Ascertainment of events from clinical notes more than doubled the completeness of hypoglycemia capture overall relative to measures from structured data, and increased capture of non-serious events more than 20-fold. The structured data and clinical notes are complementary within the EHR, and both need to be considered in order to fully assess the occurrence of hypoglycemia (Diabetes Research and Clinical Practice)
Diabetes News
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Association Between HbA1c Variability and Risk of Microvascular Complications in Adolescents With Type 1 Diabetes
Greater HbA1c variability predicts retinopathy, early nephropathy, and CAN, in addition to established risk factors, in adolescents with T1D. Minimizing long term fluctuations in glycemia may provide additional protection against the development of microvascular complications (Journal of Clinical Endocrinology & Metabolism)
Abdominal Obesity Is More Closely Associated With Diabetic Kidney Disease Than General Obesity
The current study expands the current body of knowledge on the association of obesity with DKD and highlights abdominal obesity as a more important risk factor for DKD in T2D patients than general obesity (Diabetes Care)
Bariatric surgery for patients with early-onset vs late-onset type 2 diabetes
This article describes the largest long-term study examining bariatric surgery for patients with early-onset T2DM. Bariatric surgery may achieve better and more long-lasting glycemic control in select patients with early-onset T2DM than in those with late-onset T2DM (JAMA Surgery)
Initiation and Intensification Strategies in Type 2 Diabetes Management: A Comparison of Basal Plus and Premix Regimens
The current review argues that both basal plus and premix insulin regimens are relatively efficacious and safe options for patients with T2D during both insulin initiation in insulin-naïve patients and intensification in patients who have failed on basal insulin (Diabetes Therapy)
Persons with latent autoimmune diabetes in adults express higher dipeptidyl peptidase-4 activity compared to persons with type 2 and type 1 diabetes
Persons with LADA express higher DPP-4 activity compared to persons with both type 1 and type 2 diabetes. The possible patophysiological role of DPP-4 in the LADA pathogenesis needs to be further evaluated (Diabetes Research and Clinical Practice)
Clinical predictors differentiating non-diabetic renal diseases from diabetic nephropathy in a large population of type 2 diabetes patients
Shorter duration of diabetes (⩽5 years), absence of retinopathy, and presence of glomerular hematuria were independent indicators associated with NDRDs, indicating the need for renal biopsy (Diabetes Research and Clinical Practice)
Patterns of anti-diabetic medication use in patients with type 2 diabetes mellitus in England and Wales
In over three-quarters of patients, anti-diabetic drugs are being prescribed per NICE guidance. When insulin is being used earlier than recommended, there appears to be a need for urgent and rapid glycaemic control (Pharmacoepidemiology and Drug Safety)
Hemoglobin A1c Levels and Risk of Sudden Cardiac Death – a Nested Case-Control Study
In these prospective cohorts, HbA1c levels associated with SCD risk, particularly among those without known CVD, even after controlling for diabetes status. These data support the hypothesis that hyperglycemia mediates SCD risk among patients with diabetes (Heart Rhythm)
Dipeptidyl peptidase-4 inhibitors and cardiovascular risks in patients with pre-existing heart failure
In this nationwide T2DM cohort, the risks of mortality and the combination of MI and ischaemic stroke were lower for patients receiving DPP-4 inhibitors than for those who did not receive such treatment. DPP-4 inhibitor use was not associated with a higher risk of hospitalisation for HF even in patients with pre-existing HF (Heart)
Safety of a Hybrid Closed-Loop Insulin Delivery System in Patients With Type 1 Diabetes
Hybrid closed-loop automated insulin delivery was associated with few serious or device-related adverse events in patients with type 1 diabetes (JAMA)
Effect of Contemporary Bariatric Surgical Procedures on Type 2 Diabetes Remission. A Population-Based Matched Cohort Study
Remission of diabetes may continue for up to 6 years after bariatric surgical procedures. Diabetes outcomes are generally more favourable after gastric bypass or sleeve gastrectomy than LAGB (Obesity Surgery)
Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes
In patients with type 2 diabetes who were at high cardiovascular risk, the rate of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke was significantly lower among patients receiving semaglutide than among those receiving placebo, an outcome that confirmed the noninferiority of semaglutide (NEJM)
Exenatide once weekly plus dapagliflozin once daily versus exenatide or dapagliflozin alone in patients with type 2 diabetes inadequately controlled with metformin monotherapy (DURATION-8)
Co-initiation of exenatide and dapagliflozin improved various glycaemic measures and cardiovascular risk factors in patients with type 2 diabetes inadequately controlled by metformin monotherapy. The dual treatment regimen was well tolerated, with the expected safety profile for this combination. Additional data from an ongoing study (eg, AWARD-10; NCT02597049) will further inform the use of these drug classes in combination (The Lancet Diabetes & Endocrinology)
Addition or Switch to Insulin Therapy in People Treated with GLP-1 Receptor Agonists: A Real World Study in 66,583 Patients
Significant delay in intensification of treatment by addition of insulin is observed in patients with T2DM inadequately controlled with GLP-1RA. Earlier addition of insulin is associated with better glycaemic control, while switching to insulin is not clinically beneficial during 2 years of treatment. Non-responding patients on GLP-1RA would benefit by adding insulin therapy, rather than switching to insulin (Diabetes, Obesity and Metabolism)
Continuous glucose monitoring for patients with type 1 diabetes and impaired awareness of hypoglycaemia (IN CONTROL): a randomised, open-label, crossover trial
CGM increased time spent in normoglycaemia and reduced severe hypoglycaemia in patients with type 1 diabetes and impaired awareness of hypoglycaemia, compared with SMBG. Our results support the concept of using CGM in this high-risk population (The Lancet Diabetes & Endocrinology)
Mixed methods study of engagement in behaviors to prevent type 2 diabetes among employees with pre-diabetes
Most employees found to have pre-diabetes through a workplace screening were engaged in a recommended preventive behavior 3 months after the screening. This engagement could be enhanced by optimizing motivation and risk perception as well as leveraging social networks and external supports (BMJ)
Personalised treatment targets in type 2 diabetes patients: The Dutch approach
A clearly defined and relatively simple personalised approach leads to a higher proportion of T2DM patients considered as cardiometabolic well-controlled (Primary Care Diabetes)
Novel glucose-sensing technology and hypoglycaemia in type 1 diabetes: a multicentre, non-masked, randomised controlled trial
Novel flash glucose testing reduced the time adults with well controlled type 1 diabetes spent in hypoglycaemia (Lancet)
Weight loss efficacy of a novel mobile Diabetes Prevention Program delivery platform with human coaching
Our findings support the effectiveness of a uniquely mobile prediabetes intervention, producing weight loss comparable to studies with high engagement, with potential for scalable population health management (BMJ)
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