Glycosmedia

Diabetes News Service

Diabetes News

Category: Management

Glycaemic control and mortality in older people with type 2 diabetes: The Fremantle Diabetes Study Phase II

Tight glycaemic control may be hazardous in older people with type 2 diabetes when achieved with pharmacotherapy with metformin, and especially with insulin or sulphonylureas. These data confirm that overtreatment is likely to be an important clinical problems in this vulnerable population (Diabetes, Obesity and Metabolism)

SGLT2 Inhibitors in Combination Therapy: From Mechanisms to Clinical Considerations in Type 2 Diabetes Management

With guidelines moving away from a one-size-fits-all approach toward setting patient-centered goals and allowing flexibility in choosing a second-/third-line drug from the growing number of U.S. Food and Drug Administration–approved glucose-lowering agents, keen personalized management in T2D has become a challenge for health care providers in daily practice (Diabetes Care)

A retrospective observational study of people with Type 1 diabetes with self‐reported severe hypoglycaemia reveals high level of ambulance attendance but low levels of therapy change and specialist intervention

We observed a high level of ambulance service intervention but surprisingly low levels of hypoglycaemia follow‐up, therapy change and specialist intervention in people self‐reporting severe hypoglycaemia. These results suggest there may be important gaps in care pathways for people with Type 1 diabetes self‐reporting severe hypoglycaemia (Diabetic Medicine)

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)

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)

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)

Treatment Intensification in Type 2 Diabetes: A Real-World Study of 2-OAD Regimens, GLP-1 RAs, or Basal Insulin

Despite robust HbA1c lowering following treatment initiation, many patients did not achieve HbA1c < 7.0%. Basal insulin, generally prescribed for patients with high baseline HbA1c, was associated with a large reduction in HbA1c and with higher costs. Therapy intensification at an appropriate time could lead to clinical and economic benefits and should be investigated further (Diabetes Therapy)

Mean HbA1c, HbA1c variability, and mortality in people with diabetes aged 70 years and older: a retrospective cohort study

Both low and high levels of glycaemic control were associated with an increased mortality risk, and the level of variability also seems to be an important factor, suggesting that a stable glycaemic level in the middle range is associated with lower risk  (The Lancet Diabetes & Endocrinology)

How Does Diabetes Affect Daily Life? A Beyond-A1C Perspective on Unmet Needs

Patients across cultures and countries report negative experiences from diabetes, not only with regard to glycemia, but also regarding physical, emotional, social, and financial health metrics. Diabetes is a 24/7 unwanted job with no vacations, breaks, or set-it-and-forget-it phone apps (Clinical Diabetes)

Cost-effectiveness of insulin pumps compared with multiple daily injections both provided with structured education for adults with type 1 diabetes

A health economic analysis of the Relative Effectiveness of Pumps over Structured Education (REPOSE) randomised controlled trial. Our analysis of the REPOSE data suggests that routine use of pumps in adults without an immediate clinical need for a pump, as identified by National Institute for Health and Care Excellence, would not be cost-effective (BMJ Open)

Long-term outcomes associated with triple-goal achievement in patients with type 2 diabetes mellitus

Achievement of triple-goal was associated with better health outcomes among veterans with T2DM compared to those that did not, while LDL-C has more weight of influence. Multi-faceted treatment strategies targeting hypertension, hyperglycemia and hyperlipidemia may improve health outcome in veterans with T2DM (Diabetes Research and Clinical Practice)

Young Adult Diabetes: Engaging to improve; outcomes of the young adult clinic restructure

Using results of local audits and feedback from a subsequent multi-disciplinary team (MDT) and patient focus group meeting, the young adult diabetes clinic was re-designed with a vision to have a structured, patient-led, flexible clinic service with specific aims and objectives, to be achieved within 12 months (December 2016) (NICE)

Timing of Exercise Affects Glycemic Control in Type 2 Diabetes Patients Treated with Metformin

Results suggest that timing of exercise is a modifiable factor influencing postexercise glycemic control and exercise at 30 minutes postbreakfast may be preferred in terms of lowering and stabilizing postprandial glucose levels in patients treated with metformin (Journal of Diabetes Research)

The Berlin Declaration: A call to action to improve early actions related to type 2 diabetes. How can specialist care help?

The Berlin Declaration focuses on four aspects of early action, and proposes actionable policies relating to each aspect: early detection, prevention, early control and early access to the right interventions. In addition, a number of treatment targets are also proposed to provide goals for these policies (Diabetes Research and Clinical Practice)

Changing Patients’ Treatment Preferences and Values with a Decision Aid for Type 2 Diabetes Mellitus: Results from the Treatment Arm of a Randomized Controlled Trial

The values-focused PDA for T2DM medication intensification prepared patients to make a shared decision with their clinician and changed patients’ values regarding what was important in making that decision (Diabetes Therapy)

Supporting the management of type 2 diabetes with pharmacist-led reviews and implementing NICE recommended nine key care processes

The project aimed to reduce the number of missing care processes and optimise pharmaceutical treatment (NICE Guideline 28) of patients whose treatment targets for glycated haemoglobin (HbA1c), blood pressure (BP) or total cholesterol (TC) readings were not being achieved (NICE)

Transfer from paediatric to adult care for young adults with Type 2 diabetes: the SEARCH for Diabetes in Youth Study

Young adults with Type 2 diabetes exhibit worsening glycaemic control and loss to follow-up during the transfer from paediatric to adult care. Our study highlights the need for development of tailored clinical programmes and healthcare system policies to support the growing population of young adults with youth-onset Type 2 diabetes (Diabetic Medicine)

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