Monday, 30 June 2014

American Diabetes Association issues new guidelines for type 1 diabetes

In its new document, the American Diabetes Association called for an A1c target of less than 7.5% for all under 18s, bringing its recommendations into line with those of the International Society for Pediatric and Adolescent Diabetes, the Pediatric Endocrine Society, and the International Diabetes Federation (BMJ)

Association Between Impaired Cardiovascular Autonomic Function and Hypoglycemia in Patients With Type 1 Diabetes

Increased GV promoting hypoglycemic stress was associated with reduced HRV independent of glycemic control as assessed by HbA1c. These pilot data suggest that glucose variability may contribute to cardiovascular autonomic dysfunction among adults with type 1 diabetes (Diabetes Care)

Dietary Fat Composition and Cardiac Events in Patients with Type 2 Diabetes

In patients with type 2 diabetes without ischemic heart disease, a high intake of polyunsaturated fatty acids, especially alpha linolenic acid, was protective for the development of cardiac events (Atherosclerosis)

Sunday, 29 June 2014

Should thyroid-stimulating hormone goals be reviewed in patients with Type 1 diabetes mellitus? Results from The Brazilian Type 1 Diabetes Study Group

Thyroid-stimulating hormone levels of 0.4–2.5 mU/l are associated with a lower risk of diabetic retinopathy and renal failure in individuals with Type 1 diabetes, independently of glycaemic control and duration of the disease (Diabetic Medicine)

Saturday, 28 June 2014

FDA approves Afrezza to treat diabetes

The U.S. Food and Drug Administration today approved Afrezza (insulin human) Inhalation Powder, a rapid-acting inhaled insulin to improve glycemic control in adults with diabetes mellitus. Afrezza is a rapid-acting inhaled insulin that is administered at the beginning of each meal, or within 20 minutes after starting a meal (FDA)

Friday, 27 June 2014

First biosimilar insulin to receive CHMP positive opinion in the EU

CHMP Recommends Lilly and Boehringer Ingelheim's Investigational New Insulin Glargine Product for Approval in the European Union (Lilly)

A common Greenlandic TBC1D4 variant confers muscle insulin resistance and type 2 diabetes

These findings are concomitant with a severely decreased insulin-stimulated glucose uptake in muscle, leading to postprandial hyperglycaemia, impaired glucose tolerance and T2D (Nature)

Thursday, 26 June 2014

National Diabetes Inpatient Audit 2013

Key findings about the quality of care of inpatients with diabetes in England and Wales

Genetic Variants in Transcription Factors Are Associated With the Pharmacokinetics and Pharmacodynamics of Metformin

Overall, our study highlights the importance of genetic variants in transcription factors as modulators of metformin PK and response (Clinical Pharmacology & Therapeutics)

Wednesday, 25 June 2014

Canagliflozin in combination therapy for treating type 2 diabetes

NICE technology appraisal guidance

Phase 3a liraglutide 3 mg trial demonstrated significant weight loss and improved cardiovascular risk factors in adults with obesity and type 2 diabetes

Data demonstrated that, at 56 weeks, in addition to clinically meaningful weight loss, treatment with liraglutide 3 mg provided statistically significantly greater improvements in risk factors for cardiovascular (CV) disease, compared with placebo, in combination with diet and physical activity (Novo Nordisk)

Effects of sitagliptin therapy on markers of low-grade inflammation and cell adhesion molecules in patients with type 2 diabetes

Treatment with sitagliptin for 6 weeks reduced plasma markers of low-grade inflammation and cell adhesion molecules, most likely by increasing plasma GLP-1 levels and improving glucose-insulin homeostasis. These beneficial effects of sitagliptin might represent a further advantage in the management of diabetes and its proatherogenic comorbidities (Metabolism - Clinical and Experimental)

Tuesday, 24 June 2014

Sedentary time and markers of inflammation in people with newly diagnosed type 2 diabetes

Higher sedentary time is associated with IL-6 in men and women with type 2 diabetes, and reducing sedentary time is associated with improved levels of CRP in women. Interventions to reduce sedentary time may help to reduce inflammation in women with type 2 diabetes (Nutrition, Metabolism & Cardiovascular Diseases)

Fear of hypoglycemia in parents of children with type 1 diabetes

Fear of hypoglycaemia is associated with worse glycaemic control. It is highest among parents of 6- to 11-year-olds but is not affected by previous severe hypoglycaemia or associated with increased contact with the diabetes team (Journal of Paediatrics and Child Health)

Identification of Novel Autoantibodies in Type 1 Diabetic Patients Using a High-Density Protein Microarray

This approach identified autoantibodies that can provide a new dimension of information indicative of T1DM independent of GADA and new insights into diagnosis and classification of T1DM (Diabetes)

Monday, 23 June 2014

No Effect of High-Dose Vitamin D Supplementation on Glycemic Status or Cardiovascular Risk Factors in Subjects With Prediabetes

This study shows that vitamin D supplementation does not improve glycemic indices, blood pressure, or lipid status in subjects with IFG and/or IGT (Diabetes Care)

A Practical Method to Measure GFR in people with type 1 diabetes

Iohexol clearance measured with DBS performed better than eGFR methods. Correction for ambient blood glucose improved precision and accuracy of GFR measurement. This method is more convenient than the gold-standard GFR method and may improve screening and diagnostic capabilities in people with type 1 diabetes, especially when GFR is >60 ml/min/1.73 m2 (Diabetes and Its Complications)

Friday, 20 June 2014

Prevalence of prediabetes in England from 2003 to 2011: population-based, cross-sectional study

There has been a marked increase in the proportion of adults in England with prediabetes. The socioeconomically deprived are at substantial risk. In the absence of concerted and effective efforts to reduce risk, the number of people with diabetes is likely to increase steeply in coming years (BMJ Open)

Increased immune cell infiltration of the exocrine pancreas: a possible contribution to the pathogenesis of type 1 diabetes

Our study provides the first information on the precise tissue distribution of CD8 T cells in pancreata from T1D, T2D, Ab+ and healthy controls (Diabetes)

Thursday, 19 June 2014

Outpatient Glycemic Control with a Bionic Pancreas in Type 1 Diabetes

As compared with an insulin pump, a wearable, automated, bihormonal, bionic pancreas improved mean glycemic levels, with less frequent hypoglycemic episodes, among both adults and adolescents with type 1 diabetes mellitus (NEJM)

Wednesday, 18 June 2014

Mesenchymal stem cell-based treatment for microvascular and secondary complications of Diabetes mellitus

MSC administration has significant potential in the treatment of diabetic microvascular and secondary complications but challenges remain in terms of engraftment, persistence, tissue targeting, and cell manufacture (Frontiers in Endocrinology)

Differential reduction in corneal nerve fiber length in patients with type 1 or type 2 diabetes mellitus

Corneal confocal microscopy of the sub-basal nerve plexus may be an indicator of early peripheral nerve degeneration in type 1 DM. Type of diabetes, in addition to degree of neuropathy, may influence the extent of corneal nerve damage (Diabetes and Its Complications)

Resubmission of New Drug Application for empagliflozin to FDA

Type 2 diabetes: Boehringer Ingelheim and Eli Lilly and Company announce resubmission of New Drug Application for empagliflozin to FDA (Lilly)

Monday, 16 June 2014

Outpatient Glycemic Control with a Bionic Pancreas in Type 1 Diabetes

As compared with an insulin pump, a wearable, automated, bihormonal, bionic pancreas improved mean glycemic levels, with less frequent hypoglycemic episodes, among both adults and adolescents with type 1 diabetes mellitus (NEJM)

Diabetes in athletes

Diabetes is not necessarily as debilitating to a sportsperson's career as some people might think. With proper management, any sport is possible (The Lancet Diabetes & Endocrinology)

Insulin Action in Brain Regulates Systemic Metabolism and Brain Function

In addition, insulin signaling modulates phosphorylation of tau protein, an early component in the development of Alzheimer disease. Thus, alterations in insulin action in the brain can contribute to metabolic syndrome, and the development of mood disorders and neurodegenerative diseases (Diabetes)

Bydureon - data presented today at the 74th Scientific Sessions of the American Diabetes Association

Latest data demonstrate sustained results of Bydureon® treatment over six years with a second, retrospective study showing a higher likelihood of adherence with exenatide once-weekly vs. other GLP-1 therapies in type 2 diabetes patients (AstraZeneca)

Sunday, 15 June 2014

Studies Show Investigational New Insulin Glargine Product from Lilly and Boehringer Ingelheim Similar Safety and Efficacy Profile to Lantus

For the first time today, Eli Lilly and Boehringer Ingelheim Pharmaceuticals Inc. presented data showing that LY2963016, the alliance's investigational new insulin glargine product, has a similar safety and efficacy profile to currently marketed insulin glargine (Lantus®)

Lilly's Once-Weekly Dulaglutide Shows Similar Reductions in Average Blood Glucose Levels as Once-Daily Liraglutide in Head-to-Head Trial

Once-Weekly Dulaglutide 1.5 mg Also Demonstrates Weight Loss, Low Rates of Hypoglycemia in AWARD-6 Trial (Lilly)

Sanofi Reports Positive Phase 3 Results for Toujeo

Sanofi announce that, in a pooled analysis, investigational therapy Toujeo® (insulin glargine [rDNA origin] injection, 300 U/mL) consistently showed significantly fewer low blood sugar events (hypoglycemia) at any time of day, including night-time events, compared with Lantus® (insulin glargine [rDNA origin] injection, 100 U/mL)

Sanofi and Medtronic to Form Strategic Alliance in Diabetes to Improve Patient Experience and Outcomes

The alliance will initially focus on two key priorities: the development of drug-device combinations and delivery of care management services to improve adherence, simplify insulin treatment, and help people with diabetes better manage their condition (Sanofi)

MANF Is Indispensable for the Proliferation and Survival of Pancreatic ß Cells

We demonstrate that MANF specifically promotes ß cell proliferation and survival, thereby constituting a therapeutic candidate for ß cell protection and regeneration (Cell Reports)

Diabetic cardiomyopathy is associated with defective myocellular copper regulation and both defects are rectified by divalent copper chelation

Myocardial copper deficiency and defective cellular copper transport/trafficking are revealed as key molecular defects underlying LV impairment in diabetes, and TETA-mediated restoration of copper regulation provides a potential new class of therapeutic molecules for DCM (Cardiovascular Diabetology)

Wednesday, 11 June 2014

Association Between Intensification of Metformin Treatment With Insulin vs Sulfonylureas and Cardiovascular Events and All-Cause Mortality Among Patients With Diabetes 

Among patients with diabetes who were receiving metformin, the addition of insulin vs a sulfonylurea was associated with an increased risk of a composite of nonfatal cardiovascular outcomes and all-cause mortality. These findings require further investigation to understand risks associated with insulin use in these patients (JAMA)

Letter - Concerns about the latest NICE draft guidance on statins

We (9 signatories) are concerned about your draft guidance on CV risk for discussion and debate. We would ask for a delay until our concerns are addressed. Whilst we agree with much of the guidance, our concerns focus on six key areas: medicalization of healthy individuals, true levels of adverse events, hidden data, industry bias, loss of professional confidence, and conflicts of interest

Tuesday, 10 June 2014

Incidence of Pancreatitis and Pancreatic Cancer in a Randomized Controlled Multicenter Trial (SAVOR-TIMI 53) of the Dipeptidyl Peptidase-4 (DPP-4) Inhibitor Saxagliptin

In the SAVOR-TIMI 53 trial, within 2.1 years of follow-up, risk for pancreatitis in type 2 diabetic patients treated with saxagliptin was low and apparently similar to placebo, with no sign of increased risk for pancreatic cancer (Diabetes Care)

Retinal Vessel Calibers Predict Long-term Microvascular Complications in Type 1 Diabetes Mellitus

Early retinal vessel caliber changes are seemingly early markers of microvascular processes, precede the development of microvascular complications and a potential non-invasive predictive test on future risk of diabetic retinopathy, neuropathy and nephropathy (Diabetes)

Roux-en-Y Gastric Bypass Surgery or Lifestyle With Intensive Medical Management in Patients With Type 2 Diabetes

In obese patients with type 2 diabetes, RYGB produces greater weight loss and sustained improvements in HbA1c and cardiometabolic risk factors compared with medical management, with emergent differences over 1 year (JAMA Surgery)

Interpretation of HbA1c: association with mean cell volume and haemoglobin concentration

A mean HbA1c difference of 5 mmol/mol (0.5%) across the mean cell haemoglobin concentration reference range suggests that an accompanying full blood count examination may be required for its use in the diagnosis of diabetes (Diabetic Medicine)

Serum bilirubin concentrations are positively associated with serum C-peptide levels in patients with Type 2 diabetes

Serum bilirubin concentrations within the physiological range were positively associated with serum C-peptide levels in patients with Type 2 diabetes (Diabetic Medicine)

Monday, 9 June 2014

A big thank you to Janssen a new sponsor of Glycosmedia

And to all our sponsors for supporting our free service. (Editor)

England-wide Care Home Diabetes Audit 

The initial findings from the first-ever England-wide Care Home Diabetes Audit have unfortunately revealed a lack of comprehensive assessment, monitoring and specialist care (Institute of Diabetes for Older People)

Brachial-Ankle Pulse Wave Velocity Predicts All-Cause Mortality and Cardiovascular Events in Patients With Diabetes: The Kyushu Prevention Study for Atherosclerosis

This large-scale cohort study provided evidence that high baPWV is a useful independent predictor of mortality and cardiovascular morbidity in subjects with diabetes (Diabetes Care)

Influence of duration and dose of metformin on cobalamin deficiency in type 2 diabetes patients using metformin

A higher daily and cumulative doses of metformin were strongly associated with lower cobalamin and holotranscobalamin concentrations, while duration was not. It is thus important to account for metformin dose in recommendations for screening for cobalamin deficiency (Acta Diabetologica)

Type 2 diabetes susceptibility gene variants predispose to adult-onset autoimmune diabetes

LADA and adult-onset type 1 diabetes share genetic risk variants with type 2 diabetes, supporting the idea of a hybrid form of diabetes and distinguishing them from patients with classical young-onset type 1 diabetes (Diabetologia)

Friday, 6 June 2014

Advancing Basal Insulin Replacement in Type 2 Diabetes Inadequately Controlled With Insulin Glargine Plus Oral Agents: A Comparison of Adding Albiglutide, a Weekly GLP-1 Receptor Agonist, Versus Thrice-Daily Prandial Insulin Lispro

Weekly albiglutide is a simpler therapeutic option than thrice-daily lispro for advancing basal insulin glargine therapy, resulting in comparable HbA1c reduction with weight loss and lower hypoglycemia risk (Diabetes Care)

Thursday, 5 June 2014

Association between participation in a brief diabetes education programme and glycaemic control in adults with newly diagnosed diabetes

Despite its brevity, participation in a diabetes education programme was associated with an additional reduction in HbA1c in newly diagnosed people that was comparable with that reported in trials of programmes targeted at those with prevalent diabetes (Diabetic Medicine)

Epidemiological ramifications of diagnosing diabetes with HbA1c levels

Using the FPG rather than the HbA1c criterion to diagnose diabetes in those without a history significantly increased the total prevalence of diabetes in Caucasians but not in African Americans or Hispanics (Diabetes and Its Complications)

Do static and dynamic insulin resistance indices perform similarly in predicting pre-diabetes and type 2 diabetes?

Dynamic insulin resistance indices are stronger predictors of future PDM/DM than static indices. This may be because dynamic indices better reflect the full range of physiologic disturbances in PDM/DM (Diabetes Research and Clinical Practice)

Effects of lipids and lipoproteins on diabetic foot in people with type 2 diabetes mellitus: A meta-analysis

Our results suggested that decreased HDL-cholesterol was associated with diabetic foot, so possible measures to prevent diabetic foot should include targeting increases in HDL-cholesterol (Diabetes and Its Complications)

Wednesday, 4 June 2014

Efficacy of treatment for hyperglycemic crisis in elderly diabetic patients in a day hospital

Day hospital care for hyperglycemic crises is more cost-effective than conventional hospitalization care, with a net saving of 1,418.4 € per case, lower number of readmissions and pressure ulcer rates, and similar short-term glycemic control and hypoglycemia rates (Clinical Interventions in Aging)

Insulin-induced glucose control improves HDL cholesterol levels but not reverse cholesterol transport in type 2 diabetic patients

Glucose control correlates with increased HDL-C, but not with improved RCT. Thus, persistent HDL dysfunction despite improved HbA1c and HDL-C can contribute to residual cardiovascular risk in T2D (Atherosclerosis)

Metformin promotes lifespan through mitohormesis via the peroxiredoxin PRDX-2

We show that metformin extends lifespan through the process of mitohormesis and propose a signaling cascade in which metformin-induced production of reactive oxygen species increases overall life expectancy (PNAS)

Tuesday, 3 June 2014

Correlation between diabetic retinopathy severity and elevated skin autofluorescence as a marker of advanced glycation end-product accumulation in type 2 diabetic patients

Skin AF levels, which can be measured non-invasively on a screening basis without skin biopsy or blood sampling, have a greater predictive ability for the presence and severity of DR than single measurement of HbA1c or self-assessed DM duration in patients with type 2 DM (Diabetes and Its Complications)

Monday, 2 June 2014

The Efficacy of Metformin-based Oral Anti-diabetic Drug is not Inferior to Insulin Glargine in Newly Diagnosed Type 2 Diabetic Patients with Severe Hyperglycemia after Short-term Intensive Insulin Therapy

Considering the metformin's superiorities in safety, cost and convenience, metformin-based OAD therapy should be strongly recommended for these patients (Journal of Diabetes)

Are changes in glycaemic control associated with diabetes-specific quality of life and health status in screen-detected type 2 diabetes patients? four-year follow up of the ADDITION-Cambridge cohort

Increases in HbA1c from one to five years post-diagnosis were independently associated with increased odds of reporting a negative impact of diabetes on QoL (Diabetes/Metabolism Research and Reviews)

Osteocalcin levels are inversely associated with Hba1c and BMI in adult subjects with long-standing type 1 diabetes

These data show that in T1DM of long duration, OC serum levels are inversely associated with HbA1c and BMI, supporting the hypothesis that a poor glycemic control can affect osteoblast function (Journal of Endocrinological Investigation)