Friday, 27 December 2013

Takeda Announces Termination of Fasiglifam (TAK-875) Development

Takeda Pharmaceutical Company Limited (Takeda) announced that it has decided voluntarily to terminate the development activities for fasiglifam (TAK-875), an investigational treatment for type 2 diabetes, due to concerns about liver safety (Takeda)

Bardoxolone Methyl in Type 2 Diabetes and Stage 4 Chronic Kidney Disease

Among patients with type 2 diabetes mellitus and stage 4 chronic kidney disease, bardoxolone methyl did not reduce the risk of ESRD or death from cardiovascular causes. A higher rate of cardiovascular events with bardoxolone methyl than with placebo prompted termination of the trial (New England Journal of Medicine)

Tuesday, 24 December 2013

Early Microvascular Changes with Loss of the Glycocalyx in Children with Type 1 Diabetes

Our results disclose the glycocalyx as a possible monitoring measurement for earlier detection of diabetic microangiopathy and may provide a basis for new therapeutic strategies aiming at protection or restoration of the glycocalyx (The Journal of Pediatrics)

Erythropoietin, a novel repurposed drug: An innovative treatment for wound healing in patients with diabetes mellitus

In this review, the mechanism of EPO's action in skin wound healing is reviewed, and its potential for treating acute and chronic skin wounds and stimulating tissue regeneration in diabetic patients is discussed (Wound Repair and Regeneration)

Friday, 20 December 2013

Diabetes Community Health Profiles

The Diabetes Community Health Profiles bring together a wide range of data on diabetes in adults into a single source for the purposes of benchmarking. The tool allows you to download a diabetes profile for each area in England (YHPHO)

National Paediatric Diabetes Audit Report 2011-12

Care processes and outcomes (RCPCH)

Diabetes UK State of the Nation report 2013 

This report highlights the problem that quality of care for diabetics is uneven throughout England. It notes that diabetes care is adequately funded but that the focus of the spending should be on prevention rather than treatment (Diabetes UK)

Thursday, 19 December 2013

Altered Spontaneous Brain Activity in Type 2 Diabetes: A Resting-State Functional MRI Study

The abnormalities of spontaneous brain activity reflected by ALFF and ReHo measurements in the absence of structural changes in T2DM patients may provide insights into the neurological pathophysiology underlying diabetes-associated cognitive decline (Diabetes)

Proinsulin-Transferrin Fusion Protein as a Novel Long-acting Insulin Analogue for the Inhibition of Hepatic Glucose Production

ProINS-Tf exhibited a slow, but sustained, in vivo hypoglycemic efficacy and long plasma half-life. Thus, ProINS-Tf fusion protein can potentially be administered as a prodrug with sustained Tf-mediated activation and selectivity in inhibiting hepatic glucose production (Diabetes)

Bristol-Myers Squibb - Sale of Its Diabetes Business

Bristol-Myers Squibb Company announce that it has signed an agreement to sell its global diabetes business that was part of its collaboration with AstraZeneca (Bristol-Myers Squibb)

Midlife type 2 diabetes and poor glycaemic control as risk factors for cognitive decline in early old age

The risk of accelerated cognitive decline in middle-aged patients with type 2 diabetes is dependent on both disease duration and glycaemic control (The Lancet Diabetes & Endocrinology)

Tuesday, 17 December 2013

Diabetes drugs affect hearts of men, women differently

In particular, the commonly prescribed diabetes drug metformin had positive effects on heart function in women but not in men, who experienced a shift in metabolism thought to increase the risk of heart failure (Washington University School of Medicine)

The Role of Autophagy in the Pathogenesis of Diabetic Nephropathy

In this review, we discuss new findings showing the relationships between autophagy and diabetic nephropathy and suggest the therapeutic potential of autophagy in diabetic nephropathy (Journal of Diabetes Research)

Monday, 16 December 2013

Effect of Glargine Insulin Delivery Method (Pen-Device vs. Vial-Syringe) on Glycemic Control and Patient Preferences in Patients with Type 1 and Type 2 Diabetes

Patients switching to glargine pen achieved lower HbA1c at 6 months of follow-up. Patients in both groups overwhelmingly preferred glargine pens over vial-syringe (Endocrine Practice)

Effect of once-daily insulin detemir on oral antidiabetic drug (OAD) use in patients with type 2 diabetes

Discontinuation (or switching) of OADs at the time of insulin initiation appears to be governed principally by concerns about hypoglycaemia and weight. HbA1c improvements were smaller in patients discontinuing OADs at the time of insulin initiation and may be associated with insufficient insulin titration (Journal of Clinical Pharmacy and Therapeutics)

Saxagliptin (Onglyza®) 2.5 mg and 5 mg film-coated tablets

Saxagliptin (Onglyza®) is recommended as an option for use within NHS Wales for the treatment of adult patients aged 18 years and older with type 2 diabetes mellitus to improve glycaemic control as triple oral therapy in combination with metformin plus a sulphonylurea when this regimen alone, with diet and exercise, does not provide adequate glycaemic control (All Wales Medicines Strategy Group)

Sunday, 15 December 2013

Bristol, AstraZeneca withdraw diabetes drug in Germany

Bristol-Myers Squibb and AstraZeneca said they would pull a new diabetes drug from the German market because they had failed to agree on a price with a body of medical insurers. The decision to stop marketing oral drug dapagliflozin in Germany comes just a day after it was endorsed by an advisory panel to the U.S. Food and Drug Administration (Reuters)

Saturday, 14 December 2013

This Time, FDA Panel Endorses Diabetes Drug Dapagliflozin

A US Food and Drug Advisory (FDA) panel has voted 10 to 1 in favor of approval for AstraZeneca and Bristol-Myers Squibb's diabetes drug dapagliflozin (Medscape)

Thursday, 12 December 2013

The 3rd national diabetes inpatient conference, innovations in diabetes inpatient care

Wednesday 29 January 2014 Venue: Royal Society Of Medicine, 1 Wimpole Street, London. Also call for abstracts

Silent myocardial ischemia detected by single photon emission computed tomography (SPECT) and risk of cardiac events among asymptomatic patients with type 2 diabetes

SMI detected by SPECT is associated with increased risk of cardiac death, all-cause mortality, and non-fatal cardiac events in T2DM patients without overt cardiac symptoms. Advanced intervention procedures including intensive drug management should be implemented to reduce the risk of cardiac events for SMI-positive T2DM patients

Glucose-dependent Insulinotropic Polypeptide: Blood Glucose Stabilizing Effects in Patients with Type 2 diabetes

In patients with T2DM, GIP counteracts insulin-induced hypoglycemia – most likely through a predominant glucagonotropic effect. In contrast, during hyperglycemia, GIP increases glucose disposal through a predominant effect on insulin release (Journal of Clinical Endocrinology & Metabolism)

Laparoscopic adjustable gastric banding and progression from impaired fasting glucose to diabetes

In obese people with IFG, weight loss after LAGB is associated with a substantially reduced risk of progressing to diabetes over =4 years. Bariatric surgery may be an effective diabetes prevention strategy in this population (Diabetologia)

Treatment intensification with stepwise addition of prandial insulin aspart boluses compared with full basal-bolus therapy (FullSTEP Study): a randomised, treat-to-target clinical trial

Stepwise prandial insulin intensification provides glycaemic control non-inferior to a full basal-bolus regimen after 32 weeks, with significantly lower hypoglycaemia risk and better patient satisfaction (The Lancet Diabetes & Endocrinology)

Wednesday, 11 December 2013

What happens when patients know more than their doctors? Experiences of health interactions after diabetes patient education: a qualitative patient-led study

Patients who have in-depth knowledge of their condition encounter problems when their expertise is seen as inappropriate in standard healthcare interactions, and expertise taught to patients in one branch of medicine can be considered non-compliant by those who are not specialists in that field (BMJ Open)

Tuesday, 10 December 2013

vildagliptin (Galvus® ) is accepted for restricted use within NHS Scotland
State of the Nation 2013

This year’s report shows that diabetes continues to be a major challenge for the NHS. It is still a huge drain on resources, quality of care still depends on where you live, and the crisis is still not being taken seriously (Diabetes UK)

Autonomous exercise game use improves metabolic control and quality of life in type 2 diabetes patients

In this trial a low-threshold intervention with the interactive exercise game Wii Fit Plus was able to motivate T2DM patients to improve physical activity, glucometabolic control and quality of life (BMC Endocrine Disorders)

Monday, 9 December 2013

Quantitative Estimation of Insulin Sensitivity in Type 1 Diabetic Subjects Wearing a Sensor Augmented Insulin Pump

This new index correlates well with the reference oral minimal model estimate of insulin sensitivity. The knowledge of patient-specific insulin sensitivity and its diurnal variation can help in optimizing insulin therapy in type 1 diabetes and could also inform the next generation closed-loop control systems (Diabetes Care)

Proliferative retinopathy in type 1 diabetes is associated with cerebral microbleeds, which is part of generalized microangiopathy

In PDR patients cerebral microbleeds prevalence was higher and seems part of generalized microangiopathy that may affect the skin and the brain (Diabetes Care)

Thursday, 5 December 2013

New data support flexibility in timing of administration for Sanofi's lixisenatide

The results of a 24-week Phase IIIb clinical study showed that lixisenatide met the primary endpoint of non-inferiority in blood sugar lowering (HbA1c) when administered either before breakfast or the main meal of the day. These results indicate that lixisenatide can effectively lower blood sugar at either time of administration (Sanofi)

GAD-treatment of children and adolescents with recent-onset Type 1 diabetes preserves residual insulin secretion after 30?months

Treatment with two doses of GAD-alum in children and adolescents with recent-onset T1D shows no adverse events and preserves residual insulin secretion (Diabetes/Metabolism Research and Reviews)

Assessing the cost-effectiveness of Type 1 diabetes interventions: the Sheffield Type 1 Diabetes Policy Model

This paper describes the conceptual modelling, model implementation and model validation of the Sheffield Type 1 Diabetes Policy Model (version 1.0), developed through funding by the UK National Institute for Health Research as part of the Dose Adjustment for Normal Eating research programme (Diabetic Medicine)

Wednesday, 4 December 2013

Admissions avoidance and diabetes

Guidance for clinical commissioning groups and clinical teams (JBDS – IP)

Pathophysiology and treatment of type 2 diabetes

Perspectives on the past, present, and future (The Lancet)

Co-Stimulation Modulation with Abatacept in Patients with Recent-Onset Type 1 Diabetes: Follow-Up One Year After Cessation of Treatment

Co-stimulation modulation with abatacept slowed decline of beta-cell function and improved HbA1c in recent-onset T1DM. The beneficial effect was sustained for at least one year after cessation of abatacept infusions, or three years from T1DM diagnosis (Diabetes Care)

Tuesday, 3 December 2013

Sanofi Announces New Phase 3 Results for Investigational New Insulin U300

We are encouraged by these results which suggest that U300 could be a viable treatment option for a wide range of people with type 1 and type 2 diabetes (Sanofi)

Largest Global Survey Investigating Early Type 2 Diabetes Conversations 

Launched by Boehringer Ingelheim and Eli Lilly and Company in Partnership with the International Diabetes Federation. More than 10,000 people with self-reported and diagnosed type 2 diabetes and more than 6,500 treating-physicians from 26 countries to take part in new survey (Boehringer Ingelheim)

Towards metabolic biomarkers of insulin resistance and type 2 diabetes: progress from the metabolome

These biomarkers will help to improve research and management of diabetes. In particular, several biomarkers identified could be used for early identification of diabetes risk (The Lancet Diabetes & Endocrinology)

Limited recovery of ß-cell function after gastric bypass despite clinical diabetes remission

These data show that ß-cell dysfunction persists after RYGBP, even in patients in clinical diabetes remission. This impairment can be rescued by oral glucose stimulation, suggesting that RYGBP leads to an important gastrointestinal effect, critical for improved ß-cell function after surgery (Diabetes)

Defining the Role of GLP-1 in the Enteroinsulinar Axis in Type 2 Diabetes (T2D) utilizing DPP-4 inhibition and GLP-1-Receptor Blockade

In this cohort of diabetic patients with a substantial incretin effect, GLP-1 contributed about 50% to the insulin excursion after an OGT both with and without DPP-4 inhibition. Thus, a significant DPP-4 sensitive glucose lowering mechanism contributes to glycemic control in diabetic patients that may be not mediated by circulating GLP-1 (Diabetes)

Monday, 2 December 2013

Canagliflozin: a novel treatment option for type 2 diabetes

In this manuscript we review canagliflozin and its potential role in management of type 2 diabetes mellitus (Drug Design, Development and Therapy)

Transcutaneous Oxygen Pressure Measurement in Diabetic Foot Ulcers: Mean Values and Cut-Point for Wound Healing

TcPO2= 40 mmHg was associated with diabetic foot ulcer healing, but a TcPO2= 10 mmHg was associated with failure of wound healing. We found that a cut-point of 25 mmHg was most predictive of diabetic foot ulcer healing (Journal of Wound, Ostomy and Continence Nursing)

Thursday, 28 November 2013

National Diabetes Audit - 2011-12: Report 2

This national report from the ninth year of the NDA, presents key findings on complications in 2010-2012 and deaths in 2012 for all age groups (Health and Social Care Information Centre)

Tuesday, 26 November 2013

FDA requires removal of certain restrictions on the diabetes drug Avandia

Results from the Rosiglitazone Evaluated for Cardiovascular Outcomes and Regulation of Glycemia in Diabetes (RECORD) clinical trial showed no elevated risk of heart attack or death in patients being treated with Avandia when compared to standard-of-care diabetes drugs (FDA)

SYR-472, a novel once-weekly dipeptidyl peptidase-4 (DPP-4) inhibitor, in type 2 diabetes mellitus: a phase 2, randomised, double-blind, placebo-controlled trial

Once-weekly SYR-472 treatment produced clinically and statistically significant improvements in glycaemic control in patients with type 2 diabetes. It was well tolerated and might be a new treatment option for patients with this disease (The Lancet Diabetes & Endocrinology)

Monday, 25 November 2013

INVOKANA™ (canagliflozin) Approved in the European Union for Treatment of Adults with Type 2 Diabetes 

Janssen-Cilag International NV (Janssen) announced today that the European Commission (EC) has approved INVOKANA™ (canagliflozin) in the European Union for the treatment of adults with type 2 diabetes mellitus, to improve glycaemic control[1]. Canagliflozin is an oral, once-daily medication, which belongs to a new class of medications called sodium glucose co-transporter 2 (SGLT2) inhibitors (BioSpace)

The introduction of the BPT is encouraging more paediatric diabetes specialists to consider the valuable role technology can play in enhancing service delivery. For those that have already embraced it, the results are better for the NHS, better for healthcare professionals and, most important of all, better for patients (British Journal of Diabetes & Vascular Disease)

Immature platelet fraction in diabetes mellitus and metabolic syndrome

IPF is elevated in patients with diabetes and associated with poor glycemic control and cardiovascular complication (Thrombosis Research)

Five QoF indicators for diabetes to be ‘retired’

The subject of retirement generally raises the mood of doctors, however, news that five QoF indicators are about to be ‘retired’ for diabetes in 2014/15 is likely to cause dismay in primary care, especially since they will not be replaced with alternatives. (Glycosmedia)

Friday, 22 November 2013

Novo Nordisk and Roche Diabetes Care are joining forces to make insulin pump therapy simpler for people with diabetes

The the Committee for Medicinal Products for Human Use (CHMP) under the European Medicines Agency (EMA) adopted positive opinion recommending marketing of NovoRapid® PumpCart® in Europe. NovoRapid® PumpCart® is a 1.6 ml prefilled insulin pump cartridge containing the rapid-acting insulin NovoRapid® from Novo Nordisk. It is compatible with Roche Diabetes Care’s next-generation Accu-Chek® Insight diabetes therapy system (Novo Nordisk)

Rosiglitazone may reduce thyroid cancer risk in patients with type 2 diabetes

This study suggests that rosiglitazone use in patients with type 2 diabetes may reduce the risk of thyroid cancer (Annals of Medicine)

Association of Helicobacter pylori infection with diabetes mellitus and diabetic nephropathy

Our meta-analyses suggest a relationship between H. pylori infection and the risk of diabetes mellitus and diabetic nephropathy. The bacterium may be able to play its pathogenic role in the whole disease process, and this action may be stronger in type 2 diabetic patients than in type 1 diabetic patients (Scandinavian Journal of Infectious Diseases)

Thursday, 21 November 2013

General immune dampening is associated with disturbed metabolism at diagnosis of type 1 diabetes

There is a general immune dampening at diagnosis of T1D, which appears to be related to the metabolic state close to diagnosis (Pediatric Research)

Determinants and consequences of insulin initiation for type 2 diabetes in France

Being treated with insulin was not associated with deterioration in quality of life, and insulin-treated patients were more often adherent than uncontrolled oral bitherapy or tritherapy users. These data suggest that doctors' concerns about patient adherence and detrimental effects on quality of life should not be a barrier to their decision regarding early initiation of insulin therapy (Patient Preference and Adherence)

Wednesday, 20 November 2013

Early Combination Therapy for the Treatment of Type 2 Diabetes Mellitus: Systematic Review and Meta-Analysis

These results suggest a potential benefit of initial combination therapy on glycemic outcomes in diabetes compared to metformin monotherapy across a wide range of baseline A1c levels. Further research should explore if early combination treatment may also affect longer term health outcomes in diabetes (Diabetes, Obesity and Metabolism)

Do Treatment Quality Indicators Predict Cardiovascular Outcomes in Patients with Diabetes?

Treatment quality indicators measuring lipid- and albuminuria-lowering treatment status are valid quality measures, since they predict a lower risk of cardiovascular events and mortality in patients with diabetes. The quality indicators for glucose-lowering treatment should only be used for restricted populations with elevated HbA1c levels. Intriguingly, the tested indicators for blood pressure-lowering treatment did not predict patient outcomes (PLoS ONE)

Intensification of medication and glycaemic control among patients with type 2 diabetes – the ADVANCE trial

Effective glycaemic control was associated with treatment intensification at lower HbA1c levels at all stages of the disease course and in both arms of the ADVANCE trial (Diabetes, Obesity and Metabolism)

IDF Diabetes Atlas

The 6th Edition of the IDF Diabetes Atlas generates estimates using new studies that became available in the last year, and updated population estimates. The new estimates follow the same upward trajectory evidenced by previous editions of the Atlas, and add urgency to the need for effective prevention, treatment, and an end to silence and discrimination (IDF)

Monday, 18 November 2013

A Potential Confounding Factor in the Nonclinical Assessment of Glucagon-Like Peptide (GLP)-1-Based Therapies

These data indicate that the pancreatic findings attributed to incretins are common background findings, observed without drug treatment and independent of diet or glycemic status, suggesting a need to exercise caution when interpreting the relevance of some recent reports to human safety (Diabetes)

Combined Angiotensin Inhibition for the Treatment of Diabetic Nephropathy

Combination therapy with an ACE inhibitor and an ARB was associated with an increased risk of adverse events among patients with diabetic nephropathy (NEJM)

Bardoxolone Methyl in Type 2 Diabetes and Stage 4 Chronic Kidney Disease

Among patients with type 2 diabetes mellitus and stage 4 chronic kidney disease, bardoxolone methyl did not reduce the risk of ESRD or death from cardiovascular causes. A higher rate of cardiovascular events with bardoxolone methyl than with placebo prompted termination of the trial (NEJM)

New Therapies for Diabetic Kidney Disease

Unfortunately, the failure rate of new drug therapies in clinical trials is extraordinarily high, exceeding 90% overall; even in phase 3 trials, it is still approximately 50%. In addition to bardoxolone methyl, a series of other new therapies for diabetic kidney disease have foundered over the course of drug development (NEJM)

Saturday, 16 November 2013

Who subscribes to the FREE Glycosmedia weekly newsletter by email? See here

Friday, 15 November 2013

Levels of inflammatory cytokines in type 2 diabetes patients with different urinary albumin excretion rates and their correlation with clinical variables

From our data we found a strong and graded association between C-reactive protein and UAE in patients with type 2 diabetes. Plasma concentrations of CRP were significantly higher in subjects with T2DM compared to those without T2DM (Journal of Diabetes Research)

Thursday, 14 November 2013

Restoration of the Unfolded Protein Response in Pancreatic ß Cells Protects Mice Against Type 1 Diabetes

Administration of a chemical ER stress mitigator, tauroursodeoxycholic acid (TUDCA), at the prediabetic stage resulted in a marked reduction of diabetes incidence in the T1D mouse models ( Science Translational Medicine)

Relationship between platelet volume indices with macrovasular and peripheral neuropathy complications in type 2 diabetic patients

These findings implied the predictive value of platelets volume indices in vascular and peripheral neuropathy complications in type 2 diabetes (Journal of Diabetes)

An Interprofessional Diabetes Experience to Improve Pharmacy and Nursing Students’ Competency in Collaborative Practice

Integrating interprofessional educational content and activities into a diabetes management course was feasible and effective in achieving both interprofessional and clinical-learning outcomes (American Journal of Pharmaceutical Education)

Wednesday, 13 November 2013

The Relationship Between Maternal Fear of Hypoglycaemia and Adherence in Children with Type-1 Diabetes

The results suggest that mothers who worry most about hypoglycaemia compensate by maintaining their child’s blood glucose levels above recommended levels. Elevated blood glucose levels have important consequences for long-term health, and further research could explore ways to target maternal fear of hypoglycaemia (International Journal of Behavioral Medicine)

Tuesday, 12 November 2013

New Guidelines Redefine Use of Statins

The nation’s leading heart organizations, the American Heart Association and the American College of Cardiology, released new guidelines Tuesday that will fundamentally reshape the use of cholesterol-lowering statin medicines that are now prescribed for a quarter of Americans over 40 (New York Times)

New heart disease and stroke prevention guidelines released

More Americans could benefit from statins (American Heart Association)

Cooperation between brain and islet in glucose homeostasis and diabetes

Here we present evidence of a brain-centred glucoregulatory system (BCGS) that can lower blood glucose levels via both insulin-dependent and -independent mechanisms, and propose a model in which complex and highly coordinated interactions between the BCGS and pancreatic islets promote normal glucose homeostasis (Nature)

Does a patient-managed insulin intensification strategy with insulin glargine and insulin glulisine provide similar glycemic control as a physician-managed strategy? 

In patients with type 2 diabetes on stable doses of basal insulin glargine who require bolus insulin, a simple bolus insulin patient-driven titration algorithm is as effective as a physician-driven algorithm (Diabetes Care)

Monday, 11 November 2013

Spirit Healthcare – Blood Glucose Meter Accuracy Campaign e-petition 

Start of insulin therapy in patients with type 2 diabetes mellitus promotes the influx of macrophages into subcutaneous adipose tissue

We conclude that insulin therapy in patients with type 2 diabetes mellitus improved glycaemic control but also induced body weight gain and an influx of macrophages into the subcutaneous adipose tissue. In patients characterised by a pronounced insulin-associated weight gain, the influx of macrophages into the adipose tissue was accompanied by a more pronounced inflammatory status (Diabetologia)

Friday, 8 November 2013

Ambulatory Treatment Of Type 2 Diabetes Mellitus In The United States, 1997-2012

Declining sulfonylurea and glitazone use has been offset by increases in DPP-4 inhibitor use and, to a lesser degree, use of GLP-1 agonists. Treatment of diabetes has grown in complexity while older treatments continue to be replaced or supplemented by newer therapies (Diabetes Care)

Effects of treatment with metformin on TSH levels: a meta-analysis of literature studies

Metformin induces a reduction in TSH levels both in overt and in subclinical hypothyroidism (Journal of Clinical Endocrinology & Metabolism)

Falling Threshold for Treatment of Borderline Elevated Thyrotropin Levels - Balancing Benefits and Risks

We observed a trend toward levothyroxine treatment of more marginal degrees of hypothyroidism and a substantial risk of developing a suppressed thyrotropin level following therapy (JAMA)

Wednesday, 6 November 2013

Improving Depression Screening for Adolescents With Type 1 Diabetes

Systematic depression screening in adolescents with type 1 diabetes can be reliably implemented with clinically significant results. A systematic approach, such as described in this study, can serve as a model for other chronic health conditions (Pediatrics)

Improving Depression Screening for Adolescents With Type 1 Diabetes

Systematic depression screening in adolescents with type 1 diabetes can be reliably implemented with clinically significant results. A systematic approach, such as described in this study, can serve as a model for other chronic health conditions (Pediatrics)

National Diabetes Audit 2011-12

This national report from the ninth year of the audit presents key findings on key care processes and treatment target achievement rates from 2011-2012 in all age groups in England and Wales (Health and Social Care Information Centre)

Tuesday, 5 November 2013

Effect of statin therapy on vaspin levels in type 2 diabetic patients

These results indicate that statin therapy increases plasma vaspin levels in addition to having a lipid-lowering effect. This could be a mechanism underlying the pleiotropic effects seen with statins, including their cardioprotective and antiatherosclerotic effects (Clinical Pharmacology: Advances and Applications)

Safety of Nighttime 2-Hour Suspension of Basal Insulin in Pump-Treated Type 1 Diabetes Even in the Absence of Low Glucose

Systems that suspend basal insulin for 2-hrs are safe and do not lead to clinically significant ketonemia even if BG is elevated at the time of the suspension (Diabetes Care)

Relationships between electrochemical skin conductance and kidney disease in Type 2 diabetes

Noninvasive measurement of skin conductance strongly associated with eGFR in AA with T2D, replicating results in Hong Kong Chinese. SUDOSCAN® may prove useful as a low cost, non-invasive screening tool to detect undiagnosed diabetic kidney disease in populations of African ancestry (Diabetes and Its Complications)

Monday, 4 November 2013

A randomized controlled trial of cognitive behavioral therapy for adherence and depression in patients with uncontrolled type 2 diabetes

CBT-AD is an effective intervention for adherence, depression, and glycemic control, with enduring and clinically meaningful benefits for diabetes self-management and glycemic control, in adults with type-2 diabetes and depression (Diabetes Care)

Single phosphorylation sites in Acc1 and Acc2 regulate lipid homeostasis and the insulin-sensitizing effects of metformin

These findings establish that inhibitory phosphorylation of Acc by Ampk is essential for the control of lipid metabolism and, in the setting of obesity, for metformin-induced improvements in insulin action (Nature Medicine)

Saturday, 2 November 2013

Diabetes and disability: impairments, activity limitations, participation restrictions and comorbidities

The report examines the association between diabetes and disability in Australia using data from the Australian Bureau of Statistics' Survey of Disability, Ageing and Carers 2009 (AIHW)

Effects of Sitagliptin and Metformin Treatment on Incretin Hormone and Insulin Secretory Responses to Oral and “Isoglycemic” Intravenous Glucose

Sitagliptin increased intact GLP-1 and GIP through DPP-4 inhibition, but reduced total GLP-1 and GIP (feedback inhibition) without affecting the numerical contribution of the incretin effect. Insulin secretion with sitagliptin treatment was similarly stimulated with both oral and “isoglycemic” intravenous glucose (Diabetes)

Friday, 1 November 2013

A substantial tax on sugar sweetened drinks could help reduce obesity

Public health researchers, advocates, and policy makers have increasingly proposed taxes on sugar sweetened drinks as a way to reverse the rising consumption of such drinks—a trend believed to be a major contributor to the global obesity epidemic (BMJ)

Both Dietary Protein and Fat Increase Postprandial Glucose Excursions in Children With Type 1 Diabetes, and the Effect Is Additive

Meals high in protein or fat increase glucose excursions in youth using intensive insulin therapy from 3 h to 5 h postmeal. Protein and fat have an additive impact on the delayed postprandial glycemic rise. Protein had a protective effect on the development of hypoglycemia (Diabetes Care)

Glycated nail proteins: a new approach for detecting diabetes in developing countries

This affordable method is a simple alternative for diagnosing diabetes in remote areas as the pre-analytical phase (including all processes from the time a laboratory request is made by a physician until the sample is ready for testing) is extremely robus (Tropical Medicine & International Health)

Comparative effectiveness of renin-angiotensin system blockers and other antihypertensive drugs in patients with diabetes: systematic review and bayesian network meta-analysis

Our analyses show the renoprotective effects and superiority of using ACE inhibitors in patients with diabetes, and available evidence is not able to show a better effect for ARBs compared with ACE inhibitors (BMJ)

Thursday, 31 October 2013

Earlier onset of complications in youth with type 2 diabetes

Youth with type 2 diabetes exhibit complications sooner than youth with type 1 diabetes. Younger age at diagnosis is potentially protective, and glycemic control is an important modifiable risk factor. The unexpected adverse association between RAAS inhibitor use and outcome is likely a confounder by indication; however, further evaluation in young people is warranted (Diabetes Care)

Prevalence of Prediabetes and Newly Diagnosed Diabetes in Patients with a Transient Ischemic Attack or Stroke

Prediabetes and newly diagnosed diabetes are highly prevalent in patients with a TIA or stroke. The majority of these patients would not have been identified by fasting plasma glucose levels alone. Both 2-hour postload glucose and glycosylated hemoglobin levels identify more patients with a disturbed glucose metabolism (Cerebrovascular Diseases)

Wednesday, 30 October 2013

Unimolecular Dual Incretins Maximize Metabolic Benefits in Rodents, Monkeys, and Humans

This discovery and validation of a balanced and high-potency dual incretin agonist enables a more physiological approach to management of diseases associated with impaired glucose tolerance (Science Translational Medicine)

Neuroanatomical correlates of dysglycemia in young children with type 1 diabetes mellitus

Early onset T1D affects regions of the brain that are associated with typical cognitive development (Diabetes)

Tuesday, 29 October 2013

Transplantation of human islets without immunosuppression

In this paper we present the clinical success of using a bioartificial pancreas for the transplantation of insulin-producing islets without affecting the immune system (PNAS)

Poor Glycemic Control Is Related To Increased Nitric Oxide Activity Within the Renal Circulation of Patients With Type 2 Diabetes

In line with experimental evidence, we could demonstrate in humans that poor glycemic control is related to higher NO activity and hyperperfusion of the kidney. The renal NO system may thus be a novel therapeutic target for improving renal hemodynamics in patients with diabetes (Diabetes Care)

Kidney function and the risk of cardiovascular disease in patients with type 2 diabetes

Even mildly reduced estimated GFR at baseline (under 75 ml/min per 1.73 m2) and during follow-up (under 90 ml/min per 1.73 m2) increased the risk of incident coronary heart disease and stroke among both African-American and Caucasian type 2 diabetes patients (Kidney International)

Monday, 28 October 2013

Project IMPACT: Diabetes Improves Outcomes for Underserved Patients In 25 Communities Disproportionately Affected by Diabetes

Interim clinical results fromProject IMPACT: Diabetes, announced today by the American Pharmacists Association (APhA) Foundation, show statistically significant decreases in A1C or blood sugar levels, LDL cholesterol, systolic blood pressure and Body Mass Index (BMI), which are all recognized standards of diabetes care (American Pharmacists Association)

Data Confirm Pharmacists Play a Key Role on the Healthcare Team

Project IMPACT: Diabetes Improves Outcomes for Underserved Patients In 25 Communities Disproportionately Affected by Diabetes (APhA Foundation)

Diabetes care for the most vulnerable in society – the views of professionals working in care homes and domiciliary care using focus group methodology

The main concerns of health care professionals working in care homes and in the domiciliary sector were: poor communication with all other health care agencies; the need for training, specifically in diabetes and dementia; poor support from the specialist diabetes team (British Journal of Diabetes & Vascular Disease)

Non-invasive risk scores for prediction of type 2 diabetes (EPIC-InterAct): a validation of existing models

Existing diabetes prediction models can be used to identify individuals at high risk of type 2 diabetes in the general population. However, the performance of each model varies with country, age, sex, and adiposity (The Lancet Diabetes & Endocrinology)

GP federation awarded £10m diabetes contract

A group of GP practices has won a £10m contract to provide a full community service for patients with diabetes from April 2014 (Pulse)

Friday, 25 October 2013

Poor glycemic control is a major factor in the overestimation of glomerular filtration rate in diabetic patients

eGFR overestimates Cin as glycemic controls worsen. eGFR corrected by hemoglobin A1c is considered to be clinically useful and feasible (Diabetes Care)

Risks of Diabetic Nephropathy with Variation in Hemoglobin A1c and Fasting Plasma Glucose

Annual FPG and HbA1c variations have a strong association with diabetic nephropathy in patients with type 2 diabetes. Whether intervention for reducing glucose variation should be administered needs to be examined in a future study (American Journal of Medicine)

Efficacy of carbohydrate counting in type 1 diabetes: a systematic review and meta-analysis

There is some evidence to support the recommendation of carbohydrate counting over alternate advice or usual care in adults with type 1 diabetes. Additional studies are needed to support promotion of carbohydrate counting over other methods of matching insulin dose to food intake (The Lancet Diabetes & Endocrinology)

Thursday, 24 October 2013

The Impact of Hyperglycemic Emergencies on the Kidney and Liver

Diabetic ketoacidosis and diabetic ketosis deteriorate liver and kidney function parameters, especially in patients with ketoacidosis. After considering the values of glycemic variables, the diagnosis of a hyperglycemic crisis should be cautious when based on lower prealbumin levels in overt hyperglycemia (Journal of Diabetes Research)

Type 2 diabetes mellitus and hypothyroidism: the possible influence of metformin therapy

Our results support a relatively close association between diabetes and hypothyroidism. Hypothyroidism was more common in the cohort of white subjects than in other ethnic groups. The use of metformin therapy in people with Type 2 diabetes was associated with a significantly lower prevalence of diagnosed hypothyroidism (Diabetic Medicine)

Chief Medical Officer: Prevention pays - our children deserve better

Reducing obesity by just one percentage point among children and young people could lead to savings of £1 billion each year as children would be less likely to end up with long-term health problems needing NHS treatment.

Wednesday, 23 October 2013

Managing overweight and obesity among children and young people: lifestyle weight management services

This guidance aims to provide recommendations on lifestyle weight management services for overweight and obese children and young people (NICE)

Dementia and cognitive decline in type 2 diabetes and prediabetic stages: towards targeted interventions

We identify possible opportunities for intervention to improve cognitive outcomes in people with type 2 diabetes, and suggest how treatment can be tailored to individual risk profiles and comorbidities (The Lancet Diabetes & Endocrinology)

Tuesday, 22 October 2013

Dipeptidyl peptidase-4 inhibitors and GLP-1 reduce myocardial infarct size in a glucose-dependent manner

We find that chronic treatment with DPP-4 inhibitors reduced MI size, via the GLP-1 receptor-PKA pathway, in a glucose-dependent manner. Glucose-sensitive cardioprotection of endogenous GLP-1 in diabetic patients may in part explain why intensive control of serum glucose levels has been associated with increased cardiovascular risk (Cardiovascular Diabetology)

Insulin degludec: a new insulin for today?

No abstract (Diabetic Medicine)

Monday, 21 October 2013

TB’s links to diabetes

Symposium draws researchers to strategize against metabolic diseases (Harvard Gazette)

Sunday, 20 October 2013

Indian-made medicines recalled by UK health regulator
One of the medications is gliclazide (Independent)

Anger as diabetic children miss out on insulinpumps

Some health boards in Wales are not following mandatory guidelines by failing to provide insulin pumps to children with type 1 diabetes, BBC Wales has found

Saturday, 19 October 2013

CSII experience among higher specialist trainees: a Young Diabetologists and Endocrinologists Forum survey

We conclude that the provision of CSII training varies considerably in the UK; training opportunities and exposure to pump therapy in practice vary greatly, which reflects a lack of formal detail or consideration of this in the UK curriculum. We propose a basic set of pump training competencies which diabetes registrars should be expected to work towards and fulfil prior to the completion of training (Practical Diabetes)

Obesity experts appalled by EU move to approve health claim for fructose 

Food firms using fructose will be able to boast of health benefits despite fruit sugar being implicated in soaring US obesity levels (Guardian)

Friday, 18 October 2013

Glycosmedia is now sponsoring WEDS with a news feed
Non-invasive detection of microvascular changes in a paediatric and adolescent population with type 1 diabetes

This pilot study has shown that in children and adolescents with established type 1 diabetes, abnormal microvasculature can be detected by nailfold capillaroscopy, laser Doppler flowmetry, retinal vessel analysis and 24-hr ambulatory blood pressure monitoring (BMC Endocrine Disorders)

Thursday, 17 October 2013

The peripartum management of glycaemia in women with Type 1 diabetes

Changes in the pharmacodynamic profile of insulin may contribute to the transient insulin independence sometimes observed postpartum in type 1 diabetes. A dose of 50-60% of the pre-pregnancy insulin requirement resulted in the lowest rate of hypoglycaemia and glucose excursions (Diabetes Care)

Impact of C-Peptide Preservation on Metabolic and Clinical Outcomes in the Diabetes Control and Complications Trial

As C-peptide decreased to non-measureable concentrations, the outcomes changed in a nearly linear manner, with no threshold or breakpoint. While preservation of stimulated C-peptide at =0.2 nmol/L has clinically beneficial outcomes, so also does an increase in the concentration of C-peptide across the range of values (Diabetes)

Wednesday, 16 October 2013

Needle-Free Jet Injection of Rapid-Acting Insulin Improves Early Postprandial Glucose Control in Patients With Diabetes

The considerably more rapid insulin absorption after administration by jet injector translated to a significant if modest decrease in postprandial hyperglycemia in patients with type 1 and type 2 diabetes. The improved early postprandial glucose control may specifically benefit patients who have difficulty in limiting postprandial glucose excursions (Diabetes Care)

Tuesday, 15 October 2013

MannKind Resubmits New Drug Application to U.S. FDA for AFREZZA for the Treatment of Adults with Diabetes

MannKind Corporation announces the resubmission of a new drug application (NDA) to the U.S. Food and Drug Administration (FDA) seeking approval for the marketing and sale of AFREZZA® (insulin human [rDNA origin]) Inhalation Powder with an indication to improve glycemic control in adults with type 1 or type 2 diabetes (MannKind Corporation)

Clinical Inertia in People With Type 2 Diabetes

There are delays in treatment intensification in people with type 2 diabetes despite suboptimal glycemic control. A substantial proportion of people remain in poor glycemic control for several years before intensification with OADs and insulin (Diabetes Care)

General practice-recorded depression and antidepressant use in young people with newly diagnosed Type 1 diabetes

This population-based study shows that people with Type 1 diabetes have higher rates of general practice-recorded depression and antidepressant use. The excess is present within 5 years of diabetes diagnosis, suggesting psychological input for patients is warranted in the early years of their condition (Diabetic Medicine)

Collaborative care for patients with depression and diabetes mellitus

Improving depression care in diabetic patients is very necessary and important. Comparing with usual care, collaborative care was associated with significantly better depressive outcomes and adherence in patients with depression and diabetes (BMC Psychiatry)

Gastric Bypass Leads to Improvement of Diabetic Neuropathy Independent of Glucose Normalization

As expected, BMI and HbA1c levels improved significantly after RYGB. More interestingly, neuropathy scores, such as NSS and NDS, improved significantly early after surgery. Symptomatic neuropathy was completely reversible in 67% of the patients. These findings add further evidence to the fact that RYGB might be a valuable treatment option not only for improving glycemic control but also for reducing diabetes-associated comorbidities, such as DPN (Annals of Surgery)

Monday, 14 October 2013

Social media in diabetes: bane or boon?

If the feedback from patients is that ‘this’ is the forum they would like to use then it's our responsibility to make it work. The days of ‘us’ seeing patients on our own terms are dying a slow death. We need to ensure that we can rise to the challenge and use existing forums to suit patients, especially in a disease process where engagement is the key mantra (Practical Diabetes)

Sunday, 13 October 2013

Delay in diabetic retinopathy screening increases the rate of detection of referable diabetic retinopathy

The rate of detection of referable diabetic retinopathy is elevated in those who were not screened promptly after diagnosis of Type 2 diabetes (Diabetic Medicine)

Chronic kidney disease and diabetes in the National Health Service: a cross-sectional survey of the UK National Diabetes Audit

The high prevalence of chronic kidney disease and poor attainment of treatment targets highlights a large subset of the diabetes population at increased risk of cardiovascular mortality or progressive kidney disease (Diabetic Medicine)

Thyroid autoimmunity in Type 1 diabetes: systematic review and meta-analysis

There is a markedly increased risk of thyroid dysfunction in people with Type 1 diabetes and thyroid autoimmunity. The optimal method or frequency of screening could not be determined from available data. Future studies should examine whether screening improves clinical outcomes in this population (Diabetic Medicine)

Saturday, 12 October 2013

Ethnic Differences in Glycemic Markers in Patients With Type 2 Diabetes

For a given degree of glycemia, HbA1c levels vary among different ethnic groups. Ethnicity needs to be taken into account when using HbA1c to assess glycemic control or to set glycemic targets. Estimated AG is not a reliable marker for mean glycemia and therefore is of limited clinical value (Diabetes Care)

Friday, 11 October 2013

External Validation of the UKPDS Risk Engine in Incident Type 2 Diabetes: a need for new risk type 2 diabetes-specific risk equations

The UKPDS stroke equations showed calibration ranging from poor to moderate; however, the CHD equations showed poor calibration and considerably overestimated CHD risk. There is a need for revised risk equations in type 2 diabetes (Diabetes Care)

Enhancement of Vasoreactivity and Cognition by Intranasal Insulin in Type 2 Diabetes

Intranasal insulin administration appears safe and does not affect systemic glucose control, and may provide acute improvements of cognitive function in patients with type 2 diabetes, potentially through vasoreactivity mechanisms. Intranasal insulin-induced changes in cognitive function may be related to vasodilatation in the anterior brain regions, such as insular cortex that regulates attention-related task performance (Diabetes Care)

Thursday, 10 October 2013

Glycosmedia daily updates

For other daily updates please take a look at the Glycosmedia App and Twitter feeds

Updating Diabetic Retinopathy Screening Lists using Automatic Extraction from GP Patient Records

Automatic extraction of data from General Practice identified 709 patients coded as having diabetes not previously known to the Gloucestershire DESP (Journal of Medical Screening)

Hyperglycemia following recovery from hypoglycemia worsens endothelial damage and thrombosis activation in type 1 diabetes and in healthy controls

This study shows that, in type 1 diabetes as well as in controls, the way in which recovery from hypoglycemia takes place could play an important role in favoring the activation of thrombosis and oxidative stress, widely recognized cardiovascular risk factors (Nutrition, Metabolism & Cardiovascular Diseases)

Wednesday, 9 October 2013

PONTIAC (NT-proBNP selected prevention of cardiac events in a population of diabetic patients without a history of cardiac disease)

Accelerated up-titration of RAS antagonists and beta-blockers to maximum tolerated dosages is an effective and safe intervention for the primary prevention of cardiac events for diabetic patients pre-selected using NT-proBNP (American Journal of Cardiology)

Perspectives from Before and After the Pediatric to Adult Care Transition: A Mixed-Methods Study in Type 1 Diabetes

Standardizing transition preparation programs in pediatric care and introducing transition-oriented clinics for late adolescents and young adults prior to adult care may help address patients’ preferences and common transfer-related challenges (Diabetes Care)

Tuesday, 8 October 2013

Leptin regulation of Hsp60 impacts hypothalamic insulin signaling

Type 2 diabetic patients exhibited decreased expression of HSP60 in the brain, indicating that this mechanism is relevant to human disease. These data indicate that leptin plays an important role in mitochondrial function and insulin sensitivity in the hypothalamus by regulating HSP60. Moreover, leptin/insulin crosstalk in the hypothalamus impacts energy homeostasis in obesity and insulin-resistant states (European Journal of Clinical Investigation)

Low-dose interleukin 2 in patients with type 1 diabetes

We have defined a well-tolerated and immunologically effective dose range of IL2 for application to type 1 diabetes therapy and prevention, which could be relevant to other disorders in which a Treg cell increase would be desirable (The Lancet Diabetes & Endocrinology)

Corneal nerve fibre damage precedes diabetic retinopathy in patients with Type 2 diabetes mellitus

Corneal cell pathology occurs in patients with diabetic retinopathy, but corneal nerve fibre damage seems to precede the development of diabetic retinopathy (Diabetic Medicine)

Monday, 7 October 2013

Liraglutide pancreatitis: The ABCD nationwide liraglutide audit

In cases of acute pancreatitis of a patient on liraglutide, if another cause can be found (usually gall stones associated with obesity), the drug is not be necessarily culpable. People with Type 2 diabetes are at greater risk of acute pancreatitis (hazard ratio between 1.5 and 2.8). Thus, the possibility of liraglutide-associated pancreatitis in ‘real-world’ clinical practice represents a very small risk (The British Journal of Diabetes & Vascular Disease)

Human Milk Secretory Immunoglobulin A and Lactoferrin N-Glycans Are Altered in Women with Gestational Diabetes Mellitus

The results suggest that maternal glucose dysregulation during pregnancy has lasting consequences that may influence the innate immune protective functions of breast milk (Journal of Nutrition)

Walking Works

The Ramblers and Macmillan Cancer Support, who run Walking for Health, have launched Walking Works, an extensive overview of the mounting research into the life threatening consequences of inactivity, which concludes that walking is the answer (Walking for Health)

How to improve the way medical research is applied in front-line care

Collaborations for leadership in applied health research aim to encourage staff in the NHS to adopt research-informed practices (Guardian)

Friday, 4 October 2013

New hypoglycemia and pancreatitis subanalyses from the Onglyza® (saxagliptin) SAVOR cardiovascular outcomes trial 

Additional results from the SAVOR cardiovascular outcomes trial found no increased rate of hypoglycemia among patients treated with Onglyza® (saxagliptin) compared to placebo when added to metformin monotherapy and higher rates of hypoglycemia only in the Onglyza group compared to the placebo group among patients taking sulfonylureas, agents known to cause hypoglycemia, at baseline (AstraZeneca)

Thursday, 3 October 2013

Efficacy and safety of lixisenatide once daily vs. placebo in people with Type 2 diabetes insufficiently controlled on metformin

Lixisenatide one- or two-step dose-increase regimens significantly improved glycaemic control and decreased body weight over 24 weeks and during a long-term extension period without increasing hypoglycaemia (Diabetic Medicine)

Soluble factors secreted by T-cells promote ß-cell proliferation

These data suggest that soluble factors secreted from T cells are potential therapeutic candidates to enhance ß-cell proliferation in efforts to prevent and/or delay the onset of type 1 diabetes (Diabetes)

Wednesday, 2 October 2013

Exercise “potentially as effective” as many drugs for common diseases

Analysis ofthe results of 305 randomised controlled trials involving 339,274 individuals and found no statistically detectable differences between exercise and drug interventions for secondary prevention of heart disease and prevention of diabetes (BMJ)

Roux-en-Y Gastric Bypass and Sleeve Gastrectomy: Mechanisms of Diabetes Remission and Role of Gut Hormones

RYGB and SLG have a similar impact on diabetes remission, of which baseline ß-cell glucose sensitivity and a restored GLP-1 response are the chief determinants (Journal of Clinical Endocrinology & Metabolism)

Tuesday, 1 October 2013

Diabetic macular oedema - Fluocinolone acetonide intravitreal implant (rapid review of TA271)

Final appraisal determination document - also evaluation report (NICE)

Medtronic Gains Approval of First Artificial Pancreas Device System with Threshold Suspend Automation

Medtronic's system is the first in the United States that can automatically stop insulin delivery when sensor glucose values reach a preset level and when the patient doesn't respond to the Threshold Suspend alarm ... As a condition of approval, in addition to the post-approval study, Medtronic will engage in direct patient follow up and will make certain manufacturing accommodations (Medtronic)

Researchers discover a biological link between diabetes and heart disease

Researchers have identified for the first time a biological pathway that is activated when blood sugar levels are abnormally high and causes irregular heartbeats, a condition known as cardiac arrhythmia that is linked with heart failure and sudden cardiac death (UC Davis Health System)

Sitagliptin improves albuminuria in patients with type 2 diabetes mellitus

The results suggested that sitagliptin improved albuminuria, in addition to improving glucose. The mechanism of the reduction of albuminuria by sitagliptin could be a direct effect, as well as an increase in active glucagon-like peptide-1, independently affecting blood pressure, bodyweight and glucose metabolism (Journal of Diabetes Investigation)

A psychosocial risk index for poor glycemic control in children and adolescents with type 1 diabetes

This paper presents the first psychosocial risk index for poor glycemic control in children newly diagnosed with type 1 diabetes. It is brief, easily administered, and provides a single score that translates directly into an estimate of risk that can help guide routine diabetes care (Pediatric Diabetes)

Saturday, 28 September 2013

EASD Barcelona 2013

Access to abstracts, eposters and webcasts from (EASD Virtual Meeting)

Friday, 27 September 2013

Advice for people newly diagnosed with Type 2 diabetes

This leaflet is designed to give you some initial advice until you are able to attend a structured education programme. It will help you start to manage your diabetes, whilst continuing to live a full and active life (Diabetes National Specialist Advisory Group - NHS Wales)

Novo Nordisk's diabetes combination IDegLira impresses in study

Mix of Tresiba and Victoza helps 81 per cent achieve blood sugar target in phase III (PMLive)

Impact of low-density lipoprotein cholesterol on cardiovascular outcomes in people with type 2 diabetes

Our study demonstrates that LDL cholesterol was associated with an increased risk for cardiovascular outcomes in people with type 2 diabetes, independent of other conventional risk factor (Diabetes Research and Clinical Practice)

New data for Novartis drug Lucentis

New data for Novartis drug Lucentis® reinforces transformational efficacy and well-established safety profile across four indications (Novartis)

Thursday, 26 September 2013

Health Minister launches Diabetes Delivery Plan

The Welsh Health Minister Mark Drakeford has today launched a Delivery Plan for the Welsh NHS to improve diabetes care (Welsh Government)

Wednesday, 25 September 2013

Antidepressant Medication as a Risk Factor for Type 2 Diabetes and Impaired Glucose Regulation

Although evidence exists that antidepressant use may be an independent risk factor for type 2 diabetes, long-term prospective studies of the effects of individual antidepressants rather than class effects are required (Diabetes Care)

Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study)

Treatment with dextrose gel is inexpensive and simple to administer. Dextrose gel should be considered for first-line treatment to manage hypoglycaemia in late preterm and term babies in the first 48 h after birth (The Lancet)

Tuesday, 24 September 2013

Effects of Adding Linagliptin to Basal Insulin Regimen for Inadequately Controlled Type 2 Diabetes

Linagliptin added to basal insulin therapy significantly improved glycemic control relative to placebo without increasing hypoglycemia or body weight (Diabetes Care)

Diabetes treatments and cancer risk: the importance of considering aspects of drug exposure

In this Review, we discuss representation of drug exposure in pharmacoepidemiological investigations of the connection between diabetes drugs and cancer risk. We identify principles that might improve future research (particularly in observational studies), and consider issues related to reverse causation and detection bias (The Lancet Diabetes & Endocrinology)

Type 2 diabetes: lixisenatide

Evidence summary: new medicine (NICE)

Takeda Receives Simultaneous European Marketing Authorization for Three New Type 2 Diabetes Therapies

Vipidia (alogliptin) and Fixed-Dose Combinations Vipdomet (alogliptin and metformin) and Incresync (alogliptin and pioglitazone)

Data From Post-Hoc Analyses Presented at EASD Examine Safety Profile of Linagliptin in Adults with Type 2 Diabetes

Two pooled analyses of data from clinical trials in adults with type 2 diabetes, including the elderly with normal renal function to severe renal impairment, found similar incidence of adverse events for linagliptin compared with placebo (Lilly)

The association between dietary patterns and type 2 diabetes: a systematic review and meta-analysis of cohort studies

The results of this systematic review and meta-analysis indicate that dietary patterns may be associated with the risk of type 2 diabetes (Journal of Human Nutrition and Dietetics)

Monday, 23 September 2013

Increased orosomucoid in urine is an independent predictor of cardiovascular and all-cause mortality in patients with type 2 diabetes at 10years of follow-up

UOER is an independent predictor of all-cause and cardiovascular mortality even in normoalbuminuric patients with T2DM at 10years of follow-up (Diabetes and Its Complications)

Targeting of memory T cells with alefacept in new-onset type 1 diabetes (T1DAL study)

Although the primary outcome was not met, at 12 months, alefacept preserved the 4 h C-peptide AUC, lowered insulin use, and reduced hypoglycaemic events, suggesting efficacy. Safety and tolerability were similar in the alefacept and placebo groups. Alefacept could be useful to preserve ß-cell function in patients with new-onset type 1 diabetes (The Lancet Diabetes & Endocrinology)

Sunday, 22 September 2013

Cardiac implications of hypoglycaemia in patients with diabetes - a systematic review

Emerging data suggest that there is an impact of hypoglycaemia on CV function and mechanistic link is multifactorial. Further research will be needed to ascertain the full impact of hypoglycaemia on the CV system and its complications (Cardiovascular Diabetology)

Saturday, 21 September 2013

Novo Nordisk replies to BMJ investigation on incretins and pancreatic damage

As a company with a 90 year history dedicated to diabetes care, research, and education, Novo Nordisk has always put patients first. We would like to respond and set out our position on the recent articles and related commentary on incretins and pancreatic damage (British Medical Journal)

Improvement in ß-Cell Secretory Capacity After Human Islet Transplantation According to the CIT07 Protocol

These data indicate that engrafted islet ß-cell mass is markedly improved with the CIT07 protocol, especially given more frequent use of single islet donors. Although several peritransplant differences may have each contributed to this improvement, the lack of deterioration in ß-cell secretory capacity over time in the CIT07 protocol suggests that low-dose tacrolimus and sirolimus are not toxic to islets (Diabetes)

Friday, 20 September 2013

New facility specifically built to produce a solid dose medication for treating Type 2 diabetes in adults

Aesica unveils a new High Capacity Manufacturing Facility investing £30 million at its Queenborough, UK site (Aesica)

Culturally sensitive patient-centred educational programme for self-management of type 2 diabetes: A randomized controlled trial

This study demonstrates the effectiveness of culturally sensitive, structured, group-based diabetes education in enhancing biomedical and behavioural outcomes in Diabetic patients (Primary Care Diabetes)

Wednesday, 18 September 2013

2-Aminoadipic acid is a biomarker for diabetes risk

In summary, we identified a metabolite biomarker (2-AAA) that predicts the development of diabetes in normoglycemic individuals. Individuals with high plasma 2-AAA concentrations had up to a 4-fold risk of future diabetes (Journal of Clinical Investigation)

All-Cause, Cardiovascular, and Cancer Mortality Rates in Postmenopausal White, Black, Hispanic, and Asian Women With and Without Diabetes in the United States

Within each racial/ethnic subgroup, women with diabetes had an approximately 2–3 times higher risk of all-cause, cardiovascular, and cancer mortality than did those without diabetes (American Journal of Epidemiology)

A systematic review of the experience of older women living and coping with type 2 diabetes

For female patients with diabetes, holistic care and individual psycho-education programmes appear to be facilitate more effective and successful diabetes management. In addition, carer programmes that provide information so that family and friends can support and assist the woman with diabetes are required (International Journal of Nursing Practice)

Changes in time to insulin initiation in type 2 diabetes patients: A retrospective database analysis in Germany and UK (2005–2010)

This real world data shows that the time to insulin therapy has increased in type 2 diabetes patients from 2005 to 2010 (Germany, UK). The average HbA1c values before insulin therapy also slightly increased during this period (Primary Care Diabetes)

Intensity of peri-operative glycemic control and postoperative outcomes in patients with diabetes: a meta-analysis

Pooled results suggest that in patients with diabetes, a moderate peri-operative glycemic target (150–200mg/dl [5.6–8.3mmol/l]) is associated with reduction in postoperative mortality and stroke compared with a liberal target (>200mg/dl [11.1mmol/l]), whereas no significant additional benefit was found with more strict glycemic control (<150mg/dl [5.6mmol/l]) (Diabetes Research and Clinical Practice)