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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 DiabetesSecond-line drug therapy for patients with Type 2 DiabetesA 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 Diabetes2018 Consensus Report. The ADA places newer diabetic medications
Associations of Fenofibrate Therapy WithÂ Incidence and Progression of CKD inÂ Patients With Type 2 Diabetes. 30596172 2019 02 16 2468-0249 4 1 2019 Jan Kidney international reports Kidney Int Rep Associations of Fenofibrate Therapy With Incidence and Progression of CKD in Patients With Type 2 Diabetes. 94-102 10.1016/j.ekir.2018.09.006 Abnormalities in lipid metabolism may contribute to the development and progression of chronic kidney disease (CKD) in patients with type 2 diabetes (...) 2468-0249 albuminuria chronic kidney disease diabetic nephropathy fenofibrate kidney failure 2018 06 28 2018 08 29 2018 09 10 2019 11 6 0 2019 11 6 0 2019 11 6 1 epublish 30596172 10.1016/j.ekir.2018.09.006 S2468-0249(18)30204-3 PMC6308372
liraglutide, in the management of patients with type 2 diabetes, existed in the form of the LEAD-programme. This programme consisted of six phase III, randomised, controlled, parallel-group trials. The majority were multi-national, multi-centre trials with the exception of LEAD-3 and LEAD-4, which were both multi-centre trials conducted across two countries. All six trials followed similar methodologies with the primary efficacy endpoint being a measure of the change in Hb A1C . In LEAD-1 and LEAD-2 (...) Liraglutide (Victoza) - type 2 diabetesCost-effectiveness of liraglutide (Victoza®) for the treatment of adults with insufficiently controlled type 2 diabetesas an adjunct to diet and exercise. The NCPE has issued a recommendation regarding the cost-effectiveness of liraglutide (Victoza®). Following assessment of the applicant’s submission, the NCPE recommends that liraglutide (Victoza®) not be considered for reimbursement unless cost-effectiveness can be improved relative to existing
Alpha-glucosidase inhibitors for prevention or delay of type 2 diabetesmellitus and its associated complications in people at increased risk of developing type 2 diabetesmellitus. BACKGROUND: Alpha-glucosidase inhibitors (AGI) reduce blood glucose levels and may thus prevent or delay type 2 diabetesmellitus (T2DM) and its associated complications in people at risk of developing of T2DM. OBJECTIVES: To assess the effects of AGI in people with impaired glucose tolerance (IGT), impaired fasting (...) and two investigating voglibose, that included people with IGT or people "at increased risk for diabetes". The trial duration ranged from one to six years. Most trials compared AGI with placebo (N = 4) or no intervention (N = 4).Acarbose reduced the incidence of T2DM compared to placebo: 670 out of 4014 people (16.7%) in the acarbose groups developed T2DM, compared to 812 out of 3994 people (20.3%) in the placebo groups (RR 0.82, 95% CI 0.75 to 0.89; P < 0.0001; 3 trials; 8008 participants
Association of Genetic Variants Related to Gluteofemoral vs Abdominal Fat Distribution With Type 2 Diabetes, Coronary Disease, and Cardiovascular Risk Factors. Importance: Body fat distribution, usually measured using waist-to-hip ratio (WHR), is an important contributor to cardiometabolic disease independent of body mass index (BMI). Whether mechanisms that increase WHR via lower gluteofemoral (hip) or via higher abdominal (waist) fat distribution affect cardiometabolic risk is unknown (...) measured by dual-energy x-ray absorptiometry, systolic and diastolic blood pressure, low-density lipoprotein cholesterol, triglycerides, fasting glucose, fasting insulin, type 2 diabetes, and coronary disease risk (follow-up analyses). Results: Among 452 302 UK Biobank participants of European ancestry, the mean (SD) age was 57 (8) years and the mean (SD) WHR was 0.87 (0.09). In genome-wide analyses, 202 independent genetic variants were associated with higher BMI-adjusted WHR (n = 660 648
Short-acting insulin analogues versus regular human insulin for adult, non-pregnant persons with type 2 diabetesmellitus. BACKGROUND: The use of short-acting insulin analogues (insulin lispro, insulin aspart, insulin glulisine) for adult, non-pregnant people with type 2 diabetesis still controversial, as reflected in many scientific debates. OBJECTIVES: To assess the effects of short-acting insulin analogues compared to regular human insulin in adult, non-pregnant people with type 2 diabetes (...) mellitus. SEARCH METHODS: For this update we searched CENTRAL, MEDLINE, Embase, the WHO ICTRP Search Portal, and ClinicalTrials.gov to 31 October 2018. We placed no restrictions on the language of publication. SELECTION CRITERIA: We included all randomised controlled trials with an intervention duration of at least 24 weeks that compared short-acting insulin analogues to regular human insulin in the treatment of people with type 2 diabetes, who were not pregnant. DATA COLLECTION AND ANALYSIS: Two
Dapagliflozin versus saxagliptin as add-on therapy in patients with type 2 diabetesinadequately controlled with metformin. 30304106 2018 12 11 2018 12 11 2359-4292 62 4 2018 08 Archives of endocrinology and metabolism Arch Endocrinol Metab Dapagliflozin versus saxagliptin as add-on therapy in patients with type 2 diabetesinadequately controlled with metformin. 424-430 S2359-39972018000400424 10.20945/2359-3997000000056 This analysis compared the efficacy and safety of the sodium-glucose (...) cotransporter-2 (SGLT2) inhibitor, dapagliflozin, and the dipeptidyl peptidase-4 (DPP4) inhibitor, saxagliptin, both added on to metformin. This was a post-hoc analysis from a double-blind, randomized, 24-week clinical trial (NCT01606007) of patients with type 2 diabetes (T2D) inadequately controlled with metformin. We compared the dapagliflozin 10 mg (n = 179) and saxagliptin 5 mg (n = 176) treatment arms. Dapagliflozin showed significantly greater mean reductions versus saxagliptin in HbA1c (difference
Incretin based drugs and risk of cholangiocarcinoma among patients with type 2 diabetes: population based cohort study. OBJECTIVE: To determine whether use of dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists are associated with an increased risk of cholangiocarcinoma in adults with type 2 diabetes. DESIGN: Population based cohort study. SETTING: General practices contributing data to the UK Clinical Practice Research Datalink. PARTICIPANTS: 154 162 (...) , respectively). CONCLUSION: Compared with use of other second or third line antidiabetic drugs, use of DPP-4 inhibitors, and possibly GLP-1 receptor agonists, might be associated with an increased risk of cholangiocarcinoma in adults with type 2 diabetes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
The effectiveness of peer support on self-efficacy and quality of life in adults with type 2 diabetes: A systematic review and meta-analysis 30289552 2018 11 12 1365-2648 2018 Oct 05 Journal of advanced nursing J Adv Nurs The effectiveness of peer support on self-efficacy and quality of life in adults with type 2 diabetes: A systematic review and meta-analysis. 10.1111/jan.13870 Peer support has been suggested as a promising approach for diabetes management. No conclusive evidence exists (...) on the effects of peer support on self-efficacy and quality of life in adults with type 2 diabetes. To assess the effectiveness of peer support on self-efficacy and the quality of life in adults with type 2 diabetes. A systematic review and meta-analysis of randomized controlled studies. We searched PubMed, Embase, Cochrane Central Register of Controlled Trials and Allied Health Literature database guide for relevant literatures from inception to 30 September 2017. The review was conducted according
Continuous positive airway pressure effect on visual acuity in patients with type 2 diabetesand obstructive sleep apnoea: a multicentre randomised controlled trial 30166323 2018 11 14 1399-3003 52 4 2018 Oct The European respiratory journal Eur. Respir. J. Continuous positive airway pressure effect on visual acuity in patients with type 2 diabetesand obstructive sleep apnoea: a multicentre randomised controlled trial. 1801177 10.1183/13993003.01177-2018 We sought to establish whether (...) continuous positive airway pressure (CPAP) for obstructive sleep apnoea (OSA) in people with type 2 diabetesanddiabetic macular oedema (DMO) improved visual acuity.We randomly assigned 131 eligible patients aged 30-85 years from 23 UK centres with significant DMO causing visual impairment (LogMAR letters identified ≥39 and ≤78, score 0.92-0.14) plus severe OSA on screening to either usual ophthalmology care (n=67) or usual ophthalmology care plus CPAP (n=64) for 12 months.Mean age of participants was 64 years, 73% male, mean
and safety of add-on therapy with the dipeptidyl peptidase-4 inhibitor teneligliptin compared with sitagliptin in patients with type 2 diabetes (T2DM) inadequately controlled with metformin and glimepiride. This was a phase 3, randomized, double-blind, non-inferiority study of adult Korean subjects with T2DM (n=201), with glycated hemoglobin (HbA1c) ranging from 7.0-11.0%, on stable doses of metformin plus glimepiride. Subjects were randomized in a 1:1 fashion to receive either oral teneligliptin 20 mg (...) Teneligliptin versus sitagliptin in Korean patients with type 2 diabetesinadequately controlled with metformin and glimepiride: A randomized, double-blind, non-inferiority trial 30362280 2018 10 26 1463-1326 2018 Oct 26 Diabetes, obesity & metabolism Diabetes Obes Metab Teneligliptin versus sitagliptin in Korean patients with type 2 diabetesinadequately controlled with metformin and glimepiride: A randomized, double-blind, non-inferiority trial. 10.1111/dom.13566 To assess the efficacy
Effect of switching from pioglitazone to the sodium glucose co-transporter-2 inhibitor dapagliflozin on body weight and metabolism-related factors in patients with type 2 diabetesmellitus: An open-label, prospective, randomized, parallel-group comparison 30311367 2018 11 08 1463-1326 2018 Oct 12 Diabetes, obesity & metabolism Diabetes Obes Metab Effect of switching from pioglitazone to the sodium glucose co-transporter-2 inhibitor dapagliflozin on body weight and metabolism-related factors (...) in patients with type 2 diabetesmellitus: An open-label, prospective, randomized, parallel-group comparison trial. 10.1111/dom.13557 The effects of dapagliflozin (DAP) and pioglitazone (PIO) on body weight and glycaemic control were compared in patients with type 2 diabetesmellitus. Seventy-one patients on PIO were either switched to DAP (n = 36) at 5 mg per day or continued on PIO (n = 35). Primary endpoints were superiority of body weight loss and non-inferiority of HbA1c level after 24 weeks with DAP
The Effect of a Smartphone-Based, Patient-Centered Diabetes Care System in Patients With Type 2 Diabetes: A Randomized, Controlled Trial for 24 Weeks 30377185 2018 11 09 1935-5548 2018 Oct 30 Diabetes care Diabetes Care The Effect of a Smartphone-Based, Patient-Centered Diabetes Care System in Patients With Type 2 Diabetes: A Randomized, Controlled Trial for 24 Weeks. dc172197 10.2337/dc17-2197 This study evaluated the efficacy of a smartphone-based, patient-centered diabetes care system (...) (mDiabetes) for type 2 diabetesthat contains comprehensive modules for glucose monitoring, diet, physical activity, and a clinical decision support system. We conducted a 24-week, multicenter, randomized controlled trial with adult patients with inadequately controlled type 2 diabetes. The patients were randomly assigned to the mDiabetes group or the paper logbook (pLogbook) group. The primary end point was the difference of the change in HbA 1c from baseline between the two groups. HbA 1c reduction
Effectiveness of high intensity interval training combined with resistance training vs. continuous moderate intensity training combined with resistance training in patients with type 2 diabetes - 1 year randomized controlled trial 30284352 2018 10 29 1463-1326 2018 Oct 03 Diabetes, obesity & metabolism Diabetes Obes Metab Effectiveness of high-intensity interval training combined with resistance training versus continuous moderate-intensity training combined with resistance training in patients (...) with type 2 diabetes: A one-year randomized controlled trial. 10.1111/dom.13551 To evaluate the impact of one-year high intensity interval training (HIIT) combined with resistance training (RT) vs continuous moderate intensity training (MCT) combined with RT on glycaemic control, body composition and cardiorespiratory fitness (CRF) in patients with type 2 diabetes. A randomized controlled trial included 96 participants with type 2 diabetesfor a one-year supervised exercise intervention with three groups: Control
Rotating night shift work and adherence to unhealthy lifestyle in predicting risk of type 2 diabetes: results from two large US cohorts of female nurses. OBJECTIVES: To prospectively evaluate the joint association of duration of rotating night shift work and lifestyle factors with risk of type 2 diabetesrisk, and to quantitatively decompose this joint association to rotating night shift work only, to lifestyle only, and to their interaction. DESIGN: Prospective cohort study. SETTING: Nurses (...) ' Health Study (1988-2012) and Nurses' Health Study II (1991-2013). PARTICIPANTS: 143 410 women without type 2 diabetes, cardiovascular disease, or cancer at baseline. EXPOSURES: Rotating night shift work was defined as at least three night shifts per month in addition to day and evening shifts in that month. Unhealthy lifestyles included current smoking, physical activity levels below 30 minutes per day at moderate to vigorous intensity, diet in the bottom three fifths of the Alternate Healthy Eating
Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. BACKGROUND: The cardiovascular safety profile of dapagliflozin, a selective inhibitor of sodium-glucose cotransporter 2 that promotes glucosuria in patients with type 2 diabetes, is undefined. METHODS: We randomly assigned patients with type 2 diabeteswho had or were at risk for atherosclerotic cardiovascular disease to receive either dapagliflozin or placebo. The primary safety outcome was a composite of major adverse (...) % in the placebo group (hazard ratio, 0.76; 95% CI, 0.67 to 0.87), and death from any cause occurred in 6.2% and 6.6%, respectively (hazard ratio, 0.93; 95% CI, 0.82 to 1.04). Diabetic ketoacidosis was more common with dapagliflozin than with placebo (0.3% vs. 0.1%, P=0.02), as was the rate of genital infections that led to discontinuation of the regimen or that were considered to be serious adverse events (0.9% vs. 0.1%, P<0.001). CONCLUSIONS: In patients with type 2 diabeteswho had or were at risk
SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. BACKGROUND: The magnitude of effect of sodium-glucose cotransporter-2 inhibitors (SGLT2i) on specific cardiovascular and renal outcomes and whether heterogeneity is based on key baseline characteristics remains undefined. METHODS: We did a systematic review and meta-analysis of randomised, placebo-controlled (...) , cardiovascular outcome trials of SGLT2i in patients with type 2 diabetes. We searched PubMed and Embase for trials published up to Sept 24, 2018. Data search and extraction were completed with a standardised data form and any discrepancies were resolved by consensus. Efficacy outcomes included major adverse cardiovascular events (myocardial infarction, stroke, or cardiovascular death), the composite of cardiovascular death or hospitalisation for heart failure, and progression of renal disease. Hazard ratios
(absolute incidence rate difference, 0.22 [95% CI, -0.52 to 0.97] per 100 person-years) (HR, 1.04; 95% CI, 0.89-1.22; P = .62). Adverse events occurred in 2697 (77.2%) and 2723 (78.1%) patients in the linagliptin and placebo groups; 1036 (29.7%) and 1024 (29.4%) had 1 or more episodes of hypoglycemia; and there were 9 (0.3%) vs 5 (0.1%) events of adjudication-confirmed acute pancreatitis. Conclusions and Relevance: Among adults with type 2 diabetesand high CV and renal risk, linagliptin added to usual (...) Effect of Linagliptin vs Placebo on Major Cardiovascular Events in Adults With Type 2 Diabetesand High Cardiovascular and Renal Risk: The CARMELINA Randomized Clinical Trial. Importance: Type 2 diabetesis associated with increased cardiovascular (CV) risk. Prior trials have demonstrated CV safety of 3 dipeptidyl peptidase 4 (DPP-4) inhibitors but have included limited numbers of patients with high CV risk and chronic kidney disease. Objective: To evaluate the effect of linagliptin
Semaglutide (Ozempic) - for the treatment of insufficiently controlled type 2 diabetesmellitus Final Appraisal Recommendation Advice No: 1618 – October 2018 Semaglutide (Ozempic ® ) 1.34 mg/ml solution for injection in pre-filled pen Submission by Novo Nordisk Ltd. In reaching the above recommendation AWMSG has taken account of the appraisal documentation prepared by the AWMSG Secretariat (reference number 1842), which includes the AWMSG Secretariat Assessment Report (ASAR), the Preliminary (...) Appraisal Recommendation (PAR) and the applicant company’s response to the PAR, clinical expert opinion (where available), the views of patients/patient carers (where available) and the lay member perspective. This recommendation has been ratified by Welsh Government and will be considered for review every three years. Recommendation of AWMSG Semaglutide (Ozempic ® ) is recommended as an option for restricted use within NHS Wales for the treatment of insufficiently controlled type 2 diabetesmellitus
A Practical Approach to the Management of Continuous Glucose Monitoring (CGM) / Real-Time Flash Glucose Scanning (FGS) in Type 1 Diabetes Mellitus in Children and Young People Under 18 years 1 Version 3, Oct 2018 Review 2021 Authors: ACDC Guideline Development Group N Wright, SM Ng, JC Agwu, P Adolfsson, J Drew, J Pemberton, M Kershaw, S Bissell, C Moudiotis, F Regan, C Gardner, A Astle, A Adams, G Adams, P Manning, A Timmis, A Soni, E Williams ssociation of Children ’s Diabetes Clinicians (...) FOR STAFF Healthcare professionals involved in care of children and young people with Type 1 Diabetes Mellitus PATIENTS Children and young people with diabetes mellitus This guideline is intended for use in managing continuous glucose monitoring (CGM) or real-time flash glucose scanning (FGS) for all children and young people under 18 years with Type 1 diabetes mellitus. Table of Contents Introduction 2 Overview of Pertinent NICE guidance 3 Devices Available for CGM and FGS 6 Section 1: Evidence