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)
Diabetes News
Category: Treatment
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
Insulin/Glucagon-Like Peptide-1 Receptor Agonist Combination Therapy for the Treatment of Type 2 Diabetes: Are Two Agents Better Than One?
We consider the benefits and limitations of these medications based on data from randomized clinical trials and discuss how they may address barriers to treatment intensification (Clinical Diabetes)
Gender differences in the evaluation of care for patients with type 2 diabetes: a cross-sectional study (ZODIAC-52)
Only a few factors were found to be associated with patients’ evaluation of care for men and women with T2D. Taken together, these factors explained only a small part of the variance of the EUROPEP scores. This explained variance was largely attributable to the location where the questionnaire was completed (BMC Health Services Research)
Development and validation of a scoring system for prediction of insulin requirement for optimal control of blood glucose during glucocorticoid treatments
The scoring system is a valid and reliable tool to predict insulin requirements in advance during GC treatment (Diabetes Research and Clinical Practice)
Structured education using Dose Adjustment for Normal Eating (DAFNE) reduces long‐term HbA1c and HbA1c variability
The data confirm that DAFNE participation improves glycaemic control in Type 1 diabetes with benefits being sustained for 5 years. This study is the first to demonstrate reduced HbA1c variability after completion of structured education. This is new evidence of the beneficial impact of DAFNE on glycaemic profile (Diabetic Medicine)
Impact of drugs on hypoglycaemia in hospitalised patients
The relationship between hypoglycaemia and polypharmacy reinforces the advice to limit polymedication as much as possible, especially in elderly patients. This result underlines the potential involvement of clinical pharmacists with the aim to reduce the risk of hypoglycaemia during hospitalisation (BMJ)
Hemoglobin A1c Targets for Glycemic Control With Pharmacologic Therapy for Nonpregnant Adults With Type 2 Diabetes Mellitus
Guidance Statement Update From the American College of Physicians (Annals of Internal Medicine)
Insulin Matters: A Practical Approach to Basal Insulin Management in Type 2 Diabetes
This expert panel included general practitioners (GPs), nurses, nurse practitioners, endocrinologists, dieticians, pharmacists, and a psychologist. This article summarizes the panel recommendations (Diabetes Therapy)
Clinical Benefit of Basal Insulin Analogue Treatment in Persons with Type 2 Diabetes Inadequately Controlled on Prior Insulin Therapy
Introducing basal insulin analogues in persons with T2DM previously inadequately controlled on other insulin types can significantly improve glycemic control and reduce the risk of hypoglycemia, without adversely affecting body weight (Diabetes Therapy)
Diabetes in the Elderly
This review takes a practical approach to the assessment, nursing care, and medical treatment of diabetes in the elderly. It highlights major challenges and suggests solutions to these commonly encountered clinical problems (Diabetes Therapy)
Integrating diabetes evidence into practice
Challenges and opportunities to bridge the gaps (IDF)
Control of glycemia and blood pressure in British adults with diabetes mellitus and subsequent therapy choices: a comparison across health states
Glycemic and hypertensive control exhibited statistically significant but small magnitude differences across frailty states. Medication deintensification was uncommon, even in frail patients below SBP and HbA1C targets. SBP levels were more likely to be outside recommended treatment ranges than glycemic levels (Cardiovascular Diabetology)
Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study
These results demonstrate that a novel metabolic and continuous remote care model can support adults with T2D to safely improve HbA1c, weight, and other biomarkers while reducing diabetes medication use (Diabetes Therapy)
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