the intensive treatment group and 1.03% in the standard glycaemia group. We found significantly increased risks for hypoglycaemia among women (P=0.0300), African-Americans (P<0.0001 compared with non-Hispanic whites), those with less than a high school education (P<0.0500 compared with college graduates), aged participants (P<0.0001 per 1 year increase), and those who used insulin at trial entry (P<0.0001). For every 1% unit decline in the haemoglobin A(1C) concentration from baseline to 4 month visit, there was a 28% (95% CI 19% to 37%) and 14% (4% to 23%) reduced risk of hypoglycaemia requiring medical assistance in the standard and intensive groups, respectively. In both treatment groups, the risk of hypoglycaemia requiring medical assistance increased with each 1% unit increment in the average updated haemoglobin A(1C) concentration (standard arm: hazard ratio 1.76, 95% CI 1.50 to 2.06; intensive arm: hazard ratio 1.15, 95% CI 1.02 to 1.21). CONCLUSIONS: A greater drop in haemoglobin A(1C) concentration from baseline to the 4 month visit was not associated with an increased risk for hypoglycaemia. Patients with poorer glycaemic control had a greater risk of hypoglycaemia, irrespective of treatment group. Identification of baseline subgroups with increased risk for severe hypoglycaemia can provide guidance to clinicians attempting to modify patient therapy on the basis of individual risk. TRIAL REGISTRATION: ClinicalTrials.gov number NCT00000620.", "publicationTitle": "BMJ (Clinical Research Ed.)", "publisher": "", "place": "", "date": "2010", "volume": "340", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "b5444", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "BMJ", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/20061360", "accessDate": "2010-02-05T20:44:52Z", "PMID": "", "PMCID": "", "ISSN": "1468-5833", "archive": "", "archiveLocation": "", "shortTitle": "The effects of baseline characteristics, glycaemia treatment approach, and glycated haemoglobin concentration on the risk of severe hypoglycaemia", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 20061360", "tags": [ { "tag": "Aged", "type": 1 }, { "tag": "Diabetes Mellitus, Type 2", "type": 1 }, { "tag": "Diabetic Angiopathies", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Hemoglobin A, Glycosylated", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Hypoglycemia", "type": 1 }, { "tag": "Hypoglycemic Agents", "type": 1 }, { "tag": "Kaplan-Meiers Estimate", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Risk Factors", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "9RCMQHZS", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/9RCMQHZS", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/9RCMQHZS", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "creatorSummary": "Mullan et al.", "parsedDate": "2009-09-28", "numChildren": 0 }, "data": { "key": "9RCMQHZS", "version": 1, "itemType": "journalArticle", "title": "The diabetes mellitus medication choice decision aid: a randomized trial", "creators": [ { "creatorType": "author", "firstName": "Rebecca J", "lastName": "Mullan" }, { "creatorType": "author", "firstName": "Victor M", "lastName": "Montori" }, { "creatorType": "author", "firstName": "Nilay D", "lastName": "Shah" }, { "creatorType": "author", "firstName": "Teresa J H", "lastName": "Christianson" }, { "creatorType": "author", "firstName": "Sandra C", "lastName": "Bryant" }, { "creatorType": "author", "firstName": "Gordon H", "lastName": "Guyatt" }, { "creatorType": "author", "firstName": "Lilisbeth I", "lastName": "Perestelo-Perez" }, { "creatorType": "author", "firstName": "Robert J", "lastName": "Stroebel" }, { "creatorType": "author", "firstName": "Barbara P", "lastName": "Yawn" }, { "creatorType": "author", "firstName": "Victor", "lastName": "Yapuncich" }, { "creatorType": "author", "firstName": "Maggie A", "lastName": "Breslin" }, { "creatorType": "author", "firstName": "Laurie", "lastName": "Pencille" }, { "creatorType": "author", "firstName": "Steven A", "lastName": "Smith" } ], "abstractNote": "BACKGROUND: Patient involvement in the choice of antihyperglycemic agents could improve adherence and optimize glycemic control in patients with type 2 diabetes mellitus. METHODS: We conducted a pilot, cluster randomized trial of Diabetes Medication Choice, a decision aid that describes 5 antihyperglycemic drugs, their treatment burden (adverse effects, administration, and self-monitoring demands), and impact on hemoglobin A(1c) (HbA(1c)) levels. Twenty-one clinicians were randomized to use the decision aid during the clinical encounter and 19 to dispense usual care and an educational pamphlet. We used surveys and video analysis to assess postvisit decisional outcomes, and medical and pharmacy records to assess 6-month medication adherence and HbA(1c) levels. RESULTS: Compared with usual care patients (n = 37), patients receiving the decision aid (n = 48) found the tool more helpful (clustered-adjusted mean difference [AMD] in a 7-point scale, 0.38; 95% confidence interval [CI], 0.04-0.72); had improved knowledge (AMD, 1.10 of 10 questions; 95% CI, 0.11-2.09); and had more involvement in making decisions about diabetes medications (AMD, 21.8 of 100; 95% CI, 13.0-30.5). At 6-month follow-up, both groups had nearly perfect medication use (median, 100% of days covered), with better adherence (AMD, 9% more days covered; 95% CI, 4%-14%) and persistence (AMD, 12 more days covered; 95% CI, 3-21 days) in the usual care group, and no significant impact on HbA(1c) levels (AMD, 0.01; 95% CI, -0.49 to 0.50). CONCLUSION: An innovative decision aid effectively involved patients with type 2 diabetes mellitus in decisions about their medications but did not improve adherence or HbA(1c) levels. Trial Registration clinicaltrials.gov Identifier: NCT00388050.", "publicationTitle": "Archives of Internal Medicine", "publisher": "", "place": "", "date": "Sep 28, 2009", "volume": "169", "issue": "17", "section": "", "partNumber": "", "partTitle": "", "pages": "1560-1568", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Arch. Intern. Med", "DOI": "10.1001/archinternmed.2009.293", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/19786674", "accessDate": "2009-11-10T14:04:34Z", "PMID": "", "PMCID": "", "ISSN": "1538-3679", "archive": "", "archiveLocation": "", "shortTitle": "The diabetes mellitus medication choice decision aid", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 19786674", "tags": [ { "tag": "Patient Participation" } ], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "GZ9VI4XB", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/GZ9VI4XB", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/GZ9VI4XB", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "creatorSummary": "Chaitman et al.", "parsedDate": "2009-12-22", "numChildren": 1 }, "data": { "key": "GZ9VI4XB", "version": 1, "itemType": "journalArticle", "title": "The Bypass Angioplasty Revascularization Investigation 2 Diabetes randomized trial of different treatment strategies in type 2 diabetes mellitus with stable ischemic heart disease: impact of treatment strategy on cardiac mortality and myocardial infarction", "creators": [ { "creatorType": "author", "firstName": "Bernard R", "lastName": "Chaitman" }, { "creatorType": "author", "firstName": "Regina M", "lastName": "Hardison" }, { "creatorType": "author", "firstName": "Dale", "lastName": "Adler" }, { "creatorType": "author", "firstName": "Suzanne", "lastName": "Gebhart" }, { "creatorType": "author", "firstName": "Mary", "lastName": "Grogan" }, { "creatorType": "author", "firstName": "Salvador", "lastName": "Ocampo" }, { "creatorType": "author", "firstName": "George", "lastName": "Sopko" }, { "creatorType": "author", "firstName": "Jose A", "lastName": "Ramires" }, { "creatorType": "author", "firstName": "David", "lastName": "Schneider" }, { "creatorType": "author", "firstName": "Robert L", "lastName": "Frye" } ], "abstractNote": "BACKGROUND: The Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial in 2368 patients with stable ischemic heart disease assigned before randomization to percutaneous coronary intervention or coronary artery bypass grafting strata reported similar 5-year all-cause mortality rates with insulin sensitization versus insulin provision therapy and with a strategy of prompt initial coronary revascularization and intensive medical therapy or intensive medical therapy alone with revascularization reserved for clinical indication(s). In this report, we examine the predefined secondary end points of cardiac death and myocardial infarction (MI). METHODS AND RESULTS: Outcome data were analyzed by intention to treat; the Kaplan-Meier method was used to assess 5-year event rates. Nominal P values are presented. During an average 5.3-year follow-up, there were 316 deaths (43% were attributed to cardiac causes) and 279 first MI events. Five-year cardiac mortality did not differ between revascularization plus intensive medical therapy (5.9%) and intensive medical therapy alone groups (5.7%; P=0.38) or between insulin sensitization (5.7%) and insulin provision therapy (6%; P=0.76). In the coronary artery bypass grafting stratum (n=763), MI events were significantly less frequent in revascularization plus intensive medical therapy versus intensive medical therapy alone groups (10.0% versus 17.6%; P=0.003), and the composite end points of all-cause death or MI (21.1% versus 29.2%; P=0.010) and cardiac death or MI (P=0.03) were also less frequent. Reduction in MI (P=0.001) and cardiac death/MI (P=0.002) was significant only in the insulin sensitization group. CONCLUSIONS: In many patients with type 2 diabetes mellitus and stable ischemic coronary disease in whom angina symptoms are controlled, similar to those enrolled in the percutaneous coronary intervention stratum, intensive medical therapy alone should be the first-line strategy. In patients with more extensive coronary disease, similar to those enrolled in the coronary artery bypass grafting stratum, prompt coronary artery bypass grafting, in the absence of contraindications, intensive medical therapy, and an insulin sensitization strategy appears to be a preferred therapeutic strategy to reduce the incidence of MI.", "publicationTitle": "Circulation", "publisher": "", "place": "", "date": "Dec 22, 2009", "volume": "120", "issue": "25", "section": "", "partNumber": "", "partTitle": "", "pages": "2529-2540", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Circulation", "DOI": "10.1161/CIRCULATIONAHA.109.913111", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/19920001", "accessDate": "2010-01-10T12:01:57Z", "PMID": "", "PMCID": "", "ISSN": "1524-4539", "archive": "", "archiveLocation": "", "shortTitle": "The Bypass Angioplasty Revascularization Investigation 2 Diabetes randomized trial of different treatment strategies in type 2 diabetes mellitus with stable ischemic heart disease", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 19920001", "tags": [ { "tag": "Angioplasty, Transluminal, Percutaneous Coronary", "type": 1 }, { "tag": "Coronary Artery Bypass", "type": 1 }, { "tag": "Death", "type": 1 }, { "tag": "Diabetes Mellitus, Type 2", "type": 1 }, { "tag": "Endpoint Determination", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Follow-Up Studies", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Insulin", "type": 1 }, { "tag": "Kaplan-Meiers Estimate", "type": 1 }, { "tag": "Longitudinal Studies", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Myocardial Infarction", "type": 1 }, { "tag": "Myocardial Ischemia", "type": 1 }, { "tag": "Risk Factors", "type": 1 }, { "tag": "Survival Rate", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "AJ2MREMK", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/AJ2MREMK", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/AJ2MREMK", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "creatorSummary": "Sattar et al.", "parsedDate": "2010-02-27", "numChildren": 0 }, "data": { "key": "AJ2MREMK", "version": 1, "itemType": "journalArticle", "title": "Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials", "creators": [ { "creatorType": "author", "firstName": "Naveed", "lastName": "Sattar" }, { "creatorType": "author", "firstName": "David", "lastName": "Preiss" }, { "creatorType": "author", "firstName": "Heather M", "lastName": "Murray" }, { "creatorType": "author", "firstName": "Paul", "lastName": "Welsh" }, { "creatorType": "author", "firstName": "Brendan M", "lastName": "Buckley" }, { "creatorType": "author", "firstName": "Anton J M", "lastName": "de Craen" }, { "creatorType": "author", "firstName": "Sreenivasa Rao Kondapally", "lastName": "Seshasai" }, { "creatorType": "author", "firstName": "John J", "lastName": "McMurray" }, { "creatorType": "author", "firstName": "Dilys J", "lastName": "Freeman" }, { "creatorType": "author", "firstName": "J Wouter", "lastName": "Jukema" }, { "creatorType": "author", "firstName": "Peter W", "lastName": "Macfarlane" }, { "creatorType": "author", "firstName": "Chris J", "lastName": "Packard" }, { "creatorType": "author", "firstName": "David J", "lastName": "Stott" }, { "creatorType": "author", "firstName": "Rudi G", "lastName": "Westendorp" }, { "creatorType": "author", "firstName": "James", "lastName": "Shepherd" }, { "creatorType": "author", "firstName": "Barry R", "lastName": "Davis" }, { "creatorType": "author", "firstName": "Sara L", "lastName": "Pressel" }, { "creatorType": "author", "firstName": "Roberto", "lastName": "Marchioli" }, { "creatorType": "author", "firstName": "Rosa Maria", "lastName": "Marfisi" }, { "creatorType": "author", "firstName": "Aldo P", "lastName": "Maggioni" }, { "creatorType": "author", "firstName": "Luigi", "lastName": "Tavazzi" }, { "creatorType": "author", "firstName": "Gianni", "lastName": "Tognoni" }, { "creatorType": "author", "firstName": "John", "lastName": "Kjekshus" }, { "creatorType": "author", "firstName": "Terje R", "lastName": "Pedersen" }, { "creatorType": "author", "firstName": "Thomas J", "lastName": "Cook" }, { "creatorType": "author", "firstName": "Antonio M", "lastName": "Gotto" }, { "creatorType": "author", "firstName": "Michael B", "lastName": "Clearfield" }, { "creatorType": "author", "firstName": "John R", "lastName": "Downs" }, { "creatorType": "author", "firstName": "Haruo", "lastName": "Nakamura" }, { "creatorType": "author", "firstName": "Yasuo", "lastName": "Ohashi" }, { "creatorType": "author", "firstName": "Kyoichi", "lastName": "Mizuno" }, { "creatorType": "author", "firstName": "Kausik K", "lastName": "Ray" }, { "creatorType": "author", "firstName": "Ian", "lastName": "Ford" } ], "abstractNote": "BACKGROUND: Trials of statin therapy have had conflicting findings on the risk of development of diabetes mellitus in patients given statins. We aimed to establish by a meta-analysis of published and unpublished data whether any relation exists between statin use and development of diabetes. METHODS: We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials from 1994 to 2009, for randomised controlled endpoint trials of statins. We included only trials with more than 1000 patients, with identical follow-up in both groups and duration of more than 1 year. We excluded trials of patients with organ transplants or who needed haemodialysis. We used the I(2) statistic to measure heterogeneity between trials and calculated risk estimates for incident diabetes with random-effect meta-analysis. FINDINGS: We identified 13 statin trials with 91 140 participants, of whom 4278 (2226 assigned statins and 2052 assigned control treatment) developed diabetes during a mean of 4 years. Statin therapy was associated with a 9% increased risk for incident diabetes (odds ratio [OR] 1.09; 95% CI 1.02-1.17), with little heterogeneity (I(2)=11%) between trials. Meta-regression showed that risk of development of diabetes with statins was highest in trials with older participants, but neither baseline body-mass index nor change in LDL-cholesterol concentrations accounted for residual variation in risk. Treatment of 255 (95% CI 150-852) patients with statins for 4 years resulted in one extra case of diabetes. INTERPRETATION: Statin therapy is associated with a slightly increased risk of development of diabetes, but the risk is low both in absolute terms and when compared with the reduction in coronary events. Clinical practice in patients with moderate or high cardiovascular risk or existing cardiovascular disease should not change. FUNDING: None.", "publicationTitle": "Lancet", "publisher": "", "place": "", "date": "Feb 27, 2010", "volume": "375", "issue": "9716", "section": "", "partNumber": "", "partTitle": "", "pages": "735-742", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Lancet", "DOI": "10.1016/S0140-6736(09)61965-6", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/20167359", "accessDate": "2010-03-25T11:39:15Z", "PMID": "", "PMCID": "", "ISSN": "1474-547X", "archive": "", "archiveLocation": "", "shortTitle": "Statins and risk of incident diabetes", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 20167359", "tags": [ { "tag": "Age Distribution", "type": 1 }, { "tag": "Age Factors", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Anticholesteremic Agents", "type": 1 }, { "tag": "Cardiovascular Diseases", "type": 1 }, { "tag": "Diabetes Mellitus, Type 2", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Hydroxymethylglutaryl-CoA Reductase Inhibitors", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Risk Factors", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } }, { "key": "8VK4KQT4", "version": 1, "library": { "type": "group", "id": 7612, "name": "diabetes", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/7612/items/8VK4KQT4", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes/items/8VK4KQT4", "type": "text/html" } }, "meta": { "createdByUser": { "id": 67460, "username": "dean.jenkins", "name": "Dean Jenkins", "links": { "alternate": { "href": "https://www.zotero.org/dean.jenkins", "type": "text/html" } } }, "creatorSummary": "Hirsch", "parsedDate": "2009-01-14", "numChildren": 0 }, "data": { "key": "8VK4KQT4", "version": 1, "itemType": "journalArticle", "title": "Sliding scale insulin--time to stop sliding", "creators": [ { "creatorType": "author", "firstName": "Irl B", "lastName": "Hirsch" } ], "abstractNote": "Medical professionals do not use sliding scale penicillin for fever or sliding scale oxygen for pulmonary edema. It is time to discontinue amusement park diabetes therapy so that decades from now clinicians are still not trying to abolish an illogical treatment.", "publicationTitle": "JAMA: The Journal of the American Medical Association", "publisher": "", "place": "", "date": "Jan 14, 2009", "volume": "301", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "213-214", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "JAMA", "DOI": "10.1001/jama.2008.943", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/19141770", "accessDate": "2009-10-24T12:01:09Z", "PMID": "", "PMCID": "", "ISSN": "1538-3598", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 19141770", "tags": [], "collections": [], "relations": {}, "dateAdded": "2010-10-13T21:42:17Z", "dateModified": "2010-10-13T21:42:17Z" } } ]