In this external validation study, most of the published prognostic models for gestational diabetes mellitus show acceptable discrimination and calibration. The four models with the highest discriminative abilities in this study cohort, which also perform well in a subgroup of nulliparous women, are easy models to apply in clinical practice and therefore deserve further evaluation regarding their clinical impact (BMJ
Archives for August 2016
The aim of this study is to perform a literature review to evaluate the main clinical characteristics and complications of skin disorders in diabetic’s patients. Additionally, physiopathology early-stage skin disorders and dermocosmetic management were also reviewed (Diabetology & Metabolic Syndrome)
Our results indicate that serum DPP-4 activity is associated with albuminuria in type 1 diabetes. This arises the question whether the use of DPP-4 inhibitors might serve as an additional therapeutic strategy to prevent proteinuria in patients with DKD (Journal of Diabetes and Its Complications)
A possible explanation of the results with the DPPIV inhibitors and empagliflozin might be related to their divergent effect on glucagon levels. Due to unclear effects of glucagon like peptide 1 receptor agonists on glucagon, the possible role of this hormone in the Leader trial remains unclear (Cardiovascular Diabetology)
OGTT performed early in postpartum is a useful tool for identifying women with previous GDM who must perform an OGTT 6 weeks after delivery (Diabetology & Metabolic Syndrome)
Metformin has potential cardio-protective effect through improving cEPCs, CFU-Hill’s colonies, cECs, PACs count and function independently of hypoglycaemic effect. This finding needs to be confirmed by long term cardiovascular outcome studies in type 1 diabetes (Cardiovascular Diabetology)
POC capillary maternal glucose tests were superior to customary laboratory practices for diagnosing GDM. This has considerable potential, particularly in healthcare settings where facilities for phlebotomy are distant from the laboratory or pre-analytical sample handling is substandard (BJOG)
Treatment with vildagliptin was associated with lower incidence of hypoglycemia compared with SU and showed good glycemic and weight control in patients with T2DM fasting during Ramadan in a real-life setting in Egypt (Diabetes Therapy)
These results demonstrate that β-cell death is reduced in women with GDM. This reduction is associated with impaired insulin production and hyperglycemia, suggesting that β-cell death does not contribute to GDM during the 2nd and 3rd trimester of pregnancy (Diabetology & Metabolic Syndrome)
Compared with GLAR, EXE improved the parameters of β-cell function, especially insulin secretion at 8 mmol/L glucose and β-cell glucose sensitivity, which was sustained during the 3-year treatment period (EJE)
This review shows neonatal or other maternal outcomes are similar between Internet-based self-monitoring interventions and usual diabetes care among perinatal diabetic women. The long-term effects of the intervention must be confirmed in future studies using randomized controlled trials and follow-up data (Journal of Medical Internet Research)
Among diabetics with CRC, metformin use is associated with improved survival, despite adjustments for diabetes severity and other risk factors. Impact: These data lend further support to the conduct of randomized studies of possible anti-cancer effects of metformin among patients with CRC (American Association for Cancer Research)
Lower systolic blood pressure than currently recommended is associated with significantly lower risk of cardiovascular events in patients with type 2 diabetes. The association between low blood pressure and increased mortality could be due to concomitant disease rather than antihypertensive treatment (BMJ)
Rates of community-based antibiotic treatment and hospitalisation for infection were high in patients receiving their first treatment for type 2 diabetes and differed with the choice of initial GLD used for pharmacotherapy (BMJ Open)
Almost all infections analysed were more common in people with Type 2 diabetes. Infections that are most commonly of bacterial, fungal or yeast origin were more frequent in people with worse glycaemic control (Diabetic Medicine)
Our findings show that patients with T1D have greater burden of diabetes distress in emerging adulthood than in adolescence and add to evidence suggesting the importance of addressing diabetes distress in clinical care and the necessity of wider picture beyond the physical manifestation of diabetes to be taken into consideration (Journal of Diabetes and Its Complications)
A comprehensive study guide
8th Edition (Published October 2015)
Judith Tintinalli, Editor in Chief
Picking up the book (be warned it is heavy and substantial) and looking at the front cover, the subtitle, says it is “a comprehensive study guide”. To some people this may conjure up an image of say an “A” Level study guide, a slim volume summarising the main points to help the student pass the exam well. In fact, this excellent book is the complete opposite; it seems to be a stunning and comprehensive review of a discipline which has a very diverse subject area. In fact, if you turn over to the back of the book (it is not a slim study guide but a weighty tome), the top of the back cover proudly proclaims “The most widely used and highly regarded textbook and reference of Emergency Medicine.”
An A –Z
16th Edition published 2016
Edited by Mark Kinirons and Harold Ellis
Published by CRC Press
Before delving into this book, it is worth taking a few seconds to read about Herbert French (1875-1951) who wrote half of the first edition in 1912. So this textbook is well over 100 years old and yet it still remains true to its roots. Not just retaining a nod to the original author in the title but it is an alphabetical index (from abdominal pain to wheeze) of differential diagnoses. It is unusual book in the sense that there are not many similar books around that I am aware of which tackles the subject matter in this style.
We conclude that anti-inflammatory properties of metformin are exerted irrespective of diabetes mellitus status. This may accelerate investigation of drug utility in nondiabetic cardiovascular disease groups (Circulation Research)
Author: Crispin Swinhoe (Retired consultant anaesthetist)
Published by Gibson Publishing.
The book is available via Crispin Swinhoe’s website:
In a deceptively simple beginning to his autobiography, Crispin Swinoe’s recollections slalom around the sticks and stones of childhood, related with a refreshing bemusement at such happenstances. It slides effortlessly into the ubiquitous angst and brickbats of school days. But then we are surprised by some potted philosophical and social personality analysis. A short digression from his school days to air some circumspect curmudgeon that you will find pleasingly in tune with the grit of your personal bugbears. A sprinkling of pedantic anecdotes that slowly firm up the carapace of the authors personality as it raises a conspiratorial smile.
School years are fleeting but even these few endearing recollections engender common feelings from these salad days, and a view that they are wasted on youth.
Similarly, Crispin’s days at medical school accelerate as a white knuckle ride, and for all the raucous imbibing of alcohol and assumed laissez-faire, the pages are stained with the sweat of goal-orientated hard work.