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Latest & greatest articles for type 2 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 2 diabetes or other clinical topics then use Trip today.
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‘Artificial pancreas’ improves glucose control in hospital patients with type 2 diabetesType 2 diabetescontrol improves with 'artificial pancreas' Dissemination Centre Discover Portal NIHR DC Discover ‘Artificial pancreas’ improves glucose control in hospital patients with type 2 diabetesPublished on 13 November 2018 doi: Closed-loop insulin pumps, which continuously monitor blood glucose and administer insulin accordingly, can improve blood glucose control among patients (...) with type 2 diabetesadmitted to hospital 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 diabetesis increasing. Glucose control often worsens during illness. Closed-loop pumps have been shown to improve blood glucose control in type 1 diabetes and in critical care settings. This two-centre study included 136 patients with type 2 diabeteson general
Self-monitoring of blood glucose provides no important benefit for most people with type 2 diabetesSelf-monitoring of blood glucose provides no important benefit for most people with type 2 diabetesDissemination Centre Discover Portal NIHR DC Discover Self-monitoring of blood glucose provides no important benefit for most people with type 2 diabetesPublished on 23 October 2018 doi: Patients with type 2 diabeteswho monitor their blood glucose themselves may see small, short-term improvements (...) in blood sugar 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 type 1 diabetes and for people with type2 who need insulin. The benefit for all people with type2 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
The benefits and harms of aspirin for people with type 2 diabetesare finely balanced Aspirin benefits and harms balanced in type 2 diabetesDissemination Centre Discover Portal NIHR DC Discover The benefits and harms of aspirin for people with type 2 diabetesare 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 (...) that aspirin shouldn’t 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 type2. Adults with diabetes are two to three times more likely to develop cardiovascular disease
Excess Burden of Mental Illness and Hospitalization in Young-Onset Type 2 Diabetes: A Population-Based Cohort Study. Background: 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. Objective: To determine hospitalization rates among persons with YOD and to examine the effect of age at onset on hospitalization risk. Design: Prospective (...) , 36.8% of YOD bed-days before age 40 years were due to mental illness. 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
Type 2 diabetescan be reversed with a low-calorie diet 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 four year
Nine different drug classes reviewed for type 2 diabetesSignal - Nine different drug classes reviewed for type 2 diabetesDissemination Centre Discover Portal NIHR DC Discover 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 cardiovascular causes (...) and overall mortality, though estimates are imprecise because so few people died in these studies. Risk of other side effects, such as weight gain or risk of low blood sugar did vary between treatments. This very large systematic review of 301 trials compared the drugs given alone or in combination to treat type 2 diabetesagainst each other. The researchers analysed data from direct comparisons and from studies with dummy treatment arms together. Until now it has been unclear if there are reasons to use
Fewer large babies are born to pregnant woman with type 1 diabetes if their glucose was monitored continuously 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 glucose (...) 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. Motivated
Type 2 diabetesis becoming more common in children Signal - Type 2 diabetesis becoming more common in children Dissemination Centre Discover Portal NIHR DC Discover Type 2 diabetesis becoming more common in children Published on 25 July 2017 The number of children being diagnosed with both type 1 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-supported study suggest (...) that type 2 diabetesnow accounts for up to a third of diabetes diagnoses in children. Amongst 100,000 school age children about six new cases of type 2 diabetesa year could be expected in the 1990s. This increased to about 33 new cases per year by the end of the next decade (2009 to 2013). Data was taken from the UK Clinical Practice Research Datalink, a primary care database of electronic health records. Children who are obese have about a four times greater risk of developing type 2 diabetescompared
glucose control. They are expensive though, costing around £2-3,000, with another £1,500 per year in consumables, and have a life span of four to eight years. About 6% of UK adults with type I diabetes use pumps, which is lower than in many countries. Proponents of pumps suggest more people should be offered them. The aim of this study was to compare the effectiveness of pumps with multiple daily injections. What did this study do? The Relative Effectiveness of Pumps Over MDI and Structured Education (...) Insulin pumps not much better than multiple injections for intensive control of type 1 diabetes Signal - Insulin pumps not much better than multiple injections for intensive control of type 1 diabetes Dissemination Centre Discover Portal NIHR DC Discover 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 compared with those using
Continuous insulin pumps may help manage poorly controlled type 2 diabetesSignal - Continuous insulin pumps may help manage poorly controlled type 2 diabetesDissemination Centre Discover Portal NIHR DC Discover Continuous insulin pumps may help manage poorly controlled type 2 diabetesPublished on 18 July 2017 Continuous subcutaneous insulin infusions, or pumps, reduced the amount of daily insulin required by 24 units for people with advanced type 2 diabetescompared to multiple daily insulin (...) injections. Average weight did not differ between treatments. This review compared the two treatments in 590 people from five trials and found that the pumps were linked to slightly better control for people on higher doses of insulin and those with poorer glucose control. However, looking at all the people with diabetes in these studies, there was no difference in overall control between the different forms of treatment. One main challenge in controlling type 2 diabetesis the low adherence to treatment
Motivational interviewing may encourage healthy eating in people with type 2 diabetesSignal - Motivational interviewing may encourage healthy eating in people with type 2 diabetesDissemination Centre Discover Portal NIHR DC Discover 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 care for changing other (...) 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
Flu vaccine reduces deaths for people with type 2 diabetesSignal - Flu vaccine reduces deaths for people with type 2 diabetesDissemination Centre Discover Portal NIHR DC Discover 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 with chronic medical
Sulfonylureas can be considered safe for those with type 2 diabetesSignal - Sulfonylureas can be considered safe for those with type 2 diabetesDissemination Centre Discover Portal NIHR DC Discover 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 drugs. Sulfonylureas (...) are commonly used in the treatment of adults with type 2 diabetes. The drugs in this class are relatively cheap and have been available for many decades, but there have been conflicting views on their safety. The trials in this review were large enough and sufficiently long to pick up relatively rare harmful events like death. Therefore the researchers were confident that, even if there is a small risk, less than one in 200 people treated with sulfonylureas are likely to be harmed. These findings provide
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
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.
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
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
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 (...) 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