Thursday, 30 January 2014

Oramed Announces Successful FDA Phase 2a Clinical Trial Results 

A Phase 2a clinical trial for ORMD-0801 oral insulin capsule for the treatment of type 2 diabetes met all primary and secondary endpoints (Oramed)

Prevention of type 2 diabetes; a systematic review and meta-analysis of different intervention strategies

These data indicate that several strategies prevent T2DM, making it possible to make a choice for the individual subject (Diabetes, Obesity and Metabolism)

Lifecourse: management of type 1 diabetes

Management strategies must be tailored to the individual with their age and life circumstances taken into account. Provision of education for patients and their support network is crucial, and should be a priority - includes supplementary audio (The Lancet Diabetes & Endocrinology)

Wednesday, 29 January 2014

The use of social media among health care professionals within an online postgraduate diabetes diploma course

This study reveals a successful uptake and communication of a professional message to a wider audience through Twitter and YouTube among social media-naïve HCPs studying for a postgraduate diploma in diabetes. Despite initial apprehension, HCPs felt confident in using social media to convey the message with continuing use of social media beyond the confines of the course (Practical Diabetes)

‘Join us on our journey’: exploring the experiences of children and young people with type 1 diabetes and their parents

This study is thought to be the first of its kind to consult with children, young people and parents to find out about their experiences of type 1 diabetes care provision. The research findings add to the current evidence base by highlighting the disparities in care, the urgent need for change in the way services are delivered and the involvement of service users in this process (Practical Diabetes)

Tuesday, 28 January 2014

A Randomized Comparison of Online- and Telephone-Based Care Management with Internet Training Alone in Adult Patients with Poorly Controlled Type 2 Diabetes

Online, telephone-based care management, and Web training for diabetes patients with elevated A1c were each associated with a substantial improvement in A1c over a 1-year period. Internet access and training alone may be as effective as care management in patients with poorly controlled diabetes (Diabetes Technology and Therapeutics)

Oral glucose tolerance test-based calculation identifies different glucose intolerance phenotypes within the impaired fasting glucose range

Oral glucose tolerance test does differentiate the great heterogeneity in metabolic disorders of patients with FPG 100–125 mg/dL. Furthermore, PG% can expand the diagnostic power of OGTT in the is-IFG range by distinguishing metabolic phenotypes very likely to herald different clinical risks (Journal of Diabetes Investigation)

Statistical Models to Predict Type 2 Diabetes Remission After Bariatric Surgery

Preoperative characteristics determine T2D remission rates after BS to different extents. The use of statistical models may help clinicians reliably predict T2D remission rates after BS (Journal of Diabetes)

Vitamin D concentration, obesity, and risk of diabetes: a mendelian randomisation study

Genetic variants associated with low plasma 25(OH)D concentrations are associated with type 2 diabetes and low plasma 25(OH)D concentrations might be a modest mediator between obesity and increased risk of diabetes.However, as findings for DHCR7 were not statistically significant, our results require independent confirmation (The Lancet Diabetes & Endocrinology)

Monday, 27 January 2014

Modeling of 24-Hour Glucose and Insulin Profiles in Patients With Type 2 Diabetes Mellitus Treated With Biphasic Insulin Aspart

Circadian variations in glucose homeostasis were assessed on relevant parameters, and a significant improvement was achieved by including a circadian rhythm on the endogenous glucose production in the model. The extended model is a useful tool for clinical trial simulation and for elucidating the effect profile of new insulin products (Journal of Clinical Pharmacology)

Saturday, 25 January 2014

Statin use and lower extremity amputation risk in nonelderly diabetic patients

This is the first study to report a significant association between statin use and diminished amputation risk among patients with diabetes (Journal of Vascular Surgery)

Thursday, 23 January 2014

Carbohydrate counting with an automated bolus calculator helps to improve glycaemic control in children with type 1 diabetes using multiple daily injection therapy: An 18-month observational study

CarbC helped to improve glycaemic control in children with type 1 diabetes using multiple daily injections. ABC use led to greater improvements in HbA1c, HBGI and LBGI compared with patients using only carbC, regardless of experience with carbC (Diabetes Research and Clinical Practice)

Wednesday, 22 January 2014

Xigduo™ (dapagliflozin and metformin hydrochloride) approved in the European Union for type 2 diabetes

AstraZeneca and Bristol-Myers Squibb today announced that Xigduo™ (dapagliflozin and metformin hydrochloride in 5mg/850mg and 5mg/1000mg tablets) has been granted Marketing Authorisation by the European Commission for the treatment of type 2 diabetes in the European Union (AstraZeneca)

Body mass index thresholds for intervening to prevent ill health among black, Asian and other minority ethnic groups

The prevalence of chronic conditions such as type 2 diabetes, coronary heart disease and stroke is up to 6 times higher (and they occur from a younger age) among black, Asian and other minority ethnic groups. In addition, these groups progress from being at-risk to being diagnosed with these conditions at twice the rate of white populations. (NICE)

Characteristics of Glucose Metabolism in Nordic and South Asian Subjects with Type 2 Diabetes

Subjects of South Asian ethnicity with type 2 diabetes, despite being younger and leaner, had higher basal endogenous glucose production, indicating higher hepatic insulin resistance, and a trend towards higher use of carbohydrates as fasting energy substrate compared to Nordic subjects. These findings may contribute to the understanding of the observed differences in prevalence of type 2 diabetes between the ethnic groups. (PLoS ONE)

The effect of withdrawal of rosiglitazone on treatment pathways, diabetes control and patient outcomes: A retrospective cohort study

Withdrawal of rosiglitazone was associated with worsening glucose control and subsequent intensification of treatment regimen (Diabetes and Its Complications)

Monday, 20 January 2014

Association of Myocardial Dysfunction with Vitamin D Deficiency in Patients with Type 2 Diabetes Mellitus

In patients with T2DM and no history of coronary artery disease, vit-D deficiency is independently associated with impaired global longitudinal strain. This suggests that vit-D deficiency may contribute to the development of myocardial dysfunction in these patients (Journal of Diabetes and Its Complications)

Old and New Basal Insulin Formulations: Understanding Pharmacodynamics is Still Relevant in Clinical Practice

Despite (in fact because of) the widespread use of insulin analogues it remains critical to analyse the pharmacodynamics (PD) of basal insulin formulations appropriately to interpret the results of clinical trials correctly. Importantly, these data may help physicians in tailoring insulin therapy to patients’ individual needs and, additionally, when clinical evidence is not available, to optimise insulin treatment (Diabetes, Obesity and Metabolism)

How many people inject insulin? UK estimates from 1991 to 2010

The crude prevalence rate of insulin use increased from 2.43 per 1,000 population in 1991 to 6.71 per 1,000 in 2010. The largest change was an increase in the prevalence of insulin users with a diagnosis of type 2 diabetes from 0.67 to 4.34 per 1000 population. The absolute number using insulin increased from 137,000 people in 1991 to 421,000 in 2010 (Diabetes, Obesity and Metabolism)

Saturday, 18 January 2014

Glycemic control and all-cause mortality risk in type 1 diabetes patients: the EURODIAB Prospective Complications Study

Target HbA1c below a certain threshold may not be appropriate in this population. We recognize that these low HbA1c levels may be related to anemia, renal insufficiency, infection, or other factors not available in our database. If our data are confirmed, the potential mechanisms underlying this increased mortality risk among those with low HbA1c will need further study (Journal of Clinical Endocrinology & Metabolism)

Chinese Herbal Medicine Tianqi Reduces Progression From Impaired Glucose Tolerance to Diabetes

Treatment with a Tianqi capsule for 12 months significantly decreased the incidence of T2DM in subjects with IGT, and this herbal drug was safe to use (Journal of Clinical Endocrinology & Metabolism)

Thursday, 16 January 2014

Re-analysis of study of pancreatic effects of incretin therapy: Methodological deficiencies

We find that the data presented in the Butler paper have serious methodological deficiencies that preclude any meaningful conclusions (Diabetes, Obesity and Metabolism)

Effects of saxagliptin on early microvascular changes in patients with type 2 diabetes

Our data suggest that treatment with saxagliptin for 6 weeks normalizes retinal capillary flow and improves central hemodynamics in type-2 diabetes (Cardiovascular Diabetology)

Body-Mass Index and Mortality among Adults with Incident Type 2 Diabetes

We found no evidence of lower mortality among patients with diabetes who were overweight or obese at diagnosis, as compared with their normal-weight counterparts, or of an obesity paradox (New England Journal of Medicine)

Wednesday, 15 January 2014

State of the Nation’s Waistline report

The purpose of the State of the Nation’s Waistline report is to audit the state of obesity in the UK, to identify what initiatives and policy exists, and to assess their effectiveness in tackling obesity and weight management issues (National Obesity Forum)

Re-analysis of study of pancreatic effects of incretin therapy: Methodological deficiencies

We find that the data presented in the Butler paper have serious methodological deficiencies that preclude any meaningful conclusions (Diabetes, Obesity and Metabolism)

The effect of alogliptin and pioglitazone combination therapy on various aspects of beta-cell function in patients with recent-onset type 2 diabetes

Short-term treatment with ALO/PIO or ALO improved glycemic control in well-controlled T2DM patients, but only combined ALO/PIO improved beta-cell function. These data support that initial combination therapy with a DPP-4 inhibitor and TZD to address multiple core defects in T2DM may be a sensible approach (European Journal of Endocrinology)

Tuesday, 14 January 2014

Screening All Pregnant Women for Gestational Diabetes

U.S. Preventive Services Task Force Recommends Screening All Pregnant Women for Gestational Diabetes in Final Statement (USPSTF)

Is Statin-induced Diabetes Clinically Relevant? A Comprehensive Review of the Literature

Despite the fact that higher statin doses are more likely to lead to new-onset diabetes, for every case of diabetes caused, there are approximately three cardiovascular events reduced with high dose vs. moderate dose statin therapy. Overall, the small risk of developing type 2 diabetes with statin therapy is far outweighed by the potential of statins to decrease cardiac events (Diabetes, Obesity and Metabolism)

Circulating Apelin is increased in patients with type 1 or type 2 diabetes and is associated with better glycemic control

Our study showed that apelin concentrations were increased in diabetic patients. This rise, which was greater in type 1 than in type 2 diabetic patients, suggests that obesity is not the main determinant of plasma apelin levels. The negative correlation with glycosylated hemoglobin in patients with type 2 diabetes could indicate that apelin plays a role in glycemic balance and even insulin sensitivity (Clinical Endocrinology)

Monday, 13 January 2014

Clinical and genetic determinants of progression of type 2 diabetes: A DIRECT Study

Increased triacylglyceride and low HDL are independently associated with increased rate of progression of diabetes. The genetic factors that predispose to diabetes are different from those that cause rapid progression of diabetes suggesting a difference in biological process that needs further investigation (Diabetes Care)

Deoxysphingolipids, a novel biomarker for type 2 diabetes, are cytotoxic for insulin-producing cells

Our results revealed that 1-deoxysphinganine is a cytotoxic lipid for insulin-producing cells, suggesting that the increased levels of this sphingolipid observed in diabetic patients may contribute to the reduced functionality of pancreatic ß-cells. Thus, targeting deoxy-sphingolipid synthesis may complement the currently available therapies of diabetes (Diabetes)

Friday, 10 January 2014

FDA approves Farxiga to treat type 2 diabetes

The U.S. Food and Drug Administration today approved Farxiga (dapaglifozin) tablets to improve glycemic control, along with diet and exercise, in adults with type 2 diabetes (FDA)

‘Looking for the needle in the haystack’: a qualitative study of the pathway to diagnosis of type 1 diabetes in children

This study highlights the difficulties for parents and GPs in recognising the early symptoms of T1D. It suggests that future interventions should be targeted at parents in the appraisal interval and include the importance of timely presentation to a healthcare professional and the differences between types 1 and 2 diabetes (BMJ Open)

Urine C-peptide creatinine ratio can be used to assess insulin resistance and insulin production in people without diabetes

In participants with normal renal function, UCPCR may be a simple, practical method for the assessment of IR in epidemiology studies (BMJ Open)

Continuous Subcutaneous Delivery of Exenatide via ITCA 650 Leads to Sustained Glycemic Control and Weight Loss for 48 Weeks in Metformin-Treated Subjects with Type 2 Diabetes

Significant changes in HbA1c, body weight, and FPG attained with ITCA 650 were maintained to 48 weeks. The incidence of AEs was lower in the 24-week extension than in the initial 24-week treatment phase (Diabetes and Its Complications)

NHS England vision for tackling diabetes in 2014

The new plan, Action for Diabetes, outlines how it would like to see better prevention of Type 2 diabetes, earlier diagnosis of all diabetes, and support for people to manage their diabetes better and improve their quality of life (NHS England)

Thursday, 9 January 2014

Effect of social networks intervention in type 2 diabetes: a partial randomised study

The social networks intervention showed improved integration of patients within their existing networks leading to a greater reduction in HbA1c and blood glucose, as well as improved behaviour mediating outcomes (Journal of Epidemiology & Community Health)

Efficacy and Safety of Initial Combination Therapy With Alogliptin Plus Metformin Versus Either as Monotherapy in Drug-Naïve Patients With Type 2 Diabetes

Alogliptin plus metformin initial combination therapy was well tolerated yet more efficacious in controlling glycemia in drug-naïve T2DM patients than either as monotherapy (Diabetes, Obesity and Metabolism)

HbA1c, fasting and 2 h plasma glucose in current, ex- and never-smokers: a meta-analysis

Across this heterogeneous group of studies, current smokers had a higher HbA1c and lower 2H-PG than never-smokers. This will affect the chances of smokers being diagnosed with diabetes (Diabetologia)

Current status of clinical islet transplantation

This brief overview presents recent progress in Islet transplantation. A concise historical perspective is provided, along with the latest efforts to improve islet engraftment, immune protection and ultimately, prolonged graft survival(World Journal of Transplantation)

Why do some people develop type 1 diabetes rapidly while others at risk do not?

The autoimmune process leading to type 1 diabetes can develop quickly in some children and young people but very slowly in others despite the presence of proteins in their blood indicating an on-going autoimmune process in the pancreas - Research project from the University of Bristol

Wednesday, 8 January 2014

Identifying targets to reduce the incidence of diabetic ketoacidosis at diagnosis of type 1 diabetes in the UK

Multiple HCP contacts increased risk of presentation in DKA, whereas, parental awareness of diabetes was protective. Improved public and health professional education targeting non-classical symptoms, awareness of diabetes in under 2 y, and point-of-care testing could reduce DKA at diagnosis of diabetes

Differential patterns of insulin secretion and sensitivity in patients with type 2 diabetes mellitus and nonalcoholic fatty liver disease versus patients with type 2 diabetes mellitus alone

In patients with similar levels of insulin resistance and hyperglycemia, DM-NAFLD was associated with higher serum insulin levels than T2DM alone. Hyperinsulinemia is caused mainly by beta-cell hypersecretion. The present study demonstrates pathophysiological differences in mechanisms of insulin resistance in patients with DM-NAFLD versus T2DM alone (Lipids in Health and Disease)

Tuesday, 7 January 2014

Encapsulate this

Insulin-producing islet cells could hold the secret to curing type 1 diabetes - if only scientists could figure out a way to encapsulate and transplant them into the body. But first, the right biocompatible material must be found to hold these precious cells. A team of bioengineers thinks it has discovered one (Nature Medicine)

Monday, 6 January 2014

Changes in procoagulants track longitudinally with insulin resistance: findings from the Coronary Artery Risk Development in Young Adults (CARDIA) study

An increase in fibrinogen level and persistently high levels of factor VII and von Willebrand factor are significantly associated with increased risk of insulin resistance. These findings provide new insight into the mechanisms to explain the heightened risk for thrombosis in adults with insulin resistance/diabetes (Diabetic Medicine)

Red cell distribution width, haemoglobin A1c and incidence of diabetes mellitus

Low RDW is associated with increased incidence of DM independently of other risk factors. We propose that low RDW could be a surrogate marker of reduced RBC survival, with lower HbA1c due to shorter duration of glucose exposure. RDW is a biomarker that could improve risk assessment for individuals at risk of developing DM (Journal of Internal Medicine)

Association between magnesium concentration and HbA1c in children and adolescents with type 1 diabetes mellitus

This study shows that low serum magnesium levels in children and adolescents with T1DM are associated with increased risk for poor glycaemic control, potentially contributing to the early development of cardiovascular complications (Journal of Diabetes)

Friday, 3 January 2014

NHS could be 'overwhelmed' by people with long-term medical conditions

The Role of MIF in Type 1 and Type 2 Diabetes Mellitus

We support the statement that MIF is a therapeutic target and propose that it is necessary to design synthetic MIF inhibitors that could interact with the existing therapies used to treat diabetes (Journal of Dental Research)

Thursday, 2 January 2014

Use of a New Acellular Dermal Matrix for Treatment of Nonhealing Wounds in the Lower Extremities of Patients With Diabetes

As ADMs increasingly become the surgeon’s method of choice in treating diabetic foot ulcers, it becomes more important to select the best-performing biological scaffold. This study shows favorable closure rates combined with a decreased time needed for complete closure when using D-ADM (Wounds)

Lipid-lowering treatment and inflammatory mediators in diabetes and chronic kidney disease

DM patients with CKD stages 3-4 had increased inflammatory activity compared to DM patients with normal GFR. Lipid-lowering treatment decreased the levels of MCP-1 and IFN? in DM patients with concomitant CKD, which may be beneficial with regard to the progression of both atherosclerosis and diabetic nephropathy (European Journal of Clinical Investigation)