Diabetes Therapy最新文献

{"title":"Effectiveness of a Lifestyle Improvement Support App in Combination with a Wearable Device in Japanese People with Type 2 Diabetes Mellitus: STEP-DM Study.","authors":"Akiko Takahashi, Manabu Ishii, Yurika Kino, Kazuyo Sasaki, Takahiro Matsui, Kenji Arakawa, Makoto Kunisaki","doi":"10.1007/s13300-024-01552-3","DOIUrl":"10.1007/s13300-024-01552-3","url":null,"abstract":"<p><strong>Introduction: </strong>Although the use of application (app)s and wearable devices supporting diabetes treatment has spread rapidly in recent years, evidence of their impact, especially in combination of them, is limited. TOMOCO™ is a lifestyle improvement support app that features interactive virtual conversations according to the programmed algorithm guiding users toward their goals of lifestyle improvement. We hypothesized that TOMOCO™ in combination with Fitbit, which accurately tracks users' activity level, would encourage people with type 2 diabetes mellitus (T2DM) to change their lifestyles and improve their glycated hemoglobin (HbA1c) levels without changes in conventional therapy. Thus, we performed the present study to explore the effectiveness of this combination in Japanese participants with T2DM who had not achieved their glycemic targets.</p><p><strong>Methods: </strong>In this single-arm exploratory study, participants with T2DM used the TOMOCO™ and Fitbit in addition to the conventional diet/exercise therapy and anti-diabetic drug for 12 weeks. They were provided with feedback/advice by health care providers based on the TOMOCO™ and Fitbit records. The primary endpoint was the change in HbA1c from baseline to the end of the observation period. Data were expressed as mean ± standard deviation.</p><p><strong>Results: </strong>Fifty-nine (96.7%) of the 61 participants (male, 42 [71.2%]; age, 60.1 ± 8.7 years; HbA1c level, 7.48 ± 0.37% at screening) completed the study. At the end of the observation period, the HbA1c was significantly reduced (- 0.41 ± 0.41%, p < 0.001). This trend was consistent across the preselected patient characteristics, including sex, age, and body mass index. However, it was more pronounced in the participants with earlier stages of behavioral changes defined by the transtheoretical model at baseline.</p><p><strong>Conclusions: </strong>The unique features of TOMOCO™ in combination with Fitbit, together with conventional therapy, may promote a healthy lifestyle and thus contribute to improving HbA1c in people with T2DM.</p><p><strong>Clinical trial registration: </strong>jRCT1070220007.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11043275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140329683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Implication of Diabetes-Specialized Nurses in Aiming for the Better Treatment and Management of Patients with Diabetes Mellitus: A Brief Narrative Review.","authors":"Yefang Zhu, Hongmei Zhang, Ying Xi, Hongli Zhu, Yan Lu, Xue Luo, Zhangui Tang, Hong Lei","doi":"10.1007/s13300-024-01558-x","DOIUrl":"10.1007/s13300-024-01558-x","url":null,"abstract":"<p><p>Diabetes mellitus (DM) is regarded as one of the most critical public health challenges of the 21st century. It has evolved into a burgeoning epidemic since the last century, and today ranks among the major causes of mortality worldwide. Diabetes specialist nurses (DSNs) are central to good patient care and outcomes including confident self-care management. Evidence shows that DSNs are cost-effective, improve clinical outcomes, and reduce length of stay in hospital. In this brief narrative review, we aim to describe the roles of DSNs and their contribution in the treatment and management of patients with DM. This narrative review describes the importance of DSNs in healthcare practice, in the inpatient and outpatient departments, in the pediatrics department, in managing diabetic foot ulcers, in the treatment and management of gestational diabetes, in prescribing medications for DM and in diabetes self-management education on glycosylated hemoglobin, and cardiovascular risk factors. To conclude, DSNs have a crucial role in the treatment and management of patients with DM and its complications. DSNs have a great impact on diabetes therapy, and hence implementation of DSNs and nurse-led diabetic clinics might be beneficial for the health care system. Finally, having DSNs might significantly contribute to good healthcare practice and support. Even though DSNs are not available in several regions around the globe, and even though this post is still new to several health care institutions, the presence of DSNs recognized and certified by the various healthcare systems would be very useful.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11043239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140109553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Safety and Efficacy of Sodium-Glucose Co-transporter 2 Inhibitors in Subjects with Prediabetes: A Protocol for a Randomized Controlled Trial.","authors":"Xiaxuan Zhu, Li Xia, Deshan Yin, Jin Yang, Rui Wei","doi":"10.1007/s13300-024-01560-3","DOIUrl":"10.1007/s13300-024-01560-3","url":null,"abstract":"<p><strong>Introduction: </strong>Prediabetes is a state of subclinical glycemic impairment, bridging normal glucose tolerance and diabetes. Globally, over 30% of individuals exhibit prediabetic conditions, with a significant proportion progressing to diabetes. Prediabetes augments risks of various diseases including cardiovascular and kidney disease. While interventions like lifestyle changes have shown promise in diabetes prevention, their long-term sustainability is challenging. Alternative pharmacological treatments, such as acarbose and metformin, have demonstrated efficacy in certain populations. Sodium-glucose co-transporter 2 inhibitors, a novel class of glucose-lowering agents, have shown potential benefits for heart and kidney health in patients with diabetes. This research aims to evaluate the effectiveness and safety of dapagliflozin in individuals with prediabetes, elucidating its potential role in diabetes prevention strategies.</p><p><strong>Research design and methods: </strong>This prospective trial is being conducted at Peking University Third Hospital. A total of 240 participants with prediabetes will be enrolled and randomly divided into two groups: one receiving dapagliflozin (10 mg/day) with lifestyle education, and the other with lifestyle education alone over a 12-week duration (with male/female = 1:1 in each group). Anthropometric, clinical and laboratory tests, including body mass index, waist circumference, fasting blood glucose, oral glucose tolerance test, insulin, lipid profile, liver and kidney function, sperm quality, will be conducted at the onset and conclusion of the trial. For adherence monitoring, participants will receive phone follow-ups at week 4 and week 8. The primary outcome is the change in 2-h plasma glucose during an oral glucose tolerance test over the study duration. Secondary outcomes encompass changes in various health metrics, including body mass index, lipid profiles, and liver function.</p><p><strong>Planned outcomes: </strong>The proposed study is set to refine diabetes prevention strategies on the basis of its potential benefits observed in patients with diabetes.</p><p><strong>Conclusions: </strong>This will be the first randomized controlled trial to evaluate the safety and effectiveness of sodium-glucose co-transporter 2 inhibitors compared with lifestyle education for individuals with prediabetes.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier NCT05914857 (registered 24 July 2023).</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11043312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140142949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycemic Control and Body Weight Reduction with Once-Weekly Semaglutide in Colombian Adults with Type 2 Diabetes: Findings from the COLIBRI Study","authors":"Dagoberto Serpa-Díaz, Carlos A. Llanos-Florez, Ronald Serrano Uribe, Dora I. Molina de Salazar, German C. Giraldo-Gonzalez, Miguel Urina-Triana, Andres F. Suarez-Rodriguez, Maria A. Alzate-Vinasco","doi":"10.1007/s13300-024-01586-7","DOIUrl":"https://doi.org/10.1007/s13300-024-01586-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Type 2 diabetes is a prevalent condition. The change in glucose control and body weight with the use of once-weekly semaglutide was evaluated in individuals with Type 2 diabetes in Colombia.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This was a real-world, multi-centre, single-arm study involving adults in Colombia with Type 2 diabetes treated with once-weekly subcutaneous semaglutide for approximately 26 weeks. The primary endpoint assessed the change in glycated hemoglobin (HbA1c) from baseline to end of study. Secondary endpoints included changes in body weight from baseline to end of study. The study also explored the proportion of participants achieving predefined HbA1c targets and weight-loss responses at the end of the study.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Data from 225 patients across 11 centers were collected. Most patients were women (65%), and the mean age of the population was 57 years with a median HbA1c of 7.6% and a median body weight of 86 kg. After approximately 26 weeks, semaglutide was associated with a significant reduction in HbA1c of − 0.88 and a body weight reduction of − 4.04kg. The proportion of patients with HbA1c &lt; 7% increased from 32 to 66% at end of study.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Patients treated with once-weekly semaglutide experienced a clinically significant reduction in HbA1c and body weight. These results are in line with previous clinical trials.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140834051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycemic Control and Obesity Among People With Type 2 Diabetes in Europe and Australia: A Retrospective Cohort Analysis","authors":"Rachel S. Newson, Victoria Divino, Kristina S. Boye, Justin Chen, Mitch DeKoven, Carlos Vallarino, Kari Ranta, Julie E. Mount","doi":"10.1007/s13300-024-01583-w","DOIUrl":"https://doi.org/10.1007/s13300-024-01583-w","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>In people with type 2 diabetes (PwT2D) who also have obesity, efforts targeting weight loss, including lifestyle, medication and surgical interventions, are recommended. The objective of this study was to explore the relationship between glycemic control and obesity among PwT2D in Europe and Australia using recent real-world data and applying consistent methodology across countries.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Retrospective study utilizing IQVIA electronic medical records (EMR) databases grouped into panels based on specialty of contributing physicians. General practitioner (GP) and endocrinologist/diabetologist (E/D) panels were used in Germany and France, while GP panels were used in Italy, UK and Australia. The Spanish database included all physician specialties. The sample included PwT2D with glycated hemoglobin A1c (HbA1c) and body mass index (BMI) values measured within 90 days of each other between January 2015 and December 2018 (second record termed the ‘index date’). PwT2D had a 1-year baseline period and a recorded HbA1c at the end of the 1-year post-index period.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The final sample comprised 194,729 PwT2D. At baseline, across countries/panels, 36.8–58.0% were above HbA1c target (HbA1c ≥ 7%) and 39.4–56.7% had obesity (BMI ≥ 30.0 kg/m²). Mean HbA1c ranged from 6.9 to 7.6% and mean BMI ranged from 29.3–31.6 kg/m². At baseline, a higher proportion of PwT2D with obesity (40.8–64.2%) were above HbA1c target compared to their counterparts without obesity (32.2–52.4%). A higher proportion of patients with obesity at baseline (38.1–60.6%) had post-index HbA1c above target compared to their counterparts without obesity (30.9–56.0%). In logistic regression, patients with obesity had substantially lower odds of post-index HbA1c below target compared to those without obesity in all countries/panels except for France (E/D), Spain and Australia.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>This study presents data on HbA1c and BMI among type 2 diabetes (T2D) populations in Europe and Australia. A notable proportion of PwT2D had obesity and were above HBA1c target. Higher BMI was associated with poorer glycemic control.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140810377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial Self-efficacy and its Association with Selected Potential Factors Among Adults with Type 1 Diabetes: A Cross-Sectional Survey Study","authors":"Divya Anna Stephen, Anna Nordin, Unn-Britt Johansson, Jan Nilsson","doi":"10.1007/s13300-024-01581-y","DOIUrl":"https://doi.org/10.1007/s13300-024-01581-y","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>The management of type 1 diabetes, a non-preventable chronic disease, leads to a high physical and psychological burden on the individual. Digital health technology can improve a person’s psychosocial self-efficacy and thereby contribute to improved diabetes self-care. The aim of this study was to explore associations between psychosocial self-efficacy and demographic-, disease specific-, well-being as well as digital health technology (DHT) related factors among adults with type 1 diabetes.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A primarily web-based cross sectional survey was conducted among adults with type 1 diabetes in Sweden (<i>n</i> = 301). Psychosocial self-efficacy was assessed using the Swedish version of the Diabetes Empowerment Scale, Swe-DES-23. The survey also contained questions related to demographic-, disease specific-, well-being as well as digital health technology related variables.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Higher well-being scores and lower HbA1c levels were associated with higher psychosocial self-efficacy in multiple linear regression analysis. In multivariate analysis, gender, body mass index, well-being scores, and HbA1c levels showed association with psychosocial self-efficacy. None of the DHT factors were found associated with psychosocial self-efficacy.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>In this study, higher well-being score and lower self-reported HbA1c levels were associated with higher psychosocial self-efficacy in both univariate- and multivariate analysis and accounted for 30% of the variation in psychosocial self-efficacy in the regression model. Thus, measures to improve psychosocial self-efficacy in adults with type 1 diabetes may help maintain their psychological well-being and blood glucose control.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140623890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Two COVID-19 Lockdowns on HbA1c Levels in Patients with Type 1 Diabetes and Associations with Digital Treatment, Health Literacy, and Diabetes Self-Management: A Multicenter, Observational Cohort Study Over 3 Years","authors":"Daniel Tajdar, Dagmar Lühmann, Laura Walther, Lasse Bittner, Martin Scherer, Ingmar Schäfer","doi":"10.1007/s13300-024-01574-x","DOIUrl":"https://doi.org/10.1007/s13300-024-01574-x","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Short-term studies reported improved glycemic control and a decrease in eHbA1c (estimated hemoglobin A1c) in patients with type 1 diabetes during COVID-19 lockdown, but long-term changes are unknown. Therefore, the main objectives are to (1) analyze whether laboratory-measured HbA1c changed during and after two lockdowns and (2) investigate potential variables influencing HbA1c change.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>In this cohort study, 291 adults with type 1 diabetes were followed over 3 years including the prepandemic phase and two lockdowns. The data from medical records and validated questionnaires assessing health literacy (HLS-EU-Q16), diabetes self-management (DSMQ-R27), general self-efficacy (GSE), and social support (F-SOZU-K14) were used to analyze associations with HbA1c levels (<i>N</i> = 2370) by performing multivariable linear regressions.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The median age was 54 (38–63) years and 159 (54.6%) were male. All phases of the COVID-19 pandemic were associated with a significant increase in laboratory-measured HbA1c levels in percent (e.g., during first lockdown <i>β</i> = 0.23, 95% confidence interval (CI) 0.07–0.39, <i>p</i> = 0.005; during the second lockdown, <i>β</i> = 0.27, 95% CI 0.15–0.38, <i>p</i> &lt; 0.001). HbA1c change during lockdowns was significantly affected by the number of checkups (<i>β</i> = −0.03, 95% CI −0.05 to −0.01, <i>p</i> = 0.010), the value of HbA1c at previous observation (<i>β</i> = 0.33, 95% CI 0.29–0.36, <i>p</i> &lt; 0.001), educational level (secondary versus tertiary: <i>β</i> = 0.22, 95% CI 0.06–0.38, <i>p</i> = 0.008; primary versus tertiary: <i>β</i> = 0.31, 95% CI 0.10–0.52, <i>p</i> = 0.004), health literacy score (for each point: <i>β</i> = −0.03, 95% CI −0.05 to − 0.002, <i>p</i> = 0.034), and diabetes self-management score (for each point: <i>β</i> = −0.03, 95% CI −0.04 to −0.02, <i>p</i> &lt; 0.001). The use of continuous glucose monitoring or insulin pump had no effect on HbA1c change.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Lockdowns can lead to worsening glycemic control in patients with type 1 diabetes. Particularly patients with few check-ups, poor blood glucose values, deficits in diabetes self-management, low health literacy, and a low level of education seem to be at greater risk of worsening glycemic control during lockdowns and, therefore, require special medical care, e.g., through telemedicine.</p><h3 data-test=\"abstract-sub-heading\">Trial Registration</h3><p>ClinicalTrials.gov identifier, NCT04821921.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140623701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Basal Insulinotherapy in Patients Living with Diabetes in France: The EF-BI Study","authors":"Pierre Gourdy, Patrice Darmon, Isabelle Borget, Corinne Emery, Isabelle Bureau, Bruno Detournay, Amar Bahloul, Noemie Allali, Aymeric Mahieu, Alfred Penfornis","doi":"10.1007/s13300-024-01577-8","DOIUrl":"https://doi.org/10.1007/s13300-024-01577-8","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Second-generation basal insulins like glargine 300 U/mL (Gla-300) have a longer duration of action and less daily fluctuation and interday variability than first-generation ones, such as glargine 100 U/mL (Gla-100). The EF-BI study, a nationwide observational, retrospective study, was designed to compare persistence, acute care complications, and healthcare costs associated with the initiation of such basal insulins (BI) in a real-life setting in France.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This study was conducted using the French healthcare claims database (SNDS). Adult patients living with type 1 or type 2 diabetes mellitus (T1DM or T2DM) initiating Gla-300 or Gla-100 ± other hypoglycemic medications between January 1, 2016 and December 31, 2020, and without any insulin therapy over the previous 6 months were included. Persistence was defined as remaining on the same insulin therapy until discontinuation defined by a 6 month period without insulin reimbursement. Hospitalized acute complications were identified using ICD-10 codes. Total collective costs were established for patients treated continuously with each basal insulin over 1–3 years. All comparisons were adjusted using a propensity score based on initial patient/treatment characteristics.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 235,894 patients with T2DM and 6672 patients with T1DM were included. Patients treated with Gla-300 were 83% (T1DM) and 44% (T2DM) less likely to discontinue their treatment than those treated with Gla-100 after 24 months (<i>p</i> &lt; 0.0001). The annual incidence of acute hospitalized events in patients with T2DM treated with Gla-300 was 12% lower than with Gla-100 (<i>p</i> &lt; 0.0001) but similar in patients with T1DM. Comparison of overall costs showed moderate but statistically significant differences in favor of Gla-300 versus Gla-100 for all patients over the first year, and in T2DM only over a 3-year follow-up.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Use of Gla-300 resulted in a better persistence, less acute hospitalized events at least in T2DM, and reduced healthcare expenditure. These real-life results confirmed the potential interest of using Gla-300 rather than Gla-100.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140623889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Effectiveness of the Gla-300 + Cap + App Program in Adult Users Living with Type 2 Diabetes in Taiwan","authors":"Chih-Yuan Wang, Fang L. Zhou, Aakash B. Gandhi, Tsung-Ying Lee, Nancy Cui, Jiuo-Shan Mao, Jung-Fu Chen","doi":"10.1007/s13300-024-01570-1","DOIUrl":"https://doi.org/10.1007/s13300-024-01570-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Health2Sync (H2S) is a digital health technology platform that provides coaching and titration support to patients with diabetes. The Mallya cap converts a conventional insulin pen into a smart connected device that can automatically synchronize dose values and associated timestamps (upon injection) to the H2S platform. This single-arm real-world study evaluated the effectiveness of insulin glargine 300 U/mL (Gla-300) combined with H2S and Mallya cap (Gla-300 + Cap + App program) on clinical outcomes among users with type 2 diabetes (T2D) in Taiwan.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Adults (aged ≥ 20 years) with T2D who were registered H2S users and initiated Mallya cap for a new/existing Gla-300 regimen (identification period May 1, 2021–May 31, 2022) were included in this retrospective cohort study. Follow-up data from H2S were collected for 90 days. Glycated hemoglobin (HbA_1c) change (baseline to follow-up) and HbA_1c goal attainment were primary outcomes. Hypoglycemia incidence and usage metrics of Mallya cap were secondary outcomes.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Of 83 participants, 38.6% were new Gla-300 users. HbA_1c was reduced in both new (− 2.4 [2.7] %, − 26.2 [29.5] mmol/mol) and previous Gla-300 users (− 0.5 [1.6] %, − 5.5 [17.5] mmol/mol). Reduction in HbA_1c was significant (<i>p</i> &lt; 0.05) in both groups. At follow-up, 43.4% of users had a reduction of &gt; 0.5%. Mean HbA_1c reductions increased numerically with higher baseline HbA_1c and with longer duration of Mallya cap usage.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Use of digital technology within a connected ecosystem such as Gla-300 + Cap + App program could help people with type 2 diabetes to improve their glycemic condition.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140630147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to the Use of Insulin Therapy and Potential Solutions: A Narrative Review of Perspectives from the Asia–Pacific Region","authors":"Roger Chen, Azizul Hasan Aamir, Mohammod Feroz Amin, Pongamorn Bunnag, Siew Pheng Chan, Lixin Guo, Mohammad E. Khamseh, Viswanathan Mohan, Nemencio Nicodemus, Anthony Roberts, Tri Juli Edi Tarigan, Kyu-Chang Won, Roopa Mehta","doi":"10.1007/s13300-024-01568-9","DOIUrl":"https://doi.org/10.1007/s13300-024-01568-9","url":null,"abstract":"<p>The rising prevalence of type 2 diabetes (T2D) is posing major challenges for the healthcare systems of many countries, particularly in the Asia–Pacific Region, in which T2D can present at younger ages and lower body mass index when compared with Western nations. There is an important role for insulin therapy in the management of T2D in these nations, but available evidence suggests that insulin is under-utilized and often delayed, to the detriment of patient prognosis. The authors of this article gathered as an advisory panel (representative of some of the larger Asia–Pacific nations) to identify their local barriers to insulin use in T2D, and to discuss ways in which to address these barriers, with their outputs summarized herein. Many of the key barriers identified are well-documented issues of global significance, including a lack of healthcare resources or of an integrated structure, insufficient patient education, and patient misconceptions about insulin therapy. Barriers identified as more innate to Asian countries included local inabilities of patients to afford or gain access to insulin therapy, a tendency for some patients to be more influenced by social media and local traditions than by the medical profession, and a willingness to switch care providers and seek alternative therapies. Strategies to address some of these barriers are provided, with hypothetical illustrative case histories.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140616666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}