LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 10 of total 193

Search options

  1. Article ; Online: Studies are needed to support optimal insulin dose titration in gestational diabetes mellitus: A systematic review.

    Mayne, Isabelle K / Tyzack-Clark, Henry M / McGovern, Andrew P

    Diabetes & metabolic syndrome

    2023  Volume 17, Issue 4, Page(s) 102746

    Abstract: Background and aims: We aimed to summarise the existing literature on insulin dose titration in gestation diabetes.: Methods: Databases: Medline, EMBASE, CENTRAL and CINAHL were systematically searched for trials and observational studies comparing ... ...

    Abstract Background and aims: We aimed to summarise the existing literature on insulin dose titration in gestation diabetes.
    Methods: Databases: Medline, EMBASE, CENTRAL and CINAHL were systematically searched for trials and observational studies comparing insulin titration strategies in gestational diabetes.
    Results: No trials comparing insulin dose titration strategies were identified. Only one small (n = 111) observational study was included. In this study, patient-led daily basal insulin titration was associated with higher insulin doses, tighter glycaemic control, and lower birthweight, vs weekly clinician-led titration.
    Conclusions: There is a paucity of evidence to support optimal insulin titration in gestational diabetes. Randomized trials are required.
    MeSH term(s) Pregnancy ; Female ; Humans ; Insulin/therapeutic use ; Diabetes, Gestational/drug therapy ; Hypoglycemic Agents/therapeutic use ; Pregnancy in Diabetics ; Birth Weight ; Diabetes Mellitus, Type 2 ; Observational Studies as Topic
    Chemical Substances Insulin ; Hypoglycemic Agents
    Language English
    Publishing date 2023-03-21
    Publishing country Netherlands
    Document type Systematic Review ; Journal Article
    ZDB-ID 2273766-2
    ISSN 1878-0334 ; 1871-4021
    ISSN (online) 1878-0334
    ISSN 1871-4021
    DOI 10.1016/j.dsx.2023.102746
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  2. Article ; Online: HbA

    Young, Katherine G / McGovern, Andrew P / Barroso, Inês / Hattersley, Andrew T / Jones, Angus G / Shields, Beverley M / Thomas, Nicholas J / Dennis, John M

    Diabetologia

    2023  Volume 66, Issue 8, Page(s) 1578–1579

    MeSH term(s) Humans ; Diabetes Mellitus/diagnosis ; Glycated Hemoglobin/analysis
    Chemical Substances Glycated Hemoglobin
    Language English
    Publishing date 2023-06-05
    Publishing country Germany
    Document type Letter ; Comment
    ZDB-ID 1694-9
    ISSN 1432-0428 ; 0012-186X
    ISSN (online) 1432-0428
    ISSN 0012-186X
    DOI 10.1007/s00125-023-05939-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  3. Article ; Online: Correction to: The impact of population-level HbA

    Young, Katherine G / McGovern, Andrew P / Barroso, Inês / Hattersley, Andrew T / Jones, Angus G / Shields, Beverley M / Thomas, Nicholas J / Dennis, John M

    Diabetologia

    2023  Volume 66, Issue 8, Page(s) 1585

    Language English
    Publishing date 2023-05-22
    Publishing country Germany
    Document type Published Erratum
    ZDB-ID 1694-9
    ISSN 1432-0428 ; 0012-186X
    ISSN (online) 1432-0428
    ISSN 0012-186X
    DOI 10.1007/s00125-023-05933-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  4. Article ; Online: Recent UK type 2 diabetes treatment guidance represents a near whole population indication for SGLT2-inhibitor therapy.

    Young, Katherine G / Hopkins, Rhian / Shields, Beverley M / Thomas, Nicholas J / McGovern, Andrew P / Dennis, John M

    Cardiovascular diabetology

    2023  Volume 22, Issue 1, Page(s) 302

    Abstract: Recent type 2 diabetes guidance from the UK's National Institute for Health and Care Excellence (NICE) proposes offering SGLT2-inhibitor therapy to people with established atherosclerotic cardiovascular disease (ASCVD) or heart failure, and considering ... ...

    Abstract Recent type 2 diabetes guidance from the UK's National Institute for Health and Care Excellence (NICE) proposes offering SGLT2-inhibitor therapy to people with established atherosclerotic cardiovascular disease (ASCVD) or heart failure, and considering SGLT2-inhibitor therapy for those at high-risk of cardiovascular disease defined as a 10-year cardiovascular risk of > 10% using the QRISK2 algorithm. We used a contemporary population-representative UK cohort of people with type 2 diabetes to assess the implications of this guidance. 93.1% of people currently on anti-hyperglycaemic treatment are now recommended or considered for SGLT2-inhibitor therapy under the new guidance, with the majority (59.6%) eligible on the basis of QRISK2 rather than established ASCVD or heart failure (33.6%). Applying these results to the approximately 2.20 million people in England currently on anti-hyperglycaemic medication suggests 1.75 million people will now be considered for additional SGLT2-inhibitor therapy, taking the total cost of SGLT2-inhibitor therapy in England to over £1 billion per year. Given that older people, those of non-white ethnic groups, and those at lower cardiovascular disease risk were underrepresented in the clinical trials which were used to inform this guidance, careful evaluation of the impact and safety of increased SGLT2-inhibitor prescribing across different populations is urgently required. Evidence of benefit should be weighed against the major cost implications for the UK National Health Service.
    MeSH term(s) Humans ; Aged ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/epidemiology ; Sodium-Glucose Transporter 2 Inhibitors/adverse effects ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/prevention & control ; Sodium-Glucose Transporter 2 ; State Medicine ; Heart Failure ; Atherosclerosis ; England
    Chemical Substances Sodium-Glucose Transporter 2 Inhibitors ; Sodium-Glucose Transporter 2
    Language English
    Publishing date 2023-11-02
    Publishing country England
    Document type Research Support, Non-U.S. Gov't ; Journal Article
    ZDB-ID 2093769-6
    ISSN 1475-2840 ; 1475-2840
    ISSN (online) 1475-2840
    ISSN 1475-2840
    DOI 10.1186/s12933-023-02032-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  5. Article ; Online: Risk factor associations for severe COVID-19, influenza and pneumonia in people with diabetes to inform future pandemic preparations: UK population-based cohort study.

    Hopkins, Rhian / Young, Katherine G / Thomas, Nicholas J / Godwin, James / Raja, Daniyal / Mateen, Bilal A / Challen, Robert J / Vollmer, Sebastian J / Shields, Beverley M / McGovern, Andrew P / Dennis, John M

    BMJ open

    2024  Volume 14, Issue 1, Page(s) e078135

    Abstract: Objective: This study aimed to compare clinical and sociodemographic risk factors for severe COVID-19, influenza and pneumonia, in people with diabetes.: Design: Population-based cohort study.: Setting: UK primary care records (Clinical Practice ... ...

    Abstract Objective: This study aimed to compare clinical and sociodemographic risk factors for severe COVID-19, influenza and pneumonia, in people with diabetes.
    Design: Population-based cohort study.
    Setting: UK primary care records (Clinical Practice Research Datalink) linked to mortality and hospital records.
    Participants: Individuals with type 1 and type 2 diabetes (COVID-19 cohort: n=43 033 type 1 diabetes and n=584 854 type 2 diabetes, influenza and pneumonia cohort: n=42 488 type 1 diabetes and n=585 289 type 2 diabetes).
    Primary and secondary outcome measures: COVID-19 hospitalisation from 1 February 2020 to 31 October 2020 (pre-COVID-19 vaccination roll-out), and influenza and pneumonia hospitalisation from 1 September 2016 to 31 May 2019 (pre-COVID-19 pandemic). Secondary outcomes were COVID-19 and pneumonia mortality. Associations between clinical and sociodemographic risk factors and each outcome were assessed using multivariable Cox proportional hazards models. In people with type 2 diabetes, we explored modifying effects of glycated haemoglobin (HbA1c) and body mass index (BMI) by age, sex and ethnicity.
    Results: In type 2 diabetes, poor glycaemic control and severe obesity were consistently associated with increased risk of hospitalisation for COVID-19, influenza and pneumonia. The highest HbA1c and BMI-associated relative risks were observed in people aged under 70 years. Sociodemographic-associated risk differed markedly by respiratory infection, particularly for ethnicity. Compared with people of white ethnicity, black and south Asian groups had a greater risk of COVID-19 hospitalisation, but a lesser risk of pneumonia hospitalisation. Risk factor associations for type 1 diabetes and for type 2 diabetes mortality were broadly consistent with the primary analysis.
    Conclusions: Clinical risk factors of high HbA1c and severe obesity are consistently associated with severe outcomes from COVID-19, influenza and pneumonia, especially in younger people. In contrast, associations with sociodemographic risk factors differed by type of respiratory infection. This emphasises that risk stratification should be specific to individual respiratory infections.
    MeSH term(s) Humans ; Aged ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/epidemiology ; COVID-19/epidemiology ; Pandemics ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 1/epidemiology ; Influenza, Human/epidemiology ; Glycated Hemoglobin ; Cohort Studies ; Obesity, Morbid ; COVID-19 Vaccines ; Risk Factors ; Pneumonia/epidemiology ; Obesity/complications ; Obesity/epidemiology ; Respiratory Tract Infections ; United Kingdom/epidemiology
    Chemical Substances Glycated Hemoglobin ; COVID-19 Vaccines
    Language English
    Publishing date 2024-01-31
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2023-078135
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  6. Article ; Online: The disproportionate excess mortality risk of COVID-19 in younger people with diabetes warrants vaccination prioritisation.

    McGovern, Andrew P / Thomas, Nick J / Vollmer, Sebastian J / Hattersley, Andrew T / Mateen, Bilal A / Dennis, John M

    Diabetologia

    2021  Volume 64, Issue 5, Page(s) 1184–1186

    MeSH term(s) Adult ; Age Factors ; Aged ; Aged, 80 and over ; COVID-19/mortality ; COVID-19/prevention & control ; COVID-19 Vaccines/therapeutic use ; Comorbidity ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus, Type 2/epidemiology ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Proportional Hazards Models ; SARS-CoV-2
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2021-02-16
    Publishing country Germany
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1694-9
    ISSN 1432-0428 ; 0012-186X
    ISSN (online) 1432-0428
    ISSN 0012-186X
    DOI 10.1007/s00125-021-05404-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  7. Article ; Online: Phenotype-based targeted treatment of SGLT2 inhibitors and GLP-1 receptor agonists in type 2 diabetes.

    Cardoso, Pedro / Young, Katie G / Nair, Anand T N / Hopkins, Rhian / McGovern, Andrew P / Haider, Eram / Karunaratne, Piyumanga / Donnelly, Louise / Mateen, Bilal A / Sattar, Naveed / Holman, Rury R / Bowden, Jack / Hattersley, Andrew T / Pearson, Ewan R / Jones, Angus G / Shields, Beverley M / McKinley, Trevelyan J / Dennis, John M

    Diabetologia

    2024  Volume 67, Issue 5, Page(s) 822–836

    Abstract: Aims/hypothesis: A precision medicine approach in type 2 diabetes could enhance targeting specific glucose-lowering therapies to individual patients most likely to benefit. We aimed to use the recently developed Bayesian causal forest (BCF) method to ... ...

    Abstract Aims/hypothesis: A precision medicine approach in type 2 diabetes could enhance targeting specific glucose-lowering therapies to individual patients most likely to benefit. We aimed to use the recently developed Bayesian causal forest (BCF) method to develop and validate an individualised treatment selection algorithm for two major type 2 diabetes drug classes, sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1-RA).
    Methods: We designed a predictive algorithm using BCF to estimate individual-level conditional average treatment effects for 12-month glycaemic outcome (HbA
    Results: Model development identified marked heterogeneity in glycaemic response, with 4787 (17.5%) of the development cohort having a predicted HbA
    Conclusions/interpretation: Precision medicine approaches can facilitate effective individualised treatment choice between SGLT2i and GLP1-RA therapies, and the use of routinely collected clinical features for treatment selection could support low-cost deployment in many countries.
    MeSH term(s) Male ; Humans ; Female ; Diabetes Mellitus, Type 2/complications ; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use ; Sodium-Glucose Transporter 2 Inhibitors/pharmacology ; Hypoglycemic Agents/adverse effects ; Glucagon-Like Peptide-1 Receptor Agonists ; Liraglutide/therapeutic use ; Bayes Theorem ; Glucose ; Phenotype ; Glucagon-Like Peptide-1 Receptor
    Chemical Substances Sodium-Glucose Transporter 2 Inhibitors ; Hypoglycemic Agents ; Glucagon-Like Peptide-1 Receptor Agonists ; Liraglutide (839I73S42A) ; Glucose (IY9XDZ35W2) ; Glucagon-Like Peptide-1 Receptor
    Language English
    Publishing date 2024-02-22
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1694-9
    ISSN 1432-0428 ; 0012-186X
    ISSN (online) 1432-0428
    ISSN 0012-186X
    DOI 10.1007/s00125-024-06099-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  8. Article ; Online: Downstream Revenue Realized by Facilities Placing Inflatable Penile Prosthesis in Medicare Beneficiaries to Treat Erectile Dysfunction.

    Sun, Andrew / Williams, Abimbola O / Rojanasarot, Sirikan / Moore, Gregory / McGovern, Alysha M / Hargens, Liesl M / Turner, Erin / Babbar, Paurush

    Urology

    2024  

    Abstract: Objectives: To quantify the incremental downstream revenue generated from subsequent treatment of men who received an inflatable penile prosthesis (IPP) to treat erectile dysfunction (ED), compared to men without ED.: Methods: The 100% Medicare ... ...

    Abstract Objectives: To quantify the incremental downstream revenue generated from subsequent treatment of men who received an inflatable penile prosthesis (IPP) to treat erectile dysfunction (ED), compared to men without ED.
    Methods: The 100% Medicare Standard Analytic Files were used to conduct a retrospective claims analysis of the 5-year revenue generated by patients receiving IPP to treat their ED, compared to a propensity-matched cohort of men without ED. Men aged 65 years or older with ED who underwent IPP implantation (Current Procedural Terminology® 54405) in a hospital outpatient setting between January 1, 2016 and December 31, 2021, and who had continuous Medicare Parts A and B enrollment for 12 months pre-index IPP and five years post-index IPP discharge date were included in the study. Men without ED but with comparable characteristics were identified and used as a comparator group. Revenue received by hospitals from Medicare was defined as the sum of payments for patient services, other payor-paid amounts, patient deductibles, copayments, and coinsurance. Revenue was inflated to 2022 US dollars. The mean values and their corresponding standard deviations (SD) are reported.
    Results: After matching, there were 2,905 men with ED who received an IPP and 7,462 men without ED. The IPP cohort showed a significantly higher 5-year cumulative revenue (mean=$34,571 [SD=$50,234]) compared to the men without ED (mean=$3,189 [SD=$11,527]). When stratified by diagnosis type, the differences in revenue were $10,258 for circulatory disease, $2,646 for diabetes, $2,013 for urology, and $1,043 for prostate cancer. Significantly more IPP patients had at least one health encounter for these conditions over the 5-year follow-up period than their matched controls (55.0% versus 7.8% for circulatory, 46.7% versus 16.8% for urology, 19.3% versus 3.6% for diabetes, and 19.0% versus 3.0% for prostate cancer).
    Conclusions: Men with ED who received IPP generated substantially higher revenue for the healthcare system over a 5-year period, nearly ten times as much, compared to men without ED, excluding the initial cost of the IPP procedure. The presence of ED, coupled with IPP usage, is associated with significantly increased healthcare revenue across a range of medical conditions compared to men without ED. These findings emphasize the financial implications for advanced ED programs to improve access to necessary care for these patients. Healthcare facilities may leverage these insights to effectively allocate resources to deliver critical healthcare to men with ED.
    Language English
    Publishing date 2024-04-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 192062-5
    ISSN 1527-9995 ; 0090-4295
    ISSN (online) 1527-9995
    ISSN 0090-4295
    DOI 10.1016/j.urology.2024.04.018
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  9. Article ; Online: A national retrospective study of the association between serious operational problems and COVID-19 specific intensive care mortality risk.

    Wilde, Harrison / Dennis, John M / McGovern, Andrew P / Vollmer, Sebastian J / Mateen, Bilal A

    PloS one

    2021  Volume 16, Issue 7, Page(s) e0255377

    Abstract: Objectives: To describe the relationship between reported serious operational problems (SOPs), and mortality for patients with COVID-19 admitted to intensive care units (ICUs).: Design: English national retrospective cohort study.: Setting: 89 ... ...

    Abstract Objectives: To describe the relationship between reported serious operational problems (SOPs), and mortality for patients with COVID-19 admitted to intensive care units (ICUs).
    Design: English national retrospective cohort study.
    Setting: 89 English hospital trusts (i.e. small groups of hospitals functioning as single operational units).
    Patients: All adults with COVID-19 admitted to ICU between 2nd April and 1st December, 2020 (n = 6,737).
    Interventions: N/A.
    Main outcomes and measures: Hospital trusts routinely submit declarations of whether they have experienced 'serious operational problems' in the last 24 hours (e.g. due to staffing issues, adverse weather conditions, etc.). Bayesian hierarchical models were used to estimate the association between in-hospital mortality (binary outcome) and: 1) an indicator for whether a SOP occurred on the date of a patient's admission, and; 2) the proportion of the days in a patient's stay that had a SOP occur within their trust. These models were adjusted for individual demographic characteristics (age, sex, ethnicity), and recorded comorbidities.
    Results: Serious operational problems (SOPs) were common; reported in 47 trusts (52.8%) and were present for 2,701 (of 21,716; 12.4%) trust days. Overall mortality was 37.7% (2,539 deaths). Admission during a period of SOPs was associated with a substantially increased mortality; adjusted odds ratio (OR) 1.34 (95% posterior credible interval (PCI): 1.07 to 1.68). Mortality was also associated with the proportion of a patient's admission duration that had concurrent SOPs; OR 1.47 (95% PCI: 1.10 to 1.96) for mortality where SOPs were present for 100% compared to 0% of the stay.
    Conclusion and relevance: Serious operational problems at the trust-level are associated with a significant increase in mortality in patients with COVID-19 admitted to critical care. The link isn't necessarily causal, but this observation justifies further research to determine if a binary indicator might be a valid prognostic marker for deteriorating quality of care.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bayes Theorem ; COVID-19/mortality ; COVID-19/virology ; Critical Care/methods ; Female ; Hospital Mortality ; Hospitalization ; Hospitals ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Odds Ratio ; Patient Admission ; Retrospective Studies ; Workforce ; Young Adult
    Language English
    Publishing date 2021-07-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0255377
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  10. Article ; Online: Sodium-glucose co-transporter-2 inhibitors in type 2 diabetes: Are clinical trial benefits for heart failure reflected in real-world clinical practice? A systematic review and meta-analysis of observational studies.

    Hinton, William / Ansari, Abdus Samad / Whyte, Martin B / McGovern, Andrew P / Feher, Michael D / Munro, Neil / de Lusignan, Simon

    Diabetes, obesity & metabolism

    2022  Volume 25, Issue 2, Page(s) 501–515

    Abstract: Aim: To determine the absolute risk reduction (ARR) of heart failure events in people treated with sodium-glucose co-transporter-2 (SGLT2) inhibitors.: Materials and methods: We searched PubMed, EMBASE, CINAHL and ISI Web of Science for observational ...

    Abstract Aim: To determine the absolute risk reduction (ARR) of heart failure events in people treated with sodium-glucose co-transporter-2 (SGLT2) inhibitors.
    Materials and methods: We searched PubMed, EMBASE, CINAHL and ISI Web of Science for observational studies published to 9 May 2022 that explored the association between SGLT2 inhibitors and any indication for heart failure (including new diagnosis or hospitalization for heart failure) in type 2 diabetes. Identified studies were independently screened by two reviewers and assessed for bias using the Newcastle-Ottawa scale. Eligible studies with comparable outcome data were pooled for meta-analysis using random-effects models, reporting hazard ratios (HRs) with 95% confidence intervals (CIs). The ARR per 100 person-years was determined overall, and in subgroups with and without baseline cardiovascular disease (CVD).
    Results: From 43 eligible studies, with a total of 4 818 242 participants from 17 countries, 21 were included for meta-analysis. SGLT2 inhibitors were associated with a reduced risk of hospitalization for heart failure (HR 0.65, 95% CI 0.59-0.72) overall and both in those with CVD (HR 0.78, 95% CI 0.68-0.89) and without CVD (HR 0.53, 95% CI 0.39-0.71). Risk reduction for hospitalization for heart failure in people with a history of CVD (ARR 1.17, 95% CI 0.78-1.55) was significantly greater than for those without CVD (ARR 0.39, 95% CI 0.32-0.47). The number-needed-to-treat to prevent one event of hospitalization for heart failure was 86 (95% CI 65-128) person-years of treatment for the CVD group and 256 (95% CI 215-316) person-years for those without CVD.
    Conclusions: Real-world SGLT2 inhibitor use supports randomized trial data for the size effect of reduced hospitalization for heart failure in type 2 diabetes, although with a much lower ARR in people without CVD.
    MeSH term(s) Humans ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use ; Heart Failure/drug therapy ; Heart Failure/epidemiology ; Heart Failure/complications ; Cardiovascular Diseases/complications ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/prevention & control ; Symporters/therapeutic use ; Glucose/therapeutic use ; Sodium
    Chemical Substances Sodium-Glucose Transporter 2 Inhibitors ; Symporters ; Glucose (IY9XDZ35W2) ; Sodium (9NEZ333N27)
    Language English
    Publishing date 2022-11-02
    Publishing country England
    Document type Meta-Analysis ; Systematic Review ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1454944-x
    ISSN 1463-1326 ; 1462-8902
    ISSN (online) 1463-1326
    ISSN 1462-8902
    DOI 10.1111/dom.14893
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

To top