The general concept is that increases in AGEs within the matrix cause the collagen phase to become brittle, reducing the capacity of the tissue to resist the formation and propagation of microdamage. While certainly more research into the diabetic effects on fracture resistance is necessary before clear therapeutic options are identified, diabetes should be considered a problem of bone brittleness, not just one of low bone strength (Clinical Reviews in Bone and Mineral Metabolism)
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.
Microcirculatory vasomotor changes & severity of peripheral neuropathy
This study elucidated possible interaction between impaired microvascular flow motion and diabetic peripheral neuropathy. The vasomotor changes of skin microcirculation could be detected even in the absence of overt cardiovascular dysfunction (Diabetes and Vascular Disease Research)
Low Blood Glucose Index Is Predictive of Hypoglycemia in Pump Therapy
Baseline LBGI predicts the outcome of type 1 diabetic patients who switch to CSII in terms of hypoglycemia (Diabetes Care)
New approaches to the use of insulin in diabetic ketoacidosis
In several trials it has been demonstrated that the use of subcutaneous rapid-acting insulin analogs represents a safe, cost-effective and technically simpler treatment that precludes intensive care unit admission without significant differences in outcome in the management of patients with mild to moderate, uncomplicated DKA (European Journal of Internal Medicine)
Diabetes Prevalence Model for local authorities in England
The model estimates diabetes prevalence by local authority. It updates the Diabetes Prevalence Model (APHO) to reflect the prevalence of diabetes (diagnosed and undiagnosed) and the distribution of body mass index found in the 2010 Health Survey for England (Yorkshire and Humber Public Health Observatory)
NICE gives green light to ranibizumab for macular oedema
In final guidance issued today (27 February), NICE has recommended ranibizumab (Lucentis, Novartis) as an option for treating visual impairment caused by diabetic macular oedema (NICE)
Effects of Axonal Ion-Channel Dysfunction on QoL T2D
The current study has demonstrated an association between markers of sodium channel function and QoL in DN. The study demonstrates that excitability techniques may identify patients in whom altered sodium-channel function may be the dominant abnormality. The findings suggest that excitability techniques may have a role in clinical decision making regarding neuropathic treatment prescription (Diabetes Care)
Depression and risk of mortality with diabetes
Depression significantly increases the risk of mortality among individuals with diabetes. Early detection and treatment of depression may improve health outcomes in this population (General Hospital Psychiatry)
Stepwise intensification of insulin therapy in T2D
The data indicate that a step-by-step approach with the basal-plus strategy is a promising alternative method of insulin intensification that allows for individualization of treatment and may delay progression to a full basal–bolus insulin replacement therapy for many individuals (Diabetic Medicine)
Significance of renal biopsy in presumed diabetic nephropathy
These data suggest that, even for patients with long-term DM, renal biopsy should be carried out in patients with presumed DN. Because treatment options differ between DN and primary glomerulopathies, renal biopsy should especially be considered for presumed DN without DR (Journal of Diabetes Investigation)
Efficacy and safety of linagliptin in T2D with poor glycemic control
Linagliptin was an effective, well-tolerated treatment in subjects with T2DM and insufficient glycemic control, both as monotherapy or added-on to metformin/metformin plus sulfonylurea (Journal of Diabetes and Its Complications)
Mortality & Diabetes-Related Outcomes Insulin v Other Antihyperglycemics
Conclusions: In people with T2DM, exogenous insulin therapy was associated with an increased risk of diabetes-related complications, cancer, and all-cause mortality. Differences in baseline characteristics between treatment groups should be considered when interpreting these results (The Journal of Clinical Endocrinology & Metabolism)
Clinical and socio-demographic factors associated with ketoacidosis
This study identifies specific clinical factors associated with diabetic ketoacidosis hospitalization in adults with Type 1 diabetes. This information can help to inform the detection of high-risk patients, for whom special attention and interventions may be warranted to prevent diabetic ketoacidosis (Diabetic Medicine)
Implications of new European Union driving regulations T1D
More than one episode of severe hypoglycaemia within a year was a frequent event in subjects in the Diabetes Control and Complications Trial, especially in intensively treated patients. If applied to current practice, improving road safety through these changes to European Union regulations could have a substantial impact on drivers who have Type 1 diabetes. This emphasizes the need to take into account the potential effects of severe hypoglycaemia in those who rely on a driving licence (Diabetic Medicine)
Blood ß-hydroxybutyrate vs. urine acetoacetate testing for ketoacidosis
There is evidence suggesting that blood ß-hydroxybutyrate testing is more effective than urine acetoacetate testing in reducing emergency department assessment, hospitalization and time to recovery from diabetic ketoacidosis, as well as potentially lowering healthcare expenditure. Further research in both young people and adults is needed (Diabetic Medicine)
Screening for Diabetes & Prediabetes Should be Cost-Saving
From a health economics perspective, screening for diabetes and high-risk prediabetes should target patients at higher risk, particularly those with BMI >35 kg/m2, systolic blood pressure =130 mmHg, or age older than 55 years, for whom screening can be most cost-saving. GCTpl is generally the least expensive test in high-risk groups and should be considered for routine use as an opportunistic screen in these groups (Diabetes Care)
Study of the SGLT2 Inhibitor Empagliflozin in T2D
In patients with type 2 diabetes, empagliflozin resulted in dose-dependent, clinically meaningful reductions in HbA1c and FPG, and reductions in body weight compared with placebo. Empagliflozin was well-tolerated with a favourable safety profile (Diabetes, Obesity and Metabolism)
Observational Study of Once-Daily Insulin Detemir T2D Aged 75 & over
In both the older and younger age groups, the addition of once-daily insulin detemir to existing OAD regimens was effective and safe. In older patients, an improvement in HbA1c of 1.2 % was not associated with an increased risk of severe hypoglycaemia or weight gain (Drugs and Aging)
In-patient diabetes treatment satisfaction in the UK – DIPSat study
The DIPSat programme describes the complex relationships between diabetes in-patient treatment satisfaction and in-patient diabetes care (Diabetic Medicine)
HbA1c and educational level & risk of CV events in T2D
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)
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