A large proportion of subjects with T2D is at high or very high risk. Glucose-lowering drug therapies seem not to be adequately used with respect to their potential advantages in terms of cardiovascular risk reduction (Cardiovascular Diabetology)
Diabetes News
Tag: Type 2 Diabetes
Sex-specific differences in left ventricular mass and myocardial energetic efficiency in non-diabetic, pre-diabetic and newly diagnosed type 2 diabetic subjects
Left ventricle is subject to maladaptive changes with worsening of glucose tolerance, especially in women with newly diagnosed T2DM. The sex-specific increase in LVM and decrease in MEEi, both being predictors of CVD, may have a role in explaining the stronger impact of T2DM on the excess risk of CVD in women than in men (Cardiovascular Diabetology)
Sodium–Glucose Co-Transporter 2 Inhibitors (SGLT2i) Exposure and Outcomes in Type 2 Diabetes: A Systematic Review of Population-Based Observational Studies
In T2D, SGLT2is appear safe from the CV perspective and may have associated benefit in primary as well as secondary CVD prevention. For safety, they may be associated with an increased risk of GMI, LLA and DKA, although longer follow-up studies are needed (Diabetes Therapy)
Gut microbiota compositions and metabolic functions in type 2 diabetes differ with glycemic durability to metformin monotherapy
There were different compositions of gut microbiota with unique microbial metabolic pathways between type 2 diabetes with and without glycemic durability to metformin monotherapy. Microbial salvage by increasing thiamine biosynthesis might be beneficial for the metformin durable group to maintain optimal glycemic control (Diabetes Research and Clinical Practice)
Type 2 Diabetes and the Use of Real-Time Continuous Glucose Monitoring
Based on literature review, we summarized current data on the use of rtCGM in T2D management and provided future research direction to generate more evidence on the utility of CGM in this population (Diabetes Technology and Therapeutics)
Therapeutic inertia in the management of dyslipidaemia and hypertension in incident type 2 diabetes and the resulting risk factor burden: real‐world evidence from primary care
Significant delay in initiating cardioprotective therapies was observed, time to first prescription was similar in primary prevention people irrespective of ASCVD risk status across all T2DM diagnosis age groups, resulting in poor risk factor control over 2‐years follow‐up (Diabetes, Obesity and Metabolism)
Severe Hypoglycemia Risk With Long-Acting Insulin Analogs vs Neutral Protamine Hagedorn Insulin
In this cohort study, initiation of long-acting analogs was associated with a lower risk of ED visits or hospitalizations for hypoglycemia compared with NPH insulin in older patients with type 2 diabetes in Medicare. However, this association was not seen with concomitant prandial insulin use (JAMA)
Effect of empagliflozin on ectopic fat stores and myocardial energetics in type 2 diabetes: the EMPACEF study
EMPA effectively reduced liver fat in mice and humans without changing epicardial, myocardial fat or myocardial energetics, rebutting the thrifty substrate hypothesis for cardiovascular protection of SGLT2 inhibitors (Cardiovascular Diabetology)
Results of a 24-Week Trial of Technosphere Insulin Versus Insulin Aspart in Type 2 Diabetes
Both TI and IA resulted in significant and clinically meaningful HbA1C reductions. TI also resulted in significant and clinically meaningful weight reductions. These data support the use of inhaled insulin as a treatment option for individuals with type 2 diabetes (Endocrine Practice)
Identifying patients at increased risk of hypoglycaemia in primary care: Development of a machine learning‐based screening tool
Using demographic and medication data, a model for identifying patients at increased risk of hypoglycaemia was developed using machine learning. This model can be used as a tool in primary care to screen for patients with T2D who may need additional attention to prevent or reduce hypoglycaemic events (Diabetes/Metabolism Research and Reviews)
Changes in Cardiovascular Biomarkers Associated With the Sodium–Glucose Cotransporter 2 (SGLT2) Inhibitor Ertugliflozin in Patients With Chronic Kidney Disease and Type 2 Diabetes
The effects of ertugliflozin on natriuretic peptides and neurohormones are preserved in patients with moderate CKD and consistent with plasma volume reduction. The rise in HCT without a change in erythropoiesis supports the volume contraction mechanism of SGLT2 inhibitor therapy. These effects may be important physiologically and contribute to a lower risk of CVD with SGLT2 inhibitor treatment in people with type 2 diabetes (Diabetes Care)
Sodium–glucose cotransporter 2 inhibitor‐induced reduction in the mean arterial pressure improved renal composite outcomes in type 2 diabetes mellitus patients with chronic kidney disease: A propensity score‐matched model analysis in Japan
The degree of blood pressure reduction after SGLT2 inhibitor treatment influenced renal composite outcomes in Japanese type 2 diabetes mellitus patients with CKD, confirming the importance of blood pressure management in type 2 diabetes mellitus patients with CKD, even when they are under SGLT2 inhibitor treatment (Journal of Diabetes Investigation)
Use of Dipeptidyl Peptidase‐4 inhibitors and prognosis of COVID‐19 in hospitalized patients with type 2 diabetes: a propensity score analysis from the CORONADO study
These data support the safety of DPP‐4 inhibitors for diabetes management during the COVID‐19 pandemic and they should not be discontinued (Diabetes, Obesity and Metabolism)
Characteristics and outcomes of pregnant women with type 1 or type 2 diabetes: a 5-year national population-based cohort study
Our data highlight persistent adverse pregnancy outcomes in women with type 1 or type 2 diabetes. Maternal glycaemia and BMI are the key modifiable risk factors. No maternity clinics were had appreciably better outcomes than any others, suggesting that health-care system changes are needed across all clinics (The Lancet Diabetes & Endocrinology)
Prediction of mortality and major cardiovascular complications in type 2 diabetes: External validation of UK Prospective Diabetes Study outcomes model version 2 in two European observational cohorts
The UKPDS‐OM2 consistently overpredicted the risk of mortality and MI in both cohorts during follow‐up. Period effects may partially explain the differences. Results indicate that transferability is not satisfactory for all outcomes, and new or adjusted risk equations may be needed before applying the model to the Italian or Dutch settings (Diabetes, Obesity and Metabolism)
Temporal Trends in Comorbidities and Cardiometabolic Risk Factors at the Time of Diagnosis of Type 2 Diabetes in UK
CMM and high ASCVD risk have been consistently increasing across all age groups and gender, particularly CMM in those <50 years. Our findings indicate that the ESC‐EASD recommendations need to change to consider the young‐onset people with T2DM as a high‐risk group as recommended in the Primary Care Diabetes Europe Position Statement (Diabetes, Obesity and Metabolism)
Metabolic surgery versus conventional medical therapy in patients with type 2 diabetes: 10-year follow-up of an open-label, single-centre, randomised controlled trial
Metabolic surgery is more effective than conventional medical therapy in the long-term control of type 2 diabetes. Clinicians and policy makers should ensure that metabolic surgery is appropriately considered in the management of patients with obesity and type 2 diabetes (The Lancet)
Lack of awareness of liver organ damage in patients with type 2 diabetes
Despite increasing evidence of a frequent hepatic involvement associated with poor prognosis, awareness of suffering of advanced liver disease in patients with T2D is remarkably low, likely reflecting little recognition also among the team of health care professionals (Acta Diabetologica)
Effect of sodium–glucose cotransporter 2 inhibitors on cardiac structure and function in type 2 diabetes mellitus patients with or without chronic heart failure: a meta-analysis
The use of SGLT2i was associated with significant improvements in cardiac diastolic function, plasma NT-proBNP level, and the KCCQ score in T2DM patients with or without chronic HF, but did not significantly affect cardiac structural parameters indexed by body surface area. The LVEF level was improved only in HF patients with reduced ejection fraction (Cardiovascular Diabetology)
What’s in a Name? Redefining Type 2 Diabetes Remission
This opinion piece explores existing definitions of diabetes remission and proposes a contemporary and comprehensive framework to help define this clinical state
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