Diversity of bone cell activity as a histomorphometric feature of idiopathic osteoporosis in men.

Although osteoporosis in men is an increasing health problem, studies on osteoporosis in males are still scarce. The aim of our study was to determine the characteristics of bone tissue and bone turnover in men with idiopathic osteoporosis. Transiliac crest bone samples were histomorphometrically analyzed after double tetracycline labeling in 32 men aged 37-65 years who were diagnosed with idiopathic osteoporosis by densitometry of the lumbar spine and hip. Bone volume, osteoid surface, osteoblast surface, eroded surface, osteoid thickness, trabecular thickness, trabecular number, trabecular separation, and mineral apposition rate (MAR) were determined in all trabecular bone specimens. Bone volume and structural parameters indicated trabecular bone loss in most patients. Cellular parameters and MAR indicated variations in bone cell actions. No age-related decrease in histomorphometric parameters was found. After the patients were grouped according to MAR values, osteoblast and eroded surfaces were found to be lower in the group with decreased MAR values and elevated in the group of patients with increased MAR parameter. Trabecular thickness was greater in patients with lower than normal MAR, due to reduced resorption and probably loss of very thin trabeculae. Our results suggest that idiopathic osteoporosis in man resembles many characteristics of postmenopausal osteoporosis in women resulting in impaired trabecular structure due to unbalanced cellular activity and bone turnover rate.

The impact of the timing of Humalog Mix25 injections on blood glucose fluctuations in the postprandial period in elderly patients with type 2 diabetes.

BACKGROUND: Postprandial hyperglycemia contributes to glycation of hemoglobin A1c and has been associated with cardiovascular risk in people with diabetes. We investigated the impact of injection timing of Humalog Mix25 (Mix25, known as Humalog Mix75/25 in the U.S.: 25% insulin lispro and 75% neutral protamine lispro) on glycemia and postprandial blood glucose (BG) excursions in elderly individuals MATERIAL/METHODS: Seventy-three patients aged 60 to 80 years were randomized to Mix25 (Mix25 group, 37 participants) or a continuation with maximum dose glibenclamide (control group, 36 participants). The Mix25 group was subdivided into a group of 18 patients who were injecting insulin after meals and 19 who were injecting before. RESULTS: At baseline, the absolute postprandial BG concentrations and postprandial BG excursions after breakfast were high (Mix25 group: 15.3+/-4.8 mmol/l and 3.5+/-2.7 mmol/l, respectively; controls: 15.4+/-3.9 mmol/l and 4.7+/-2.7 mmol/l, respectively). In both groups improvement was observed at the endpoint, but it was greater with Mix25 (Mix25 group: 10.3+/-3.6 mmol/l, p<0.0001 vs. baseline, p<0.003 vs. controls, and 2.0+/-2.5 mmol/l, p<0.008 vs. baseline, p=ns vs. controls; control group: 13.3+/-2.9 mmol/l, p<0.006 vs. baseline, and 4.7+/-2.7 mmol/l, p<0.006 vs. baseline). The two Mix25 subgroups had similar postprandial BG levels and BG excursions after breakfast. CONCLUSIONS: Mix25 improves postprandial BG and yields a greater effect on BG excursions compared with monotherapy with glibenclamide. The timing of Mix25 did not impact the level of BG or BG fluctuations after meals, which may be important for individuals with changing dietary pattern.

Patient acceptance and reliability of new Humulin/Humalog 3.0 ml prefilled insulin pen in ten Croatian diabetes centres.

BACKGROUND: The objective of this study was to assess feature preferences, patient acceptance, reliability, and safety of the new Lilly Humulin/Humalog 3.0 ml prefilled insulin pen in a clinical setting. MATERIAL/METHODS: A total of 330 patients in Croatia with type 1 or type 2 diabetes mellitus who required at least one injection of insulin per day were treated with Humulin 30/70 or Humalog for 4 to 6 weeks using the new prefilled pen. Questionnaires concerning various aspects of the pen performance were administered at endpoint. RESULTS: The features of the Lilly 3.0 ml pen device ranked most highly by patients (% of excellent or good ratings) were cartridge visibility (93%), attaching/replacing needles (93%), ease of dose correction (92%), checking insulin flow (90%) and dialling of insulin dose (89%). Features of the pen device rated most highly by patients in comparison with the delivery systems used before the study and the percentage of patients rating those features as much better or better were ease of dose correction (74%), cartridge visibility (67%), audible dialing clicks (55%) and size of dose numbers (52%). Most respondents (78%) preferred single-unit versus two-unit dosage increments. The majority of patients rated the new prefilled pen as being more convenient and easier to use, and indicated that it represented a significant or modest an improvement over their previous insulin injection method. CONCLUSIONS: The results of this study indicate that the new Lilly 3.0 ml prefilled pen is acceptable for patients who were previously using either reusable devices or the traditional syringe and vial.