Wednesday, 31 December 2014

The relationship between glycemic variability and diabetic peripheral neuropathy in type 2 diabetes with well-controlled HbA1c

There was a close relationship between glycemic variability evaluated by MAGE and DPN in type 2 diabetes with well-controlled HbA1c (Diabetology & Metabolic Syndrome)

Glycaemic control of Type 1 diabetes in clinical practice early in the 21st century: an international comparison

These results suggest that there are substantial variations in glycaemic control among people with Type 1 diabetes between the data sources and that there is room for improvement in all populations, especially in young adults (Diabetic Medicine)

Monday, 29 December 2014

Serum 25-hydroxyvitamin D levels and peripheral neuropathy in patients with type 2 diabetes: a systematic review and meta-analysis

Vitamin D is involved in the development of DPN in type 2 diabetic patients, and vitamin D deficiency is very likely to be associated with DPN in type 2 diabetic patients. Further studies are needed to validate the association between vitamin D deficiency and DPN (Journal of Diabetes Investigation)

Intrinsic Foot Muscle And Plantar Tissue Changes In Type 2 Diabetes Mellitus

In the present study, we noted a substantial decrease in intrinsic foot muscles and plantar tissue thickness in T2DM subjects as compared to NDM subjects. This reasons out that structural changes in the foot in an antecedent to clinically apparent PN (Journal of Diabetes)

Early phase glucagon and insulin secretory abnormalities, but not incretin secretion, are similarly responsible for hyperglycemia after ingestion of nutrients

Disordered early phase insulin and glucagon secretions but not incretin secretion are involved in hyperglycemia after ingestion of nutrients in T2DM of even a short duration (Journal of Diabetes and Its Complications)

Wednesday, 24 December 2014

Novo Nordisk receives FDA approval for Saxenda® for the treatment of obesity

Saxenda® (liraglutide 3 mg), the first once-daily human glucagon-like peptide-1 (GLP-1) analogue for the treatment of obesity (Novo Nordisk)

Clinical and pathological predictors of estimated GFR decline in patients with type 2 diabetes and overt proteinuric diabetic nephropathy

Our results suggest that not only proteinuria but also tubulointerstitial lesions should be assessed to predict rapid eGFR decline in patients with type 2 diabetes who have overt proteinuria and biopsy-proven DN (Diabetes/Metabolism Research and Reviews)

Tuesday, 23 December 2014

Management of Hyperglycemia in Type 2 Diabetes, 2015: A Patient-Centered Approach

Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes (Diabetes Care)

Should Sulfonylureas Remain an Acceptable First-Line Add-on to Metformin Therapy in Patients With Type 2 Diabetes? 

Martin J. Abrahamson: Yes, They Continue to Serve Us Well! (Diabetes Care)

Monday, 22 December 2014

Pharmacokinetics and Pharmacodynamics of Insulin Glargine Given Evening as Compared With Morning in Type 2 Diabetes Mellitus

The PD of insulin glargine differs depending on time of administration. With morning administration insulin activity is greater in the first 0–12 h, while with evening administration the activity is greater in the 12–24 h period following dosing (Diabetes Care)

Metformin use in patients with type 2 diabetes mellitus is associated with reduced risk of deep vein thrombosis: a non-randomized, pair-matched cohort study

Metformin may have protective effect in patients with type 2 DM for DVT (BMC Cardiovascular Disorders)

Saturday, 20 December 2014

Is There a Link Between Liraglutide and Pancreatitis? A Post Hoc Review of Pooled and Patient-Level Data From Completed Liraglutide Type 2 Diabetes Clinical Trials

Based on the small number of cases observed, the incidences of reported AP and CP were numerically greater with liraglutide than with comparators. Not all cases fulfilled diagnostic criteria, and confounding variables were present in 75% of the AP cases with liraglutide therapy, precluding firm conclusions (Diabetes Care)

Friday, 19 December 2014

Lilly and Adocia Announce Alliance to Co-Develop Ultra-Rapid Insulin Based on BioChaperone Technology 

Eli Lilly and Company and Adocia announce a worldwide licensing collaboration focused on developing an ultra-rapid insulin, known as BioChaperone Lispro, for treatment in people with type 1 and type 2 diabetes

Long-term Efficacy and Safety of Canagliflozin Over 104 Weeks in Patients Aged 55 to 80 Years With Type 2 Diabetes

Canagliflozin improved glycaemic control, reduced body weight and systolic BP, and was generally well tolerated in patients aged 55–80 years with T2DM over 104 weeks (Diabetes, Obesity and Metabolism)

Most People With Long-Duration Type 1 Diabetes in a Large Population-Based Study Are Insulin Microsecretors

The majority of long-duration T1D patients have detectable urine C-peptide levels. While the majority of patients are insulin microsecretors, some maintain clinically relevant endogenous insulin secretion for many years after the diagnosis of diabetes. Understanding this may lead to a better understanding of pathogenesis in T1D and open new possibilities for treatment (Diabetes Care)

Clinical predictors and time course of the improvement in ß–cell function with short-term intensive insulin therapy in patients with Type 2 diabetes

At baseline, shorter duration of diabetes and lower fasting glucose can identify patients most likely to benefit from short-term intensive insulin therapy. Most importantly, during therapy, responders had less hypoglycaemia from the third week onwards, despite lower glycaemia, suggesting that 2 weeks of intensive insulin therapy may be needed to improve endogenous islet function (Diabetic Medicine)

Thursday, 18 December 2014

Unsupervised home use of overnight closed-loop system over 3 to 4 weeks – Pooled analysis of randomized controlled studies in adults and adolescents with type 1 diabetes

Overnight closed loop at home in adults and adolescents with type 1 diabetes is feasible, demonstrating improvements in glucose control and reducing the risk of nocturnal hypoglycaemia (Diabetes, Obesity and Metabolism)

Wednesday, 17 December 2014

Effects of High vs Low Glycemic Index of Dietary Carbohydrate on Cardiovascular Disease Risk Factors and Insulin Sensitivity

In this 5-week controlled feeding study, diets with low glycemic index of dietary carbohydrate, compared with high glycemic index of dietary carbohydrate, did not result in improvements in insulin sensitivity, lipid levels, or systolic blood pressure. In the context of an overall DASH-type diet, using glycemic index to select specific foods may not improve cardiovascular risk factors or insulin resistance (JAMA)

Tuesday, 16 December 2014

The impact of diabetes-related complications on healthcare costs: new results from the UKPDS (UKPDS 84)

Diabetic complications are associated with substantial immediate and long-term healthcare costs. Our comprehensive new estimates of these costs, derived from detailed recent UK Prospective Diabetes Study post-trial data, should aid researchers and health policy analyses (Diabetic Medicine)

Detection of a low-grade enteroviral infection in the islets of Langerhans of living patients newly diagnosed with type 1 diabetes

The results provides evidence for the presence of enterovirus in pancreatic islets of type 1 diabetic patients, being consistent with the possibility that a low grade enteroviral infection in the pancreatic islets contribute to disease progression in humans (Diabetes)

Low within- and between-day variability in exposure to new insulin glargine 300 U.mL-1

Gla-300 provides predictable, evenly distributed 24-hour coverage due to low fluctuation and high reproducibility in insulin exposure, and appears suitable for effective basal insulin use (Diabetes, Obesity and Metabolism)

Initial Combination Therapy with Metformin/Pioglitazone/Exenatide is More Effective Than Sequential Add-On Therapy in Subjects with New Onset Diabetes. Results from the Efficacy and Durability of Initial Combination Therapy for Type 2 Diabetes (EDICT): A Randomized Trial

The results of this exploratory study demonstrate that combination therapy with metformin/pioglitazone/exenatide in newly diagnosed T2DM patients is more effective with less hypoglycemia than sequential add-on therapy with metformin, sulfonylurea, and then basal insulin (Diabetes, Obesity and Metabolism)

Monday, 15 December 2014

Pioglitazone has a dubious bladder cancer risk but an undoubted cardiovascular benefit

There is no association between bladder cancer and pioglitazone in randomized controlled trials, once cases that could not plausibly be related to treatment are removed ... careful study of randomized controlled trials shows evidence of cardiovascular benefit from pioglitazone in Type 2 diabetes, a condition which results, more than anything, in premature cardiovascular death and morbidity (Diabetic Medicine)

Adaptive pathways: a future approach to bring new medicines to patients?

Scientists argue that scientific and political changes will make adaptive pathways the preferred approach to make new treatments available (European Medicines Agency)

Proteomic Analysis in Type 2 Diabetes Patients before and after a Very Low Calorie Diet Reveals Potential Disease State and Intervention Specific Biomarkers

In this study, specific proteins were found to be differentially expressed in type 2 diabetes patients versus controls and before and after a VLCD. These proteins are potential disease state and intervention specific biomarkers (PLoS ONE)

Assessing the Effect of Treatment Duration on the Association between Anti-Diabetic Medication and Cancer Risk

This study demonstrates that evaluation of the variation in cancer risk in relation to treatment duration is of particular importance for enhancing the accuracy of conclusions on the link between exposure to anti-diabetic medication and cancer risk (PLoS ONE)

Friday, 12 December 2014

Autologous Islet Transplantation With Remote Islet Isolation After Pancreas Resection for Chronic Pancreatitis

Pancreatic resection with autologous islet transplantation for severe chronic pancreatitis is a safe and effective final alternative to ameliorate debilitating pain and to help prevent the development of surgical diabetes (JAMA Surgery)

“Mild dysglycemia” in type 2 diabetes. To be neglected or not?

The now available incretin-based therapies, and more specifically the DPP-4 inhibitors provide the clinician with the possibility to reduce or eradicate both the dawn phenomenon and post-meal glucose excursions with minimal side effects (Journal of Diabetes and Its Complications)

Thursday, 11 December 2014

International Comparison of Medicines Usage: Quantitative Analysis

This report was commissioned by the Association of the British Pharmaceutical Industry (ABPI) and updates to 2012/13 the quantitative analysis of UK usage of medicines per head of total population compared to that in other countries in 2008/09 which was published in the 2010 Richards Report: Extent and causes of international variations in drug usage (ABPI)

Wednesday, 10 December 2014

Hypoglycemia and Risk of Cardiovascular Disease and All-Cause Mortality in Insulin-Treated People With Type 1 and Type 2 Diabetes: A Cohort Study

Hypoglycemia is associated with an increased risk of CV events and all-cause mortality in insulin-treated patients with diabetes. The relationship between hypoglycemia and CV outcomes and mortality exists over a long period (Diabetes Care)

Short-term statin discontinuation increases endothelial progenitor cells without inflammatory rebound in type 2 diabetic patients

a brief statin withdrawal increases circulating EPCs and functional proangiogenic cells in T2D. These findings identify statin-sensitive pathways as reverse target mechanisms to stimulate vascular repair in diabetes (Vascular Pharmacology)

Tuesday, 9 December 2014

Pioglitazone and bladder cancer risk: a multipopulation pooled, cumulative exposure analysis

The cumulative use of pioglitazone or rosiglitazone was not associated with the incidence of bladder cancer in this large, pooled multipopulation analysis (Diabetologia)

Monday, 8 December 2014

Glucose-lowering with exogenous insulin monotherapy in type 2 diabetes: dose association with all-cause mortality, cardiovascular events, and incident cancer

There was an association between increasing exogenous insulin dose and increased risk of all-cause mortality, cancer and MACE in people with type 2 diabetes. Limitations of observational studies mean that this should be further investigated using an interventional study design (Diabetes, Obesity and Metabolism)

Impaired Gallbladder Motility in Adults with Newly Detected Type 2 Diabetes and Lack of Reversibility after Achieving Euglycemia

Gallbladder ejection fraction was markedly reduced in patients with newly detected diabetes compared to controls without diabetes. Control of diabetes and normalization of A1C did not reverse the motility defect (Canadian Journal of Diabetes)

A pilot study evaluating non-contact low-frequency ultrasound and underlying molecular mechanism on diabetic foot ulcers

This proof-of-concept pilot study demonstrates that NCLF-US is effective in treating neuropathic diabetic foot ulcers through, at least in part, inhibiting pro-inflammatory cytokines in chronic wound and improving tissue regeneration (International Wound Journal)

Sunday, 7 December 2014

Benefits of Timely Basal Insulin Control in Patients with Type 2 Diabetes

Early glucose control reduces the risk of both macrovascular and microvascular complications, while tight control late in diabetes has little or no macrovascular benefit. Insulin therapy offers the most potent antihyperglycemic effect of all diabetes agents, and has a unique ability to induce diabetes remission when used to normalize glycemia in newly diagnosed patients (Journal of Diabetes and Its Complications)

Friday, 5 December 2014

Effect of Statin Therapy on Incident Type 2 Diabetes Mellitus in Patients with Clinically Manifest Vascular Disease

Statin use increases the risk of incident T2DM in patients with clinically manifest vascular disease. The increase in risk was independent of the number of metabolic syndrome criteria, and was even more pronounced in patients with low baseline glucose levels (American Journal of Cardiology

Maternal body size prior to pregnancy, gestational diabetes and weight gain: associations with insulin resistance in children at 9–10 years

Maternal body size prior to pregnancy is positively associated with increases in child insulin resistance, at least until the ‘obese’ category is reached. This is independent of gestational diabetes and not mediated by body size of the child, suggesting genetic and/or developmental programming origins (Diabetic Medicine)

Years of life lost and healthy life-years lost from diabetes and cardiovascular disease in overweight and obese people: a modelling study

Our estimations for both healthy life-years and total years of life lost show the effect of excess bodyweight on cardiovascular disease and diabetes, and might provide a useful health measure for discussions between health professionals and their patients (The Lancet Diabetes & Endocrinology)

Thursday, 4 December 2014

Treatment of Diabetic Macular Edema with an Inhibitor of Vascular Endothelial-Protein Tyrosine Phosphatase That Activates Tie2

No safety concerns were identified after systemic administration of AKB-9778 for 4 weeks in patients with DME, and doses of 15 mg or more twice daily reduced macular edema and improved vision in some patients. This is a preliminary demonstration of clinical safety and efficacy of a VE-PTP inhibitor and Tie2 activator (Ophthalmology)

Understanding drug preferences, different perspectives

Regulators may value major benefits and risks of drugs for an individual diabetes patient mostly in the same way as doctors and patients but differences may exist regarding the value of minor or short-term drug effects (British Journal of Clinical Pharmacology)

Clinical trial demonstrates exercise following bariatric surgery improves insulin sensitivity

Moderate exercise following RYGB surgery provides additional improvements in SI, SG, and cardiorespiratory fitness compared with a sedentary lifestyle during similar weight loss (Journal of Clinical Investigation)

Adipose tissue content, muscle performance and physical function in obese adults with type 2 diabetes mellitus and peripheral neuropathy

T2DMPN may represent a shift in adipose tissue accumulation from SQAT to IMAT depots, which is inversely associated with muscle performance and physical function (Journal of Diabetes and Its Complications)

Wednesday, 3 December 2014

Efficacy and Safety of Canagliflozin, an Inhibitor of Sodium Glucose Cotransporter 2, When Used in Conjunction With Insulin Therapy in Patients With Type 2 Diabetes

Canagliflozin added to insulin therapy improved glycemic control and decreased body weight. There was a greater frequency of several anticipated side effects, although few led to discontinuation of treatment (Diabetes Care)

The study of once- and twice-daily biphasic insulin aspart 30 (BIAsp 30) with sitagliptin, and twice-daily BIAsp 30 without sitagliptin, in patients with type 2 diabetes uncontrolled on sitagliptin and metformin—The Sit2Mix trial

Adding BIAsp 30 to patients with T2D poorly controlled with sitagliptin and metformin is efficacious and well tolerated; however, while BIAsp BID + Sit showed superior glycaemic control, BIAsp QD + Sit had a lower rate of hypoglycaemia (Primary Care Diabetes)

Glycemic variability and diabetes retinopathy: a missing link

These findings emphasize the need to reduce glycemic variability by various measures in order to reduce development and progression of diabetes retinopathy both in type 1 and type 2 diabetes patients (Diabetes and Its Complications)

Genetic and Epigenetic alterations in Toll like Receptor 2 and wound healing impairment in type 2 diabetes patients

TLR2 down regulation in wounds of T2DM patients compared to non diabetic patients may lead to development of non healing chronic ulcers in them (Diabetes and Its Complications)

Tuesday, 2 December 2014

Metformin for primary colorectal cancer prevention in patients with diabetes: A case-control study in a US population

Metformin use appears to be associated with a reduced risk of developing CRC among diabetic patients in the United States (Cancer)

The protective effect of the Mediterranean diet on endothelial resistance to GLP-1 in type 2 diabetes: a preliminary report

These data suggest that the Mediterranean diet, using olive oil, prevents the acute hyperglycemia effect on endothelial function, inflammation and oxidative stress, and improves the action of GLP-1, which may have a favorable effect on the management of type 2 diabetes, particularly for the prevention of cardiovascular disease (Cardiovascular Diabetology)

Monday, 1 December 2014

Diabetes Improvement Plan

properties and actions to deliver improved prevention, treatment and care for people with diabetes in Scotland (Scottish Government)

Friday, 28 November 2014

Journal of Medical Economics: A cost comparison of long-acting insulin analogues versus NPH insulin-based treatment T2D 

Following insulin initiation, the difference in healthcare costs of long-acting analogues compared to NPH insulin was transient. By year 3, the cost differences were not significantly different between the two cohorts, driven by an observed reduction in the cost of self-monitoring of blood glucose (SMBG) in the analogue group and an increase in the cost of bolus insulin in the NPH group ~(Journal Medical Economics)

Thursday, 27 November 2014

Comparison of dual-hormone artificial pancreas, single-hormone artificial pancreas, and conventional insulin pump therapy for glycaemic control in patients with type 1 diabetes: an open-label randomised controlled crossover trial

Single-hormone and dual-hormone artificial pancreas systems both provided better glycaemic control than did conventional insulin pump therapy. The single-hormone artificial pancreas might be sufficient for hypoglycaemia-free overnight glycaemic control (The Lancet Diabetes & Endocrinology)

Offer weight loss surgery to obese people with diabetes

The NHS should offer weight loss surgery to thousands more people in order to tackle an epidemic of type 2 diabetes, says NICE

Glyoxylate, a New Marker Metabolite of Type 2 Diabetes

A retrospective study using samples of long-term blood donors revealed that glyoxylate levels unlike glucose levels became significantly elevated up to 3 years prior to diabetes diagnosis (Journal of Diabetes Research)

Wednesday, 26 November 2014

The durability of sitagliptin in elderly patients with type 2 diabetes

Sitagliptin has a durable effect and stabilizes microvascular complication progression in elderly patients. This study can provide useful data for clinicians and health care professionals using sitagliptin monotherapy in the treatment of elderly patients with T2DM (Clinical Interventions in Aging)

Tuesday, 25 November 2014

Risk of cardiovascular disease: The effects of diabetes and anti-diabetic drugs — A nested case–control study

We have shown an association between the use of biguanides and liraglutide and a reduced risk of composite endpoint in DM patients (International Journal of Cardiology)

Primary care screening for individuals with impaired glucose metabolism with focus on impaired glucose tolerance

The Skövde Form combined with a random plasma glucose may be used as an alternative tool for detection of individuals with IGM and IGT in particular. HbA1c may be used to identify individuals with type 2 diabetes but fails to detect most individuals with prediabetes (Primary Care Diabetes)

Monday, 24 November 2014

A randomized, double blind, placebo-controlled pilot trial of the safety and efficacy of atorvastatin in children with elevated low-density lipoprotein cholesterol (LDL-C) and type 1 diabetes

Atorvastatin lowered LDL-C, apoB, and atherogenic lipoprotein subparticles in children with T1D and elevated LDL-C without worsening insulin resistance. The drug was well tolerated and safe. Long-term studies would provide better insight on the impact of these interventions in the development of cardiovascular disease in children with diabetes (Pediatric Diabetes)

Efficacy and Safety of Dipeptidyl Peptidase-4 Inhibitors in Type 2 Diabetes Mellitus Patients with Moderate to Severe Renal Impairment: A Systematic Review and Meta-Analysis

DPP-4 inhibitors are effective at lowering HbA1c in T2DM patients with moderate to severe renal impairment. DPP-4 inhibitors also have a potential advantage in lowering the risk of adverse events (PLoS ONE)

Endothelial Dysfunction Plays a Key Role in Increasing Cardiovascular Risk in Type 2 Diabetes

Endothelial dysfunction and type 2 diabetes mellitus, IGM, or insulin resistance synergistically increase cardiovascular event risk. This identifies endothelial dysfunction as a key therapeutic target in these individuals (Hypertension)

Friday, 21 November 2014

Effect of Screening for Coronary Artery Disease Using CT Angiography on Mortality and Cardiac Events in High-Risk Patients With Diabetes

Among asymptomatic patients with type 1 or type 2 diabetes, use of CCTA to screen for CAD did not reduce the composite rate of all-cause mortality, nonfatal MI, or unstable angina requiring hospitalization at 4 years. These findings do not support CCTA screening in this population (JAMA)

Combining a GLP-1 Receptor Agonist and Basal Insulin: Study Evidence and Practical Considerations

The evidence from 15 randomized prospective studies supports the combined use of a GLP-1 receptor agonist with basal insulin in a broad range of patients with uncontrolled type 2 diabetes (Drugs)

Victoza® receives positive CHMP opinion for use in adults with type 2 diabetes and moderate renal impairment

Once the European Commission approves the label expansion, physicians in the European Union will be able to prescribe Victoza®, the once-daily human glucagon-like peptide-1 (GLP-1) analogue, to adults with type 2 diabetes and moderate renal impairment without dose adjustments (Novo Nordisk)

Thursday, 20 November 2014

Glycemic Control and Excess Mortality in Type 1 Diabetes

In our registry-based observational study, patients with type 1 diabetes and a glycated hemoglobin level of 6.9% or lower had a risk of death from any cause or from cardiovascular causes that was twice as high as the risk for matched controls (NEJM)

Wednesday, 19 November 2014

Glucose uptake in brown fat cells is dependent on mTOR complex 2–promoted GLUT1 translocation

Brown adipose tissue is the primary site for thermogenesis and can consume, in addition to free fatty acids, a very high amount of glucose from the blood, which can both acutely and chronically affect glucose homeostasis Journal of Cell Biology)

The Effect of the Endoscopic Duodenal-Jejunal Bypass Liner on Obesity and Type 2 Diabetes Mellitus, a Multicenter Randomized Controlled Trial

The DJBL is a safe and effective alternative to invasive bariatric procedures. Six months of DJBL treatment combined with diet leads to superior weight loss and improvement of T2DM when compared with diet alone (Annals of Surgery)

Intravitreal Ranibizumab for Diabetic Macular Edema with Prompt versus Deferred Laser Treatment: 5-Year Randomized Trial Results

Five-year results suggest focal/grid laser treatment at the initiation of intravitreal ranibizumab is no better than deferring laser treatment for =24 weeks in eyes with DME involving the central macula with vision impairment (Ophthalmology)

Monday, 17 November 2014

New retrospective data showed empagliflozin reduced A1C, body weight and markers of abdominal fat in adults with type 2 diabetes

Empagliflozin tablets reduced hemoglobin A1C, body weight and several markers of abdominal fat in adults with type 2 diabetes, according to a new retrospective analysis of clinical trial data presented on behalf of Boehringer Ingelheim and Eli Lilly at the 2014 Scientific Sessions of the American Heart Association in Chicago

VYTORIN® (ezetimibe/simvastatin) Significantly Reduced Cardiovascular Events More than Simvastatin Alone in Patients Presenting with Acute Coronary Syndromes in the Investigational IMPROVE-IT Study

The investigational IMPROVE-IT study met its primary and all secondary composite efficacy endpoints. In IMPROVE-IT, patients taking the LDL-cholesterol-lowering medicine VYTORIN® (ezetimibe/simvastatin) – which combines simvastatin with the non-statin ZETIA® (ezetimibe) -- experienced significantly fewer major cardiovascular events than patients treated with simvastatin alone (Merck)

Effects of ACEI/ARB in hypertensive patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled studies

Treatment with ACE/ARBs results in significant reduction in CV events and mortality in hypertensive patients with T2 DM (BMC Cardiovascular Disorders)

All-cause mortality and estimated renal function in type 2 diabetes mellitus outpatients: Is there a relationship with the equation used?

In our cohort of T2DM outpatients, different eGFR equations perform similarly in predicting ACM, whereas SCr did not (Diabetes and Vascular Disease Research)

Activation of AMP-activated protein kinase by metformin protects human coronary artery endothelial cells against diabetic lipoapoptosis

The protective effect of metformin against free fatty acid induced apoptosis is potentially clinically relevant as metformin is first line treatment for patients with T2D, a patient group which is rapidly increasing and carries a high burden of cardiovascular disease (Cardiovascular Diabetology)

The Access to Medicine Index 2014 

The fourth Access to Medicine Index report provides a finely detailed picture of how the world’s 20 largest research-based pharmaceutical companies address access to medicine. Ranking (Access to Medicine Foundation)

Diabetes self-management education: acceptability of using trained lay educators

Positive perceptions about the use of lay educators support the positive quantitative findings from the main trial. Acceptability is an important consideration in relation to implementation of the model of delivery studied. Concerns raised within the interviews should be considered in the design of training for lay educators (Postgraduate Medical Journal)

Friday, 14 November 2014

Evaluating peripheral nerve function in asymptomatic patients with Type 2 diabetes or latent autoimmune diabetes of adults (LADA): results from nerve conduction studies

Peripheral nerve dysfunction is common in asymptomatic patients with LADA or T2DM. Findings of the study suggest that LADA and T2DM differ in the pattern of peripheral nerve involvement over diabetes duration (Diabetes and Its Complications)

Thursday, 13 November 2014

Evidence of early alterations in adipose tissue biology and function and its association with obesity-related inflammation and insulin resistance in children

we show that adipocyte hypertrophy is linked to increased inflammation in AT in obese children thereby providing evidence that obesity-associated AT dysfunction develops in early childhood and is related to insulin resistance (Diabetes)

Wednesday, 12 November 2014

Type 2 diabetes and incidence of cardiovascular diseases: a cohort study in 1·9 million people

Heart failure and peripheral arterial disease are the most common initial manifestations of cardiovascular disease in type 2 diabetes. The differences between relative risks of different cardiovascular diseases in patients with type 2 diabetes have implications for clinical risk assessment and trial design (The Lancet Diabetes & Endocrinology)

Tuesday, 11 November 2014

Pioneering study combining the diabetes vaccine Diamyd® with GABA in children with type 1 diabetes approved by the US FDA

Diamyd Medical and University of Alabama at Birmingham has entered a Clinical Trial Agreement regarding the study, which will be conducted at Children’s of Alabama in Birmingham, USA. The combination has shown promising results in preclinical studies

Is the number of fast-food outlets in the neighbourhood related to screen-detected type 2 diabetes mellitus and associated risk factors?

These results suggest that increased exposure to fast-food outlets is associated with increased risk of type 2 diabetes and obesity, which has implications for diabetes prevention at a public health level and for those granting planning permission to new fast-food outlets (Public Health Nutrition)

The Effect of Medical Nutrition Therapy by a Registered Dietitian Nutritionist in Patients with Prediabetes Participating in a Randomized Controlled Clinical Research Trial

The results demonstrate that individualized medical nutrition therapy is effective in decreasing HbA1c level in patients diagnosed with prediabetes (Journal of the Academy of Nutrition and Dietetics)

Macular dysfunction is common in both type 1 and type 2 diabetic patients without macular edema

We demonstrated a significantly reduced sensitivity in both nonproliferative diabetic retinopathy groups without diabetic macular edema compared with healthy controls; this reduction was greater in Type 2 diabetic patients (Retina)

Monday, 10 November 2014

Healthcare Utilization and Costs in Diabetes Relative to the Clinical Spectrum of Painful Diabetic Peripheral Neuropathy

Patients with DPN, pDPN, and severe pDPN had significantly greater healthcare resource utilization and costs than patients with diabetes only, with the highest burden associated with severe pDPN (Diabetes and Its Complications)

Contrasting associations of insulin resistance with diabetes, cardiovascular disease and all-cause mortality in the elderly: PROSPER long-term follow-up

Our data support insulin resistance as a predictor of diabetes in later life but, perhaps surprisingly, suggest this pathway is of negligible importance to CVD outcomes in the elderly (Diabetologia)

Incidence of type 2 diabetes after bariatric surgery: population-based matched cohort study

Bariatric surgery is associated with reduced incidence of clinical diabetes in obese participants without diabetes at baseline for up to 7 years after the procedure

Friday, 7 November 2014

BMI is an important driver of beta cell loss in type 1 diabetes upon diagnosis in 10-18 year old children

These observations indicate that increased body weight and increased insulin demand are associated with more rapid disease progression after diagnosis of type 1 diabetes in age group 10-18 years. This should be considered in studies of beta-cell function in type 1 diabetes (EJE)

Chronic inflammatory demyelinating polyneuropathy (CIDP) Variants in Diabetes: Measuring Treatment Response with A Small Nerve Fiber Test

Sudoscan electrochemical skin conductances have been found to correlate well with peripheral small fiber function and neuropathic symptoms in DPN (Diabetes and Its Complications)

Wednesday, 5 November 2014

Comparison of placental findings in type 1 and type 2 diabetic pregnancies

Both types of pregestational diabetes have significant impact on placental growth and development. The comparison between the two groups suggests different pathogenetic mechanisms and may be helpful for better management of diabetic pregnancy (Placenta)

Tuesday, 4 November 2014

CD247, a Novel T Cell–Derived Diagnostic and Prognostic Biomarker for Detecting Disease Progression and Severity in Patients With Type 2 Diabetes Mellitus

Our results suggest the use of CD247 as a biomarker in diabetic patients for evaluating the state of chronic inflammation that contributes to morbidity and mortality in this disease and for the prediction of future cardiovascular events (Diabetes Care)

Obesity lost weight with liraglutide

New phase 3a data demonstrate that 9 out of 10 adults with obesity lost weight with liraglutide 3 mg and clinical trial completers lost an average of 9.2% (Novo Nordisk)

Dual Add-on Therapy in Type 2 Diabetes Poorly Controlled With Metformin Monotherapy: A Randomized Double-Blind Trial of Saxagliptin Plus Dapagliflozin Addition Versus Single Addition of Saxagliptin or Dapagliflozin to Metformin

In this first report of adding a well-tolerated combination of saxagliptin plus dapagliflozin to background metformin therapy in patients poorly controlled with metformin, greater improvements in glycemic control were obtained with triple therapy by the dual addition of saxagliptin and dapagliflozin than dual therapy with the addition of saxagliptin or dapagliflozin alone (Diabetes Care)

Monday, 3 November 2014

Efficacy and Safety of Linagliptin in Subjects With Long-Standing Type 2 Diabetes Mellitus (>10 Years): Evidence From Pooled Data of Randomized, Double-Blind, Placebo-Controlled, Phase III Trials

This pooled analysis found that linagliptin was well tolerated and significantly improved hyperglycemia in a clinically challenging population of patients with long-standing T2DM ... hypothesis that regulation of glucagon release from pancreatic a cells may be of particular relevance for improving hyperglycemia in patients with long-term T2DM (Clinical Therapeutics)

Thursday, 30 October 2014

Adipose Tissue, Muscle, and Function: Potential Mediators of Associations Between Body Weight and Mortality in Older Adults With Type 2 Diabetes

Normal weight participants had elevated mortality risk compared with overweight participants. This paradoxical association was mediated in part by muscle size (Diabetes Care)

Impact of Acute and Chronic Hyperglycemia on In-Hospital Outcomes of Patients With Acute Myocardial Infarction

These results suggested that acute-HG, but not chronic-HG, was associated with adverse short-term outcomes after AMI. Paradoxically, in patients with acute-HG, chronic-HG might abate the adverse effects of acute-HG (American Journal of Cardiology)

The mean platelet volume is significantly associated with higher glycated hemoglobin in a large population of unselected outpatients

The results of our investigation, which is supposed to be the largest cohort study on unselected outpatients assessing the relationship between HbA1c and platelets number or size, indicate that elevated MPV is significantly associated with higher HbA1c levels and vice versa (Primary Care Diabetes)

Wednesday, 29 October 2014

Facilitating global development of biosimilars

EMA to allow use of non-EEA authorised comparator in clinical studies (European Medicines Agency)

Complications and comorbidities of T2DM in adolescents: findings from the TODAY clinical trial

The early manifestation of diabetes complications in youth-onset T2DM suggests that this group will be burdened with the tangible consequences of cardiovascular disease, nephropathy, and retinopathy in the third and fourth decades of life (Diabetes and Its Complications)

Tuesday, 28 October 2014

A case study approach to the examination of a telephone-based health coaching intervention in facilitating behaviour change for adults with Type 2 diabetes

Telephone coaching is a cost-effective approach to supporting health behaviour change for those with diabetes. It embraces the principles of empowerment and warrants further evaluation in supporting long-term behavioural changes. As such coaching emerges as a suitable proposition for this cohort (Journal of Clinical Nursing)

Initial Choice of Oral Glucose-Lowering Medication for Diabetes Mellitus

Beginning treatment with metformin was associated with reduced subsequent treatment intensification, without differences in rates of hypoglycemia or other adverse clinical events (JAMA Internal Medicine)

Monday, 27 October 2014

Influence of the glycation gap on the diagnosis of type 2 diabetes

The differences between HbA1C-based and FPG/OGTT-based diagnoses are largely due to the influence of the glycation gap, which may also influence the early stages of FPG/OGTT-defined diabetes (Acta Diabetologica)

Serum ferritin, diabetes, diabetes control, and insulin resistance

Elevated serum ferritin levels were associated with higher risks of diabetes, higher levels of HbA1c, and HOMA-IR independent of several confounders (Acta Diabetologica)

Friday, 24 October 2014

A Very Low-Carbohydrate, Low–Saturated Fat Diet for Type 2 Diabetes Management: A Randomized Trial

Both diets achieved substantial improvements for several clinical glycemic control and CVD risk markers. These improvements and reductions in GV and antiglycemic medication requirements were greatest with the LC compared with HC (Diabetes Care)

New study to prevent type 1 diabetes planned for Diamyd Medical’s diabetes vaccine

A new study is planned for the Diamyd® diabetes vaccine that will comprise 80 children with high risk of presenting with type 1 diabetes. The aim is to test whether the diabetes vaccine can prevent or delay the onset in the children (Diamyd)

Latent Autoimmune Diabetes in Adults With Low-Titer GAD Antibodies: Similar Disease Progression With Type 2 Diabetes: A Nationwide, Multicenter Prospective Study (LADA China Study 3)

In selected LADA patients, initial GADA titers identified subjects with different degrees of persistent autoimmunity and disease progression. LADA patients with a low GADA titer had metabolic phenotypes and loss of ß-cell function similar to type 2 diabetic patients (Diabetes Care)

Benefits of Chinese medicine among patients with diabetic foot: an expert review from clinical studies

It is becoming increasingly important for integrated CM and biomedicine therapy to treat diabetes-related vascular complications. The opportunities for effective CM interventions are significant, and more solid evidence is warranted to show the efficacy of CM in the treatment of diabetic foot ulcers in the near future (Current Vascular Pharmacology)

The validation of cardiovascular risk scores for patients with type 2 diabetes mellitus

All 10 evaluated models had a comparable and moderate discriminative ability. The recalibrated, but not the original, prediction models provided accurate risk estimates. These models can assist clinicians in identifying type 2 diabetes patients who are at low or high risk of developing CVD (Heart)

Thursday, 23 October 2014

Mortality risk among sulfonylureas: a systematic review and network meta-analysis

Gliclazide and glimepiride were associated with a lower risk of all-cause and cardiovascular-related mortality compared with glibenclamide. Clinicians should consider possible differences in risk of mortality when selecting a sulfonylurea (The Lancet Diabetes & Endocrinology)

Therapeutic inertia: underdiagnosed and undertreated hypertension in children participating in the T1D Exchange Clinic Registry

HTN is likely under diagnosed and undertreated even in pediatric diabetes clinics. The relatively low proportion of hypertensive children receiving ACE-I therapy and reaching BP goals probably identifies an important area for improving care in children with type 1 diabetes (Pediatric Diabetes)

A pharmacogenetic association between a variation in calpain 10 (CAPN10) gene and the response to metformin treatment in patients with type 2 diabetes

The present study provides the first observation of an association between a variant in CAPN10 gene and the response to metformin therapy in patients with type 2 diabetes. This observation needs to be replicated in further studies in different populations (European Journal of Clinical Pharmacology)

Wednesday, 22 October 2014

Abnormal levels of age-elastin derived peptides in sera of diabetic patients with arterial hypertension

The measurement of non-invasive markers of elastin glycation may be useful in monitoring development of vascular wall alterations and therapeutic interventions (Central European Journal of Immunology)

Oramed Pharmaceuticals Reports Positive Top-Line Data from U.S. Phase IIa Trial with Oral Insulin in Type 1 Diabetes 

Demonstrates Proof-of-Concept for ORMD-0801 Oral Insulin to Reduce Exogenous Insulin Requirements (Oramed Pharmaceuticals)

Tuesday, 21 October 2014

Does treatment with an insulin pump improve glycaemic control in children and adolescents with type 1 diabetes? A retrospective case–control study

This study shows that treatment with CSII resulted in an improvement in HbA1c levels up to 1yr and decreased the number of severe hypoglycaemic events, but the frequency of ketoacidosis increased (Pediatric Diabetes)

Evaluation of the effectiveness of liraglutide and sitagliptin in type 2 diabetes: a retrospective study in UK primary care

Clinical trials show superior glycaemic control and weight reduction with liraglutide compared with sitagliptin. This finding is reflected in routine clinical practice in the UK (International Journal of Clinical Practice)

Targets and Candidate Agents for Type 2 Diabetes Treatment with Computational Bioinformatics Approach

In the present study, a systematic understanding for the mechanism underlying T2D development was provided with biological informatics methods. The significant nodes and bioactive small molecules may be drug targets and candidate agents for T2D treatment (Journal of Diabetes Research)

Monday, 20 October 2014

Is insulin the most effective injectable antihyperglycaemic therapy?

HbA1c reduction with the GLP-1RAs appears at least equivalent to that with basal insulin, irrespective of baseline HbA1c. This suggests that liraglutide and exenatide OW may be appropriate alternatives to basal insulin in type 2 diabetes, including when baseline HbA1c is very high (Diabetes, Obesity and Metabolism)

Log (TG)/HDL-C ratio as a predictor of decreased islet beta cell function in patients with type 2 diabetes: 6-year cohort study

In Chinese T2D patients, high baseline log (TG)/HDL-C ratio predicts fast progression of islet beta cell dysfunction. It may be a simple index to predict progression speed of islet beta cell dysfunction (Journal of Diabetes)

Metformin powder formulation compared to metformin tablets on glycemic control and on treatment satisfaction in subjects with type 2 diabetes mellitus

Metformin powder formulation seems to be more appropriate for the treatment of diabetic patients. The improvement of glycemic control suggests a better adherence to the powder formulation (Journal of Clinical Pharmacology)

Friday, 17 October 2014

Plasma triglycerides predict ten-years all-cause mortality in outpatients with type 2 diabetes mellitus: a longitudinal observational study

This finding suggests that more attention should be given to the management of cardiovascular risk in type 2 diabetic patients with high triglycerides levels (Cardiovascular Diabetology)

Thursday, 16 October 2014

Improving the delivery of adult diabetes care through integration

Sharing experience and learning (Diabetes UK)

Pharmacological interventions for preventing or delaying onset of type 2 diabetes mellitus

Evidence exists that none of the drugs currently available could sustainably lower cumulative diabetes incidence, none has been shown to provide a durable delay in diabetes diagnosis and none has provided a convincing concomitant excess benefit for micro-or macrovascular risk (Diabetes, Obesity and Metabolism)

Wednesday, 15 October 2014

Use of non-steroidal anti-inflammatory drugs and risk of chronic kidney disease in people with Type 2 diabetes mellitus, a nationwide longitudinal cohort study

The results suggest that there is a positive temporal relationship between non-steroidal anti-inflammatory drug use and increased risk of chronic kidney disease in people with Type 2 diabetes. The use of non-steroidal anti-inflammatory drugs should be based on clinical evaluations of benefits and risks, and should be prescribed with caution for people with Type 2 diabetes (Diabetic Medicine)

Tuesday, 14 October 2014

Empagliflozin (Jardiance®) is accepted for restricted use within NHS Scotland

Empagliflozin was superior to placebo for glycaemic control in combination with various anti-diabetic medicines (metformin; metformin plus sulphonylurea; thiazolidinedione ± metformin; and insulin) and it was non-inferior to a sulphonylurea in combination with metformin (Scottish Medicines Consortium)

Evaluating Cardiovascular Safety of Novel Therapeutic Agents for the Treatment of Type 2 Diabetes Mellitus

Results from the first major CV outcome studies in type 2 diabetes, SAVOR-TIMI 53 and EXAMINE, have shown that neither saxagliptin nor alogliptin had increases in major CV events relative to placebo in high-risk patients. Ongoing and future trials will elucidate the CV safety for other DPP-4 inhibitors compared to SUs and the GLP-1 agonists versus placebo (Current Cardiology Reports)

Mental health in adolescents with Type 1 diabetes: results from a large population-based study

This is one of the first population-based studies to examine mental health of adolescents with Type 1 diabetes. There was no evidence of increased psychopathology across a wide range of mental health measures. These findings contradict previous studies, and suggest that Type 1 diabetes is not associated with an increased risk of psychosocial problems (BMC Endocrine Disorders)

Monday, 13 October 2014

C-peptide concentration, mortality and vascular complications in people with Type 2 diabetes. The Skaraborg Diabetes Register

Measurement of C-peptide concentration at diagnosis could help identify patients who are at high risk and who presumably would benefit from more intensive treatment (Diabetic Medicine)

Predictive models for all-cause and cardiovascular mortality in type 2 diabetic inpatients. A cohort study

This study provides tools to predict premature mortality in type 2 diabetic inpatients (International Journal of Clinical Practice)

Plasma triglycerides predict ten-years all-cause mortality in outpatients with type 2 diabetes mellitus: a longitudinal observational study

This finding suggests that more attention should be given to the management of cardiovascular risk in type 2 diabetic patients with high triglycerides levels (Cardiovascular Diabetology)

Friday, 10 October 2014

Preventing type 2 diabetes: population and community-level interventions

Evidence Update October 2014 (NICE)

Generation of Functional Human Pancreatic ß Cells In Vitro

The cells secrete human insulin into the serum of mice shortly after transplantation in a glucose-regulated manner, and transplantation of these cells ameliorates hyperglycemia in diabetic mice. (Cell)

Initial combination of linagliptin and metformin compared with linagliptin monotherapy in newly diagnosed type 2 diabetes patients with marked hyperglycaemia

These results support early combination treatment strategies and suggest newly diagnosed, significantly hyperglycaemic individuals may be effectively managed with oral, non-insulin therapy (Diabetes, Obesity and Metabolism)

Distinct HbA1c trajectories in a type 2 diabetes cohort

Four subgroups with distinct HbA1c trajectories were identified. More than 90 % reached and maintained good glycemic control (subgroup one and two). Patients within the two subgroups that showed a more unfavorable course of glycemic control were younger, had higher HbA1c levels and a longer diabetes duration at baseline (Acta Diabetologica)

Thursday, 9 October 2014

Relationship between social determinants of health and processes and outcomes in adults with type 2 diabetes: validation of a conceptual framework

This study provides the first validation of a conceptual framework for the relationship between socioeconomic and psychological components of social determinants of health and diabetes outcomes (BMC Endocrine Disorders)

Wednesday, 8 October 2014

Hemoglobin A1c Levels and Risk of Severe Hypoglycemia in Children and Young Adults with Type 1 Diabetes from Germany and Austria

A Trend Analysis in a Cohort of 37,539 Patients between 1995 and 2012 (PLOS Medicine)

Diabetes Mellitus Prevalence and Control in Sleep-Disordered Breathing: The European Sleep Apnea Cohort (ESADA) Study

Increasing OSA severity is associated with increased likelihood of concomitant T2DM and worse diabetic control in patients with T2DM (Chest Journal)

The Influence of New European Union Driver’s License Legislation on Reporting of Severe Hypoglycemia by Patients With Type 1 Diabetes

Reporting of severe hypoglycemia by patients with type 1 diabetes is significantly reduced following implementation of EU driver’s licensing legislation that implies withdrawal of driver’s licensing in case of recurrent episodes within 1 year (Diabetes Care)

The experiences of diabetics on self-monitoring of blood glucose: a qualitative metasynthesis

Insights into and discussions regarding the self-monitoring of blood glucose experiences of diabetic patients enable health care professionals to understand the factors that influence the intentions of patients to perform self-monitoring of blood glucose and facilitate establishing customised self-monitoring of blood glucose treatment plans (Journal of Clinical Nursing)

Tuesday, 7 October 2014

Screening for Abnormal Glucose and Type 2 Diabetes Mellitus

The USPSTF recommends screening for abnormal blood glucose and type 2 diabetes mellitus in adults who are at increased risk for diabetes

Monday, 6 October 2014

Diabetes self-management arrangements in Europe: a realist review to facilitate a project implemented in six countries

This realist review should be interpreted within the wider context of a whole systems approach regarding self-care support and chronic illness management (BMC Health Services Research)

Friday, 3 October 2014

Safety, effectiveness, and cost effectiveness of long acting versus intermediate acting insulin for patients with type 1 diabetes: systematic review and network meta-analysis

We found that glargine once daily, detemir once daily, and detemir twice daily significantly reduced HbA1c compared with NPH once daily in our network meta-analysis. Given the small reduction in hemoglobin HbA1c observed, no differences are likely to be clinically relevant because they did not approach the commonly accepted 0.5% minimal clinically important difference in hemoglobin HbA1c (BMJ)

Thursday, 2 October 2014

National Diabetes Audit - 2012-2013: Report 1, Care Processes and Treatment Targets

This national report from the tenth year of the audit presents key findings on key care processes and treatment target achievement rates from 2012-2013 in all age groups in England and Wales (HSCIC)

Wednesday, 1 October 2014

How Do People With Diabetes Describe Their Experiences in Primary Care? 

Evidence from 85,760 patients with self-reported diabetes from the english general practice patient survey (Diabetes Care)

Association between circulating 25-hydroxyvitamin D and incident type 2 diabetes: a mendelian randomisation study

The association between 25(OH)D concentration and type 2 diabetes is unlikely to be causal (The Lancet Diabetes & Endocrinology)

The effects of intravenous insulin infusions on early mortality for patients with acute coronary syndromes who present with hyperglycaemia: A matched propensity analysis using data from the MINAP database 2008–2012

As used in current clinical practice to treat hyperglycaemia in acute coronary syndromes, IVII appears to be of benefit only for patients with STEMI who are not known to have diabetes. IVII is associated with adverse early outcomes in patients with NSTEMI (European Heart Journal – Cardiovascular Care)

Visceral, subcutaneous abdominal adiposity and liver fat content distribution in normal glucose tolerance, impaired fasting glucose and/or impaired glucose tolerance

Liver fat was associated with iIGT but not with iIFG, whereas visceral adiposity was associated with both. Liver fat and visceral adiposity were associated with nT2D, whereas subcutaneous adiposity showed an inverse relationship with nT2D in women (International Journal of Medical Obesity)

Advances in the Etiology and Mechanisms of Type 1 Diabetes

The past few decades have seen tremendous progress in our understanding of the molecular basis of the disease, with the identification of susceptibility genes and autoantigens, the demonstration of several abnormalities affecting various cell types and functions, and the development of improved assays to detect and monitor autoimmunity and beta cell function ... (Discovery Medicine)

Tuesday, 30 September 2014

Acknowledging and allocating responsibility for clinical inertia in the management of Type 2 diabetes in primary care: a qualitative study

In order to understand and address the problem of clinical inertia, provider, patient- and system-level barriers should be considered together rather than as separate issues. Acknowledgement of responsibility should be regarded positively as a motivator for change (Diabetic Medicine)

Serum neuron-specific enolase is elevated as a novel indicator of diabetic retinopathy including macular oedema

Serum neuron-specific enolase is elevated in and indicative of diabetic retinopathy. Neuron-specific enolase may be a potential biomarker of diabetic retinopathy (Diabetic Medicine)

Low-Dose vs Standard-Dose Insulin in Pediatric Diabetic Ketoacidosis

Low dose is noninferior to standard dose with respect to rate of blood glucose decrease and resolution of acidosis (JAMA Pediatrics)

Mortality and Incidence of Renal Replacement Therapy in People With Type 1 Diabetes Mellitus-A Three Decade Long Prospective Observational Study in the Lainz T1DM Cohort

A clear linear relationship between early glycemic control and the later development of end stage renal disease and mortality has been found (Journal of Clinical Endocrinology & Metabolism)

Liraglutide and the Preservation of Pancreatic ß-Cell Function in Early Type 2 Diabetes: The LIBRA Trial

Liraglutide provides robust enhancement of ß-cell function that is sustained over 48 weeks in early T2DM but lost upon cessation of therapy (Diabetes Care)

GLP-1 as a Mediator in the Remission of Type 2 Diabetes After Gastric Bypass and Sleeve Gastrectomy Surgery

The relative importance of the GLP-1 and insulin response versus improvement in insulin action in the liver and skeletal muscles for the glucose tolerance after RYGB and SG depends on when the patients are studied after surgery (Diabetes)

Friday, 26 September 2014

Effects of a patient oriented decision aid for prioritising treatment goals in diabetes: pragmatic randomised controlled trial

We found no evidence that the patient oriented treatment decision aid improves patient empowerment by an important amount (BMJ)

Liraglutide and the Preservation of Pancreatic ß-Cell Function in Early Type 2 Diabetes: The LIBRA Trial

Liraglutide provides robust enhancement of ß-cell function that is sustained over 48 weeks in early T2DM but lost upon cessation of therapy (Diabetes Care)

Thursday, 25 September 2014

Artificial sweeteners induce glucose intolerance by altering the gut microbiota

Our results link non-caloric artificial sweeteners consumption, dysbiosis and metabolic abnormalities, thereby calling for a reassessment of massive NAS usage (Nature)

Follow-up of Blood-Pressure Lowering and Glucose Control in Type 2 Diabetes

The benefits with respect to mortality that had been observed among patients originally assigned to blood-pressure–lowering therapy were attenuated but still evident at the end of follow-up. There was no evidence that intensive glucose control during the trial led to long-term benefits with respect to mortality or macrovascular events (NEJM)

Glucagon-Like Peptide 1 Receptor Agonist or Bolus Insulin With Optimized Basal Insulin in Type 2 Diabetes

Adding exenatide to titrated glargine with metformin resulted in similar glycemic control as adding lispro and was well tolerated. These findings support exenatide as a noninsulin addition for patients failing basal insulin (Diabetes Care)

Wednesday, 24 September 2014

Reduced Testing Frequency for Glycated Hemoglobin, HbA1c, Is Associated With Deteriorating Diabetes Control

These findings provide, in a large, multicenter data set, objective evidence that testing outside guidance on HbA1c monitoring frequency is associated with a significant detrimental effect on diabetes control (Diabetes Care)

Prevalence and Incidence Trends for Diagnosed Diabetes Among Adults Aged 20 to 79 Years, United States, 1980-2012

Analyses of nationally representative data from 1980 to 2012 suggest a doubling of the incidence and prevalence of diabetes during 1990-2008, and a plateauing between 2008 and 2012 (JAMA)

HMG-coenzyme A reductase inhibition, type 2 diabetes, and bodyweight

Evidence from genetic analysis and randomised trials (The Lancet)

Patient Empowerment Programme (PEP) in Primary Care Reduced All-cause Mortality and Cardiovascular Diseases in Patients with Type 2 Diabetes Mellitus

Enrolment in PEP was associated with reduced all-cause mortality and first CVD events among T2DM patients (Diabetes, Obesity and Metabolism)

Relationships between patient activation, disease-specific knowledge and health outcomes among people with diabetes; a survey study

Among people with diabetes, patient activation level was especially related to disease-specific knowledge and less with health-related behavior and outcomes. The PAM might therefore especially be an useful instrument for clinical practice to identify patients most in need for diabetes education (BMC Health Services Research)

Tuesday, 23 September 2014

Effect of Atorvastatin on Pancreatic Beta-Cell Function and Insulin Resistance in Type 2 Diabetes Mellitus Patients: A Randomized Pilot Study

Atorvastatin in the dose used failed to produce significant change in pancreatic beta-cell function and insulin resistance in type 2 diabetes patients as assessed by the HOMA2 index (Canadian Journal of Diabetes)

Living with Sensor-Augmented Pump Therapy in Type 1 Diabetes: Adolescents' and Parents' Search for Harmony

Success with SAPT requires exploration of adolescent and parental expectations for SAPT as well as the degree to which parents have previously fostered their adolescent's involvement in and responsibility for diabetes management (Canadian Journal of Diabetes)

Plasma Triglycerides Predict Incident Albuminuria and Progression of Coronary Artery Calcification in Adults with Type 1 Diabetes: the Coronary Artery Calcification in Type 1 Diabetes Study

In adults with type 1 diabetes, fasting TG independently predicted cardiorenal disease over 6 years and improved reclassification of risk by conventional risk factors (Journal of Clinical Lipidology)

Impact of Islet Autoimmunity on the Progressive ß-Cell Functional Decline in Type 2 Diabetes

These pilot data suggest that the development of islet autoimmunity in T2D is associated with a significantly more rapid ß-cell functional decline (Diabetes Care)

Metformin and low levels of thyroid-stimulating hormone in patients with type 2 diabetes mellitus

In this longitudinal population-based study, metformin use was associated with an increased incidence of low TSH levels in patients with treated hypothyroidism, but not in euthyroid patients (CMAJ)

Friday, 19 September 2014

Effects of telecare intervention for glycemic control in Type 2 Diabetes: A systematic review and meta-analysis of randomized controlled trials

Patients monitored by telecare showed significant improvement in glycemic control in type 2 diabetes than those monitored by routine follow-up (European Society of Endocrinology)

FDA Approves Trulicity™ (dulaglutide), Lilly's Once-Weekly Therapy for Adults with Type 2 Diabetes

Trulicity is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes (Lilly)

Xultophy® (IDegLira) approved in Europe

Xultophy® is for the treatment of type 2 diabetes mellitus in adults. The authorisation covers all 27 European Union member states. Press release (Novo Nordisk)

Thursday, 18 September 2014

Patterns and trends in insulin intensification among patients with type 2 diabetes: A systematic review

Guidelines recommend insulin intensification over time to achieve HbA1c targets ... The paucity of available studies prevented a comprehensive understanding of patterns and trends in insulin intensification. Such information is needed to assess the quality of pharmacologic care for patients with T2DM (Primary Care Diabetes)

Wednesday, 17 September 2014

Insulin pumps (CSII) and cardiovascular diseases and mortality in the Swedish national diabetes register

This large prospective observational study showed risk reductions of around 5% for cardiovascular diseases and mortality with CSII compared to insulin injections in patients with type 1 diabetes followed for 6 years (Presentation Abstract, EASD)

Tuesday, 16 September 2014

Safety and effectiveness of biphasic insulin aspart 30 in people with type 2 diabetes switching from basal-bolus insulin regimens in the A1chieve study

24 weeks after switching from basal-bolus insulin regimens to biphasic insulin aspart 30, glycaemic control and HRQoL were significantly improved, and hypoglycaemia was significantly reduced (Primary Care Diabetes)

Diabetes, antidiabetic medications, and pancreatic cancer risk: an analysis from the International Pancreatic Cancer Case-Control Consortium

This study provides the most definitive quantification to date of an excess risk of pancreatic cancer among diabetics. It also shows that a 30% excess risk persists for more than two decades after diabetes diagnosis, thus supporting a causal role of diabetes in pancreatic cancer. Oral antidiabetics may decrease the risk of pancreatic cancer, whereas insulin showed an inconsistent duration–risk relationship (Annals of Oncology)

Monday, 15 September 2014

Reversal of diabetes with insulin-producing cells derived in vitro from human pluripotent stem cells

Although S7 cells are not fully equivalent to mature beta cells, their capacity for glucose-responsive insulin secretion and rapid reversal of diabetes in vivo makes them a promising alternative to pancreatic progenitor cells or cadaveric islets for the treatment of diabetes (Nature Biotechnology)

Saturday, 13 September 2014

High-Intensity Statin Therapy Alters the Natural History of Diabetic Coronary Atherosclerosis: Insights From SATURN

High-intensity statin therapy alters the progressive nature of diabetic coronary atherosclerosis, yielding regression of disease in diabetic and nondiabetic patients (Diabetes Care)

Effectiveness of chamomile tea on glycemic control and serum lipid profile in patients with type 2 diabetes

Chamomile tea significantly decreased concentration of HbA1C, serum insulin levels, insulin resistance, total cholesterol, triglyceride, and low-density lipoprotein cholesterol compared with control group (Journal of Endocrinological Investigation)

Friday, 12 September 2014

Glucagon-like peptide-1 receptor agonist and basal insulin combination treatment for the management of type 2 diabetes: a systematic review and meta-analysis

GLP-1 agonist and basal insulin combination treatment can enable achievement of the ideal trifecta in diabetic treatment: robust glycaemic control with no increased hypoglycaemia or weight gain. This combination is thus a potential therapeutic strategy that could improve the management of patients with type 2 diabetes (The Lancet)

Greater Dose-Ranging Effects on A1C Levels Than on Glucosuria With LX4211, a Dual Inhibitor of Sodium Glucose Transporters SGLT1 and SGLT2, in Type 2 Diabetes on Metformin Monotherapy

Dual inhibition of SGLT1/SGLT2 with LX4211 produced significant dose-ranging improvements in glucose control without dose-increasing glucosuria and was associated with reductions in weight and systolic BP in metformin-treated type 2 diabetes (Diabetes Care)

Saxenda® for the treatment of obesity receives positive 14-1 vote in favour of approval from FDA Advisory Committee 

Saxenda®, the intended brand name for liraglutide 3 mg, is a once-daily human GLP-1 analogue for the treatment of obesity (Novo Nordisk)

Thursday, 11 September 2014

How can pharma meet the need for new diabetes drugs in cash-strapped healthcare markets? 

Experts will be discussing this issue in a Tweetchat, hosted by PMLiVE and M3, the global provider of technology services in healthcare. From noon to 1pm (UK time) you will be able to follow the discussion live on Twitter using the hashtag #M3diabetes and (should you want to) you are invited to join in with your own questions and comments.

Short-term intensive insulin therapy at diagnosis in type 2 diabetes

An expert workshop was convened to assess the available evidence and the potential application of STII therapy should it be advocated for inclusion in clinical practice (Diabetes/Metabolism Research and Reviews)

Targeting intensive versus conventional glycaemic control for type 1 diabetes mellitus

There was no significant effect towards improved all-cause mortality when targeting intensive glycaemic control compared with conventional glycaemic control. However, there may be beneficial effects of targeting intensive glycaemic control on the composite macrovascular outcome and on nephropathy, and detrimental effects on severe hypoglycaemia (BMJ Open)

Wednesday, 10 September 2014

European Commission grants Lilly and Boehringer Ingelheim's insulin glargine product marketing authorisation in Europe

Lilly/Boehringer Ingelheim's insulin glargine product is the first insulin treatment approved through the European Medicines Agency's biosimilar pathway and the fourth diabetes product approved in the EU from the Lilly-Boehringer Ingelheim Alliance

Incretin-Based Drugs and the Risk of Congestive Heart Failure

In our population-based study, incretin-based drug use was not associated with an increased risk of CHF among patients with type 2 diabetes (Diabetes Care)

Ethnicity-specific obesity cut-points in the development of Type 2 diabetes – a prospective study including three ethnic groups in the United Kingdom

In prospective analyses, British South Asians and African-Caribbeans had equivalent diabetes incidence rates at substantially lower obesity levels than the conventional European cut-points (Diabetic Medicine)

Statin use before diabetes diagnosis and risk of microvascular disease: a nationwide nested matched study

Use of statins before diagnosis of incident diabetes was not associated with an increased risk of microvascular disease. Whether statins are protective against some forms of microvascular disease—a possibility raised by these data—will need to be addressed in other studies (The Lancet Diabetes & Endocrinology)

Increase in the pharmacological management of Type 2 diabetes with pay-for-performance in primary care in the UK

We conclude that a greater proportion of people with newly diagnosed diabetes are being initiated on medication within 1 and 2 years of diagnosis as a result of the introduction of financial incentives for tight glycaemic control (Diabetic Medicine)

Tuesday, 9 September 2014

Transcutaneous oxygen pressure (TcPO2): A novel diagnostic tool for peripheral neuropathy in type 2 diabetes patients

This large study of diabetic patients confirms that the sitting-supine position difference in TcPO2 is higher in DPN patients than control subjects, indicating that TcPO2 examination is a promising valuable diagnostic tool for DPN (Diabetes Research and Clinical Practice)

Monday, 8 September 2014

Hemoglobin A1c, comorbid conditions and all-cause mortality in older patients with diabetes: A retrospective 9-year cohort study

In our patient population, HbA1c scores < 6.4% have significantly higher all-cause mortality. CHF is a major determinant of all-cause mortality. Adults with comorbid CHF and high HbA1c scores have lower all-cause mortality (Diabetes Research and Clinical Practice)

Illness beliefs predict self-care behaviours in patients with diabetic foot ulcers: A prospective study

Patients’ beliefs are important determinants of foot-care practices. They may, therefore, also be influential in determining ulcer outcomes. Interventions aimed at modifying illness beliefs may offer a means for promoting self-care and improving ulcer outcomes (Diabetes Research and Clinical Practice)

Estimated insulin sensitivity predicts regression of albuminuria in Type 1 diabetes

Over 6 years, higher baseline estimated insulin sensitivity and change in estimated insulin sensitivity independently predicted regression of albuminuria. Improving insulin sensitivity in people with Type 1 diabetes is a potential therapeutic target to increase rates of regression of albuminuria (Diabetic Medicine)

Friday, 5 September 2014

High risk of failing eradication of Helicobacter pylori in patients with diabetes: A meta-analysis

Current meta-analysis confirmed the higher risk of HP eradication failure in individuals with diabetes compared with those without diabetes, suggesting the necessity of prolonging treatment or developing a new regimen for HP eradication in patients with diabetes (Diabetes Research and Clinical Practice)

Thursday, 4 September 2014

Reduced risk of hypoglycemia with once-daily glargine versus twice-daily NPH and number needed to harm with NPH to demonstrate the risk of one additional hypoglycemic event in type 2 diabetes

This analysis of long-term insulin treatment confirms findings from short-term studies and demonstrates that glargine provides sustained, clinically meaningful reductions in risk of hypoglycemia compared with NPH in patients with T2DM (Diabetes and Its Complications)

Lilly's Basal Insulin Peglispro Demonstrated HbA1c Superiority against Lantus® in Phase III Trials in Patients with Type 1 Diabetes

Eli Lilly and Company's basal insulin peglispro (BIL) demonstrated a statistically significant lower HbA1c compared with insulin glargine (Lantus®) at 26 weeks and 52 weeks, respectively, in the IMAGINE-1 and IMAGINE-3 Phase III clinical trials in patients with type 1 diabetes (Lilly)

Sanofi Diabetes is on a mission to support children, parents and carers of children with type 1 diabetes through gaming

The New Mission T1D app, created by Sanofi Diabetes to address the need for greater understanding of T1D amongst children, parents and carers, friends and in the school environment is now available, free of charge, from the Apple UK store (Sanofi)

Wednesday, 3 September 2014

Hypoglycemia After Antimicrobial Drug Prescription for Older Patients Using Sulfonylureas 

Prescription of interacting antimicrobial drugs to patients on sulfonylureas is very common, and is associated with substantial morbidity and increased costs (JAMA)

Androgen-deprivation Therapy and Diabetes Control Among Diabetic Men with Prostate Cancer

ADT is associated with worsening of diabetes control and increases in HbA1c levels despite the use of additional diabetes medications (European Urology)

Tuesday, 2 September 2014

Hemoglobin A1c less than 6.5% on admission increases risk for in-hospital and 1-year mortality in patients with diabetes and chest pain

Patients with diabetes admitted for chest pain with HbA1c less than 6.5% may be at increased risk for in-hospital and 1-year mortality. The mechanism for death may be mediated in part by hypoglycemia (Cardiovascular Endocrinology)

A qualitative synthesis of diabetes self-management strategies for long term medical outcomes and quality of life in the UK

This synthesis has explored how patients give meaning to the experiences of interventions for T2DM and subsequent attempts to balance biomarkers with quality of life in the long term (BMC Health Services Research)

Friday, 29 August 2014

Takeda Announces Completion of the Post-Marketing Commitment to Submit Data to the FDA, the EMA and the PMDA for Pioglitazone Containing Medicines Including ACTOS

No overall statistically significant increased risk of bladder cancer in patients ever exposed to pioglitazone in a completed 10-year epidemiological study (Takeda)

Effects of the Multidisciplinary Risk Assessment and Management Program for Patients with Diabetes Mellitus (RAMP-DM) on biomedical outcomes, observed cardiovascular events and cardiovascular risks in primary care

The RAMP-DM resulted in greater improvements in HbA1c and reduction in observed and predicted cardiovascular risks at 12 months follow-up, which indicated a risk-stratification multidisciplinary intervention was an effective strategy for managing Chinese people with diabetes in the primary care setting (Cardiovascular Diabetology)

Antihyperglycaemic treatment patterns, observed glycaemic control and determinants of treatment change among patients with type 2 diabetes in the United Kingdom primary care: a retrospective cohort study

There are patients for whom glycaemic control worsens and a majority remained above the recommended level, suggesting an unmet need despite the availability of many OAD (BMC Endocrine Disorders)

Postpartum plasma C-peptide and ghrelin concentrations are predictive of type 2 diabetes in women with previous gestational diabetes mellitus

This is the first report that identifies C-peptide and ghrelin as potential biomarkers for the prediction of type 2 diabetes in women with a history of GDM (Journal of Diabetes)

Relationship between mid-trimester ultrasound fetal liver length measurements and gestational diabetes mellitus

Fetal liver length is strongly correlated with OGTT results, and could serve as a valid marker in prediction of GDM in high risk population (Journal of Diabetes)

Treatment of type 2 diabetes by free fatty acid receptor agonists 

In this review we show that FFA receptor agonism is a potential clinical target for T2D treatment and discuss ongoing drug development programs within industry and academia aimed at improving the safety and effectiveness of these potential treatments (Frontiers in Endocrinology)

Thursday, 28 August 2014

Endothelial cell autoantibodies in predicting declining renal function, end-stage renal disease, or death in adult type 2 diabetic nephropathy

These results suggest that anti-endothelial cell antibodies interact significantly with albuminuria in predicting the composite endpoint of death, ESRD, or substantial decline in renal function in older, adult type 2 diabetic nephropathy (Frontiers in Endocrinology)

Peripheral neuropathy and the risk of cardiovascular events in type 2 diabetes mellitus

PN is associated with increased risk for a first cardiovascular event among individuals with diabetes (Heart)