Among adults with type 2 diabetes diagnosed for less than 10 years, a lifestyle intervention compared with standard care resulted in a change in glycemic control that did not reach the criterion for equivalence, but was in a direction consistent with benefit. Further research is needed to assess superiority, as well as generalizability and durability of findings )JAMA)
Diabetes News
Category: Treatment
Hypoglycemia After Initiation of Basal Insulin in Patients with Type 2 Diabetes in the United States: Implications for Treatment Discontinuation and Healthcare Costs and Utilization
US patients with T2D who experienced hypoglycemia within 6 months of basal insulin initiation were more likely to discontinue treatment, accompanied by a greater healthcare burden (Advances in Therapy)
What determines treatment satisfaction of patients with type 2 diabetes on insulin therapy? An observational study in eight European countries
A number of factors including diabetes education, perceived and actual hyperglycaemia and macrovascular complications are associated with treatment satisfaction. Self-management education programmes should incorporate these factors for ongoing support in patients with T2DM (BMJ Open)
Prescribing for Diabetes England 2006/07 to 2016/17
Prescribing for Diabetes reports on and examines prescribing trends on medicines prescribed in primary care in England for the treatment and monitoring of diabetes during the period April 2006 to March 2017 (NHS Digital)
Is It Time to Change the Type 2 Diabetes Treatment Paradigm? No!
Metformin Should Remain the Foundation Therapy for Type 2 Diabetes (Diabetes Care)
Is It Time to Change the Type 2 Diabetes Treatment Paradigm? Yes!
GLP-1 RAs Should Replace Metformin in the Type 2 Diabetes Algorithm (Diabetes Care)
Insulin pumps not much better than multiple injections for intensive control of type 1 diabetes
Simply increasing use of insulin pumps may increase resource costs without seeing improvements to diabetes control. If after training individuals still find blood glucose control challenging, they could be offered pump treatment in line with NICE guidance to see if this improves quality of life. (NIHR)
Overcoming clinical inertia in insulin initiation in primary care for patients with type 2 diabetes
Australian study – Stepping Up was associated with improved glycaemic control compared to usual care for 24 months, suggesting that the model facilitated more timely treatment intensification. Ongoing RN-CDE support may be needed to facilitate ongoing treatment intensification (Primary Care Diabetes)
Glycaemic outcomes of an Individualised treatMent aPproach for oldER vulnerable patIents: A randomised, controlled stUdy in type 2 diabetes Mellitus (IMPERIUM)
Similar proportions of older, vulnerable aged ≥65 years patients with type 2 diabetes achieved/maintained glycaemic treatment goals without clinically significant hypoglycaemia with Strategies A or B (Diabetes, Obesity and Metabolism)
Improvement in Glycemic Control of Type 2 Diabetes After Successful Treatment of Hepatitis C Virus
DAA-based eradication of HCV is associated with improved glycemic control in patients with diabetes as evidenced by decreased mean HbA1c and decreased insulin use. These endocrine benefits of SVR provide additional justification for considering antiviral treatment in all patients with diabetes (Diabetes Care)
NHS RightCare Pathway: Diabetes
NHS RightCare
Carbohydrate Counting at Meal Time Followed by a Small Secondary Postprandial Bolus Injection at 3 Hours Prevents Late Hyperglycemia, Without Hypoglycemia, After a High-Carbohydrate, High-Fat Meal in Type 1 Diabetes
When a meal has a high-carbohydrate and high-fat content using the carbohydrate counting method for insulin dose adjustments at mealtime and administering additional bolus insulin units 3 h later provide similar postprandial glucose control to a meal containing negligible fat, without causing hypoglycemia (Diabetes Care)
Very strict blood sugar control in critically ill children provides no benefit
Strict control of blood sugar levels for critically ill children in ICU with high blood sugar did not increase the number of days they spent outside of ICU in the first month (NIHR)
Older people with Type 2 diabetes, including those with chronic kidney disease or dementia, are commonly overtreated with sulfonylurea or insulin therapies
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)
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)
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