This short report details the top-level findings for the 2018-19 audit. The full report, scheduled for 2020, will contain full key findings, recommendations and results of new analyses into HbA1c check frequencies and blood glucose drug cohorts (NHS Digital)
Diabetes News
Glycosmedia is dedicated to bringing free, non-promotional, editorially independent news to a global audience about developments in diabetes, and is primarily aimed at health professionals.
Diabetes Prevention Programme 2018-19, Short Report
This report is for England only. Unlike the NDA, it does not include information on Wales (NHS Digital)
Three European Retrospective Real-World Chart Review Studies to Determine the Effectiveness of Flash Glucose Monitoring on HbA1c in Adults with Type 2 Diabetes
Three European real-world, chart review studies in people with type 2 diabetes managed using basal bolus insulin therapy each concluded that HbA1c was significantly reduced after changing to use of flash glucose monitoring for 3–6 months in a real-world setting (Diabetes Therapy)
Surgery for the diabetic foot: A key component of care
This brief overview from the Association for Diabetic Foot Surgeons describes common conditions best treated by surgical interventions, as well as specific indications (Diabetes/Metabolism Research and Reviews)
Metformin use and cardiovascular outcomes after acute myocardial infarction in patients with type 2 diabetes
Our study suggests that metformin use at the time of first AMI is associated with increased risk of cardiovascular disease and death in patients with T2DM, while its use post-AMI might be beneficial (Cardiovascular Diabetology)
Longitudinal changes in glucose metabolism in women with gestational diabetes, from late pregnancy to the postpartum period
In women with GDM, delivery was associated with improvement in both insulin sensitivity and insulin production within the first few days. Improvement in insulin production persisted for 6–12 weeks, but insulin sensitivity deteriorated slightly (Diabtologia)
The Utility of Lower Glycemic Targets for Treating Gestational Diabetes: A Retrospective Study
Lower glycemic targets did not produce large reductions in fetal overgrowth, but they were associated with a higher rate of inductions. As there were no observed differences in maternal or neonatal outcomes otherwise, aiming for lower glycemic targets in GDM is likely not cost-effective (Journal of Diabetes Research)
Fournier’s gangrene and sodium‐glucose co‐transporter‐2 inhibitors: A meta‐analysis of randomized controlled trials
Data from RCTs do not show an increased risk of FG among patients, unlike pharmacovigilance reports, but the number of recorded cases is small (Diabetes, Obesity and Metabolism)
Are the cardiovascular and kidney benefits of empagliflozin influenced by baseline glucose‐lowering therapy?
The addition of empagliflozin to anti‐hyperglycemic regimens of patients with type 2 diabetes and CV disease consistently reduced their risks of adverse CV outcomes and mortality irrespective of baseline use of metformin, sulfonylurea, or insulin. For CKD progression, there may be a larger benefit from empagliflozin in those patients who are not using metformin (Diabetes, Obesity and Metabolism)
Persistent whole day meal effects of three dipeptidyl peptidase‐4 inhibitors on glycemia and hormonal responses in metformin‐treated type 2 diabetes
DPP‐4 inhibition has persistent daytime effects on glucose, islet and incretin hormones with no difference between three different DPP‐4 inhibitors (Diabetes, Obesity and Metabolism)
Impact of chronic kidney disease definition on assessment of its incidence and risk factors in patients with newly diagnosed type 1 and type 2 diabetes in the UK
A cohort study using primary care data from the United Kingdom (Primary Care Diabetes)
Long-term effects of intensive multifactorial therapy in individuals with screen-detected type 2 diabetes in primary care: 10-year follow-up of the ADDITION-Europe cluster-randomised trial
Sustained reductions in glycaemia and related cardiovascular risk factors over 10 years among people with screen-detected diabetes managed in primary care are achievable. The differences in prescribed treatment and cardiovascular risk factors in the 5 years following diagnosis were not maintained at 10 years, and the difference in cardiovascular events and mortality remained non-significant (The Lancet Diabetes & Endocrinology)
Effectiveness of self‐management interventions in young adults with type 1 and 2 diabetes: a systematic review and meta‐analysis
Current self‐management interventions did not improve outcomes in young adults with diabetes. Our findings, which contrast with those from systematic reviews in older adults, highlight the need for the development of more effective interventions for young adults with diabetes (Diabetic Medicine)
The cross‐sectional association between diabetes and orthostatic hypotension in community‐dwelling older people
Over one‐fifth of older people with diabetes had orthostatic hypotension. Recovery of DBP is related to dynamic changes in total peripheral resistance and impairment of this baroreflex‐mediated response may explain the higher prevalence in diabetes (Diabetic Medicine)
The increased risk of microvascular complications in South Asians with type 1 diabetes is influenced by migration: results from the UK–India multi‐ethnic migration study
In this hypothesis‐generating study, we report that South Asian ethnicity is associated with greater risk of diabetic kidney disease and retinopathy, and lower risk of neuropathy than white European ethnicity (Diabetic Medicine)
A review of the NG17 recommendations for the use of basal insulin in type 1 diabetes
Many of the trials used in this analysis were treat‐to‐target, which minimize differences in HbA1c. In the NMAs, statistical significance was severely undermined by the wide credible intervals. Despite these limitations, point estimates of HbA1c were used to rank the insulins and formed the basis of NG17 guidance. This study queries whether such analyses should be used to make specific clinical recommendations (Diabetic Medicine)
Effects of Gender-Affirming Hormone Therapy on Insulin Sensitivity and Incretin Responses in Transgender People
In this cohort of transgender persons, insulin sensitivity but also post-OGTT incretin responses tend to increase with masculinization and to decrease with feminization (Diabetes Care)
Incretin‐based glucose‐lowering medications and the risk for acute pancreatitis and malignancies ‐ a meta‐analysis based on cardiovascular outcomes trials
Based on a large database of randomized, placebo‐controlled, prospective cardiovascular outcomes studies with GLP‐1 receptor agonists and DPP‐4 inhibitors, no signal for pancreatic cancer or any malignant neoplasms was detected. However, a 75% risk increase for development of an acute pancreatitis was seen in the meta‐analysis of DPP‐4 inhibitor CVOTs (Diabetes, Obesity and Metabolism)
Microvascular complications burden (nephropathy, retinopathy and peripheral polyneuropathy) affects risk of major vascular events and all-cause mortality in type 1 diabetes
The presence and number of microvascular complications should be considered in stratifying overall cardiovascular risk in type 1 diabetes (Cardiovascular Diabetology)
Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction
Among patients with heart failure and a reduced ejection fraction, the risk of worsening heart failure or death from cardiovascular causes was lower among those who received dapagliflozin than among those who received placebo, regardless of the presence or absence of diabetes (NEJM)
Glycosmedia is also available as an App: