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Article ; Online: Fracture of the Bone Inducing Its Necrosis as the End Point in the Evolution of Untreated Neuroarthropathy.

Dardari, Dured / Penfornis, Alfred

2021 Volume 58, Issue 1

Abstract: We describe here the case of a female patient with type I diabetes who developed active Charcot neuroarthropathy in the foot. Due to therapeutic noncompliance, talus necrosis was discovered 2 years after the presentation of neuroarthropathy. The impact ... ...

Abstract	We describe here the case of a female patient with type I diabetes who developed active Charcot neuroarthropathy in the foot. Due to therapeutic noncompliance, talus necrosis was discovered 2 years after the presentation of neuroarthropathy. The impact of untreated neuroarthropathy on the bone is commonly described as fracture and joint dislocation, but we describe the complete disappearance of the bony structure and its necrosis associated with active neuroarthropathy in a patient who refused offloading.
MeSH term(s)	Arthropathy, Neurogenic/diagnostic imaging ; Diabetic Foot ; Female ; Foot ; Fractures, Bone/diagnostic imaging ; Humans ; Necrosis
Language	English
Publishing date	2021-12-22
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina58010011
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Article: Basal Insulinotherapy in Patients Living with Diabetes in France: The EF-BI Study.

Gourdy, Pierre / Darmon, Patrice / Borget, Isabelle / Emery, Corinne / Bureau, Isabelle / Detournay, Bruno / Bahloul, Amar / Allali, Noemie / Mahieu, Aymeric / Penfornis, Alfred

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

2024

Abstract: Introduction: 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 ... ...

Abstract	Introduction: 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. Methods: 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. Results: 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 (p < 0.0001). The annual incidence of acute hospitalized events in patients with T2DM treated with Gla-300 was 12% lower than with Gla-100 (p < 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. Conclusion: 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.
Language	English
Publishing date	2024-04-20
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/s13300-024-01577-8
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Article ; Online: European Survey on Adult People With Type 1 Diabetes and Their Caregivers: Insights Into Perceptions of Technology.

Penfornis, Alfred / Down, Su / Seignez, Antoine / Vives, Alizé / Bonnemaire, Mireille / Kulzer, Bernhard

Journal of diabetes science and technology

2023 , Page(s) 19322968231208690

Abstract: Background: Type 1 diabetes (T1D) is a complex condition requiring constant monitoring and self-management. The landscape of diabetes management is evolving with the development of new technologies. This survey aimed to gain insight into the perceptions ...

Abstract	Background: Type 1 diabetes (T1D) is a complex condition requiring constant monitoring and self-management. The landscape of diabetes management is evolving with the development of new technologies. This survey aimed to gain insight into the perceptions and experiences of people with T1D (PWD) and their caregivers on the use of technology in diabetes care, and identify future needs for T1D management. Methods: PWD and caregivers (≥18 years) living in five European countries (France, Germany, Italy, Spain, and the United Kingdom) completed an online survey. Data were collected during July and August 2021. Results: Responders included 458 PWD and 54 caregivers. More than 60% of PWD perceived devices/digital tools for diabetes management as useful and 63% reported that access to monitoring device data made their life easier. Nearly half of participants hoped for new devices and/or digital tools. While approximately one-third of all PWD had used teleconsultation, perceptions and usage varied significantly between countries and by age (both Conclusions: Most PWD and caregivers had positive perceptions and experiences of new technologies/digital solutions for diabetes management, although improved support and structured education for devices/digital tools are still required.
Language	English
Publishing date	2023-11-08
Publishing country	United States
Document type	Journal Article
ISSN	1932-2968
ISSN (online)	1932-2968
DOI	10.1177/19322968231208690
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Article ; Online: Closed-Loop Insulin Delivery Systems for People with Type 1 Diabetes and Chronic Very Poor Metabolic Control: It Works and Is Safe!

Deepchand, Sonia / Balla, Vanessa / Eroukhmanoff, Juliette / Ly Sall, Khadijatou / Romain, Bénédicte / Lejeune, Marie / Penfornis, Alfred / Amadou, Coralie

Diabetes technology & therapeutics

2024 Volume 26, Issue 2, Page(s) 125–129

Abstract: To evaluate the percentage of patients with type 1 diabetes (T1D) and very poor metabolic control who would agree to be treated with a hybrid closed-loop (HCL) insulin delivery system, and to assess metabolic improvement and safety. In a single center, ... ...

Abstract	To evaluate the percentage of patients with type 1 diabetes (T1D) and very poor metabolic control who would agree to be treated with a hybrid closed-loop (HCL) insulin delivery system, and to assess metabolic improvement and safety. In a single center, we identified all patients aged >18 years with hemoglobin A1c (HbA1c) >11% (97 mmol/mol) before HCL treatment. We collected metabolic control and safety data up to 1 year post-HCL in those who accepted HCL after it was proposed to them. We identified 65 patients eligible for the study, 32 (50%) already used, or accepted to start using HCL. Patients were aged 18-49 years; mean(±standard deviation) baseline HbA1c was 12.5(±1.8)% (113 ± 20 mmol/mol). After 1 year, 25 patients (78%) were still using HCL and their mean HbA1c decreased to 9.4(±1.9)% (79 mmol/mol) (
MeSH term(s)	Humans ; Diabetes Mellitus, Type 1/drug therapy ; Insulin/therapeutic use ; Hypoglycemic Agents/therapeutic use ; Blood Glucose ; Glycated Hemoglobin ; Insulin Infusion Systems ; Insulin, Regular, Human/therapeutic use ; Blood Glucose Self-Monitoring
Chemical Substances	Insulin ; Hypoglycemic Agents ; Blood Glucose ; Glycated Hemoglobin ; Insulin, Regular, Human
Language	English
Publishing date	2024-01-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	1452816-2
ISSN	1557-8593 ; 1520-9156
ISSN (online)	1557-8593
ISSN	1520-9156
DOI	10.1089/dia.2023.0379
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Article: Users' needs for a digital smoking cessation application and how to address them: A mixed-methods study.

Albers, Nele / Neerincx, Mark A / Penfornis, Kristell M / Brinkman, Willem-Paul

PeerJ

2022 Volume 10, Page(s) e13824

Abstract: Background: Despite their increasing prevalence and potential, eHealth applications for behavior change suffer from a lack of adherence and from dropout. Advances in virtual coach technology provide new opportunities to improve this. However, these ... ...

Abstract	Background: Despite their increasing prevalence and potential, eHealth applications for behavior change suffer from a lack of adherence and from dropout. Advances in virtual coach technology provide new opportunities to improve this. However, these applications still do not always offer what people need. We, therefore, need a better understanding of people's needs and how to address these, based on both actual experiences of users and their reflections on envisioned scenarios. Methods: We conducted a longitudinal study in which 671 smokers interacted with a virtual coach in five sessions. The virtual coach assigned them a new preparatory activity for quitting smoking or increasing physical activity in each session. Participants provided feedback on the activity in the next session. After the five sessions, participants were asked to describe barriers and motivators for doing their activities. In addition, they provided their views on videos of scenarios such as receiving motivational messages. To understand users' needs, we took a mixed-methods approach. This approach triangulated findings from qualitative data, quantitative data, and the literature. Results: We identified 14 main themes that describe people's views of their current and future behaviors concerning an eHealth application. These themes relate to the behaviors themselves, the users, other parties involved in a behavior, and the environment. The most prevalent theme was the perceived usefulness of behaviors, especially whether they were informative, helpful, motivating, or encouraging. The timing and intensity of behaviors also mattered. With regards to the users, their perceived importance of and motivation to change, autonomy, and personal characteristics were major themes. Another important role was played by other parties that may be involved in a behavior, such as general practitioners or virtual coaches. Here, the themes of companionableness, accountability, and nature of the other party ( Conclusions: The integrated method of experience-based and envisioning-based needs acquisition with a triangulate analysis provided a comprehensive needs classification (empirically and theoretically grounded). We expect that our themes and recommendations for addressing them will be helpful for designing applications for health behavior change that meet people's needs. Designers should especially focus on the perceived usefulness of application components. To aid future work, we publish our dataset with user characteristics and 5,074 free-text responses from 671 people.
Language	English
Publishing date	2022-08-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2703241-3
ISSN	2167-8359
ISSN	2167-8359
DOI	10.7717/peerj.13824
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Article: Rapid correction of hyperglycemia: A necessity but at what price? A brief report of a patient living with type 1 diabetes.

Huret, Priscille / Lopes, Philippe / Dardari, Randa / Penfornis, Alfred / Thomas, Claire / Dardari, Dured

World journal of diabetes

2023 Volume 14, Issue 11, Page(s) 1710–1716

Abstract: Background: The correction and control of chronic hyperglycemia are the management goals of patients living with diabetes. Chronic hyperglycemia is the main factor inducing diabetes-related complications. However, in certain situations, the rapid and ... ...

Abstract	Background: The correction and control of chronic hyperglycemia are the management goals of patients living with diabetes. Chronic hyperglycemia is the main factor inducing diabetes-related complications. However, in certain situations, the rapid and intense correction of chronic hyperglycemia can paradoxically favor the onset of microvascular complications. Case summary: In this case report, we describe the case of a 25-year-old woman living with type 1 diabetes since the age of 9 years. Her diabetes was chronic and unstable but without complications. During an unplanned pregnancy, her diabetes was intensely managed with the rapid correction of her hyperglycemia. However, over the following 2 years, she developed numerous degenerative microvascular complications: Charcot neuroarthropathy with multiple joint involvement, severe proliferative diabetic retinopathy, gastroparesis, bladder voiding disorders, and end-stage renal failure requiring hemodialysis. Conclusion: In the literature to date, the occurrence of multiple microvascular complications following the rapid correction of chronic hyperglycemia has been rarely described in the same individual.
Language	English
Publishing date	2023-11-30
Publishing country	United States
Document type	Case Reports
ZDB-ID	2583471-X
ISSN	1948-9358
ISSN	1948-9358
DOI	10.4239/wjd.v14.i11.1710
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Article: Impact of Intensive Glycemic Treatment on Diabetes Complications-A Systematic Review.

Poonoosamy, Juliana / Lopes, Philippe / Huret, Priscille / Dardari, Randa / Penfornis, Alfred / Thomas, Claire / Dardari, Dured

Pharmaceutics

2023 Volume 15, Issue 7

Abstract: Diabetes complications can be related to the long duration of the disease or chronic hyperglycemia. The follow-up of diabetic patients is based on the control of chronic hyperglycemia, although this correction, if obtained rapidly in people living with ... ...

Abstract	Diabetes complications can be related to the long duration of the disease or chronic hyperglycemia. The follow-up of diabetic patients is based on the control of chronic hyperglycemia, although this correction, if obtained rapidly in people living with severe chronic hyperglycemia, can paradoxically interfere with the disease or even induce complications. We reviewed the literature describing the impact of the rapid and intense treatment of hyperglycemia on diabetic complications. The literature review showed that worsening complications occurred significantly in diabetic microangiopathy with the onset of specific neuropathy induced by the correction of diabetes. The results for macroangiopathy were somewhat mixed with the intensive and rapid correction of chronic hyperglycemia having a neutral impact on stroke and myocardial infarction but a significant increase in cardiovascular mortality. The management of diabetes has now entered a new era with new therapeutic molecules, such as gliflozin for patients living with type 2 diabetes, or hybrid insulin delivery systems for patients with insulin-treated diabetes. Our manuscript provides evidence in support of these personalized and progressive algorithms for the control of chronic hyperglycemia.
Language	English
Publishing date	2023-06-22
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527217-2
ISSN	1999-4923
ISSN	1999-4923
DOI	10.3390/pharmaceutics15071791
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Article: The onset of acute Charcot neuroarthropathy during pregnancy in patients with type 1 diabetes.

Dardari, Dured / Penfornis, Alfred / Hartemann, Agnes

Endocrinology, diabetes & metabolism case reports

2020 Volume 2020

Abstract: Summary: We report the onset of acute Charcot neuroarthropathy during pregnancy in two patients with type 1 diabetes using retrospective review of case notes. We describe for the first time the onset of acute Charcot neuroarthropathy during pregnancy in ...

Abstract	Summary: We report the onset of acute Charcot neuroarthropathy during pregnancy in two patients with type 1 diabetes using retrospective review of case notes. We describe for the first time the onset of acute Charcot neuroarthropathy during pregnancy in two patients with type 1 diabetes. Pregnancy may promote the onset and worsening of a number of diabetic complications. A link between pregnancy and the onset of acute Charcot neuroarthropathy is demonstrated for the first time in this report. Learning points: Patients with already diagnosed sensitive neuropathy can develop an active phase of Charcot neuroarthropathy during pregnancy. The rapid correction of hyperglycaemia may induce an active phase of Charcot neuroarthropathy during pregnancy.
Language	English
Publishing date	2020-07-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2785530-2
ISSN	2052-0573
ISSN	2052-0573
DOI	10.1530/EDM-20-0002
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Article ; Online: Performance of a new reusable insulin pen.

Penfornis, Alfred

Diabetes technology & therapeutics

2011 Volume 13, Issue 3, Page(s) 373–379

Abstract: Background: The aim of this multinational (Canada, France, Germany, United Kingdom, and United States), task and interview-based study was to compare the ease of use and performance of the ClikSTAR® (sanofi-aventis, Paris, France) insulin pen with other ...

Abstract	Background: The aim of this multinational (Canada, France, Germany, United Kingdom, and United States), task and interview-based study was to compare the ease of use and performance of the ClikSTAR® (sanofi-aventis, Paris, France) insulin pen with other commonly used reusable pens based on participant and interviewer assessments. Methods: People with diabetes (n = 654) were asked to demonstrate four pens consecutively-ClikSTAR, Lilly Luxura ® (Eli Lilly, Indianapolis, IN), and NovoPen ® 3 and 4 (Novo Nordisk, Bagsvaerd, Denmark)-according to the respective instruction manuals. The endpoint was assessed by a rating from the participants and the interviewer. While the participants focused on the pen's ease of use, the interviewer considered the participants' difficulty in preparing and delivering a 40-unit dose and their requirement for help. Results: Twenty percent of U.S. participants and 24% of participants from the other countries had type 1 diabetes. Approximately 50% of participants in each group had prior insulin pen experience. A higher proportion of participants, including those with dexterity or visual impairments, reported ClikSTAR as easier to use than other pens (P < 0.05). Participants using ClikSTAR did not experience any difficulty in completing the tasks. The proportion of participants not requiring help in completing the tasks with ClikSTAR was rated as numerically higher than, or similar to, that observed with Lilly Luxura or NovoPen 3 or 4 (75%, 74%, 62%, and 65%, respectively). According to participants, ClikSTAR and NovoPen 4 emerged as the most highly rated pens. Conclusions: In comparison with other pens, ClikSTAR was significantly easier to use, which, when taken together with overall performance, meets the need of people with diabetes.
MeSH term(s)	Adolescent ; Adult ; Aged ; Child ; Diabetes Mellitus/drug therapy ; Drug Delivery Systems/methods ; Humans ; Hypoglycemic Agents/administration & dosage ; Insulin/administration & dosage ; Interviews as Topic ; Middle Aged ; Surveys and Questionnaires ; Young Adult
Chemical Substances	Hypoglycemic Agents ; Insulin
Language	English
Publishing date	2011-02-03
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	1452816-2
ISSN	1557-8593 ; 1520-9156
ISSN (online)	1557-8593
ISSN	1520-9156
DOI	10.1089/dia.2010.0174
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Article ; Online: Short course corticosteroid treatment and closed-loop insulin delivery system: The experience of the DBLG1 pre-launch.

Amadou, Coralie / Franc, Sylvia / Huneker, Erik / Charpentier, Guillaume / Penfornis, Alfred

Diabetes & metabolism

2021 Volume 48, Issue 4, Page(s) 101294

Abstract: No abstract (brief report). ...

Abstract	No abstract (brief report).
MeSH term(s)	Adrenal Cortex Hormones/therapeutic use ; Blood Glucose ; Cross-Over Studies ; Diabetes Mellitus, Type 1/drug therapy ; Humans ; Hypoglycemic Agents/therapeutic use ; Insulin/therapeutic use ; Insulin Infusion Systems ; Treatment Outcome
Chemical Substances	Adrenal Cortex Hormones ; Blood Glucose ; Hypoglycemic Agents ; Insulin
Language	English
Publishing date	2021-10-16
Publishing country	France
Document type	Journal Article
ZDB-ID	1315751-6
ISSN	1878-1780 ; 1262-3636 ; 0338-1684
ISSN (online)	1878-1780
ISSN	1262-3636 ; 0338-1684
DOI	10.1016/j.diabet.2021.101294
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