In this issue of JAMA, the US Preventive Services Task Force (USPSTF) addresses this important issue with a new Recommendation Statement on screening for prediabetes and type 2 diabetes in children and adolescents based on an Evidence Report and Systematic Review of the evidence on screening for prediabetes and type 2 diabetes in asymptomatic, nonpregnant persons younger than 18 year (JAMA)
Diabetes News
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Mechanisms underlying the blood pressure lowering effects of empagliflozin, losartan and their combination in people with type 2 diabetes: a secondary analysis of a randomized cross-over trial
In people with T2D, SGLT2 inhibition in combination with ARB had a larger blood-pressure lowering effect versus placebo than either of the drugs alone. Our data further suggest that the mechanisms underlying these blood pressure reductions at least partially differ between these agents (Diabetes, Obesity and Metabolism)
Temporal trends in the prevalence and incidence of depression and the interplay of comorbidities in patients with young- and usual-onset type 2 diabetes from the USA and the UK
Depression risk has been increasing in people with incident type 2 diabetes in the UK and USA, particularly among those with young-onset type 2 diabetes, irrespective of other comorbidities. This suggests that proactive mental health assessment from the time of type 2 diabetes diagnosis in primary care is essential for effective clinical management of people with type 2 diabetes (Diabetologia)
Real-world glycaemic outcomes in adult persons with type 1 diabetes using a real-time continuous glucose monitor compared to an intermittently scanned glucose monitor
A retrospective observational study from the Canadian LMC diabetes registry (REAL-CGM-T1D) (Diabetic Medicine)
Sodium-Glucose Cotransporter 2 Inhibitors and Risk of Hyperkalemia in People With Type 2 Diabetes: A Meta-Analysis of Individual Participant Data From Randomized, Controlled Trials
SGLT2 inhibitors reduce the risk of serious hyperkalemia in people with type 2 diabetes at high cardiovascular risk or with chronic kidney disease without increasing the risk of hypokalemia (Circulation)
Association Between SGLT2 Inhibitor Treatment and Diabetic Ketoacidosis and Mortality in People With Type 2 Diabetes Admitted to Hospital With COVID-19
We demonstrate a low risk of DKA and high mortality rate in people with T2D admitted to hospital with COVID-19 and limited power, but no evidence, of increased risk of DKA or in-hospital mortality associated with prescription of SGLT2is (Diabetes Care)
The experiences of insulin use among older people with Type 2 diabetes mellitus: A thematic synthesis
The review indicates issues surrounding the technical aspects of insulin administration, side effects of treatment and reactions to insulin administration are common amongst older people. However, research evidence is limited, and there is an urgent need for empirical, participatory research with older insulin dependent adults with type 2 diabetes (Primary Care Diabetes)
Open-Source Automated Insulin Delivery in Type 1 Diabetes
In children and adults with type 1 diabetes, the use of an open-source AID system resulted in a significantly higher percentage of time in the target glucose range than the use of a sensor-augmented insulin pump at 24 weeks (NEJM)
Closed-Loop Therapy and Preservation of C-Peptide Secretion in Type 1 Diabetes
In youths with new-onset type 1 diabetes, intensive glucose control for 24 months did not appear to prevent the decline in residual C-peptide secretion (NEJM)
Beyond Detecting and Understanding Disparities in Novel Diabetes Treatment
Several underrepresented racial and ethnic groups, including American Indian, Asian, Black, and Hispanic individuals, experience a higher prevalence of type 2 diabetes and higher rates of disease-attributable morbidity and mortality than White individuals (JAMA)
Large Effect Size in Composite Kidney Outcomes than in Majors Cardiovascular Events of SGLT2 inhibitors compared with GLP-1 RAs: A Pooled Analysis of Type 2 Diabetes Trials
In T2D patients, treatment effect sizes were greater for kidney than for macrovascular (MACE-3) outcomes, with important differences according to the drugs considered. CKO and MACE-3 are independent. Caution must be taken when interpreting CKO in the absence of MACE-3 data (Diabetes, Obesity and Metabolism)
Dapagliflozin improves myocardial flow reserve in patients with type 2 diabetes: the DAPAHEART Trial: a preliminary report
SGLT-2 inhibition increases MFR in T2D patients. We provide new insight into SGLT-2i CV benefits, as our data show that patients on SGLT-2i are more resistant to the detrimental effects of obstructive coronary atherosclerosis due to increased MFR, probably caused by an improvement in coronary microvascular dysfunction (Cardiovascular Diabetology)
The link between gestational diabetes and cardiovascular diseases: potential role of extracellular vesicles
understanding the effect of EV signaling during pregnancy, on fetal programming for the development of metabolic diseases such as CVD, is a fertile area for future investigation (Cardiovascular Diabetology)
Advanced hybrid closed loop therapy versus conventional treatment in adults with type 1 diabetes (ADAPT): a randomised controlled study
In people with type 1 diabetes using multiple daily injections of insulin plus isCGM and with HbA1c of at least 8%, the use of AHCL confers benefits in terms of glycaemic control beyond those that can be achieved with multiple daily injections of insulin plus isCGM. These data support wider access to AHCL in people with type 1 diabetes not at target glucose levels (The Lancet Diabetes & Endocrinology)
Barriers and Facilitators to the Initiation of Injectable Therapies for Type 2 Diabetes Mellitus: A Mixed Methods Study
GPs recognise the need to initiate injectables but lack practical skills and time to address patient concerns and provide education. Primary care nurses also report difficulties in maintaining these skills. Primary care HCPs initiating injectables require additional training to provide practical demonstrations, patient education and how to identify and address concerns (Diabetes Therapy)
The Gut Microbiome Composition Is Altered in Long-standing Type 1 Diabetes and Associates With Glycemic Control and Disease-Related Complications
Our data show that the gut microbiome is altered in people with (long-standing) type 1 diabetes and is associated with glycemic control and diabetes-related complications. As a result of the cross-sectional design, the causality of these relationships remains to be determined (Diabetes Care)
Protein Biomarkers and Cardiovascular Outcomes in People With Type 2 Diabetes and Acute Coronary Syndrome: The ELIXA Biomarker Study
NT-proBNP and other proteins independently predict cardiovascular outcomes in people with type 2 diabetes following acute coronary syndrome. Adding other biomarkers only marginally increased NT-proBNP’s prognostic value (Diabetes Care)
Sodium–Glucose Cotransporter 2 Inhibitors in Cardiovascular and Renal Outcomes in Patients With Diabetes but Without Established Cardiovascular Disease: A Nationwide Population-Based Cohort Study
Our study provided clinical evidence that the cardiovascular and renoprotective benefits of SGLT2 inhibitors could be consistently extended to primary prevention strategies among patients with diabetes with low cardiovascular risk (Diabetes Care)
Twenty-Year Temporal Trends in Risk of Ischemic Stroke in Incident Type 2 Diabetes: A Danish Population-Based Cohort Study
From 1996 to 2015, the 5-year risk of first-time ischemic stroke was approximately halved in patients with incident T2DM and no prior ASCVD, coinciding with markedly increased use of prophylactic cardiovascular medications (Diabetes Care)
Circulating ceramides and sphingomyelins and the risk of incident cardiovascular disease among people with diabetes: the strong heart study
While replication of the findings from the SHS in other populations is warranted, our findings add to a growing body of research suggesting that ceramides, in particular Cer-16, not only are associated with higher diabetes risk, but may also be associated with higher CVD risk after diabetes onset (Cardiovascular Diabetology)
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