The American Diabetes Association’s (ADA’s) Standards of Medical Care in Diabetes is updated and published annually in a supplement to the January issue of Diabetes Care
Diabetes News
Category: Treatment
A qualitative study of clinician attitudes towards closed‐loop systems in mainstream diabetes care in England
Clinicians recognize the value of closed‐loop systems in terms of health benefits, but also identify a range of concerns for both users and healthcare staff, which could impact negatively on user access (Diabetic Medicine)
Effectiveness and Safety of Insulin Glargine 300 U/mL in Insulin‐Naïve Patients with Type 2 Diabetes after Failure of Oral Therapy in a Real World Setting
Starting a BOT regimen with Gla‐300 allowed about 60% of 721 German and Swiss patients with inadequately controlled type 2 diabetes to achieve glycaemic control within 12 months in daily clinical practice. Glycaemic control was achieved without weight gain or increased risk of nocturnal or severe hypoglycaemia (Diabetes, Obesity and Metabolism)
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)
Sleep and HbA1c in Patients With Type 2 Diabetes: Which Sleep Characteristics Matter Most?
Sleep in general may be a modifiable factor of importance for patients with T2D. The prevention of sleep curtailment may serve as a primary focus in the sleep-centered management of T2D (Diabetes Care)
Variation in the achievement of HbA1c, blood pressure and LDL cholesterol targets in type 2 diabetes in general practice and characteristics associated with risk factor control
Clinical diabetes management is difficult, and few people meet all three risk factor control targets. The proportion of people reaching target varied among general practitioners and practices. Several population, general practitioner and practice characteristics only explained a small part of the total variation (Diabetic Medicine)
Six-Month Randomized, Multicenter Trial of Closed-Loop Control in Type 1 Diabetes
In this 6-month trial involving patients with type 1 diabetes, the use of a closed-loop system was associated with a greater percentage of time spent in a target glycemic range than the use of a sensor-augmented insulin pump. (NEJM)
Improving Type 2 Diabetes Management in General Practice Using a Second-Generation Basal Insulin Analogue Insulin Glargine 300 U/mL: A Practical Guide
The clinical application of the use of Gla-300 include advantages such as less intra- and interpatient variability in glucose control resulting in rather less hypoglycaemia, longer duration of action and greater flexibility in the timing of administration thus suiting a wide range of patient presentations (Diabetes Therapy)
De-Intensification Of Blood Glucose Lowering Medication In People Identified As Being Over-Treated: A Mixed Methods Study
Treatment had been de-intensified in more than half of the patients (56.3%). Insight in reasons for not de-intensifying elderly patients is important since treatment for them can be “person-centred care”. De-intensification is an iterative and time-intensive process (Patient Preference and Adherence)
Effect of diabetes duration on the relationship between glycaemic control and risk of death in older adults with type 2 diabetes
In elderly individuals with T2D, the effect of glycaemic control (measured by HbA1c) on all‐cause mortality depended on the duration of diabetes. Of particular clinical importance, we found that strict glycaemic control was associated with an increased risk of death among individuals with long (>5 years) diabetes duration (Diabetes, Obesity and Metabolism)
Short term optimization of glycaemic control using insulin improves sympatho-vagal tone activities in patients with type 2 diabetes
The optimization of glycaemic control using a basal plus insulin regimen while inducing a significant reduction in glycated hemoglobin, significantly improves 24-hour ambulatory ECG derived sympathetic and parasympathetic activities. This suggests that tight glycaemic control using insulin may revert cardiac autonomic neuropathy in type 2 diabetes mellitus patients (Diabetes Research and Clinical Practice)
Dual GIP–GLP1-Receptor Agonists In The Treatment Of Type 2 Diabetes: A Short Review On Emerging Data And Therapeutic Potential
Combined GIP- and GLP1R activators have the potential to become a treatment option for patients with type 2 diabetes (Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy)
Type 2 Diabetes Mellitus and Menopausal Hormone Therapy: An Update
Although in the past women with T2DM would be excluded from MHT, nowadays there is strong evidence to support an individualised approach after careful evaluation of their CVD risk (Diabetes Therapy)
Predicting Short‐term and Long‐term HbA1c Response after Insulin Initiation in Patients with Type 2 Diabetes Mellitus using Machine Learning
Machine‐learning algorithm performed well in the prediction of an individual’s short‐term and long‐term HbA1c response using baseline clinical variables (Diabetes, Obesity and Metabolism)
Commissioning Standard: Dental Care for People with Diabetes
This commissioning standard document supports commissioners in NHS England and NHS Improvement with the implementation of a standardised framework for the local commissioning of dental services for people with diabetes (type 1 and type 2) and people with non-diabetic hyperglycaemia (NDH)
Intensive vs Standard Treatment of Hyperglycemia and Functional Outcome in Patients With Acute Ischemic Stroke
Among patients with acute ischemic stroke and hyperglycemia, treatment with intensive vs standard glucose control for up to 72 hours did not result in a significant difference in favorable functional outcome at 90 days. These findings do not support using intensive glucose control in this setting (JAMA)
Do GLP‐1RAs and SGLT‐2is reduce cardiovascular events in black patients with type 2 diabetes? A systematic review and meta‐analysis
Given that black patients with type 2 diabetes were not well represented in CVSTs and such trials were underpowered to evaluate racial differences, it remains unclear whether GLP‐1RAs or SGLT‐2is would reduce cardiovascular risk in such patients, and additional studies targeting black patients are urgently needed (Diabetes, Obesity and Metabolism)
Changes in the Prescription of Glucose‐Lowering Medications in Patients With Type 2 Diabetes Mellitus After a Cardiovascular Event: A Call to Action From the DATAFILE Study
This study highlights that occurrence of a CVE in T2DM patients did not prime the prescription of glucose‐lowering medications provided with cardiovascular protective effects, even though glucose control remained poor. These data emphasize the need to optimize the therapeutic regimen of T2DM patients with established cardiovascular disease, according to updated guidelines (JAHA)
Post-Basal Insulin Intensification and Healthcare Resource Use in Type 2 Diabetes: A Web-Based Physician Survey in the United States and United Kingdom
Less complex regimens for intensification following basal insulin may help reduce the time and healthcare resources required for intensification and address some of the challenges T2D patients face when intensifying to basal–bolus or basal with GLP-1 (Diabetes Therapy)
Improved treatment satisfaction in patients with type 2 diabetes treated with once‐weekly semaglutide in the SUSTAIN trials
Semaglutide was associated with significantly greater (SUSTAIN 2–5) or similar (SUSTAIN 7) improvements in overall treatment satisfaction versus comparators/placebo. Improvements in overall treatment satisfaction were generally greater in patients achieving versus not achieving treatment targets (Diabetes, Obesity and Metabolism)
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