Glycemic Variability Is Associated with Frequency of Blood Glucose Testing and Bolus: Post Hoc Analysis Results from the ProAct Study

ntroduction: The ProAct study has shown that a pump switch to the Accu-Chek® Combo system (Roche Diagnostics Deutschland GmbH, Mannheim, Germany) in type 1 diabetes patients results in stable glycemic control with significant improvements in glycated hemoglobin (HbA1c) in patients with unsatisfactory baseline HbA1c and shorter pump usage time. Patients and Methods: In this post hoc analysis of the ProAct database, we investigated the glycemic control and glycemic variability at baseline by determination of several established parameters and scores (HbA1c, hypoglycemia frequency, J-score, Hypoglycemia and Hyperglycemia Indexes, and Index of Glycemic Control) in participants with different daily bolus and blood glucose measurement frequencies (less than four day, four or five per day, and more than five per day, in both cases). The data were derived from up to 299 patients (172 females, 127 males; age [mean±SD], 39.4±15.2 years; pump treatment duration, 7.0±5.2 years). Results: Participants with frequent glucose readings had better glycemic control than those with few readings (more than five readings per day vs. less than four readings per day: HbA1c, 7.2±1.1% vs. 8.0±0.9%; mean daily blood glucose, 151±22 mg/dL vs. 176±30 mg/dL; percentage of readings per month >300 mg/dL, 10±4% vs. 14±5%; percentage of readings in target range [80-180 mg/dL], 59% vs. 48% [P<0.05 in all cases]) and had a lower glycemic variability (J-score, 49±13 vs. 71±25 [P<0.05]; Hyperglycemia Index, 0.9±0.5 vs. 1.9±1.2 [P<0.05]; Index of Glycemic Control, 1.9±0.8 vs. 3.1±1.6 [P<0.05]; Hypoglycemia Index, 0.9±0.8 vs. 1.2±1.3 [not significant]). Frequent self-monitoring of blood glucose was associated with a higher number of bolus applications (6.1±2.2 boluses/day vs. 4.5±2.0 boluses/day [P<0.05]). Therefore, a similar but less pronounced effect on glycemic variability in favor of more daily bolus applications was observed (more than five vs. less than four bolues per day: J-score, 57±17 vs. 63±25 [not significant]; Hypoglycemia Index, 1.0±1.0 vs. 1.5±1.4 [P<0.05]; Hyperglycemia Index, 1.3±0.6 vs. 1.6±1.1 [not significant]; Index of Glycemic Control, 2.3±1.1 vs. 3.1±1.7 [P<0.05]). Conclusions: Pump users who perform frequent daily glucose readings have a better glycemic control with lower glycemic variability.

Denying the foreseeability of an event as a means of self-protection. The Impact of Self-Threatening Outcome Information on the Strength of the Hindsight Bias

The hindsight bias represents the tendency of people to falsely believe that they would have predicted the outcome of an event, once the outcome is known. Two experiments will be presented that show a reduction or even reversal of the hindsight bias when the outcome information is self-threatening for the participants. Participants read a report of an interaction between a man and a woman that ended with different outcomes: The woman was raped vs. the woman was not raped vs. no outcome information was given. Results of the first experiment indicated that especially female participants, who did not accept rape myths, showed a reversed hindsight bias, when they received the rape outcome information. The more threatening the rape outcome had been, the lower was their estimated likelihood of rape. Results of the second experiment confirmed those of the first. Female participants, who did not accept rape myths and perceived themselves highly similar to the victim, showed a strong reversed hindsight bias, when threatened by the rape outcome, whereas female participants, who did believe in rape myth and were not similar to the victim, showed a classical hindsight bias. These effects were interpreted in terms of self-serving or in-group serving functions of the hindsight bias: Participants deny the foreseeability of a self-threatening outcome as a means of self-protection even if they are not personally affected by the negative information, but a member of their group.

Exculpating victims and the reversal of hindsight bias

This experiment examines the role of the hindsight bias and of motivational forces such as the motive to believe in a just world as possible causes of the derogation of victims effect in the context of rape. The hindsight bias is the tendency of people to falsely believe that they would have predicted the outcome of an event once the outcome is known. Participants read descriptions of an interaction between a man and a woman that ended with one of four possible outcomes: The woman was raped with very severe consequences for her future life vs. rape with only minor consequences for her future life vs. no rape (assailant was forced to retreat by the strong defense of the victim) vs. no outcome information. To test motivational predictions the hindsight bias and the derogation effect were analyzed as a consequence of the sex of participants, the seriousness of the consequences of the rape, the belief in a just world and the acceptance of rape myths. Results supported the assumption that derogation effects are at least partly driven by hindsight bias and that motivational processes work via the hindsight bias. However, in this study we did not find a classical hindsight bias but a reversed hindsight bias: Especially female participants in the severe consequences of rape condition and those participants who did not accept rape myths rated the likelihood of rape in the rape outcome condition as smaller than participants in the no outcome information control group. They also derogated the victim less than participants in the no information control group. These effects were interpreted in terms of self-serving or in-group serving functions of the hindsight bias. Finally no support was found for the assumption that derogation effects are driven by the motive to believe in a just world.

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 678 - Mitteilung über den Inhalt der vorausgegangenen Korrespondenz mit Gottlieb Wilhelm Skerle

u.a.: Aufenthalt von Johanna Schopenhauer in Mannheim; Erbschaftangelegenheiten;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 703 - Mitteilung über den aktuellen Sachstand der Untersuchungen gegen den ehemaligen Sachverwalter der Familien, Carl Stattmiller

u.a.: Umzug Arthur Schopenhauers nach Mannheim;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 17 - Antwortschreiben mit umfangreichen autobiographischen Angaben

Umzug nach Frankfurt am Main 1833; Erstbegegnung Anthime Gregoire de Blésimaires in Trittau; Cholera in Berlin; Kritik an der Regierung in Deutschland; Philosophie von Jean Paul; Johann Wolfgang von Goethe; weitere philosophische Veröffentlichungen nach "Die Welt als Wille und Vorstellung" von 1819; Alexander von Humboldt; Lehrtätigkeit als Professor an der Berliner Universität von 1820 bis 1831; zwischenzeitlicher Aufenthalt in Mannheim von 1831 bis 1833; Vorzüge von Frankfurt; Flötenspielerei; Sprachkenntnisse; kompliziertes Verhältnis zur in Bonn lebenden Mutter Johanna Schopenhauer;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 178 - Entschuldigungsschreiben nach einem Streit

u.a.: Besuch in Mannheim; Feuchter;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 576 - Antwortschreiben von Georg Friedrich Creuzer zur Stellung der Philosophie in Deutschland

u.a.: Aufenthalt Schopenhauers in Mannheim; Anstieg der Habilitationen und Privatdozenten; Georg Wilhelm Friedrich Hegel;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 244 - Rechnungsbestätigungen und Mitteilungen der Transaktionen

u.a.: Bankgeschäfte; Mexikanische Anleihe;