Diabetes News

Compared with data in recent consensus statements, the Dallas protocol is associated with extremely low rates of death and disability (0.08% vs 0.3%) from DKA (The Journal of Pediatrics)

A summary of selected new evidence relevant to NICE clinical guideline 119 ‘Inpatient management of diabetic foot problems’ 2011 (NHS Evidence)

FDA investigating reports of possible increased risk of pancreatitis and pre-cancerous findings of the pancreas from incretin mimetic drugs for type 2 diabetes ( U.S. Food and Drug Administration)

Dual-hormone, closed-loop delivery guided by advanced algorithms improved short-term glucose control and reduced the risk of hypoglycemia in a group of 15 adults with type 1 diabetes (Canadian Medical Association Journal)

A recent analysis from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study showed a significantly reduced rate of minor, but not major amputations in patients with Type 2 diabetes treated with fenofibrate. Mechanistic studies are clearly needed to understand the basis of this benefit (Diabetic Medicine)

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)

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)

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)

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)

The intervention improved patient-centred outcomes, with a small effect on glycaemic control. More research needs to be performed with care home residents to develop the evidence base for appropriate interventions in this neglected group of patients (British Journal of Diabetes & Vascular Disease)

Among patients with elevated HbA1c, glucose therapy intensification was associated with a decreased 30-day readmission/emergency department admission risk and lower outpatient HbA1c levels (Diabetic Medicine)

Paediatric patients with type 1 diabetes using an insulin pump presented with lower glycaemic variability and a concomitantly lower glycaemic risk parameter compared to those using MDII (Clinical Endocrinology)

The findings suggest that, compared with younger adults, older adults receive equal glycemic benefit from participating in self-management interventions. Moreover, older adults showed the greatest glycemic improvement in the two group conditions (Diabetes Care)

Antidiabetic therapy in cirrhotic diabetic patients often seems to be inappropriate in everyday medicine, while glycemic control is frequently not satisfactory, possibly due to incompliance or insufficient metabolic control. hepatic encephalopathy occurs more often in cirrhotic patients with diabetes than in nondiabetic patients with cirrhosis (Digestion)

ADC changes during DKA treatment (reflective of vasogenic CE) do not appear to be substantially affected by the rate of intravenous fluid administration (Pediatrics)

The purpose of this review is to provide guidance to primary care physicians for the initiation and intensification of basal-bolus insulin therapy in patients with T2D (Annals of Medicine)

Overall, intensive lifestyle intervention achieved, with less medication, a comparable long-term effect on cardiovascular disease risk factors, to that seen in the metformin and placebo groups. (Diabetic Medicine)

Self-treated hypoglycaemia is common in approximately one third of patients using insulin analogue regimens. Additionally, self-treated hypoglycaemia was found to be associated with clinically significant effects on patient well-being and functioning, patient and physician management and healthcare utilisation (Current Medical Research and Opinion)

The participants expressed that they were the “hub” of diabetes care, but they were subordinated by the physicians. In order to achieve “good” diabetes care, GPs and nurses should collaborate more to try to understand each other´s areas of responsibility in order to improve the diabetes care (Internet Journal of Advanced Nursing Practice)

Nongap acidosis was present in many children with prolonged metabolic acidosis. We suggest that a continuous acetate or bicarbonate therapy via maintenance fluid might be beneficial in this subgroup of patients (Pediatric Emergency Care)