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Editorial: Insulin glargine and cancer-an unsubstantiated allegation

1 Barbara Davis Center for Childhood Diabetes , Aurora, Colorado.
Diabetes Technology &amp Therapeutics (Impact Factor: 2.29). 08/2009; 11(8):473-6. DOI: 10.1089/dia.2009.1705
Source: PubMed
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    • "This has raised the question of mitogenic potential, which may be resulting from an enhanced affinity towards the IGF-1 receptor or because of the occupancy time of the insulin receptor by the analogue. So far, no reliable data on this has been published [19]. Table 1 summarizes the main characteristics of rapid and long-acting insulin analogues described below. "
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    ABSTRACT: Inadequately controlled diabetes accounts for chronic complications and increases mortality. Its therapeutic management aims in normal HbA1C, prandial and postprandial glucose levels. This review discusses diabetes management focusing on the latest insulin analogues, alternative insulin delivery systems and the artificial pancreas. Intensive insulin therapy with multiple daily injections (MDI) allows better imitation of the physiological rhythm of insulin secretion. Longer-acting, basal insulin analogues provide concomitant improvements in safety, efficacy and variability of glycaemic control, followed by low risks of hypoglycaemia. Continuous subcutaneous insulin infusion (CSII) provides long-term glycaemic control especially in type 1 diabetic patients, while reducing hypoglycaemic episodes and glycaemic variability. Continuous subcutaneous glucose monitoring (CGM) systems provide information on postprandial glucose excursions and nocturnal hypo- and/or hyperglycemias. This information enhances treatment options, provides a useful tool for self-monitoring and allows safer achievement of treatment targets. In the absence of a cure-like pancreas or islets transplants, artificial "closed-loop" systems mimicking the pancreatic activity have been also developed. Individualized treatment plans for insulin initiation and administration mode are critical in achieving target glycaemic levels. Progress in these fields is expected to facilitate and improve the quality of life of diabetic patients.
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    ABSTRACT: An observational study in Germany implicated the specific action of insulin glargine to increase cancer risk; however, this study accumulated a number of methodological errors. There was no confirmation of these results in the three other European studies commissioned by the editor in chief of Diabetologia to validate or to refute the German data. Indeed, more generally, a moderate increase of cancer risk, with the exception of prostate cancer, has been shown in type 2 diabetic patients and in those with abnormal glucose tolerance, mainly digestive sites, independently of obesity. Insulin-resistance with compensatory hyperinsulinemia, and elevated levels of circulating growth factors are usually considered as the link between cancer and hyperglycemia, through activated cell proliferation. Treatments for diabetes that elevate plasma insulin seem to increase cancer risk and, in contrast, insulin-sensitizer drugs for diabetes (metformin, thiazolidinediones) seem to reduce cancer risk.
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    ABSTRACT: We present a perceptual organization based on method for motion stream analysis. The computation model was developed based upon a perception principle: visual feature partitioning and grouping. In the method, perceptual edge features are extracted and classified into generic edge tokens (GETs) using edge tracking and partitioning on the fly. GETs are perceptually distinctive features of lines and curve segments. Various structures and patterns of GETs can be grouped in terms of the rules of perceptual organization laws. GETs are descriptive and therefore can be manipulated qualitatively. For each consecutive image pair, motion GETs (MGETs) are segmented by directly subtracting the GETs extracted in the first image from the same locations in the second image, in that no explicit GET pair matching is needed. The MGETs are then grouped into clusters based on selected rules and domain knowledge of the objects. The motion clusters are evaluated using the measure of motion persistence (over multi-frames) for eliminating unstable data, i.e. noises. Two result demonstrations include road mark following and vehicle tracking.
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