In type 2 diabetics, IGC was associated with a reduction in the risk for LEA. After 3.7 years of IGC there was an enduring protective effect against LEA. Improved glycemic control was a strong predictor of decreased risk for subsequent LEA. This study suggests that tight glycemic control, even over a short time period, has potential to reduce risk of limb loss (Journal of the American College of Surgeons)
Diabetes News
Category: Treatment
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 (Diabetes Research and Clinical Practice)
Closed-loop insulin delivery in suboptimally controlled type 1 diabetes: a multicentre, 12-week randomised trial
Hybrid closed-loop insulin delivery improves glucose control while reducing the risk of hypoglycaemia across a wide age range in patients with suboptimally controlled type 1 diabetes (The Lancet)
Artificial Pancreas or Novel Beta-Cell Replacement Therapies: a Race for Optimal Glycemic Control?
Closed loop insulin delivery devices are promising treatment strategies and are likely to be used in clinical practice in the short term. But this approach will always suffer from delays in glucose measurement and insulin action preventing it from normalizing glycemic control. In the long term, stem cell-derived beta cell transplantation may be able to achieve this, but wide implementation in clinical practice is still far away (Current Diabetes Reports)
Recent Advances in the Development of Vaccines for Diabetes, Hypertension, and Atherosclerosis
Metabolic diseases are becoming the first noticeable disorder which threatens the health and longevity of human. Vaccines are powerful tools in this battle if used properly (Journal of Diabetes Research)
Metabolic Control in Type 1 Diabetes: Is Adjunctive Therapy the Way Forward?
Restricting therapy for T1DM to insulin replacement is perhaps an over-simplistic approach, and we focus in this work on reviewing the role of adjuvant therapy in this population (Diabetes Therapy)
Time to Treatment Intensification After Monotherapy Failure and Its Association With Subsequent Glycemic Control Among 93,515 Patients With Type 2 Diabetes
Earlier treatment intensification is associated with shorter time to subsequent glycemic control, independent of whether patients initiate first-line treatment with metformin or a sulfonylurea (Diabetes Care)
The Legacy Effect in Type 2 Diabetes: Impact of Early Glycemic Control on Future Complications (the Diabetes & Aging Study)
Among patients with newly diagnosed diabetes and 10 years of survival, HbA1c levels ≥6.5% (≥48 mmol/mol) for the 1st year after diagnosis were associated with worse outcomes. Immediate, intensive treatment for newly diagnosed patients may be necessary to avoid irremediable long-term risk for diabetic complications and mortality (Diabetes Care)
Real‐World outcomes of insulin pump compared to injection therapy in a population based sample of children with type 1 diabetes
Patients using insulin pump therapy had a better long‐term glycemic control relative to the matched injection therapy cohort. Large population‐based cohort studies using real‐world data provide a valuable perspective on evaluation of new technologies in children with T1D (Pediatric Diabetes)
Closed-Loop Insulin Delivery for Glycemic Control in Noncritical Care
Among inpatients with type 2 diabetes receiving noncritical care, the use of an automated, closed-loop insulin-delivery system resulted in significantly better glycemic control than conventional subcutaneous insulin therapy, without a higher risk of hypoglycemia (NEJM)
Practical guidance for treatment of patients with diabetes using flash glucose monitoring: a pilot study
Recognition of the characteristic correlation patterns between SG and SMBG values is indispensable for certified diabetes educators to provide appropriate treatment guidance to patients with diabetes (Diabetology & Metabolic Syndrome)
Closed-Loop Insulin Delivery for Glycemic Control in Noncritical Care
Among inpatients with type 2 diabetes receiving noncritical care, the use of an automated, closed-loop insulin-delivery system resulted in significantly better glycemic control than conventional subcutaneous insulin therapy, without a higher risk of hypoglycemia (NEJM)
For Patients With Type 2 Diabetes, What’s the Best Target Hemoglobin A1C?
The ACP set its target higher than recommended by other prominent health groups. The American Diabetes Association (ADA) generally recommends an HbA1C goal of less than 7%, while the American Association of Clinical Endocrinologists (AACE) advises even tighter control of 6.5% or lower if it can be achieved safely (JAMA)
Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis
Neither the rate of administration nor the sodium chloride content of intravenous fluids significantly influenced neurologic outcomes in children with diabetic ketoacidosis (NEJM)
The relationship between intensification of blood glucose-lowering therapies, health status and quality of life in type 2 diabetes: The Fremantle Diabetes Study Phase II
These real-life data show that treatment intensification, including insulin initiation, does not impact adversely on patient well-being in community-based type 2 diabetes (Diabetes Research and Clinical Practice)
Islet transplantation versus insulin therapy in patients with type 1 diabetes with severe hypoglycaemia or poorly controlled glycaemia after kidney transplantation (TRIMECO)
For the indications assessed in this study, islet transplantation effectively improves metabolic outcomes. Although studies with longer-term follow-up are needed, islet transplantation seems to be a valid option for patients with severe, unstable type 1 diabetes who are not responding to intensive medical treatments. However, immunosuppression can affect kidney function, necessitating careful selection of patients (The Lancet Diabetes & Endocrinology)
Intralymphatic glutamic acid decarboxylase (GAD)-alum administration induced Th2-like specific immunomodulation in responder patients: a pilot clinical trial in type 1 diabetes
GAD-alum given into lymph nodes to Type 1 diabetes patients participating in an open-label pilot trial resulted in preservation of C-peptide similar to promising results from other trials (Journal of Diabetes Research)
Standards of Medical Care in Diabetes—2018
Diabetes Care Supplement
Artificial pancreas treatment for outpatients with type 1 diabetes: systematic review and meta-analysis
Artificial pancreas systems are an efficacious and safe approach for treating outpatients with type 1 diabetes. The main limitations of current research evidence on artificial pancreas systems are related to inconsistency in outcome reporting, small sample size, and short follow-up duration of individual trials (BMJ)
Hemoglobin A1c Targets for Glycemic Control With Pharmacologic Therapy for Nonpregnant Adults With Type 2 Diabetes Mellitus
A Guidance Statement Update From the American College of Physicians
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