000			04558nam a22006497a 4500
008			160113s20142014 xxu||||| |||| 00| 0 eng d
022			_a0149-5992
040			_aOvid MEDLINE(R)
099			_a24898300
245			_aAdvancing basal insulin replacement in type 2 diabetes inadequately controlled with insulin glargine plus oral agents: a comparison of adding albiglutide, a weekly GLP-1 receptor agonist, versus thrice-daily prandial insulin lispro. []
251			_aDiabetes Care. 37(8):2317-25, 2014 Aug.
252			_aDiabetes Care. 37(8):2317-25, 2014 Aug.
253			_aDiabetes care
260			_c2014
260			_fFY2015
266			_d2016-01-13
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520			_aCONCLUSIONS: Weekly albiglutide is a simpler therapeutic option than thrice-daily lispro for advancing basal insulin glargine therapy, resulting in comparable HbA1c reduction with weight loss and lower hypoglycemia risk.Copyright � 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
520			_aOBJECTIVE: GLP-1 receptor agonists may provide an alternative to prandial insulin for advancing basal insulin therapy. Harmony 6 was a randomized, open-label, active-controlled trial testing once-weekly albiglutide vs. thrice-daily prandial insulin lispro as an add-on to titrated once-daily insulin glargine.
520			_aRESEARCH DESIGN AND METHODS: Patients taking basal insulin (with or without oral agents) with HbA1c 7-10.5% (53-91 mmol/mol) entered a glargine standardization period, followed by randomization to albiglutide, 30 mg weekly (n = 282), subsequently uptitrated to 50 mg, if necessary, or thrice-daily prandial lispro (n = 281) while continuing metformin and/or pioglitazone. Glargine was titrated to fasting plasma glucose of <5.6 mmol/L, and lispro was adjusted based on glucose monitoring. The primary end point was the difference in the HbA1c change from baseline at week 26.
520			_aRESULTS: At week 26, HbA1c decreased from baseline by -0.82 +/- SE 0.06% (9.0 mmol/mol) with albiglutide and -0.66 +/- 0.06% (7.2 mmol/mol) with lispro; treatment difference, -0.16% (95% CI -0.32 to 0.00; 1.8 mmol/mol; P < 0.0001), meeting the noninferiority end point (margin, 0.4%). Weight decreased with albiglutide but increased with lispro (-0.73 +/- 0.19 kg vs. +0.81 +/- 0.19 kg). The mean glargine dose increased from 47 to 53 IU (albiglutide) and from 44 to 51 IU (lispro). Adverse events for albiglutide versus lispro included severe hypoglycemia (0 vs. 2 events), documented symptomatic hypoglycemia (15.8% vs. 29.9%), nausea (11.2% vs. 1.4%), vomiting (6.7% vs. 1.4%), and injection site reactions (9.5% vs. 5.3%).
650			_a*Diabetes Mellitus, Type 2/dt [Drug Therapy]
650			_a*Glucagon-Like Peptide 1/aa [Analogs & Derivatives]
650			_a*Hypoglycemic Agents/ad [Administration & Dosage]
650			_a*Insulin Lispro/ad [Administration & Dosage]
650			_a*Insulin, Long-Acting/ad [Administration & Dosage]
650			_a*Insulin/ad [Administration & Dosage]
650			_aAdministration, Oral
650			_aAdult
650			_aAged
650			_aBlood Glucose/de [Drug Effects]
650			_aDiabetes Mellitus, Type 2/me [Metabolism]
650			_aDrug Administration Schedule
650			_aDrug Substitution
650			_aDrug Therapy, Combination
650			_aFemale
650			_aGlucagon-Like Peptide 1/ad [Administration & Dosage]
650			_aHemoglobin A, Glycosylated/an [Analysis]
650			_aHumans
650			_aMale
650			_aMeals
650			_aMetformin/ad [Administration & Dosage]
650			_aMiddle Aged
650			_aReceptors, Glucagon/ag [Agonists]
650			_aThiazolidinediones/ad [Administration & Dosage]
650			_aTreatment Outcome
651			_aMedStar Health Research Institute
657			_aClinical Trial, Phase III
657			_aJournal Article
657			_aMulticenter Study
657			_aRandomized Controlled Trial
657			_aResearch Support, Non-U.S. Gov't
700			_aRatner, Robert E
790			_aAhren B, Chow FC, Fonseca VA, Gross JL, Harmony 6 Study Group, Johnson SL, Leiter LA, Miller D, Ratner RE, Rosenstock J, Stewart MW, Yang F
856			_uhttp://dx.doi.org/10.2337/dc14-0001 _zhttp://dx.doi.org/10.2337/dc14-0001
942			_cART _dArticle
999			_c1209 _d1209