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Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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. This can be disadvantageous as most patients and healthcare professionals are not experienced in filtering this information. To ensure the dissemination of peer-reviewed, evidence-based medicine on YouTube®, Concise Medical Information Cines (CoMICs
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the widespread use of insulin sliding scales, a reactive approach to management, waiting for hyperglycemia to occur to correct it ( 1 , 2 ). As new evidence became available, the optimal management of hyperglycemia in the hospital evolved. The
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Xiamen Key Laboratory for Clinical Efficacy and Evidence-Based Research of Traditional Chinese Medicine, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
Fujian Province Key Laboratory of Diabetes Translational Medicine, The First Affiliated Hospital of Xiamen University, School of medicine, Xiamen University, Xiamen, China
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Database (SHLD) to provide new real-world evidence for the management and therapy of T2DM. Methods Data source Data in this study were extracted from SHLD, which included electronic health records (EHRs) for patients from 37 tertiary hospitals
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Department of Medicine, Copenhagen University Hospital – Amager and Hvidovre, Hvidovre, Denmark
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Imperial College Healthcare NHS Trust, St Mary’s Hospital, London, UK
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events. As a result of this clinical evidence, bariatric surgery is more often considered as an option for the treatment of obesity and diabetes, as well as for other metabolic complications such as non-alcoholic fatty liver disease ( 1 ). Given the
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Cambridge University Hospitals NHS Foundation Trust, Wolfson Diabetes and Endocrine Clinic, Cambridge, UK
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such as Fiasp (Novo Nordisk) and Lyumjev (Eli Lilly) are now available. While these have only shown small overall benefits over standard insulin analogues when applied in HCL systems ( 68 , 69 ), there is evidence of reduced postprandial hyperglycaemia
Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China
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Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China
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Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China
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Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China
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Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China
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prospective studies showed that COPD appeared to be an important risk factor for the development of type 2 diabetes mellitus (T2DM) after adjusting for possible confounders ( 2 , 30 , 31 ). Recent evidence suggests that hyperglycemia could exacerbate the
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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because it is structurally modified ( 20 , 21 ). In addition to activating the insulin receptor cascade response, long-acting insulin analogs can also affect the IGF-1 receptor cascade response ( 22 ). And there is evidence from Alvaro’s study that IGF-1
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-line therapies worldwide ( 24 , 67 ). A study ( 70 ) ( n = 29 patients with T2DM) with gliclazide reported no change in SUA levels. Similar results have been reported in another study ( 71 ). At present, the mechanism is unclear, and there is no evidence
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Insulin administration remains vital to the treatment of diabetes and although there have been advances in insulin delivery, evidence suggests that many people with diabetes on insulin therapy have suboptimal glycemic management. Recent advancements in insulin administration techniques include connected insulin devices, such as connected insulin pens and pen caps. In this review, we provide an overview of the literature on the use of connected insulin pens and pen caps to further elucidate the clinical benefits and drawbacks of these devices. We discuss the development of these devices, outlining the characteristics of insulin pens and pen caps with regulatory approvals. These devices have different features that can ease the burden of diabetes management, including automatic recording of insulin dose information, tracking of insulin-on-board, bolus calculators, and missed dose alerts. Despite the advantages of connected pens and pen caps, a small percentage of insulin users are currently using these devices, due to many factors, including lack of health-care professional awareness, initial training for prescribers, and setup of the device. Overcoming these barriers and publishing more data demonstrating the glycemic outcomes associated with these systems could improve diabetes management for people living with diabetes. As health-care systems become increasingly digital, connected insulin pens have the potential to allow a data-driven approach to diabetes management for people who are not interested in, cannot afford, or do not have intensive insulin regimens that might warrant use of insulin pumps or automated insulin delivery systems.
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supplementations. In addition, the estimates of the effect of ALA supplementation, including the certainty of the evidence for each estimate and the magnitude of the observed impact based on the minimal clinically important difference (MCID), have not been