DSPN and CAN are prevalent in young adults with T1D with no association found with CSII treatment (Diabetes Technology and Therapeutics)
Diabetes News
Category: Management
Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)
The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the prior position statements, published in 2012 and 2015, on the management of type 2 diabetes in adults (Diabetes Care)
Efficacy of a self-management education programme on patients with type 2 diabetes in primary care: A randomised controlled trial
HbA1c reductions are difficult to obtain in adequately controlled patients. On the other hand, raising awareness on one´s disease can increase disease control self-efficacy. This finding, accompanied by reduced medication consumption and healthcare use rates, highlights that usual care would be benefited by incorporating certain SDSMP aspects (Primary Care Diabetes)
Glycemic control with a basal-bolus insulin protocol in hospitalized diabetic patients treated with glucocorticoids: a retrospective cohort study
A significantly higher percentage of patients with diabetes who were treated with glucocorticoids during hospitalization did not achieve glycemic control with a basal-bolus insulin protocol (BMC Endocrine Disorders)
Effect of Health Information Technologies on Glycemic Control Among Patients with Type 2 Diabetes
Our meta-analysis shows that overall, HITs have favorable impact on glycemic control of patients with type 2 diabetes. On average, mobile-based interventions produce larger effects compared to other forms of approaches under review (Current Diabetes Reports)
Management of Hyperglycemia in Type 2 Diabetes, 2018
A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)
Standards of Medical Care in Diabetes—2018
16 sections (Diabetes Care)
NICE impact diabetes
This report considers how NICE’s evidence-based guidance can contribute to improvements in the prevention and management of diabetes
Inpatient hypoglycaemia; should we should we focus on the guidelines, the targets or our tools?
These guidelines suggest using lower limits of glucose targets varying from 4.0 to 6.0 mmol/l [2–4]. Levy et al. propose a lower glucose limit of 5 mmol/l with the catchphrase ‘stop at 5 and keep the inpatient alive’ (Diabetic Medicine)
Effect of a Remotely Delivered Tailored Multicomponent Approach to Enhance Medication Taking for Patients With Hyperlipidemia, Hypertension, and Diabetes
A remotely delivered multicomponent behaviorally tailored intervention resulted in a statistically significant increase in medication adherence but did not change clinical outcomes (JAMA Internal Medicine)
Nurse-led psychological intervention for type 2 diabetes: a cluster randomised controlled trial (Diabetes-6 study) in primary care
Training nurses in MI and basic CBT to support self-management did not lead to improvements in glycaemic control or other secondary outcomes in people with T2D at 18 months. It was also unlikely to be cost-effective. Furthermore, the increased contact with standard-care nurses did not improve glycaemic control (British Journal of General Practice)
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)
Young people’s experiences of managing Type 1 diabetes at university: a national study of UK university students
The study quantifies the high level of risk experienced by students with Type 1 diabetes during the transition to university, in particular, female students and those moving to a new university healthcare provider (Diabetic Medicine)
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)
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