Among adults with type 2 diabetes uncontrolled with metformin with or without sulfonylurea, oral semaglutide, 7 mg/d and 14 mg/d, compared with sitagliptin, resulted in significantly greater reductions in HbA1c over 26 weeks, but there was no significant benefit with the 3-mg/d dosage. Further research is needed to assess effectiveness in a clinical setting (JAMA)
Diabetes News
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The Future of the GLP-1 Receptor Agonists
Overall, the findings of the PIONEER 3 trial, along with other recent studies, indicate that the introduction of semaglutide, the first oral preparation of a GLP-1RA for which the subcutaneous agent has shown positive cardiovascular benefit, should be an important addition to the growing list of pharmacologic options for type 2 diabetes (JAMA)
Retinopathy Outcomes With Empagliflozin Versus Placebo in the EMPA-REG OUTCOME Trial
Empagliflozin also reduced the risk of a prespecified microvascular outcome (composite of time to first initiation of retinal photocoagulation, vitreous hemorrhage, diabetes-related blindness, or incident/worsening nephropathy) by 38% versus placebo (Diabetes Care)
Long-term Effects of Metformin on Diabetes Prevention: Identification of Subgroups That Benefited Most in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study
Metformin reduces the development of diabetes over 15 years. The subsets that benefitted the most include subjects with higher baseline fasting glucose or HbA1c and women with a history of GDM (Diabetes Care)
Changes in Screening Practices for Prediabetes and Diabetes Since the Recommendation for Hemoglobin A1c Testing
As we observed in 2004, rates of screening are high. HbA1c is still used less frequently than glucose for screening but is more likely to result in a clinical diagnosis. Evidence to support guidelines to define the role of random glucose screening, including definition of appropriate cut points and follow-up, is needed (Diabetes Care)
Checkpoint inhibitor-induced insulin-dependent diabetes: an emerging syndrome
A new form of insulin-dependent diabetes has been recognised, occurring in patients with cancers who are treated with checkpoint inhibitors (The Lancet Diabetes & Endocrinology)
Dapagliflozin and Cardiovascular Outcomes in Patients with Type 2 Diabetes and Prior Myocardial Infarction
A Sub-analysis From DECLARE TIMI-58 Trial (Circulation)
Association of Higher Circulating Insulin Antibody with Increased Mean Amplitude Glycemic Excursion in Patients with Type 2 Diabetes Mellitus
The higher circulating IA titer was associated with increased MAGE in T2DM patients, indicating that those patients with elevated IA titer should receive GV assessment and individualized treatment (Journal of Diabetes Research)
Cardiovascular disease prevalence and risk factor prevalence in Type 2 diabetes: a contemporary analysis
There continues to be a high prevalence of CVD among people with Type 2 diabetes and a high level of unmet need for risk factor control. This implies substantial scope for reducing the excess risk of CVD in diabetes through improved management of known risk factors (Diabetic Medicine)
Double‐blind, randomized clinical trial assessing the efficacy and safety of early initiation of sitagliptin during metformin uptitration in the treatment of patients with type 2 diabetes: The CompoSIT‐M study
In participants not at HbA1c goal on a sub‐maximal dose of metformin, addition of sitagliptin at the time of metformin dose uptitration improved glycaemic response and HbA1c goal attainment, with similar safety and tolerability, compared to metformin uptitration alone (Diabetes, Obesity and Metabolism)
Metformin attenuates the postprandial fall in blood pressure in type 2 diabetes
Metformin acutely attenuates the hypotensive response to oral glucose, associated with augmented GLP‐1 secretion and delayed gastric emptying, effects potentially relevant to its favourable cardiovascular profile (Diabetes, Obesity and Metabolism)
Association between full monitoring of biomedical and lifestyle target indicators and HbA1c level in primary type 2 diabetes care: an observational cohort study (ELZHA-cohort 1)
This study shows that in a care group setting, fully monitored patients had significantly lower HbA1c levels compared with incompletely monitored patients (BMJ Open)
Sodium-Glucose Cotransporter-2 Inhibitors (SGLT-2i) Reduce Hospitalization for Heart Failure Only and Have No Effect on Atherosclerotic Cardiovascular Events: A Meta-Analysis
The predominant impact of SGLT-2i is on “hHF or CV mortality” composite driven predominantly by reduction in hHF and not atherosclerotic CV disease (Diabetes Therapy)
Association between full monitoring of biomedical and lifestyle target indicators and HbA1c level in primary type 2 diabetes care: an observational cohort study (ELZHA-cohort 1)
his study shows that in a care group setting, fully monitored patients had significantly lower HbA1c levels compared with incompletely monitored patients. Since this difference might have considerable clinical impact in terms of T2DM-related risks, this might help general practices in care group settings to overcome barriers on adequate registration and thus improve structured T2DM primary care (BMJ Open)
Longitudinal Changes in HbA1c following Treatment Intensification after Inadequate Response to Two Oral Antidiabetic Agents in Patients with Type 2 Diabetes
In patients with T2DM, intensification following A1c ≥7.0% on 2OADs was associated with a significant improvement in glycemic control. Patients intensified with insulin had a higher baseline A1c but greater A1c reduction than those intensified with a non‐insulin agent. However, A1c remained above 8.0% overall (Diabetes, Obesity and Metabolism)
Meeting the needs of multimorbid patients with Type 2 diabetes mellitus
Additional care management did not influence HRQoL over and above standard disease management. Improving diabetes patients’ self-care behavior in the context of structured disease management programs may be difficult to achieve. Women might benefit from additional care management, but this finding needs to be confirmed in future research (Diabetes Research and Clinical Practice)
Variation of carbohydrate intake in diabetic children on carbohydrate counting
Children varied their CI significantly from one meal to another more than one in three times. CC offers flexibility and a better quality of life for children using this method (Diabetes Research and Clinical Practice)
C-reactive protein and blood pressure variability in type 2 hypertensive diabetic patients
In patients with diabetes and hypertension, higher CRP levels are linked to cardiometabolic derangements, although they are not associated with increased BP variability (Blood Pressure Monitoring)
Clinical factors associated with the recovery of cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus
Younger age was the most important factor in CAN recovery in subjects with type 2 diabetes, including recovery from the definite or severe stage. HbA1c reduction, body weight reduction, no concurrent micro/macroalbuminuria, and shorter duration of diabetes were also significantly associated with CAN recovery (Cardiovascular Diabetology)
Poor short-term glycemic control in patients with type 2 diabetes impairs the intestinal mucosal barrier: a prospective, single-center, observational study
T2DM patients who incapable of maintaining stable blood glucose level are at a higher risk to associated with intestinal mucosal barrier injury (BMC Endocrine Disorders)
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