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  1. Article ; Online: Glucagon-like peptide-1 receptor agonists and the cardiorenal axis in Type 2 diabetes: a focus on dulaglutide.

    MacIsaac, Richard J

    Future cardiology

    2021  Volume 17, Issue 3, Page(s) 459–473

    Abstract: Results from cardiovascular outcomes trials (CVOTs) in people with Type 2 diabetes (T2D), such as the Researching Cardiovascular Events with a Weekly Incretin in Diabetes (REWIND) study with dulaglutide, have led to a shift toward glucose lowering ... ...

    Abstract Results from cardiovascular outcomes trials (CVOTs) in people with Type 2 diabetes (T2D), such as the Researching Cardiovascular Events with a Weekly Incretin in Diabetes (REWIND) study with dulaglutide, have led to a shift toward glucose lowering therapies that provide broad benefits, including cardiovascular (CV) risk reduction and renoprotection. Dulaglutide reduces atherosclerotic CV outcomes (hazard ratio 0.88; 95% CI: 0.79-0.99) and composite kidney outcomes (hazard ratio 0.85; 95% CI: 0.77-0.93) in people with T2D with high risk or established CV disease. The cardiologists' role has now expanded to include not only screening for T2D and treating risk factors, but also recommending or incorporating glucose-lowering agents with proven CV benefit into the care of their patients with T2D.
    MeSH term(s) Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Glucagon-Like Peptide-1 Receptor ; Glucagon-Like Peptides/analogs & derivatives ; Humans ; Hypoglycemic Agents/therapeutic use ; Immunoglobulin Fc Fragments ; Recombinant Fusion Proteins
    Chemical Substances Glucagon-Like Peptide-1 Receptor ; Hypoglycemic Agents ; Immunoglobulin Fc Fragments ; Recombinant Fusion Proteins ; Glucagon-Like Peptides (62340-29-8) ; dulaglutide (WTT295HSY5)
    Language English
    Publishing date 2021-04-06
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2274267-0
    ISSN 1744-8298 ; 1479-6678
    ISSN (online) 1744-8298
    ISSN 1479-6678
    DOI 10.2217/fca-2020-0210
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Dulaglutide and Insulin: How Can the AWARD Studies Help Guide Clinical Practice?

    MacIsaac, Richard J

    Diabetes therapy : research, treatment and education of diabetes and related disorders

    2020  Volume 11, Issue 8, Page(s) 1627–1638

    Abstract: The glucagon-like peptide 1 receptor agonist (GLP-1RA) dulaglutide has many characteristics to recommend it both as a second-line agent and as an alternative to or in combination with insulin. This commentary summarises recent updates to diabetes ... ...

    Abstract The glucagon-like peptide 1 receptor agonist (GLP-1RA) dulaglutide has many characteristics to recommend it both as a second-line agent and as an alternative to or in combination with insulin. This commentary summarises recent updates to diabetes management guidelines regarding the use of GLP-1RAs such as dulaglutide, both as a second-line agent and as a first-line injectable agent in type 2 diabetes (T2D). It also examines how the Assessment of Weekly AdministRation of LY2189265 [dulaglutide] in Diabetes (AWARD) studies with dulaglutide and insulin may help to guide clinical practice for the use of dulaglutide as an alternative to basal insulin or in combination with insulin.Individualising glucose-lowering therapy is important in patients with T2D, especially given patients' heterogeneity in terms of age, lifestyle, disease duration, level of hyperglycaemia and comorbidities. Choice of therapy should be guided by clinical considerations (e.g. high risk or existing cardiovascular [CV] disease, heart failure, chronic kidney disease, risk of hypoglycaemia), side effect profile, contraindications, patient preferences and cost. The recently updated American Diabetes Association/European Association for the Study of Diabetes (ADA/EASD) guidelines now recommend adding a GLP-1RA with proven CV benefit to metformin in patients with T2D and indicators of high risk or established atherosclerotic CV disease. The AWARD studies demonstrate that dulaglutide provides effective glucose lowering together with sustained weight loss and a low incidence of hypoglycaemia when used as the first injectable option and when used in combination with titrated basal insulin or prandial insulin, providing a valid treatment option across a wide range of patients with T2D, including those with chronic kidney disease.
    Language English
    Publishing date 2020-06-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2566702-6
    ISSN 1869-6961 ; 1869-6953
    ISSN (online) 1869-6961
    ISSN 1869-6953
    DOI 10.1007/s13300-020-00863-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Ketoacidosis: 'A diagnosis that is difficult to stomach'.

    Stringer, Felicity / Ashkar, Claudia / Franco, Pamela / Moroney, Emily / Denton, Matthew / Read, Matthew / Nathanson, Andrew / Ward, Glenn M / MacIsaac, Richard J

    Diabetic medicine : a journal of the British Diabetic Association

    2024  , Page(s) e15341

    Language English
    Publishing date 2024-04-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 605769-x
    ISSN 1464-5491 ; 0742-3071 ; 1466-5468
    ISSN (online) 1464-5491
    ISSN 0742-3071 ; 1466-5468
    DOI 10.1111/dme.15341
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Insulin pump troubleshooting: a case vignette and systematic approach.

    Chakrabarti, Anindita / MacIsaac, Richard J / McAuley, Sybil A

    The Medical journal of Australia

    2022  Volume 216, Issue 11, Page(s) 595–596

    MeSH term(s) Blood Glucose ; Diabetes Mellitus, Type 1/drug therapy ; Glycated Hemoglobin A/analysis ; Humans ; Hypoglycemic Agents/therapeutic use ; Insulin/therapeutic use ; Insulin Infusion Systems
    Chemical Substances Blood Glucose ; Glycated Hemoglobin A ; Hypoglycemic Agents ; Insulin
    Language English
    Publishing date 2022-05-25
    Publishing country Australia
    Document type Letter
    ZDB-ID 186082-3
    ISSN 1326-5377 ; 0025-729X
    ISSN (online) 1326-5377
    ISSN 0025-729X
    DOI 10.5694/mja2.51559
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Utility of Repeat Sampling in Bilateral Aldosterone Suppression During Adrenal Vein Sampling for Primary Aldosteronism.

    Halim, Bella / Yong, Eric X Z / Egan, Matthew / MacIsaac, Richard J / O'Neal, David / Sachithanandan, Nirupa

    JCEM case reports

    2024  Volume 2, Issue 4, Page(s) luae051

    Abstract: Primary aldosteronism (PA) is the most common form of secondary hypertension. Accurate subtyping of PA is essential to identify unilateral disease, as adrenalectomy improves outcomes. Subtyping PA requires adrenal vein sampling (AVS), which is ... ...

    Abstract Primary aldosteronism (PA) is the most common form of secondary hypertension. Accurate subtyping of PA is essential to identify unilateral disease, as adrenalectomy improves outcomes. Subtyping PA requires adrenal vein sampling (AVS), which is technically challenging and results from AVS may not always be conclusive. We present a case of a 37-year-old man with PA whose AVS studies were inconclusive due to apparent bilateral aldosterone suppression (ABAS). As a result, our patient was misdiagnosed as having bilateral PA and medically managed until a repeat AVS showed lateralization to the right adrenal gland. ABAS is an underrecognized phenomenon that may confound the subtyping of PA. We recommend repeating AVS in such cases and discuss strategies to minimize ABAS.
    Language English
    Publishing date 2024-04-10
    Publishing country England
    Document type Case Reports
    ISSN 2755-1520
    ISSN (online) 2755-1520
    DOI 10.1210/jcemcr/luae051
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Outcomes associated with a variable rate insulin infusion diabetic ketoacidosis protocol.

    Koneshamoorthy, Anojian / Epa, Dilan Seneviratne / O'Neal, David N / Lee, Melissa H / Santamaria, John D / MacIsaac, Richard J

    Journal of diabetes and its complications

    2024  Volume 38, Issue 3, Page(s) 108702

    Abstract: Aims: To relate adverse events with glucose correction rates in diabetic ketoacidosis (DKA) using variable rate intravenous insulin-infusions (VRIII).: Methods: Retrospective, observational study in adults with DKA who received insulin infusions ... ...

    Abstract Aims: To relate adverse events with glucose correction rates in diabetic ketoacidosis (DKA) using variable rate intravenous insulin-infusions (VRIII).
    Methods: Retrospective, observational study in adults with DKA who received insulin infusions between 2012 and 2017 at St Vincent's Hospital, Melbourne. Early correction of hyperglycaemia (<10 mmol/L) was evaluated for association with hypoglycaemia (<4.0 mmol/L), hypokalaemia (potassium <3.3 mmol/L) and clinical outcomes via regression analysis.
    Results: The study involved 97 patients, with 93 % having type 1 diabetes. The mean age was 38 years, 47 % were women and 35 % were admitted to intensive care. Hypoglycaemia rates during 12 and 24 h of treatment were 6.2 % and 8.2 %, respectively with 58 % of patients recording their first BGL <10 mmol/L within 12 h and 88 % within 24 h. Ketone clearance time averaged at 15.6 h. Hyperglycaemia correction rates to <10 mmol/L were not different in those with/without hypoglycaemia at 12/24 h, in multivariate analysis including admission BGL. Hypokalaemia occurred in 40.2 % of patients and was associated with lower pH but not BGL correction rates.
    Conclusion: The VRIII protocol achieved early hyperglycaemia correction and ketoacidosis reversal with low hypoglycaemia risk. However, high hypokalaemia rates suggest the need for aggressive potassium replacement, especially in markedly acidotic patients.
    MeSH term(s) Adult ; Female ; Humans ; Male ; Diabetes Mellitus ; Diabetic Ketoacidosis/drug therapy ; Diabetic Ketoacidosis/epidemiology ; Hyperglycemia/prevention & control ; Hypoglycemia/chemically induced ; Hypoglycemia/prevention & control ; Hypokalemia/chemically induced ; Hypokalemia/epidemiology ; Insulin/adverse effects ; Insulin, Regular, Human ; Potassium ; Retrospective Studies
    Chemical Substances Insulin ; Insulin, Regular, Human ; Potassium (RWP5GA015D)
    Language English
    Publishing date 2024-02-15
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 1105840-7
    ISSN 1873-460X ; 1056-8727
    ISSN (online) 1873-460X
    ISSN 1056-8727
    DOI 10.1016/j.jdiacomp.2024.108702
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Hospital admissions for cardiovascular complications of people with or without diabetes, Victoria, 2004-2016.

    Kiburg, Katerina V / MacIsaac, Andrew I / Wilson, Andrew / Sundararajan, Vijaya / MacIsaac, Richard J

    The Medical journal of Australia

    2021  Volume 215, Issue 2, Page(s) 85–86

    MeSH term(s) Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 2/complications ; Diabetic Cardiomyopathies/epidemiology ; Diabetic Cardiomyopathies/etiology ; Female ; Heart Failure/epidemiology ; Heart Failure/etiology ; Hospitalization/statistics & numerical data ; Humans ; Incidence ; Male ; Myocardial Infarction/epidemiology ; Myocardial Infarction/etiology ; Stroke/epidemiology ; Stroke/etiology ; Victoria/epidemiology
    Language English
    Publishing date 2021-05-24
    Publishing country Australia
    Document type Comparative Study ; Letter
    ZDB-ID 186082-3
    ISSN 1326-5377 ; 0025-729X
    ISSN (online) 1326-5377
    ISSN 0025-729X
    DOI 10.5694/mja2.51101
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Temporal trends in non-traumatic lower extremity amputations (LEAs) and their association with 12-month mortality in people with diabetes, 2004-2016.

    Kiburg, Katerina V / Galligan, Anna / Sundararajan, Vijaya / MacIsaac, Richard J

    Journal of diabetes and its complications

    2022  Volume 36, Issue 7, Page(s) 108221

    Abstract: Aims: To assess trends in hospital admissions for non-traumatic lower extremity amputations (LEAs) and for mortality following LEAs in adult patients with type 1 diabetes (T1DM) or type 2 diabetes (T2DM) admitted to hospitals in Victoria, Australia ... ...

    Abstract Aims: To assess trends in hospital admissions for non-traumatic lower extremity amputations (LEAs) and for mortality following LEAs in adult patients with type 1 diabetes (T1DM) or type 2 diabetes (T2DM) admitted to hospitals in Victoria, Australia during 2004-2016.
    Methods: Using hospital discharge data, we calculated age- and sex- adjusted admission rates for incident cases of any LEA, minor LEAs, major LEAs and 12-month mortality following any LEAs for patients according to diabetes type. Joinpoint regression analysis was used to identify changes in linear trends that were described as average annual percentage change (AAPC).
    Results: Significant declines in rates of admission for any LEA (AAPC -4.9), minor LEAs (-3.0 %) and major LEAs (AAPC -11.5 %) were seen for patients with T2DM. Overall, admission rates for any LEA did not significantly change for patients with T1DM during 2004 and 2016, however, we detected a significant rise in admissions for any LEAs (AAPC +5.1) in female patients with T1DM. This increase was most prominent in younger (<60 years) patients undergoing minor LEAs. During 2009-2016, younger patients with type 1 DM, regardless of sex, also experienced significant increases in admissions for any LEA (AAPC +14) and major LEAs (AAPC +15). Mortality associated with LEAs in T2DM declines, with a 12-month mortality rate of 6.3 %) associated with LEAs in T2M decline (AAPC -4.2 %) whereas rates for T1DM remained stable (1.9 %) during 2004-2016.
    Conclusions: There were significant differences in LEA hospital admission trends by type of diabetes, age and sex. The decline in LEAs and its associated mortality is welcome news for patients with T2DM. However, reasons for the increase in LEAs in younger patients with T1DM remain to be determined.
    MeSH term(s) Adult ; Amputation ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/surgery ; Diabetic Foot/complications ; Diabetic Foot/epidemiology ; Diabetic Foot/surgery ; Female ; Humans ; Incidence ; Lower Extremity/surgery ; Victoria
    Language English
    Publishing date 2022-06-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1105840-7
    ISSN 1873-460X ; 1056-8727
    ISSN (online) 1873-460X
    ISSN 1056-8727
    DOI 10.1016/j.jdiacomp.2022.108221
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Is it time to screen health literacy in diabetes clinical practice?

    Seger, Moa / Ryan, Chris D / Januszewski, Andrzej S / Kilov, Gary / MacIsaac, Richard J / Ludvigsson, Johnny / O'Neal, David N / Jenkins, Alicia J

    Diabetes research and clinical practice

    2024  Volume 208, Page(s) 111117

    MeSH term(s) Humans ; Health Literacy ; Diabetes Mellitus/diagnosis ; Health Knowledge, Attitudes, Practice ; Diabetes Mellitus, Type 2 ; Self Care
    Language English
    Publishing date 2024-01-26
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 632523-3
    ISSN 1872-8227 ; 0168-8227
    ISSN (online) 1872-8227
    ISSN 0168-8227
    DOI 10.1016/j.diabres.2024.111117
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Progression of Diabetic Kidney Disease in the Absence of Albuminuria.

    MacIsaac, Richard J / Ekinci, Elif I

    Diabetes care

    2019  Volume 42, Issue 10, Page(s) 1842–1844

    MeSH term(s) Albuminuria ; Diabetes Mellitus, Type 1 ; Diabetic Nephropathies ; Disease Progression ; Glomerular Filtration Rate ; Humans
    Language English
    Publishing date 2019-09-10
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 441231-x
    ISSN 1935-5548 ; 0149-5992
    ISSN (online) 1935-5548
    ISSN 0149-5992
    DOI 10.2337/dci19-0030
    Database MEDical Literature Analysis and Retrieval System OnLINE

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