Wednesday, 31 December 2014

The relationship between glycemic variability and diabetic peripheral neuropathy in type 2 diabetes with well-controlled HbA1c

There was a close relationship between glycemic variability evaluated by MAGE and DPN in type 2 diabetes with well-controlled HbA1c (Diabetology & Metabolic Syndrome)

Glycaemic control of Type 1 diabetes in clinical practice early in the 21st century: an international comparison

These results suggest that there are substantial variations in glycaemic control among people with Type 1 diabetes between the data sources and that there is room for improvement in all populations, especially in young adults (Diabetic Medicine)

Monday, 29 December 2014

Serum 25-hydroxyvitamin D levels and peripheral neuropathy in patients with type 2 diabetes: a systematic review and meta-analysis

Vitamin D is involved in the development of DPN in type 2 diabetic patients, and vitamin D deficiency is very likely to be associated with DPN in type 2 diabetic patients. Further studies are needed to validate the association between vitamin D deficiency and DPN (Journal of Diabetes Investigation)

Intrinsic Foot Muscle And Plantar Tissue Changes In Type 2 Diabetes Mellitus

In the present study, we noted a substantial decrease in intrinsic foot muscles and plantar tissue thickness in T2DM subjects as compared to NDM subjects. This reasons out that structural changes in the foot in an antecedent to clinically apparent PN (Journal of Diabetes)

Early phase glucagon and insulin secretory abnormalities, but not incretin secretion, are similarly responsible for hyperglycemia after ingestion of nutrients

Disordered early phase insulin and glucagon secretions but not incretin secretion are involved in hyperglycemia after ingestion of nutrients in T2DM of even a short duration (Journal of Diabetes and Its Complications)

Wednesday, 24 December 2014

Novo Nordisk receives FDA approval for Saxenda® for the treatment of obesity

Saxenda® (liraglutide 3 mg), the first once-daily human glucagon-like peptide-1 (GLP-1) analogue for the treatment of obesity (Novo Nordisk)

Clinical and pathological predictors of estimated GFR decline in patients with type 2 diabetes and overt proteinuric diabetic nephropathy

Our results suggest that not only proteinuria but also tubulointerstitial lesions should be assessed to predict rapid eGFR decline in patients with type 2 diabetes who have overt proteinuria and biopsy-proven DN (Diabetes/Metabolism Research and Reviews)

Tuesday, 23 December 2014

Management of Hyperglycemia in Type 2 Diabetes, 2015: A Patient-Centered Approach

Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes (Diabetes Care)

Should Sulfonylureas Remain an Acceptable First-Line Add-on to Metformin Therapy in Patients With Type 2 Diabetes? 

Martin J. Abrahamson: Yes, They Continue to Serve Us Well! (Diabetes Care)

Monday, 22 December 2014

Pharmacokinetics and Pharmacodynamics of Insulin Glargine Given Evening as Compared With Morning in Type 2 Diabetes Mellitus

The PD of insulin glargine differs depending on time of administration. With morning administration insulin activity is greater in the first 0–12 h, while with evening administration the activity is greater in the 12–24 h period following dosing (Diabetes Care)

Metformin use in patients with type 2 diabetes mellitus is associated with reduced risk of deep vein thrombosis: a non-randomized, pair-matched cohort study

Metformin may have protective effect in patients with type 2 DM for DVT (BMC Cardiovascular Disorders)

Saturday, 20 December 2014

Is There a Link Between Liraglutide and Pancreatitis? A Post Hoc Review of Pooled and Patient-Level Data From Completed Liraglutide Type 2 Diabetes Clinical Trials

Based on the small number of cases observed, the incidences of reported AP and CP were numerically greater with liraglutide than with comparators. Not all cases fulfilled diagnostic criteria, and confounding variables were present in 75% of the AP cases with liraglutide therapy, precluding firm conclusions (Diabetes Care)

Friday, 19 December 2014

Lilly and Adocia Announce Alliance to Co-Develop Ultra-Rapid Insulin Based on BioChaperone Technology 

Eli Lilly and Company and Adocia announce a worldwide licensing collaboration focused on developing an ultra-rapid insulin, known as BioChaperone Lispro, for treatment in people with type 1 and type 2 diabetes

Long-term Efficacy and Safety of Canagliflozin Over 104 Weeks in Patients Aged 55 to 80 Years With Type 2 Diabetes

Canagliflozin improved glycaemic control, reduced body weight and systolic BP, and was generally well tolerated in patients aged 55–80 years with T2DM over 104 weeks (Diabetes, Obesity and Metabolism)

Most People With Long-Duration Type 1 Diabetes in a Large Population-Based Study Are Insulin Microsecretors

The majority of long-duration T1D patients have detectable urine C-peptide levels. While the majority of patients are insulin microsecretors, some maintain clinically relevant endogenous insulin secretion for many years after the diagnosis of diabetes. Understanding this may lead to a better understanding of pathogenesis in T1D and open new possibilities for treatment (Diabetes Care)

Clinical predictors and time course of the improvement in ß–cell function with short-term intensive insulin therapy in patients with Type 2 diabetes

At baseline, shorter duration of diabetes and lower fasting glucose can identify patients most likely to benefit from short-term intensive insulin therapy. Most importantly, during therapy, responders had less hypoglycaemia from the third week onwards, despite lower glycaemia, suggesting that 2 weeks of intensive insulin therapy may be needed to improve endogenous islet function (Diabetic Medicine)

Thursday, 18 December 2014

Unsupervised home use of overnight closed-loop system over 3 to 4 weeks – Pooled analysis of randomized controlled studies in adults and adolescents with type 1 diabetes

Overnight closed loop at home in adults and adolescents with type 1 diabetes is feasible, demonstrating improvements in glucose control and reducing the risk of nocturnal hypoglycaemia (Diabetes, Obesity and Metabolism)

Wednesday, 17 December 2014

Effects of High vs Low Glycemic Index of Dietary Carbohydrate on Cardiovascular Disease Risk Factors and Insulin Sensitivity

In this 5-week controlled feeding study, diets with low glycemic index of dietary carbohydrate, compared with high glycemic index of dietary carbohydrate, did not result in improvements in insulin sensitivity, lipid levels, or systolic blood pressure. In the context of an overall DASH-type diet, using glycemic index to select specific foods may not improve cardiovascular risk factors or insulin resistance (JAMA)

Tuesday, 16 December 2014

The impact of diabetes-related complications on healthcare costs: new results from the UKPDS (UKPDS 84)

Diabetic complications are associated with substantial immediate and long-term healthcare costs. Our comprehensive new estimates of these costs, derived from detailed recent UK Prospective Diabetes Study post-trial data, should aid researchers and health policy analyses (Diabetic Medicine)

Detection of a low-grade enteroviral infection in the islets of Langerhans of living patients newly diagnosed with type 1 diabetes

The results provides evidence for the presence of enterovirus in pancreatic islets of type 1 diabetic patients, being consistent with the possibility that a low grade enteroviral infection in the pancreatic islets contribute to disease progression in humans (Diabetes)

Low within- and between-day variability in exposure to new insulin glargine 300 U.mL-1

Gla-300 provides predictable, evenly distributed 24-hour coverage due to low fluctuation and high reproducibility in insulin exposure, and appears suitable for effective basal insulin use (Diabetes, Obesity and Metabolism)

Initial Combination Therapy with Metformin/Pioglitazone/Exenatide is More Effective Than Sequential Add-On Therapy in Subjects with New Onset Diabetes. Results from the Efficacy and Durability of Initial Combination Therapy for Type 2 Diabetes (EDICT): A Randomized Trial

The results of this exploratory study demonstrate that combination therapy with metformin/pioglitazone/exenatide in newly diagnosed T2DM patients is more effective with less hypoglycemia than sequential add-on therapy with metformin, sulfonylurea, and then basal insulin (Diabetes, Obesity and Metabolism)

Monday, 15 December 2014

Pioglitazone has a dubious bladder cancer risk but an undoubted cardiovascular benefit

There is no association between bladder cancer and pioglitazone in randomized controlled trials, once cases that could not plausibly be related to treatment are removed ... careful study of randomized controlled trials shows evidence of cardiovascular benefit from pioglitazone in Type 2 diabetes, a condition which results, more than anything, in premature cardiovascular death and morbidity (Diabetic Medicine)

Adaptive pathways: a future approach to bring new medicines to patients?

Scientists argue that scientific and political changes will make adaptive pathways the preferred approach to make new treatments available (European Medicines Agency)

Proteomic Analysis in Type 2 Diabetes Patients before and after a Very Low Calorie Diet Reveals Potential Disease State and Intervention Specific Biomarkers

In this study, specific proteins were found to be differentially expressed in type 2 diabetes patients versus controls and before and after a VLCD. These proteins are potential disease state and intervention specific biomarkers (PLoS ONE)

Assessing the Effect of Treatment Duration on the Association between Anti-Diabetic Medication and Cancer Risk

This study demonstrates that evaluation of the variation in cancer risk in relation to treatment duration is of particular importance for enhancing the accuracy of conclusions on the link between exposure to anti-diabetic medication and cancer risk (PLoS ONE)

Friday, 12 December 2014

Autologous Islet Transplantation With Remote Islet Isolation After Pancreas Resection for Chronic Pancreatitis

Pancreatic resection with autologous islet transplantation for severe chronic pancreatitis is a safe and effective final alternative to ameliorate debilitating pain and to help prevent the development of surgical diabetes (JAMA Surgery)

“Mild dysglycemia” in type 2 diabetes. To be neglected or not?

The now available incretin-based therapies, and more specifically the DPP-4 inhibitors provide the clinician with the possibility to reduce or eradicate both the dawn phenomenon and post-meal glucose excursions with minimal side effects (Journal of Diabetes and Its Complications)

Thursday, 11 December 2014

International Comparison of Medicines Usage: Quantitative Analysis

This report was commissioned by the Association of the British Pharmaceutical Industry (ABPI) and updates to 2012/13 the quantitative analysis of UK usage of medicines per head of total population compared to that in other countries in 2008/09 which was published in the 2010 Richards Report: Extent and causes of international variations in drug usage (ABPI)

Wednesday, 10 December 2014

Hypoglycemia and Risk of Cardiovascular Disease and All-Cause Mortality in Insulin-Treated People With Type 1 and Type 2 Diabetes: A Cohort Study

Hypoglycemia is associated with an increased risk of CV events and all-cause mortality in insulin-treated patients with diabetes. The relationship between hypoglycemia and CV outcomes and mortality exists over a long period (Diabetes Care)

Short-term statin discontinuation increases endothelial progenitor cells without inflammatory rebound in type 2 diabetic patients

a brief statin withdrawal increases circulating EPCs and functional proangiogenic cells in T2D. These findings identify statin-sensitive pathways as reverse target mechanisms to stimulate vascular repair in diabetes (Vascular Pharmacology)

Tuesday, 9 December 2014

Pioglitazone and bladder cancer risk: a multipopulation pooled, cumulative exposure analysis

The cumulative use of pioglitazone or rosiglitazone was not associated with the incidence of bladder cancer in this large, pooled multipopulation analysis (Diabetologia)

Monday, 8 December 2014

Glucose-lowering with exogenous insulin monotherapy in type 2 diabetes: dose association with all-cause mortality, cardiovascular events, and incident cancer

There was an association between increasing exogenous insulin dose and increased risk of all-cause mortality, cancer and MACE in people with type 2 diabetes. Limitations of observational studies mean that this should be further investigated using an interventional study design (Diabetes, Obesity and Metabolism)

Impaired Gallbladder Motility in Adults with Newly Detected Type 2 Diabetes and Lack of Reversibility after Achieving Euglycemia

Gallbladder ejection fraction was markedly reduced in patients with newly detected diabetes compared to controls without diabetes. Control of diabetes and normalization of A1C did not reverse the motility defect (Canadian Journal of Diabetes)

A pilot study evaluating non-contact low-frequency ultrasound and underlying molecular mechanism on diabetic foot ulcers

This proof-of-concept pilot study demonstrates that NCLF-US is effective in treating neuropathic diabetic foot ulcers through, at least in part, inhibiting pro-inflammatory cytokines in chronic wound and improving tissue regeneration (International Wound Journal)

Sunday, 7 December 2014

Benefits of Timely Basal Insulin Control in Patients with Type 2 Diabetes

Early glucose control reduces the risk of both macrovascular and microvascular complications, while tight control late in diabetes has little or no macrovascular benefit. Insulin therapy offers the most potent antihyperglycemic effect of all diabetes agents, and has a unique ability to induce diabetes remission when used to normalize glycemia in newly diagnosed patients (Journal of Diabetes and Its Complications)

Friday, 5 December 2014

Effect of Statin Therapy on Incident Type 2 Diabetes Mellitus in Patients with Clinically Manifest Vascular Disease

Statin use increases the risk of incident T2DM in patients with clinically manifest vascular disease. The increase in risk was independent of the number of metabolic syndrome criteria, and was even more pronounced in patients with low baseline glucose levels (American Journal of Cardiology

Maternal body size prior to pregnancy, gestational diabetes and weight gain: associations with insulin resistance in children at 9–10 years

Maternal body size prior to pregnancy is positively associated with increases in child insulin resistance, at least until the ‘obese’ category is reached. This is independent of gestational diabetes and not mediated by body size of the child, suggesting genetic and/or developmental programming origins (Diabetic Medicine)

Years of life lost and healthy life-years lost from diabetes and cardiovascular disease in overweight and obese people: a modelling study

Our estimations for both healthy life-years and total years of life lost show the effect of excess bodyweight on cardiovascular disease and diabetes, and might provide a useful health measure for discussions between health professionals and their patients (The Lancet Diabetes & Endocrinology)

Thursday, 4 December 2014

Treatment of Diabetic Macular Edema with an Inhibitor of Vascular Endothelial-Protein Tyrosine Phosphatase That Activates Tie2

No safety concerns were identified after systemic administration of AKB-9778 for 4 weeks in patients with DME, and doses of 15 mg or more twice daily reduced macular edema and improved vision in some patients. This is a preliminary demonstration of clinical safety and efficacy of a VE-PTP inhibitor and Tie2 activator (Ophthalmology)

Understanding drug preferences, different perspectives

Regulators may value major benefits and risks of drugs for an individual diabetes patient mostly in the same way as doctors and patients but differences may exist regarding the value of minor or short-term drug effects (British Journal of Clinical Pharmacology)

Clinical trial demonstrates exercise following bariatric surgery improves insulin sensitivity

Moderate exercise following RYGB surgery provides additional improvements in SI, SG, and cardiorespiratory fitness compared with a sedentary lifestyle during similar weight loss (Journal of Clinical Investigation)

Adipose tissue content, muscle performance and physical function in obese adults with type 2 diabetes mellitus and peripheral neuropathy

T2DMPN may represent a shift in adipose tissue accumulation from SQAT to IMAT depots, which is inversely associated with muscle performance and physical function (Journal of Diabetes and Its Complications)

Wednesday, 3 December 2014

Efficacy and Safety of Canagliflozin, an Inhibitor of Sodium Glucose Cotransporter 2, When Used in Conjunction With Insulin Therapy in Patients With Type 2 Diabetes

Canagliflozin added to insulin therapy improved glycemic control and decreased body weight. There was a greater frequency of several anticipated side effects, although few led to discontinuation of treatment (Diabetes Care)

The study of once- and twice-daily biphasic insulin aspart 30 (BIAsp 30) with sitagliptin, and twice-daily BIAsp 30 without sitagliptin, in patients with type 2 diabetes uncontrolled on sitagliptin and metformin—The Sit2Mix trial

Adding BIAsp 30 to patients with T2D poorly controlled with sitagliptin and metformin is efficacious and well tolerated; however, while BIAsp BID + Sit showed superior glycaemic control, BIAsp QD + Sit had a lower rate of hypoglycaemia (Primary Care Diabetes)

Glycemic variability and diabetes retinopathy: a missing link

These findings emphasize the need to reduce glycemic variability by various measures in order to reduce development and progression of diabetes retinopathy both in type 1 and type 2 diabetes patients (Diabetes and Its Complications)

Genetic and Epigenetic alterations in Toll like Receptor 2 and wound healing impairment in type 2 diabetes patients

TLR2 down regulation in wounds of T2DM patients compared to non diabetic patients may lead to development of non healing chronic ulcers in them (Diabetes and Its Complications)

Tuesday, 2 December 2014

Metformin for primary colorectal cancer prevention in patients with diabetes: A case-control study in a US population

Metformin use appears to be associated with a reduced risk of developing CRC among diabetic patients in the United States (Cancer)

The protective effect of the Mediterranean diet on endothelial resistance to GLP-1 in type 2 diabetes: a preliminary report

These data suggest that the Mediterranean diet, using olive oil, prevents the acute hyperglycemia effect on endothelial function, inflammation and oxidative stress, and improves the action of GLP-1, which may have a favorable effect on the management of type 2 diabetes, particularly for the prevention of cardiovascular disease (Cardiovascular Diabetology)

Monday, 1 December 2014

Diabetes Improvement Plan

properties and actions to deliver improved prevention, treatment and care for people with diabetes in Scotland (Scottish Government)