Diabetes News May 27th 2011

Evaluation of the User Involvement in Local Diabetes Care project
This two year project, which focussed on services for adults with diabetes, was funded by NHS Diabetes and led by Diabetes UK. Diabetes UK has developed an online practical resource Making Involvement Happen (Diabetes UK)

Insulin resistance and hypertension in patients with type 1 diabetes?
Hypertension was present in approximately one third of patients with type 1 diabetes, especially in men, those with microangiopathy, overweight or obesity, older age and longer diabetes duration. Hypertension prevalence increased in parallel to the degree of renal impairment and was inversely related to insulin sensitivity (Journal of Diabetes and Its Complications)

Increased Risk of Hypertension After Gestational Diabetes
These results indicate that women with GDM are at a significant increased risk of developing hypertension after the index pregnancy – Findings from a large prospective cohort study (Diabetes Care)

Glucose Absorption in Gestational Diabetes Mellitus During an Oral Glucose Tolerance Test
In GDMpreg, OGTT gut glucose absorption is markedly lower during hyperglycemia, whereas both glycemia and glucose absorption in NGTpreg are comparable between pregnant and postpartum states. Thus, hyperglycemia in GDM does not seem to result from too rapid or increased glucose absorption (Diabetes Care)

The metabolic syndrome influences the response to incretin-based therapies
The presence of MS appears to modify the response to incretin-based therapies. Given the non-randomized nature of this study, these data need to be replicated (Acta Diabetologica)

Diet, commensals and the intestine as sources of pathogen-associated molecular patterns in atherosclerosis, type 2 diabetes and non-alcoholic fatty liver disease
This review summarises the evidence supporting the proposal that ‘pathogen-associated molecular patterns’ (PAMPs) derived from dietary and commensal sources may contribute to the chronic inflammatory processes that underpin the development of these diseases via stimulation of TLR2 and TLR4 (Atherosclerosis)

Changes in Glucose Homeostasis after Roux-en-Y Gastric Bypass Surgery for Obesity at Day Three, Two Months, and One Year after Surgery: Role of Gut Peptides
Both enhanced insulin sensitivity and incretin hormones, such as GLP-1, contribute to the early control of glucose homeostasis. Progressively increasing postprandial levels of enteroglucagon (oxyntomodulin) and GLP-1 facilitate weight loss and enhance insulin effectiveness (Journal of Clinical Endocrinology & Metabolism)

Retinal Vascular Geometry Predicts Incident Retinopathy in Young People With Type 1 Diabetes
Lower arteriolar LDR and greater ST were independently associated with incident retinopathy in young people with type 1 diabetes. These vascular geometry measures may serve as risk markers for diabetic retinopathy and provide insights into the early structural changes in diabetic microvascular complications (Diabetes Care)

The effect of socioeconomic deprivation on efficacy of continuous subcutaneous insulin infusion: a retrospective paediatric case-controlled survey
Parental educational deprivation was associated with a failure of MDI but not CSII therapy. These outcomes need confirmation by larger studies (European Journal of Pediatrics)

The achievement of target cholesterol level differs between coronary heart disease and diabetic patients
The rate of reaching the LDL-C target level was higher among the CHD and CHD and DM patients than DM ones. The rate of reaching LDL-C target level should be increased in all high risk patients, mainly diabetic ones (European Journal of Internal Medicine)

Long-Term Outcome of Individuals Treated With Oral Insulin
Overall, oral insulin treatment effect in individuals with confirmed IAAs =80 nU/mL appeared to be maintained with additional follow-up; however, once therapy stopped, the rate of developing diabetes in the oral insulin group increased to a rate similar to that in the placebo group (Diabetes Care)

Insulin Detemir Reduces Weight Gain As a Result of Reduced Food Intake in Patients With Type 1 Diabetes
The reduced weight gain with insulin detemir compared with NPH insulin is attributed to reduced energy intake rather than increased energy expenditure. This may be mediated by a direct or indirect effect of insulin detemir on the hormones that control satiety (Diabetes Care)

Effect of Antihyperglycemic Agents Added to Metformin and a Sulfonylurea on Glycemic Control and Weight Gain in Type 2 Diabetes: A Network Meta-analysis
There is no clear difference in benefit between drug classes when adding a third agent to treatment of patients with type 2 diabetes who are already receiving metformin and a sulfonylurea. The most appropriate option should depend on each patient’s clinical characteristics (Annals of Internal Medicine)

Lilly Comments on Court Ruling in Amylin Litigation
Comments on a ruling issued by the U.S. District Court for the Southern District of California granting a request by Amylin Pharmaceuticals for a temporary restraining order related to litigation involving the two companies’ diabetes collaboration agreement (Lilly)