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Latest & greatest articles for type 1 diabetes
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, placebo-controlled trial. 10.1111/dom.13161 This prospective, multicentre, phase III study (NCT02104804) evaluated the efficacy and safety of saxagliptin add-on therapy in Chinese patients with type 2 diabetesinadequately controlled by insulin ± metformin. Patients with glycated haemoglobin (HbA1c) 7.5% to 10.5% and fasting plasma glucose (FPG) <15 mmol/L (270 mg/dL) on stable insulin therapy (20-150 U/d) were randomized (1:1) to saxagliptin 5 mg once daily (N = 232) or placebo (N = 230) for 24 weeks (...) Saxagliptin add-on therapy in Chinese patients with type 2 diabetesinadequately controlled by insulin with or without metformin: Results from the SUPER study, a randomized, double-blind, placebo-controlled trial 29144061 2017 12 21 1463-1326 2017 Nov 16 Diabetes, obesity & metabolism Diabetes Obes Metab Saxagliptin add-on therapy in Chinese patients with type 2 diabetesinadequately controlled by insulin with or without metformin: Results from the SUPER study, a randomized, double-blind
Incidence of End-Stage Renal Disease in Patients With Type 1 Diabetes 29263163 2017 12 21 1935-5548 2017 Dec 20 Diabetes care Diabetes Care Incidence of End-Stage Renal Disease in Patients With Type 1 Diabetes. dc172364 10.2337/dc17-2364 To investigate how risk of end-stage renal disease (ESRD) among patients with type 1 diabetes has changed over time and further how the risk is affected by age, sex, and time period of diagnosis of diabetes. A cohort including all patients <30 years old (...) diagnosed with type 1 diabetes in Finland in 1965-2011 was followed until start of renal replacement therapy, death, or end of follow-up at the end of 2013. Altogether, 29,906 patients were included. The main outcome was cumulative risk of ESRD, accounting for death as a competing risk. The patients were followed up for a median of 20 years. During 616,403 patient-years, 1,543 ESRD cases and 4,185 deaths were recorded. The cumulative risk of ESRD was 2.2% after 20 years and 7.0% after 30 years from
Intensive Blood Pressure Lowering in Patients With and Patients Without Type 2 Diabetes: A Pooled Analysis From Two Randomized Trials 29212825 2017 12 07 1935-5548 2017 Dec 06 Diabetes care Diabetes Care Intensive Blood Pressure Lowering in Patients With and Patients Without Type 2 Diabetes: A Pooled Analysis From Two Randomized Trials. dc171722 10.2337/dc17-1722 The Action to Control Cardiovascular Risk in Diabetes Blood Pressure (ACCORD-BP) study did not find a significant beneficial effect (...) of intensive systolic blood pressure (SBP) lowering on cardiovascular events in hypertensive patients with type 2 diabetesmellitus (T2DM), while the Systolic Blood Pressure Intervention Trial (SPRINT) did find a significant beneficial effect in patients without T2DM. The objective of this analysis was to assess the effect of both T2DM and baseline cardiovascular disease (CVD) risk on the treatment effect of intensive blood pressure lowering. The individual patient data from the ACCORD-BP and SPRINT
Mortality and acute complications in children and young adults diagnosed with Type 1 diabetes in Yorkshire, UK: a cohort study 29111600 2017 12 11 1464-5491 35 1 2018 Jan Diabetic medicine : a journal of the British Diabetic Association Diabet. Med. Mortality and acute complications in children and young adults diagnosed with Type 1 diabetes in Yorkshire, UK: a cohort study. 112-120 10.1111/dme.13544 To examine all-cause and cause-specific mortality in a population-based cohort of people (...) with early and late onset of Type 1 diabetes. The Yorkshire Register of Diabetes in Children and Young People includes individuals with early (0-14 years) and late (15-29 years) Type 1 diabetes onset, diagnosed between 1978 and 2013. This register was linked to death certification data from the Office for National Statistics to calculate standardized mortality ratios, cumulative mortality curves using Kaplan-Meier survival estimates, and Cox regression modelling. Ethnicity was derived using Onomap
Metformin hydrochloride (Glucophage) - Reduction in the risk or delay of the onset of type 2 diabetesmellitus Published 15 January 2018 Statement of Advice: metformin hydrochloride 500mg, 750mg and 1000mg prolonged release tablets (Glucophage SR ® ) SMC No 1308/18 Merck Serono Ltd 8 December 2017 ADVICE: in the absence of a submission from the holder of the marketing authorisation metformin hydrochloride (Glucophage SR ® ) is not recommended for use within NHS Scotland. Indication under review (...) : Reduction in the risk or delay of the onset of type 2 diabetesmellitus in adult, overweight patients with impaired glucose tolerance and/or impaired fasting glucose, and/or increased HbA1C who are: • at high risk for developing overt type 2 diabetesmellitus and • still progressing towards type 2 diabetesmellitus despite implementation of intensive lifestyle change for 3 to 6 months. The holder of the marketing authorisation has not made a submission to SMC regarding this product in this setting
Association of Modifiable Risk Factors in Young Adulthood With Racial Disparity in Incident Type 2 DiabetesDuring Middle Adulthood. Importance: In the United States, black individuals are twice as likely to develop type 2 diabetescompared with white individuals, and these disparities are particularly pronounced in young and middle age. Prior studies have identified differences in traditional risk factors that may be associated with racial disparities in diabetes incidence but have (...) biological (eg, fasting glucose, body mass index), neighborhood (racial segregation and tract-level poverty), psychosocial (depressive symptoms), socioeconomic (eg, personal and parental educational attainment, current employment), and behavioral (eg, regular alcohol consumption, smoking) domains. Main Outcomes and Measures: Incident type 2 diabetesmellitus. Results: The mean (SD) age at baseline was 25 (3.6) years, 49% (n = 2066) of the sample was black, and 54% (n = 2304) were women. Over a mean
and no modifications or adaptations are made. Page 5960 Effect of educational intervention based on the Health Belief Model on promoting self-care behaviors of type-2 diabetespatients Parisa Shabibi 1 , Mohammad Sadegh Abedzadeh Zavareh 2 , Kourosh Sayehmiri 3 , Mostafa Qorbani 4, 5 , Omid Safari 6 , Babak Rastegarimehr 7 , Morteza Mansourian 8,9 1 M.Sc. of Health Education and Promotion, Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran 2 Ph.D. of Health Education and Promotion (...) Type 2Electronic physician Page 5961 1. Introduction Diabetes is alarmingly increasing across the world (1). Demographic changes and cultural transition of societies and aging in developing countries have turned diabetes into a global epidemic (2); accordingly, the World Health Organization (WHO) has called it a silent epidemic (3). Diabetes is a metabolic disease and a multi-factorial disorder characterized by chronic blood sugar or hyperglycemia, resulting from impaired insulin secretion
Individualized Glycemic Control for U.S. Adults With Type 2 Diabetes: A Cost-Effectiveness Analysis. Background: Intensive glycemic control in type 2 diabetes (glycated hemoglobin [HbA1c] level <7%) is an established, cost-effective standard of care. However, guidelines recommend individualizing goals on the basis of age, comorbidity, diabetes duration, and complications. Objective: To estimate the cost-effectiveness of individualized control versus uniform intensive control (HbA1c level < (...) ;7%) for the U.S. population with type 2 diabetes. Design: Patient-level Monte Carlo-based Markov model. Data Sources: National Health and Nutrition Examination Survey 2011-2012. Target Population: The approximately 17.3 million persons in the United States with diabetes diagnosed at age 30 years or older. Time Horizon: Lifetime. Perspective: Health care sector. Intervention: Individualized versus uniform intensive glycemic control. Outcome Measures: Average lifetime costs, life-years
Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. BACKGROUND: Type 2 diabetesis 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 (...) with type 2 diabeteswithin the past 6 years, had a body-mass index of 27-45 kg/m 2 , and were not receiving insulin. The intervention comprised withdrawal of antidiabetic and antihypertensive drugs, total diet replacement (825-853 kcal/day formula diet for 3-5 months), stepped food reintroduction (2-8 weeks), and structured support for long-term weight loss maintenance. Co-primary outcomes were weight loss of 15 kg or more, and remission of diabetes, defined as glycated haemoglobin (HbA 1c ) of less than 6·5
Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitors and Incident Type 2 DiabetesMellitus: A Systematic Review and Meta-analysis With Over 96,000 Patient-Years 29180351 2017 11 28 1935-5548 2017 Nov 27 Diabetes care Diabetes Care Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitors and Incident Type 2 DiabetesMellitus: A Systematic Review and Meta-analysis With Over 96,000 Patient-Years. dc171464 10.2337/dc17-1464 Like mutations with loss of function in the proprotein (...) convertase subtilisin/kexin type 9 (PCSK9) gene, inhibitors of PCSK9 (PCSK9i) may potentially favor the manifestation of diabetes. A meta-analysis of phase 2/3 randomized clinical trials (RCTs) assessed PCSK9i versus placebo in primary hypercholesterolemia setting. Statins and ezetimibe were used in 98.4% of these studies and balanced between PCSK9i and placebo. We calculated relative risks (RRs) and 95% CIs using random- and fixed-effect models. We included 68,123 participants (20 RCTs) with median
the risk of severe hypoglycemia associated with initiating monotherapy with sulfonylurea compared with metformin for the treatment of type 2 diabetes. By using the UK Clinical Practice Research Datalink and Hospital Episode Statistics linked to the Office for National Statistics, we identified a cohort of patients with type 2 diabeteswho initiated sulfonylureas or metformin monotherapy between April 1, 1998, and December 31, 2012, with follow-up until December 31, 2013. Sulfonylurea users were matched (...) Sulfonylureas as Initial Treatment for Type 2 Diabetesand the Risk of Severe Hypoglycemia 29032229 2017 12 19 1555-7162 2017 Oct 12 The American journal of medicine Am. J. Med. Sulfonylureas as Initial Treatment for Type 2 Diabetesand the Risk of Severe Hypoglycemia. S0002-9343(17)31030-6 10.1016/j.amjmed.2017.09.044 The magnitude of the risk of severe hypoglycemia associated with sulfonylureas as the initial treatment for type 2 diabetesin the real-world setting is unknown. We assessed
Effect of Financial Incentives on Glucose Monitoring Adherence and Glycemic Control Among Adolescents and Young Adults With Type 1 Diabetes: A Randomized Clinical Trial 29059263 2017 12 12 2017 12 12 2168-6211 171 12 2017 Dec 01 JAMA pediatrics JAMA Pediatr Effect of Financial Incentives on Glucose Monitoring Adherence and Glycemic Control Among Adolescents and Young Adults With Type 1 Diabetes: A Randomized Clinical Trial. 1176-1183 10.1001/jamapediatrics.2017.3233 Glycemic control often (...) deteriorates during adolescence and the transition to young adulthood for patients with type 1 diabetes. The inability to manage type 1 diabetes effectively during these years is associated with poor glycemic control and complications from diabetes in adult life. To determine the effect of daily financial incentives on glucose monitoring adherence and glycemic control in adolescents and young adults with type 1 diabetes. The Behavioral Economic Incentives to Improve Glycemic Control Among Adolescents
Premixed vs basal-bolus insulin regimen in Type 2 diabetes: comparison of clinical outcomes from randomized controlled trials and real-world data 28945928 2017 11 15 1464-5491 34 12 2017 Dec Diabetic medicine : a journal of the British Diabetic Association Diabet. Med. Premixed vs basal-bolus insulin regimen in Type 2 diabetes: comparison of clinical outcomes from randomized controlled trials and real-world data. 1728-1736 10.1111/dme.13518 To evaluate the concordance between data derived from (...) randomized controlled trial (RCT) and real-world estimates of HbA1c and weight change after 24 weeks of initiation of a basal-bolus compared with a premixed insulin regimen in people with Type 2 diabetes. Data eight RCTs were pooled after a systematic review of studies examining basal-bolus (n = 1893) or premixed (n = 1517) regimens. Real-world data were extracted from the UK primary care dataset for people on basal-bolus (n = 7483) or premixed insulin regimens (n=10 744). The mean differences between