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Article: Hypoglycaemia in elderly diabetic patients.

Lassmann-Vague, V

2005 Volume 31 Spec No 2, Page(s) 5S53–5S57

Abstract: Occurring in the elderly diabetic patients, hypoglycaemia may have serious consequences in terms of morbidity and mortality, but this severe prognosis is nowadays less frequently observed. The clinical manifestations may be somewhat different from those ... ...

Abstract	Occurring in the elderly diabetic patients, hypoglycaemia may have serious consequences in terms of morbidity and mortality, but this severe prognosis is nowadays less frequently observed. The clinical manifestations may be somewhat different from those observed in young subjects: symptoms are less frequent, generally neurologic manifestations. The rate of severe hypoglycaemia remains low (about 1.4 episode per 100 patient-years), but increases rapidly in the very elderly and also with insulin therapy, co-morbid conditions especially renal insufficiency, and associated treatments, as well as with unawareness of symptoms. Prevention requires reinforced education for the patient and caregiver, particularly concerning diet, knowledge of signs of hypoglycaemia, and appropriate treatment. Self-monitoring of blood glucose, by the patient when possible, or by a familial or medical caregiver, should be encouraged in order to detect asymptomatic episodes of hypoglycaemia and better adapt antidiabetic treatment.
MeSH term(s)	Aged ; Diabetes Mellitus/blood ; Humans ; Hypoglycemia/epidemiology ; Hypoglycemia/mortality ; Hypoglycemic Agents/adverse effects ; Hypoglycemic Agents/therapeutic use ; Insulin/adverse effects ; Insulin/therapeutic use
Chemical Substances	Hypoglycemic Agents ; Insulin
Language	English
Publishing date	2005-12
Publishing country	France
Document type	Journal Article ; Review
ZDB-ID	1315751-6
ISSN	1262-3636 ; 0338-1684
ISSN	1262-3636 ; 0338-1684
DOI	10.1016/s1262-3636(05)73651-x
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Article: Prescrire, ajuster, surveiller un traitement basal-bolus chez un diabétique de type 1 ou de type 2.

Lassmann-Vague, V J R

Journees annuelles de diabetologie de l'Hotel-Dieu

2007 , Page(s) 103–110

Title translation	Prescription, adjustment and surveillance od bolus treatment in type 1 or type 2 diabetes.
MeSH term(s)	Diabetes Mellitus, Type 1/drug therapy ; Diabetes Mellitus, Type 2/drug therapy ; Drug Prescriptions ; Humans ; Patient Acceptance of Health Care ; Social Adjustment
Language	French
Publishing date	2007
Publishing country	France
Document type	Journal Article
ZDB-ID	603984-4
ISSN	0075-4439
ISSN	0075-4439
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Article: Alternatives routes of insulin delivery.

Lassmann-Vague, V / Raccah, D

Diabetes & metabolism

2006 Volume 32, Issue 5 Pt 2, Page(s) 513–522

Abstract: Optimal glycaemic control is necessary to prevent diabetes-related complications. An intensive treatment, which could mimic physiological insulin secretion, would be the best one. However subcutaneous insulin treatment is not physiologic and represents a ...

Abstract	Optimal glycaemic control is necessary to prevent diabetes-related complications. An intensive treatment, which could mimic physiological insulin secretion, would be the best one. However subcutaneous insulin treatment is not physiologic and represents a heavy burden for patients with type 1 and type 2 diabetes mellitus. Consequently, more acceptable, at least as effective, alternative routes of insulin delivery have been developed over the past years. Up to now, only pulmonary administration of insulin (inhaled insulin) has become a feasible alternative to cover mealtime insulin requirements and one of the various administration systems was recently approved for clinical use in Europe and the United States. But, due to advances in technology, other routes, such as transdermal or oral (buccal and intestinal) insulin administration, could become feasible in a near future, and they could be combined together to offer non-invasive, efficacious and more physiological way of insulin administration to patients with diabetes.
MeSH term(s)	Administration, Cutaneous ; Administration, Intranasal ; Administration, Oral ; Drug Delivery Systems/methods ; Humans ; Hypoglycemic Agents/administration & dosage ; Hypoglycemic Agents/therapeutic use ; Insulin/administration & dosage ; Insulin/therapeutic use ; Iontophoresis
Chemical Substances	Hypoglycemic Agents ; Insulin
Language	English
Publishing date	2006-02-16
Publishing country	France
Document type	Journal Article ; Review
ZDB-ID	1315751-6
ISSN	1262-3636 ; 0338-1684
ISSN	1262-3636 ; 0338-1684
DOI	10.1016/s1262-3636(06)72804-x
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Article: Diabetes and education in the elderly.

Tessier, D M / Lassmann-Vague, V J R

Diabetes & metabolism

2007 Volume 33 Suppl 1, Page(s) S75–8

Abstract: Diabetes mellitus (DM) in the elderly is a chronic disease where self management is a key aspect. This includes lifestyle modification (diet and exercise), medication compliance and hypoglycaemia management. Education is an important part of this process ...

Abstract	Diabetes mellitus (DM) in the elderly is a chronic disease where self management is a key aspect. This includes lifestyle modification (diet and exercise), medication compliance and hypoglycaemia management. Education is an important part of this process and the specific needs of the older population with DM have been underlined. The literature has shown that education through a multidisciplinary approach may improve the glycaemic control in selected elderly patients with DM. This article will focus on the evidences from the medical literature and the multiple challenges of teaching in this population.
MeSH term(s)	Aged ; Blood Glucose/metabolism ; Diabetes Mellitus/rehabilitation ; Humans ; Patient Education as Topic ; Problem Solving ; Self Care
Chemical Substances	Blood Glucose
Language	English
Publishing date	2007-08-11
Publishing country	France
Document type	Journal Article ; Review
ZDB-ID	1315751-6
ISSN	1262-3636 ; 0338-1684
ISSN	1262-3636 ; 0338-1684
DOI	10.1016/s1262-3636(07)80059-0
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Article: Voies alternatives d'administration de l'insuline.

Lassmann-Vague, V

Diabete & metabolisme

1994 Volume 20, Issue 2 Pt 2, Page(s) 206–210

Abstract: Ideally, insulin administration should be done through portal route, with a precise kinetic. It should also lead to a reproducible biologic effect, with minimal side-effects and be acceptable for the majority of diabetic patients. Many alternative routes ...

Title translation	Alternative routes for insulin administration.
Abstract	Ideally, insulin administration should be done through portal route, with a precise kinetic. It should also lead to a reproducible biologic effect, with minimal side-effects and be acceptable for the majority of diabetic patients. Many alternative routes of insulin administration try to fulfill one or more of these criteria. Intraperitoneal route is already used with implantable pumps. It has proven safety and metabolic efficacy, particularly upon the reduction of severe hypoglycaemia. Nasal route could provide a rapid kinetic, but its long-term utilisation depends on improvement of bioavailability and studies of local toxicity. Results concerning intrabronchic insulin seem promising, but are still preliminary. In the future, the choice among these alternative routes of insulin administration will be guided by the development of a closed-loop system.
MeSH term(s)	Administration, Inhalation ; Administration, Intranasal ; Administration, Oral ; Animals ; Drug Administration Routes ; Humans ; Infusion Pumps, Implantable ; Injections, Intravenous ; Insulin/administration & dosage ; Portal Vein
Chemical Substances	Insulin
Language	French
Publishing date	1994
Publishing country	France
Document type	English Abstract ; Journal Article ; Review
ZDB-ID	195866-5
ISSN	0338-1684
ISSN	0338-1684
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Article: Technologie et fiabilité de l'autosurveillance glycémique: historique et état actuel.

Dufaitre-Patouraux, L / Vague, P / Lassmann-Vague, V

Diabetes & metabolism

2003 Volume 29, Issue 2 Pt 2, Page(s) S7–14

Abstract: Self-monitoring of blood glucose started only fifty years ago. Until then metabolic control was evaluated by means of qualitative urinary blood measure often of poor reliability. Reagent strips were the first semi quantitative tests to monitor blood ... ...

Title translation	History, accuracy and precision of SMBG devices.
Abstract	Self-monitoring of blood glucose started only fifty years ago. Until then metabolic control was evaluated by means of qualitative urinary blood measure often of poor reliability. Reagent strips were the first semi quantitative tests to monitor blood glucose, and in the late seventies meters were launched on the market. Initially the use of such devices was intended for medical staff, but thanks to handiness improvement they became more and more adequate to patients and are now a necessary tool for self-blood glucose monitoring. The advanced technologies allow to develop photometric measurements but also more recently electrochemical one. In the nineties, improvements were made mainly in meters' miniaturisation, reduction of reaction time and reading, simplification of blood sampling and capillary blood laying. Although accuracy and precision concern was in the heart of considerations at the beginning of self-blood glucose monitoring, the recommendations of societies of diabetology came up in the late eighties. Now, the French drug agency: AFSSAPS asks for a control of meter before any launching on the market. According to recent publications very few meters meet reliability criteria set up by societies of diabetology in the late nineties. Finally because devices may be handled by numerous persons in hospitals, meters use as possible source of nosocomial infections have been recently questioned and is subject to very strict guidelines published by AFSSAPS.
MeSH term(s)	Blood Glucose/analysis ; Blood Glucose Self-Monitoring/history ; Blood Glucose Self-Monitoring/standards ; Blood Specimen Collection/methods ; Capillaries ; History, 20th Century ; History, 21st Century ; Humans ; Reagent Strips ; Reproducibility of Results ; Sensitivity and Specificity ; Time Factors
Chemical Substances	Blood Glucose ; Reagent Strips
Language	French
Publishing date	2003-04
Publishing country	France
Document type	English Abstract ; Historical Article ; Journal Article ; Review
ZDB-ID	1315751-6
ISSN	1262-3636 ; 0338-1684
ISSN	1262-3636 ; 0338-1684
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Article: Reproducibility of plasma insulin kinetics during intraperitoneal insulin treatment by programmable pumps.

Schaepelynck Bélicar, P / Vague, P / Lassmann-Vague, V

Diabetes & metabolism

2003 Volume 29, Issue 4 Pt 1, Page(s) 344–348

Abstract: Objective: To study the reproducibility of plasma insulin kinetics during intraperitoneal (IP) insulin therapy using an implanted programmable pump in patients with type 1, insulin dependent, diabetes mellitus (IDDM).: Research design and methods: In ...

Abstract	Objective: To study the reproducibility of plasma insulin kinetics during intraperitoneal (IP) insulin therapy using an implanted programmable pump in patients with type 1, insulin dependent, diabetes mellitus (IDDM). Research design and methods: In a group of ten type 1 IDDM patients beginning chronic IP insulin treatment with an implanted pump, plasma free insulin profiles were determined from 12: 00 am to 12: 30 pm on two separate test days, one month apart. Anti-insulin antibody (AIA) levels were measured on each test day. Results: From test day 1 to test day 2, no difference was observed in morning fasting free insulin levels (m +/- SD): 9.7 +/- 5.4 mU/L versus 9.8 +/- 5.3 mU/L, insulin peak values: 19.1 +/- 17 mU/L versus 20.8 +/- 9.9 mU/L, time to peak: 40 +/- 15 versus 42.8 +/- 16 minutes or post-bolus area under the plasma free insulin curve (AUC): 40.7 +/- 29 mU/L.h versus 45.5 +/- 29 mU/L.h. The intrapatient coefficient of variation was 14.4 +/- 13% for insulin peaks and 16.9 +/- 9.2% for post-bolus AUC. A significant increase in AIA levels (m +/- SD) was observed from 16.5 +/- 18% on test day 1 to 28.1 +/- 28% on test day 2. Conclusions: The reproducibility of plasma free insulin profiles is highly satisfactory during insulin delivery by the IP route using an implanted device.
MeSH term(s)	Adult ; Age of Onset ; Area Under Curve ; Body Mass Index ; Diabetes Mellitus, Type 1/blood ; Diabetes Mellitus, Type 1/drug therapy ; Diabetes Mellitus, Type 1/immunology ; Humans ; Insulin/blood ; Insulin/pharmacokinetics ; Insulin/therapeutic use ; Insulin Antibodies/blood ; Insulin Infusion Systems ; Radioimmunoassay ; Reproducibility of Results
Chemical Substances	Insulin ; Insulin Antibodies
Language	English
Publishing date	2003-10-19
Publishing country	France
Document type	Clinical Trial ; Journal Article
ZDB-ID	1315751-6
ISSN	1262-3636 ; 0338-1684
ISSN	1262-3636 ; 0338-1684
DOI	10.1016/s1262-3636(07)70045-9
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Article: Local adverse events associated with long-term treatment by implantable insulin pumps. The French EVADIAC Study Group experience. Evaluation dans le Diabète du Traitement par Implants Actifs.

Bélicar, P / Lassmann-Vague, V

Diabetes care

1998 Volume 21, Issue 2, Page(s) 325–326

MeSH term(s)	Diabetes Mellitus, Type 1/drug therapy ; Diabetes Mellitus, Type 1/epidemiology ; Follow-Up Studies ; France/epidemiology ; Humans ; Infusion Pumps, Implantable/adverse effects ; Insulin/administration & dosage ; Insulin/therapeutic use ; Retrospective Studies ; Time Factors
Chemical Substances	Insulin
Language	English
Publishing date	1998-02
Publishing country	United States
Document type	Letter
ZDB-ID	441231-x
ISSN	1935-5548 ; 0149-5992
ISSN (online)	1935-5548
ISSN	0149-5992
DOI	10.2337/diacare.21.2.325
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Article: Improved metabolic control in diabetic adolescents using the continuous glucose monitoring system (CGMS).

Schaepelynck-Bélicar, P / Vague, Ph / Simonin, G / Lassmann-Vague, V

Diabetes & metabolism

2003 Volume 29, Issue 6, Page(s) 608–612

Abstract: Objective: To determine the utility of the continuous glucose monitoring system (CGMS) as an outpatient procedure to improve management of diabetes in adolescents.: Research design and methods: Twelve adolescents (mean age: 16.2 +/- 3 years) with ... ...

Abstract	Objective: To determine the utility of the continuous glucose monitoring system (CGMS) as an outpatient procedure to improve management of diabetes in adolescents. Research design and methods: Twelve adolescents (mean age: 16.2 +/- 3 years) with poorly controlled type 1 diabetes (HbA(1c) > 8%) were included in this trial. Mean HbA(1c) during the previous year was 10.1 +/- 1.2%. Insulin treatment consisted of 2 or 3 daily injections in 10 cases and CSII in 2. At the beginning of the study, HbA(1c) was determined and low blood glucose index (LBGI) was calculated. Continuous glucose monitoring was performed for three days. After downloading and analyzing data, results were discussed with the patient and insulin treatment was adjusted. Two months later testing was repeated and all parameters were reassessed. Results: Initial CGMS profiles demonstrated glycemic excursions unrecognized by capillary measurements in all twelve patients. Glycemia before and after meals varied from<60 mg/dL to > 200 mg/dL in 2 patients (2 episodes). Postprandial hyperglycemia exceeded 200 mg/dL in 10 patients (24 episodes). Prolonged overnight hyperglycemia was observed in 5 patients (7 episodes), dawn phenomenon in 4 patients (6 episodes) and nighttime hypoglycemia in 4 patients (4 episodes). A day-to-day reproducibility of glycemic profiles was observed in 8 patients. Then insulin treatment was adjusted according to CGMS data. Changes involved dose levels in 3 patients, insulin type in 7, number of injections, i.e. 3 instead of 2, in 5 or change from insulin injection to CSII in 1. Reassessment two months later demonstrated a significant reduction of glycemic excursions in 8 patients. HbA(1c) (m +/- SD) decreased from 10.3 +/- 2.1% to 8.75 +/- 1.06% (p<0.05). LBGI increased from 1.7 +/- 0.9 to 2.4 +/- 1.4 but the difference was not significant. Conclusions: Use of CGMS in diabetic adolescent outpatients achieved a significant improvement in metabolic control not only by providing accurate data for adjustment of insulin treatment but also by promoting patient communication and motivation.
MeSH term(s)	Adolescent ; Adult ; Blood Glucose/analysis ; Blood Glucose Self-Monitoring/instrumentation ; Blood Glucose Self-Monitoring/methods ; Diabetes Mellitus, Type 1/blood ; Diabetes Mellitus, Type 1/therapy ; Female ; Food ; Glycated Hemoglobin A/analysis ; Humans ; Hyperglycemia/epidemiology ; Hypoglycemia/epidemiology ; Insulin/administration & dosage ; Male ; Reproducibility of Results ; Time Factors
Chemical Substances	Blood Glucose ; Glycated Hemoglobin A ; Insulin
Language	English
Publishing date	2003-12-22
Publishing country	France
Document type	Journal Article
ZDB-ID	1315751-6
ISSN	1262-3636 ; 0338-1684
ISSN	1262-3636 ; 0338-1684
DOI	10.1016/s1262-3636(07)70076-9
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Article: Les voies inhabituelles d'administration de l'insuline.

Lassmann-Vague, V

Diabete & metabolisme

1988 Volume 14, Issue 6, Page(s) 728–731

Title translation	Unusual ways of insulin administration.
MeSH term(s)	Administration, Buccal ; Administration, Inhalation ; Administration, Intranasal ; Administration, Rectal ; Administration, Sublingual ; Diabetes Mellitus, Type 1/drug therapy ; Humans ; Insulin/administration & dosage ; Insulin/therapeutic use
Chemical Substances	Insulin
Language	French
Publishing date	1988-12
Publishing country	France
Document type	Journal Article ; Review
ZDB-ID	195866-5
ISSN	0338-1684
ISSN	0338-1684
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