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Latest & greatest articles for type 1 diabetes
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on type 1 diabetes or other clinical topics then use Trip today.
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Implementation of a Health Plan Program for Switching From Analogue to Human Insulin and Glycemic Control Among Medicare Beneficiaries With Type 2 Diabetes. Prices for newer analogue insulin products have increased. Lower-cost human insulin may be effective for many patients with type 2 diabetes.To evaluate the association between implementation of a health plan-based intervention of switching patients from analogue to human insulin and glycemic control.A retrospective cohort study using (...) 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.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 prescriptions. The mean HbA1c was 8.46% (95% CI, 8.40%-8.52%) at baseline and decreased at a rate of -0.02
The benefits and harms of aspirin for people with type 2 diabetes are finely balanced Aspirin benefits and harms balanced in type 2 diabetes Discover Portal Discover Portal 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 in every 100 from having (...) 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, and nearly twice
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 metformin (...) Sulfonylureas can be considered safe for those with type 2 diabetes Sulfonylureas can be considered safe for those with type 2 diabetes Discover Portal Discover Portal Sulfonylureas can be considered safe for those with type 2 diabetes Published on 20 July 2016 doi: 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 are commonly used
Fewer large babies are born to pregnant woman with type1diabetes if their glucose was monitored continuously Fewer large babies are born to pregnant woman with type1diabetes if their glucose was monitored continuously Discover Portal Discover Portal Fewer large babies are born to pregnant woman with type1diabetes if their glucose was monitored continuously Published on 12 December 2017 doi: Pregnant women with type1diabetes who used a continuous glucose monitoring system were half (...) , 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 type1diabetes, 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 women may find continuous
(OR, 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 Nine different drug classes reviewed for type 2 diabetes Discover Portal Discover Portal Nine different drug classes reviewed for type 2 diabetes Published on 17 January 2017 doi: 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 and overall mortality
.,Stefanetti, R.,Trenell, M.,Welsh, P.,Kean, S.,Ford, I.,McConnachie, A.,Sattar, N.,Taylor, R. Lancet , 2017 BACKGROUND: Type 2 diabetes is a chronic disorder that requires lifelong treatment. We aimed to assess whether intensive weight management within routine primary care would achieve remission of type 2 diabetes. METHODS: We did this open-label, cluster-randomised trial (DiRECT) at 49 primary care practices in Scotland and the Tyneside region of England. Practices were randomly assigned (1:1), via (...) Type 2 diabetes can be reversed with a low-calorie diet Type 2 diabetes can be reversed with a low-calorie diet Discover Portal Discover Portal Type 2 diabetes can be reversed with a low-calorie diet Published on 13 February 2018 doi: 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
Insulin pumps not much better than multiple injections for intensive control of type1diabetes Insulin pumps not much better than multiple injections for intensive control of type1diabetes Discover Portal Discover Portal Insulin pumps not much better than multiple injections for intensive control of type1diabetes Published on 11 July 2017 doi: People with type1diabetes offered insulin pumps did not achieve better blood glucose control compared with those using multiple daily injections (...) treatment might actually have been a reflection of the training given to them. Currently just 10% of adults with type1diabetes access these training courses. These results support NICE guidelines around the restricted use of insulin pumps and suggest that training improves self-management of the condition. Efforts should therefore be made to encourage training uptake. Share your views on the research. Why was this study needed? People with type1diabetes require lifelong treatment with insulin. Doses
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 type1diabetes. 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 views (...) 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 type1diabetes. 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 randomised
Type 2 diabetes is becoming more common in children Type 2 diabetes is becoming more common in children Discover Portal Discover Portal Type 2 diabetes is becoming more common in children Published on 25 July 2017 doi: The number of children being diagnosed with both type1 and type 2 diabetes is rising, but new cases of type 2 diabetes, the form associated with being overweight, has risen five-fold in about five years. New analysis in this NIHR-supported study suggest that type 2 diabetes now (...) weight. Having type 2 diabetes brings an increased risk of other complications and healthcare problems for individuals and is associated with extra resource use and costs for society. NICE has produced guidance about preventing type 2 diabetes, but it appears that more needs to be done to promote healthier lifestyles to children and their families. Share your views on the research. Why was this study needed? The number of children and young people in England and Wales with both diabetestype1 and 2
Flu vaccine reduces deaths for people with type 2 diabetes Flu vaccine reduces deaths for people with type 2 diabetes Discover Portal Discover Portal Flu vaccine reduces deaths for people with type 2 diabetes Published on 18 October 2016 doi: 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 conditions such as diabetes receive
for non-critical care. Those using the system spent about six hours longer in the target range, and this could hasten their recovery and reduce staff workload. The number of hospitalised patients with type 2 diabetes is increasing. Glucose control often worsens during illness. Closed-loop pumps have been shown to improve blood glucose control in type1diabetes and in critical care settings. This two-centre study included 136 patients with type 2 diabetes on general hospital wards. Patients using (...) (hypoglycaemia) can delay recovery and increase the risk of complications. However, illness, medication and changes in routine, such as mealtimes, can make it difficult to maintain blood glucose targets. A Canadian review of 20 studies showed that a newer closed-loop insulin pump, also known as an artificial pancreas, increased the time that patients with type1diabetes spent in the target blood glucose range, and decreased the risk of severe hypoglycaemia. This study aimed to see if it could benefit
control. This is not enough to be clinically important or outweigh the costs and personal inconvenience of long-term self-testing. Self-monitoring is a well-established strategy for type1diabetes and for people with type 2 who need insulin. The benefit for all people with type 2 is debatable. This review pooled 24 randomised controlled trials comparing self-monitoring with any control strategy for people not taking insulin. Self-monitoring gave a 0.3 percentage point reduction in glycated (...) . . Cochrane Database of Syst Rev. 2012;(1):CD005060. Why was this study needed? There are around 3.7 million people living with diabetes in the UK. Around 90% of those affected have type 2 diabetes. Management of type 2 diabetes usually begins with lifestyle changes, followed by the addition of oral blood-glucose-lowering medications, progressing to additional drugs and insulin if needed. Blood glucose is monitored by measuring HbA1c every three to six months. The aim is to keep HbA1c ideally below 6.5
Motivational interviewing may encourage healthy eating in people with type 2 diabetes Motivational interviewing may encourage healthy eating in people with type 2 diabetes Discover Portal Discover Portal Motivational interviewing may encourage healthy eating in people with type 2 diabetes Published on 15 March 2016 doi: A motivational communication approach may help people with type 2 diabetes eat more healthily, but may be no better than usual care for changing other behaviours or improving (...) doesn’t support the wide adoption of motivational interviewing, as described in this review because it is not known yet why many studies showed no effect. Next steps could be to identify which components of the interventions worked, how intensive they need to be and what the impact of prior skill and training in delivery of the intervention was. Share your views on the research. Why was this study needed? Diabetes affects around four million people living in the UK. Around 90% have type 2 diabetes
Excess Burden of Mental Illness and Hospitalization in Young-Onset Type 2 Diabetes: A Population-Based Cohort Study. Type 2 diabetes (T2D) increases hospitalization risk. Young-onset T2D (YOD) (defined as onset before age 40 years) is associated with excess morbidity and mortality, but its effect on hospitalizations is unknown.To determine hospitalization rates among persons with YOD and to examine the effect of age at onset on hospitalization risk.Prospective cohort study.Hong Kong.Adults aged (...) . The adjusted rate ratios showed increased hospitalization in YOD versus usual-onset T2D (onset at age ≥40 years) (all-cause, 1.8 [95% CI, 1.7 to 2.0]; renal, 6.7 [CI, 4.2 to 10.6]; diabetes, 3.7 [CI, 3.0 to 4.6]; cardiovascular, 2.1 [CI, 1.8 to 2.5]; infection, 1.7 [CI, 1.4 to 2.1]; P < 0.001 for all). Models estimated that intensified risk factor control in YOD (hemoglobin A1c level <6.2%, systolic blood pressure <120 mm Hg, low-density lipoprotein cholesterol level <2.0 mmol/L [<77.3 mg/dL], triglyceride
... - PRESIDENTS AND STAFF - REFERENCES . - APPENDIX 1 Author Relationships With Industry and Other Entities (Relevant)—2018 ACC Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes .. - APPENDIX 2 Peer Reviewer Information .. - APPENDIX 3 Abbreviations .. - PREFACE The American College of Cardiology (ACC) develops a wide range of policy documents to provide members with guidance on clinical topics. Although Clinical Practice Guidelines remain (...) the leading cause of morbidity and mor- tality in patients with type 2 diabetes (T2D) (1).Overthat time, the prevalence of T2D has increased, while the excess risk of adverse CV events in patients with T2D (compared with patients without diabetes) has remained largely unchanged (2). Accordingly, the development of treatment strategies to improve CV outcomes in this vulnerable patient population remains a major priority. Diabetes is typically thought of as a disease of elevated blood glucose (3). Although
Semaglutide (Ozempic) - the treatment of adults with insufficiently controlled type 2 diabetes mellitus (T2DM) as an adjunct to diet and exercise 1 Published 14 January 2019 1 SMC2092 semaglutide 0.25mg, 0.5mg and 1mg solution for injection in pre-filled pen (Ozempic®) Novo Nordisk Ltd. 9 November 2018 (Issued 7 December 2018) The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its (...) with type 2 diabetes (T2DM), the postprandial rise in endogenous GLP-1 is reduced or absent. GLP-1 receptor agonists can supplement or replace this deficiency. The submitting company has requested that SMC considers semaglutide when positioned for use in line with the current use of other GLP-1 receptor agonists, in addition to other medicinal products for the treatment of diabetes (i.e. as an add-on therapy to oral anti-diabetic drugs [OADs] or basal insulin). 3 The Semaglutide Unabated Sustainability
Ertugliflozin (Steglatro) - type 2 diabetes mellitus 1 Published 14 January 2019 1 SMC2102 ertugliflozin 5mg, 15mg film-coated tablet (Steglatro®) Merck Sharp & Dohme 7 December 2018 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its use in NHSScotland. The advice is summarised as follows: ADVICE: following a full submission ertugliflozin (Steglatro ® ) is accepted (...) , therefore hypoglycaemia is unlikely. 6 Efficacy is dependent on renal function, and is reduced in patients with moderate renal impairment and likely to be absent in severe renal impairment. Ertugliflozin is formulated as an immediate-release tablet that is taken once daily. 1 Current UK guidance recommends that SGLT-2 inhibitors used as monotherapy be considered as options for treating type 2 diabetes in adults for whom metformin is contraindicated or not tolerated and when diet and exercise alone do
KP National Heart Failure Lead KP Southern California Heart Failure Lead Reference: 1. Davies MJ, D’Alessio, DA, Fradkin, J, et al. Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2018 Oct 4. (...) Second-line Drug Therapy for Patients with Type 2 Diabetes Second-line drug therapy for patients with Type 2 Diabetes A Consensus Statement from the Kaiser Permanente National Integrated Cardiovascular Health (ICVH) Work Group November 19, 2018 The Kaiser Permanente ICVH group is aware of the new treatment recommendations published in the American Diabetes Association’s (ADA) Management of Hyperglycemia in Type 2 Diabetes 2018 Consensus Report. The ADA places newer diabetic medications
Minimed 670g - for the management of type1diabetes mellitus Search Page - Drug and Health Product Register Language selection Search and menus Search Search website Search Topics menu You are here: Summary Basis of Decision - - Health Canada Expand all Summary Basis of Decision (SBD) for Contact: Summary Basis of Decision (SBD) Summary basis of decision (SBD) documents provide information related to the original authorization of a product. The for the is located below. Updated: The following (...) table describes post-licensing activity for the . For more information on the type of information found in PLATs, please refer to the For additional information about the medical device application process, refer to the . Licence Number: Post-Licensing Activity Table (PLAT) Activity/Application Type, Application Number Date Submitted Decision and Date Summary of Activities 1 What was approved? Application Milestones: Application Milestone Date For additional information about the medical device
Cardiovascular Benefits and Harms of Step Therapy in the Treatment of Type 2 Diabetes in Adults with and without Atherosclerotic Cardiovascular Disease Cardiovascular Benefits and Harms of Step Therapy in the Treatment of Type 2 Diabetes in Adults with and without Atherosclerotic Cardiovascular Disease Kaiser Permanente Research Affiliates Evidence-based Practice Center Corinne Evans, MPP; Nicholas Emptage, MAE; Megan Rushkin, MPH; and Jennifer S. Lin, MD, MCR Summary Question 1. In persons (...) with type 2 diabetes with or without known atherosclerotic cardiovascular disease (ASCVD) who cannot attain adequate glucose control with metformin, what is the benefit of GLP-1 agonists or SGLT-2 inhibitors on cardiovascular morbidity and mortality? • Evidence of benefit in persons with known ASCVD on cardiovascular disease (CVD) outcomes, CVD mortality and all-cause mortality (ACM) o Based on limited evidence in persons without ASCVD, no evidence of benefit on CVD outcomes • Presumed class effect