The latest NICE guidelines for the management of type 2 diabetes are now available for consultation. They contain sensible recommendations regarding lifestyle, patient education, monitoring and targets. Unfortunately, the pharmacotherapy section shows a distinct failure of common sense (The British Journal of Diabetes & Vascular Disease)
Diabetes News
Tag: Type 2 Diabetes
Association between pulse pressure and risk of hospital admissions for cardiovascular events among people with Type 2 diabetes: a population-based case–control study
In people with Type 2 diabetes, pulse pressure is a good predictor of risk of hospitalization for cardiovascular events. The risk is lowest with a pulse pressure of 57–63 mmHg (Diabetic Medicine)
An educational program for insulin self-adjustment associated with structured self-monitoring of blood glucose significantly improves glycemic control in patients with type 2 diabetes mellitus after 12 weeks
Training for self-titrating insulin doses combined with structured SMBG can safely improve glycemic control in poorly controlled insulin-treated T2DM patients
Comparative Effectiveness of Early versus Delayed Metformin in the Treatment of Type 2 Diabetes
Treatment with metformin earlier in the course of type 2 diabetes is associated with better glycemic control, more pronounced weight reduction, and a lower risk for therapy intensification than delayed treatment. Antihyperglycemic therapy should be initiated early after diagnosis to achieve optimal outcomes
Estimating Cost-Effectiveness in Type 2 Diabetes
A marked difference in treatment cost-effectiveness was demonstrated when comparing routine clinical practice with guideline-advocated therapy escalation. This is important to both health care professionals and the wider health economic community with respect to understanding the true cost-effectiveness profile of any particular T2DM therapy option (Medical Decision Making)
Safety and effectiveness of dipeptidyl peptidase-4 inhibitors versus intermediate-acting insulin or placebo for patients with type 2 diabetes failing two oral antihyperglycaemic agents
DPP-4 inhibitors were superior to placebo in reducing HbA1c levels in adults with T2DM taking at least two oral agents. Compared with placebo, no safety signals were detected with DPP-4 inhibitors and there was a reduced risk of infection. There was no significant difference in HbA1c observed between NPH and placebo or NPH and DPP-4 inhibitors (BMJ Open)
Effects of Glucagon-Like Peptide-1 Receptor Agonists on Weight Loss in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis
Our results suggest GLP-1 RAs are promising candidates for weight control in comparison with traditional hypoglycemic drugs (Journal of Diabetes Research)
Determining Predictors of Early Response to Exenatide in Patients with Type 2 Diabetes Mellitus
Our study identified that baseline HbA1c acted as the sole predictor of exenatide response and that response may be determined after 3 months of exenatide administration (Journal of Diabetes Research)
Evidence-base on type 2 diabetes mellitus
This document summarises the evidence-base on type 2 diabetes mellitus. It is a key therapeutic topic which has been identified to support Medicines Optimisation. It is not formal NICE guidance (NICE)
Insulin secretion in patients with latent autoimmune diabetes (LADA): half way between type 1 and type 2 diabetes: action LADA 9
The present study shows that the magnitude of stimulated insulin secretion in LADA is intermediate between that of type 1 and type 2 diabetes mellitus (BMC Endocrine Disorders)
Remission of Type 2 Diabetes After Roux-en-Y Gastric Bypass or Sleeve Gastrectomy Is Associated With a Distinct Glycemic Profile
Remission of T2DM after RYGBP and SG is associated with distinct glycemic profiles. However, longer time spent in hyperglycemia and in hypoglycemia after RYGBP compared with SG is not associated with persistence of altered beta cell function or higher rates of relapse of T2DM over time (Annals of Surgery)
Insulin Cessation and Diabetes Remission After Bariatric Surgery in Insulin-Treated Type 2 Diabetic Adults
Insulin-treated type 2 diabetes patients have a greater probability of stopping insulin after RYGB than after LAGB (62% vs. 34%, respectively, at 1 year), with weight-independent effects in the early months after surgery. These findings support RYGB as the procedure of choice for reversing I-T2D (Diabetes Care)
Glycemic Variability Is Associated With Reduced Cardiac Autonomic Modulation in Women With Type 2 Diabetes
In patients with newly diagnosed and well-controlled type 2 diabetes, increased glycemic variability was associated with reduced cardiac autonomic modulation in women but not in men (Diabetes Care)
Insulin Cessation and Diabetes Remission After Bariatric Surgery in Insulin-Treated Type 2 Diabetic Adults
Insulin-treated type 2 diabetes patients have a greater probability of stopping insulin after RYGB than after LAGB (62% vs. 34%, respectively, at 1 year), with weight-independent effects in the early months after surgery (Diabetes Care)
NICE guideline consultations
Allopurinol treatment improves renal function in patients with type 2 diabetes and asymptomatic hyperuricemia: 3-year randomized parallel-controlled study
Long-term effective control of serum uric acid can decrease UAER and serum creatinine, increase GFR and may exert kidney protection effects in patients with type 2 diabetes and asymptomatic hyperuricemia (Clinical Endocrinology)
Management of Hyperglycemia in Type 2 Diabetes, 2015
A Patient-Centered Approach: Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes (Diabetes Care)
Type 2 diabetes and cancer: umbrella review of meta-analyses of observational studies
Though type 2 diabetes has been extensively studied in relation to risk of developing cancer and cancer mortality and strong claims of significance exist for most of the studied associations, only a minority of these associations have robust supporting evidence without hints of bias (BMJ)
Early phase glucagon and insulin secretory abnormalities, but not incretin secretion, are similarly responsible for hyperglycemia after ingestion of nutrients
Disordered early phase insulin and glucagon secretions but not incretin secretion are involved in hyperglycemia after ingestion of nutrients in T2DM of even a short duration (Journal of Diabetes and Its Complications)
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