Delivering evidence based, patient centered care to people with type 2 diabetes requires a paradigm shift and departure from the predominantly glucocentric view of diabetes management. Instead of prioritizing intensive glycemic control, the focus needs to be on ensuring access to adequate diabetes care (BMJ)
Diabetes News
Tag: Type 2 Diabetes
Cardiovascular risk and the implications for clinical practice of cardiovascular outcome trials in type 2 diabetes
To date, all CVOTs have shown non-inferiority versus placebo (both added to standard of care) against a primary endpoint of 3- or 4-point major adverse cardiovascular event (MACE), confirming CV safety of these treatments. Additionally, some CVOTs have shown superiority to placebo against the same MACE endpoint, suggesting a cardioprotective action for these treatments. This is reflected in guideline updates, which primary care physicians should consider when personalizing treatments (Primary Care Diabetes)
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)
Vertebral Fractures in Individuals With Type 2 Diabetes: More Than Skeletal Complications Alone
Based on our findings, individuals with T2D should be systematically assessed for presence of VFs, and, as in individuals without T2D, their presence constitutes an indication to start osteoporosis treatment for the prevention of future fractures (Diabetes Care)
Patient-Centred Care in Type 2 Diabetes Mellitus – Key Aspects of PDM-ProValue are reflected in the 2018 ADA/EASD Consensus Report
The decision cycle, investigated in PDM-ProValue and similarly recommended by the 2018 ADA/EASD consensus report, can benefit diabetes management in persons with type 2 diabetes (Diabetes Research and Clinical Practice)
Different Analysis of β-Cell Dysfunction as Fasting Glucose Progresses in Obese and Nonobese Newly Diagnosed Type 2 Diabetic Patients
During the progression of baseline FBG, β-cell dysfunction and insulin resistance worsened. As FBG increased, increased BMI had a positive influence on β-cell dysfunction in all FBG groups. The independent factors that correlated to EISI differed with the increasing of baseline FBG (Journal of Diabetes Research)
Variability in Glycated Hemoglobin and Risk of Poor Outcomes Among People With Type 2 Diabetes in a Large Primary Care Cohort Study
HbA1c variability was strongly associated with overall mortality and emergency hospitalization and not explained by average HbA1c or hypoglycemic episodes. Only for CAD and IS hospitalizations was no association found, with average HbA1c strongly predictive. Targets should focus on both stability and absolute level of HbA1c (Diabetes Care)
Oral semaglutide for type 2 diabetes: a systematic review and meta‐analysis
Oral semaglutide can effectively and safely reduce blood glucose, body weight and systolic blood pressure. Nevertheless, it is associated with increased incidence of gastrointestinal adverse events (Diabetes, Obesity and Metabolism)
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)
Costarting sitagliptin with metformin is associated with a lower likelihood of disease progression in newly treated people with type 2 diabetes: a cohort study
Costarting drug therapy with sitagliptin and metformin was associated with a lower likelihood of disease progression in people with type 2 diabetes compared with adding sitagliptin later (Diabetic Medicine)
Cardiovascular Outcome Trials in Type 2 Diabetes: What Do They Mean for Clinical Practice?
In this article, the authors review the study designs and results of CV outcomes trials conducted with sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists and discuss how these may affect clinical practice (Clinical Diabetes)
Disparities in glycaemic control, monitoring, and treatment of type 2 diabetes in England: A retrospective cohort analysis
Our findings suggest that disparity in glycaemic control, diabetes-related monitoring, and prescription of newer therapies remains a challenge in diabetes care. Both SES and ethnicity were important determinants of inequality (PLOS Medicine)
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)
Prevalence of Established Cardiovascular Disease in Patients with Type 2 Diabetes Mellitus in the UK
Approximately one-third of patients with T2DM in the UK have concomitant CVD (Diabetes Therapy)
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)
Behaviour change, weight loss and remission of Type 2 diabetes: a community‐based prospective cohort study
In a population‐based sample of adults with screen‐detected Type 2 diabetes, weight loss of ≥10% early in the disease trajectory was associated with a doubling of the likelihood of remission at 5 years (Diabetic Medicine)
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)
How to perform better intervention to prevent and control diabetic retinopathy among patients with type 2 diabetes: A meta-analysis of randomized controlled trials
We found that multifactorial interventions can significantly reduce the risk of developing DR and its progression among patients with type 2 diabetes. More importantly, we found all these multifactorial interventions contained individualization of targets and communication between health professionals and patients, suggesting ophthalmologists and diabetes health professionals should work together with patients to set more individualized targets while taking into account multiple factors so as to achieve optimal effect in DR prevention and control (Diabetes Research and Clinical Practice)
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)
Effect of Linagliptin vs Glimepiride on Major Adverse Cardiovascular Outcomes in Patients With Type 2 Diabetes – The CAROLINA Randomized Clinical Trial
Among adults with relatively early type 2 diabetes and elevated cardiovascular risk, the use of linagliptin compared with glimepiride over a median 6.3 years resulted in a noninferior risk of a composite cardiovascular outcome (JAMA)
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