Wednesday, 31 July 2013

Use of an Insulin Bolus Advisor Improves Glycemic Control in Multiple Daily Insulin Injection (MDI) Therapy Patients With Suboptimal Glycemic Control

Use of an automated bolus advisor resulted in improved glycemic control and treatment satisfaction without increasing severe hypoglycemia (Diabetes Care)

HbA1c and Risk of Severe Hypoglycemia in Type 2 Diabetes

Severe hypoglycemia was common among patients with type 2 diabetes across all levels of glycemic control. Risk tended to be higher in patients with either near-normal glycemia or very poor glycemic control (Diabetes Care)
Implications of Rising Prediabetes Prevalence

Close surveillance of rising prediabetes prevalence is critical to projecting the future burden of diabetes and the resources that will be required to combat diabetes going forward (Diabetes Care)
New Diabetes Update: National Diabetes Inpatient Audit England & Wales 2012

In hospitals around the UK, diabetes teams complain that their attempts to up-skill healthcare professionals are thwarted by last minute withdrawals due to staff shortages on the wards. Until this is met head-on, we will continue to see high-profile disasters on programmes such as ‘Week in, week out’ (‘Wales's Diabetes Disgrace’ 2012) and massive pay-outs will stretch already limited NHS funds (Glycosmedia)

Novel Role of Parathyroid Hormone-Related Protein in the Pathophysiology of the Diabetic Kidney: Evidence from Experimental and Human Diabetic Nephropathy

Collectively, these results indicate that the renal PTHrP/PTH1R system is upregulated in experimental as well human diabetes, appears to be involved with renal hypertrophy, and adversely affects the outcome of DN (Journal of Diabetes Research)

First Patient Enrolled in New Cardiovascular and Renal Outcomes Trial for TRADJENTA® (linagliptin) Tablets in Type 2 Diabetes

Boehringer Ingelheim and Lilly initiate post-marketing trial with a planned enrollment of more than 8,000 adults with type 2 diabetes in 24 countries (Lilly)

Risk of developing diabetes mellitus and hyperlipidemia among patients with bipolar disorder, major depressive disorder, and schizophrenia

This first 10-year nationwide population-based prospective matched control cohort study showed increased risks of initiation of anti-diabetic and anti-hyperlipidemia medications among patients with BD and schizophrenia. No significant increased risk was noted among the patients with MDD (Journal of Affective Disorders)

Tuesday, 30 July 2013

Type 1 diabetes and living without a partner

Psychological and social aspects, self-management behaviour, and glycaemic control (Diabetes Research and Clinical Practice)

Monday, 29 July 2013

Preserved GLP-1 and exaggerated GIP secretion in type 2 diabetes and relationships with triglycerides and ALT

The present study confirms that in type 2 diabetes, GLP-1 secretion is generally preserved, and that GIP secretion is exaggerated. The mechanism underlying the divergent associations of GLP-1 and GIP metabolism with fat metabolism and liver fat accumulation warrants further study (European Journal of Endocrinology)

Sunday, 28 July 2013

Dapagliflozin - Food and Drug Administration

Endocrinologic and Metabolic Drugs Advisory Committee will discuss new drug application (NDA) 202293 dapagliflozin (FDA)
Home Secretary Theresa May diagnosed with Type 1 diabetes

Home Secretary Theresa May has revealed she has been diagnosed with Type 1 diabetes but insists it will not affect her political career (BBC)

Friday, 26 July 2013

Impact of Specific Glucose-Control Strategies on Microvascular and Macrovascular Outcomes in 58,000 Adults With Type 2 Diabetes

In a large representative cohort of adults with type 2 diabetes, more aggressive glucose-control strategies have mixed short-term effects on microvascular complications and do not reduce the myocardial infarction rate over 4 years of follow-up (Diabetes Care)

Biomarkers for type 2 diabetes and impaired fasting glucose using a non-targeted metabolomics approach

This T2D-IFG biomarker study has surveyed the broadest panel of non-targeted metabolites to date, revealing both novel and known associated metabolites and providing potential novel targets for clinical prediction and a deeper understanding of causal mechanisms (Diabetes)

Vipidia (alogliptin)

The Committee for Medicinal Products for Human Use (CHMP) adopted a positive opinion, recommending the granting of a marketing authorisation for Vipidia, 6.25 mg, 12.5 mg and 25 mg, film-coated tablet intended for the treatment of type 2 diabetes mellitus (European Medicines Agency)

Investigation into GLP-1 based diabetes therapies concluded

No new concerns for GLP-1 therapies identified on the basis of available evidence (European Medicines Agency)

Thursday, 25 July 2013

Mechanisms of Hypoglycemia-Associated Autonomic Failure in Diabetes

Asymptomatic hypoglycemia is a major problem in diabetes. Mechanisms involved in a patient's inability to sense low glucose levels are reviewed. Autonomic dysfunction is a key contributor. Mechanistic studies suggest interventions that may restore the normal autonomic response (NEJM)

Abbott Receives FDA Clearance for FreeStyle Precision Pro Blood Glucose and ß–Ketone Monitoring System

Only inpatient blood glucose monitoring system among leading hospital brands to use individually foil-wrapped test strips, helping reduce risk of test strip cross-contamination (Abbott)

Categorical Analysis of the Impact of Aerobic and Resistance Exercise Training, Alone and in Combination, on Cardiorespiratory Fitness Levels in Patients With Type 2 Diabetes Mellitus

Structured exercise training, especially the AT component, was associated with a greater number of participants moving above established cut points indicative of low CRF. These results have public health and clinical implications for the growing number of patients with type 2 diabetes at high risk for CVD (Diabetes Care)

Corneal Nerve Loss Detected With Corneal Confocal Microscopy Is Symmetrical and Related to the Severity of Diabetic Polyneuropathy

IVCCM noninvasively detects corneal nerve loss, which relates to the severity of neuropathy, and is symmetrical, except in those with severe diabetic neuropathy (Diabetes Care)

Clues Emerge for Autonomic Glitch in Diabetes

The mechanisms of hypoglycemia-associated autonomic failure (HAAF) in diabetes remain unknown, but several recently uncovered clues suggest the condition can be prevented or its effects minimized, according to this review (Medscape)
Insulin Resistance is Associated with Increased Plasma Levels of 12a-hydroxylated Bile Acids

These findings suggest a role for 12a-hydroxylated Bile acids (BAs) in metabolic abnormalities in the natural history of T2D, and raise the possibility of developing insulin-sensitizing therapeutics based on manipulations of BA composition (Diabetes)

Wednesday, 24 July 2013

Diabetes 'linked to disability risk'

Older people with diabetes are 50% to 80% more likely to develop a physical disability than those without, according to a review of 26 studies (BBC)
Evaluation of insulin initiation on resource utilization and direct costs of treatment over 12 months in patients with type 2 diabetes in Europe: results from INSTIGATE and TREAT observational studies

Contributors to total cost differed between countries, potentially reflecting local clinical practice patterns and insulin regimens. In each country, mean direct total costs of T2DM care increased during the first 6 months after insulin initiation and decreased thereafter (Journal of Medical Economics)

Excess mortality during hospital stays among patients with recorded diabetes compared with those without diabetes

A diagnosis of diabetes has an adverse impact on hospital mortality that cannot be explained by usual case-mix adjustments, and the additional risk of dying is greatest among hospital admissions that would normally have a low risk of death. This implies that diabetes may override the usual risk factors for hospital mortality (Diabetic Medicine)

New-Onset Diabetes Mellitus in Elderly Subjects - Association between HbA1c levels, mortality, and coronary revascularization

An HbA1c level >7.5% (58 mmol/mol) is associated with increased risk for all-cause mortality and with a lower revascularization rate in elderly patients with new-onset DM (Diabetes Care)

Safety and Efficacy of Sitagliptin Therapy for the Inpatient Management of General Medicine and Surgery Patients With Type 2 Diabetes

Results of this pilot indicate that treatment with sitagliptin alone or in combination with basal insulin is safe and effective for the management of hyperglycemia in general medicine and surgery patients with T2D (Diabetes Care)

Tuesday, 23 July 2013

Clinical value of inflammatory urinary biomarkers in overt diabetic nephropathy

Multiple urinary biomarkers predict outcome in overt diabetic nephropathy. However, urinary MCP-1 and TGF-ß1 are also independent and additive to proteinuria in predicting the rate of renal function decline and could serve as useful clinical tools in patient risk stratification (Diabetes Research and Clinical Practice)

Monday, 22 July 2013

Resolution of fatty liver and risk of incident diabetes

Change in fatty liver status over time is associated with markedly variable risks of incident diabetes (Journal of Clinical Endocrinology & Metabolism)
Big pharma mobilising patients in battle over drugs trials data

Leaked memo from industry bodies reveals strategy to combat calls by regulators to force companies to publish results (Guardian)
Photoreceptor precursors derived from three-dimensional embryonic stem cell cultures integrate and mature within adult degenerate retina

This study shows conclusively that ESCs can provide a source of photoreceptors for retinal cell transplantation (Nature Biotechnology)

Saturday, 20 July 2013

In the first step toward animal-to-human transplants of insulin-producing cells for people with type 1 diabetes, Northwestern Medicine scientists have successfully transplanted islets, the cells that produce insulin, from one species to another. And the islets survived without immunosuppressive drugs.

Friday, 19 July 2013

The administration of insulin is one of the most common treatment interventions made by community nurses. The risks associated with the administration of insulin are well known and the maladministration of insulin is now a Never Event (East and South East England Specialist Pharmacy Services)

Thursday, 18 July 2013

Effects of Metformin Dose on Cancer Risk Reduction in Patients with Type 2 Diabetes Mellitus

The magnitude of cancer risk reduction and prolonged cancer onset times produced by metformin in patients with type 2 diabetes depended on the dose of metformin, regardless of whether metformin was used alone or combined with other antidiabetic drugs (Pharmacotherapy)
The impact of supported telemetric monitoring in people with type 2 diabetes: study protocol for a randomised controlled trial

The proposed trial will provide additional information on the cost-effectiveness and feasibility of supported telemetric monitoring of two common, chronic conditions, diabetes and hypertension, whose prevalence is expected to continue increasing across the world (Trials)
Boehringer Ingelheim and EFSD announce first recipients of diabetes research funding

BI and EFSD commit €2.5 million to help accelerate European initiatives in key areas of diabetes research

Wednesday, 17 July 2013

A multifactorial intensive intervention in type 2 diabetes is feasible and effective in clinical practice and it is associated with significant and durable improvement in HbA1c and CVD risk profile (Diabetes Care)
Glycosmedia Google ranking

Searching for "Diabetes news" on Google places Glycosmedia 3rd from 279 million!
Above Diabetes UK,, Science Daily, Topix, ABC News, BBC News, Fox News, NBC News, WebMD Diabetes, DWRF, Pulse etc.
Alizé Pharma launches the first phase 1 clinical trial for AZP-531, its unacylated ghrelin analog, in type 2 diabetes

The Medicine and Healthcare Regulatory Authority (MHRA) has granted authorization to conduct a trial in the UK on AZP-531 in healthy volunteers, obese subjects and diabetic patients (Alizé Pharma)
Optimal Diabetes Care - Can we afford it?

In a time of economic austerity, and unprecedented pressure to reduce costs of health care in the UK, are there ways improving care, without driving up cost? Evidence based diabetes care could be highly cost-effective (QJM)

Associations and interactions between lipid profiles, retinopathy and nephropathy in patients with type 1 diabetes: the FinnDiane Study

Nephropathy had a strong effect on the associations between lipid variables and retinopathy, while dyslipidaemia was associated with nephropathy only in the presence of retinopathy.. This finding suggests the existence of shared pathogenic mechanisms between retinopathy and nephropathy which could be targeted to prevent complications in patients with metabolic risk factors (Journal of Internal Medicine)

To promote stronger engagement, Agency for Healthcare Research and Quality developed the Guide to Patient and Family Engagement in Hospital Quality and Safety, a tested, evidence-based resource to help hospitals work as partners with patients and families to improve quality and safety

Tuesday, 16 July 2013

Length of time a young adult is obese linked with development of silent heart disease

The length of time a young adult is obese is associated with the development of silent, or subclinical, heart disease in middle age, independent of body mass index or waist circumference, according to National Institutes of Health-supported research (NIH)
More Data Will Inform Place of SGLT2 Inhibitors in Diabetes

The position of a novel class of drugs, the sodium-glucose cotransporter-2 (SGLT2) inhibitors, in the stepwise treatment of type 2 diabetes is currently unclear, but ongoing clinical trials will help better establish the place of these agents, says a new editorial in the Lancet, published online July 12 (Medscape)
Metformin Cuts Dementia Risk in Type 2 Diabetes

Type 2 diabetes doubles the risk for dementia, and a large new observational study suggests that treatment with metformin may significantly lower that risk. In contrast, other diabetes treatments, including insulin, were associated with increased dementia risk (Medscape)
Association of Glycation Gap With Mortality and Vascular Complications in Diabetes

We confirm published associations of G-gap with retinopathy and nephropathy. We newly demonstrate a relationship with macrovascular and mortality outcomes and potential links to distinct subpopulations of diabetes (Diabetes Care)
Personalizing guidelines for diabetes management: twilight or dawn of the expert?

In this article we outlined the matrix of options available to the physician and highlighted factors critical to decision-making, without setting out a precise plan, in the spirit of ‘personalized’ therapy. It is our contention that the complexity of the matrix of options precludes rigid guidelines (BMC Medicine)
EU Battles Medicine Shortages
European governments are under pressure to take regulatory action, but solving the problem of medicine shortages is not as straightforward as it seems (PharmTech)

Clinical Reference Groups – membership page

Apply to be a Member of the Specialised Commissioning Medicines Optimisation Clinical Reference Group (NHS England)

Monday, 15 July 2013

Inadequate Sleep May in Itself Up Odds of Diabetes Onset

Troubled sleep, short sleep, and sleep apnea predicted the onset of type 2 diabetes, independent of mental-health disorders, in a prospective study of young, healthy military personne (Medscape)

Early Weight Gain in Pregnancy May Be Bad Start for Infant

Mothers who put on too much weight early in their pregnancies have bigger, fatter babies, a new study shows (Medscape)

Inaccuracy in the Observer newspaper on diabetes and obesity

JDRF says that there was a very unfortunate inaccuracy in The Observer's front page article of July 14, entitled: "British child death rates are 'a major crisis', says paediatricians' leader."

Joslin Researchers Find Key Mechanism in Increased Atherosclerosis Risk for People with Diabetes

Researchers at Joslin Diabetes Center have discovered that when excessive PKC beta is found in the endothelium, the thin layer of cells that line blood vessels, atherosclerosis is exacerbated (Joslin Diabetes Center)
The aggressive diagnosis and treatment of patients with type 2 diabetes, metabolic syndrome or insulin resistance, and atherogenic dyslipidemia has been advocated by the ADA, AHA, NCEP, and NLA. By diagnosing and aggressively treating patients at increased risk for cardiovascular disease, clinicians can reduce the burden these diseases place on patients and society (Journal of the American Academy of Physician Assistants)

Benchmarking Is Associated With Improved Quality of Care in Type 2 Diabetes

In this prospective, randomized, controlled study, benchmarking was shown to be an effective tool for increasing achievement of critical quality indicators and potentially reducing patient cardiovascular residual risk profile (Diabetes Care)

F-CPI was correlated only with unadjusted indexes of insulin secretion, whereas PP-CPI was correlated with such indexes as well as with those adjusted for insulin sensitivity. The better clinical utility of PP-CPI might be attributable to these physiological characteristics (Metabolism)

Efficacy and safety of canagliflozin versus glimepiride in patients with type 2 diabetes inadequately controlled with Metformin 

Canagliflozin provides greater HbA1c reduction than does glimepiride, and is well tolerated in patients with type 2 diabetes receiving metformin. These findings support the use of canagliflozin as a viable treatment option for patients who do not achieve sufficient glycaemic control with Metformin therapy (The Lancet)

Quarter of people with diabetes not getting vital kidney check

According to the analysis, based on National Diabetes Audit data, 25 per cent of people with diabetes in England were not recorded as having the urine check (called a urinary albumin) during 2010/11. The situation is only slightly better in Wales, where 21.6 per cent did not get a check during the same period. (Diabetes UK)

Sunday, 14 July 2013

Dr Shareen Forbes, head of Scotland's Islet Transplantation Programme, said as many as 3,000 people with diabetes in Scotland may be helped by an infusion of cells from a donor pancreas to help them produce insulin again (Scotsman)

British child death rates are 'a major crisis', says paediatricians' leader

Failings in care mean that only 4% of children with diabetes, which is closely linked to obesity, receive care that complies with existing guidance. (Guardian)

Saturday, 13 July 2013

The present findings suggest that an HbA1c target of less than 6.5% or 48 mmol/mol might be too low for some patients and large reductions, or increases, in HbA1c levels should be approached cautiously. The findings also point to potential age-related differences in HbA1c levels and mortality rates with younger diabetes patients being at relatively greater risk of mortality associated with low HbA1c levels even though absolute risks are smaller at young ages (PLoS ONE)

Canagliflozin provides greater HbA1c reduction than does glimepiride, and is well tolerated in patients with type 2 diabetes receiving metformin. These findings support the use of canagliflozin as a viable treatment option for patients who do not achieve sufficient glycaemic control with metformin therapy (The Lancet)