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Advances in β-cell replacement therapy for the treatment of type1diabetes. The main goal of treatment for type1diabetes is to control glycaemia with insulin therapy to reduce disease complications. For some patients, technological approaches to insulin delivery are inadequate, and allogeneic islet transplantation is a safe alternative for those patients who have had severe hypoglycaemia complicated by impaired hypoglycaemia awareness or glycaemic lability, or who already receive (...) immunosuppressive drugs for a kidney transplant. Since 2000, intrahepatic islet transplantation has proven efficacious in alleviating the burden of labile diabetes and preventing complications related to diabetes, whether or not a previous kidney transplant is present. Age, body-mass index, renal status, and cardiopulmonary status affect the choice between pancreas or islet transplantation. Access to transplantation is limited by the number of deceased donors and the necessity of immunosuppression. Future
Changing the landscape for type1diabetes: the first step to prevention. Over several decades, studies have described the progression of autoimmune diabetes, from the first appearance of autoantibodies until, and after, the diagnosis of clinical disease with hyperglycaemia and insulin dependence. Despite the improved management of type1diabetes with exogenous insulin, most patients do not meet clinical glycaemic goals, and diabetes remains an important medical problem that affects children (...) and adults. Clinical and preclinical studies have suggested strategies to prevent the diagnosis of type1diabetes in people at risk, but the outcomes of previous clinical trials have not met their primary endpoints of disease prevention or delay. The results from the TN-10 teplizumab prevention trial show that the diagnosis of type1diabetes can be delayed by treatment with a FcR non-binding monoclonal antibody to CD3 in people at high risk for disease. This Series paper discusses how this clinical
Excess mortality and life expectancy of individuals with type1diabetes: a rapid review 2019 www.kce.fgov.be KCE REPORT 314 EXCESS MORTALITY AND LIFE EXPECTANCY OF INDIVIDUALS WITH TYPE1DIABETES: A RAPID REVIEW 2019 www.kce.fgov.be KCE REPORT 314 HEALTH SERVICES RESEARCH EXCESS MORTALITY AND LIFE EXPECTANCY OF INDIVIDUALS WITH TYPE1DIABETES: A RAPID REVIEW PETER LOUWAGIE, CHRIS DE LAET, DOMINIQUE ROBERFROID COLOPHON Title: Excess mortality and life expectancy of individuals with type1 (...) : Diabetes Mellitus, Type1; Life expectancy; Mortality; Survival NLM Classification: WK810 Language: English Format: Adobe® PDF™ (A4) Legal depot: D/2019/10.273/37 ISSN: 2466-6459 Copyright: KCE reports are published under a “by/nc/nd” Creative Commons Licence http://kce.fgov.be/content/about-copyrights-for-kce-publications. How to refer to this document? Louwagie P, De Laet C, Roberfroid D. Excess mortality and life expectancy of individuals with type1diabetes: a rapid review. Health Services
Insulin degludec + liraglutide (Xultophy) - Diabetes mellitus, Type 2 insulin degludec + liraglutide | CADTH.ca Find the information you need insulin degludec + liraglutide insulin degludec + liraglutide Last Updated: October 3, 2019 Result type: Reports Project Number: SR0599-000 Product Line: Generic Name: insulin degludec + liraglutide Brand Name: Xultophy Manufacturer: Novo Nordisk Canada Inc. Indications: Diabetes mellitus, Type 2 Manufacturer Requested Reimbursement Criteria 1 (...) : To be reimbursed as an adjunct to lifestyle modifications to improve glycemic control in adults with type 2 diabetes mellitus when oral glucose-lowering medications combined with basal insulin, or basal insulin alone do not provide adequate glycemic control. Submission Type: New Combination Project Status: Active Biosimilar: No Fee Schedule: Schedule A The requested reimbursement criteria are provided by the applicant and do not necessarily reflect the views of CADTH. Reimbursement criteria from CADTH
Long-Acting Insulin Analogues versus Human NPH Insulin for Adults with Type 2 Diabetes and Unresponsive to Non-insulin Therapies: Clinical Effectiveness, Cost-Effectiveness, and Guidelines Long-Acting Insulin Analogues versus Human NPH Insulin for Adults with Type 2 Diabetes and Unresponsive to Non-insulin Therapies: Clinical Effectiveness, Cost-Effectiveness, and Guidelines | CADTH.ca Find the information you need Long-Acting Insulin Analogues versus Human NPH Insulin for Adults with Type 2 (...) Diabetes and Unresponsive to Non-insulin Therapies: Clinical Effectiveness, Cost-Effectiveness, and Guidelines Long-Acting Insulin Analogues versus Human NPH Insulin for Adults with Type 2 Diabetes and Unresponsive to Non-insulin Therapies: Clinical Effectiveness, Cost-Effectiveness, and Guidelines Last updated: May 3, 2019 Project Number: RB1331-000 Product Line: Research Type: Drug Report Type: Summary of Abstracts Result type: Report Question What is the comparative clinical effectiveness of long
, please . CADTH undertook a project to assess the clinical and cost-effectiveness of new drugs for the treatment of patients with type 2 diabetes. These new drugs were in three classes: dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 (GLP-1) analogues, and sodium-glucose cotransporter-2 (SGLT-2) inhibitors. As part of this project, recommendations from the CADTH Canadian Drug Expert Committee (CDEC) were developed. This project is an update to two large projects on pharmacotherapy (...) Drugs for Type 2 Diabetes: Second-Line Therapy Review Update Drugs for Type 2 Diabetes: Second-Line Therapy Review Update | CADTH.ca Find the information you need Drugs for Type 2 Diabetes: Second-Line Therapy Review Update Drugs for Type 2 Diabetes: Second-Line Therapy Review Update Published on: February 7, 2018 Project Number: TR0012-000 Product Line: Therapeutic Review Result type: Report For an update on the status of CADTH’s Therapeutic Review of Third-Line Drugs for Type 2 Diabetes
To What Target Hemoglobin A1c Level Would You Treat This Patient With Type 2 Diabetes?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center. In the United States, 9.4% of all adults-and 25% of those older than 65 years-have diabetes. Diabetes is the leading cause of blindness and end-stage renal disease and contributes to both microvascular and macrovascular complications. The management of patients with type 2 diabetes (T2D) is a common and important activity in primary care (...) proposed a level between 7% and 8% for most patients. The ACP also advised deintensification of therapy for patients who have an HbA1c level lower than 6.5% and avoidance of HbA1c-targeted treatment for patients with a life expectancy of less than 10 years. This guidance contrasts with a recommendation from the American Diabetes Association to aim for HbA1c levels less than 7% for many nonpregnant adults and to consider a target of 6.5% if it can be achieved safely. Here, 2 experts, a diabetologist
Switching to iGlarLixi Versus Continuing Daily or Weekly GLP-1 RA in Type 2 Diabetes Inadequately Controlled by GLP-1 RA and Oral Antihyperglycemic Therapy: The LixiLan-G Randomized Clinical Trial Fixed-ratio combinations of basal insulin plus glucagon-like peptide 1 receptor agonist (GLP-1 RA) allow concomitant administration of two proven complementary injectable therapies for type 2 diabetes. This study investigated switching to a titratable fixed-ratio combination of insulin glargine plus (...) lixisenatide (iGlarLixi) in patients with type 2 diabetes receiving daily or weekly GLP-1 RA therapy.LixiLan-G, a randomized, open-label, 26-week trial, comparing switching to iGlarLixi versus continuing prior GLP-1 RA in patients with type 2 diabetes and HbA1c 7-9% (53-75 mmol/mol) taking maximum tolerated doses of a GLP-1 RA daily (60% on liraglutide once daily or exenatide twice daily) or weekly (40% on dulaglutide, exenatide extended release, or albiglutide) with metformin with or without pioglitazone
Anti-interleukin-1 treatment in patients with rheumatoid arthritis and type 2 diabetes (TRACK): A multicentre, open-label, randomised controlled trial The inflammatory contribution to type 2 diabetes (T2D) has suggested new therapeutic targets using biologic drugs designed for rheumatoid arthritis (RA). On this basis, we aimed at investigating whether interleukin-1 (IL-1) inhibition with anakinra, a recombinant human IL-1 receptor antagonist, could improve both glycaemic and inflammatory (...) %) anakinra-treated participants. Additionally, we observed nonsevere infections, including influenza, nasopharyngitis, upper respiratory tract infection, urinary tract infection, and diarrhoea in both groups. Our study has some limitations, including open-label design and previously unplanned ad interim analysis, small size, lack of some laboratory evaluations, and ongoing use of other drugs.In this study, we observed an apparent benefit of IL-1 inhibition in participants with RA and T2D, reaching
Prevention of type 2 diabetes in prediabetic patients by using functional olive oil enriched in oleanolic acid: The PREDIABOLE study, a randomized controlled trial To assess whether the regular intake of an oleanolic acid (OA)-enriched olive oil is effective in the prevention of diabetes.In the PREDIABOLE study, prediabetic individuals (impaired fasting glucose and impaired glucose tolerance) of both sexes (176 patients, aged 30-80 years) were randomized to receive 55 mL/day of OA-enriched (...) olive oil (equivalent dose 30 mg OA/day) [intervention group (IG)] or the same oil not enriched [control group (CG)]. The main outcome was the incidence of new-onset type 2 diabetes in both groups.Forty-eight new diabetes cases occurred, 31 in the CG and 17 in the IG. The multivariate-adjusted hazard ratio was 0.45 (95% CI, 0.24-0.83) for the IG compared with the CG. Intervention-related adverse effects were not reported.The intake of OA-enriched olive oil reduces the risk of developing diabetes
Cardiovascular Outcome Trials for Type 2 Diabetes Cardiovascular Outcome Trials for Type 2 Diabetes | CADTH.ca CADTH Document Viewer Cardiovascular Outcome Trials for Type 2 Diabetes Table of Contents Search this document Cardiovascular Outcome Trials for Type 2 Diabetes June 2019 Summary Dipeptidyl peptidase-4 (DPP-4) inhibitors, sodium-glucose cotransporter-2 (SGLT-2) inhibitors, and glucagon-like peptide-1 (GLP-1) receptor agonists are classes of medications used in diabetes mellitus (DM (...) agonists reported a reduction in MACE. Recent guidelines have identified three drugs pertaining to these classes that may be preferred over other drugs for patients with CVD; i.e., canagliflozin, empagliflozin, and liraglutide. Background Diabetes mellitus, or diabetes, is a lifelong condition in which the body cannot transform sugar from food into energy, resulting in high blood sugar levels. 1 Two broad types of diabetes prevail. In type1diabetes (T1DM), the body makes an insufficient amount
Non-Insulin Therapies versus Prandial Insulin for Adults with Type 2 Diabetes: Clinical Effectiveness, Cost-Effectiveness, and Guidelines Non-Insulin Therapies versus Prandial Insulin for Adults with Type 2 Diabetes: Clinical Effectiveness, Cost-Effectiveness, and Guidelines | CADTH.ca Find the information you need Non-Insulin Therapies versus Prandial Insulin for Adults with Type 2 Diabetes: Clinical Effectiveness, Cost-Effectiveness, and Guidelines Non-Insulin Therapies versus Prandial (...) Insulin for Adults with Type 2 Diabetes: Clinical Effectiveness, Cost-Effectiveness, and Guidelines Last updated: April 24, 2019 Project Number: RB1329-000 Product Line: Research Type: Drug Report Type: Summary of Abstracts Result type: Report Question What is the comparative clinical effectiveness of non-insulin therapies versus prandial insulin for the treatment of adults with type 2 diabetes who are receiving basal insulin? What is the comparative cost-effectiveness of non-insulin therapies versus
of type 2 diabetes. JAMA 2012; 308:2489–96. https://doi.org/10.1001/jama.2012.67929 Wing RR, Phelan S. Long-term weight loss maintenance. Am J Clin Nutr 2005;82(1 Suppl):222S–5S. https://doi.org/10.1093/ajcn/82.1.222S Lean ME, Leslie WS, Barnes AC, et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet 2018;391:541–51. https://doi.org/10.1016/S0140-6736(17)33102-1 DOI: Refbacks There are currently no refbacks. The Journal (...) Remission of type 2 diabetes: a position statement Remission of type 2 diabetes: a position statement from the Association of British Clinical Diabetologists (ABCD) and the Primary Care Diabetes Society (PCDS) | Nagi | British Journal of Diabetes Font Size User Username Password Remember me Click for EXTOD PEAK 2019 Conference 18th October 2019, Glasgow ABCD Autumn Meeting 2019 28 / 29 November 2019, London All issues 2014-present Browse Search All issues from 2014 Refine 2001-2013 at OR View
%) in the linagliptin group and 2856 (94.9%) in the glimepiride group, with 15 participants (0.5%) in the linagliptin group vs 16 (0.5%) in the glimepiride group with adjudicated-confirmed acute pancreatitis. At least 1 episode of hypoglycemic adverse events occurred in 320 (10.6%) participants in the linagliptin group and 1132 (37.7%) in the glimepiride group (HR, 0.23 [95% CI, 0.21-0.26]).Among adults with relatively early type 2 diabetes and elevated cardiovascular risk, the use of linagliptin compared (...) Effect of Linagliptin vs Glimepiride on Major Adverse Cardiovascular Outcomes in Patients With Type 2 Diabetes: The CAROLINA Randomized Clinical Trial. Type 2 diabetes is associated with increased cardiovascular risk. In placebo-controlled cardiovascular safety trials, the dipeptidyl peptidase-4 inhibitor linagliptin demonstrated noninferiority, but it has not been tested against an active comparator.This trial assessed cardiovascular outcomes of linagliptin vs glimepiride (sulfonylurea
to be determined.Vildagliptin Efficacy in combination with metfoRmIn For earlY treatment of type 2 diabetes (VERIFY) was a randomised, double-blind, parallel-group study of newly diagnosed patients with type 2 diabetes conducted in 254 centres across 34 countries. The study consisted of a 2-week screening visit, a 3-week metformin-alone run-in period, and a 5-year treatment period, which was further split into study periods 1, 2, and 3. Patients aged 18-70 years were included if they had type 2 diabetes diagnosed within 2 (...) Glycaemic durability of an early combination therapy with vildagliptin and metformin versus sequential metformin monotherapy in newly diagnosed type 2 diabetes (VERIFY): a 5-year, multicentre, randomised, double-blind trial. Early treatment intensification leading to sustained good glycaemic control is essential to delay diabetic complications. Although initial combination therapy has been suggested to offer more opportunities than a traditional stepwise approach, its validity remains
Trends in incidence of total or type 2 diabetes: systematic review. To assess what proportions of studies reported increasing, stable, or declining trends in the incidence of diagnosed diabetes.Systematic review of studies reporting trends of diabetes incidence in adults from 1980 to 2017 according to PRISMA guidelines.Medline, Embase, CINAHL, and reference lists of relevant publications.Studies of open population based cohorts, diabetes registries, and administrative and health insurance (...) databases on secular trends in the incidence of total diabetes or type 2 diabetes in adults were included. Poisson regression was used to model data by age group and year.Among the 22 833 screened abstracts, 47 studies were included, providing data on 121 separate sex specific or ethnicity specific populations; 42 (89%) of the included studies reported on diagnosed diabetes. In 1960-89, 36% (8/22) of the populations studied had increasing trends in incidence of diabetes, 55% (12/22) had stable trends
(MACE) in patients with type 2 diabetes and obesity.Of 287 438 adult patients with diabetes in the Cleveland Clinic Health System in the United States between 1998 and 2017, 2287 patients underwent metabolic surgery. In this retrospective cohort study, these patients were matched 1:5 to nonsurgical patients with diabetes and obesity (body mass index [BMI] ≥30), resulting in 11 435 control patients, with follow-up through December 2018.Metabolic gastrointestinal surgical procedures vs usual care (...) Association of Metabolic Surgery With Major Adverse Cardiovascular Outcomes in Patients With Type 2 Diabetes and Obesity. Although metabolic surgery (defined as procedures that influence metabolism by inducing weight loss and altering gastrointestinal physiology) significantly improves cardiometabolic risk factors, the effect on cardiovascular outcomes has been less well characterized.To investigate the relationship between metabolic surgery and incident major adverse cardiovascular events