Abstract #314: Prolonged Hypoglycemia from Glargine Overdose: an Approach to Investigation
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Drug overdose
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This cohort study was conducted to identify risk factors for lifetime emergency room treatment due to overdose in injection drug users. Data of 1049 patients on admission for opioid detoxification were analyzed. More than every third injection drug user (34.7%) experienced emergency room treatment due to an overdose. Using multiple logistic regression not living with a significant other drug user (odds ratio [OR] = 1.78, P = .002), history of suicide attempt (OR = 3.0, P = .000), daily use of barbiturates (OR = 2.17, P = .006) and cannabis (OR = 1.89, P = .001) were independently associated with emergency room treatment, whereas shorter duration of opioid use (OR = 0.23, P = .001) was independently associated with lack of emergency room treatment. Suicidal thoughts and multiple use of central nervous system depressants should be considered in injection drug users entering the emergency room due to an overdose. Emergency rooms should be seen as important places for offering further assistance (e.g., counselling) or referral to an addiction unit to drug users.
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Subcutaneous MYL1501D insulin glargine 100 U/mL (hereafter referred to as MYL1501D insulin glargine) [Semglee®] is a long-acting human insulin analogue approved as a biosimilar of insulin glargine 100 U/mL (hereafter referred to as reference insulin glargine 100 U/mL) [Lantus®] in various countries, including those of the EU for the treatment of diabetes mellitus in patients aged ≥ 2 years, as well as Japan for diabetes where insulin therapy is indicated. MYL1501D insulin glargine has similar physicochemical characteristics and biological properties to those of EU- and US-sourced reference insulin glargine 100 U/mL, with the bioequivalence of pharmacodynamic and pharmacokinetic parameters between these agents shown in adults with type 1 diabetes. Once-daily MYL1501D insulin glargine demonstrated noninferior glycaemic efficacy to that of once-daily reference insulin glargine 100 U/mL in adults with type 1 or 2 diabetes, with its glycated haemoglobin-lowering benefits maintained over the longer-term (52 weeks) and unaffected by previous insulin exposure. Switching between MYL1501D insulin glargine and reference insulin glargine 100 U/mL did not appear to impact glycaemic efficacy in adults with type 1 diabetes. MYL1501D insulin glargine was well tolerated, demonstrating a safety and immunogenicity profile similar to that of reference insulin glargine 100 U/mL in patients with type 1 and 2 diabetes, and in those with type 1 diabetes switching between the two agents. As expected, hypoglycaemia was the most frequently reported treatment-emergent adverse event. Thus, MYL1501D insulin glargine provides an effective biosimilar alternative for patients requiring insulin glargine therapy.
Bioequivalence
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Diabetes mellitus not only brings heavy health burden to patients,but also impairs their quality of life.The treatment of diabetes aims to lower the morbidity and mortality of diabetic complications of patients,but may decrease the short-term quality of life.Insulin glargine is an insulin analogue which has better glucose control and less hypoglycemic episodes.Studies in type 1 diabetes found that,compared to NPH insulin or other conventional insulin therapy for type 1 diabetes,treatment with insulin glargine can improve the treatment satisfaction,total emotional well-being and total health well-being.Adding insulin glargine to oral antihyperglycemic agents can improve the treatment satisfaction.
Insulin analog
Kowsar
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Objective:To investigate the clinical application and clinical observation on Insulin Glargine. Methods:Type 2 diabetes patients with NPH failure (n=42) were shifted to Insulin Glargine. Results:Diabetes patients with Insulin Glargine,blood glucose better than before. Conclusion:Compared with the NPH insulin,Insulin Glargine can simulate normal insulin secretion and lower the risk of hypoglycemia as it works to keep the blood sugar level under control,it improves the patient's quality of life significantly.
NPH insulin
Blood sugar
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Objective To compare quality of life and treatment satisfaction by using insulin glargine and by using NPH insulin in patients with type 2 diabetes.Methods 73 patients with type 2 diabetes were randomly divided into insulin glargine plus oral antididiabetes(OAD) or to NPH insulin(twice daily),the Diabetes Treatment Satisfaction Questionnaire(DTSQ) were compared at baseline,at weeks 12 and 24 weeks.Results In mean baseline,score were not markedly difference between two groups,and score in treatment satisfaction and flexibility at 12 weeks and 24 weeks was significantly improved with glargine compared with that for NPH(P(0.05)).Conclusion Insulin glargine impruves treatment satisfaction,and improves QoL in comparison with NPH insulin in type 2 diabetes.
NPH insulin
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Insulin degludec
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Insulin therapy is often essential in people with type 2 diabetes mellitus (T2DM) but is typically not initiated early enough or aggressive enough, leading to worsening of glycaemic control and the majority of people staying above recommended haemoglobin A(1c) (HbA(1c)) targets of <7%. The extensive clinical experience gained with insulin glargine, in particular, the low risk of hypoglycaemia and consistent improvements in HbA(1c), suggests that insulin glargine can be initiated aggressively to help patients reach such HbA(1c) targets. However, many clinicians may be unaware of how easy it is to initiate insulin glargine. Indeed, the once-daily injection of insulin glargine plus once-daily measurement of blood glucose should provide little difficulty for patients. In the current review, the options for the initiation of insulin glargine in T2DM and how the patient can become more involved in management of their diabetes are discussed. The advantages of insulin glargine in randomized controlled trials and how these have translated into everyday clinical practice are also discussed.
Clinical Practice
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