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Title of Journal: Diabetologia

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Abbravation: Diabetologia

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Springer Berlin Heidelberg

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DOI

10.1007/s10529-007-9587-z

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1432-0428

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Benefit of adjunct corticosteroids for communitya

Authors: Milica Popovic Claudine A Blum Nicole Nigro Beat Mueller Philipp Schuetz Mirjam ChristCrain
Publish Date: 2016/09/10
Volume: 59, Issue: 12, Pages: 2552-2560
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Abstract

We have recently shown that adjunct prednisone shortens the time taken to reach clinical stability time to clinical stability TTCS in patients with communityacquired pneumonia CAP Considering the hyperglycaemic effects of prednisone there are concerns about the efficacy and safety of this therapy for diabetic patients with CAP Our objective was to evaluate whether diabetes and/or hyperglycaemia on admission to hospital has an influence on the effect of corticosteroids on outcome in a welldefined cohort of patients with CAPThis is a preplanned subanalysis of a prospective randomised doubleblind placebocontrolled multicentre trial Patients aged 18 years or older with CAP were eligible and were recruited from seven tertiary care hospitals in Switzerland within 24 h of presentation Patients were randomised 11 ratio to receive either 50 mg of prednisone daily for 7 days or placebo Allocation was concealed with a prespecified computergenerated randomisation list Patients treating physicians investigators and data assessors were masked to treatment allocation The primary endpoint was TTCS secondary endpoints were length of stay mortality duration of antibiotic treatment CAP complications and new insulin requirement at day 30 Furthermore we analysed whether these endpoints were influenced by a glycaemic dysregulation during the study timeOf 802 patients randomised n = 402 in the prednisone n = 400 in the placebo group 726 patients were treated per protocol and included in this analysis n = 362 in the prednisone n = 364 in the placebo group Nineteen per cent of 726 patients had diabetes mellitus n = 66 in the prednisone group n = 72 in the placebo group Adjunct prednisone shortened TTCS in diabetic and nondiabetic patients HR 165 95 CI 116 235 p = 0007 130 95 CI 110 153 p = 0002 with no evidence for effect modification by diabetes in interaction analysis p = 044 No difference was found in other clinically relevant endpoints Although adjunct prednisone was associated with glycaemic dysregulation this did not translate into worse clinical outcomes in either group and there was no difference in secondary endpoints

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  1. Oral probiotic administration induces interleukin-10 production and prevents spontaneous autoimmune diabetes in the non-obese diabetic mouse
  2. Glycated albumin but not HbA 1c reflects glycaemic control in patients with neonatal diabetes mellitus
  3. Comparison of high-fat and high-protein diets with a high-carbohydrate diet in insulin-resistant obese women
  4. Lack of association between gene variants in the ALMS1 gene and Type 2 diabetes mellitus
  5. Lack of association between gene variants in the ALMS1 gene and Type 2 diabetes mellitus
  6. Low-density-lipoprotein cholesterol concentrations and risk of incident diabetes: epidemiological and genetic insights from the Framingham Heart Study
  7. AMPK phosphorylation of ACC2 is required for skeletal muscle fatty acid oxidation and insulin sensitivity in mice
  8. Effects of fenofibrate on renal function in patients with type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study
  9. Angiotensin-I converting enzyme insertion/deletion polymorphism and its association with diabetic nephropathy: a meta-analysis of studies reported between 1994 and 2004 and comprising 14,727 subjects
  10. Microarray analysis of genes with impaired insulin regulation in the skeletal muscle of type 2 diabetic patients indicates the involvement of basic helix-loop-helix domain-containing, class B, 2 protein (BHLHB2)
  11. Amino acids require glucose to enhance, through phosphoinositide-dependent protein kinase 1, the insulin-activated protein kinase B cascade in insulin-resistant rat adipocytes
  12. Prevalence and 25 year incidence of proliferative retinopathy among Danish type 1 diabetic patients
  13. Prevalence and 25 year incidence of proliferative retinopathy among Danish type 1 diabetic patients
  14. Retinol-binding protein 4 is associated with components of the metabolic syndrome, but not with insulin resistance, in men with type 2 diabetes or coronary artery disease
  15. Effects of exenatide on circulating glucose, insulin, glucagon, cortisol and catecholamines in healthy volunteers during exercise
  16. Genome-wide scans for heritability of fasting serum insulin and glucose concentrations in hypertensive families
  17. Mouse hypothalamic GT1-7 cells demonstrate AMPK-dependent intrinsic glucose-sensing behaviour
  18. Polymorphisms in the gene encoding adiponectin receptor 1 are associated with insulin resistance and high liver fat
  19. Delta cell death in the islet of Langerhans and the progression from normal glucose tolerance to type 2 diabetes in non-human primates (baboon, Papio hamadryas )
  20. Metabolic and hormonal response to intermittent high-intensity and continuous moderate intensity exercise in individuals with type 1 diabetes: a randomised crossover study
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  22. Induction of the chemokine interferon-γ-inducible protein-10 in human pancreatic islets during enterovirus infection
  23. Increased tissue kallikrein levels in type 2 diabetes
  24. Glucose tolerance and insulin resistance in Indian children: relationship to infant feeding pattern
  25. The response of serum glucose, free fatty acid and immunoreactive insulin to oral glucose and intravenous tolbutamide in normal, potentially diabetic and diabetic subjects
  26. An RBP4 promoter polymorphism increases risk of type 2 diabetes
  27. Müller glial dysfunction during diabetic retinopathy in rats is linked to accumulation of advanced glycation end-products and advanced lipoxidation end-products
  28. WNT/β-catenin increases the production of incretins by entero-endocrine cells
  29. Enhanced susceptibility of Cpt1c knockout mice to glucose intolerance induced by a high-fat diet involves elevated hepatic gluconeogenesis and decreased skeletal muscle glucose uptake
  30. Is rs34861192 or rs1862513 a more promising variant for determining plasma resistin in an aged Japanese population?
  31. Environmental pollutants and type 2 diabetes: a review of mechanisms that can disrupt beta cell function
  32. Reply to comment on: Høi-Hansen T, Pedersen-Bjergaard U, Thorsteinsson B (2005) The Somogyi phenomenon revisited using continuous glucose monitoring in daily life. Diabetologia 48:2437–2438
  33. The prevalence of insulin autoantibodies at the onset of Type 1 diabetes is higher in males than females during adolescence
  34. Anaemia in diabetes: is there a rationale to TREAT?
  35. —to: Hales CN, Ozanne SE (2003) For Debate: Fetal and early postnatal growth restriction lead to diabetes, the metabolic syndrome and renal failure. Diabetologia 46:1013–1019
  36. Causal interpretation requires appropriate study design. Reply to Priest PC [letter]
  37. Is type 2 diabetes an amyloidosis and does it really matter (to patients)?
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  41. A newly identified mutation in an IPF1 binding site of the insulin gene promoter may predispose to type 2 diabetes mellitus
  42. Silencing of miR-195 reduces diabetic cardiomyopathy in C57BL/6 mice
  43. Characterisation of subjects with early abnormalities of glucose tolerance in the Stockholm Diabetes Prevention Programme: the impact of sex and type 2 diabetes heredity
  44. Adenovirus-mediated overexpression of Tcfe3 ameliorates hyperglycaemia in a mouse model of diabetes by upregulating glucokinase in the liver
  45. Type 2 diabetes mellitus is associated with an imbalance in circulating endothelial and smooth muscle progenitor cell numbers
  46. Pancreatic safety of GLP-1-based therapeutic agents: further insights from rodent studies?
  47. A longitudinal study of iron status during pregnancy and the risk of gestational diabetes: findings from a prospective, multiracial cohort
  48. Progression of diabetic retinopathy during pregnancy in women with type 2 diabetes
  49. Redox state-dependent and sorbitol accumulation-independent diabetic albuminuria in mice with transgene-derived human aldose reductase and sorbitol dehydrogenase deficiency
  50. Harry Keen, 1925–2013
  51. Interaction between prenatal growth and high-risk genotypes in the development of type 2 diabetes
  52. Loss of BMP receptor type 1A in murine adipose tissue attenuates age-related onset of insulin resistance
  53. R. Tattersall. Diabetes: the biography. Oxford University Press, Oxford, 2009
  54. The role of hyperinsulinema and the vagus nerve in hypothalamic hyperphagia reexamined
  55. Relationship between ulcer healing after hyperbaric oxygen therapy and transcutaneous oximetry, toe blood pressure and ankle–brachial index in patients with diabetes and chronic foot ulcers
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  57. Comment on: Nathan DM, Buse JB, Davidson MB et al. (2006) Management of hyperglycaemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia 49: 1711–1721
  58. Early life treatment with vancomycin propagates Akkermansia muciniphila and reduces diabetes incidence in the NOD mouse
  59. Effect of thalidomide and rosiglitazone on the prevention of diabetic retinopathy in streptozotocin-induced diabetic rats
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  61. The BioBreeding rat diabetes model is infected with Ljungan virus
  62. Low TCR signal strength induces combined expansion of Th2 and regulatory T cell populations that protect mice from the development of type 1 diabetes
  63. Maternal overweight and obesity and risk of pre-eclampsia in women with type 1 diabetes or type 2 diabetes
  64. Expression of the enteroviral capsid protein VP1 in the islet cells of patients with type 1 diabetes is associated with induction of protein kinase R and downregulation of Mcl-1
  65. Expression of the enteroviral capsid protein VP1 in the islet cells of patients with type 1 diabetes is associated with induction of protein kinase R and downregulation of Mcl-1
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  67. Relationship between glycated haemoglobin and microvascular complications: Is there a natural cut-off point for the diagnosis of diabetes?
  68. N-terminal pro-brain natriuretic peptide and risk of cardiovascular events in older patients with type 2 diabetes: the Edinburgh Type 2 Diabetes Study
  69. Impact of cancer on use of glucose-lowering drug treatment in individuals with diabetes: potential mechanisms. Reply to Pouwer F [letter]
  70. Presence of sulphatide (3′-sulphogalactosylceramide) in pericytes in the choroid layer of the eye: sharing of this glycolipid autoantigen with islets of Langerhans
  71. Age-related insulin resistance in hypothalamus and peripheral tissues of orexin knockout mice
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  85. Comment on: Nathan DM, Buse JB, Davidson MB et al (2006) Management of hyperglycaemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia 49:1711–1721
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  94. Reply to Comment on: Weets I, Kaufman L, Van der Auwera B et al. (2004) Seasonality in clinical onset of Type 1 diabetes in Belgian patients above the age of 10 is restricted to HLA DQ2/DQ8 -negative males, which explains the male to female excess in incidence. Diabetologia 47:614–621
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