Thursday, 31 July 2014

Adult obesity and type 2 diabetes

The aim of this paper is to describe the relationship between obesity and diabetes to support public health policy makers and practitioners (Public Health England)

Insulin Sensitivity Is an Important Determinant of Renal Health in Adolescents With Type 2 Diabetes

A significant proportion of adolescents with type 2 diabetes showed evidence of early DN, and IS, rather than HbA1c, blood pressure, or lipid control, was the strongest determinant of renal health (Diabetes Care)

The price of medicines

Continuing an open and honest debate - Alison Clough, ABPI Executive Director - Commercial UK, responds to NICE Chairman, David Haslam's, interview with Pharmafocus last month (ABPI)


Tuesday, 29 July 2014

Novo Nordisk receives positive opinion on Xultophy® (IDegLira) from the European regulatory authorities

Xultophy® is the intended brand name for IDegLira, the first once-daily single injection combination of Tresiba® (insulin degludec) and Victoza® (liraglutide), developed for the treatment of type 2 diabetes. EMA summary of opinion (Novo Nordisk)

Bariatric Surgery Induces Weight Loss but Does Not Improve Glycemic Control in Patients With Type 1 Diabetes

However, the small sample size and limited time of follow-up of this latest and other previous reports preclude drawing firm conclusions (Diabetes Care)

Potential of Oncostatin M to accelerate diabetic wound healing

The results of this study indicate that topical application of OSM may have the potential to accelerate healing of diabetic wounds (Internal Wound Journal)

Monday, 28 July 2014

Metabolic profiles and treatment gaps in young-onset type 2 diabetes in Asia (the JADE programme): a cross-sectional study of a prospective cohort

In clinic-based settings across Asia, one in five adult patients had young-onset diabetes. Compared with patients with late-onset diabetes, metabolic control in those with young-onset diabetes was poor, and fewer received organ-protective drugs (The Lancet)

Bariatric surgery: implications for primary care

GPs play a pivotal role in the management of obesity with early referral of motivated individuals who have failed to achieve substantial weight loss (British Journal of General Practice)

Early pregnancy metabolite profiling discovers a potential biomarker for the subsequent development of gestational diabetes mellitus

The current pilot study found that itaconic acid may have potential as a novel biomarker in early pregnancy to predict the subsequent development of gestational diabetes mellitus (Acta Diabetologica)

Effect of Glycemic Control on Nocturnal Arterial Oxygen Saturation. A case-control study in Type 2 Diabetic patients

Glycemic control improvement significantly reduces the increased number of nocturnal oxygen desaturations that exist in type 2 diabetes (Journal of Diabetes)

Blood pressure and heart failure risk among diabetic patients

The current study suggests a U-shaped association between observed BP and the risk of HF among diabetic patients (International Journal of Cardiology)

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 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 risk of pancreatic cancer risk, whereas insulin showed an inconsistent duration-risk relationship (Annals of Oncology)

Friday, 25 July 2014

Dietary Carbohydrate restriction as the first approach in diabetes management. Critical review and evidence base

This review describes 12 points of evidence based on published clinical and experimental studies and the experience of the authors. The points are supported by established principles in biochemistry and physiology and emphasize that the benefits are immediate and documented while the concerns about risk are conjectural and long term (Nutrition - via Science Direct)

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)

Glucagon-like peptide 1 receptor agonist is more efficacious than insulin glargine for poorly controlled type 2 diabetes: a systematic review and meta-analysis

GLP-1RA showed greater efficacy compared to IGlar for type 2 diabetes, and it may also prove beneficial for other diabetes-associated characteristics, including obesity, hypertension, and hyperlipidaemia (Journal of Diabetes)

Online social networking services in the management of patients with diabetes mellitus: Systematic review and meta-analysis of randomised controlled trials

Online SNS provide a novel, feasible approach to improving glycaemic control, particularly in patients with Type 2 diabetes (Diabetes Research and Clinical Practice)

Thursday, 24 July 2014

Increased Risk of Severe Hypoglycemic Events with Increasing Frequency of Non-severe Hypoglycemic Events in Patients with Type 1 and Type 2 Diabetes

A statistically significant association between non-severe hypoglycemic events and severe hypoglycemic events frequency was found in T1DM and T2DM. These data provide a clear rationale for the reduction of hypoglycemic events, regardless of severity, while striving for optimal glycemic control (Diabetes Therapy)

Characteristics of microbial drug resistance and its correlates in chronic diabetic foot ulcer infections

Several multidrug resistant strains were observed among the samples tested and most of these strains had the ability to elicit moderate to high levels of biofilm. The weakened immune response in diabetic individuals and synergism among pathogenic microorganisms may be critical factors that may determine the delicate balance of wound healing process (Journal of Medical Microbiology)

Tuesday, 22 July 2014

Defects in ß-Cell Ca2+ Dynamics in Age-Induced Diabetes

Our data suggest that ageing is associated with a progressive decline in ß-cell mitochondrial function that negatively impacts on the fine tuning of Ca2+ dynamics. This is conceptually important since it emphasizes that even relatively modest changes in ß-cell signal-transduction over time lead to compromised insulin release and a diabetic phenotype (Diabetes)

Specificity and sensitivity of commercially available assays for glucagon-like peptide-1 (GLP-1): Implications for GLP-1 measurements in clinical studies

The specificity and sensitivity of commercially available kits for analysis of GLP-1 levels varies considerably. This should be taken into account when selecting which assay to use and when comparing data from different studies (Diabetes, Obesity and Metabolism)

Rectal Sensitivity in Diabetes Patients with Symptoms of Gastroparesis

this study provided evidence of the generalized nature of diabetic autonomic neuropathy. Diabetes patients with signs and symptoms of upper GI dysfunction displayed reduced rectal sensitivity to heat and mechanical and electrical stimulation. Also, the heart rate variability was impaired. In a clinical setting, the presence of autonomic dysfunction could be regarded as a diffuse neuropathic complication (Journal of Diabetes Research)

Monday, 21 July 2014

The association between retinal vascular geometry changes and diabetic retinopathy and their role in prediction of progression – an exploratory study

The study findings suggest that RVG alterations can act as novel markers indicative of progression of DR severity and establishment of PDR. RVG may also have a potential predictive role in determining the risk of future retinopathy progression (BMC Ophthalmology)

Thursday, 17 July 2014

The Effect of Diabetes Self-Management Education on Body Weight, Glycemic Control, and Other Metabolic Markers in Patients with Type 2 Diabetes Mellitus

DSME, even though in low intensity, significantly improved the glycemic and body weight control in patients with type 2 diabetes (Journal of Diabetes Research)

Wednesday, 16 July 2014

Novartis to license Google "smart lens" technology

Helping diabetic patients manage their disease by providing a continuous, minimally invasive measurement of the body's glucose levels via a "smart contact lens" which is designed to measure tear fluid in the eye and connects wirelessly with a mobile device (Novartis)

Increased Circulating Levels of Betatrophin in Newly Diagnosed Type 2 Diabetic Patients

Circulating concentrations of betatrophin are significantly increased in T2DM patients. Our results suggest that betatrophin may play a role in the pathogenesis of T2DM (Diabetes Care)

Tuesday, 15 July 2014

Barriers to Initiating Insulin in Type 2 Diabetes Patients: Development of a New Patient Education Tool to Address Myths, Misconceptions and Clinical Realities

The educational tool developed through this study was designed to help patients who are deciding whether or not to initiate insulin therapy as recommended by their physician, and facilitate patient–health-care provider interactions (The Patient - Patient-Centered Outcomes Research)

Assessment of the association between glycemic variability and diabetes-related complications in type 1 and type 2 diabetes

Consistent findings suggest that in type 2 diabetes glucose variability is associated with development of microvascular complications. The role of increased glucose variability in terms of microvascular and macrovascular complications in type 1 diabetes is less clear; more data in are needed (Diabetes Research and Clinical Practice)

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)

Effect of Patients’ Risks and Preferences on Health Gains With Plasma Glucose Level Lowering in Type 2 Diabetes Mellitus

Improving glycemic control can provide substantial benefits, especially for younger patients; however, for most patients older than 50 years with an HbA1c level less than 9% receiving metformin therapy, additional glycemic treatment usually offers at most modest benefits (JAMA)

Friday, 11 July 2014

Can people with type 2 diabetes live longer than people without diabetes? 

Patients with type 2 diabetes initiated with metformin monotherapy had longer survival than did matched, non-diabetic controls. Those treated with sulfonylurea had markedly reduced survival than both matched controls and those receiving metformin monotherapy. This supports the position of metformin as first-line therapy and implies that metformin may confer benefit in non-diabetes. Sulfonylurea remains a continued concern (Diabetes, Obesity and Metabolism)

Thursday, 10 July 2014

The changes of leukocyte telomere length and telomerase activity after sitagliptin intervention in newly diagnosed type 2 diabetes

In type 2 diabetes patients, leukocyte telomere length is significantly reduced, while the telomerase activity seems less influenced. Sitagliptin might protect ß-cells in the pancreas by elongating the telomere length (Diabetes/Metabolism Research and Reviews)

Wednesday, 9 July 2014

Genetics Studies in Diabetes - Part 1

It is useful to consider basic terminology and then focus on the potential benefits of genetic analyses (OmniaMed)

FDA Accepts Sanofi’s New Drug Application for Basal Insulin Toujeo®

The U.S. Food and Drug Administration (FDA) has accepted for review the company’s New Drug Application (NDA) for Toujeo® (insulin glargine [rDNA origin] injection, 300 U/mL),an investigational basal insulin (Sanofi)

Validating an ontology-based algorithm to identify patients with Type 2 Diabetes Mellitus in Electronic Health Records

This DMO-based algorithm is sufficiently accurate to support a semantic approach, using the RFV, Rx and Path to define patients with T2DM from EHR data. However, the accuracy can be compromised by incomplete or incorrect data. The extent of compromise requires further study, using ontology-based and other approaches (International Journal of Medical Informatics)

Tuesday, 8 July 2014

Corneal Confocal Microscopy Detects Neuropathy in Subjects With Impaired Glucose Tolerance

Subjects with IGT have evidence of neuropathy, particularly small-fiber damage, which can be detected using skin biopsy and CCM (Diabetes Care)

The effect of leptin promoter and leptin receptor gene polymorphisms on lipid profile among the diabetic population: modulations by atorvastatin treatment and environmental factors

Although lipid profile regulation is a multifactorial process, -2548G/A LEP polymorphism seems to affect statins treatment response among diabetic patients. More studies are required to specifically define factors that influence lipid profiles interaction with statin treatment response especially among patients with diabetes (Journal of Endocrinological Investigation)

Monday, 7 July 2014

Scottish Medicines Consortium issues positive advice for Forxiga® (dapagliflozin) use as part of a triple therapy regimen for type 2 diabetes 

The Scottish Medicines Consortium has issued guidance stating that Forxiga® (dapagliflozin), AstraZeneca’s first-in-class sodium-glucose co-transporter 2 (SGLT2) inhibitor for type 2 diabetes, is now accepted for restricted use within NHS Scotland as part of a triple therapy in combination with metformin and sulphonylurea, as an alternative to dipeptidyl peptidase-4 (DPP-4) inhibitors.3 (AstraZeneca)

Friday, 4 July 2014

Insulin pump treatment compared with multiple daily injections for treatment of type 2 diabetes (OpT2mise): a randomised open-label controlled trial

In patients with poorly controlled type 2 diabetes despite using multiple daily injections of insulin, pump treatment can be considered as a safe and valuable treatment option (Lancet)

Thursday, 3 July 2014

Sitagliptin Use in Patients With Diabetes and Heart Failure

Sitagliptin use was not associated with an increased risk of all-cause hospitalizations or death, but was associated with an increased risk of HF-related hospitalizations among patients with T2D with pre-existing HF (JACC)

Wednesday, 2 July 2014

Durable change in glycaemic control following intensive management of type 2 diabetes in the ACCORD clinical trial

Time-limited intensive glycaemic management using a combination of agents that achieves HbA1c levels below 6.5% in established diabetes is associated with glycaemic control more than 1 year after therapy is relaxed

Retinal vascular fractals predict long-term microvascular complications in type 1 diabetes mellitus

The retinal vascular fractal dimension is a shared biomarker of diabetic microvasculopathy, thus indicating a possible common pathogenic pathway. Retinal fractal analysis therefore is a potential tool for risk stratification in type 1 diabetes (Diabetologia)

Cost of diabetic foot disease to the National Health Service in England

The cost of diabetic foot disease is substantial. Ignorance of the cost of current care may hinder commissioning of effective services for prevention and management in both community and secondary care (Diabetic Medicine)

Tuesday, 1 July 2014

Diabetes Overtreatment in Elderly Individuals: Risky Business in Need of Better Management

A patient safety indicator derived from administrative data can identify high-risk patients for whom reevaluation of glycemic management may be appropriate, consistent with meaningful use criteria for electronic medical records (JAMA)

Osteopontin Is a Strong Predictor of Incipient Diabetic Nephropathy, Cardiovascular Disease, and All-Cause Mortality in Patients With Type 1 Diabetes

Serum OPN is a strong predictor of incipient diabetic nephropathy, a first-ever CVD event, and all-cause mortality in patients with T1D. Serum OPN may be of clinical significance for the risk prediction of CVD events in patients with T1D (Diabetes Care)