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Effects of MK-0941, a Novel Glucokinase Activator, on Glycemic Control in Insulin-Treated Patients With Type 2 Diabetes

OBJECTIVE

To assess the efficacy and safety of MK-0941, a glucokinase activator (GKA), when added to stable-dose insulin glargine in patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS

In this double-blind study, 587 patients taking stable-dose insulin glargine (±metformin ≥1,500 mg/day) were randomized (1:1:1:1:1) to MK-0941 10, 20, 30, or 40 mg or matching placebo t.i.d. before meals (a.c.). This study included an initial 14-week, dose-ranging phase followed by a 40-week treatment phase during which patients were to be uptitrated as tolerated to 40 mg (or placebo) t.i.d. a.c. The primary efficacy end point was change from baseline in A1C at Week 14.

RESULTS

At Week 14, A1C and 2-h postmeal glucose (PMG) improved significantly versus placebo with all MK-0941 doses. Maximal placebo-adjusted least squares mean changes from baseline in A1C (baseline A1C 9.0%) and 2-h PMG were –0.8% and –37 mg/dL (–2 mmol/L), respectively. No significant effects on fasting plasma glucose were observed at any dose versus placebo. By 30 weeks, the initial glycemic responses noted at 14 weeks were not sustained. MK-0941 at one or more doses was associated with significant increases in the incidence of hypoglycemia, triglycerides, systolic blood pressure, and proportion of patients meeting criteria for predefined limits of change for increased diastolic blood pressure.

CONCLUSIONS

In patients receiving stable-dose insulin glargine, the GKA MK-0941 led to improvements in glycemic control that were not sustained. MK-0941 was associated with an increased incidence of hypoglycemia and elevations in triglycerides and blood pressure.




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The Colombian Response to the Venezuelan Migration Crisis: A Dialogue with Colombia’s Migration Czar

Felipe Muñoz, Advisor to the President of Colombia for the Colombian-Venezuelan Border, discusses how Colombia is coping with the influx of Venezuelan migrants, plans for future policy decisions surrounding this migration, and developments in regional and international cooperation.




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Immigration and the U.S.-Mexico Border during the Pandemic: A Conversation with Members of Congress

In this bipartisan discussion, two border-state members of Congress—Rep. Veronica Escobar and Rep. Dan Crenshaw—discuss the response to the coronavirus outbreak, how it is affecting the interconnected border region, and what the future might hold.
 




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Barriers to COVID-19 Testing and Treatment: Immigrants without Health Coverage in the United States

As millions of U.S. workers lose jobs and the health insurance associated with them, Medicaid and similar programs are increasingly important for people seeking COVID-19 testing and treatment. Yet many low-income uninsured noncitizens, including green-card holders, are excluded from such programs because of their immigration status, as this fact sheet explores.




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Thinking with AND: Insights from KIND’s story

“I’m a confused Mexican Jew.” So says Daniel Lubetzky, Founder and CEO of KIND Snack, in his very personal interview with Columbia faculty member David Rogers at BRITE ’16. Their discussion touched on the many ideas behind KIND Snacks, from the beginnings of the company, to the strategic thinking that forces Lubetzky to stay away […]




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Evaluating the Effect of U-500 Insulin Therapy on Glycemic Control in Veterans With Type 2 Diabetes

Joseph A. Granata
Jan 1, 2015; 33:14-19
Feature Articles




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Diabetes and Back Pain: Markers of Diabetes Disease Progression Are Associated With Chronic Back Pain

Lorenzo Rinaldo
Jul 1, 2017; 35:126-131
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Diapression: An Integrated Model for Understanding the Experience of Individuals With Co-Occurring Diabetes and Depression

Paul Ciechanowski
Apr 1, 2011; 29:43-49
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Diabetes Management Issues for Patients With Chronic Kidney Disease

Kerri L. Cavanaugh
Jul 1, 2007; 25:90-97
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Health Care Transition in Adolescents and Young Adults With Diabetes

Michael E. Bowen
Jun 1, 2010; 28:99-106
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Stigma in People With Type 1 or Type 2 Diabetes

Nancy F. Liu
Jan 1, 2017; 35:27-34
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Amylin Replacement With Pramlintide in Type 1 and Type 2 Diabetes: A Physiological Approach to Overcome Barriers With Insulin Therapy

John B. Buse
Jul 1, 2002; 20:
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Review Article – Within a single lifetime: Recent writings on autism

AHP readers will be interested in a review article now available online from History of the Human Sciences “Within a single lifetime: Recent writings on autism.” Written by Gregory Hollin the piece reviews five recent books on autism.




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4 Ways Therapists Assist People with Mental Health Issues

One of the primary reasons people seek therapy is to get help with mental health issues. Some of the more common mental disorders affecting individuals today include depression, anxiety, post traumatic stress (PTSD), phobias, addiction, and attention deficit hyperactivity (ADHD). Depending on the type and intensity of your issue, your therapist may adjust his treatment […]




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Without farmers, you'd be hungry, naked and sober | Eric Sannerud

Farmers keep us fed and our economies stable, but in the US they're retiring faster than they're being replaced. Take a crash course in agricultural policy with Eric Sannerud to see why this problem can't be solved by simply buying from your local farmer's market -- and learn how you can use your vote to create a better future for farmers.




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How repaying loans with social service transforms communities | Angie Murimirwa

What if you could repay loans through volunteering and mentorship instead of money? Activist Angie Murimirwa shares how a game-changing economic tool known as "social interest" is reinvigorating sub-Saharan communities once trapped in cycles of poverty. Join her as she explains how this approach to lending is creating opportunities for thousands of African women and girls -- and shows why this model can be replicated anywhere with lasting effects.




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How we can navigate the coronavirus pandemic with courage and hope | Rabbi Lord Jonathan Sacks

Rabbi Lord Jonathan Sacks offers thoughts on how we can navigate the coronavirus pandemic with courage, hope and empathy. With wisdom and clarity, he speaks on leadership, fear, death, hope and how we could use this moment to build a more just world. Watch for a special, impromptu prayer about halfway through the conversation. (This virtual conversation is part of the TED Connects series, hosted by head of TED Chris Anderson and head of curation Helen Walters. Recorded March 30, 2020)




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Teenagers Who Believe They Are Particularly Intelligent Tend To Be More Narcissistic And Happier With Life

By Emily Reynolds. But self-assessed intelligence was not actually related to objective measures of intelligence




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How Do Films Like ‘Joker’ Shape Attitudes Towards People With Mental Health Issues?

By Emily Reynolds. Study finds viewers had slightly more negative perceptions of people with mental illness after seeing the movie.




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Hidden Segregation Within Schools Is Tracked in New Study

When schools reduce racial segregation between schools, racial isolation within the classes inside those schools goes up, according to an analysis of 20 years of North Carolina data.




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W. Virginia teachers hold car parade with students, families




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Teachers Without Internet Work in Parking Lots, Empty School Buildings During COVID-19

While most teachers have online access at home, internet service for many educators in rural areas is spotty, expensive, or nonexistent.




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LeBron James to honor Class of 2020 with all-star event




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Raimondo tells schoolkids: I'll help you cope with isolation




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Daily videos help teachers stay in touch with students




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With camps shut, families face summer in the great indoors




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How to Teach Math to Students With Disabilities, English Language Learners

Experts recommend emphasizing language skills, avoiding assumptions about ability based on broad student labels, and focusing on students’ strengths rather than their weaknesses.




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Official: Schools should be flexible with start dates




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Oregon schools to furlough teachers, boost pay with stimulus




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Budget Cuts Lead Wyoming to Scale Back Relationship With Accrediting Agency

AdvancED, the national accreditation company, has for the last two years operated Wyoming's entire accreditation process but the state will now do the work on its own.




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Assistant Principal Removed After Writing Book With White Nationalist Symbol

The assistant principal wrote a children's book featuring Pepe the Frog, a cartoon character that has been adopted by the alt-right.




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Some States Without NCLB Waivers Say They Dodged a Bullet

Not having to negotiate with federal officials on the finer points of teacher evaluation, rigorous standards, or school turnarounds has made it easier to chart their own paths, some education leaders say.




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North Dakota Districts to Switch to Four-Day Week

Two rural North Dakota school districts will switch to a four-day school week to save costs and improve student and teacher morale.




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Teachers Without Internet Work in Parking Lots, Empty School Buildings During COVID-19

While most teachers have online access at home, internet service for many educators in rural areas is spotty, expensive, or nonexistent.




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Yonkers, N.Y., District Commits to More Inclusion of Students with Disabilities

The U.S. Department of Education's office for civil rights said that some students were placed in self-contained special education settings without an individualized justification for doing so.




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New York Leap-Frogs ESSA With Its Own Financial Transparency Rule

New York will require some districts next year to have their school-by-school spending amounts approved by the state, an effort to assure that state funds are being distributed as intended.




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New York Denied ESSA Waiver to Test Students With Disabilities Off Grade Level

The state will be required to test all students using grade level tests, except for those with significant cognitive disabilities.




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Teachers Without Internet Work in Parking Lots, Empty School Buildings During COVID-19

While most teachers have online access at home, internet service for many educators in rural areas is spotty, expensive, or nonexistent.




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LeBron James to honor Class of 2020 with all-star event




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Raimondo tells schoolkids: I'll help you cope with isolation




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Daily videos help teachers stay in touch with students




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With camps shut, families face summer in the great indoors




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How to Teach Math to Students With Disabilities, English Language Learners

Experts recommend emphasizing language skills, avoiding assumptions about ability based on broad student labels, and focusing on students’ strengths rather than their weaknesses.




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Official: Schools should be flexible with start dates




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Oregon schools to furlough teachers, boost pay with stimulus




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W. Virginia teachers hold car parade with students, families




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With a Schools Superintendent Running the State, What Lies Ahead for Wisconsin?

After years of shepherding the state’s K-12 system, Democrat Tony Evers will be called on to make good as governor on his pledge of more funding for K-12.




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With no school, calls drop but child abuse hasn't amid virus




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Newark Group Presses on With Schools Boycott

Parents Unified for Local School Education New Jersey is calling for community-driven schools and opposes the One Newark reorganization plan.




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With Waiver Denial, Utah Mulls Second Accountability System

Utah is one of four states where state laws conflict with components of the federal Every Student Succeeds Act meaning districts may have to answer to two separate accountability systems this fall.