In this issue of JAMA, the US Preventive Services Task Force (USPSTF) addresses this important issue with a new Recommendation Statement on screening for prediabetes and type 2 diabetes in children and adolescents based on an Evidence Report and Systematic Review of the evidence on screening for prediabetes and type 2 diabetes in asymptomatic, nonpregnant persons younger than 18 year (JAMA)
Diabetes News
Tag: Type 2 Diabetes
Mechanisms underlying the blood pressure lowering effects of empagliflozin, losartan and their combination in people with type 2 diabetes: a secondary analysis of a randomized cross-over trial
In people with T2D, SGLT2 inhibition in combination with ARB had a larger blood-pressure lowering effect versus placebo than either of the drugs alone. Our data further suggest that the mechanisms underlying these blood pressure reductions at least partially differ between these agents (Diabetes, Obesity and Metabolism)
Temporal trends in the prevalence and incidence of depression and the interplay of comorbidities in patients with young- and usual-onset type 2 diabetes from the USA and the UK
Depression risk has been increasing in people with incident type 2 diabetes in the UK and USA, particularly among those with young-onset type 2 diabetes, irrespective of other comorbidities. This suggests that proactive mental health assessment from the time of type 2 diabetes diagnosis in primary care is essential for effective clinical management of people with type 2 diabetes (Diabetologia)
Sodium-Glucose Cotransporter 2 Inhibitors and Risk of Hyperkalemia in People With Type 2 Diabetes: A Meta-Analysis of Individual Participant Data From Randomized, Controlled Trials
SGLT2 inhibitors reduce the risk of serious hyperkalemia in people with type 2 diabetes at high cardiovascular risk or with chronic kidney disease without increasing the risk of hypokalemia (Circulation)
Association Between SGLT2 Inhibitor Treatment and Diabetic Ketoacidosis and Mortality in People With Type 2 Diabetes Admitted to Hospital With COVID-19
We demonstrate a low risk of DKA and high mortality rate in people with T2D admitted to hospital with COVID-19 and limited power, but no evidence, of increased risk of DKA or in-hospital mortality associated with prescription of SGLT2is (Diabetes Care)
The experiences of insulin use among older people with Type 2 diabetes mellitus: A thematic synthesis
The review indicates issues surrounding the technical aspects of insulin administration, side effects of treatment and reactions to insulin administration are common amongst older people. However, research evidence is limited, and there is an urgent need for empirical, participatory research with older insulin dependent adults with type 2 diabetes (Primary Care Diabetes)
Beyond Detecting and Understanding Disparities in Novel Diabetes Treatment
Several underrepresented racial and ethnic groups, including American Indian, Asian, Black, and Hispanic individuals, experience a higher prevalence of type 2 diabetes and higher rates of disease-attributable morbidity and mortality than White individuals (JAMA)
Large Effect Size in Composite Kidney Outcomes than in Majors Cardiovascular Events of SGLT2 inhibitors compared with GLP-1 RAs: A Pooled Analysis of Type 2 Diabetes Trials
In T2D patients, treatment effect sizes were greater for kidney than for macrovascular (MACE-3) outcomes, with important differences according to the drugs considered. CKO and MACE-3 are independent. Caution must be taken when interpreting CKO in the absence of MACE-3 data (Diabetes, Obesity and Metabolism)
Dapagliflozin improves myocardial flow reserve in patients with type 2 diabetes: the DAPAHEART Trial: a preliminary report
SGLT-2 inhibition increases MFR in T2D patients. We provide new insight into SGLT-2i CV benefits, as our data show that patients on SGLT-2i are more resistant to the detrimental effects of obstructive coronary atherosclerosis due to increased MFR, probably caused by an improvement in coronary microvascular dysfunction (Cardiovascular Diabetology)
Barriers and Facilitators to the Initiation of Injectable Therapies for Type 2 Diabetes Mellitus: A Mixed Methods Study
GPs recognise the need to initiate injectables but lack practical skills and time to address patient concerns and provide education. Primary care nurses also report difficulties in maintaining these skills. Primary care HCPs initiating injectables require additional training to provide practical demonstrations, patient education and how to identify and address concerns (Diabetes Therapy)
Protein Biomarkers and Cardiovascular Outcomes in People With Type 2 Diabetes and Acute Coronary Syndrome: The ELIXA Biomarker Study
NT-proBNP and other proteins independently predict cardiovascular outcomes in people with type 2 diabetes following acute coronary syndrome. Adding other biomarkers only marginally increased NT-proBNP’s prognostic value (Diabetes Care)
Twenty-Year Temporal Trends in Risk of Ischemic Stroke in Incident Type 2 Diabetes: A Danish Population-Based Cohort Study
From 1996 to 2015, the 5-year risk of first-time ischemic stroke was approximately halved in patients with incident T2DM and no prior ASCVD, coinciding with markedly increased use of prophylactic cardiovascular medications (Diabetes Care)
Transitioning to active-controlled trials to evaluate cardiovascular safety and efficacy of medications for type 2 diabetes
In summary, the rapidly evolving therapeutic environment for T2DM has provided new options for patients that can further mitigate risk for CV disease complications, which remains a major cause of mortality and morbidity in this population (Cardiovascular Diabetology)
Risk of all-cause mortality according to the European Society of Cardiology risk categories in individuals with type 2 diabetes: the Renal Insufficiency And Cardiovascular Events (RIACE) Italian Multicenter Study
The negligible number of moderate-risk patients suggests that these classifications might overestimate risk of ASCVD death. Downgrading patients with ≥ 3 additional ASCVD risk factors to the high-risk category is consistent with mortality data. Risk of death is very high in the presence of TOD irrespective of established ASCVD (Acta Diabetologica)
Characteristics and care of young people with type 2 diabetes included in the national diabetes audit datasets for England
The substantial number of people under 40 years of age with type 2 diabetes, are more likely to have characteristics associated with inequalities and are less likely to achieve HbA1c targets and receive recommended care processes. These findings highlight the need to consider novel approaches to service provision for this high-risk group (Diabetic Medicine)
Correlation Between Blood Glucose Control and Levels of Carbohydrate Antigen 19-9 and Carcinoembryonic Antigen in Patients with Type-2 Diabetes Mellitus
Both CA19-9 and CEA might be elevated at low levels in patients with T2DM; levels were closely correlated to the degree of glycemic control (Metabolic Syndrome and Obesity)
Association of Time in Range with Endothelial Injury in Patients with Type 2 Diabetes Treated with Exenatide
Treatment with exenatide increases TIR and decreases glycemic variability in patients with T2DM. Moreover, the amelioration of endothelial injury is more pronounced in patients with TIR > 70% after the treatment (Diabetes Therapy)
New Discovered Adipokines Associated with the Pathogenesis of Obesity and Type 2 Diabetes
This review aims to summarize several adipokines discovered recently that have promising functions in obesity and T2DM. Among them, the levels of FSTL1, WISP1 and Asprosin in subjects with obesity or diabetes are commonly higher than in normal controls, suggesting that they may be pathogenic. Inversely, SFRP5, Metrnl, NRG4 and FAM19A5 may serve as the protective factors ( Diabetes, Metabolic Syndrome and Obesity)
SGLT2 inhibitors in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials balancing their risks and benefits
Our study is limited to aggregate data. In a population of individuals with type 2 diabetes and a high CVD risk, the cardiovascular and renal benefits of SGLT2i remain substantial despite the risk of DKA and even the hypothetical risk of amputation (Diabetologia)
Cardiovascular outcomes trials: a paradigm shift in the current management of type 2 diabetes
The aim of this review is to provide an in-depth summary of CVOT data—crystallising the key findings, from safety to efficacy—and to offer a practical perspective for physicians. Finally, we discuss the next steps for the post-CVOT era, with ongoing studies that may further transform clinical practice and improve outcomes for people with T2D, heart failure or renal disease (Cardiovascular Diabetology)
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