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Hypoglycemia Following Antifungal Tx in Affected person With Kind 1 Diabetes

Micafungin is a member of the echinocandin class of antifungal agents A recent report published in The Journal of Clinical Endocrinology and Metabolis...

Micafungin is a member of the echinocandin class of antifungal agents

Micafungin is a member of the echinocandin class of antifungal agents

A recent report published in The Journal of Clinical Endocrinology and Metabolism, describes the case of a patient with type 1 diabetes mellitus (T1DM) who developed hypoglycemia following antifungal therapy for a severe infection.

The 29-year-old female patient had a long history of uncontrolled T1DM and was diagnosed with cervical necrotizing fasciitis with mediastinal spread after presenting for evaluation of worsening dysphagia and dyspnea. Several debridement surgeries as well as broad spectrum antibiotics and antifungal therapy were required to treat her. At admission, she had an HbA1c of 13.4%; due to worsening infection, continuous tube feeds, and multiple surgeries, her insulin needs subsequently increased.

To provide broader antimicrobial coverage, micafungin, a member of the echinocandin class of antifungal agents, was initiated. After administration of micafungin, the patient’s insulin requirement dropped to 0 for more than 48 hours. Upon discontinuing micafungin and switching to a different antifungal, her insulin needs increased again.

“This is the first report of decreased insulin requirements in a patient with T1DM correlating with micafungin administration,” noted the authors. While the exact mechanism by which micafungin induces hypoglycemia has yet to be established, they hypothesized that the agent reduces blood glucose levels through inhibition of sodium-glucose transporter-1 (SGLT1) function.

Medical trial examines affect of high-dose omega-Three and vitamin D on halting kind 1 diabetes


Scientists from the Diabetes Analysis Institute (DRI) on the College of Miami Miller Faculty of Drugs right now introduced the launch of a brand new scientific trial that may assess the affect of high-dose omega-Three fatty acids and vitamin D supplementation on halting the development of kind 1 diabetes (T1D). The DRI has obtained FDA IND clearance to proceed with the Part I/IIa trial, named the POSEIDON Research (Pilot examine of Omega-Three and Vitamin D Excessive Doses in T1D), to check the consequences of the proposed intervention in youngsters and adults newly recognized and in these with longer-standing T1D to judge any advantage of early and late interventions.

A number of scientific studies have recommended that using high-dose omega-Three and vitamin D, each of which have recognized anti-inflammatory and immunomodulatory properties, could provide a possible useful impact on autoimmune situations, like kind 1 diabetes. DRI researchers hypothesize that the therapy could delay or forestall the illness.

“My impetus for beginning this examine is to find out if modulating irritation and immunity may halt, or at the least delay, the development of kind 1 diabetes. Irritation could also be one of many triggers for autoimmunity that results in the onset of the illness, but in addition has an impact on insulin resistance and, subsequently, islet dysfunction,” mentioned Camillo Ricordi, M.D., examine sponsor and Director of the Diabetes Analysis Institute on the Miller Faculty of Drugs. “Outcomes from our latest case research analyzing the function of omega-Three/vitamin D in preserving beta cell operate in three pediatric topics with kind 1 diabetes warrant additional investigation of this potential therapeutic technique,” continued Dr. Ricordi, referring to his latest findings in collaboration with Italian facilities in Rome and Novara, together with these printed in European Assessment for Medical and Pharmacological Sciences.

The DRI plans to enroll 56 adults and youngsters within the two-arm, open-label examine. The investigators will evaluate youngsters and adults with kind 1 diabetes, each newly recognized and people greater than six months post-diagnosis, who take both vitamin D alone or together with omega-Three fatty acids. The contributors shall be handled for one yr, adopted by a one-year remark interval to measure any long-term impact on blood sugar management, improve in endogenous insulin manufacturing, and different outcomes.

Members shall be randomized to both 25-hydroxyvitamin D (cholecalciferol) alone, or together with ultra-refined omega-Three EPA/DHA derived from fish oil. Though preliminary dosing shall be primarily based on components like age and physique weight, investigators will monitor and modify vitamin D dosing each 4 months. They may even modify the omega-Three fatty acids dosage primarily based on month-to-month monitoring of the ratio of arachidonic acid to eicosapentaenoic acid (AA/EPA).

The next AA/EPA ratio is taken into account detrimental as a result of AA is believed to advertise irritation and reduce the regulatory cells that would defend towards autoimmunity, whereas EPA could be protecting. Extra EPA may enhance different situations the place irritation performs a key function.

“Reversing autoimmunity could possibly be useful effectively past topics with kind 1 diabetes. In actual fact, related methods needs to be examined in different autoimmune illnesses like Crohn’s, rheumatoid arthritis and lupus erythematous,” Dr. Ricordi mentioned.

All contributors will obtain normal diabetes therapy with insulin and dietary management.

“If mixture omega-Three and vitamin D remedy is ready to delay development or halt autoimmunity in kind 1 diabetes, that is anticipated to end in retention of insulin secretion, minimal use of exogenous insulin, and improved metabolic management thus minimizing the dangers related to unstable blood glucose ranges,” Dr. Ricordi mentioned.



Scientific trial finding out sort 1 diabetes reaches full enrollment


A scientific trial finding out sort 1 diabetes has reached full enrollment.

The Sanford Venture: T-Rex Examine, a Section 2 scientific trial performed collaboratively by Sanford Well being and Caladrius Biosciences, Inc., (Caladrius)(Nasdaq: CLBS), has accomplished enrollment of 110 kids with sort 1 diabetes. The examine began with two websites at Sanford Well being in Sioux Falls, South Dakota, and Fargo, North Dakota, and expanded to 13 further websites throughout the US.

The mission is finding out the potential of CLBS03, Caladrius’ cell remedy consisting of every affected person’s personal regulatory T cells, or Tregs, to assist the physique struggle sort 1 diabetes.

Topics can be adopted for 2 years, with the first endpoint of persistence of insulin manufacturing at one yr after remedy. A deliberate, interim evaluation of the primary half of the contributors at six months after remedy is anticipated by the top of the primary quarter.

“I’m thrilled to have reached this vital milestone,” mentioned Kurt Griffin, M.D., Ph.D., director of scientific trials for The Sanford Venture. “It has taken an incredible quantity of labor from a big group to get this far. We nonetheless have one other yr of follow-up earlier than we are able to actually see how this remedy could also be working.”

Griffin and Fargo-based pediatric endocrinologist Luis Casas, M.D., are the examine’s principal investigators at Sanford Well being.

People with sort 1 diabetes expertise a lack of insulin-producing beta cells as their immune system targets these cells inappropriately. Treg cells normally preserve the immune system beneath management, however they’re missing in quantity and exercise in folks with sort 1 diabetes. The Sanford Venture: T-Rex Examine is exploring whether or not increasing the physique’s provide of Treg cells can rebalance the immune system, cease destruction of beta cells and protect insulin manufacturing. Members have been randomized to both of two doses within the remedy arms or to placebo. For these within the remedy teams, the participant’s personal Treg cells have been extracted from the physique, purified, expanded in tradition, and returned to blood circulation. The cell identification and enlargement course of is patented know-how licensed by Caladrius, a cell-therapy growth firm.

The remedy getting used on this trial, CLBS03, has acquired quick monitor designation from the U.S. Meals and Drug Administration (FDA), a primary for any sort 1 diabetes intervention. That designation is reserved for medication or biologics that handle a severe well being situation, like sort 1 diabetes, the place there may be an unmet medical want. This standing permits for extra frequent communication with the FDA and quicker suggestions in regards to the remedy throughout the approval course of. It additionally permits researchers to submit information and experiences on a rolling foundation. CLBS03 additionally has been granted European Medicines Company’s Superior Therapeutic Medicinal Product classification and FDA Orphan Drug designation as a possible new remedy for recent-onset T1D.

The Sanford Venture is a cornerstone initiative at Sanford Well being specializing in discovering a remedy for sort 1 diabetes. The initiative was launched as a part of a $ 400 million present from philanthropist Denny Sanford in 2007.​



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FDA Approves New Type Of Heart Failure Drug


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