Diabetes News

Treatment quality indicators measuring lipid- and albuminuria-lowering treatment status are valid quality measures, since they predict a lower risk of cardiovascular events and mortality in patients with diabetes. The quality indicators for glucose-lowering treatment should only be used for restricted populations with elevated HbA1c levels. Intriguingly, the tested indicators for blood pressure-lowering treatment did not predict patient outcomes (PLoS ONE)

Prediabetes and newly diagnosed diabetes are highly prevalent in patients with a TIA or stroke. The majority of these patients would not have been identified by fasting plasma glucose levels alone. Both 2-hour postload glucose and glycosylated hemoglobin levels identify more patients with a disturbed glucose metabolism (Cerebrovascular Diseases)

Accelerated up-titration of RAS antagonists and beta-blockers to maximum tolerated dosages is an effective and safe intervention for the primary prevention of cardiac events for diabetic patients pre-selected using NT-proBNP (American Journal of Cardiology)

Researchers have identified for the first time a biological pathway that is activated when blood sugar levels are abnormally high and causes irregular heartbeats, a condition known as cardiac arrhythmia that is linked with heart failure and sudden cardiac death (UC Davis Health System)

Emerging data suggest that there is an impact of hypoglycaemia on CV function and mechanistic link is multifactorial. Further research will be needed to ascertain the full impact of hypoglycaemia on the CV system and its complications (Cardiovascular Diabetology)

These results suggest that beneficial effects of fluvastatin on diabetic cardiomyopathy might result, at least in part, from improving coronary microvasculature through reduction in myocardial oxidative stress and upregulation of angiogenic factor (Heart and Vessels)

Circulating GLP-1 was found to be positivity associated with coronary atherosclerosis in humans. The clinical relevance of this observation needs further investigation (Cardiovascular Diabetology)

Our results indicate that glycemic memory causes irreversible changes in stiffness of endothelial cells. The formation of the observed “stiffness memory” could be important in the context of vascular complications which develop despite the normalization of the glucose level (Cardiovascular Diabetology)

An intensive lifestyle intervention focusing on weight loss did not reduce the rate of cardiovascular events in overweight or obese adults with type 2 diabetes (NEJM)

The results demonstrated an independent association between ba-PWV and hs-TNI in patients with T2DM with no clinical evidence of macrovascular disease. These findings suggest that increased arterial stiffness is closely related to subclinical myocardial injury in patients with T2DM (Cardiovascular Diabetology)

Fasting insulin was positively associated with adverse echocardiographic features and risk of subsequent HF in Cardiovascular Health Study participants, including those without an antecedent myocardial infarction (Circulation: Heart Failure)

2013 has seen the publication of two meta-analyses which examine the link between sulphonylurea use and cardiovascular outcomes. They reported an increase in both cardiovascular and all-cause mortality with sulphonylurea therapy. So what are clinicians meant to make of these data?

The diabetes medication vildagliptin may be beneficial in patients with type 2 diabetes and heart failure, but its cardiovascular safety is uncertain, a placebo-controlled trial showed (Medpage)

In older patients with myocardial infarction, we found intensive-dose statin therapy to be effective in reducing repeat hospitalization for acute coronary syndrome. The rate of new-onset diabetes mellitus at long term was not significantly different between intensive-dose and moderate-dose statins (Circulation: Cardiovascular Quality and Outcomes)

In people with type 2 diabetes, a coronary artery calcium score of 10 or greater predicts all cause mortality or cardiovascular events, or both, and cardiovascular events alone, with high sensitivity but low specificity (BMJ)

Here, we review both basic and clinical studies on diabetic cardiomyopathy and summarize problems remaining to be solved for improving management of this type of cardiomyopathy (Heart Failure Reviews)

Whilst the interplay between type 2 diabetes and cardiovascular disease (CVD) has been recognised for many years, recent analyses of existing studies have helped refine several aspects of this relationship with relevance to clinical practice (Diabetologia)

Among patients with diabetes and chronic angina despite treatment with up to 2 agents, ranolazine reduced angina and sublingual nitroglycerin use and was well tolerated (Journal of the American College of Cardiology)

Our results lend support to the recent American Diabetes Association/ European Association for the Study of Diabetes position statement that emphasizes the importance of additional factors, including the propensity for hypoglycaemia, which should influence HbA1c targets and treatment choices for individual patients (Diabetic Medicine)

Improved glycemic control based on glycated albumin (GA) and plasma glucose predicted CV-related hospitalizations; GA also predicted CV hospitalization length of stay. HbA1c did not predict cause-specific hospitalizations in dialysis populations (American Journal of Nephrology)