These results suggest that HbA1c values may be potentially useful not only to indicate long-term glycemic control to indicate onset of complications at a clinically detectable level and molecular level (Diabetes Research and Clinical Practice)
Archives for May 2014
These results show that a stimulated C-peptide response can be measured in some people with long-term Type 1 diabetes (Diabetic Medicine)
Behavioural interventions that deal with both diet and physical activity show small but significant benefits on weight loss maintenance (British Medical Journal)
Reviewed by Dr Harry Brown
Chantal Simon, Hazel Everitt, Francoise van Dorp and Matt Burkes
4th Edition published 2014
I was once speaking to a non medical healthcare professional who said that he felt sorry for GPs (yes it does happen sometimes!) as it can sometimes be a lonely job when there is so much to know and do. Of course we can’t know it all, even if you have loads of experience and sometimes it is good to ask someone else. In addition, you can also look up the Oxford Handbook of General Practice which covers an amazing breadth of relevant topics.
CAN was independently associated with CKD, albuminuria and eGFR in patients with type 2 diabetes. In addition, CAN was an independent predictor of the decline in eGFR over the follow-up period (Diabetologia)
Kajimoto T. Sawamura M. et al. Diabetology & Metabolic Syndrome. Doi: 10.1186/1758-5996-6-51
This is not an easy paper to follow but it attempts to achieve something very useful; trying to predict cardiovascular risk in people with known diabetes. Using information from a combination of physical tests and laboratory investigations, the risk of ischaemic heart disease can be ascertained. Of course we are looking for people at high risk who need intervention to try and reduce the risk of ischaemic heart disease. The battery of tests deployed were not too expensive and generally fairly standard. The statistics in this paper are hard to understand and I would suspect that any conclusions generated would have to be confirmed in much larger trials. There were only 337 patients enrolled in this study but it was over a five year period. Diabetic patients who are routinely followed up, generate a lot of data-this study attempts to use this kind of information to produce a hard outcome. The holy grail of finding high risk ischaemic heart disease patients in a diabetic population using a proven method is certainly worth working towards.
African-Americans have an increased risk of developing type 2 diabetes and are less likely to achieve glycemic targets due to genetic and environmental factors, yet they are underrepresented in clinical trials … The findings from this retrospective pooled data analysis help support the efficacy and safety profile of linagliptin as a treatment option for African-American adults with type 2 diabetes (Lilly)
Reviewed by Jim Young
Editors: Leonid Poretsky, Emilia Pauline Liao.
Consulting editor: Derek LeRoith
Published by Elsevier
This is the December 2013 edition in a series of quarterly publications by the Endocrinology and Metabolism Clinics of North America.
A concise, well structured and extensively referenced compilation of 13 reviews around the theme of acute and chronic complications of diabetes, it offers a collection of succinct discourses that will enthral during the three months between this and the next publication.
Saxagliptin reverses PACs dysfunction associated with T2D in vitro and improves inducible angiogenesis by circulating cells in vivo. These data add knowledge to the potential pleiotropic cardiovascular effects of DPP-4 inhibition (Cardiovascular Diabetology)
Atherogenic dyslipidemia was more closely associated with the development of T2D than fasting glucose or glycated hemoglobin in subjects with NGT (Acta Diabetologica)
In generally healthy adults, greater IR is associated with alterations in WM tissue integrity. These cross-sectional findings suggest that IR contributes to WM microstructural alterations in middle-aged and older adults (Neurology)
Intensified insulin-based glycaemic control after acute myocardial infarction in patients with diabetes and hyperglycaemia at admission had a long-lasting effect on longevity (The Lancet Diabetes & Endocrinology)
Eli Lilly today announced positive top-line results of three completed Phase III clinical trials in patients with type 2 diabetes for basal insulin peglispro (BIL), which is being studied as a once-daily treatment for both type 1 and type 2 diabetes (Lilly)
A new project has been launched to assess the awareness, treatment and implications of diabetic retinopathy globally. Results are intended to inform decision-making and policy development around this common and serious complication of diabetes (International Diabetes Federation )
Appropriate use of REAL-Time CGM improved glyco-metabolic control in T1D patients. The effects of CGM were more evident in patients under MDI treatment, compared to CSII. Glucose variability, in addition to glycaemic control, was improved in compliant diabetic patients. This article is protected by copyright (Diabetes/Metabolism Research and Reviews)
IDegAsp BID effectively improves HbA1c and fasting PG levels with fewer hypoglycemia episodes versus BIAsp 30 in patients with uncontrolled type 2 diabetes previously treated with once- or twice-daily pre- or self-mixed insulin (Diabetes Care)
This article examines the foundation of ß-cell failure in type 2 diabetes (T2D) and suggests areas for future research on the underlying mechanisms that may lead to improved prevention and treatment (Diabetes Care)
Our review suggests that the treatment of chronic complications should focus on erasing metabolic memory by targeting chromatin modification enzymes and by restoring miRNA levels (Diabetes Research and Clinical Practice)
The GDN project has proved an effective, innovative means of disseminating new genetic information from a centre of excellence and is suggested as a model for the successful and rapid dissemination of genetic information into routine clinical care in other conditions (Royal College of Physicians)
Su DF, Wang XY. Diabetes Research and Clinical Practice. Doi:10.1016/j.diabres.2013.12.056
Despite being around for more than 50 years, papers continue to be published extolling the benefits of Metformin in ever widening numbers of patients. Despite being widely used in gestational diabetes and pregnant Type 2 diabetes patients, it is still reassuring to have its safety reinforced in this systematic review. This looked at six randomized control trials involving 1420 patients from four databases. The data (acknowledged as limited by the authors due to small patient numbers) suggested that compared to insulin, using Metformin in subjects with gestational diabetes did not significantly increase adverse maternal and neonatal outcomes. Patients gained less weight and neonatal hypoglycemia was reduced. However, there was a small increase in premature birth. Perhaps the reassurance given by papers such as this and others may allow removal of the often unhelpful caveat ‘if the likely benefits from improved glycaemic control outweigh the potential for harm’ found in current NICE guidance’.