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)