Diabetes News

Glucose fluctuation was improved by the addition of voglibose or miglitol to alogliptin. Glucose fluctuations and postprandial hyperglycemia were similar between a-GIs (Journal of Diabetes Investigation)

Most physicians are comfortable with initiating basal insulin replacement therapy in their patients with type 2 diabetes who are no longer meeting treatment goals with oral antidiabetic agents. What is more challenging is what to do when treatment goals are no longer being met despite adequate titration of basal insulin (Diabetes, Obesity and Metabolism)

This article reviews clinical data for lixisenatide to date, both as monotherapy and in combination with basal insulin, and discusses the implications of lixisenatide for the management of T2DM (Expert Review of Endocrinology & Metabolism)

While further study will be required, advances in basal insulin replacement may offer important advantages over existing options for starting insulin strategies (Diabetes, Obesity and Metabolism)

In final guidance issued today (27 February), NICE has recommended ranibizumab (Lucentis, Novartis) as an option for treating visual impairment caused by diabetic macular oedema (NICE)

In patients with type 2 diabetes, empagliflozin resulted in dose-dependent, clinically meaningful reductions in HbA1c and FPG, and reductions in body weight compared with placebo. Empagliflozin was well-tolerated with a favourable safety profile (Diabetes, Obesity and Metabolism)

In both the older and younger age groups, the addition of once-daily insulin detemir to existing OAD regimens was effective and safe. In older patients, an improvement in HbA1c of 1.2 % was not associated with an increased risk of severe hypoglycaemia or weight gain (Drugs and Aging)

Sanofi portfolio expands to offer first once-a-day prandial GLP-1 receptor agonist (Sanofi)

Once daily pre-breakfast lixisenatide provided a significantly greater reduction in PPG (AUC) during a morning test meal versus pre-breakfast liraglutide. Lixisenatide provided significant decreases in postprandial insulin, C-peptide (vs an increase with liraglutide), and glucagon, and better gastrointestinal tolerability than liraglutide (Diabetes, Obesity and Metabolism)

We examined insulin secretion impairment and insulin resistance in overweight patients with T2D who had metformin failure, with elevated HbA1c at maximal metformin dose (Acta Diabetologica)

All subjects with type 1 diabetes need insulin and, given the current lack of disease-modifying drugs, all patients with type 2 diabetes will eventually need insulin if they live long lives. The data supporting the use of the new ‘ultra-long’ acting insulin analogue degludec which are currently being considered by the regulatory authorities show a continued improvement in duration and variability of action but the well-known downsides of weight-gain and hypoglycaemia (albeit diminished) remain. So, what next for insulin?

The majority of patients with type 2 diabetes and RI were normoalbuminuric despite the fact that 25% of these patients had no ongoing treatment with RAAS-blocking agents. Thus, RI in many patients with type 2 diabetes is likely to be caused by other factors than diabetic microvascular disease and ongoing RAAS-blockade. (Diabetes and Its Complications)

In T2DM subjects whose hyperglycemia is poorly controlled on one or two oral agents, bromocriptine-QR therapy for 24 weeks can provide significant added improvement in glycemic control relative to adding placebo (Endocrine Practice)

A dispersed insulin injection strategy enhanced the effect of a fast-acting insulin analog. The increased surface-to-volume ratio of the subcutaneous insulin depot can facilitate insulin absorption into the vascular system (Diabetes Care)

This evidence that dietary fat increases glucose levels and insulin requirements highlights the limitations of the current carbohydrate-based approach to bolus dose calculation (Diabetes Care)

This review is aimed to look at important mechanistic differences between incretin mimetics and enhancers through direct comparison trials and impact of these differences on biochemical, metabolic and patient satisfaction parameters (BMC Medicine)

Epalrestat prevented progression of diabetic neuropathy and retinopathy/nephropathy. The effect on diabetic retinopathy/nephropathy may have occurred indirectly because of the prevention of progression of diabetic neuropathy, in addition to the inhibitory action of epalrestat on aldose reductase (Diabetic Medicine)

FORXIGA is a selective and reversible inhibitor of sodium-glucose cotransporter 2 (SGLT2) that works independently of insulin to help remove excess glucose from the body, a unique mode of action not seen in any other currently available treatments for type 2 diabetes (AstraZeneca and Bristol-Myers Squibb)

An FDA advisory committee voted 8-4 Thursday in favor of approval of a new ultra-long-acting insulin for type 1 and type 2 diabetes. (medpage TODAY)

This evidence summary considers the use of insulin degludec in adults with type 2 diabetes (NICE)