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

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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)