In this cohort of patients with T2DM, beta cell function progressively deteriorated despite current therapies. Among a large set of clinical and biochemical predictors, only baseline HbA1c levels and their deterioration overtime were associated with higher beta cell stress over time (Diabetes/Metabolism Research and Reviews)
Diabetes News
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Stratification of type 2 diabetes based on routine clinical markers
Patients with type 2 diabetes cluster into clinically relevant sub-groups based on routine clinical markers. The prevalence of diabetes complications seems to be sub-group specific. Our data suggests the need for a tailored strategy for the treatment of type 2 diabetes (Diabetes Research and Clinical Practice)
Effectiveness of text message based, diabetes self management support programme (SMS4BG)
A tailored, text message based, self management support programme resulted in modest improvements in glycaemic control in adults with poorly controlled diabetes. Although the clinical significance of these results is unclear, the findings support further investigation into the use of SMS4BG and other text message based support for this patient population (BMJ)
Neuropathic pain in adults: pharmacological management in non-specialist settings
The guideline sets out how drug treatments for neuropathic pain differ from traditional pain management (NICE)
Islet transplantation versus insulin therapy in patients with type 1 diabetes with severe hypoglycaemia or poorly controlled glycaemia after kidney transplantation (TRIMECO)
For the indications assessed in this study, islet transplantation effectively improves metabolic outcomes. Although studies with longer-term follow-up are needed, islet transplantation seems to be a valid option for patients with severe, unstable type 1 diabetes who are not responding to intensive medical treatments. However, immunosuppression can affect kidney function, necessitating careful selection of patients (The Lancet Diabetes & Endocrinology)
Diabetes Care in Pregnancy
A midwife education needs analysis (Diabetes Care Trust (ABCD) Limited )
Continuous glucose monitoring during diabetic pregnancy (GlucoMOMS): A multicentre randomized controlled trial
In diabetic pregnancy, use of intermittent retrospective CGM did not reduce the risk of macrosomia. CGM provides detailed information concerning glycaemic fluctuations but, as a treatment strategy, does not translate into improved pregnancy outcome (Diabetes, Obesity and Metabolism)
Higher cardiometabolic risk in idiopathic versus autoimmune type 1 diabetes: a retrospective analysis
Patients with IDM show many metabolic complications at onset, such as visceral obesity, hepatic steatosis and hypercholesterolemia and a higher cardiometabolic risk, than patients with ADM, similarly to patients with type 2 diabetes at onset (Diabetology & Metabolic Syndrome)
Multiple risk factor control, mortality and cardiovascular events in type 2 diabetes and chronic kidney disease: a population-based cohort study
Multiple risk factor control (MRFC) may lower the increased risks for mortality and cardiovascular events in people with diabetes and CKD (BMJ Open)
Sex-specific relevance of diabetes to occlusive vascular and other mortality
A collaborative meta-analysis of individual data from 980 793 adults from 68 prospective studies (The Lancet Diabetes & Endocrinology)
Maternal Non-glycemic Contributors to Fetal Growth in Obesity and Gestational Diabetes: Spotlight on Lipids
Early vs. later gestational exposure to excess maternal fuels in fasting and postprandial conditions may differentially impact fetoplacental outcomes. Compelling evidence suggests that targeting interventions early in pregnancy beyond glucose may be critical to improve fetal growth patterns (Current Diabetes Reports)
Intralymphatic glutamic acid decarboxylase (GAD)-alum administration induced Th2-like specific immunomodulation in responder patients: a pilot clinical trial in type 1 diabetes
GAD-alum given into lymph nodes to Type 1 diabetes patients participating in an open-label pilot trial resulted in preservation of C-peptide similar to promising results from other trials (Journal of Diabetes Research)
Type 2 diabetes mellitus in older people: a brief statement of key principles of modern day management including the assessment of frailty.
We present a framework for the assessment of older adults and guidelines for the management of this population according to their frailty status, with the intention of reducing complications and improving quality of life for these people (Diabetic Medicine)
Exploring Variation in Glycemic Control Across and Within Eight High-Income Countries
Data were collected between 2013 and 2014 from 64,666 children with T1D who were <18 years of age across 528 centers in Germany, Austria, England, Wales, US, Sweden, Denmark, and Norway (Diabetes Care)
Diabetes foot care profiles: annual update, 2018
Annual update of indicators in the diabetes foot care profiles (Public Health England)
Standards of Medical Care in Diabetes—2018
Diabetes Care Supplement
Cardiovascular disease risk factor responses to a type 2 diabetes care model including nutritional ketosis induced by sustained carbohydrate restriction at 1 year
A continuous care treatment including nutritional ketosis in patients with T2D improved most biomarkers of CVD risk after 1 year. The increase in LDL-cholesterol appeared limited to the large LDL subfraction. LDL particle size increased, total LDL-P and ApoB were unchanged, and inflammation and blood pressure decreased (Cardiovascular Diabetology)
Association of Metformin Treatment with Reduced Severity of Diabetic Retinopathy in Type 2 Diabetic Patients
Long-term use of metformin is independently associated with a significant lower rate of SNPDR/PDR in patients with type 2 diabetes ≥ 15 years (Journal of Diabetes Research)
Barriers to foot care in patients with diabetes as identified by healthcare professionals
The crucial barrier to diabetic foot care is delay in accessing specialist care. Until this is addressed, care will be less than optimum and amputations will continue (Diabetic Medicine)
Pathophysiology‐based phenotyping in type 2 diabetes: A clinical classification tool
Patients clinically diagnosed with type 2 diabetes are a heterogeneous group. In the future, targeted treatment based on pathophysiological characteristics rather than the current “one size fits all” approach may improve patient prognosis (Diabetes/Metabolism Research and Reviews)
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