Diabetes News January 20th 2012

Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin (Review)
From this review, we conclude that when diabetes duration is over one year, the overall effect of self-monitoring of blood glucose on glycaemic control in patients with type 2 diabetes who are not using insulin is small up to six months after initiation and subsides after 12 months (Cochrane Collaboration)

Establishing an evidence base for frequency of monitoring glycated haemoglobin levels in patients with Type 2 diabetes: projections of effectiveness from a regression model
In patients with initial HbA1c close to treatment goal, retesting at 6 months would yield more true-positive than false-positive tests. For patients with lower initial HbA1c, retesting at 6 months would yield more false than true-positive tests. In all patients, retesting at 12 months yields more true than false-positive tests. In very few patients would retesting at 3 months be justified (Diabetic Medicine)

Exposure to Gestational Diabetes Mellitus and Low Socioeconomic Status
Maternal GDM and low SES, especially in combination, heighten the risk for childhood ADHD. Long-term prevention efforts should be directed at mothers with GDM to avoid suboptimal neurobehavioral development and mitigate the risk for ADHD among their offspring (Archives of Pediatrics & Adolescent Medicine)

The development and validation of a clinical prediction model to determine the probability of MODY in patients with young-onset diabetes
We have developed clinical prediction models that calculate an individual’s probability of having MODY. This allows an improved and more rational approach to determine who should have molecular genetic testing (Diabetologia)

Novel Urinary Protein Biomarkers Predicting the Development of Microalbuminuria and Renal Function Decline in Type 1 Diabetes
A panel of four novel protein biomarkers predicted early renal damage in type 1 diabetes. These findings require further validation in other populations for prediction of renal complications and treatment monitoring (Diabetes Care)

Surgical and visual outcome following 20-gauge vitrectomy in proliferative diabetic retinopathy over a 10-year period, evidence for change in practice
Outcomes from vitreoretinal surgery for complications of diabetic retinopathy have improved. In addition, the visual outcome after diabetic vitrectomy steadily improved over the 10-year period, which may in part be due to the move to operate on patients with better vision (Eye – Nature Publishing Group)

Statins: risk of hyperglycaemia and diabetes
Statin use may be associated with a level of hyperglycaemia in some patients where formal diabetes care is appropriate. The risk appears to be mainly in patients already at increased risk of developing diabetes (MHRA)

Proton Pump Inhibitor Therapy Associated with Lower Glycosylated Hemoglobin Levels in Type 2 Diabetes
The observed association between PPI therapy and lower HbA1c levels suggests that PPIs may be useful as adjunctive therapy for type 2 diabetes (Journal of the American Board of Family Medicine)

Demonstration of islet-autoreactive CD8 T cells in insulitic lesions from recent onset and long-term type 1 diabetes patients
Our observations provide the first direct proof for islet autoreactivity within human islets and underscore the heterogeneous and chronic disease course (Journal of Experimental Medicine)

‘Killer cells’ and diabetes
Killer T-cells in the human body which help protect us from disease can inadvertently destroy cells that produce insulin, new University research has uncovered (Cardiff University)

NICE gives green light to prolonged-release exenatide for type 2 diabetes in final draft guidance
In final draft guidance NICE, has confirmed its initial draft recommendation of prolonged release exenatide (Bydureon, Eli Lilly) in triple therapy regimens (in combination with metformin and a sulphonylurea, or metformin and a thiazolidinedionei) as a treatment option for people with type 2 diabetes (NICE)

BMS and AZ Receive Complete Response Letter from U.S. Food and Drug Administration for Dapagliflozin
The complete response letter requests additional clinical data to allow a better assessment of the benefit-risk profile for dapagliflozin. This includes clinical trial data from ongoing studies and may require information from new clinical trials (Bristol-Myers Squibb)