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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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Artificial pancreas treatment for outpatients with type 1 diabetes: systematic review and meta-analysis. OBJECTIVE: To evaluate the efficacy and safety of artificial pancreas treatment in non-pregnant outpatients with type 1 diabetes. DESIGN: Systematic review and meta-analysis of randomised controlled trials. DATA SOURCES: Medline, Embase, Cochrane Library, and grey literature up to 2 February 2018. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials in non-pregnant (...) outpatients with type 1 diabetes that compared the use of any artificial pancreas system with any type of insulin based treatment. Primary outcome was proportion (%) of time that sensor glucose level was within the near normoglycaemic range (3.9-10 mmol/L). Secondary outcomes included proportion (%) of time that sensor glucose level was above 10 mmol/L or below 3.9 mmol/L, low blood glucose index overnight, mean sensor glucose level, total daily insulin needs, and glycated haemoglobin. The Cochrane
Association Between Use of Sodium-Glucose Cotransporter 2 Inhibitors, Glucagon-like Peptide 1 Agonists, and Dipeptidyl Peptidase 4 Inhibitors With All-Cause Mortality in Patients With Type 2 Diabetes: A Systematic Review and Meta-analysis. Importance: The comparative clinical efficacy of sodium-glucose cotransporter 2 (SGLT-2) inhibitors, glucagon-like peptide 1 (GLP-1) agonists, and dipeptidyl peptidase 4 (DPP-4) inhibitors for treatment of type 2 diabetesis unknown. Objective: To compare (...) the efficacies of SGLT-2 inhibitors, GLP-1 agonists, and DPP-4 inhibitors on mortality and cardiovascular end points using network meta-analysis. Data Sources: MEDLINE, Embase, Cochrane Library Central Register of Controlled Trials, and published meta-analyses from inception through October 11, 2017. Study Selection: Randomized clinical trials enrolling participants with type 2 diabetesand a follow-up of at least 12 weeks were included, for which SGLT-2 inhibitors, GLP-1 agonists, and DPP-4 inhibitors were
Change in Overweight from Childhood to Early Adulthood and Risk of Type 2 Diabetes. Background Childhood overweight is associated with an increased risk of type 2 diabetesin adulthood. We investigated whether remission of overweight before early adulthood reduces this risk. Methods We conducted a study involving 62,565 Danish men whose weights and heights had been measured at 7 and 13 years of age and in early adulthood (17 to 26 years of age). Overweight was defined in accordance with Centers (...) for Disease Control and Prevention criteria. Data on type 2 diabetesstatus (at age ≥30 years, 6710 persons) were obtained from a national health registry. Results Overweight at 7 years of age (3373 of 62,565 men; 5.4%), 13 years of age (3418 of 62,565; 5.5%), or early adulthood (5108 of 62,565; 8.2%) was positively associated with the risk of type 2 diabetes; associations were stronger at older ages at overweight and at younger ages at diagnosis of type 2 diabetes. Men who had had remission of overweight
, 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 diabetesNIHR DC | Signal - Nine different drug classes reviewed for type 2 diabetesDissemination Centre Discover Portal NIHR DC Discover NIHR Signal Nine different drug classes reviewed for type 2 diabetesPublished 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
Flu vaccine reduces deaths for people with type 2 diabetesNIHR DC | Signal - Flu vaccine reduces deaths for people with type 2 diabetesDissemination Centre Discover Portal NIHR DC Discover NIHR Signal Flu vaccine reduces deaths for people with type 2 diabetesPublished 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 diabetesin 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
Motivational interviewing may encourage healthy eating in people with type 2 diabetesNIHR DC | Signal - Motivational interviewing may encourage healthy eating in people with type 2 diabetesDissemination Centre Discover Portal NIHR DC Discover NIHR Signal Motivational interviewing may encourage healthy eating in people with type 2 diabetesPublished on 15 March 2016 A motivational communication approach may help people with type 2 diabeteseat more healthily, but may be no better than usual (...) type 2 diabetesthat, if not managed well, can cause serious long-term health problems including heart disease, stroke, blindness and amputations leading to disability. Good management includes education for a healthy diet, exercise and maintaining blood glucose levels within safe limits. Motivational interviewing is a counselling approach used to motivate people to change their behaviour, so could be useful in encouraging good diabetes self-management. It typically involves open-ended questions, reflective
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 diabetesrecommends a sulfonylurea as an initial treatment option if the standard first-choice drug (...) Sulfonylureas can be considered safe for those with type 2 diabetesNIHR DC | Signal - Sulfonylureas can be considered safe for those with type 2 diabetesDissemination Centre Discover Portal NIHR DC Discover NIHR Signal Sulfonylureas can be considered safe for those with type 2 diabetesPublished 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
Education can restore awareness of low blood glucose in people with type 1 diabetes NIHR DC | Signal - Education can restore awareness of low blood glucose in people with type 1 diabetes Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Education can restore awareness of low blood glucose in people with type 1 diabetes Published on 20 October 2015 This systematic review found that a range of educational and technological interventions could help adults with type 1 diabetes (...) regain awareness of when they have low blood glucose (hypoglycaemia). Nearly one in every three adults with type 1 diabetes stops noticing low blood sugar levels. This means they cannot take action quickly to prevent a medical crisis. People with low awareness of their blood sugar levels are six times more likely to have severe hypoglycaemia, which can cause fits and even coma. The authors recommended an approach to restoring awareness that starts with structured teaching about flexible insulin
Type 2 diabetescan be reversed with very low-calorie diet NIHR DC | Signal - Type 2 diabetescan be reversed with a low-calorie diet Dissemination Centre Discover Portal NIHR DC Discover Type 2 diabetescan 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 diabeteswithin 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
Fewer large babies are born to pregnant woman with type 1 diabetes if their glucose was monitored continuously NIHR DC | 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 (...) indicate 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
Type 2 diabetesis becoming more common in children NIHR DC | Signal - Type 2 diabetesis becoming more common in children Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Type 2 diabetesis becoming more common in children Published on 25 July 2017 The number of children being diagnosed with both type1 and type 2 diabetesis 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 (...) type 2 diabetescompared with those of a normal weight. Having type 2 diabetesbrings 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. Why was this study needed? The number of children and young people in England and Wales with both diabetestype1
the low adherence to treatment. 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 diabetesas 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 (...) 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 diabetesis 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 diabetesin order to inform the development of patient-centred treatment approaches. What did this study do? This meta-analysis included five randomised
Insulin pumps not much better than multiple injections for intensive control of type 1 diabetes NIHR DC | Signal - Insulin pumps not much better than multiple injections for intensive control of type 1 diabetes Dissemination Centre Discover Portal NIHR DC Discover NIHR Signal Insulin pumps not much better than multiple injections for intensive control of type 1 diabetes Published on 11 July 2017 People with type 1 diabetes offered insulin pumps did not achieve better blood glucose control (...) . This is important because previously observed benefits from pump treatment might actually have been a reflection of the training given to them. Currently just 10% of adults with type 1 diabetes 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. Why was this study needed? People with type 1 diabetes require lifelong
Meta-analysis of metabolic surgery versus medical treatment for microvascular complications in patients with type 2 diabetesmellitus 29405276 2018 02 06 1365-2168 105 3 2018 Feb The British journal of surgery Br J Surg Meta-analysis of metabolic surgery versus medical treatment for microvascular complications in patients with type 2 diabetesmellitus. 168-181 10.1002/bjs.10724 This study aimed to examine the effect of metabolic surgery on pre-existing and future microvascular complications (...) in patients with type 2 diabetesmellitus (T2DM) in comparison with medical treatment. Although metabolic surgery is the most effective treatment for obese patients with T2DM regarding glycaemic control, it is unclear whether the incidence or severity of microvascular complications is reduced. A systematic literature search was performed in MEDLINE, Embase, Web of Science and the Cochrane Central Register of Controlled Trials (CENTRAL) with no language restrictions, looking for RCTs, case-control trials
A randomized controlled pilot study of continuous glucose monitoring and flash glucose monitoring in people with Type 1 diabetes and impaired awareness of hypoglycaemia 29230878 2018 04 13 1464-5491 35 4 2018 Apr Diabetic medicine : a journal of the British Diabetic Association Diabet. Med. A randomized controlled pilot study of continuous glucose monitoring and flash glucose monitoring in people with Type 1 diabetes and impaired awareness of hypoglycaemia. 483-490 10.1111/dme.13561 (...) Hypoglycaemia in Type 1 diabetes is associated with mortality and morbidity, especially where awareness of hypoglycaemia is impaired. Clinical pathways for access to continuous glucose monitoring (CGM) and flash glucose monitoring technologies are unclear. We assessed the impact of CGM and flash glucose monitoring in a high-risk group of people with Type 1 diabetes. A randomized, non-masked parallel group study was undertaken. Adults with Type 1 diabetes using a multiple-dose insulin-injection regimen
Canagliflozin and Heart Failure in Type 2 DiabetesMellitus: Results From the CANVAS Program (Canagliflozin Cardiovascular Assessment Study) 29526832 2018 03 12 1524-4539 2018 Mar 11 Circulation Circulation Canagliflozin and Heart Failure in Type 2 DiabetesMellitus: Results From the CANVAS Program (Canagliflozin Cardiovascular Assessment Study). CIRCULATIONAHA.118.034222 10.1161/CIRCULATIONAHA.118.034222 BACKGROUND : Canagliflozin is a sodium glucose cotransporter 2 inhibitor that reduces (...) the risk of cardiovascular events. We report the effects on heart failure and cardiovascular death overall, in those with and without a baseline history of heart failure, and in other participant subgroups. METHODS : The CANVAS Program (Canagliflozin Cardiovascular Assessment Study) enrolled 10 142 participants with type 2 diabetesmellitus and high cardiovascular risk. Participants were randomly assigned to canagliflozin or placebo and followed for a mean of 188 weeks. The primary end point
The role of metformin and statins in the incidence of epithelial ovarian cancer in type 2 diabetes: a cohort and nested case-control study 29412502 2018 03 12 1471-0528 2018 Feb 07 BJOG : an international journal of obstetrics and gynaecology BJOG The role of metformin and statins in the incidence of epithelial ovarian cancer in type 2 diabetes: a cohort and nested case-control study. 10.1111/1471-0528.15151 To obtain evidence of the effects of metformin and statins on the incidence of ovarian (...) cancer in women with type 2 diabetes (T2D). A retrospective cohort study and nested case-control study. The data were obtained from a diabetes database (FinDM) combining information from several nationwide registers. A cohort of 137 643 women over 40 years old and diagnosed with T2D during 1996-2011 in Finland. In full cohort analysis Poisson regression was used to estimate the hazard ratios (HR) in relation to ever use of metformin, insulin other oral anti-diabetic medication or statins. In the