Latest & greatest articles for type 1 diabetes

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Top results for type 1 diabetes

1. Effect of Additional Oral Semaglutide vs Sitagliptin on Glycated Hemoglobin in Adults With Type 2 Diabetes Uncontrolled With Metformin Alone or With Sulfonylurea: The PIONEER 3 Randomized Clinical Trial. (PubMed)

Effect of Additional Oral Semaglutide vs Sitagliptin on Glycated Hemoglobin in Adults With Type 2 Diabetes Uncontrolled With Metformin Alone or With Sulfonylurea: The PIONEER 3 Randomized Clinical Trial. Importance: Phase 3 trials have not compared oral semaglutide, a glucagon-like peptide 1 receptor agonist, with other classes of glucose-lowering therapy. Objective: To compare efficacy and assess long-term adverse event profiles of once-daily oral semaglutide vs sitagliptin, 100 mg added (...) on to metformin with or without sulfonylurea, in patients with type 2 diabetes. Design, Setting, and Participants: Randomized, double-blind, double-dummy, parallel-group, phase 3a trial conducted at 206 sites in 14 countries over 78 weeks from February 2016 to March 2018. Of 2463 patients screened, 1864 adults with type 2 diabetes uncontrolled with metformin with or without sulfonylurea were randomized. Interventions: Patients were randomized to receive once-daily oral semaglutide, 3 mg (n = 466), 7 mg (n

2019 JAMA

2. Type 2 diabetes in children

Type 2 diabetes in children Type 2 diabetes in children - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Type 2 diabetes in children Last reviewed: February 2019 Last updated: March 2019 Summary A progressive disorder due to a deficit in both insulin secretion and insulin action, with obesity being the primary cause in children. Often asymptomatic and diagnosed by screening in a high-risk individual (e.g., family (...) ). Treatment includes lifestyle modifications, metformin, and insulin. Definition Type 2 diabetes mellitus is a progressive disorder due to a deficit in both insulin secretion and insulin action leading to abnormal glucose metabolism and related metabolic derangements. Diagnosis is based on a fasting plasma glucose of 7 mmol/L or greater (126 mg/dL or greater) on 2 separate occasions, a random plasma glucose of 11.1 mmol/L or greater (200 mg/dL or greater) with symptoms of polyuria or polydipsia, a plasma

2019 BMJ Best Practice

3. Effect of a Behavioral Intervention Strategy on Sustained Change in Physical Activity and Sedentary Behavior in Patients With Type 2 Diabetes: The IDES_2 Randomized Clinical Trial. (PubMed)

among individuals with type 2 diabetes. Design, Setting, and Participants: The Italian Diabetes and Exercise Study 2 was an open-label, assessor-blinded, randomized clinical superiority trial, with recruitment from October 2012 to February 2014 and follow-up until February 2017. In 3 outpatient diabetes clinics in Rome, 300 physically inactive and sedentary patients with type 2 diabetes were randomized 1:1 (stratified by center, age, and diabetes treatment) to receive a behavioral intervention (...) Effect of a Behavioral Intervention Strategy on Sustained Change in Physical Activity and Sedentary Behavior in Patients With Type 2 Diabetes: The IDES_2 Randomized Clinical Trial. Importance: There is no definitive evidence that changes in physical activity/sedentary behavior can be maintained long term in individuals with type 2 diabetes. Objective: To investigate whether a behavioral intervention strategy can produce a sustained increase in physical activity and reduction in sedentary time

2019 JAMA

4. Management of Type 1 Diabetes Mellitus during illness in children and young people under 18 years (Sick Day Rules)

Management of Type 1 Diabetes Mellitus during illness in children and young people under 18 years (Sick Day Rules) 1 Version 4, Feb 2018 Review 2021 Authors: SM Ng, A Soni, JC Agwu, JA Edge, JH Drew, C Moudiotis, NP Wright, M Kershaw, MC Gardner, L Connellan, W Assam ssociation of Children’s Diabetes Clinicians Clinicians SETTING FOR STAFF Medical and nursing staff PATIENTS Children and young people with diabetes mellitus Contents 1. Introduction 2 2. Importance of Local ‘Sick-Day’ Rules 2 3 (...) . Ketone testing 2 4. Fluid Management 3 5. Out of hours diabetes advice 4 6. Diabetes Self Management Education 4 7. General Rules for Managing Diabetes During Illness 4 7.1. Using sick day doses on pump therapy 7 7.2. Management of infections usually associated with hypoglycaemia eg. gastroenteritis ... 7 8. References 8 9. Appendix: Patient Advice Leaflet…………………………………………………………………...10 Clinical Guideline Management of Type 1 Diabetes Mellitus during illness in children and young people under 18 years

2019 British Society for Paediatric Endocrinology and Diabetes

5. Long-term efficacy and safety of ertugliflozin in patients with type 2 diabetes mellitus inadequately controlled with metformin monotherapy: 104-week VERTIS MET trial

Long-term efficacy and safety of ertugliflozin in patients with type 2 diabetes mellitus inadequately controlled with metformin monotherapy: 104-week VERTIS MET trial 30614616 2019 02 14 1463-1326 2019 Jan 07 Diabetes, obesity & metabolism Diabetes Obes Metab Long-term efficacy and safety of ertugliflozin in patients with type 2 diabetes mellitus inadequately controlled with metformin monotherapy: 104-week VERTIS MET trial. 10.1111/dom.13631 To evaluate the long-term efficacy and safety (...) of ertugliflozin in adults with type 2 diabetes mellitus inadequately controlled on metformin. A 104-week Phase III, randomized double-blind study with a 26-week placebo-controlled period (Phase A) and a 78-week period (Phase B) where blinded glimepiride was added to non-rescued placebo participants with fasting fingerstick glucose ≥6.1 mmol/L. Results through week 104 are reported. Mean (standard error) change in HbA1c from baseline was -0.7% (0.07) and -1.0% (0.07) at week 52; -0.6% (0.08) and -0.9% (0.08

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2019 EvidenceUpdates

6. Carbohydrate restriction for glycaemic control in Type 2 diabetes: a systematic review and meta-analysis

Carbohydrate restriction for glycaemic control in Type 2 diabetes: a systematic review and meta-analysis 30426553 2019 02 16 1464-5491 36 3 2019 Mar Diabetic medicine : a journal of the British Diabetic Association Diabet. Med. Carbohydrate restriction for glycaemic control in Type 2 diabetes: a systematic review and meta-analysis. 335-348 10.1111/dme.13862 To conduct a systematic review and meta-analysis to evaluate the effect of carbohydrate restriction on glycaemic control in Type 2 diabetes (...) . We searched Medline, EMBASE and CINAHL for the period between 1976 and April 2018. We included randomized controlled trials comparing carbohydrate restriction with a control diet which aimed to maintain or increase carbohydrate intake, and that reported HbA 1c as an outcome and reported the amount of carbohydrate consumed during or at the end of the study, with outcomes reported at ≥3 months. We identified 1402 randomized controlled trials, 25 of which met the inclusion criteria, incorporating

2019 EvidenceUpdates

7. Automated insulin dosing guidance to optimise insulin management in patients with type 2 diabetes: a multicentre, randomised controlled trial. (PubMed)

Automated insulin dosing guidance to optimise insulin management in patients with type 2 diabetes: a multicentre, randomised controlled trial. BACKGROUND: Insulin therapy is most effective if dosage titrations are done regularly and frequently, which is seldom practical for most clinicians, resulting in an insulin titration gap. The d-Nav Insulin Guidance System (Hygieia, Livonia, MI, USA) is a handheld device that is used to measure glucose, determine glucose patterns, and automatically (...) determine the appropriate next insulin dose. We aimed to determine whether the combination of the d-Nav device and health-care professional support is superior to health-care professional support alone. METHODS: In this multicentre, randomised, controlled study, we recruited patients from three diabetes centres in the USA (in Detroit MI; Minneapolis, MN; and Des Moines IA). Patients were eligible if they were aged 21-70 years, diagnosed with type 2 diabetes with a glycated haemoglobin (HbA 1c

2019 Lancet

8. Metformin?s role in type 1 diabetes: the removal trial

Metformin?s role in type 1 diabetes: the removal trial Metformin’s Role in Type 1 Diabetes: the REMOVAL Trial – Clinical Correlations Search Metformin’s Role in Type 1 Diabetes: the REMOVAL Trial February 14, 2019 By William Plowe Peer Reviewed Metformin has been the first-line drug in type 2 diabetes for over a decade, but its possible benefit in type 1 diabetes (DM1) is still a matter of study. The American Diabetes Association lists metformin as an investigational agent that may reduce (...) that the incidence of obesity has increased among type 1 diabetic children, adolescents, . Metformin is also associated with improved glycemic control in the subset of patients with type 2 diabetes who, like those with DMI, require insulin. The prospective randomized placebo-controlled HOME trial compared metformin to placebo in patients with insulin-dependent type 2 diabetes, showing improved glycemic control and lower insulin requirements over 16 weeks (HbA 1c decrease -0.91 with metformin vs -0.27 While

2019 Clinical Correlations

9. Effect of Resveratrol on Blood Lipid Levels in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

Effect of Resveratrol on Blood Lipid Levels in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis 30569644 2018 12 20 1930-739X 27 1 2019 Jan Obesity (Silver Spring, Md.) Obesity (Silver Spring) Effect of Resveratrol on Blood Lipid Levels in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. 94-102 10.1002/oby.22348 Few studies have considered the effect of resveratrol on blood lipid levels, and the results of these studies are inconsistent. In this study (...) , the first meta-analysis on the effect of resveratrol on blood lipid levels in patients with type 2 diabetes was conducted. This study used keywords such as type 2 diabetes, total cholesterol, triglyceride (TG), high-density lipoprotein, low-density lipoprotein, and resveratrol and their abbreviations, free words, and related words to search PubMed, Cochrane Library, and Embase. The Cochrane risk of bias tool was used to evaluate the risk of bias, and Review Manager 5.3 and Stata 13.0 were used for data

2019 EvidenceUpdates

10. The effects of incretin-based therapies on beta-cell function and insulin resistance in type 2 diabetes: A systematic review and network meta-analysis combining 360 trials

of incretin-based therapies, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dipeptidyl peptidase-4 inhibitors (DPP-4Is), on β-cell function and insulin resistance in patients with type 2 diabetes mellitus (T2DM). Medline, Embase, the Cochrane Library and www.clinicaltrials.gov were searched for randomized controlled trials (RCTs) with a duration of at least 4 weeks. Network meta-analysis was performed, followed by subgroup analysis and meta-regression. The Grading of Recommendations (...) The effects of incretin-based therapies on beta-cell function and insulin resistance in type 2 diabetes: A systematic review and network meta-analysis combining 360 trials 30536884 2019 01 17 1463-1326 2018 Dec 09 Diabetes, obesity & metabolism Diabetes Obes Metab The effects of incretin-based therapies on β-cell function and insulin resistance in type 2 diabetes: A systematic review and network meta-analysis combining 360 trials. 10.1111/dom.13613 To evaluate the comparative effects

2019 EvidenceUpdates

11. OurPath app for management of type 2 diabetes

OurPath app for management of type 2 diabetes OurPath app - Health Technology Wales > OurPath app OurPath app Topic Status Complete OurPath app for management of type 2 diabetes Summary Health Technology Wales researchers searched for evidence on whether the use of the OurPath app is an effective alternative to GP referral to weight-loss programmes in people deemed to be at ‘high-risk’ of type 2 diabetes. The evidence is insufficient in quality and quantity to enable an appraisal by Health

2019 Health Technology Wales

12. A randomized, multicentre trial evaluating the efficacy and safety of fast-acting insulin aspart in continuous subcutaneous insulin infusion in adults with type 1 diabetes (onset 5)

A randomized, multicentre trial evaluating the efficacy and safety of fast-acting insulin aspart in continuous subcutaneous insulin infusion in adults with type 1 diabetes (onset 5) 30537180 2019 02 11 1463-1326 2018 Dec 09 Diabetes, obesity & metabolism Diabetes Obes Metab A randomized, multicentre trial evaluating the efficacy and safety of fast-acting insulin aspart in continuous subcutaneous insulin infusion in adults with type 1 diabetes (onset 5). 10.1111/dom.13610 To evaluate (...) the efficacy and safety of fast-acting insulin aspart (faster aspart) vs insulin aspart (IAsp) used in continuous subcutaneous insulin infusion (CSII) in participants with type 1 diabetes (T1D). This was a double-blind, treat-to-target, randomized, 16-week trial investigating CSII treatment with faster aspart (n = 236) or IAsp (n = 236). All available information, regardless of treatment discontinuation, was used for the evaluation of effect. Faster aspart was non-inferior to IAsp regarding the change from

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2019 EvidenceUpdates

13. Implementation of a Health Plan Program for Switching From Analogue to Human Insulin and Glycemic Control Among Medicare Beneficiaries With Type 2 Diabetes. (PubMed)

Implementation of a Health Plan Program for Switching From Analogue to Human Insulin and Glycemic Control Among Medicare Beneficiaries With Type 2 Diabetes. Importance: Prices for newer analogue insulin products have increased. Lower-cost human insulin may be effective for many patients with type 2 diabetes. Objective: To evaluate the association between implementation of a health plan-based intervention of switching patients from analogue to human insulin and glycemic control. Design, Setting (...) to human insulin. Main Outcomes and Measures: The primary outcome was the change in mean hemoglobin A1c (HbA1c) levels estimated over three 12-month periods: preintervention (baseline) in 2014, intervention in 2015, and postintervention in 2016. Secondary outcomes included rates of serious hypoglycemia or hyperglycemia using ICD-9-CM and ICD-10-CM diagnostic codes. Results: Over 3 years, 14 635 members (mean [SD] age: 72.5 [9.8] years; 51% women; 93% with type 2 diabetes) filled 221 866 insulin

2019 JAMA

14. The benefits and harms of aspirin for people with type 2 diabetes are finely balanced

The benefits and harms of aspirin for people with type 2 diabetes are finely balanced Aspirin benefits and harms balanced in type 2 diabetes Dissemination Centre Discover Portal NIHR DC Discover The benefits and harms of aspirin for people with type 2 diabetes are finely balanced Published on 4 December 2018 doi: Daily aspirin reduced the risk of serious vascular events among people with diabetes, while increasing the risk of major bleeding to a similar extent. Aspirin prevented one person (...) that aspirin shouldn’t be prescribed to people with diabetes who do not have existing cardiovascular disease. Share your views on the research. Why was this study needed? Cardiovascular disease is the leading cause of death in the UK. It accounted for 152,465 deaths in 2016, of which 66,076 deaths were from coronary heart disease and 37,771 from stroke. Around 4 million people in the UK have diabetes, mostly type 2. Adults with diabetes are two to three times more likely to develop cardiovascular disease

2019 NIHR Dissemination Centre

15. Fewer large babies are born to pregnant woman with type 1 diabetes if their glucose was monitored continuously

Fewer large babies are born to pregnant woman with type 1 diabetes if their glucose was monitored continuously Signal - Fewer large babies are born to pregnant woman with type 1 diabetes if their glucose was monitored continuously Dissemination Centre Discover Portal NIHR DC Discover Fewer large babies are born to pregnant woman with type 1 diabetes if their glucose was monitored continuously Published on 12 December 2017 Pregnant women with type 1 diabetes who used a continuous glucose (...) diabetic control over 12 weeks, only improved slightly. This may be unsurprising because HbA1c results are less reliable in pregnancy and women found it hard to stick to the continuous monitoring protocol. Strict control of blood glucose levels during pregnancy reduces the risk for women with type 1 diabetes, and their babies are less likely to be large or need treatment for low blood glucose. Continuous monitoring provides many readings but requires the user to deliver insulin accordingly. Motivated

2019 NIHR Dissemination Centre

16. Type 2 diabetes can be reversed with a low-calorie diet

Type 2 diabetes can be reversed with a low-calorie diet Signal - Type 2 diabetes can be reversed with a low-calorie diet Dissemination Centre Discover Portal NIHR DC Discover Type 2 diabetes can be reversed with a low-calorie diet Published on 13 February 2018 Nearly half of people given a formula replacement diet of 830 calories per day for three to five months, followed by food reintroduction, went into remission from type 2 diabetes. They were supported to achieve and maintain weight (...) reduction by primary care nurses or dieticians. This trial involved 298 adults who had been diagnosed with type 2 diabetes within six years. Those that stuck with the program were more likely to lose weight (average 10kg was lost) and to go into remission compared to usual care. More than two-thirds of them were also able to stop both diabetic and high blood pressure tablets. These results were seen after one year. The challenge will be to see if the results can be maintained over the planned four year

2019 NIHR Dissemination Centre

17. Flu vaccine reduces deaths for people with type 2 diabetes

Flu vaccine reduces deaths for people with type 2 diabetes Signal - Flu vaccine reduces deaths for people with type 2 diabetes Dissemination Centre Discover Portal NIHR DC Discover Flu vaccine reduces deaths for people with type 2 diabetes Published on 18 October 2016 Flu vaccination helps prevent some deaths, serious strokes, heart failure and pneumonia in people with type 2 diabetes. Vaccination is linked to less hospital admissions for these reasons, but there is no link to rates (...) of admissions for heart attack. The results come from a reliable population-based study that looked back at the general practice and hospital records of almost 125,000 adults with type 2 diabetes in England. Outcome rates were compared between those who had and hadn’t received the flu vaccine over seven successive flu seasons. The researchers carefully adjusted for things like the seasonal change in flu numbers. The findings strongly support current recommendations that people with chronic medical

2019 NIHR Dissemination Centre

18. Nine different drug classes reviewed for type 2 diabetes

, 0.12 [95% CI, 0.08 to 0.18]; RD, -22% [-27% to -18%]). When added to metformin and sulfonylurea, GLP-1 receptor agonists were associated with the lowest odds of hypoglycemia (OR, 0.60 [95% CI, 0.39 to 0.94]; RD, -10% [95% CI, -18% to -2%]). CONCLUSIONS AND RELEVANCE: Among adults with type 2 diabetes, there were no significant differences in the associations between any of 9 available classes of glucose-lowering drugs (alone or in combination) and the risk of cardiovascular or all-cause mortality (...) Nine different drug classes reviewed for type 2 diabetes Signal - Nine different drug classes reviewed for type 2 diabetes Dissemination Centre Discover Portal NIHR DC Discover Nine different drug classes reviewed for type 2 diabetes Published on 17 January 2017 Metformin worked best at keeping blood sugar levels under control and remains a good first choice as single therapy. Overall, the nine classes of blood sugar-lowering drugs had similar effect on risk of death from cardiovascular causes

2019 NIHR Dissemination Centre

19. Sulfonylureas can be considered safe for those with type 2 diabetes

looking at the timing of use of sulfonylureas – as first-line treatment, second-line treatment, unspecified, or specifically as add-on therapy to metformin. Statistical analysis found that the overall sample size was large enough to conclude that the number of people harmed by sulfonylureas is likely to be less than 1 in 200. What does current guidance say on this issue? NICE’s 2015 guidance on type 2 diabetes recommends a sulfonylurea as an initial treatment option if the standard first-choice drug (...) Sulfonylureas can be considered safe for those with type 2 diabetes Signal - Sulfonylureas can be considered safe for those with type 2 diabetes Dissemination Centre Discover Portal NIHR DC Discover Sulfonylureas can be considered safe for those with type 2 diabetes Published on 20 July 2016 This large review finds that sulfonylurea drugs are not associated with an increased risk of death, heart attack or stroke when compared with placebo, diet control or other diabetes drugs. Sulfonylureas

2019 NIHR Dissemination Centre

20. Continuous insulin pumps may help manage poorly controlled type 2 diabetes

. Other studies have found that this may be improved with continuous insulin pumps. Larger studies will be required to confirm if this is the case and to assess the safety of the technique for advanced type 2 diabetes as it is currently only recommended for type 1 diabetes. This treatment option is more expensive than multiple daily injections so cost-effectiveness will also need to be looked at. Nevertheless, these are promising results for people with poorly controlled type 2 diabetes. Share your (...) options for advanced stages of the disease, but approximately one in every four people on insulin injections has a very poor control of blood sugar levels. Evidence on insulin pumps in type 2 diabetes is sparse compared to the evidence in type 1 diabetes. This study aimed to assess blood sugar control using continuous subcutaneous insulin infusions in type 2 diabetes in order to inform the development of patient-centred treatment approaches. What did this study do? This meta-analysis included five

2019 NIHR Dissemination Centre