This NCEPOD report highlights the quality of diabetes care for patients aged 16 years or older who underwent a surgical procedure. The report takes a critical look at areas where the care of patients might have been improved. Remediable factors have also been identified in the clinical and the organisational care of these patientsNational Confidential Enquiry into Perioperative Deaths (NCEPOD)
Diabetes News
Glycosmedia is dedicated to bringing free, non-promotional, editorially independent news to a global audience about developments in diabetes, and is primarily aimed at health professionals.
Applicability of telemedicine in the screening of diabetic retinopathy (DR): The first multicentre study in Italy. The No Blind Study
Our findings, in an Italian setting, confirm main data in the literature about DR prevalence. Hence, telemedicine could represent an accurate, fast and cheap method for screening of DR (Diabetes/Metabolism Research and Reviews)
The effects of incretin‐based therapies on beta‐cell function and insulin resistance in type 2 diabetes: a systematic review and network meta‐analysis combining 360 trials
Incretin‐based therapies not only show an increase of HOMA‐β and fasting C‐Peptide level, but also achieve a reduction of HOMA‐IR and FPG in comparison with placebo. Even though GRADE evidences indicate low to moderate for most comparisons, incretin‐based therapies seem to be advisable option for long term treatment to obtain preservation of β‐cell function (Diabetes, Obesity and Metabolism)
How Representative are the Patients Included in the CV outcome Trials with SGLT2 Inhibitors of a General Type 2 Diabetes Population?
In large T2D populations from Europe, consistent patterns of representativeness for CVOTs were found when applying main enrollment criteria. DECLARE‐TMI 58 showed the highest representativeness, indicating that it includes and examines patients who are most representative of the general T2D patient in the studied countries (Diabetes, Obesity and Metabolism)
Investigating the Association Between Baseline Characteristics (HbA1c and Body Mass Index) and Clinical Outcomes of Fast-Acting Insulin Aspart in People with Diabetes
In participants with T1D and T2D, treatment differences (for change in HbA1c and overall hypoglycaemia) between mealtime faster aspart and insulin comparators were similar to the corresponding overall analysis across baseline HbA1c and BMI subgroups. The finding of a lower total daily insulin dose in participants with obesity (BMI > 30 kg/m2) and T1D treated with faster aspart, versus those treated with IAsp, may warrant further investigation (Diabetes Therapy)
Effects of intensive interventions compared to standard care in people with type 2 diabetes and microalbuminuria on risk factors control and cardiovascular outcomes
Apart from blood pressure outcomes, there was no evidence that intensive interventions improve or worsen HbA1c, total cholesterol, LDL, triglycerides, urinary albumin excretion rate, risk of cardiovascular or mortality outcomes in people with type 2 diabetes and microalbuminuria. Results of this review are mainly influenced by one small trial, hence uncertainty surrounding the effect of intensive interventions in people with type 2 diabetes and microalbuminuria still exists. Large studies are urgently required in this high risk cardiovascular group of patients (Diabetes Research and Clinical Practice)
Assessment of Self-monitoring of Blood Glucose in Individuals With Type 2 Diabetes Not Using Insulin
No statistical difference between patients who do not self-monitor their blood glucose multiple times per day and those who do self-monitor their blood glucose multiple times per day in glycemic control, nor evidence of effects on health-related quality of life, patient satisfaction, or decreased number of hypoglycemic episodes (JAMA)
HbA1c screening in the community: Lessons for safety and quality management of a point of care programme
POC testing must be conducted within stringent quality assurance processes prior to and while in use. Within such a system, POC testing for HbA1c can be sufficiently accurate for screening and diagnosis of diabetes (Primary Care Diabetes)
Commencing insulin glargine 100 U/mL therapy in people with type 2 diabetes: Determinants of achievement of HbA1c goal <7.0%
Baseline HbA1c was the strongest determinant for achieving target HbA1c <7.0% by supplementary Gla‐100 therapy while sex and BMI were also useful indicators. However, age and C‐peptide levels at baseline did not predict glycaemic response to the introduction of basal insulin (Diabetes, Obesity and Metabolism)
Non-traditional biomarkers and incident diabetes in the Diabetes Prevention Program: comparative effects of lifestyle and metformin interventions
The findings strengthen evidence linking adiponectin to diabetes development, and argue against a central role for endothelial dysfunction. The findings have implications for the pathophysiology of diabetes development and its prevention (Diabetologia)
A systematic review on costs and cost-effectiveness of screening and prevention of type 2 diabetes in women with prior gestational diabetes: exploring uncharted territory
An oral glucose tolerance test per three years leads to the lowest cost per case detected, and prevention is potentially cost-effective or cost-saving. More health economic evaluations are needed that compare all relevant alternatives, including ‘doing nothing’ (Diabetes Research and Clinical Practice)
Sliding scale insulin for non‐critically ill hospitalised adults with diabetes mellitus
Based on low‐ to very low‐certainty evidence, our results for non‐critically ill hospitalised adults with diabetes mellitus in the medical and surgical in‐hospital setting showed that a basal‐bolus insulin strategy that applied higher total daily doses of insulin than the sliding scale insulin regimen might result in better short‐term glycaemic control but might also cause an increase in severe hypoglycaemic episodes (Cochrane Systematic Review)
Effect of metformin in addition to dietary and lifestyle advice for pregnant women who are overweight or obese: the GRoW randomised, double-blind, placebo-controlled trial
For pregnant women who are overweight or obese, metformin given in addition to dietary and lifestyle advice initiated at 10–20 weeks’ gestation does not improve pregnancy and birth outcomes (The Lancet Diabetes & Endocrinology)
24-Hour Blood Pressure-Lowering Effect of an SGLT-2 Inhibitor in Patients with Diabetes and Uncontrolled Nocturnal Hypertension: Results from the Randomized, Placebo-Controlled SACRA Study
Non-severely obese older diabetes patients with uncontrolled nocturnal hypertension showed significant BP reductions without marked reductions in glucose with the addition of empagliflozin to existing antihypertensive and antidiabetic therapy. Use of SGLT2 inhibitors in specific groups (e.g. those with nocturnal hypertension, diabetes, and high salt sensitivity) could help reduce the risk of heart failure and cardiovascular mortality (Circulation)
Empagliflozin on top of metformin treatment improves arterial function in patients with type 1 diabetes mellitus
Empagliflozin on top of metformin treatment significantly improved arterial stiffness compared to metformin in T1DM patients. Endothelial function was similarly improved in all treatment groups (Cardiovascular Diabetology)
Differential Effects of Thiazolidinediones and Dipeptidyl Peptidase-4 Inhibitors on Insulin Resistance and β-Cell Function in Type 2 Diabetes Mellitus
TZD users showed significantly better insulin sensitivity, whereas DPP-4 inhibitor users secreted more insulin from β-cells under similar glycemic control (Diabetes Therapy)
Vascular complications in patients with type 2 diabetes: prevalence and associated factors in 38 countries (the DISCOVER study program)
The global burden of microvascular and macrovascular complications is substantial in these patients with type 2 diabetes who are relatively early in the disease process. These findings highlight an opportunity for aggressive early risk factor modification, particularly in regions with a high prevalence of complications (Cardiovascular Diabetology)
Impact of type 2 diabetes mellitus on short- and long-term mortality after coronary artery bypass surgery
Diabetic and non-diabetic patients have similar in-hospital mortality rates. Survival rates of diabetic patients start to deteriorate 3 year after surgery. Type 2 DM is an independent predictor for long-term mortality after isolated CABG surgery. Mortality is even higher when the diabetes treatment strategy included insulin (Cardiovascular Diabetology)
Cardiovascular risk reduction over time in patients with diabetes or pre-diabetes undergoing bariatric surgery: data from a single-center retrospective observational study
Bariatric surgery reduces CVD risk in type 2 diabetes and pre-diabetes. Given that patients with type 2 diabetes benefit the most, more studies are necessary to consider pre-diabetes as a criterion for metabolic surgery in patients with BMI ≥ 35 kg/m2 (BMC Endocrine Disorders)
FDA takes steps to advance the safety and accuracy of blood glucose monitors to empower patients with diabetes with reliable tools to manage their health
The updated draft guidances issued today include recommendations to help ensure greater accuracy, reliability, and safe use of blood glucose monitoring test systems for each setting. (FDA)
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