Interest in the potential for precision medicine in the prevention, treatment, and ongoing management of diabetes continues to grow across many of the most important stakeholder groups, including people with diabetes (Diabetes Care)
Diabetes News
Category: Treatment
Randomized Trial of Closed-Loop Control in Very Young Children with Type 1 Diabetes
A hybrid closed-loop system significantly improved glycemic control in very young children with type 1 diabetes, without increasing the time spent in hypoglycemia (NEJM)
Predictors of cardio-kidney complications and treatment failure in patients with chronic kidney disease and type 2 diabetes treated with SGLT2 inhibitors
Our study demonstrated high rates of residual cardio-kidney outcomes and treatment failure in patients with DKD treated with SGLT2is. Patients with high baseline CV risk and the presence of certain conditions, such as atrial fibrillation, PVD, and heart failure, were at higher risk for cardio-kidney events (BMC Medicine)
Switching from Neutral Protamine Hagedorn (NPH) Insulin to Insulin Glargine 300 U/mL in Older and Younger Patients with Type 2 Diabetes: A Post Hoc Analysis of a Multicenter, Prospective, Observational Study
The switch from NPH insulin to Gla-300 improved glycemic control in older patients with T2D and in those with a longer disease duration. Older patients with T2D and those with a longer disease duration benefited even more from the switch to Gla-300 than younger patients and those with a shorter disease duration, with significantly greater reductions in the risk of hypoglycemia (Diabetes Therapy)
A Practical Approach to Continuous Glucose Monitoring (rtCGM) and FreeStyle Libre systems (isCGM) in Children and Young people with Type 1 Diabetes
This article, aims to provide a practical approach and help identify which patients may be most likely to benefit and how the technology may be implemented in order to maximise the clinical benefits (Diabetes Research and Clinical Practice)
Standards of Medical Care in Diabetes—2022
The Standards of Care, is intended to provide clinicians, researchers, policy makers, and other interested individuals with the components of diabetes care, general treatment goals, and tools to evaluate the quality of care (Diabetes Care)
Use of Real-Time Continuous Glucose Monitoring Improves Glycemic Control and Other Clinical Outcomes in Type 2 Diabetes Patients Treated with Less Intensive Therapy
rtCGM use was associated with significant glycemic improvements in T2D patients treated with basal insulin only or noninsulin therapy. Given the growing body of evidence supporting rtCGM use in this population, insurance eligibility criteria should be modified to expand rtCGM use by T2D patients treated with less intensive therapies (Diabetes Technology and Therapeutics)
Comparisons of biochemical parameters and diabetic ketoacidosis severity in adult patients with type 1 and type 2 diabetes
There are no differences in DKA-related biochemical parameters between type 1 and type 2 diabetes patients. The present findings suggest that DKA should be assessed and treated similarly, regardless of its occurrence in type 1 or type 2 diabetes patients (BMC Endocrine Disorders)
Standards of Medical Care in Diabetes—2022
Professional Practice Committee: Standards of Medical Care in Diabetes—2022 (Diabetes Care)
The Role of Glucagon in Glycemic Variability in Type 1 Diabetes: A Narrative Review
There is growing evidences to illustrate the contribution of glucagon secretion to the glycemic variability in patients with T1DM, which may promote the development of new treatment strategies aiming to mitigate glycemic variability associated with aberrant glucagon secretion (Metabolic Syndrome and Obesity)
Closed-Loop Insulin Delivery Versus Sensor-Augmented Pump Therapy in Older Adults With Type 1 Diabetes (ORACL): A Randomized, Crossover Trial
Closed-loop therapy is an effective treatment option for older adults with long-duration type 1 diabetes, and no safety issues were identified. These older adults had higher TIR accompanied by less time below range during closed-loop than during sensor-augmented pump therapy. Of particular clinical importance, closed loop reduced the time spent in hypoglycemic range overnight (Diabetes Care)
Association between dysglycemia and mortality by diabetes status and risk factors of dysglycemia in critically ill patients: a retrospective study
The identified factors for dysglycemia could be used for risk assessment in glucose management requirement in critically ill patients, which may improve clinical outcomes (Acta Diabetologica)
When and how to deintensify type 2 diabetes care
Deintensifying type 2 diabetes care can include deprescribing and reducing diabetes-specific assessments that no longer improve quality of life of older adults (BMJ)
A systematic review and meta-analysis of interventions to preserve insulin-secreting beta cell function in people newly diagnosed with type 1 diabetes: results from intervention studies aimed at improving glucose control
This is the largest comprehensive review of RCTs in this area. It demonstrates a lack of robust evidence that interventions to improve glucose control preserve beta cell function in new onset type 1 diabetes, although analysis was hampered by low quality evidence and inconsistent reporting of studies (Diabetic Medicine)
Factors Associated with Adherence to Clinical Practice Guidelines for Patients with Type 2 Diabetes Mellitus: Results of a Spanish Delphi Consensus
Nonadherence to CPGs on T2DM is a multifactorial problem but the existence multiple CPGs, the lack of time, the therapeutic inertia, and insufficient human resources have been identified as factors limiting adherence. Hypoglycemia continues to be a barrier for achievement of targets recommended by CPGs (Journal of Diabetes Research)
The Management of Type 1 Diabetes in Adults. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)
This report has covered many areas of the management of type 1 diabetes; however, the writing group recognizes that huge gaps exist in our knowledge in the prevention, diagnosis, and treatment of the disease. People with type 1 diabetes deserve better, higher quality research evidence on which to determine their optimal care (Diabetes Care)
Glucose Regulation Beyond HbA1c in Type 2 Diabetes Treated With Insulin: Real-World Evidence From the DIALECT-2 Cohort
In this study, a high HbA1c did not reduce the occurrence of nocturnal hypoglycemia, and low HbA1c was not associated with the highest TIR. Optimal personalization of glycemic control requires the use of newer tools, including CGM-derived parameters (Diabetes Care)
Structured self-monitoring of blood glucose is associated with more appropriate therapeutic interventions than unstructured self-monitoring: a novel analysis of data from PRISMA
Our data strongly support that structured SMBG has clinical value in reducing HbA1c in non-insulin-treated T2D and suggest that this clinical benefit may be mediated by more appropriate and timely changes in drug therapy (Diabetes Research and Clinical Practice)
Amplifying the antidiabetic actions of GLP-1: potential benefits of new adjunct therapies
Taken together, therapies that activate GLP-1 receptor signalling, in combination with various other cell signalling pathways, show potential for treating type-2 diabetes and obesity with superiority over GLP-1 receptor agonist therapy alone (Diabetic Medicine)
Individual, healthcare professional and system-level barriers and facilitators to initiation and adherence to injectable therapies for type 2 diabetes
A model is presented to help patients, health practitioners and policy makers identify barriers and facilitators and understand the complex interplay of physical, psychological and social factors involved when prescribing injectable therapies (Diabetic Medicine)
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