The NIHR Horizon Scanning Research and Intelligence Centre has published a horizon scanning review on new and emerging non-invasive glucose monitoring technologies in development for people with diabetes
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Different bariatric/metabolic procedures provide us with experimental tools to probe GI tract physiology. Embracing this approach through the application of detailed phenotyping, genomics, metabolomics, and gut microbiome studies will enhance our understanding of metabolic regulation and help identify novel therapeutic targets (Diabetes Care)
The gastrointestinal tract plays a major role in the regulation of postprandial glucose profiles (Diabetes Care)
New guidelines for the surgical treatment of type 2 diabetes bolster hopes of finding a cure (Nature)
Changing the Landscape of Diabetes Care (Diabetes Care)
This retrospective analysis demonstrates the sustained efficacy of insulin pump therapy in patients with type 2 diabetes with MDI failure (Diabetes Care)
Our findings may call attention to a major contributing factor to hypoglycemia among insulin users. In reality, insulin dosage is seldom adjusted and thus transient periods of decrease in insulin requirements and overtreatment are usually overlooked (Journal of Diabetes and Its Complications)
Urinary albumin excretion with sitagliptin compared to sulfonylurea as add on to metformin in type 2 diabetes patients with albuminuria: a real-world evidence study
This ‘real-world’ study compares the reduction in microalbuminuria (assessed by urine albumin:creatinine ratio [UACR]) seen when adding a gliptin to background metformin therapy, versus that with a sulphonylurea. The conclusion is that both therapies reduce UACR but the gliptin (in this case, sitagliptin) is more efficacious.
There are several health-warnings that need to be applied to this study. It is small (N=564 patients), patients were followed for a very short period (mean of nine months) and the result was a ‘trend’. Furthermore, elevated UACR is a highly variable marker, which needs to be repeated to be valid (in some studies, four timed urine collections have been analysed); this assessment of computerised records used only one spot-test. Moreover, whilst the diabetes community have been brain-washed into thinking that elevations in UACR mean impending dialysis, it is clear that increased UACR can be a result of multiple pathologies and that end-stage renal disease is a highly unlikely outcome for the vast majority of patients with diabetes. This is probably the reason for it dropping off the QoF agenda, although the implication was that it has now become so embedded in GP psychology that it will continue to be assessed without compensation. I doubt that this will prove to be the case, nor do I think that it should be, given that widespread screening for an elevated UACR has ever been justified.
I would suggest that regarding microalbuminuria, appropriate blood pressure control should be the focus rather than UACR and that for gliptins and SUs, HbA1c reduction, hypoglycaemia and weight are the outcomes that should guide choices….
Professor Steve Bain
Our results show that commonly measured parameters may predict treatment failure in type 2 diabetes and suggest that early treatment with metformin plus secretagogues may foretell this failure (Acta Diabetologica)
Our results provide evidence that obesity and RYGB have a dynamic effect on the skeletal muscle proteome (Diabetes)
Our results suggest that both sitagliptin and SU reduce albuminuria as an add-on therapy to metformin, but that sitagliptin may provide greater reductions in albuminuria independent of glycemic control when compared to SU. Larger population studies are required to further explore this (Diabetes and Its Complications)
These findings highlight the need for exercise-management strategies tailored to individuals’ overall diabetes management, for despite making exercise-specific adjustments for care, many people with type 1 diabetes still report significant difficulties with BG control when it comes to exercise (Canadian Journal of Diabetes)
Individuals with diabetic foot ulcers were found to possess fewer cognitive resources than individuals with diabetes without this complication. Thus, they appear to face more self-treatment challenges, while possessing significantly fewer cognitive resources (Diabetes Care)
Our findings provide novel evidence that EECP improves glycemic control in patients with T2DM that persist for up to 3 months following treatment (Acta Diabetologica)
Day and night artificial pancreas (D/N-AP) and evening and night artificial pancreas (E/N-AP) both achieved better glucose control than sensor augmented pump (SAP) under free-living conditions. Although time in the different glycemic ranges was similar between D/N-AP and E/N-AP, D/N-AP further reduces glucose variability (Diabetes Care)
Our study is one of the first pharmacogenetic studies in the field of T2D, employing a recall-by-genotype design. It demonstrated that the effect of melatonin on glucose metabolism is dependent upon genotype. Although yet to be proven, carriers of the MTNR1B risk variant are likely to have lower cAMP levels in pancreatic β cells. In view of this, incretin-based therapy, which amplifies cAMP signaling in β cells, may be particularly well suited for these patients (Cell Metabolism)
The prevalence of GDM varies according to seasons, which leads to the possible overdiagnosis of GDM in summer and/or underdiagnosis in winter. Further research into standardization of the GTT or seasonal adjustment of the results may need to be considered (Diabetes Care)
These results suggest that suppression of EGP by central KATP channel activation may be lost in type 2 diabetes. Restoration of central regulation of glucose metabolism could be a promising therapeutic target to reduce hyperglycemia in type 2 diabetes (Diabetes)
Due to lack of data it is not possible to conclude whether SGLT 2 inhibitors prevent or delay the diagnosis of T2DM and its associated complications (Cochrane)
The aim of this document is to provide a framework for the operational delivery of hospital Trust based diabetic foot services. Ensuring that patients with acute diabetic foot disease receive the same high quality of care irrespective of where they present (Diabetes UK)