Wednesday, 30 April 2014

Self-monitoring of blood glucose: a promise still unfulfilled?

It is the responsibility of diabetes specialists to ensure that people with diabetes are equipped with the knowledge to use self-monitoring more effectively (Diabetologia)

Soluble Glucagon Formulation for Pumps

Dosing of First Patient in Phase 2 Clinical Trial of Investigational Soluble Glucagon Formulation for Pumps (Xeris Pharmaceuticals)

Statins impair glucose uptake in human cells

Statins impair glucose uptake by cells involved in regulation of glucose homeostasis by inducing cholesterol-dependent conformational changes in GLUTs (BMJ Open, Diabetes Research & Care)

Magnetic Resonance Neuroimaging Study of Brain Structural Differences in Diabetic Peripheral Neuropathy

This is the first study to focus on structural changes in the brain associated with DPN. Our findings suggest increased peripheral gray matter volume loss, localized to regions involved with somatosensory perception in subjects with DPN. This may have important implications for the long-term prognosis of DPN (Diabetes Care)

Combination therapy with metformin plus sulfonylureas versus metformin plus DPP-4 inhibitors: association with major adverse cardiovascular events and all-cause mortality

There was a reduction in all-cause mortality for patients treated with metformin combined with DPP-4i versus metformin plus SU, and a similar trend for MACE (Diabetes, Obesity and Metabolism)

Tuesday, 29 April 2014


On 20 February 2014, the Committee for Medicinal Products for Human Use (CHMP) adopted a positive opinion, recommending the granting of a marketing authorisation for Vokanamet for the treatment type 2 diabetes mellitus (EMA)

Metformin vs insulin in the management of gestational diabetes

Metformin will not increase the incidence of adverse maternal outcomes and neonatal outcomes (Diabetes Research and Clinical Practice)

The psychosocial impact associated with diabetes-related amputation

The present study found that the impact of diabetes-related amputation was significant for body image disturbance. However, it appears that other psychosocial outcomes are better accounted for by medical co-morbidities common in this group rather than the amputation itself (Diabetic Medicine)

Diabetes-specific emotional distress in people with Type 2 diabetes: a comparison between primary and secondary care

In primary care, lower levels of diabetes distress were reported than in secondary care. The difference in diabetes distress between care settings can be largely, but not fully, explained by specific demographic and clinical characteristics (Diabetic Medicine)

Monday, 28 April 2014

Association between diabetes mellitus and angina after acute myocardial infarction: analysis of the TRIUMPH prospective cohort study

Contrary to conventional wisdom, angina is more prevalent and more severe among patients with DM, both prior to and following AMI (European Journal of Preventive Cardiology)

Thursday, 24 April 2014

Can a Selective PPAR? Modulator Improve Glycemic Control in Patients With Type 2 Diabetes With Fewer Side Effects Compared With Pioglitazone?

INT131 demonstrated dose-dependent reductions in HbA1c, equivalent to 45 mg pioglitazone, but with less fluid accumulation and weight gain, consistent with its SPPARM design (Diabetes Care)

Statins use is associated with poorer glycaemic control in a cohort of hypertensive patients with diabetes and without diabetes

Statins use is associated with increased HbA1c levels among hypertensive patients and hypertensive patients with diabetes. Clinicians managing hypertensive patients on statins should consider monitoring the HbA1c level and ensure that those with diabetes have their hyperglycaemia kept under control (Diabetology & Metabolic Syndrome)

The Patient Perspective of Diabetes Care: A Systematic Review of Stated Preference Research

The goal of this study was to examine how stated preference methods are applied in diabetes care, and to evaluate the value of this information in developing the patient perspective in clinical and policy decisions. (The Patient - Patient-Centered Outcomes Research)

Vascular calcification in patients with type 2 diabetes: the involvement of matrix Gla protein

High dp-ucMGP levels were independently associated with below-knee arterial calcification score in patients with type 2 diabetes and normal or slightly altered kidney function. The reversibility of the elevation of dp-ucMGP levels and the latter's relationship with clinical events merit further investigation (Cardiovascular Diabetology)

Wednesday, 23 April 2014

Diabetes and Vascular Disease in Different Arterial Territories

In a large population-based study, the association between diabetes and vascular disease differed according to vascular phenotype (Diabetes Care)

Improving the cost-effectiveness of photographic screening for diabetic macular oedema: a prospective, multi-centre, UK study

Retinal screening programmes in the UK should reconsider the screening pathway to make best use of existing and new technologies (British Journal of Ophthalmology)

Tuesday, 22 April 2014

The Effects of a Mediterranean Diet on Need for Diabetes Drugs and Remission of Newly Diagnosed Type 2 Diabetes: Follow-up of a Randomized Trial

In patients with newly diagnosed type 2 diabetes, an LCMD resulted in a greater reduction of HbA1c levels, higher rate of diabetes remission, and delayed need for diabetes medication compared with a low-fat diet (Diabetes Care)

One of the largest diabetes studies ever performed.

Insights from 20,000 patients (

Monday, 21 April 2014

Elevated Serum Free Light Chains Predict Cardiovascular Events in Type 2 Diabetes

cFLC elevation is a novel marker for CVD outcomes in type 2 diabetes that warrants further investigation (Diabetes Care)

Serum Triglyceride Levels Correlated with the Rate of Change in Insulin Secretion Over Two Years in Prediabetic Subjects

Baseline TG level of prediabetic subjects appeared to be associated with rate of change in insulinogenic index and disposition index over a 2-year period, indicating that TG levels among prediabetic subjects should be carefully monitored (Annals of Nutrition and Metabolism)

Wednesday, 16 April 2014

Incretin treatment and risk of pancreatitis in patients with type 2 diabetes mellitus: systematic review and meta-analysis of randomised and non-randomised studies

The available evidence suggests that the incidence of pancreatitis among patients using incretins is low and that the drugs do not increase the risk of pancreatitis. Current evidence, however, is not definitive, and more carefully designed and conducted observational studies are warranted to definitively establish the extent, if any, of increased risk (BMJ)

Association between first-line monotherapy with sulfonylurea versus metformin and risk of all-cause mortality and cardiovascular events

All-cause mortality was significantly increased in patients prescribed sulfonylurea compared with metformin monotherapy (Diabetes, Obesity and Metabolism)

Circulating natriuretic peptide concentrations reflect changes in insulin sensitivity over time in the Diabetes Prevention Program

Circulating NT-proBNP was associated with a measure of insulin sensitivity before and during preventive interventions for type 2 diabetes in the DPP (Diabetologia)

High efficient and cost-effective screening method for diabetic cardiovascular risk

Ischemic heart disease could be predicted in patients with diabetes using a combination of results from conventional physical and laboratory tests (Diabetology & Metabolic Syndrome)

Tuesday, 15 April 2014

SGLT2 inhibitors in the treatment of type 2 diabetes

This article summarizes the rationale for use of these agents and reviews available clinical data on their efficacy, safety, and risks/benefits (Diabetes Research and Clinical Practice)

Observational Study of Kidney Function and Albuminuria in Patients With Type 2 Diabetes Treated With Exenatide BID Versus Insulin Glargine

There were no significant differences in change in kidney function or albuminuria at 1 year in patients treated with exenatide BID compared with insulin glargine as administered in routine practice (Annals of Pharmacotherapy)

Screening for Peripheral Neuropathies in Children With Diabetes: A Systematic Review

Data show extremely low diagnostic utility for standard screening methods (tuning fork and 10-g monofilament) but acceptable utilities for biothesiometry and finer (1 g) monofilaments. Data on the diagnostic utility should be used to inform national and international guidelines on diabetes management (Pediatrics)

Gene expression changes in cancellous bone of type 2 diabetics: a biomolecular basis for diabetic bone disease

This study identifies considerable changes in the expression of transcription factors and extracellular matrix (ECM) components of bone in 2DM patients. Furthermore, the analysis of key differentiation factors of osteoblasts revealed significant alterations in gene expression of these factors, which may contribute to the dysregulation of energy metabolism in 2DM (Langenbeck's Archives of Surgery)

Two new book reviews on Glycosmedia

Cancer Virus: The story of Epstein-Barr Virus - Davidson’s Principles and Practice of Medicine

Monday, 14 April 2014

Ketosis Onset Type 2 Diabetes Had Better Islet b-Cell Function and More Serious Insulin Resistance

From these data, we concluded that ketosis onset T2DM had better islet b-cell function and more serious insulin resistance than nonketotic onset T2DM (Journal of Diabetes Research)

Serious harm from inpatient hypoglycaemia: a survey of hospitals in the UK

An alarming number of serious adverse events was reported: 12 serious adverse events with three deaths over a 1-year period in 41 Trusts. This may be the tip of the iceberg, considering the potential under-reporting (Diabetic Medicine)

Friday, 11 April 2014

Aging is associated with increased HbA1c levels, independently of glucose levels and insulin resistance, and also with decreased diagnostic specificity

In two large datasets, using different methods to measure HbA1c, the association of age with higher HbA1c levels: was consistent and similar; was both statistically and clinically significant; was unexplained by features of aging; and reduced diagnostic specificity. Age should be taken into consideration when using HbA1c for the diagnosis and management of diabetes and prediabetes (Diabetic Medicine)

Thursday, 10 April 2014

Multidisciplinary diabetes care with and without bariatric surgery in overweight people: a randomised controlled trial

When added to multidisciplinary care, laparoscopic adjustable gastric band surgery for overweight people with type 2 diabetes improves glycaemic control with an acceptable adverse event profile. Laparoscopic adjustable gastric band surgery is a reasonable treatment option for this population (The Lancet Diabetes & Endocrinology)

Alogliptin in patients with type 2 diabetes after acute coronary syndromes: heart failure outcomes and cardiovascular safety in heart failure patients

(Journal of the American College of Cardiology)

Cardiovascular mortality in patients with type 2 diabetes and recent acute coronary syndromes from the Examine trial

(Journal of the American College of Cardiology)

Baseline renal function and cardiovascular risk in patients treated with saxagliptin

Observations from the Savor-timi 53 trial (Journal of the American College of Cardiology)

Changes in basal rates and bolus calculator settings in insulin pumps during pregnancy in women with type 1 diabetes

In women with type 1 diabetes on insulin pump therapy with a bolus calculator, the carbohydrate-to-insulin ratio declined 4-fold from early to late pregnancy, whereas changes in basal insulin delivery were smaller (Journal of Maternal-Fetal and Neonatal Medicine)

Tuesday, 8 April 2014

Glucagon-Like Peptide 1 Attenuates the Acceleration of Gastric Emptying Induced by Hypoglycemia in Healthy Subjects

Acute administration of exogenous GLP-1 attenuates, but does not abolish, the acceleration of gastric emptying by insulin-induced hypoglycemia in healthy subjects (Diabetes Care)

Does pharmacologic treatment in patients with established coronary artery disease and diabetes fulfil guideline recommended targets? A report from the EUROASPIRE III cross-sectional study

This European study demonstrates a low use of cardioprotective drug therapies among patients with a combination of coronary artery disease and diabetes, which will be contributing to the poor achievement of risk factor treatment targets for cardiovascular prevention (Preventative Cardiology)

Monday, 7 April 2014

Effects of low dose metformin in adolescents with type I diabetes mellitus: a randomized, double-blinded placebo-controlled study

Low-dose metformin likely improves BMI as well as insulin sensitivity in T1DM adolescents, as indicated by a decrease in total daily insulin dose (Pediatric Diabetes)

Serum Uric Acid and Hypertension in Adults: A Paradoxical Relationship in Type 1 Diabetes

A positive association was observed between serum uric acid and systolic blood pressure in nondiabetic adults. In contrast, an inverse relationship was demonstrated after multivariable adjustments in type 1 diabetes (Journal of Clinical Hypertension)

Glucose Sensing in the Peritoneal Space Offers Faster Kinetics than Sensing in the Subcutaneous Space

Combined with the known faster kinetics of IP insulin delivery over SQ delivery, our findings suggest that artificial pancreas technologies may be optimized by both sensing glucose and delivering insulin in the IP space (Diabetes)

Friday, 4 April 2014

Effect of large doses of parenteral vitamin D on glycaemic control and calcium/phosphate metabolism in patients with stable type 2 diabetes mellitus

D3 improved insulin sensitivity (based on HOMA-IR) and affected the course of HbA1c positively compared with placebo in patients with T2DM (Swiss Medical Weekly)

Exenatide once weekly versus insulin glargine for type 2 diabetes (DURATION-3): 3-year results of an open-label randomised trial

Efficacy of once-weekly exenatide is sustained for 3 years. GLP-1 receptor agonists could be a viable long-term injectable treatment option in patients with type 2 diabetes who have not yet started taking insulin (The Lancet Diabetes & Endocrinology)

Thursday, 3 April 2014

Effects of Five-Year Treatment with Testosterone Undecanoate on Metabolic and Hormonal Parameters in Ageing Men with Metabolic Syndrome

Normalization of Testosterone levels in men with Metabolic Syndrome improved obesity, glycemic control, blood pressure, lipid profile, and bone mineral density compared with controls (International Journal of Endocrinology)

Small Intestinal Glucose Exposure Determines the Magnitude of the Incretin Effect in Health and Type 2 Diabetes

Based on these data, we conclude that the rate of small intestinal glucose exposure (i.e. glucose load) is a major determinant of the comparative secretion of GIP and GLP-1, as well as the magnitude of the incretin effect and gastrointestinal glucose disposal in health and type 2 diabetes (Diabetes)

Wednesday, 2 April 2014

FDA Advisory Committee Recommends Approval of AFREZZA(R), MannKind Corporation's Investigational Drug to Treat Diabetes

The U.S. Food and Drug Administration voted to recommend that AFREZZA® (insulin human [rDNA origin]) Inhalation Powder be granted marketing approval to improve glycemic control in adults with type 1 diabetes and in adults with type 2 diabetes (MannKind Corporation)

Early Impact of Bariatric Surgery on Type II Diabetes, Hypertension, and Hyperlipidemia

In summary, our study showed that laparoscopic bariatric surgery is an effective therapeutic option to reduce the cardiovascular risk in severe obese patients (Obesity Surgery)

Tuesday, 1 April 2014

The Ipswich Touch Test: a simple and novel method to screen patients with diabetes at home for increased risk of foot ulceration

With clearly written instructions, this simple test can be used by non-professionals to accurately assess for loss of protective sensation. We believe that the Ipswich Touch Test may also be a useful educational adjunct to improve awareness of diabetes foot disease in patients and relatives alike and empower them to seek appropriate care if sensation was found to be abnormal (Diabetic Medicine)