Lessons on developing a better basal insulin.
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Clinical Trials as Topic↗
Biomedical subjects
Andrew Ahmann
Publications and source records attributed to Andrew Ahmann.
Effects of a low-fat diet compared with those of a high-monounsaturated fat diet on body weight, plasma lipids and lipoproteins, and glycemic control in type 2 diabetes.
BACKGROUND: An important therapeutic goal for patients with type 2 diabetes is weight loss, which improves metabolic abnormalities. Ad libitum low-fat diets cause weight loss in nondiabetic populations. Compared with diets higher in monounsaturated fat, however, eucaloric low-fat diets may increase plasma triacylglycerol concentrations and worsen glycemic control in persons with type 2 diabetes. OBJECTIVE: We investigated whether, in type 2 diabetes patients, an ad libitum low-fat diet would cause greater weight loss than would a high-monounsaturated fat diet and would do this without increasing plasma triacylglycerol concentrations or worsening glycemic control. DESIGN: Eleven patients with type 2 diabetes were randomly assigned to receive an ad libitum low-fat, high-carbohydrate diet or a high-monounsaturated fat diet, each for 6 wk. The diets offered contained 125% of the estimated energy requirement to allow self-selection of food quantity. The response variables were body weight; fasting plasma lipid, lipoprotein, glucose, glycated hemoglobin A(1c), and fructosamine concentrations; insulin sensitivity; and glucose disposal. RESULTS: Body weight decreased significantly (1.53 kg; P < 0.001) only with the low-fat diet. Plasma total, LDL-, and HDL-cholesterol concentrations tended to decrease during both diets. There were no interaction effects between diet and the lipid profile response over time. Plasma triacylglycerol concentrations, glycemic control, and insulin sensitivity did not differ significantly between the 2 diets. CONCLUSION: Contrary to expectations, the ad libitum, low-fat, high-fiber diet promoted weight loss in patients with type 2 diabetes without causing unfavorable alterations in plasma lipids or glycemic control.
Blood Glucose↗
Management of diabetes and hyperglycemia in hospitals.
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Diabetes Mellitus↗
Reduction of hospital costs and length of stay by good control of blood glucose levels.
OBJECTIVE: To discuss the available literature regarding the potential benefits of improving blood glucose control in hospitalized patients. RESULTS: Subjects with diabetes constitute an increasing proportion of hospitalized patients. Hospital costs attributable to diabetes are in excess of $40 billion annually in the United States. Numerous reports have confirmed a correlation between blood glucose control at the time of hospitalization and adverse inpatient outcomes for various admission diagnoses, in some cases with or without a previous diagnosis of diabetes. Several studies have specifically found a relationship between improved inpatient control of blood glucose levels and decreased hospital length of stay. Likewise, cost savings have been proposed for intensive inpatient glucose management for a few critical admission diagnoses. Although the apparent economic advantage of aggressive control of blood glucose levels is substantial, cost-effectiveness analyses have been few and limited in scope. CONCLUSION: Improved blood glucose control in the hospital setting appears to reduce the duration of hospital stay and the hospital costs. Comprehensive analyses of cost-effectiveness through prospective, randomized intervention trials are needed, however, to characterize these benefits more precisely.
Blood Glucose↗