References of "Radermecker, Régis"
     in
Bookmark and Share    
Full Text
Peer Reviewed
See detailQu'apportent les nouvelles recommandations américaines à propos de la prise en charge des dyslipidémies en prévention cardiovasculaire ? Comparaison avec les recommandations européennes et belges
Descamps, O; Rietzschel, E; Langlois, M et al

in Louvain Medical (2014), 133(1), 26-35

Les dernières recommandations américaines concernant la prise en charge des dyslipidémies en prévention cardiovasculaire ont soulevé de nombreuses questions par leurs différences avec nos approches ... [more ▼]

Les dernières recommandations américaines concernant la prise en charge des dyslipidémies en prévention cardiovasculaire ont soulevé de nombreuses questions par leurs différences avec nos approches habituelles. Entre autres, elles ont éradiqué la nécessité de « cible » de LDL-C à atteindre en fonction du niveau de risque cardiovasculaire et ont proposé plutôt une stratégie basée sur l’intensité de la réduction relative du LDL-C. L’examen critique et la comparaison des recommandations font apparaitre, toutefois, plus de similitudes que de différences, tout en encourageant à repenser certains aspects de notre pratique et à raviver notre motivation pour le plus grand bien des patients. [less ▲]

Detailed reference viewed: 33 (5 ULg)
Full Text
Peer Reviewed
See detailA propos de l'hémoglobine glycquée: les limites de son interprétation
Sepulchre, E; LUTTERI, Laurence ULg; CAVALIER, Etienne ULg et al

in Revue Médicale de Liège (2014), 69(9), 497-503

Determining the level of glycated haemoglobin, in particular its major fraction called HbA1c, is an attractive tool in the management of diabetic patients. In fact, it provides a global evaluation of the ... [more ▼]

Determining the level of glycated haemoglobin, in particular its major fraction called HbA1c, is an attractive tool in the management of diabetic patients. In fact, it provides a global evaluation of the glycemic control’s level through the past 8-12 weeks. However, this tool must be used with caution. First of all, it does not allow to examine the glycemic kinetics since it represents a glycemic average. Secondly, it does not allow to appreciate the glycemic evolution through the full day. This dosage needs then sometimes to be complemented by fingersticks blood glucose testing. Last but not least, caution is advised in interpreting the results because a number of physiological, pathological and technical factors might interfere with HbA1c measurement. It is therefore important that physicians keep a critical view of the values obtained. The paper reviews the different methods used to determine the level of glycated haemoglobin and their limitations. It also emphasizes the medical situations in which over- and under-estimation of the real HbA1c value could occur. It does not address the specific issue of the new expression values of HbA1c in mmol/mol instead of %. Moreover, the medical situations in which over- and under estimation of the real HbA1c value could occur will be described. [less ▲]

Detailed reference viewed: 5 (1 ULg)
Full Text
Peer Reviewed
See detailComparison of insulin degludec with insulin glargine in insulin-naive subjects with Type 2 diabetes: a 2-year randomized, treat-to-target trial.
Begin once trial investigators; RADERMECKER, Régis ULg

in Diabetic Medicine : A Journal of the British Diabetic Association (2013)

Detailed reference viewed: 23 (2 ULg)
Full Text
Peer Reviewed
See detailComparison of insulin degludec with insulin glargine in insulin-naive subjects with Type 2 diabetes: a 2-year randomized, treat-to-target trial.
BEGIN Once Long Trial Investigators; RADERMECKER, Régis ULg

in Diabetic Medicine : A Journal of the British Diabetic Association (2013)

Detailed reference viewed: 23 (0 ULg)
Full Text
Peer Reviewed
See detailRecommandations europeennes pour la prise en charge du diabete, du pre-diabete et des maladies cardio-vasculaire. 1ere partie. Gestion du diabete et des facteurs de risque cardio-vasculaire.
Scheen, André ULg; RADERMECKER, Régis ULg; PHILIPS, Jean-Christophe ULg et al

in Revue medicale de Liege (2013), 68(11), 585-92

The patient with prediabetes or diabetes has a high or very high risk of cardiovascular diseases.We summarize the recent guidelines jointly published by the European Society of Cardiology and the European ... [more ▼]

The patient with prediabetes or diabetes has a high or very high risk of cardiovascular diseases.We summarize the recent guidelines jointly published by the European Society of Cardiology and the European Society for the Study of Diabetes. In this first article, we focus mainly on the preventive approaches of cardiovascular diseases in patients with prediabetes or (type 1 or type 2) diabetes. The crucial importance of a global multifactorial strategy is emphasized and the target levels of various risk factors are updated. The management of these cardiovascular complications in presence of diabetes will be considered in a second article. [less ▲]

Detailed reference viewed: 38 (8 ULg)
Full Text
See detailRegard sur la peau diabétique et ses méhins.
PIERARD, Gérald ULg; RADERMECKER, Régis ULg; SCHEEN, André ULg

in Revue de l'Association Belge du Diabète (2013), 56

La peau exprime certains changements qui sont souvent proportionnels à la durée et la sévérité du diabète. La plupart des composants de la peau sont affectés à des degrés divers, parfois cliniquement ... [more ▼]

La peau exprime certains changements qui sont souvent proportionnels à la durée et la sévérité du diabète. La plupart des composants de la peau sont affectés à des degrés divers, parfois cliniquement imperceptibles, parfois très sévères et invalidants. [less ▲]

Detailed reference viewed: 16 (4 ULg)
Full Text
Peer Reviewed
See detailVitamin D and type 2 diabetes mellitus: Where do we stand?
CAVALIER, Etienne ULg; DELANAYE, Pierre ULg; SOUBERBIELLE, J.-C. et al

in Diabètes & Métabolism (2011), 37(4), 265-72

AIMS: In-vitro and observational studies have established a link between vitamin D deficiency and different type 2 diabetes outcomes (insulin resistance, insulin secretion, glucose intolerance). Although ... [more ▼]

AIMS: In-vitro and observational studies have established a link between vitamin D deficiency and different type 2 diabetes outcomes (insulin resistance, insulin secretion, glucose intolerance). Although the number of randomized controlled trials vs placebo is small, vitamin D (VTD) has been shown to prevent increases in glucose concentration and insulin resistance, enhance insulin sensitivity and reduce systolic blood pressure in type 2 diabetic patients. METHODS: In this review, we have focused on the potential mechanisms that might explain the association between VTD and type 2 diabetes mellitus (T2DM). We have also evaluated the different epidemiological and observational studies on the topic, as well as the various interventional studies. RESULTS: Although the in vitro studies appear to be promising in explaining the link between VTD metabolism and T2DM, the results of in vivo studies are conflicting. This could be related to differences in their methodological approaches. CONCLUSION: Although more studies are needed to confirm the role of VTD in the treatment of T2DM, there is nevertheless enough evidence at this time to suggest a need to maintain 25-OH vitamin D levels in T2DM patients around 30ng/mL over the course of a year. [less ▲]

Detailed reference viewed: 62 (8 ULg)
Full Text
Peer Reviewed
See detailInhibiteurs du cotransporteur du glucose SGLT rénal pour traiter le diabète de type 2
SCHEEN, André ULg; RADERMECKER, Régis ULg; ERNEST, Philippe ULg et al

in Revue Médicale Suisse (2011), 7(306), 1621-1629

Detailed reference viewed: 27 (6 ULg)
Full Text
See detailMonitoring continu du glucose: où en est on?
RADERMECKER, Régis ULg

Conference (2011, May 21)

Présentation des données actuelles sur le monitoring continu du glucose en Diabétologie.

Detailed reference viewed: 22 (6 ULg)
Full Text
See detailDiabète et autocontrôle
RADERMECKER, Régis ULg

in Revue de l'Association Belge du Diabète (2011), 54(2), 18-21

Detailed reference viewed: 60 (11 ULg)
Peer Reviewed
See detailTight Glycaemic control and nutrition: A comparison of two protocols
Suhaimi, F; Le Compte, AJ; Preiser, JC et al

in Proceedings of the Centre for Bio-Engineering One Day Conference 2010 (2010)

Detailed reference viewed: 14 (2 ULg)
Full Text
Peer Reviewed
See detailWhat makes tight glycemic control tight? The impact of variability and nutrition in two clinical studies.
Suhaimi, Fatanah; Le Compte, Aaron; Preiser, Jean-Charles ULg et al

in Journal of Diabetes Science and Technology (2010), 4(2), 284-98

INTRODUCTION: Tight glycemic control (TGC) remains controversial while successful, consistent, and effective protocols remain elusive. This research analyzes data from two TGC trials for root causes of ... [more ▼]

INTRODUCTION: Tight glycemic control (TGC) remains controversial while successful, consistent, and effective protocols remain elusive. This research analyzes data from two TGC trials for root causes of the differences achieved in control and thus potentially in glycemic and other outcomes. The goal is to uncover aspects of successful TGC and delineate the impact of differences in cohorts. METHODS: A retrospective analysis was conducted using records from a 211-patient subset of the GluControl trial taken in Liege, Belgium, and 393 patients from Specialized Relative Insulin Nutrition Titration (SPRINT) in New Zealand. Specialized Relative Insulin Nutrition Titration targeted 4.0-6.0 mmol/liter, similar to the GluControl A (N = 142) target of 4.4-6.1 mmol/liter. The GluControl B (N = 69) target was 7.8-10.0 mmol/liter. Cohorts were matched by Acute Physiology and Chronic Health Evaluation II score and percentage males (p > .35); however, the GluControl cohort was slightly older (p = .011). Overall cohort and per-patient comparisons (median, interquartile range) are shown for (a) glycemic levels achieved, (b) nutrition from carbohydrate (all sources), and (c) insulin dosing for this analysis. Intra- and interpatient variability were examined using clinically validated model-based insulin sensitivity metric and its hour-to-hour variation. RESULTS: Cohort blood glucose were as follows: SPRINT, 5.7 (5.0-6.6) mmol/liter; GluControl A, 6.3 (5.3-7.6) mmol/liter; and GluControl B, 8.2 (6.9-9.4) mmol/liter. Insulin dosing was 3.0 (1.0-3.0), 1.5 (0.5-3), and 0.7 (0.0-1.7) U/h, respectively. Nutrition from carbohydrate (all sources) was 435.5 (259.2-539.1), 311.0 (0.0-933.1), and 622.1 (103.7-1036.8) kcal/day, respectively. Median per-patient results for blood glucose were 5.8 (5.3-6.4), 6.4 (5.9-6.9), and 8.3 (7.6-8.8) mmol/liter. Insulin doses were 3.0 (2.0-3.0), 1.5 (0.8-2.0), and 0.5 (0.0-1.0) U/h. Carbohydrate administration was 383.6 (207.4-497.7), 103.7 (0.0-829.4), and 207.4 (0.0-725.8) kcal/day. Overall, SPRINT gave approximately 2x more insulin with a 3-4x narrower, but generally non-zero, range of nutritional input to achieve equally TGC with less hypoglycemia. Specialized Relative Insulin Nutrition Titration had much less hypoglycemia (<2.2 mmol/liter), with 2% of patients, compared to GluControl A (7.7%) and GluControl B (2.9%), indicating much lower variability, with similar results for glucose levels <3.0 mmol/liter. Specialized Relative Insulin Nutrition Titration also had less hyperglycemia (>8.0 mmol/liter) than groups A and B. GluControl patients (A+B) had a approximately 2x wider range of insulin sensitivity than SPRINT. Hour-to-hour variation was similar. Hence GluControl had greater interpatient variability but similar intrapatient variability. CONCLUSION: Protocols that dose insulin blind to carbohydrate administration can suffer greater outcome glycemic variability, even if average cohort glycemic targets are met. While the cohorts varied significantly in model-assessed insulin resistance, their variability was similar. Such significant intra- and interpatient variability is a further significant cause and marker of glycemic variability in TGC. The results strongly recommended that TGC protocols be explicitly designed to account for significant intra- and interpatient variability in insulin resistance, as well as specifying or having knowledge of carbohydrate administration to minimize variability in glycemic outcomes across diverse cohorts and/or centers. [less ▲]

Detailed reference viewed: 39 (7 ULg)
Full Text
See detailDiabète, convention et trajet de soins
RADERMECKER, Régis ULg

in Actualités Innovations Médecine (2010), (12), 21-22

Detailed reference viewed: 26 (1 ULg)
Full Text
Peer Reviewed
See detailManagement of blood glucose in patients with stroke.
Radermecker, Régis ULg; Scheen, André ULg

in Diabètes & Métabolism (2010), 36S3

Stroke is a leading cause of death worldwide and the most common cause of long-term disability amongst adults, more particularly in patients with diabetes mellitus and arterial hypertension. Increasing ... [more ▼]

Stroke is a leading cause of death worldwide and the most common cause of long-term disability amongst adults, more particularly in patients with diabetes mellitus and arterial hypertension. Increasing evidence suggests that disordered physiological variables following acute ischaemic stroke, especially hyperglycaemia, adversely affect outcomes. Post-stroke hyperglycaemia is common (up to 50% of patients) and may be rather prolonged, regardless of diabetes status. A substantial body of evidence has demonstrated that hyperglycaemia has a deleterious effect upon clinical and morphological stroke outcomes. Therefore, hyperglycaemia represents an attractive physiological target for acute stroke therapies. However, whether intensive glycaemic manipulation positively influences the fate of ischaemic tissue remains unknown. One major adverse event of management of hyperglycaemia with insulin (either glucose-potassium-insulin infusions or intensive insulin therapy) is the occurrence of hypoglycaemia, which can also induce cerebral damage. Novel insights into post-stroke hyperglycaemia management have been derived from continuous glucose monitoring systems (CGMS). This article aims: 1) to describe the adverse effects of hyperglycaemia following acute ischaemic stroke and the risk associated with iatrogenic hypoglycaemia; 2) to summarise the evidence from current glucose-lowering treatment trials; and 3) to show the usefulness of CGMS in both non-diabetic and diabetic patients with acute stroke. [less ▲]

Detailed reference viewed: 37 (7 ULg)
Full Text
Peer Reviewed
See detailContinuous glucose monitoring reduces both hypoglycaemia and HbA1c in hypoglycaemia-prone type 1 diabetic patients treated with a portable pump.
Radermecker, Régis ULg; Saint-Remy, Annie ULg; Scheen, André ULg et al

in Diabètes & Métabolism (2010), 36(5), 409-13

AIM: This study aimed to assess the effectiveness of continuous glucose monitoring (CGM) for glucose control in type 1 diabetic patients treated by continuous subcutaneous insulin infusion (CSII) and ... [more ▼]

AIM: This study aimed to assess the effectiveness of continuous glucose monitoring (CGM) for glucose control in type 1 diabetic patients treated by continuous subcutaneous insulin infusion (CSII) and presenting with frequent hypoglycaemic episodes. METHODS: Thirteen patients with type 1 diabetes (diabetes duration: 25+/-15 years; CSII duration: 5.5+/-7.0 years), with more than six recorded capillary blood glucose (CBG) values <60 mg/dL, according to their metres for the past 14 days, were offered the permanent use of a CGM device (Guardian RT((R)), Medtronic) plus ongoing self-monitoring of blood glucose (SMBG) for 12 weeks, followed by a 12-week crossover period of SMBG only, or vice versa. Glucose control, determined by recorded 14-day CBG values <60 mg/dL and HbA(1c) levels, and quality of life according to the Diabetes Quality of Life (DQOL) questionnaire, were assessed at baseline, and after 12- and 24-week follow-ups. RESULTS: Four patients withdrew from the study during the first period (of whom three were using CGM). In the nine study completers, the number of low CBG values decreased significantly from 13.9+/-9.2 to 7.6+/-6.8 (P=0.011) when patients used CGM, in either the initial or final trial period, while a decrease in HbA(1c) from 8.3+/-0.7 to 7.7+/-0.6% (P=0.049) was also observed, in contrast to the absence of any significant differences during the SMBG-only period. DQOL scores were also essentially unaffected. CONCLUSION: This pilot observational study supports the hypothesis that CGM use can significantly improve overall glucose control while reducing hypoglycaemic episodes in hypoglycaemia-prone type 1 diabetic patients treated by CSII. [less ▲]

Detailed reference viewed: 40 (3 ULg)
Full Text
Peer Reviewed
See detailAddition of incretin therapy to metformin in type 2 diabetes.
Scheen, André ULg; Radermecker, Régis ULg

in Lancet (2010), 375(9724), 1410-2

Detailed reference viewed: 31 (5 ULg)
Full Text
Peer Reviewed
See detailEducation therapeutique et mesure continue de la glycemie chez le patient diabetique insulino-traite.
Thielen, Vinciane ULg; Radermecker, Régis ULg; Renard, Eric et al

in Revue Médicale Suisse (2010), 6(260), 1596-600

L’efficacité d’un programme éducationnel fondé sur l’utilisation d’une mesure continue du glucose avec un affichage en temps réel a été évaluée chez des patients diabétiques de type 1 (système couplé à ... [more ▼]

L’efficacité d’un programme éducationnel fondé sur l’utilisation d’une mesure continue du glucose avec un affichage en temps réel a été évaluée chez des patients diabétiques de type 1 (système couplé à une pompe à insuline externe - Paradigm Real Time®) et chez des patients diabétiques de type 2 mal contrôlés sous insuline (système Guardian RT® une semaine par mois pendant 3 mois versus automesure classique). Ces deux essais pilote montrent une diminution du taux d’hémoglobine glyquée (HbA1c) avec le « glucose sensor », avec moins d’hypoglycémies symptomatiques. Malgré certaines difficultés techniques (surtout chez les diabétiques de type 2), l’approche représente un outil intéressant d’éducation thérapeutique. Ces résultats prometteurs plaident pour des études de plus grande envergure chez des patients diabétiques bien sélectionnés. [less ▲]

Detailed reference viewed: 69 (5 ULg)
Full Text
Peer Reviewed
See detailStrategies pour eviter l'inertie et la non-observance dans les essais cliniques.
Jandrain, Bernard ULg; Ernest, Philippe ULg; Radermecker, Régis ULg et al

in Revue Médicale de Liège (2010), 65(5-6), 246-9

Randomised controlled trials play a key role in evidence-based medicine as far as the assessment of both efficacy and safety of drugs is concerned. Various strategies are used to avoid physician's inertia ... [more ▼]

Randomised controlled trials play a key role in evidence-based medicine as far as the assessment of both efficacy and safety of drugs is concerned. Various strategies are used to avoid physician's inertia and to combat patient's non compliance, two pitfalls that may hinder the demonstration of the therapeutic efficacy of the drug. Clinical inertia may be limited by titration, forced or optional, driven by therapeutic targets, or by the use, if necessary, of rescue medications. Compliance may be verified by "pill count". This simple technique allows to exclude non compliant patients when they are detected during the placebo run-in period before randomisation or not to take into account patients with poor compliance in the final evaluation by using a statistical analysis restricted to individuals who have strictly adhered to the study protocol ("per protocol analysis"). Self-monitoring and patient's empowerment in the treatment also contribute to improve drug compliance. Clinicians may take advantage of these approaches derived from clinical trials to improve their daily practice. [less ▲]

Detailed reference viewed: 155 (11 ULg)
Full Text
Peer Reviewed
See detailComment optimaliser le traitement hypolipidemiant: ne pas oublier la problematique du defaut d'observance.
Radermecker, Régis ULg; Scheen, André ULg

in Revue Médicale de Liège (2010), 65(5-6), 311-7

The pharmacological treatment of dyslipidaemia, essentially by statins, should take place in a global strategy of prevention of cardiovascular diseases. Treating a risk factor, asymptomatic by definition ... [more ▼]

The pharmacological treatment of dyslipidaemia, essentially by statins, should take place in a global strategy of prevention of cardiovascular diseases. Treating a risk factor, asymptomatic by definition, which imposes an early constraint for a potential late benefit, exposes to patient's noncompliance. Besides physician's clinical inertia to initiate and adjust the lipid-lowering therapy in at risk patients, such lack of patient's compliance is one of the key elements that may explain the failure to reach or maintain therapeutic targets, and represents a major pharmacoeconomical concern. This article analyses first the main reasons explaining the poor compliance to lipid-lowering therapy and, then, describes some approaches to improve patient's adherence to medications in order to better prevent cardiovascular diseases. [less ▲]

Detailed reference viewed: 94 (3 ULg)