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Effects of Novel Dual GIP and GLP-1 Receptor Agonist Tirzepatide on Biomarkers of Nonalcoholic Steatohepatitis in Patients With Type 2 Diabetes

OBJECTIVE

To determine the effect of tirzepatide, a dual agonist of glucose-dependent insulinotropic polypeptide and glucagon-like peptide 1 receptors, on biomarkers of nonalcoholic steatohepatitis (NASH) and fibrosis in patients with type 2 diabetes mellitus (T2DM).

RESEARCH DESIGN AND METHODS

Patients with T2DM received either once weekly tirzepatide (1, 5, 10, or 15 mg), dulaglutide (1.5 mg), or placebo for 26 weeks. Changes from baseline in alanine aminotransferase (ALT), aspartate aminotransferase (AST), keratin-18 (K-18), procollagen III (Pro-C3), and adiponectin were analyzed in a modified intention-to-treat population.

RESULTS

Significant (P < 0.05) reductions from baseline in ALT (all groups), AST (all groups except tirzepatide 10 mg), K-18 (tirzepatide 5, 10, 15 mg), and Pro-C3 (tirzepatide 15 mg) were observed at 26 weeks. Decreases with tirzepatide were significant compared with placebo for K-18 (10 mg) and Pro-C3 (15 mg) and with dulaglutide for ALT (10, 15 mg). Adiponectin significantly increased from baseline with tirzepatide compared with placebo (10, 15 mg).

CONCLUSIONS

In post hoc analyses, higher tirzepatide doses significantly decreased NASH-related biomarkers and increased adiponectin in patients with T2DM.




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A Randomized Controlled Trial Comparing Glargine U300 and Glargine U100 for the Inpatient Management of Medicine and Surgery Patients With Type 2 Diabetes: Glargine U300 Hospital Trial

OBJECTIVE

The role of U300 glargine insulin for the inpatient management of type 2 diabetes (T2D) has not been determined. We compared the safety and efficacy of glargine U300 versus glargine U100 in noncritically ill patients with T2D.

RESEARCH DESIGN AND METHODS

This prospective, open-label, randomized clinical trial included 176 patients with poorly controlled T2D (admission blood glucose [BG] 228 ± 82 mg/dL and HbA1c 9.5 ± 2.2%), treated with oral agents or insulin before admission. Patients were treated with a basal-bolus regimen with glargine U300 (n = 92) or glargine U100 (n = 84) and glulisine before meals. We adjusted insulin daily to a target BG of 70–180 mg/dL. The primary end point was noninferiority in the mean difference in daily BG between groups. The major safety outcome was the occurrence of hypoglycemia.

RESULTS

There were no differences between glargine U300 and U100 in mean daily BG (186 ± 40 vs. 184 ± 46 mg/dL, P = 0.62), percentage of readings within target BG of 70–180 mg/dL (50 ± 27% vs. 55 ± 29%, P = 0.3), length of stay (median [IQR] 6.0 [4.0, 8.0] vs. 4.0 [3.0, 7.0] days, P = 0.06), hospital complications (6.5% vs. 11%, P = 0.42), or insulin total daily dose (0.43 ± 0.21 vs. 0.42 ± 0.20 units/kg/day, P = 0.74). There were no differences in the proportion of patients with BG <70 mg/dL (8.7% vs. 9.5%, P > 0.99), but glargine U300 resulted in significantly lower rates of clinically significant hypoglycemia (<54 mg/dL) compared with glargine U100 (0% vs. 6.0%, P = 0.023).

CONCLUSIONS

Hospital treatment with glargine U300 resulted in similar glycemic control compared with glargine U100 and may be associated with a lower incidence of clinically significant hypoglycemia.




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Protecting the DREAM: The Potential Impact of Different Legislative Scenarios for Unauthorized Youth

With the Trump administration having announced the end of the DACA program, Congress is facing growing calls to protect unauthorized immigrants who came to the U.S. as children. This fact sheet examines DREAM Act bills introduced in Congress as of mid-2017, offering estimates of who might earn conditional legal status—and ultimately legal permanent residence—based on educational, professional, and other requirements in the legislation.




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Differing DREAMs: Estimating the Unauthorized Populations That Could Benefit under Different Legalization Bills

2017 saw the introduction of several bills—two of them by Senate Republicans in the weeks following the Trump administration’s announcement that it would terminate the Deferred Action for Childhood Arrivals (DACA) program—that would provide a pathway to conditional and then legal permanent residence to unauthorized immigrants brought to the United States as children, if they meet a range of educational, professional, and other criteria.




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Settling In: A Profile of the Unauthorized Immigrant Population in the United States

This fact sheet and accompanying interactive data tools provide characteristics of the estimated 11.3 million unauthorized immigrants in the United States, using a unique MPI methodology that assigns legal status to U.S. Census Bureau data. The fact sheet and tools offer statistics on these immigrants’ origins, U.S. destinations, educational attainment, English proficiency, employment, income, home ownership, and more.




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UPI News Quiz: Asian baseball, Grimes' baby, scary insects

Asian baseball, Grimes' baby, scary invasive insects -- how well did you follow the news this week? Take the UPI News Quiz for May 8, 2020.




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DNA genealogy leads police to James E. Zastawnik in 1987 killing of Ohio teen Barbara Blatnik

Cleveland police say they have used DNA research to solve the 33-year-old strangling of a teenage girl, and arrest her killer.




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Electrolyte disorders in a young female following short-term omeprazole therapy

A 29 years old female presented to us in the metabolic clinic of the University of Port Harcourt Teaching Hospital (UPTH) on account of a week history of easy fatigability, weakness, and lower extremity muscle cramps associated with numbness and tingling sensation in the peri-oral area, fingers and toes. Two weeks prior to the onset of her presenting symptoms, she had visited a local pharmaceutical shop on account of a distressing epigastric discomfort and was subsequently placed on daily oral omeprazole 20mg daily for a month by a pharmacist. She had been on the omeprazole medication for two weeks before her present symptoms manifested. Her past medical history was not suggestive of hypoparathyroidism nor pancreatitis. She was married with three children and has an uneventful family, social and obstetric histories. On examination, she was a healthy well-oriented young female with positive Trousseau’s, Chvostek’s and epigastric tenderness signs. Further Laboratory evaluation revealed she had low plasma magnesium, low plasma albumin-corrected calcium, and low serum parathyroid hormone levels, while other laboratory parameters were essentially normal. A diagnosis of omeprazole-induced electrolyte disorders (hypomagnesaemia and hypocalcaemia) associated with hypoparathyroidism was made following the review of her clinical examination and laboratory findings. She was subsequently managed with oral magnesium supplements following the withdrawal of the omeprazole medication (replaced with oral ranitidine), monitored weekly, and full recovery was achieved after three weeks.




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Business as Usual? Regularizing Foreign Labor in Costa Rica

With the growing urbanization and consolidation of Nicaraguan immigrants in sectors such as construction and domestic service, Costa Rica has shifted its focus from immigration enforcement to integration. Tension has emerged between the government and private sector as a new mechanism for regularizing unauthorized immigrant workers has failed to gain traction.




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Leadership Visions: A Discussion with Mexican Foreign Minister Claudia Ruiz-Massieu

An MPI Leadership Visions discussion with the Foreign Minister of Mexico, Claudia Ruiz-Massieu, for her first public appearance in Washington, DC. 




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Mike Pompeo to travel to Israel, meet with Benjamin Netanyahu, Benny Gantz

Secretary of State Mike Pompeo plans to travel to Israel next week to meet with Prime Minister Benjamin Netanyahu in his first international trip since coronavirus-related restrictions were put in place.




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USS Montgomery, USNS Cesar Chavez enter South China Sea to support drill ship

The USS Montgomery and the USNS Cesar Chavez sailed into the South China Sea this week in support of the West Capella drill ship, according to U.S. Indo-Pacific Command.




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Watch: Gwyneth Paltrow, Ben Schwartz read texts from their moms on 'Kimmel'

Gwyneth Paltrow, Ben Schwartz and other celebrities read text messages from their mothers on "Jimmy Kimmel Live" in honor of Mother's Day.




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Look: Minzy to release 'Lovely' single May 24

K-pop star Minzy shared a comeback schedule for her new solo single, "Lovely."




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CBS orders first seasons of 'Clarice,' 'Equalizer,' 'B Positive' for 2020-21

CBS said it has ordered first seasons of three new shows -- "Clarice," "The Equalizer" and "B Positive" for the 2020-21 television season.




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Can Return Migration Revitalize the Baltics? Estonia, Latvia, and Lithuania Engage Their Diasporas, with Mixed Results

Faced with high emigration rates and shrinking, aging populations, the Baltic states—Estonia, Latvia, and Lithuania—are exploring different ways to lure back nationals who have emigrated and establish or solidify ties with members of the diaspora. Of the three countries, Estonia is proving the most successful, while Latvia appears to be ignoring the looming demographic crisis and lacks an immigration plan.






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[ Politics ] Open Question : Why are other countries like New Zealand and Australia destroying the virus while America is killing people off to restart the economy?




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Amid Economic Crisis and Political Turmoil, Venezuelans Form a New Exodus

Record number of Venezuelans are emigrating to escape the country's economic mismanagement, insecurity, and shortages. This article examines the causes of the current crisis and draws from a study of thousands of Venezuelans abroad to examine who is leaving, where they have headed, and what their hopes are for the future of Venezuela. It also scopes future opportunities for diaspora engagement.




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Migration and Integration in Czechia: Policy Advances and the Hand Brake of Populism

Since regaining its independence in 1989, the Czech Republic has transformed from a country of emigration to one of rising immigration, amid growing labor market needs. Even as Czechia received few asylum seekers during the 2015-16 European migration crisis, the country has taken a harder line on immigration, and public opinion and political stances have grown more negative towards immigrants and refugees.




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The Multicultural Dilemma: Amid Rising Diversity and Unsettled Equity Issues, New Zealand Seeks to Address Its Past and Present

New Zealand drew global attention for its unity and support for the Muslim community targeted during the horrific Christchurch attacks. Yet the country's road to inclusion has been far from straightforward, and amid rising diversity it is grappling with the best way to achieve inclusion for its multiethnic population, including indigenous Māori peoples and migrants. This article outlines the opportunities and challenges to fostering multiculturalism against a backdrop of bicultural policies.




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"Event" Cells in the Brain Help Organize Memory into Meaningful Segments

Neurons in the hippocampus categorize what we experience into abstract, discrete events, such as taking a walk versus having lunch

-- Read more on ScientificAmerican.com




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The Human Toll of Alzheimer's

Alzheimer’s took my wife’s memory and her life and tortured our family. There was nothing we—or medicine—could do to stop it 

-- Read more on ScientificAmerican.com




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The Future of Medicine: A New Era for Alzheimer's

It is time for a fresh approach to the illness

-- Read more on ScientificAmerican.com




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Longevity Gene May Protect against a Notorious Alzheimer's Risk Gene

Some nominally high-risk individuals may have a lower chance of developing dementia than once thought

-- Read more on ScientificAmerican.com




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A New Era for Alzheimer's

Fresh approaches and hopeful clues in the search for novel therapies

-- Read more on ScientificAmerican.com




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Five Types of Research, Underexplored until Recently, Could Produce Alzheimer's Treatments

Research into the brain’s protein-disposal systems, electrical activity and three other areas looks promising

-- Read more on ScientificAmerican.com




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A Harder Look at Alzheimer's Causes and Treatments

Amyloid, the leading target for dementia therapy, faces skepticism after drug failures

-- Read more on ScientificAmerican.com




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Horses Recognize Pics of Their Keepers

Horses picked out photographs of their current keepers, and even of former keepers whom they had not seen in months, at a rate much better than chance.

-- Read more on ScientificAmerican.com




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Menopause Predisposes a Fifth of Women to Alzheimer's

Being female is a risk factor for Alzheimer’s. Why?

-- Read more on ScientificAmerican.com




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Eliot Spitzer and the Price-Placebo Effect

In Eliot Spitzer's sex scandal and tragicomic downfall, the question that bugged many people did not have to do with ethics or politics, but whether Spitzer got a raw deal.




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How Terrorist Organizations Work Like Clubs

Days before the Sept. 11, 2001, attacks, Osama bin Laden left his compound in Kandahar in Afghanistan and headed into the mountains. His driver, Salim Ahmed Hamdan, traveled with him. As U.S. and Northern Alliance forces stood poised to capture Kandahar a few months later, bin Laden told Hamdan t...




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9/11, Iraq and the Desensitization of the Victimized

In the days after the attacks of Sept. 11, 2001, with the twin towers vanished from Manhattan's skyline, a poem by W.H. Auden could have been the song of a wounded nation. "September 1, 1939," written on the eve of World War II, seemed eerily prescient:




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Open Door for Venezuelan and Nicaraguan Migrants in Latin America &amp; Caribbean Closes a Bit amid Scale of Flows, Strains on Public Services

WASHINGTON – Even as governments in Latin America and the Caribbean have taken generous and innovative steps to address forced displacement from Venezuela and more recently Nicaragua, the warm welcome has cooled in places amid the vast scale of the inflows, strains on public services and growing public concern.




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Las puertas abiertas para los migrantes venezolanos y nicaragüenses en América Latina y el Caribe se cierran un poco a medida que aumenta la escala de los flujos y la presión en los servicios públicos

WASHINGTON – A pesar de que los gobiernos de América Latina y el Caribe han tomado medidas generosas e innovadoras para lidiar con el desplazamiento forzado desde Venezuela y más recientemente desde Nicaragua, la cálida bienvenida se ha enfriado en algunos lugares a medida que el número de entradas, la presión sobre los servicios públicos y la preocupación del público aumenta.




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MPI Estimates No More than 167,000 Non-Citizens Could Be Ineligible for Green Cards Based on Current Public Benefits Use

WASHINGTON – While the new Trump administration public charge rule is likely to vastly reshape future legal immigration based on its test to assess if a person might ever use public benefits in the future, the universe of non-citizens who could be denied a green card based on current benefits use is quite small.




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Beyond Work: Reducing Social Isolation for Refugee Women and Other Marginalized Newcomers

As migrant- and refugee-receiving countries in Europe, North America, and beyond prioritize services that are focused on employment, language instruction, and civic integration, newcomers who are not in the workplace are at high risk for social isolation. As a result, societies should reconsider what successful integration looks like for vulnerable newcomers who will never find traditional employment or who need a longer-than-average timeline to get there.




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Bacon wrapped mozzarella chicken breasts

When it comes to bacon, it's everything in moderation... This recipe uses bacon as a seasoning.




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Pizza dough

600 ml warm water 1 kg strong pizza flour 8 g instant dry yeast 1tablespoon salt 2 teaspoons sugar 50 ml olive oil




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Okonomiyake - Japanese pizza with soy, honey and ginger sauce

Referred to as a Japanese 'pizza', okonomiyaki is probably best described as a cabbage fritter. There are many versions that can include seafood, pork belly, kimchi or cheese, and either served with the sauce described or with Japanese mayonnaise. Delicious snack food, which can also be a meal.




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Beetroot, yoghurt, date and za'atar dip

500g cooked and peeled beetroot (about 900g fresh) 2 garlic cloves, crushed 1 red chilli, deseeded and finely chopped 1 cup of Greek yoghurt 5 fresh Medjool dates 3 tbsps. olive oil 1 tbsp. Za'atar Good pinch of Himalayan salt 2 shallots, finely sliced on the diagonal Handful of toasted and crushed hazelnuts 50g goat's cheese, crumbled




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Muscavado pavlova with chocolate and hazelnut mousse and Christmas cherries

I love Christmas my all time favourite time of year. It's also a great time for awesome summer sweet produce. Muscovado brown sugar is a treacle like flavour and makes a welcome texture to a traditional pavlova.




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ZUCCHINI, BASIL AND GOAT'S CHEESE FRITTATA

A good frittata is really simple to make, but it does need a little TLC to make sure that the eggs don't overcook. At its best the eggs are softly set and still really tender and the whole thing is such a pleasure to eat. So do take just a little extra care with this, it's really worth it.




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Chicken and zucchini burgers

500g chicken mince 1 large zucchini, coarsely grate(200g) 2 shallots, finely sliced 1 free range egg 1 handful of chopped mint leaves 1 handful of chopped fresh coriander 2 garlic cloves, crushed 1 tsp. ground cumin 1 tsp. Himalayan salt 1/2 tsp. ground black pepper A pinch of chilli flakes Sunflower oil for pan frying Soured Cream And Sumac Sauce 100g sour cream 150g Greek yoghurt 1 tsp. finely grated lemon zest 1 tbsp. lemon juice 1 garlic clove, crushed 1 and 1/2 tbsps. olive oil 1 tbsp. sumac Pinch of salt and pepper




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Italian tomato, saffron and mozzarella arancini

1/2 cup chicken stock 1 pinch of saffron olive oil, for cooking 1 small brown onion, diced 1 tbsp. tomato paste 150 g Carnaroli rice or Arborio rice Himalayan salt and freshly ground black pepper 100 ml white wine 60 g grated parmesan finely grated zest of 1 lemon 100 g grated mozzarella 3 eggs 125 ml (1/2 cup) milk 50 g plain flour 160 g panko breadcrumbs (see Note) vegetable oil, for deep-frying




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Pork and Pea Pastizzi with Mustard Mayonnnaise

This recipe features on Foodie Tuesday, a weekly segment on 774 Drive with Raf Epstein, 3.30PM, courtesy of Shane Delia. This recipe is from Shane's book, and SBS series, "Shane Delia's Spice Journey".




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EASY- PEASY PEAR AND HAZELNUT 'CAKE'

I'm never quite sure what to call this; it's baked in a ceramic pie or gratin dish so it looks a bit like a tart, especially with the glistening pear slices fanned over the top, and yet the moist, satisfyingly crunchy texture is more that of a cake. It doesn't really matter, what does is that it's a breeze to make, has a lovely homely flavour, and is just the sort of thing to whip up when you want a rather fabulous dessert in a hurry.




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Zucchini slices

375g zucchini, grated (approx 2 large zucchini) 5 eggs 150g (1 cup) self-raising flour, sifted 1 large onion, finely diced 200g bacon, chopped 1 cup grated cheddar cheese 60ml (1/4 cup) vegetable oil




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Spanish Chocolate and Hazelnut Figs

This simple recipe is bursting with sweetness from the figs, combined with a hearty crunch of hazlenuts.