Our analysis found no threshold for the optimal duration or route of administration of antibiotic therapy to prevent recurrences of DFI. These limited data might support possibly shorter treatment duration for patients with DFI (Diabetes, Obesity and Metabolism)
Archives for January 2019
Adults with YOD have excess hospitalizations across their lifespan compared with persons with usual-onset T2D, including an unexpectedly large burden of mental illness in young adulthood. Efforts to prevent YOD and intensify cardiometabolic risk factor control while focusing on mental health are urgently needed (Annals of Internal Medicine)
The American Diabetes Association’s (ADA’s) Standards of Medical Care in Diabetes is updated and published annually in a supplement to the January issue of Diabetes Care
In T2D treatment, the use of acarbose as an add-on remedy to metformin was associated with lower risks of major atherosclerotic events, ischemic stroke, and hypoglycemia compared with the use of sulfonylurea as an add-on remedy (Journal of Clinical Endocrinology & Metabolism)
This study highlights the application of precision medicine techniques to predict progression to diabetes over a 3‐year window in TEDDY subjects. This multifaceted model provides preliminary improvement in prediction over simpler prediction tools. Additional tools are needed to maximize the predictive value of these approaches (Pediatric Diabetes)
This is the second published report for the NDTA and contains linked data from the NPDA and NDA for the audit period 2011-12 to 2016-17. The report focuses on young people with Type 1 diabetes (NHS Digital)
Results suggest that insulin bolus delivery with fast delivery speed may result in more rapid insulin absorption and, thus, may provide a better control of meal-related glucose excursions than that obtained with bolus delivery using slow delivery speeds. Our findings may have important implications for the future design of the bolus delivery unit of insulin pumps (Diabetes Technology and Therapeutics)
Both low and high HbA1c were associated with increased all-cause mortality, among older patients with insulin-treated T2D. This cohort study supports the need for individualisation of care and suggests better outcomes with HbA1c levels around 6.5–7.4% and markedly excess risk with HbA1c > 11% (Age and Ageing)
My Health Explained
When I first came across My Health Explained it was with some scepticism that I decided to review it. My initial reaction to such online help programmes is ‘Oh no! not another one!’ – but I have to say that this support and educational package for people with diabetes has proved to be the exception to the misrule.
Written by a consultant Diabetologist, My Health Explained is far more than just another package of dry information about diabetes, listed in a cold and impersonal way. Rather, it is a personalised online video-based diabetes education program for people with type 2 diabetes, prediabetes, and gestational diabetes, that explains exactly what diabetes is, and why that matters.
The variant rs8192675 in the SLC2A2 gene (C allele) is associated with an improved glucose response to metformin monotherapy during the first year after diagnosis in type 2 diabetes (Diabetologia)
Despite the financial and human resources involved and the relevance for therapeutic guidelines and clinical decisions, about one-third of phase III clinical trials on diabetic nephropathy remain unpublished. Interventions used in published trials showed a low efficacy on renal outcome (Diabetes Therapy)
This study indicates that dapagliflozin in T2DM patients can decrease the levels of urinary proximal tubular injury biomarkers, thus highlighting its renoprotective effect. SGLT2 inhibitors could prove useful in treating T2DM by protecting against renal tubular injury and may lead to reduced long-term renal outcomes (Clinical Kidney Journal)
In participants not at HbA1c goal on a sub‐maximal dose of metformin, addition of sitagliptin at the time of metformin dose up‐titration improved glycemic response and HbA1c goal attainment with similar safety and tolerability compared to metformin up‐titration alone (Diabetes, Obesity and Metabolism)
The glucagon response to an MMTT in people with long-standing type 1 diabetes is not reduced by the presence of residual beta cells. The reduction of GLP-1 responses according to residual C-peptide levels suggests specific regulatory pathways (Diabetologia)
In summary, taking into account the findings from these new studies, it is suggested that a GLP-1RA should be offered to all people with CVD and type 2 diabetes, and SGLT2 inhibitors should be prescribed for those at high risk of heart failure or with progressive decline in eGFR. DPP4 inhibitors are a safe choice within the glucose-lowering stepped algorithm (Diabetologia)
Approximately one‐third of all stroke patients have diabetes. Uniform methods to screen for diabetes after stroke are required to identify individuals with diabetes to design interventions aimed at reducing poor outcomes in this high‐risk population (Journal of Diabetes Investigation)
In this study of middle-aged patients with type 2 diabetes and relatively low fracture risk, canagliflozin was not associated with increased risk for fracture compared with GLP-1 agonists (Annals of Internal Medicine)
By Gavin Clunie, Nick Wilkinson, Elena Nikiphorou and Deepak Jadon
Published August 2018 by Oxford University Press
In the acknowledgement section of the book which is at the beginning, it is stated that some contributors have helped “to establish the Oxford Handbook of Rheumatology at the market leader small textbook for rheumatology”. That does not really surprise me; the Oxford Handbook series continues to go from strength to strength as some of its many constituents are refreshed and updated on a cyclical basis. This excellent book is now in its 4th edition and recently updated as it was published in late 2018. It may be small in size but it packs in 750 pages within the handbook.
Effective prevention and long term reversal of Type 2 diabetes is feasible. The impact upon the individual must be considered during delivery of advice and support (Diabetic Medicine)