This synopsis focuses on selected guidance relating to use of diabetes technology in adults with diabetes. Recommendations address self-monitoring of blood glucose, continuous glucose monitors, and automated insulin delivery systems (Annals of Internal Medicine)
Diabetes News
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Longitudinal evaluation of gastric emptying in type 2 diabetes
In patients with long-term type 2 diabetes, gastric emptying of solids and liquids does not usually become more delayed over time, and abnormally slow gastric emptying of solids may improve (Diabetes Research and Clinical Practice)
What Next After Metformin? Thinking Beyond Glycaemia: Are SGLT2 Inhibitors the Answer?
There is growing evidence to illustrate the overall safety profile of this class of agents and support the benefit–risk profile of SGLT2 inhibitors as a preferred option following metformin monotherapy failure, with respect to both kidney disease progression and heart failure outcomes (Diabetes Therapy)
Association between blood pressure variability, cardiovascular disease and mortality in type 2 diabetes
Our results suggest that BPV might provide additional information rather than mean blood pressure on the risk of cardiovascular disease in patients with type 2 diabetes (Diabetes, Obesity and Metabolism)
Liraglutide in Children and Adolescents with Type 2 Diabetes
In children and adolescents with type 2 diabetes, liraglutide, at a dose of up to 1.8 mg per day (added to metformin, with or without basal insulin), was efficacious in improving glycemic control over 52 weeks. This efficacy came at the cost of an increased frequency of gastrointestinal adverse events (NEJM)
Traveling down the Long Road to Type 1 Diabetes Mellitus Prevention
Investigative efforts have centered on prevention, aiming to either delay or prevent disease onset. However, that requires the elucidation of the relevant pathophysiological mechanisms that lead to the pancreatic beta-cell destruction thought to be the root cause of type 1 diabetes (NEJM)
Angiopoietins in Diabetic Retinopathy: Current Understanding and Therapeutic Potential
The function of the Ang proteins in regulating blood vessel permeability and neovascularisation is discussed, and we also evaluate recent preclinical and clinical studies highlighting the potential benefits of modulating Ang signalling as a treatment for DR (Journal of Diabetes Research)
Oxidative Stress as the Main Target in Diabetic Retinopathy Pathophysiology
In this review, we propose oxidative stress as the focus point of this complication onset (Journal of Diabetes Research)
Commissioning Standard: Dental Care for People with Diabetes
This commissioning standard document supports commissioners in NHS England and NHS Improvement with the implementation of a standardised framework for the local commissioning of dental services for people with diabetes (type 1 and type 2) and people with non-diabetic hyperglycaemia (NDH)
Impact of angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers on renal and mortality outcomes in people with Type 2 diabetes and proteinuria
Angiotensin‐converting enzyme inhibitors and angiotensin receptor blockers may reduce the risk of end‐stage renal disease and slow the progression of nephropathy, but they do not appear to decrease all‐cause or cardiovascular mortality in people with Type 2 diabetes and proteinuria (Diabetic Medicine)
Distinct trajectories of HbA1c in newly diagnosed Type 2 diabetes from the DPV registry using a longitudinal group‐based modelling approach
Four subgroups with distinct HbA1c trajectories were determined in newly diagnosed Type 2 diabetes using a group‐based modelling approach. Approximately one‐third of people with newly diagnosed Type 2 diabetes need either better medication adherence or earlier intensification of glucose‐lowering therapy (Diabetic Medicine)
National Diabetes Audit – Insulin Pump Report 2017-18
This report provides information on people with Type 1 diabetes on an insulin pump at National, Local Health Board (LHB), and Specialist Diabetes Service level for the audit period 2017-18 (NHS Digital)
Metformin Use and Clinical Outcomes among Patients with Diabetes with or without Heart Failure or Kidney Dysfunction
In a cohort of 12,156 patients with T2DM and high CV risk, metformin use was associated with lower rates of all-cause mortality, including after adjustment for clinical variables and biomarkers, but not lower rates of the composite endpoint of CV death, MI, or ischemic stroke (Circulation)
Clinical Implications of Urinary C-Peptide Creatinine Ratio in Patients with Different Types of Diabetes
UCPCR is a practical and noninvasive marker that can distinguish between TIDM and T2DM or monogenic diabetes. reflects severe impaired beta cell function and the need for insulin or secretagogue therapy in T2DM patients (Journal of Diabetes Research)
Class effects of SGLT2 inhibitors on cardiorenal outcomes
Dapagliflozin, empagliflozin, and canagliflozin have internally and externally consistent and biologically plausible class effects on cardiorenal outcomes. Baseline renal filtration function and degree of albuminuria are the most significant indicators of risk for both CV and renal events. Thus, these two factors also anticipate the greatest clinical benefit for SGLT2i (Cardiovascular Diabetology)
Dapagliflozin vs Non‐SGLT‐2i Treatment is Associated with Lower Hospital Care Costs in Type 2 Diabetes Patients Similar to the DECLARE‐TIMI 58 Participants
In a nationwide, real‐world, DECLARE‐like population, dapagliflozin was associated with lower hospital costs compared with oGLD, mainly as a result of reduced rates of CV‐ and T2D‐associated complications (Diabetes, Obesity and Metabolism)
Public Health Approaches to Type 2 Diabetes Prevention: the US National Diabetes Prevention Program and Beyond
Successful type 2 diabetes prevention strategies are being realized in the USA through the National Diabetes Prevention Program and elsewhere in the world. A multi-tiered approach involving appropriate risk targeting and whole-population efforts is essential to curb the global diabetes epidemic (Current Diabetes Reports)
Changes in behaviors after diagnosis of type 2 diabetes and 10-year incidence of cardiovascular disease and mortality
In the year following diabetes diagnosis, small reductions in alcohol use were associated with lower hazard of CVD and small reductions in calorie intake were associated with lower hazard of all-cause mortality in a population-based sample (Cardiovascular Diabetology)
Standards of Medical Care in Diabetes—2019
Table of Contents (Diabetes Care)
The future is now: SGLT2 inhibitors and type 1 diabetes – what about exercise?
This novel drug class, which has received wide attention in its glucose-lowering and cardiovascular-protective properties in the management of type 2 diabetes, also bears potential for individuals with T1D who are struggling with achieving glycaemic targets
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