We here present the updated 2019 guidelines on diagnosis, prognosis, and management of PAD in patients with a foot ulcer and diabetes, and we suggest some key future topics of particular research interest (Diabetes/Metabolism Research and Reviews)
Diabetes News
Category: Diagnosis
Immunological and clinical characteristics of latent autoimmune diabetes in the elderly
Autoantibodies GADA and Znt8A may be useful markers in identifying a subgroup of older patients with a clinical presentation of diabetes which could be characterized as latent autoimmune diabetes in the elderly (Diabetes/Metabolism Research and Reviews)
Type 1 diabetes defined by severe insulin deficiency occurs after 30 years of age and is commonly treated as type 2 diabetes
Type 1 diabetes diagnosed over 30 years of age, defined by severe insulin deficiency, has similar clinical and biological characteristics to that occurring at younger ages, but is frequently not identified. Clinicians should be aware that patients progressing to insulin within 3 years of diagnosis have a high likelihood of type 1 diabetes, regardless of initial diagnosis (Diabetologia)
Stratification of type 2 diabetes based on routine clinical markers
Patients with type 2 diabetes cluster into clinically relevant sub-groups based on routine clinical markers. The prevalence of diabetes complications seems to be sub-group specific. Our data suggests the need for a tailored strategy for the treatment of type 2 diabetes (Diabetes Research and Clinical Practice)
Opportunities for earlier diagnosis of type 1 diabetes in children: A case-control study using routinely collected primary care records
There may be opportunities to reduce time to diagnosis for up to one third of cases, by up to two weeks. Diagnostic opportunities might be maximised by measures that improve access to primary care, and public awareness of T1DM (Primary Care Diabetes)
Autoimmune Aspects of Type 2 Diabetes Mellitus – A Mini-Review
The identification of autoantibodies in elderly patients with slowly progressive manifestation of diabetes led to the introduction of a distinct clinical entity termed latent autoimmune diabetes of the adult (LADA), which combines features of both T1DM and T2DM (Gerontology)
‘Looking for the needle in the haystack’: a qualitative study of the pathway to diagnosis of T1D in children
This study highlights the difficulties for parents and GPs in recognising the early symptoms of T1D. It suggests that future interventions should be targeted at parents in the appraisal interval and include the importance of timely presentation to a healthcare professional and the differences between types 1 and 2 diabetes (BMJ Open)
Systematic review of predictive risk models for diabetes complications
Our analysis of the literature led us to the conclusion that researchers and medical practitioners should take in account that some limitations undermine the applicability of risk assessment models; for example, it is hard to judge whether results obtained on a specific cohort can be effectively translated to other populations (Journal of Diabetes and Its Complications)
Evidence strong enough to change the diagnosis gestational diabetes?
By using these criteria about 18% of pregnant women will be diagnosed as having gestational diabetes mellitus. The question arises if we are ready for such an enormous increase in gestational diabetes mellitus patients, if outcome would really improve by using these criteria, and if additional studies are necessary before deciding on new diagnostic thresholds. In this clinical opinion, the pros and cons will be discussed (American Journal of Obstetrics & Gynecology)
HbA1c Categories & ß-Cell Function Relative to Insulin Sensitivity in Obesity
Overweight/obese adolescents with HbA1c in the at-risk/prediabetes category demonstrate impaired ß-cell function relative to insulin sensitivity, a metabolic marker for heightened risk of type 2 diabetes. Thus, HbA1c may be a suitable screening tool in large-scale epidemiological observational and/or interventional studies examining the progression or reversal of type 2 diabetes risk (Diabetes Care)
New Diabetes Diagnostic Threshold of Hemoglobin A1c and the 3-Year Incidence of Retinopathy
Our longitudinal results support the validity of the new hemoglobin A1c threshold of 6.5% or higher for diagnosing diabetes (Diabetes)
Alternative Markers of Hyperglycemia and Risk of Diabetes
Fructosamine, glycated albumin, and 1,5-AG were associated with the subsequent development of diabetes independently of baseline A1C and fasting glucose. Our results suggest these alternative biomarkers may be useful in identifying persons at risk for diabetes (Diabetes Care)
Skin Intrinsic Fluorescence Is Associated With Coronary Artery Disease in Individuals With Long Duration of Type 1 Diabetes
SIF has a significant cross-sectional association with CAD. This association is strongly linked to age and duration and, to a lesser degree, to mean A1C and renal disease. SIF therefore may be a useful overall marker of CAD risk in type 1 diabetes (Diabetes Care)
A discovery-phase urine proteomics investigation in type 1 diabetes
This study gives new insights on potential molecular mechanisms associated with the complications of type 1 diabetic disease providing evidences of urine proteins potentially exploitable as putative prognostic biomarkers (Acta Diabetologica)
A Pilot Trial Assessing Urinary Gene Expression Profiling with an mRNA Array for Diabetic Nephropathy
Our pilot study demonstrated that mRNA array might serve as a high-throughput and sensitive tool for detecting mRNA expression in urinary sediment. Thus, this primary study indicated that mRNA array probably could be a useful tool for searching new biomarkers for DN (PLoS ONE)
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