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)
Diabetes News
Category: Treatment
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)
Glycemic goal attainment and hypoglycemia outcomes in type 2 diabetes patients initiating insulin glargine 300 units/mL or 100 units/mL: Real‐world results from the DELIVER Naïve cohort study
Among insulin‐naïve adults with T2D, Gla‐300 was associated with significantly better HbA1c reductions (latest value during 90–180‐day follow‐up) and similar or improved hypoglycemia outcomes (3‐ and 6‐month follow‐up) than Gla‐100 (Diabetes, Obesity and Metabolism)
A Type 1 diabetes technology pathway: consensus statement for the use of technology in Type 1 diabetes
This pathway is endorsed by UK‐wide clinical and patient associations and we recommend that providers and commissioners use it to ensure the right individual with diabetes has access to the right technology in a timely way to help achieve better outcomes (Diabetic Medicine)
Glycemic Control after Treatment Intensification in Patients with Type 2 Diabetes Uncontrolled on Two or More Non‐Insulin Antidiabetic Drugs in a Real‐World Setting
Despite intensification, most patients failed the glycaemic goal of HbA1c <7%. The reduction depended mainly on pre‐intensification HbA1c values, with small differences between drugs (Diabetes, Obesity and Metabolism)
The Standard of Care in Type 2 Diabetes: Re-evaluating the Treatment Paradigm
The symposium, while acknowledging the need for newer antidiabetic drugs in specific situations and patient groups, recommended the continuation of SUs and metformin as the primary oral antidiabetic agents in resource-constrained regions of the world (Diabetes Therapy)
Association of Insulin Dose, Cardiometabolic Risk Factors, and Cardiovascular Disease in Type 1 Diabetes During 30 Years of Follow-up in the DCCT/EDIC Study
During DCCT/EDIC, higher insulin doses were associated with adverse trends in several cardiometabolic risk factors, even after multivariable adjustment, but not with incident CVD outcomes (Diabetes Care)
Incretin-Based Antihyperglycemic Agents for the Management of Acute Ischemic Stroke in Patients with Diabetes Mellitus: A Review
Several preclinical studies consistently showed that GLP-1 receptor agonists reduce infarct volume and improve the functional outcome after ischemic stroke. These beneficial effects appear to be mediated by anti-inflammatory, antioxidant, and anti-apoptotic actions of these agents (Diabetes Therapy)
Participants’ Experiences of, and Views About, Daytime Use of a Day-and-Night Hybrid Closed-Loop System in Real Life Settings
While participants reported substantial benefits to using the closed loop during the day, they also identified ways in which the technology could be refined and education and training tailored to optimize effective use. Our findings suggest that mainstreaming this technology will not necessarily lead to increased demands on clinical staff (Diabetes Technology and Therapeutics)
Effect of Remote Glucose Monitoring Utilizing Computerized Insulin Dose Adjustment Algorithms: A Pilot Project
Remote glucose monitoring utilizing computerized insulin dose adjustment algorithms saved time for both providers and patients while effectively improving glycemia (Diabetes Therapy)
Physician–patient communication at prescription of an additional oral drug for type 2 diabetes and its links to patient outcomes – new findings from the global IntroDia® study
Encouraging and patient-inclusive conversations at add-on moments may improve patient well-being and self-care outcomes. People with T2DM who attempted to delay additional medication reported poorer PPCQ and outcomes (Diabetes Research and Clinical Practice)
Insulin Bolus Administration in Insulin Pump Therapy: Effect of Bolus Delivery Speed on Insulin Absorption from Subcutaneous Tissue
Results suggest that insulin bolus delivery with fast delivery speed may result in more rapid insulin absorption and, thus, may provide a better control of meal-related glucose excursions than that obtained with bolus delivery using slow delivery speeds. Our findings may have important implications for the future design of the bolus delivery unit of insulin pumps (Diabetes Technology and Therapeutics)
Relationship between HbA1c and all-cause mortality in older patients with insulin-treated type 2 diabetes: results of a large UK Cohort Study
Both low and high HbA1c were associated with increased all-cause mortality, among older patients with insulin-treated T2D. This cohort study supports the need for individualisation of care and suggests better outcomes with HbA1c levels around 6.5–7.4% and markedly excess risk with HbA1c > 11% (Age and Ageing)
Double‐blind, randomized clinical trial assessing the efficacy and safety of early initiation of sitagliptin during metformin up‐titration in 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 up‐titration improved glycemic response and HbA1c goal attainment with similar safety and tolerability compared to metformin up‐titration alone (Diabetes, Obesity and Metabolism)
Perioperative Diabetes: High and Lows
This NCEPOD report highlights the quality of diabetes care for patients aged 16 years or older who underwent a surgical procedure. The report takes a critical look at areas where the care of patients might have been improved. Remediable factors have also been identified in the clinical and the organisational care of these patientsNational Confidential Enquiry into Perioperative Deaths (NCEPOD)
Investigating the Association Between Baseline Characteristics (HbA1c and Body Mass Index) and Clinical Outcomes of Fast-Acting Insulin Aspart in People with Diabetes
In participants with T1D and T2D, treatment differences (for change in HbA1c and overall hypoglycaemia) between mealtime faster aspart and insulin comparators were similar to the corresponding overall analysis across baseline HbA1c and BMI subgroups. The finding of a lower total daily insulin dose in participants with obesity (BMI > 30 kg/m2) and T1D treated with faster aspart, versus those treated with IAsp, may warrant further investigation (Diabetes Therapy)
Effects of intensive interventions compared to standard care in people with type 2 diabetes and microalbuminuria on risk factors control and cardiovascular outcomes
Apart from blood pressure outcomes, there was no evidence that intensive interventions improve or worsen HbA1c, total cholesterol, LDL, triglycerides, urinary albumin excretion rate, risk of cardiovascular or mortality outcomes in people with type 2 diabetes and microalbuminuria. Results of this review are mainly influenced by one small trial, hence uncertainty surrounding the effect of intensive interventions in people with type 2 diabetes and microalbuminuria still exists. Large studies are urgently required in this high risk cardiovascular group of patients (Diabetes Research and Clinical Practice)
Commencing insulin glargine 100 U/mL therapy in people with type 2 diabetes: Determinants of achievement of HbA1c goal <7.0%
Baseline HbA1c was the strongest determinant for achieving target HbA1c <7.0% by supplementary Gla‐100 therapy while sex and BMI were also useful indicators. However, age and C‐peptide levels at baseline did not predict glycaemic response to the introduction of basal insulin (Diabetes, Obesity and Metabolism)
Sliding scale insulin for non‐critically ill hospitalised adults with diabetes mellitus
Based on low‐ to very low‐certainty evidence, our results for non‐critically ill hospitalised adults with diabetes mellitus in the medical and surgical in‐hospital setting showed that a basal‐bolus insulin strategy that applied higher total daily doses of insulin than the sliding scale insulin regimen might result in better short‐term glycaemic control but might also cause an increase in severe hypoglycaemic episodes (Cochrane Systematic Review)
Fasting Plasma Glucose Indicates Reversibility of the Acute Insulin Response after Short-Term Intensive Insulin Therapy in Patients with Various Duration of Type 2 Diabetes
We concluded that recovery of the AIR could be obtained in T2DM patients of varying disease duration by short-term intensive insulin therapy and it could be conveniently estimated using posttreatment fasting plasma glucose and other fasting indicators (Journal of Diabetes Research)
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