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Amadou C, Melki V, Allain J, Clavel S, Gouet D, Chaillous L, Catargi B, Schaeplynck-Belicard P, Petit C, Thivolet C, Penfornis A. Performance and patients' satisfaction with the A7+TouchCare insulin patch pump system: A randomized controlled non-inferiority study. PLoS One 2023; 18:e0289684. [PMID: 37616289 PMCID: PMC10449223 DOI: 10.1371/journal.pone.0289684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 07/06/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND We assessed the performance and patient satisfaction of a new insulin patch pump, the A7+TouchCare (Medtrum), compared with the Omnipod system. METHODS This multicenter, randomized, open-label, controlled study enrolled 100 adult patients with type 1 or type 2 diabetes mellitus (A1C ≥ 6.5% and ≤ 9.5%, i.e., 48 to 80 mmol/mol) who were assigned with the Omnipod or with the A7+TouchCare pump for 3 months. The primary study outcome was the glucose management indicator (GMI) calculated with continuous glucose monitoring (CGM). RESULTS Premature withdrawals occurs respectively in 2 and 9 participants in the Omnipod and TouchCare groups. In the Per Protocol analysis, the difference in GMI between groups was 0.002% (95% confidence interval -0.251; 0.255). The non-inferiority was demonstrated since the difference between treatments did not overlap the pre-defined non-inferiority margin (0.4%). There was no significant difference in CGM parameters between groups. On average, patients in both groups were satisfied/very satisfied with the insulin pump system. Patients preferred Omnipod as an insulin management system and especially the patch delivery system but preferred the A7+TouchCare personal diabetes manager to control the system. CONCLUSIONS This study showed that the A7+TouchCare insulin pump was as efficient as the Omnipod pump in terms of performance and satisfaction. CLINICAL TRAIL REGISTRATION The study was registered in the ClinicalTrials.gov protocol register (NCT04223973).
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Affiliation(s)
- Coralie Amadou
- Service d’Endocrinologie, Diabétologie et Maladies Métaboliques, Centre Hospitalier Sud-Francilien de Corbeil-Essonnes, Corbeil-Essonnes, France
- Université Paris-Saclay, Gif-sur-Yvette, France
| | - Vincent Melki
- Service de Diabétologie–Maladies Métaboliques—Nutrition, CHU Hôpital Rangueil, Toulouse, France
| | - Jennifer Allain
- Service d’Endocrinologie-Diabétologie, Centre Hospitalier de Gonesse, Gonesse, France
| | | | - Didier Gouet
- Hôpitaux La Rochelle, Ré, Aunis, La Rochelle, France
| | - Lucy Chaillous
- Hôpital Nord Laennec, CHU Nantes, Saint-Herblain, France
| | | | | | - Catherine Petit
- Service d’Endocrinologie, Diabétologie et Maladies Métaboliques, Centre Hospitalier Sud-Francilien de Corbeil-Essonnes, Corbeil-Essonnes, France
- Université Paris-Saclay, Gif-sur-Yvette, France
| | - Charles Thivolet
- Centre du diabète Diab-e-Care—Hospices Civils de Lyon, Lyon, France
| | - Alfred Penfornis
- Service d’Endocrinologie, Diabétologie et Maladies Métaboliques, Centre Hospitalier Sud-Francilien de Corbeil-Essonnes, Corbeil-Essonnes, France
- Université Paris-Saclay, Gif-sur-Yvette, France
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Reach G, Benarbia L, Benhamou PY, Delemer B, Dubois S, Gouet D, Guerci B, Jeandidier N, Lachgar K, Le Pape G, Leroy R, Masgnaux JH, Raclet P, Reznik Y, Riveline JP, Schaepelynck P, Vambergue A, Vergès B. An Unsafe/Safe Typology in People with Type 2 Diabetes: Bridging Patients' Expectations, Personality Traits, Medication Adherence, and Clinical Outcomes. Patient Prefer Adherence 2022; 16:1333-1350. [PMID: 35642243 PMCID: PMC9148599 DOI: 10.2147/ppa.s365398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/05/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Support programs are provided to people with diabetes to help them manage their disease. However, adherence to and persistence in support programs are often low, making it difficult to demonstrate their effectiveness. AIM To identify the determinants of patients' perceived interest in diabetes support programs because it may be a powerful determinant of effective participation in such programs. PATIENTS AND METHODS An online study conducted in April 2021 in metropolitan France on 600 people with diabetes recruited from a consumer panel. A 64-item psychosocial questionnaire including a question asking to evaluate the helpfulness of a support program was used. Univariate, multivariate, and multiple correspondence analyses were performed. RESULTS The existence of a typology, known as Unsafe/Safe, was discovered, in which patients with type 2 diabetes respond in two distinct ways. Type U (unsafe) patients, who believe that a support program would be helpful, are more likely to be nonadherent to their treatment, have high hemoglobin A1c levels, have at least one diabetic complication, lack information regarding their disease and treatment, rate the burden of their disease and impairment of their quality of life as high, worry about their future, and are pessimistic. Type S (safe) patients have the opposite characteristics. Type U patients can be dichotomized into two broad classes: one in which they lack information regarding disease and treatment and the other in which alterations in the quality of life and burden of the disease predominate. Insulin-treated patients give more importance to the lack of information, whereas noninsulin-treated patients complain primarily about the burden of the disease and impairment of quality of life. CONCLUSION This study describes this new U/S typology, proposes a simple method based on a nine-item questionnaire to identify type U patients by calculating a Program Helpfulness Score described herein, and clarifies the nature of the intervention to be provided to them. This novel approach could be applied to other chronic diseases.
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Affiliation(s)
- Gérard Reach
- Health Education and Promotion Laboratory (LEPS EA 3412), Sorbonne Paris Nord University, Bobigny, France
- Correspondence: Gérard Reach, Health Education and Promotion Laboratory (LEPS EA 3412), Sorbonne Paris Nord University, 74 Rue Marcel Cachin, Bobigny Cedex, 93017, France, Tel + 33 (0)6 60 84 53 25, Email
| | | | - Pierre-Yves Benhamou
- Department of Endocrinology, Grenoble University Hospital; Grenoble Alpes University, INSERM U1055, LBFA, Grenoble, France
| | - Brigitte Delemer
- Service d’Endocrinologie – Diabète – Nutrition, CHU de Reims - Hôpital Robert Debré, and Université de Reims Champagne Ardenne, UFR Sciences Exactes Et Naturelles, Reims, France
| | - Séverine Dubois
- Department of Diabetology and Endocrinology, CHU Angers, Angers, France
| | - Didier Gouet
- Department of Diabetology and Endocrinology, Saint Louis Hospital, La Rochelle, France
| | - Bruno Guerci
- Department of Endocrinology, Diabetology and Nutrition, CHRU of Nancy, Brabois Hospital, and ILCV Lorraine University, Vandoeuvre-les-Nancy, France
| | - Nathalie Jeandidier
- Department of Endocrinology, Diabetes and Nutrition, Hôpitaux Universitaires de Strasbourg, and Université de Strasbourg, Strasbourg, France
| | - Karim Lachgar
- Department of Diabetology and Endocrinology, Centre Hospitalier Simone Veil, Eaubonne, France
| | | | - Rémy Leroy
- Private Medical Practice, Endocrinology and Diabetology, Lille, France
| | | | - Philippe Raclet
- Association Française des Diabétiques de Bourgogne Franche-Comté, Dijon, France
| | - Yves Reznik
- Department oEndocrinology and Diabetology, CHU Côte de Nacre, Caen, and University of Caen Basse-Normandie, Medical School, Caen, France
| | - Jean-Pierre Riveline
- Department of Diabetology and Endocrinology, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
- Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, and Université de Paris, Paris, France
| | - Pauline Schaepelynck
- Department of Nutrition-Endocrinology-Metabolic Diseases, Pôle ENDO, APHM-Hôpital la Conception, Marseille, France
| | - Anne Vambergue
- Department of Diabetology, Endocrinology, Metabolism and Nutrition, CHU Lille, and University Hospital European Genomic Institute for Diabetes, Lille, France
| | - Bruno Vergès
- Department of Endocrinology-Diabetology,CHU Dijon, and University of Burgundy, INSERM LNC UMR1231, Dijon, France
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Suteau V, Saulnier PJ, Wargny M, Gonder-Frederick L, Gand E, Chaillous L, Allix I, Dubois S, Bonnet F, Leguerrier AM, Fradet G, Delcourt Crespin I, Kerlan V, Gouet D, Perlemoine C, Ducluzeau PH, Pichelin M, Ragot S, Hadjadj S, Cariou B, Briet C. Association between sleep disturbances, fear of hypoglycemia and psychological well-being in adults with type 1 diabetes mellitus, data from cross-sectional VARDIA study. Diabetes Res Clin Pract 2020; 160:107988. [PMID: 31866527 DOI: 10.1016/j.diabres.2019.107988] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/06/2019] [Accepted: 12/17/2019] [Indexed: 02/01/2023]
Abstract
AIM To assess the relationship between sleep quality, fear of hypoglycemia, glycemic variability and psychological well-being in type 1 diabetes mellitus. METHODS Our data were provided by the VARDIA Study, a multicentric cross-sectional study conducted between June and December 2015. Sleep characteristics were assessed by the Pittsburgh Sleep Quality Index (PSQI). Fear of hypoglycemia and psychological well-being were measured with the Hypoglycemia Fear Survey version II (HFS-II) and the Hospital Anxiety and Depression Scale (HADS), respectively. Glycemic variability (GV) was determined using the CV of three 7-point self-monitoring blood glucose profiles and the mean amplitude of glycemic excursion (MAGE). RESULTS 315 patients were eligible for PSQI questionnaire analysis: 54% women, mean age 47 ± 15, mean diabetes duration of 24 ± 13 years, HbA1c of 7.6 ± 0.9% (60 ± 7,5mmol/mol). Average PSQI score was 6.0 ± 3.3 and 59.8% of the patients had a PSQI score > 5. HFS-II score and HADS were significantly higher among "poor" sleepers (p < 0.0001) and PSQI score was positively associated with HADS (β = 0.22; 95% CI = 0.08;0.35). GV evaluated by CV or MAGE did not differ between "poor" and "good" sleepers (p = 0.28 and 0.54, respectively). CONCLUSIONS Adult patients with type 1 diabetes have sleep disturbances which correlate with psychological well-being. This study suggests that psychological management can be a target to improve sleep quality in adults with type 1 diabetes mellitus.
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Affiliation(s)
- Valentine Suteau
- Institut MITOVASC, UMR CNRS 6015, INSERM 1083, Université d'Angers, 3 rue Roger Amsler, 49100 Angers, France; Diabetes Department, CHU d'Angers, 4 rue Larrey, 49100 Angers, France.
| | - Pierre-Jean Saulnier
- Clinical Investigation Center CIC1402, CHU de Poitiers 2 rue de la Miletrie, 86000 Poitiers, France; CHU Poitiers, Diabetes Department, 2 rue de la Milétrie, CS 90577, 86000 Poitiers, France.
| | - Matthieu Wargny
- L'institut du thorax, CHU Nantes, INSERM CIC1413, Hôpital Nord Laennec Boulevard Jacques-Monod Saint-Herblain, 44093 Nantes Cedex 1, France.
| | | | - Elise Gand
- Clinical Investigation Center CIC1402, CHU de Poitiers 2 rue de la Miletrie, 86000 Poitiers, France.
| | - Lucy Chaillous
- L'institut du thorax, CHU Nantes, INSERM CIC1413, Hôpital Nord Laennec Boulevard Jacques-Monod Saint-Herblain, 44093 Nantes Cedex 1, France.
| | - Ingrid Allix
- Diabetes Department, CHU d'Angers, 4 rue Larrey, 49100 Angers, France.
| | - Séverine Dubois
- Diabetes Department, CHU d'Angers, 4 rue Larrey, 49100 Angers, France; INSERM U1063, Oxidative Stress and Metabolic Pathologies, Université d'Angers, CHU Angers, 4 Rue Larrey, 49933 Angers Cedex 9, France.
| | - Fabrice Bonnet
- CHU Rennes, Diabetes Department, 2 rue Henri Le Guilloux, 35033 Rennes Cedex 9, France.
| | - Anne-Marie Leguerrier
- CHU Rennes, Diabetes Department, 2 rue Henri Le Guilloux, 35033 Rennes Cedex 9, France
| | - Gerard Fradet
- CH Départemental Vendée, Boulevard Stéphane Moreau, 85000 La Roche-sur-Yon, France.
| | | | - Véronique Kerlan
- CHU Brest, Diabetes Department, Hôpital de La Cavale Blanche, Boulevard Tanguy Prigent, 29200 Brest, France.
| | - Didier Gouet
- CH La Rochelle, Diabetes Department, Rue du docteur Schweitzer, 17019 La Rochelle Cedex, France.
| | - Caroline Perlemoine
- CH Bretagne Sud, Diabetes Department, 5 Avenue Choiseul, 56322 Lorient, France.
| | | | - Matthieu Pichelin
- L'institut du thorax, CHU Nantes, INSERM CIC1413, Hôpital Nord Laennec Boulevard Jacques-Monod Saint-Herblain, 44093 Nantes Cedex 1, France.
| | - Stéphanie Ragot
- Clinical Investigation Center CIC1402, CHU de Poitiers 2 rue de la Miletrie, 86000 Poitiers, France.
| | - Samy Hadjadj
- Clinical Investigation Center CIC1402, CHU de Poitiers 2 rue de la Miletrie, 86000 Poitiers, France; CHU Poitiers, Diabetes Department, 2 rue de la Milétrie, CS 90577, 86000 Poitiers, France.
| | - Bertrand Cariou
- L'institut du thorax, CHU Nantes, INSERM CIC1413, Hôpital Nord Laennec Boulevard Jacques-Monod Saint-Herblain, 44093 Nantes Cedex 1, France.
| | - Claire Briet
- Institut MITOVASC, UMR CNRS 6015, INSERM 1083, Université d'Angers, 3 rue Roger Amsler, 49100 Angers, France; Diabetes Department, CHU d'Angers, 4 rue Larrey, 49100 Angers, France.
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Meneghini L, Doshi A, Gouet D, Vilsbøll T, Begtrup K, Őrsy P, Ranthe MF, Lingvay I. Insulin degludec/liraglutide (IDegLira) maintains glycaemic control and improves clinical outcomes, regardless of pre-trial insulin dose, in people with type 2 diabetes that is uncontrolled on basal insulin. Diabet Med 2020; 37:267-276. [PMID: 31705547 PMCID: PMC7003817 DOI: 10.1111/dme.14178] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/07/2019] [Indexed: 12/16/2022]
Abstract
AIMS To assess whether people with type 2 diabetes transferring from higher basal insulin doses (> 20 units) to a starting dose of 16 units of insulin degludec/liraglutide (IDegLira) benefit from IDegLira with/without transient loss of glycaemic control. METHODS Post hoc analysis of DUAL V and VII assessed fasting self-measured blood glucose (SMBG) over weeks 1-8, changes in HbA1c, body weight and mean insulin dose over 26 weeks, and percentage of participants achieving HbA1c < 53 mmol/mol (7.0%) by end of trial in participants with type 2 diabetes uncontrolled with basal insulin. IDegLira was compared with continued up-titration of insulin glargine (IGlar U100) in DUAL V, or switching to basal-bolus therapy in DUAL VII (IGlar U100 and insulin aspart), across pre-trial insulin dose groups (20-29, 30-39 and 40-50 units/day). RESULTS In all subgroups, participants treated with IDegLira experienced significant improvements in HbA1c by end of trial, which were greater than with IGlar U100 up-titration (estimated treatment difference -5.86, -6.59 and -6.91 mmol/mol for pre-trial insulin doses of 20-29, 30-39 and 40-50 units/day, respectively) and similar to basal-bolus therapy (estimated treatment difference -0.16, -1.0 and -0.01 mmol/mol for pre-trial insulin doses of 20-29, 30-39 and 40-50 units/day, respectively). Compared with IGlar U100 and basal-bolus therapy, IDegLira participants experienced weight loss vs. weight gain, lower rates of hypoglycaemia and a lower mean end of trial total daily insulin dose. In both trials, mean fasting SMBG decreased from weeks 1 to 8 across all subgroups, despite a temporary increase in mean fasting SMBG in the 40-50 units pre-trial insulin dose group during week 1 [mean increase (sd) +1.1 (2.0) mmol/l for DUAL V and +1.1 (2.1) mmol/l for DUAL VII], which reverted to baseline by week 4. CONCLUSIONS Regardless of pre-trial insulin dose, IDegLira resulted in improved clinical outcomes, even in participants transferring from 40-50 units of basal insulin, despite a transient (< 4 weeks), clinically non-relevant, elevation in pre-breakfast SMBG. (Clinical Trial Registry Number NCT01952145 and NCT02420262).
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Affiliation(s)
- L. Meneghini
- University of Texas Southwestern Medical Center and Parkland Health & Hospital SystemDallasTXUSA
| | - A. Doshi
- PrimeCare Medical GroupHoustonTXUSA
| | - D. Gouet
- La Rochelle HospitalLa RochelleFrance
| | - T. Vilsbøll
- Steno Diabetes Center CopenhagenUniversity of CopenhagenCopenhagenDenmark
| | | | - P. Őrsy
- Novo Nordisk A/SSøborgDenmark
| | | | - I. Lingvay
- University of Texas Southwestern Medical Center and Parkland Health & Hospital SystemDallasTXUSA
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Gourdy P, Bahloul A, Boultif Z, Gouet D, Guerci B. Efficacy and Safety of Switching Patients Inadequately Controlled on Basal Insulin to Insulin Glargine 300 U/mL: The TRANSITION 2 Study. Diabetes Ther 2020; 11:147-159. [PMID: 31782050 PMCID: PMC6965550 DOI: 10.1007/s13300-019-00734-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION This study aimed to determine, in close to real-life conditions, the efficacy and safety of switching from any basal insulin to insulin glargine 300 U/mL (Gla-300) in patients with uncontrolled type 2 diabetes (T2D). METHODS This was an interventional, multicenter, single-arm, prospective study with a 24-week treatment phase. Adult patients with T2D treated with basal insulin with or without other antidiabetics, HbA1c > 7.5%, and fasting self-monitored blood glucose (F-SMBG) > 130 mg/dL (mean of three measures) at baseline were included. Insulin dose was titrated to reach F-SMBG 90-130 mg/dL. Efficacy and safety were assessed at 12 weeks (W12) and 24 weeks (W24). The main outcome parameter was HbA1c change between baseline and W24. Safety parameters included self-reported hypoglycemia (any type). Patients' satisfaction with the treatment was assessed by the Diabetes Treatment Satisfaction Questionnaire (DTSQ). RESULTS A total of 140 patients were included and 137 were treated. Mean HbA1c decreased from 8.64% at baseline to 8.14% at W12 (mean difference [95% CI] - 0.51% [- 0.64; - 0.38]) and 8.01% at W24 (- 0.64% [- 0.81; - 0.46]). Target F-SMBG was reached in 35.0% of the patients at W12 and 38.4% at W24. The percentages of patients reaching HbA1c levels < 7.0%, < 7.5%, and < 8.0% at W24 were 11.4%, 29.5%, and 50.8%, respectively, while only 31.6% had an HbA1c value < 8.0% at baseline. HbA1c reduction was greater in patients with higher baseline levels. During the treatment phase, 46.0% of the participants had at least one hypoglycemia event; 31.4% documented symptomatic hypoglycemia, 2.2% severe hypoglycemia, and 12.2% nocturnal hypoglycemia. Treatment satisfaction increased by 20% between baseline and W24. CONCLUSION These data, derived from close to real-life practice in France, confirm the reassuring results of randomized trials on the efficacy and safety of Gla-300. TRIAL REGISTRATION EudraCT number 2015-002416-33.
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Affiliation(s)
- Pierre Gourdy
- Service de diabétologie, maladies métaboliques et nutrition, CHU et Université de Toulouse, Toulouse, France.
| | | | | | - Didier Gouet
- Centre Hospitalier de La Rochelle, La Rochelle, France
| | - Bruno Guerci
- Service d'Endocrinologie, Diabétologie et Nutrition, CHRU de Nancy & Université de Lorraine, Nancy, France
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Saulnier PJ, Briet C, Gand E, Chaillous L, Dubois S, Bonnet F, Leguerrier AM, Fradet G, Delcourt Crespin I, Kerlan V, Gouet D, Perlemoine C, Ducluzeau PH, Pichelin M, Wargny M, Gonder-Frederick L, Ragot S, Hadjadj S, Cariou B. No association between fear of hypoglycemia and blood glucose variability in type 1 diabetes: The cross-sectional VARDIA study. J Diabetes Complications 2019; 33:554-560. [PMID: 31182337 DOI: 10.1016/j.jdiacomp.2019.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 12/20/2018] [Accepted: 05/05/2019] [Indexed: 01/17/2023]
Abstract
AIMS In type 1 diabetes (T1D), treatment efficacy is limited by the unpredictability of blood glucose results and glycemic variability (GV). Fear of Hypoglycemia (FOH) remains a major brake for insulin treatment optimization. We aimed to assess the association of GV with FOH in participants with T1D in an observational cross-sectional study performed in 9 French Diabetes Centres (NCT02790060). METHODS Participants were T1D for ≥5 years, aged 18-75 years, on stable insulin therapy for ≥3 months. The coefficient of variation (CV) of blood glucose and mean amplitude of glycemic excursions (MAGE) were used to assess GV from 7-point self-monitoring of blood glucose (SMBG). FOH was assessed using the validated French version of the Hypoglycemia Fear Survey-II (HFS-II) questionnaire. RESULTS Among a total of 570 recruited participants, 298 were suitable for analysis: 46% women, 58% on continuous subcutaneous insulin infusion [CSII], mean age 49 ± 16 years, HbA1c 7.5 ± 0.9%, HFS-II score 67 ± 18 and 12% with recent history of severe hypoglycemia during the previous 6 months, mean CV 39.8 ± 9.7% and MAGE 119 ± 42 mg/dL. CV and MAGE did not significantly correlate with HFS-II score (R = -0.05;P = 0.457 and R = 0.08;P = 0.170). Participants with severe hypoglycemia in the previous 6 months had higher HFS scores. Participants with higher HFS scores presented more hypoglycemias during follow-up. CONCLUSIONS FOH as determined using the HFS-II questionnaire was not associated with 7-point SMBG variability in participants with T1D, but was associated with a positive history of severe hypoglycemia. Higher FOH was associated with higher frequency of hypoglycemia during follow-up.
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Affiliation(s)
- Pierre Jean Saulnier
- Clinical Investigation Centre CIC1402, CHU Poitiers, University of Poitiers, INSERM, Poitiers, France; Endocrinology, Diabetes and Nutrition Department, CHU Poitiers, Poitiers, France.
| | - Claire Briet
- Diabetes Department, CHU Angers, Angers University, Institut MITOVASC, INSERM U1083, Angers, France
| | - Elise Gand
- Endocrinology, Diabetes and Nutrition Department, CHU Poitiers, Poitiers, France
| | - Lucy Chaillous
- L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France
| | - Severine Dubois
- Diabetes Department, CHU Angers, Angers University, Institut MITOVASC, INSERM U1083, Angers, France
| | | | | | | | | | | | | | | | | | - Matthieu Pichelin
- L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France
| | - Matthieu Wargny
- L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France
| | | | - Stephanie Ragot
- Clinical Investigation Centre CIC1402, CHU Poitiers, University of Poitiers, INSERM, Poitiers, France
| | - Samy Hadjadj
- Clinical Investigation Centre CIC1402, CHU Poitiers, University of Poitiers, INSERM, Poitiers, France; Endocrinology, Diabetes and Nutrition Department, CHU Poitiers, Poitiers, France; L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France
| | - Bertrand Cariou
- L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France
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Roussel R, Fontaine P, Gouet D, Serusclat P, Martinez L, Detournay B, Martin-Kristensen M. Le traitement du diabète de type 2 en France est dynamique plutôt qu’inerte : analyse des prescriptions de 847 122 patients. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/s1957-2557(18)30096-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Billings LK, Doshi A, Gouet D, Oviedo A, Rodbard HW, Tentolouris N, Grøn R, Halladin N, Jodar E. Efficacy and Safety of IDegLira Versus Basal-Bolus Insulin Therapy in Patients With Type 2 Diabetes Uncontrolled on Metformin and Basal Insulin: The DUAL VII Randomized Clinical Trial. Diabetes Care 2018; 41:1009-1016. [PMID: 29483185 DOI: 10.2337/dc17-1114] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 02/05/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE In patients with uncontrolled type 2 diabetes on basal insulin, prandial insulin may be initiated. We assessed the efficacy and safety of initiating insulin degludec/liraglutide fixed-ratio combination (IDegLira) versus basal-bolus insulin. RESEARCH DESIGN AND METHODS A phase 3b trial examined patients with uncontrolled type 2 diabetes on insulin glargine (IGlar U100) 20-50 units/day and metformin, randomized to IDegLira or IGlar U100 and insulin aspart ≤4 times per day. RESULTS Glycated hemoglobin (HbA1c) decreased from 8.2% (66 mmol/mol) to 6.7% (50 mmol/mol) with IDegLira and from 8.2% (67 mmol/mol) to 6.7% (50 mmol/mol) with basal-bolus (estimated treatment difference [ETD] -0.02% [95% CI -0.16, 0.12]; -0.2 mmol/mol [95% CI -1.7, 1.3]), confirming IDegLira noninferiority versus basal-bolus (P < 0.0001). The number of severe or blood glucose-confirmed symptomatic hypoglycemia events was lower with IDegLira versus basal-bolus (risk ratio 0.39 [95% CI 0.29, 0.51]; rate ratio 0.11 [95% CI 0.08, 0.17]). Body weight decreased with IDegLira and increased with basal-bolus (ETD -3.6 kg [95% CI -4.2, -2.9]). Fasting plasma glucose reductions were similar; lunch, dinner, and bedtime self-monitored plasma glucose measurements were significantly lower with basal-bolus. Sixty-six percent of patients on IDegLira vs. 67.0% on basal-bolus achieved HbA1c <7.0% (53 mmol/mol). Total daily insulin dose was lower with IDegLira (40 units) than basal-bolus (84 units total; 52 units basal). CONCLUSIONS In patients with uncontrolled type 2 diabetes on IGlar U100 and metformin, IDegLira treatment elicited HbA1c reductions comparable to basal-bolus, with statistically superior lower hypoglycemia rates and weight loss versus weight gain.
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Affiliation(s)
- Liana K Billings
- NorthShore University HealthSystem, Evanston, IL .,University of Chicago Pritzker School of Medicine, Chicago, IL
| | | | | | - Alejandra Oviedo
- Santojanni Hospital and Cenudiab, Ciudad Autonoma de Buenos Aires, Argentina
| | | | | | | | | | - Esteban Jodar
- H. U. QuirónSalud Madrid y Ruber Juan Bravo, Universidad Europea de Madrid, Madrid, Spain
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9
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Hanaire H, Attali C, Lecointre B, Fraysse M, Gouet D, Babel MR, Charbonnel B, Sarkozy F, Gourmelen J, Detournay B. [Determinants of the cost of initiation of insulin therapy type 2 diabetic patients in France: possible approaches to optimization]. Sante Publique 2016; 28:781-789. [PMID: 28155773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Increased costs cannot be exclusively attributed to the consequences of insulin prescription. Any initiative designed to accelerate acquisition of patient autonomy would be likely to reduce the costs observed after switching to insulin, provided this initiative is adapted to the patient’s health profile, diabetes history and available medical resources.</ce:para>.
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10
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Kerlan V, Gouet D, Marre M, Renard É. Use of insulin degludec, a new basal insulin with an ultra-long duration of action, in basal-bolus therapy in type 1 and type 2 diabetes. Ann Endocrinol (Paris) 2013; 74:487-90. [PMID: 23978337 DOI: 10.1016/j.ando.2013.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 04/24/2013] [Indexed: 11/25/2022]
Abstract
Insulin degludec is a new basal insulin analogue with an ultra-long duration of action that provides a flat and stable action profile with a duration of action greater than 42 hours. Two clinical trials comparing insulin degludec and insulin glargine in basal-bolus therapy have recently been published. Both were 52-week, multicentre, randomised (3:1), treat-to-target trials in patients already using insulin. In both type 1 (n=629) and type 2 diabetes (n=1006), insulin degludec was non-inferior to insulin glargine with respect to reduction in HbA1c at 52 weeks. There were also no significant differences between treatment groups with respect to fasting plasma glucose. At similar levels of glycaemic control, however, insulin degludec was associated with lower rates of hypoglycaemia than insulin glargine. In type 1 diabetes, overall confirmed hypoglycaemia (plasma glucose concentration<3.1 mmol/L or severe episodes requiring assistance) was similar in the two treatment groups, but nocturnal confirmed hypoglycaemia (occurring from 00h01 to 05h59) was 25% lower with insulin degludec (P=0.021). In type 2 diabetes, overall confirmed hypoglycaemia was 18% lower (P=0.0359) and nocturnal confirmed hypoglycaemia was 25% lower (P=0.0399) with insulin degludec. Reductions in hypoglycaemia could reduce physicians' and patients' fears and encourage them to titrate insulin more aggressively, and to adhere more closely to treatment, with consequent better glycaemic control. The results of these trials suggest that insulin degludec has a place in the French clinical setting in basal-bolus therapy in type 1 and type 2 diabetes.
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Affiliation(s)
- Véronique Kerlan
- Centre hospitalier universitaire La Cavale-Blanche, boulevard Tanguy-Prigent, 29600 Brest, France.
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11
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Heise T, Tack CJ, Cuddihy R, Davidson J, Gouet D, Liebl A, Romero E, Mersebach H, Dykiel P, Jorde R. A new-generation ultra-long-acting basal insulin with a bolus boost compared with insulin glargine in insulin-naive people with type 2 diabetes: a randomized, controlled trial. Diabetes Care 2011; 34:669-74. [PMID: 21285389 PMCID: PMC3041205 DOI: 10.2337/dc10-1905] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Insulin degludec/insulin aspart (IDegAsp) is a soluble coformulation of the novel basal analog insulin degludec (IDeg: 70%) and insulin aspart (IAsp: 30%). We compared the safety and efficacy of IDegAsp, an alternative formulation (AF) (55% IDeg and 45% IAsp), and insulin glargine (IGlar) in insulin-naïve subjects with type 2 diabetes inadequately controlled with oral antidiabetic drugs. RESEARCH DESIGN AND METHODS In this 16-week, open-label trial, subjects (mean age 59.1 years, A1C 8.5%, BMI 30.3 kg/m(2)) were randomized to once-daily IDegAsp (n = 59), AF (n = 59), or IGlar (n = 60), all in combination with metformin. Insulin was administered before the evening meal and dose-titrated to a fasting plasma glucose (FPG) target of 4.0-6.0 mmol/L. RESULTS After 16 weeks, mean A1C decreased in all groups to comparable levels (IDegAsp: 7.0%; AF: 7.2%; IGlar: 7.1%). A similar proportion of subjects achieved A1C <7.0% without confirmed hypoglycemia in the last 4 weeks of treatment (IDegAsp: 51%; AF: 47%; IGlar: 50%). Mean 2-h postdinner plasma glucose increase was lower for IDegAsp (0.13 mmol/L) and AF (0.24 mmol/L) than IGlar (1.63 mmol/L), whereas mean FPG was similar (IDegAsp: 6.8 mmol/L; AF: 7.4 mmol/L; IGlar: 7.0 mmol/L). Hypoglycemia rates were lower for IDegAsp and IGlar than AF (1.2, 0.7, and 2.4 events/patient year). Nocturnal hypoglycemic events occurred rarely for IDegAsp (1 event) and IGlar (3 events) compared with AF (27 events). CONCLUSIONS In this proof-of-concept trial, once-daily IDegAsp was safe, well tolerated, and provided comparable overall glycemic control to IGlar at similar low rates of hypoglycemia, but better postdinner plasma glucose control.
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Affiliation(s)
- Tim Heise
- Profil Institut für Stoffwechselforschung, Neuss, Germany.
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12
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Courreges JP, Donnet JP, Clavel S, Gabreau T, Gouet D, Verlet E, Jan P, Cosson E, Cirette B, Leutenegger E. Suivi de patients diabétiques de type 2 mis sous pompe ambulatoire à insuline. Données préliminaires à 1 an. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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13
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Paccalin M, Gouet D, Ribouleau V, Delwail V, Lefort G, Babin P, Kraimps JL, Maréchaud R. [Primary thyroid lymphoma: report of 8 cases]. Rev Med Interne 2001; 22:934-8. [PMID: 11695316 DOI: 10.1016/s0248-8663(01)00451-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Primary thyroid lymphoma (PTL) is a rare disease. Few patients are reported in the literature. We report eight new cases of PTL with long-term follow-up. RESULTS The clinical presentation was usually an enlarging neck mass squeezing surrounding structures. The diagnosis was established after thyroidectomy with histopathologic and immunohistochemical studies. Histology showed infiltrates of chronic lymphocytic thyroiditis in all cases. Three patients had thyroid lymphoma arising from mucosa-associated lymphoid tissue. One patient died postoperatively. The other seven were treated with combined chemotherapy and radiotherapy. They were still in remission after a 6-year follow-up. CONCLUSION Diagnosis of PTL should be suspected when there is a recent thyroid enlargement. Surgery associated with chemotherapy and radiation gave good results in our study with long-term follow-up, though surgery was not always recommended in previous reports.
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Affiliation(s)
- M Paccalin
- Service de médecine interne endocrinologie, CHU La Milétrie, rue de La Milétrie, 86021 Poitiers, France.
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14
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Touchard G, Preud'homme JL, Aucouturier P, Giraud C, Gouet D, Yver L, Patte D. Nephrotic syndrome associated with chronic lymphocytic leukemia: an immunological and pathological study. Clin Nephrol 1989; 31:107-16. [PMID: 2465858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Three patients with B chronic lymphocytic leukemia and the nephrotic syndrome had atypical membranous glomerulonephritis or lobular membranoproliferative glomerulonephritis with subepithelial and subendothelial deposits containing IgG1 kappa, IgG1 lambda or IgM and IgG by immunofluorescence, respectively. A monoclonal cryoglobulin was intermittently found in the serum in one case. In two patients, kidney deposits were made of organized microtubular structures. Intracytoplasmic immunoglobulin inclusions in the two patients' lymphocytes showed a very similar electron microscopic pattern. The immunologic phenotype of leukemic lymphocytes was analogous in the three cases (with expression of CD2) and suggestive of a late maturation step. A complete remission of the nephrotic syndrome was observed after therapy with chlorambucil (and prednisone). These observations suggest a direct role of monoclonal immunoglobulins in kidney disease.
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Affiliation(s)
- G Touchard
- Department of Nephrology, Poitiers University Hospital, CHUR, France
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15
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Preud'homme JL, Gouet D, Alcalay M, Rochard E, Danon F, Touchard G, Aucouturier P. [Diagnostic value of the study of classes of native anti-DNA antibodies using an immuno-enzymatic method]. Rev Rhum Mal Osteoartic 1988; 55:911-4. [PMID: 3060975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- J L Preud'homme
- Laboratoire d'Immunologie et Immunopathologie (CNRS UA 1172), CHU La Milètrie, Poitiers
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16
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Preud'homme JL, Danon F, Rochard E, Gouet D, Touchard G, Aucouturier P, Alcalay M. [Detection of anti-double stranded DNA antibodies of IgG, IgA and IgM classes by ELISA. Comparison with the Farr test and indirect immunofluorescence]. Presse Med 1988; 17:1401-4. [PMID: 2971167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Anti-double stranded DNA antibodies were measured by an immunoglobulin class-specific immunoenzymatic assay (ELISA), in 450 sera from 265 patients as well as by indirect immunofluorescence using Crithidia luciliae as a substrate and, for 124 sera, by the Farr test. ELISA proved specific and reproducible and it yielded results that were well correlated with the Farr assay, with a slightly higher sensitivity of ELISA. Correlation with immunofluorescence was not as good because of the lower sensitivity of the latter method. ELISA enables the levels and isotypes of anti-DNA antibodies to be determined. Both appear to be critical parameters for a clinical interpretation of results, especially with respect to the diagnosis of systemic lupus erythematosus.
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17
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Marechaud R, Boissonnot M, Holderer-Fieuzal S, Gouet D, Boissonnot L. [Idiopathic intracranial hypertension during treatment of Cushing's disease with mitotane]. Presse Med 1987; 16:2131. [PMID: 2963295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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19
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Gouet D, Bataille B, Roblot P, Babin P, Maréchaud R, Sudre Y. [Cushing's disease arrested with dexamethasone: 1 case]. Rev Med Interne 1987; 8:203-5. [PMID: 3589211 DOI: 10.1016/s0248-8663(87)80172-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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20
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Gallimard JF, Poupet JY, Chaix AF, Coisne DC, Allal J, Gouet D, Barraine R. [Atypical echocardiographic aspects of cardiac amylosis]. Ann Cardiol Angeiol (Paris) 1986; 35:377-80. [PMID: 3800280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Echographic abnormalities of cardiac amylosis are now well known and quite useful to the diagnosis. Forms that are morphologically atypical are rare. From three observations (2 hypertrophic, asymmetrical and obstructive forms, and 1 hypertrophic and dilated form) and a review from the literature, we study the nosological, diagnostic and therapeutic problems presented by these atypical echographic of cardiac amylosis.
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21
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Neau JP, Gil R, Marechaud R, Gouet D, Sudre Y, Lefevre JP. [Effects of the artificial pancreas on peripheral nerve function in the diabetic]. Rev Electroencephalogr Neurophysiol Clin 1986; 16:191-6. [PMID: 3764040 DOI: 10.1016/s0370-4475(86)80011-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Twenty-one diabetic subjects were studied; all manifested fasting hyperglycemia and elevated Hb A1C. Motor conduction velocity of the median, ulnar and peroneal nerves; F wave of the peroneal nerve; sensory conduction velocity and sensory potential amplitude of the median and ulnar nerves and H reflex were determinated immediately before and after two days of strict glucose control with an artificial endocrine pancreas. A significant and acute improvement of some electrophysiological parameters led us to presume that repair of structural lesions would be unlikely. Only a metabolic disturbance, due to hyperglycemia, can be rapidly corrected.
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22
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Gouet D, Azaïs I, Maréchaud R, Alcalay M, Barrière H, Bontoux D, Sudre Y. [Prognosis of generalized scleroderma. A retrospective study of 78 cases]. Rev Med Interne 1986; 7:233-41. [PMID: 3764128 DOI: 10.1016/s0248-8663(86)80004-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
From 1960 to 1984, 78 new patients with progressive systemic sclerosis were followed up: 60 women and 18 men whose ages ranged from 20 to 83 years, with a mean age of 58 years. Twenty nine are known to be dead and 3 were lost of follow-up. Forty six have been followed up to the present time for a mean period of 5 years. The cumulative survival rates were 88 +/- 7 p. 100 at one year, 62,5 +/- 11,5 p. 100 at five years and 50,5 +/- 15 p. 100 at ten years. These figures are significantly different from those found in a matched group from the French general population. Nine features at the time of diagnosis which might influence prognosis were studied. Seven factors apparently have not affected prognosis: sex, age, time elapsed between initial symptom and definitive diagnosis, location of scleroderma, blood pressure, erythrocyte sedimentation rate and creatinine clearance. On the other hand, survival declined significantly faster in the 28 patients with anemia than in the 50 patients without anemia (P less than 0,001). Similarly, the 47 patients with radiological pulmonary involvement or pulmonary function abnormalities were at significantly higher risk for death than the 31 patients without interstitial pulmonary fibrosis. Anemia and pulmonary involvement are predictors of mortality and important prognostic tools in the management of the different drugs that have been recommended for the treatment of patients with systemic sclerosis.
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23
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Gouet D, Marechaud R, Aucouturier P, Touchard G, Sudre Y, Preud'homme JL. Atenolol induced systemic lupus erythematosus syndrome. J Rheumatol Suppl 1986; 13:446-7. [PMID: 3723506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We report the first case of an illness resembling idiopathic lupus erythematosus, with fever, pleuropericarditis, antinuclear antibodies and antidenaturated DNA antibodies after 18 months of treatment with atenolol for hypertension. After withdrawal of atenolol our patient's clinical symptoms disappeared and laboratory test results returned to normal, which strongly suggests the role of atenolol in inducing the syndrome, therefore atenolol should be added to the list of beta blocking agents capable of inducing a lupus-like syndrome.
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24
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Gouet D, Maréchaud R, Le Berre D, Alcalay M, Becq-Giraudon B, Boissonnot L, Bontoux D, Gil R, Lefevre JP, Risse JF. [Prognosis of treated temporal arteritis. Retrospective study of 87 cases]. Presse Med 1986; 15:603-6. [PMID: 2939417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Eighty-seven patients (mean age 73 years) with histologically proven Horton's disease were followed up in 5 different specialized hospital units from 1970 to 1984. Except for one patient treated exclusively with antimalarials, all were under corticosteroids. The mean initial dose of prednisone or equivalent was 0.7 mg/kg/day and the mean maintenance dose, 10 mg/day. Steroids could be discontinued in 21 cases after 36 months on average; the other patients could not be weaned, even though 4 of them had been on steroids for more than 10 years. Side-effects were noted in 43 cases. Twenty-four patients died, mostly of cardiovascular diseases. Survival rates were 89 +/- 6.35% at 1 year, 60.2 +/- 8.7% at 5 years and 48 +/- 11.3% at 10 years. In the long run, mortality in our series proved to be exactly the same as in the general population. Nineteen patients had ocular manifestations of giant cell arteritis always from the onset, except for a fall in visual acuity; 26 relapses were observed in 18 patients, either during reduction of steroid dosage (21 cases) or after withdrawal (5 cases). In 2 cases histology showed typical lesions of giant cell arteritis after 41 and 50 months respectively under corticosteroid therapy.
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Gouet D, Saunier B, Touchard G, Marechaud R, Robert R, Aucouturier P, Preud'homme JL, Sudre Y. [Lymphoid interstitial pneumopathy in acquired immunodeficiency syndrome]. Rev Med Interne 1986; 7:74-6. [PMID: 3704397 DOI: 10.1016/s0248-8663(86)80087-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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26
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Aucouturier P, Couderc LJ, Gouet D, Danon F, Gombert J, Matheron S, Saimot AG, Clauvel JP, Preud'homme JL. Serum immunoglobulin G subclass dysbalances in the lymphadenopathy syndrome and acquired immune deficiency syndrome. Clin Exp Immunol 1986; 63:234-40. [PMID: 3955884 PMCID: PMC1577345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Serum IgG subclass levels were measured by an indirect competitive immunoenzymatic assay with monoclonal antibodies in 61 adult patients of different geographic origins affected either with the lymphoadenopathy syndrome (LAS, 46 cases) or with the acquired immune deficiency syndrome (AIDS, 15 cases). In spite of considerable variations from patient to patient, IgG-1 and IgG-3 levels were higher than in normal Caucasians, with IgG-1 levels much more elevated in LAS than in AIDS patients. In Caucasians with AIDS or LAS, IgG-4 levels were low. IgG-2 levels tended to be low and correlated negatively with IgG-1 levels. IgG subclass imbalances were especially striking in patients with lymphoid interstitial pneumonitis. The results suggest that the IgG increase predominantly affects the less T-dependent subclasses. The low levels of the more T-dependent isotypes do not appear to play a clear role in the occurrence of pyogenic infections in certain patients.
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27
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Neau JP, Gil R, Marechaud R, Gouet D, Sudre Y, Lefèvre JP. [Blink reflex and stimulus detection by the facial nerve in 21 diabetics. Testing before and after precise blood sugar normalization by the artificial pancreas]. Acta Neurol Belg 1985; 85:310-7. [PMID: 4072617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Study of the blink reflex and stimulodetection of the facial nerve in 21 diabetics with chronic hyperglycemia (HbA1C: 12.17 +/- 2.34%) shows normal or slightly prolonged R1, R2 and M latent periods in most cases. Forty-eight hour metabolic correction by artificial pancreas produces an overall improvement in the latent periods of the blink reflex, while the motor latent period of the facial nerve remained unchanged. The improvement, also observed in studies of limb responses, points towards a metabolic process directly related to the hyperglycemia.
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28
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Saunier B, Gouet D, Meurice JC, Babin P, Rossi F, Marechaud R, Sudre Y. [Temporal necrotizing angiitis]. Presse Med 1985; 14:1246. [PMID: 2861603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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29
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Gouet D, Alcalay D, Azais I, Alcalay M, Becq-Giraudon B, Sudre Y, Bontoux D. HLA-DR antigens in polymyalgia rheumatica and giant cell arteritis. J Rheumatol 1985; 12:627-8. [PMID: 3862847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Sudre Y, Marechaud R, Rossi F, Abadie JC, Gouet D. [Remission induced at the early stage of insulin-dependent diabetes: do predictive factors exist?]. Rev Med Interne 1984; 5:206-11. [PMID: 6390593 DOI: 10.1016/s0248-8663(84)80055-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The induction of a remission has been attempted in 28 patients with insulin-dependent diabetes of less than 3 months' duration by strictly normalizing glycemia either with a period of external artificial pancreas followed by continuous subcutaneous insulin infusion (22 patients) or with continuous subcutaneous insulin infusion alone (6 patients). HLA A, B and DR antigens were determined in every patient. Residual beta-cell function was evaluated by measuring C peptide and the ratio of C peptide to glycemia, and by testing the response to a glucagon stimulation before initiating and after withdrawing insulin treatment. Oral treatment with 15 mg glibenclamide and 840 mg metformin daily was administered when insulin had been stopped. A remission was obtained in 17 of the 28 cases. The likelihood of a remission was greater if: (1) the patient was older (mean age was 25.6 years in case of success and 16.6 Years in case of failure); (2) initial daily needs for insulin were smaller (0.88 v. 1.23 U/kg); and (3) stimulated secretion of C peptide was larger (0.22 v. 0.11 mmol/l).
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31
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Brégeon C, Gouet D, Hurez D. [A case of multiple myeloma with a 21-year preclinical biological stage]. Rev Med Interne 1984; 5:233-5. [PMID: 6438749 DOI: 10.1016/s0248-8663(84)80061-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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32
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Touchard G, Debiais P, Gouet D, Babin P, Payen J. [Does the direct immunofluorescence examination of superficial temporal artery biopsies have any value? Results of the study of 101 biopsies]. Ann Pathol 1984; 4:115-21. [PMID: 6375688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The lesions in temporal arteritis (TA) are known to be often segmental and the pathologic study of involved temporal arteries may be falsely negative. Several reports suggest that direct immunofluorescence (IF) may be of value in the diagnosis of the disease. We have studied by IF 101 consecutive biopsies from 100 patients investigated during the last two years. Adjacent segments were processed for light and immunofluorescent microscopy. For the latter, tissues were immediately frozen in liquid nitrogen and stored at -- 70 degrees C. Cryostat sections were stained with anti-gamma, alpha, mu, C3, fibrinogen and albumin conjugates. A sister section was also stained with HE for light microscopy. Deposits of Ig and/or C were either granular (intra- or extra-cellular) or linear closely applied to internal elastic lamina. The 100 patients fall into 4 groups: Group I, (19 patients) with diagnosis ascertained upon typical clinical record and clear cut anatomic lesions by light microscopy; Group II (10 patients) with the clinical features of TA and a negative biopsy by light microscopy; Group III (29 patients) in whom the diagnostic criteria of polymyalgia rheumatica were fulfilled according to Forestier and Certonciny; Group IV (42 patients) affected with various diseases unrelated to T.A. (1 with polyarteritis nodosa, 5 with rheumatoid arthritis...). The following results were obtained by IF: in group I, deposits were found in 63% of the patients studied (linear in 11 and granular in 4 cases). They included Ig usually with C3 and fibrinogen. In group II, we observed linear deposits of IgG in one patient and granular C3 deposits in another case.(ABSTRACT TRUNCATED AT 250 WORDS)
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Gouet D, Marechaud R, Neau JP, Abadie JC, Rossi F, Sudre Y. [Chronic atrophic polychondritis. Critical analysis of the therapeutic efficacy of dapsone. 2 cases]. Presse Med 1984; 13:723-6. [PMID: 6231576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Dapsone has been used since 1976 in the treatment of relapsing polychondritis. A critical analysis of its therapeutic effectiveness based on 2 personal cases and 14 cases reported in the literature, all treated with dapsone alone, showed that treatment had to be discontinued in 4 on account of side effects (haemolytic anaemia, erythema multiforme, somnolence, headache, nausea); 1 patient showed no improvement and 5 relapsed; 6 responded favourably and without relapse during a 3 months' to 4 years' follow-up. Considering the unpredictable course of relapsing polychondritis and the fact that some of its clinical manifestations, notably auricular chondritis, may spontaneously resolve, the response of the disease to dapsone is difficult to establish and requires to be confirmed by a controlled clinical trial.
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Gouet D, Anquez M, Risse JF, Becq-Giraudon B. [Association of Vogt-Koyanagi disease, Gougerot-Sjögren syndrome and erythema nodosum]. Presse Med 1984; 13:624. [PMID: 6242511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Gouet D, Rouffineau J, Pouget-Abadie JF, Besson I, Becq-Giraudon B. [Immunoblastic lymphadenopathy occurring during treatment with carbamazepine. 2 cases]. Rev Med Interne 1984; 5:72-4. [PMID: 6718840 DOI: 10.1016/s0248-8663(84)80083-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Dysimmune lymphadenopathies during carbamazepine treatment. A report of two cases. We report on two cases of dysimmune lymphadenopathies with histological aspect of angio immunoblastic lymphadenopathy (AIL) developing after administration of carbamazepine. Clinical manifestations consisted of fever, erythroderma, generalized pruritus, facial edema, lymphadenopathy, liver enlargement. The two patients had anemia, hypogammaglobulinemia, impaired liver function and a negative Coomb's test. Lymphocyte stimulation test with carbamazepine in vitro was positive in both cases. Lymph node biopsy disclosed the angioimmunoblastic proliferation characteristic of AIL. After discontinuing carbamazepine, a complete remission was obtained.
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Becq-Giraudon B, Lemaire M, Gouet D, Crémault A. [Infectious mononucleosis without heterophilic antibodies and with spontaneously reversible acute agranulocytosis]. Rev Med Interne 1983; 4:259-60. [PMID: 6689374 DOI: 10.1016/s0248-8663(83)80024-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Abstract
The authors report the case of a 81 years-old-woman who had simultaneously atypical Cogan's syndrome, cutaneous vasculitis and diverticular sigmoiditis. The relations being between these three diseases are discussed.
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Gouet D, Touchard G, Thomas P, Alcalay M, Bontoux D. [Generalized scleroderma with hepatic and lymph node granulomatosis]. Presse Med 1983; 12:1173. [PMID: 6221290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Gouet D, Marechaud R, Neau JP, Bontoux D, Sudre Y. [Chronic atrophying polychondritis with destructive arthropathy]. Presse Med 1983; 12:1172-3. [PMID: 6221289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Gouet D, Alcalay M, Briaud M, Touchard G, Bontoux D. [Hepatitis induced by pyrithioxine: direct toxicity or idiosyncrasy?]. Rev Rhum Mal Osteoartic 1983; 50:167-168. [PMID: 6857132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Touchard G, Gouet D, Maire P, Briaud M, Becq-Giraudon B, Crémault A, Matuchansky C. [Is Behçet's syndrome really a possible etiology of colitis with epitheliogigantocellular granuloma?]. Gastroenterol Clin Biol 1983; 7:227-8. [PMID: 6840472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Abadie JC, Maréchaud R, Gouet D, Rossi F, Queron B, Sudre Y. [Artificial pancreas and portable insulin pump in incipient insulin-dependent diabetes of the young adult: induced remissions]. Rev Med Interne 1982; 3:313-9. [PMID: 6761816 DOI: 10.1016/s0248-8663(82)80038-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Gouet D, Rouffineau J, Chauvin C, Abadie JC, Ribet M, Becq Giradon B. [Repeated recurrences of hepatic amoebiasis with failure of metronidazole treatment]. Nouv Presse Med 1982; 11:3349. [PMID: 7155835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Gouet D, Marechaud R, Touchard G, Abadie JC, Pourrat O, Sudre Y. [Nephrotic syndrome associated with chronic lymphoid leukemia. Review of the literature apropos of a case]. Nouv Presse Med 1982; 11:3047-9. [PMID: 7145687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A case of chronic lymphoid leukaemia complicated by a nephrotic syndrome is reported. There was no evidence of amyloidosis or renal vein thrombosis. Percutaneous renal biopsy disclosed lobular membranoproliferative glomerulonephritis with subendothelial deposits of IgG, C3, C4 and C1q. Circulating immune complexes, IgG lambda cryoglobulin and low CH50 levels due to activation of the classical pathway were demonstrated in serum. Immunosuppressive treatment of the leukaemia resulted in complete regression of the nephrotic syndrome.
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Cremault A, Gouet D, Lemaire M, Touchard G, Aubert J, Sudre Y, Becq-Giraudon B. [Acute bilateral funiculitis disclosing periarteritis nodosa in an adolescent]. Nouv Presse Med 1982; 11:2850. [PMID: 6129612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Sudre Y, Abadie JC, Marechaud R, Rossi F, Gouet D, Queron B. [Blood sugar control in diabetics with the insulin pump. Comparison with discontinuous injections]. Sem Hop 1982; 58:1801-4. [PMID: 6291163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Eighteen insulin-dependent diabetic patients received insulin in a continuous subcutaneous infusion delivered by a portable pump. Short-term glycemic control was evaluated on the average glycemia (serum glucose was assayed seven times per 24 hours for three to five days), on the MAGE coefficient which gives an estimate of glycemic lability, and, in eight patients, on serum C-peptide concentrations. Results were compared to those recorded with two daily subcutaneous injections of a combination of regular and intermediate insulin. The average glycemia and the MAGE coefficient were 1.32 + 0.05 milligram (m + SEM) and 1 + 0.05 milligram respectively under continuous infusion, compared to 2.05 + 0.12 and 1.76 + 0.12 milligram respectively under insulin injections. Insulin requirements were significantly lower under continuous infusion (0.99 + 0.08 U/kg versus 1.35 + 0.11 U/kg). In three patients with brittle diabetes the use of the pump ensured rapid metabolic control. The advantages and drawbacks of portable insulin pumps are discussed in the light of this experience.
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Sudre Y, Marechaud R, Abadie JC, Rossi F, Gouet D. [Efficacy of aprotinin in insulin resistance caused by subcutaneous degradation of insulin]. Nouv Presse Med 1982; 11:131-2. [PMID: 6173842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Abadie JC, Gouet D, Marechaud R, Becq-Giraudon B, Sudre Y. [Toxic staphylococcal shock syndrome with an extragynecologic entry]. Nouv Presse Med 1981; 10:3793. [PMID: 7322915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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