Based on the available evidence, dipeptidyl peptidase‐4 inhibitors should be considered for hospitalized patients with type 2 diabetes and an algorithm for this is proposed (Figure 1). In relation to the use of GLP‐1 and GLP‐1 receptor agonist, further research is required to help define their role in the inpatient setting (Journal of Diabetes Investigation)
Diabetes News
Tag: Type 2 Diabetes
Oral Semaglutide versus Empagliflozin in Patients with Type 2 Diabetes Uncontrolled on Metformin: The PIONEER 2 Trial
Oral semaglutide was superior to empagliflozin in reducing HbA1c but not body weight at 26 weeks in patients with type 2 diabetes uncontrolled on metformin. At week 52, HbA1c and body weight (trial product estimand) were significantly reduced versus empagliflozin. Oral semaglutide was well tolerated within the established safety profile of GLP-1 receptor agonists (Diabetes Care)
Efficacy and safety of once-weekly semaglutide versus daily canagliflozin as add-on to metformin in patients with type 2 diabetes (SUSTAIN 8)
Once-weekly semaglutide 1·0 mg was superior to daily canagliflozin 300 mg in reducing HbA 1c and bodyweight in patients with type 2 diabetes uncontrolled on metformin therapy. These outcomes might guide treatment intensification choices (The Lancet Diabetes & Endocrinology)
Trends in incidence of total or type 2 diabetes: systematic review
The incidence of clinically diagnosed diabetes has continued to rise in only a minority of populations studied since 2006, with over a third of populations having a fall in incidence in this time period. Preventive strategies could have contributed to the fall in diabetes incidence in recent years. Data are limited in low and middle income countries, where trends in diabetes incidence could be different (BMJ)
SGLT2 inhibitors for the prevention of kidney failure in patients with type 2 diabetes: a systematic review and meta-analysis
SGLT2 inhibitors reduced the risk of dialysis, transplantation, or death due to kidney disease in individuals with type 2 diabetes and provided protection against acute kidney injury. These data provide substantive evidence supporting the use of SGLT2 inhibitors to prevent major kidney outcomes in people with type 2 diabetes (The Lancet Diabetes & Endocrinology)
Ticagrelor in Patients with Stable Coronary Disease and Diabetes
In patients with stable coronary artery disease and diabetes without a history of myocardial infarction or stroke, those who received ticagrelor plus aspirin had a lower incidence of ischemic cardiovascular events but a higher incidence of major bleeding than those who received placebo plus aspirin (NEJM)
Effects of sitagliptin on gastric emptying of, and the glycaemic and blood pressure responses to, a carbohydrate meal in type 2 diabetes
In type 2 diabetes, while sitagliptin has no effect on either gastric emptying or postprandial blood pressure, it’s effects to lower postprandial glucose is dependent on the basal rate of gastric emptying (Diabetes, Obesity and Metabolism)
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)
Lack of Durable Improvements in β-Cell Function Following Withdrawal of Pharmacological Interventions in Adults With Impaired Glucose Tolerance or Recently Diagnosed Type 2 Diabetes
In adults with IGT or recently diagnosed type 2 diabetes, interventions that improved β-cell function during active treatment failed to produce persistent benefits after treatment withdrawal. These observations suggest that continued intervention may be required to alter the progressive β-cell dysfunction in IGT or early type 2 diabetes (Diabetes Care)
PIONEER 1: Randomized Clinical Trial of the Efficacy and Safety of Oral Semaglutide Monotherapy in Comparison With Placebo in Patients With Type 2 Diabetes
In patients with type 2 diabetes, oral semaglutide monotherapy demonstrated superior and clinically relevant improvements in HbA1c (all doses) and body weight loss (14 mg dose) versus placebo, with a safety profile consistent with other GLP-1 receptor agonists (Diabetes Care)
Controversies for Glucose Control Targets in Type 2 Diabetes: Exposing the Common Ground
The evidence suggests that glucose control takes 5 years or more to have any impact on vascular outcomes or mortality, so targets may also be higher in those with shorter life expectancy or higher health burden or simply reflect individual preferences. This article discusses the evidence behind these conclusions (Diabetes Care)
Longitudinal evaluation of gastric emptying in type 2 diabetes
In patients with long-term type 2 diabetes, gastric emptying of solids and liquids does not usually become more delayed over time, and abnormally slow gastric emptying of solids may improve (Diabetes Research and Clinical Practice)
Association between blood pressure variability, cardiovascular disease and mortality in type 2 diabetes
Our results suggest that BPV might provide additional information rather than mean blood pressure on the risk of cardiovascular disease in patients with type 2 diabetes (Diabetes, Obesity and Metabolism)
Liraglutide in Children and Adolescents with Type 2 Diabetes
In children and adolescents with type 2 diabetes, liraglutide, at a dose of up to 1.8 mg per day (added to metformin, with or without basal insulin), was efficacious in improving glycemic control over 52 weeks. This efficacy came at the cost of an increased frequency of gastrointestinal adverse events (NEJM)
Traveling down the Long Road to Type 1 Diabetes Mellitus Prevention
Investigative efforts have centered on prevention, aiming to either delay or prevent disease onset. However, that requires the elucidation of the relevant pathophysiological mechanisms that lead to the pancreatic beta-cell destruction thought to be the root cause of type 1 diabetes (NEJM)
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)
Impact of angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers on renal and mortality outcomes in people with Type 2 diabetes and proteinuria
Angiotensin‐converting enzyme inhibitors and angiotensin receptor blockers may reduce the risk of end‐stage renal disease and slow the progression of nephropathy, but they do not appear to decrease all‐cause or cardiovascular mortality in people with Type 2 diabetes and proteinuria (Diabetic Medicine)
Distinct trajectories of HbA1c in newly diagnosed Type 2 diabetes from the DPV registry using a longitudinal group‐based modelling approach
Four subgroups with distinct HbA1c trajectories were determined in newly diagnosed Type 2 diabetes using a group‐based modelling approach. Approximately one‐third of people with newly diagnosed Type 2 diabetes need either better medication adherence or earlier intensification of glucose‐lowering therapy (Diabetic Medicine)
Clinical Implications of Urinary C-Peptide Creatinine Ratio in Patients with Different Types of Diabetes
UCPCR is a practical and noninvasive marker that can distinguish between TIDM and T2DM or monogenic diabetes. reflects severe impaired beta cell function and the need for insulin or secretagogue therapy in T2DM patients (Journal of Diabetes Research)
Dapagliflozin vs Non‐SGLT‐2i Treatment is Associated with Lower Hospital Care Costs in Type 2 Diabetes Patients Similar to the DECLARE‐TIMI 58 Participants
In a nationwide, real‐world, DECLARE‐like population, dapagliflozin was associated with lower hospital costs compared with oGLD, mainly as a result of reduced rates of CV‐ and T2D‐associated complications (Diabetes, Obesity and Metabolism)
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