Diabetes News

Meta-analysis of individual patient data in randomised trials of self monitoring of blood glucose in people with non-insulin treated type 2 diabetes
Evidence from this meta-analysis of individual patient data was not convincing for a clinically meaningful effect of clinical management of non-insulin treated type 2 diabetes by self monitoring of blood glucose levels compared with management without self monitoring, although the difference in HbA1c level between groups was statistically significant (BMJ)

The Accuracy Benefit of Multiple Amperometric Glucose Sensors in People With Type 1 Diabetes
Sensor accuracy is significantly improved with the use of multiple sensors compared with the use of a single sensor. These finding isrelevant to the design of an artificial pancreas device (Diabetes Care)

Oral Disposition Index in Obese Youth from Normal to Prediabetes to Diabetes: Relationship to Clamp Disposition Index
The oDI is a simple surrogate estimate of ß-cell function relative to insulin sensitivity that can be applied to obese adolescents with varying glucose tolerance in large-scale epidemiological studies where the applicability of clamp studies is limited due to feasibility, cost, and labor intensiveness (The Journal of Pediatrics)

The Hyperglycemia and Adverse Pregnancy Outcome Study
Both maternal GDM and obesity are independently associated with adverse pregnancy outcomes. Their combination has a greater impact than either one alone (Diabetes Care)

SOD1 suppresses maternal hyperglycemia-increased iNOS expression and consequent nitrosative stress in diabetic embryopathy
We conclude that oxidative stress induces iNOS expression, nitrosative stress, and apoptosis in diabetic embryopathy (American Journal of Obstetrics & Gynecology)

Impact of type 2 diabetes on serial changes in tissue characteristics of coronary plaques: an integrated backscatter intravascular ultrasound analysis
Accelerated plaque progression with an increase in the lipid-rich component of non-culprit plaques was observed in T2DM, despite the use of standard medical treatment. Better glycaemic control ameliorated the worsening of plaque characteristics in T2DM (European Heart Journal – Cardiovascular Imaging)

The management of Type 2 diabetes: A survey of Australian general practitioners
There were significant differences between diabetologists and GPs on the management of diabetes. The survey suggests significant under-dosing by GPs. These findings warrant further investigation (Diabetes Research and Clinical Practice)

Incidence of diabetic retinopathy in people with type 2 diabetes mellitus attending the Diabetic Retinopathy Screening Service for Wales: retrospective analysis
Our analysis supports the extension of the screening interval for people with type 2 diabetes mellitus beyond the currently recommended 12 months, with the possible exception of those with diabetes duration of 10 years or more and on insulin treatment (BMJ)

Emerging Pharmacotherapies for Diabetic Macular Edema
Pharmacotherapies for DME include locally and systemically administered agents. We review several agents that have been studied for the treatment of DME (Experimental Diabetes Research)

Phase III trial tests addition of twice-daily exenatide to insulin glargine in patients with type 2 diabetes
A randomised, double-blind, 30-week, phase III trial (n = 261) found that adding twice-daily exenatide to basal insulin therapy with insulin glargine improved HbA1c levels in patients with sub-optimally controlled type 2 diabetes (NPC Rapid Review)

TAK-875 is the first GPR40 agonist to reach late-stage (Phase 3) clinical development
Phase 2 Data of Takeda’s Investigational GPR40 Agonist, Published in The Lancet, Demonstrated Improved Glycemic Control in Patients with Type 2 Diabetes (Takeda)

Study finds some insulin production in long-term type 1 diabetes
C-peptide production and beta cell functioning detected decades after disease onset (Massachusetts General Hospital)

Acute Response of Peripheral Blood Cell to Autologous Hematopoietic Stem Cell Transplantation in Type 1 Diabetic Patient
Despite the small patient number and prospective study design, we believe our findings provide important insights for understanding AHST effectiveness and possible molecular clues for optimizing AHST management in T1D patients (PLoS ONE)

Integrating an Automated Diabetes Management System Into the Family Management of Children With Type 1 Diabetes
Using the ADMS 1–3 times/week may help children with type 1 diabetes improve glycemic control and gain diabetes self-management skills, as well as improve the BGM effect of parents (Diabetes Care)

CK-elevation, lactacidosis and metabolic myopathy in adult patients with diabetes
Hyper-CK-emia occurs in one fifth and lactacidosis in one quarter of the patients with diabetes. Hyper-CK-emia in these patients is attributable to a primary metabolic myopathy in most of the cases. Hyper-CK-emia in patients with diabetes requires further neurological diagnostic work-up (Endocrine Practice)

Clinical Utility of Creatinine- and Cystatin C-Based Definition of Renal Function for Risk Prediction of Primary Cardiovascular Events in Patients With Diabetes
Only the cystatin C-based CKD definition was an independent risk predictor for cardiovascular events in our diabetic study cohort and indicated a potentially better clinical utility for cardiovascular risk prediction than creatinine-based equations (Diabetes Care)

Enrolment in primary care networks: impact on outcomes and processes of care for patients with diabetes
Compared with patients whose prevalent diabetes is managed outside of primary care networks, patients in primary care networks had a lower rate of diabetes-specific ambulatory care sensitive conditions, were more likely to see an ophthalmologist or optometrist and had better glycemic control (Canadian Medical Journal)

The Risk of a Persistent Glucose Metabolism Impairment After Gestational Diabetes Mellitus Is Increased in Patients With Polycystic Ovary Syndrome
Patients with PCOS are at increased risk for a persistent impaired glucose metabolism after GDM (Diabetes Care)

Hypertensive Disorders in Pregnancy and Subsequent Diabetes Mellitus: A Retrospective Cohort Study
HDP women with obesity and hyperlipidemia are at an extremely high risk of diabetes mellitus. Early identification of women with HDP is needed for prevention, particularly those with other comorbidities (American Journal of Medicine)

Associations of maternal A1C and glucose with pregnancy outcomes
On the basis of associations with adverse outcomes, these findings suggest that A1C measurement is not a useful alternative to an OGTT in pregnant women (Diabetes Care)

Elevated Amylase and Lipase in Patients Using GLP-1 Receptor Agonists or DPP-4 Inhibitors in the Outpatient Setting
Both GLP-1 agonists and DPP-4 inhibitors are associated with increased serum lipase more than serum amylase in many patients with type 2 diabetes possibly suggesting pancreatic inflammation. Whether this may potentially lead to acute pancreatitis or chronic pancreatitis as reported in rat models remains a question. Careful observation of patients taking these medications may be required. (Endocrine Practice)

Exenatide prolonged-release suspension for injection in combination with oral antidiabetic therapy for the treatment of type 2 diabetes
Prolonged-release exenatide in triple therapy regimens (that is, in combination with metformin and a sulphonylurea, or metformin and a thiazolidinedione) is recommended as a treatment option for people with type 2 diabetes as described in ‘Type 2 diabetes: the management of type 2 diabetes‘ (NICE)

CHMP Recommends Approval of BYETTA® for Use With Basal Insulin
The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) has issued a positive opinion in the European Union (EU) for the expanded use of BYETTA® (exenatide twice-daily) as an add-on therapy to basal insulin, with or without metformin and/or Actos® (pioglitazone), for the treatment of type 2 diabetes in adults who have not achieved adequate glycemic control with these agents (Lilly)

Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus
A Clinical Practice Guideline From the American College of Physicians (Annals of Internal Medicine)

Angiotensin receptor blockers for prevention of new-onset type 2 diabetes: A meta-analysis of 59,862 patients
There is sufficient evidence that ARBs have beneficial effect in preventing new-onset type 2 diabetes. ARBs should be considered in patients with high risk of developing diabetes (International Journal of Cardiology)

Incidence of insulin-treated diabetes in Australia 2000–2009
During this period, 222,544 people began using insulin to treat their diabetes. Of these, 77% had Type 2 diabetes, 12% had gestational diabetes and 10% had Type 1 diabetes. The remaining 1% had other types of diabetes (Australian Institute of Health and Welfare)

Social adaptability index predicts overall mortality in patients with diabetes
Social adaptability index is associated with mortality in the diabetic population and is useful in identifying individuals who are at risk for inferior outcomes (Journal of Diabetes and Its Complications)

Body composition in children with type 1 diabetes in the first year after diagnosis: relationship to glycaemic control and cardiovascular risk
Insulin deficiency at diagnosis of diabetes causes a catabolic state that is predominantly lipolytic. Body composition normalises within 6 weeks of treatment, though girls remain thinner than boys both at diagnosis and 1 year thereafter, in contrast to published findings. Despite girls being prescribed a larger insulin dose, their HbA1c and cholesterol levels are higher at 1 year suggesting increased insulin resistance and cardiovascular risk (Archives of Diseases in Childhood)

The branching pattern of villous capillaries and structural changes of placental terminal villi in type 1 diabetes mellitus
It is concluded that type 1 maternal diabetes enhances the surface area of the capillary wall by elongation, enlargement of diameter and higher branching of villous capillaries and disrupts the stromal structure of terminal villi (Placenta)

Hyperfiltration in type 1 diabetes: does it exist and does it matter for nephropathy?
In the absence of incipient or overt nephropathy, conventionally determined renal function in patients with type 1 diabetes appears no different from that in the general population. This is hardly surprising, given that these individuals, by all definitions, do not have kidney disease (Diabetologia)

Large-Scale Gene-Centric Meta-Analysis across 39 studies Identifies Type 2 Diabetes Loci
This large-scale meta-analysis involving a dense gene-centric approach has uncovered additional loci and variants that contribute to T2D risk and suggests substantial overlap of T2D association signals across multiple ethnic groups (American Journal of Human Genetics)

Regulation of core clock genes in human islets
The data suggest that perturbations of circadian clock components may contribute to islet pathophysiology in human type 2 diabetes mellitus (Metabolism – Clinical and Experimental)

Gene Expression Differences in Skin Fibroblasts in Identical Twins Discordant for Type 1 Diabetes
This is the first in vitro study demonstrating diabetes-relevant gene expression differences between T1D-discordant identical twins. These SF gene expression differences, persistent despite the HG in vitro conditions, likely reflect “metabolic memory”, and discordant identical twins thus represent an excellent model for studying diabetic epigenetic processes in humans (Diabetes)

Age-related islet autoantibody incidence in offspring of patients with type 1 diabetes
The age period 9 months to 2 years is associated with a high incidence of activation of type 1 diabetes-associated autoimmunity in genetically at-risk children and should be targeted for effective primary prevention strategies (Diabetologia)

Continuous Subcutaneous Insulin Infusion of Insulin Lispro in Children and Adolescents with Type 1 Diabetes
In 26 studies of over 2500 pediatric and adolescent patients with type 1 diabetes, with over 1000 patients specifically receiving lispro CSII, insulin lispro CSII therapy consistently demonstrated similar or improved efficacy and safety versus studied comparators (Endocrine Practice)

Profile of Inflammatory Mediators in Gestational Diabetes Mellitus: Phenotype and Genotype
Women with GDM have significantly lower adiponectin levels in the third trimester, regardless of BMI (American Journal of Reproductive Immunology)

Peri-conception hyperglycaemia and nephropathy are associated with risk of congenital anomaly in women with pre-existing diabetes
A population-based cohort study (Diabetologia)

Mitochondrial Fission Triggered by Hyperglycemia Is Mediated by ROCK1 Activation in Podocytes and Endothelial Cells
Several lines of evidence suggest that mitochondrial dysfunction plays a critical role in the pathogenesis of microvascular complications of diabetes, including diabetic nephropathy … These findings provide insights into the unexpected role of ROCK1 in a signaling cascade that regulates mitochondrial dynamics (Cell Metabolism)

Helicobacter pylori Infection Is Associated With an Increased Rate of Diabetes
We demonstrated for the first time that H. pylori infection leads to an increased rate of incident diabetes in a prospective cohort study. Our findings implicate a potential role for antibiotic and gastrointestinal treatment in preventing diabetes (Diabetes Care)

Diabetes Working Group White Paper
Through new research sponsored by the DWG, this white paper examines provider barriers to offering the current standards of diabetes care and offers recommendations to mitigate these barriers (Avalere Health LLC on behalf of the Diabetes Working Group)

Long-term conditions and mental health – The cost of co-morbidities
More than 4 million people in England with a long-term physical health condition also have mental health problems, and many of them experience significantly poorer health outcomes and reduced quality of life as a result – Download (The King’s Fund, UK)

The pathogenesis of early retinal changes of diabetic retinopathy
This review explores the earliest changes to the retina in DR and the factors that predispose or prevent DR, including sleep apnoea, receptor degenerations laser treatment and VEGF polymorphism. The review also presents the evidence that retinal hypoxia, existing in the earliest stages, causes DR (Documenta Ophthalmologica)

Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus
A Clinical Practice Guideline From the American College of Physicians (Annals of Internal Medicine)

Diabetes Update for January – Pregnancy
Interesting monthly Diabetes Updates on the Glycosmedia website

Chronic Kidney Disease Resource Pack
This resource pack, developed by NHS Kidney Care, contains a variety of resources designed to help support the management of CKD in the community (NHS Kidney Care)

When Is Hemoglobin A1c Inaccurate In Assessing Glycemic Control?
It is useful to consider the situations in which HbA1c may be spuriously elevated or depressed. These issues are best understood after reviewing how HbA1c is defined and measured–topics fraught with considerable confusion (Clinical Correlations)

Introduction of metformin for gestational diabetes mellitus in clinical practice: has it had an impact?
Women treated with metformin had a significantly lower incidence of macrosomic and large for gestational age neonates as well as a reduced caesarean section rate (European Journal of Obstetrics & Gynecology and Reproductive Biology)

Diabetes indicators in Australia
Standardised measures of the highest priority information that can be used to: establish benchmarks – monitor and compare the diabetes status of population groups over time – and monitor and evaluate the effectiveness of health policy, prevention and management strategies (AIHW)

When Is Diabetes Distress Clinically Meaningful?
In two samples of type 2 diabetic patients we found a consistent pattern of curvilinear relationships between the DDS and HbA1c, diabetes self-efficacy, diet, and physical activity. The shape of these relationships suggests cut points for three patient groups: little or no, moderate, and high distress (Diabetes Care)

Age Before Stage: Insulin Resistance Rises Before the Onset of Puberty
IR starts to rise in mid-childhood, some years before puberty. Its emergence relates more to the age of the child than to pubertal onset. More than 60% of the variation in IR prior to puberty was unexplained. The demography of childhood diabetes is changing, and prepubertal IR may be important (Diabetes Care)

Can sharing experiences in groups reduce the burden of living with diabetes, regardless of glycaemic control?
Support groups are able to reduce diabetes-related and psychological distress 1 year after the intervention for patients with both good and poor glycaemic control displaying high levels of distress (Diabetic Medicine)

Silencing of insulin receptor substrate–1 increases cell death in retinal Müller cells
In these studies, we show for the first time that salmeterol, a beta-2-adrenergic receptor agonist, can reduce retinal Müller cell death through IRS-1 actions. These findings also suggest the importance of IRS-1 in beta-adrenergic receptor signaling in the prevention of cell death in retinal Müller cells (Molecular Vision)

Variations in tissue selectivity amongst insulin secretagogues: a systematic review
Insulin secretagogues display different tissue selectivity characteristics at therapeutic doses. This may translate into different levels of cardiovascular risk (Diabetes, Obesity and Metabolism)

FDA Approves BYDUREON™ – The First and Only Once-Weekly Treatment for Type 2 Diabetes
Provides Glycemic Control in a Once-Weekly Dose (Amylin Pharmaceuticals)

Retinal Vascular Geometry Predicts Incident Renal Dysfunction in Young People With Type 1 Diabetes
Retinal venular geometry independently predicted incident renal dysfunction in young people with type 1 diabetes. These noninvasive retinal measures may help to elucidate early mechanistic pathways for microvascular complications (Diabetes Care)

Increased prevalence of chronic kidney disease in patients with Type 1 diabetes and non-alcoholic fatty liver
Our findings demonstrate that ultrasound-diagnosed non-alcoholic fatty liver is associated with a higher prevalence of chronic kidney disease in patients with Type 1 diabetes, independently of several risk factors, including the components of the metabolic syndrome (Diabetic Medicine)

How much does screening bring forward the diagnosis of type 2 diabetes and reduce complications? Twelve year follow-up of the Ely cohort
Diabetes screening resulted in cases being identified on average 3.3 years earlier, a difference significantly shorter than previous estimates. Earlier diagnosis did not appear to impact on health outcomes. Further evidence is needed to justify the introduction of population-based screening (Diabetologia)

Screening for Gestational Diabetes Mellitus: Are the Criteria Proposed by the International Association of Diabetes and Pregnancy Study Groups Cost-Effective?
The IADPSG recommendation for glucose screening in pregnancy is cost-effective. The model is most sensitive to the likelihood of preventing future diabetes in patients identified with GDM using postdelivery counseling and intervention (Diabetes Care)

Proposed new diagnostic criteria for gestational diabetes – a pause for thought?
New criteria for the diagnosis of gestational diabetes promulgated by the International Association of Diabetes and Pregnancy Study Groups (IADSPG) have been adopted by a number of groups, including the American Diabetes Association. These criteria will increase two- to three-fold the number of women diagnosed with gestational diabetes and have enormous resource implications (Diabetic Medicine)

Integrated Management of Type 2 Diabetes Mellitus and Depression Treatment to Improve Medication Adherence: A Randomized Controlled Trial
A randomized controlled trial of a simple, brief intervention integrating treatment of type 2 diabetes and depression was successful in improving outcomes in primary care. An integrated approach to depression and type 2 diabetes treatment may facilitate its deployment in real-world practices with competing demands for limited resources (Annals of Family Medicine)

Statin Use and Risk of Diabetes Mellitus in Postmenopausal Women in the Women’s Health Initiative
Statin medication use in postmenopausal women is associated with an increased risk for DM. This may be a medication class effect. Further study by statin type and dose may reveal varying risk levels for new-onset DM in this population (Archives of Internal Medicine)

FRAX underestimates fracture risk in patients with diabetes
FRAX underestimated observed major osteoporotic and hip fracture risk in diabetics (adjusted for competing mortality) but demonstrated good concordance with observed fractures for nondiabetics. We conclude that diabetes confers an increased risk of fracture that is independent of FRAX derived with BMD. This suggests that diabetes might be considered for inclusion in future iterations of FRAX (Journal of Bone and Mineral Research)

Reversal of type 1 diabetes via islet beta cell regeneration following immune modulation by cord blood-derived multipotent stem cells
Stem Cell Educator therapy is safe, and in individuals with moderate or severe T1D, a single treatment produces lasting improvement in metabolic control. Initial results indicate Stem Cell Educator therapy reverses autoimmunity and promotes regeneration of islet beta cells (BMC Medicine)

Localisation and composition of skeletal muscle diacylglycerol predicts insulin resistance in humans
These data indicate that both cellular localisation and composition of DAG influence the relationship to insulin sensitivity. Our results suggest that only saturated DAG in skeletal muscle membranes are related to insulin resistance in humans (Diabetologia)

Acute and chronic animal models for the evaluation of anti-diabetic agents
The present review highlights the various methods of inducing diabetes in experimental animals in order to test the newer drugs for their anti-diabetic potential – Provisional PDF (Cardiovascular Diabetology)

Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin (Review)
From this review, we conclude that when diabetes duration is over one year, the overall effect of self-monitoring of blood glucose on glycaemic control in patients with type 2 diabetes who are not using insulin is small up to six months after initiation and subsides after 12 months (Cochrane Collaboration)

Establishing an evidence base for frequency of monitoring glycated haemoglobin levels in patients with Type 2 diabetes: projections of effectiveness from a regression model
In patients with initial HbA1c close to treatment goal, retesting at 6 months would yield more true-positive than false-positive tests. For patients with lower initial HbA1c, retesting at 6 months would yield more false than true-positive tests. In all patients, retesting at 12 months yields more true than false-positive tests. In very few patients would retesting at 3 months be justified (Diabetic Medicine)

Exposure to Gestational Diabetes Mellitus and Low Socioeconomic Status
Maternal GDM and low SES, especially in combination, heighten the risk for childhood ADHD. Long-term prevention efforts should be directed at mothers with GDM to avoid suboptimal neurobehavioral development and mitigate the risk for ADHD among their offspring (Archives of Pediatrics & Adolescent Medicine)

The development and validation of a clinical prediction model to determine the probability of MODY in patients with young-onset diabetes
We have developed clinical prediction models that calculate an individual’s probability of having MODY. This allows an improved and more rational approach to determine who should have molecular genetic testing (Diabetologia)

Novel Urinary Protein Biomarkers Predicting the Development of Microalbuminuria and Renal Function Decline in Type 1 Diabetes
A panel of four novel protein biomarkers predicted early renal damage in type 1 diabetes. These findings require further validation in other populations for prediction of renal complications and treatment monitoring (Diabetes Care)

Surgical and visual outcome following 20-gauge vitrectomy in proliferative diabetic retinopathy over a 10-year period, evidence for change in practice
Outcomes from vitreoretinal surgery for complications of diabetic retinopathy have improved. In addition, the visual outcome after diabetic vitrectomy steadily improved over the 10-year period, which may in part be due to the move to operate on patients with better vision (Eye – Nature Publishing Group)

Statins: risk of hyperglycaemia and diabetes
Statin use may be associated with a level of hyperglycaemia in some patients where formal diabetes care is appropriate. The risk appears to be mainly in patients already at increased risk of developing diabetes (MHRA)

Proton Pump Inhibitor Therapy Associated with Lower Glycosylated Hemoglobin Levels in Type 2 Diabetes
The observed association between PPI therapy and lower HbA1c levels suggests that PPIs may be useful as adjunctive therapy for type 2 diabetes (Journal of the American Board of Family Medicine)

Demonstration of islet-autoreactive CD8 T cells in insulitic lesions from recent onset and long-term type 1 diabetes patients
Our observations provide the first direct proof for islet autoreactivity within human islets and underscore the heterogeneous and chronic disease course (Journal of Experimental Medicine)

‘Killer cells’ and diabetes
Killer T-cells in the human body which help protect us from disease can inadvertently destroy cells that produce insulin, new University research has uncovered (Cardiff University)

NICE gives green light to prolonged-release exenatide for type 2 diabetes in final draft guidance
In final draft guidance NICE, has confirmed its initial draft recommendation of prolonged release exenatide (Bydureon, Eli Lilly) in triple therapy regimens (in combination with metformin and a sulphonylurea, or metformin and a thiazolidinedionei) as a treatment option for people with type 2 diabetes (NICE)

BMS and AZ Receive Complete Response Letter from U.S. Food and Drug Administration for Dapagliflozin
The complete response letter requests additional clinical data to allow a better assessment of the benefit-risk profile for dapagliflozin. This includes clinical trial data from ongoing studies and may require information from new clinical trials (Bristol-Myers Squibb)

Research Effects of glucagon-like peptide-1 receptor agonists on weight loss: systematic review and meta-analyses of randomised controlled trials
The present review provides evidence that treatment with GLP-1R agonists leads to weight loss in overweight or obese patients with or without type 2 diabetes mellitus (BMJ)

The adaptive immune system as a fundamental regulator of adipose tissue inflammation and insulin resistance
This review highlights critical roles of adipose tissue lymphocytes in governing glucose homeostasis (Immunology and Cell Biology)

Study of Women, Infant Feeding, and Type 2 diabetes mellitus after GDM pregnancy (SWIFT), a prospective cohort study: methodology and design
This is the first, large prospective, community-based study involving a racially and ethnically diverse cohort of women with recent GDM that rigorously assesses lactation intensity and duration and examines their relationship to incident type 2 diabetes while accounting for numerous potential confounders not assessed previously (BMC Public Health)

Effects of combining simvastatin with rosiglitazone on inflammation, oxidant stress and ambulatory blood pressure in patients with the metabolic syndrome: the SIROCO study
Our data show that patients with the metabolic syndrome given a statin/TZD combination manifest greater reductions in markers of vascular inflammation and oxidant stress, 24-h ambulatory BP and increases in adiponectin as well as improved glycaemic indices (Diabetes, Obesity and Metabolism)

Trends of insulin use among US adults with type 2 diabetes: the Behavioral Risk Factor Surveillance System, 1995–2007
The proportion of insulin use decreased from 1995 to 2007 among US adults aged =40 years. Continuing efforts may be needed to properly identify those who may need to initiate and maintain insulin therapy among patients with type 2 diabetes as medically indicated (Journal of Diabetes and Its Complications)

Potential Implications of Coronary Artery Calcium Testing for Guiding Aspirin Use Among Asymptomatic Individuals With Diabetes Mellitus
CAC can help risk stratify individuals with diabetes and may aid in selection of patients who may benefit from therapies such as low-dose aspirin for primary prevention (Diabetes Care)

Statin Use and Risk of Diabetes Mellitus in Postmenopausal Women in the Women’s Health Initiative
Statin medication use in postmenopausal women is associated with an increased risk for DM. This may be a medication class effect. Further study by statin type and dose may reveal varying risk levels for new-onset DM in this population (Archives of Internal Medicine)

Ramipril-based versus diuretic-based antihypertensive primary treatment in patients with pre-diabetes (ADaPT) study
Ramipril treatment is preferable over diuretic based treatment regimens for the treatment of hypertension in pre-diabetic patients, because new-onset diabetes is delayed. (Cardiovascular Diabetology)

European Commission backs Takeda’s pioglitazone-containing drugs
European Commission adopts European Medicines Agency’s opinion confirming pioglitazone-containing medicines remain a valid treatment option for appropriate type 2 diabetes patients (Takeda)

Oramed Pharmaceuticals Files US Patent Application for Combination Oral Treatment of Diabetes
Oramed Pharmaceuticals Inc. a developer of oral drug delivery systems, announced that it has filed a provisional patent application with the United States Patent and Trademark Office for a combination therapy of its lead compound, ORMD-0801 in combination with its oral exenatide formulation, ORMD-0901. There is no such approved combination product available on the market today (Oramed)

Prevention study with Diamyd´s diabetes vaccine fully recruited
A total of 50 children aged four and older with a high risk of developing type 1 diabetes have been enrolled in a researcher-initiated Phase II study, DiAPREV-IT, with Diamyd Medical’s diabetes vaccine Diamyd®

Food Insecurity and Glycemic Control Among Low-Income Patients With Type 2 Diabetes
Food insecurity is an independent risk factor for poor glycemic control in the safety net setting. Screening patients with diabetes for food insecurity may be appropriate, particularly in the safety net setting (Diabetes Care)

A Study of Patients’ Perceptions of Diabetes Care Delivery and Diabetes
Group treatment reinforces communication and peer identification and may achieve its clinical results by promoting awareness, self-efficacy, positive attitudes toward diabetes and the setting of care, an internal locus of control, and, ultimately, empowerment in the patients (Diabetes Care)

Increased Retinal Blood Flow Velocity in Patients With Early Diabetes Mellitus
There was an increase in arterial and venous retinal blood flow velocities of patients with early DM with no diabetic retinopathy. These findings support the notion that abnormalities in vessel function exist in diabetic eyes before the development of structural changes (Retina)

Beta-Cell Specific Deletion of Dicer1 Leads to Defective Insulin Secretion and Diabetes Mellitus
ß-cell specific disruption of the miRNAs network, although allowing for apparently normal ß-cell development, leads to progressive impairment of insulin secretion, glucose homeostasis and diabetes development (PLoS ONE)

Glucagon in the Pathogenesis of Hypoglycemia and Hyperglycemia in Diabetes
In type 1 diabetes and advanced type 2 diabetes, the absence of an increment in glucagon secretion, in the setting of an absent decrement in insulin secretion and an attenuated increment in sympathoadrenal activity, in response to falling plasma glucose concentrations plays a key role in the pathogenesis of iatrogenic hypoglycemia. In addition, there is increasing evidence that, in the aggregate, suggests that relative hyperglucagonemia, in the setting of deficient insulin secretion, plays a role in the pathogenesis of hyperglycemia in diabetes (Endocrinology)

Heparan sulfate and heparanase play key roles in mouse ß cell survival and autoimmune diabetes
Our results identified HS as a critical molecular requirement for islet ß cell survival and HS degradation as a mechanism for ß cell destruction. Our findings suggest that preservation of islet HS could be a therapeutic strategy for preventing T1D (Journal of Clinical Investigation)

Cancer mortality reduction and metformin: a retrospective cohort study in type 2 diabetic patients
Metformin users showed a lower risk of cancer-related mortality than not users or patients on diet only; this may represent another reason to choose metformin as a first-line therapy in T2DP (Diabetes, Obesity and Metabolism)

Osiris Therapeutics Provides Update on Groundbreaking Stem Cell Trial for Type 1 Diabetes
The interim assessment at one year showed that systemic infusions of Prochymal were well-tolerated in this unique population … No significant differences in the rates of disease progression have been observed … however there was a trend towards fewer hypoglycemic events for patients treated with Prochymal as compared to controls (Osiris Therapeutics)

AMs asked to shout down diabetes myths for Diabetes Week
Diabetes UK Cymru and Jeff Cuthbert AM are asking AMs to shout down the myths about diabetes in an event at the Welsh Assembly for Diabetes Week (Diabetes UK)

Much to do in tackling this diabetes epidemic
Following the first meeting of the new Cross-Party Group on Diabetes at the National Assembly in March, Dai Williams, national director of Diabetes UK Cymru, explains why it is needed more than ever (Wales Online)

NCD alliance website launched
In conjuction with the World Health Assembly in Geneva, the Non-Communicable Disease (NCD) Alliance has launched a unique global online platform to facilitate the campaign against the growing epidemic of NCDs (International Diabetes Federation)

The effect of healthcare provider education on diabetes management of hospitalised patients
Implementing an educational programme for healthcare providers had significant effects on the lowering of mean BG values and the incidence of hyperglycaemia, but increased the risk of hypoglycaemia (International Journal of Clinical Practice)

Type 2 Diabetes Comorbidities and Treatment Challenges
Many patients with type 2 diabetes have disease-related complications or comorbid conditions, which can hinder disease management. In choosing antihyperglycemic medications, efficacy for improving glycemic control must be balanced against safety and tolerability issues that can adversely affect these complications and comorbidities (Postgraduate Medicine)

Record Number of Medicines Currently in Development to Treat Diabetes
A record 235 new medicines to treat diabetes, one of the fastest-growing diseases in America, are being developed by America’s pharmaceutical research and biotechnology companies, according to a national report (PubMed Diabetes)

Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency
Randomised placebo controlled trial (BMJ)

An update on the treatment of type 1 and type 2 diabetes mellitus: focus on insulin detemir, a long-acting human insulin analog
Recent guidelines for treatment of type 2 diabetes suggest starting intensive therapy of hyperglycemia at an early stage of diabetes and recommend therapeutic options that provide the possibility of reaching HbA1c goals individually, with a low risk of hypoglycemia or other adverse effects of treatment. The properties of insulin detemir match these requirements (Vascular Health and Risk Management)

EURADIA DIAMAP Road Map reports
Road Map reports are now available for a 1-month consultation period open to the general public (DIAMAP)

Study links viral infection to juvenile diabetes
In a small study of 112 children with juvenile diabetes, Antonio Toniolo of the University of Insubria in Varese, Italy, found that more than 80 percent had evidence of enterovirus infection in their blood (Reuters)

Type 3 Diabetes: Brain Diabetes?
Intensive study is underway in an attempt to better characterize type 3 diabetes and to develop preventative and therapeutic strategies (US Pharmacist)

Endothelial Cell–Derived Endothelin-1 Promotes Cardiac Fibrosis in Diabetic Hearts Through Stimulation of Endothelial-to-Mesenchymal Transition
These results provide new insights suggesting that diabetes mellitus–induced cardiac fibrosis is associated with the emergence of fibroblasts from endothelial cells and that this endothelial-to-mesenchymal transition process is stimulated by ET-1 (Circulation)

TeleHealth Improves Diabetes Self-Management in an Underserved Community: Diabetes TeleCare
Telehealth effectively created access to successfully conduct a one year remote DSME by a nurse CDE and dietitian that improved metabolic control and reduced cardiovascular risk in an ethnically diverse and rural population (Diabetes Care)

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