In the present cohort of older people with Type 2 diabetes prescribed sulfonylurea or insulin therapies, overtreatment was common, even in the presence of comorbidities known to increase hypoglycaemia risk (Diabetic Medicine)
Diabetes News
Category: Treatment
Continuous subcutaneous insulin infusion (CSII) therapy at Derby Teaching Hospitals: sustained benefits in glucose control
CSII therapy led to a sustained long-term improvement in glycaemic control in addition to a reduction in self-reported hypoglycaemia (Diabetic Medicine)
Treatment of Diabetic Ketoacidosis (DKA)/Hyperglycemic Hyperosmolar State (HHS): Novel Advances in the Management of Hyperglycemic Crises (UK Versus USA)
There is considerable overlap but important differences between the UK and USA guidelines for the management of DKA and HHS. Further research needs to be done to delineate a unifying diagnostic and treatment protocol (Current Diabetes Reports)
Faster insulin action is associated with improved glycemic outcomes during closed-loop insulin delivery and sensor-augmented pump therapy in adults with type 1 diabetes
Faster insulin action is associated with improved glycemic control during closed-loop insulin delivery and sensor-augmented pump therapy (Diabetes, Obesity and Metabolism)
Are the results from the 2014 UK national survey on the management of diabetic ketoacidosis applicable to individual centres?
The data from the national DKA survey, even though based on a maximum of 5 people per hospital from across the UK are applicable at a hospital level (Diabetes Research and Clinical Practice)
CCBYNC Open access Research Supporting insulin initiation in type 2 diabetes in primary care: results of the Stepping Up pragmatic cluster randomised controlled clinical trial
The Stepping Up model of care was associated with increased insulin initiation rates in primary care, and improvements in glycated haemoglobin without worsening emotional wellbeing (BMJ)
Is all hypoglycaemia treated as equal? An observational study of how the type of diabetes and treatment prescribed prior to admission influences quality of treatment of inpatient hypoglycaemia
This analysis suggests that quality of care of hypoglycaemia varies according to diagnosis and medication. The group with the highest TTR (T2DM sulphonylurea treated) are possibly the clinical group in whom hypoglycaemia is most concerning. These data therefore suggest a need for education and raising awareness within the inpatient nursing staff (Acta Diabetologica)
3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes
Liraglutide 3·0 mg might provide health benefits in terms of reduced risk of diabetes in individuals with obesity and prediabetes (The Lancet)
Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus: A Clinical Practice Guideline Update From the American College of Physicians
The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on oral pharmacologic treatment of type 2 diabetes in adults. This guideline serves as an update to the 2012 ACP guideline on the same topic. This guideline is endorsed by the American Academy of Family Physicians (Annals of Internal Medicine)
A real-world study of treatment patterns and outcomes in US managed-care patients with type 2 Diabetes initiating injectable therapies
There were clinically relevant baseline differences in both groups, suggesting that GLA and LIRA are prescribed for different patient groups, and highlighting that efficacy results from clinical trials do not always translate into real-world practice. Significant increases in healthcare costs were observed in the LIRA group, warranting further cost-effectiveness analysis (Diabetes, Obesity and Metabolism)
Predictors of insulin uptake among adults with type 2 diabetes in the Stepping Up Study
Controlling for randomisation, 12-month insulin use was predicted by higher baseline HbA1c and ‘willingness’ to use insulin if recommended. Negative insulin appraisals reduced following insulin initiation (Diabetes Research and Clinical Practice)
Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus
A Clinical Practice Guideline Update From the American College of Physicians (Annals of Internal Medicine)
GAD vaccine reduces insulin loss in recently diagnosed type 1 diabetes: findings from a Bayesian meta-analysis
The biological effect of this vaccination should be developed further in order to reach clinically desirable reductions in insulin loss in patients recently diagnosed with type 1 diabetes (Diabetologia)
Home use of a bihormonal bionic pancreas versus insulin pump therapy in adults with type 1 diabetes: a multicentre randomised crossover trial
Relative to conventional and sensor-augmented insulin pump therapy, the bihormonal bionic pancreas, initialised only with participant weight, was able to achieve superior glycaemic regulation without the need for carbohydrate counting. Larger and longer studies are needed to establish the long-term benefits and risks of automated glycaemic management with a bihormonal bionic pancreas (Lancet)
Exploring the characteristics of suboptimally controlled patients after 24 weeks of basal insulin treatment: an individualized approach to intensification
Baseline characteristics related to severity of disease were strongly associated with suboptimal glycemic control in patients with T2DM receiving basal insulin. These factors may help clinicians in identifying patients who may require an individualized approach to titration or intensification of treatment (Diabetes Research and Clinical Practice)
Lowest Glucose Variability and Hypoglycemia Are Observed With the Combination of a GLP-1 Receptor Agonist and Basal Insulin (VARIATION Study)
The lowest GV and lowest hypoglycemia were observed in patients using the combination of basal insulin with a GLP-1 RA, supporting the complementary glycemic action of these agents in type 2 diabetes (Diabetes Care)
New Insulin Delivery Recommendations
New, practical, and comprehensive recommendations for diabetes injections and infusions (Mayo Clinic Proceedings)
Ambulatory glucose profile analysis of the juvenile diabetes research foundation continuous glucose monitoring dataset—Applications to the pediatric diabetes population
AGP analysis of the JDRF-CGM data highlights significant differences in glycemic profiles between pediatric and adult age groups and between well and less well-controlled patient populations (Pediatric Diabetes)
Closed-loop insulin delivery in inpatients with type 2 diabetes: a randomised, parallel-group trial
Closed-loop insulin delivery without meal-time boluses is effective and safe in insulin-treated adults with type 2 diabetes in the general ward (The Lancet Diabetes & Endocrinology)
Strategies for Diabetes Management: Using Newer Oral Combination Therapies Early in the Disease
Use of SPCs is an option for double or triple oral combination therapy and may result in better adherence (Diabetes Therapy)
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