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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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Antisense Inhibition of Glucagon Receptor by IONIS-GCGRRx Improves Type2Diabetes Without Increase in Hepatic Glycogen Content in Patients With Type2Diabetes on Stable Metformin Therapy To evaluate the safety and efficacy of IONIS-GCGRRx, a 2'-O-methoxyethyl antisense oligonucleotide targeting the glucagon receptor (GCGR), and the underlying mechanism of liver transaminase increases in patients with type2diabetes on stable metformin therapy.In three phase 2, randomized, double-blind (...) studies, patients with type2diabetes on metformin received weekly subcutaneous injections of IONIS-GCGRRx (50-200 mg) or placebo for 13 or 26 weeks.Significant reductions in HbA1c were observed after IONIS-GCGRRx treatment versus placebo at week 14 (-2.0% 200 mg, -1.4% 100 mg, -0.3% placebo; P < 0.001) or week 27 (-1.6% 75 mg, -0.9% 50 mg, -0.2% placebo; P < 0.001). Dose-dependent increases in transaminases were observed with IONIS-GCGRRx, which were attenuated at lower doses and remained mostly
Effect of SGLT2 inhibitors on cardiovascular, renal and safety outcomes in patients with type2diabetes mellitus and chronic kidney disease: a systematic review and meta-analysis The use of sodium glucose co-transporter 2 (SGLT2) inhibitors in patients with type2diabetes mellitus (T2DM) and chronic kidney disease (CKD) has been limited, primarily because glycaemic efficacy is dependent on kidney function. We performed a systematic review and meta-analysis to assess the efficacy and safety
The ups and downs of low-carbohydrate diets in the management of Type 1 diabetes: a review of clinical outcomes Dietary management has been a mainstay of care in Type 1 diabetes since before the discovery of insulin when severe carbohydrate restriction was advocated. The use of insulin facilitated re-introduction of carbohydrate into the diet. Current management guidelines focus on a healthy and varied diet with consideration of glycaemic load, protein and fat. As a result of frustration (...) with glycaemic outcomes, low-carbohydrate diets have seen a resurgence in popularity. To date, low-carbohydrate diets have not been well studied in the management of Type 1 diabetes. Studies looking at glycaemic outcomes from low-carbohydrate diets have largely been cross-sectional, without validated dietary data and with a lack of control groups. The participants have been highly motivated self-selected individuals who follow intensive insulin management practices, including frequent blood glucose
Management of Type 1 Diabetes Mellitus during illness in children and young people under 18 years (Sick Day Rules) 1 Version 4, Feb 2018 Review 2021 Authors: SM Ng, A Soni, JC Agwu, JA Edge, JH Drew, C Moudiotis, NP Wright, M Kershaw, MC Gardner, L Connellan, W Assam ssociation of Children’s Diabetes Clinicians Clinicians SETTING FOR STAFF Medical and nursing staff PATIENTS Children and young people with diabetes mellitus Contents 1. Introduction 22. Importance of Local ‘Sick-Day’ Rules 2 3 (...) . Ketone testing 2 4. Fluid Management 3 5. Out of hours diabetes advice 4 6. Diabetes Self Management Education 4 7. General Rules for Managing Diabetes During Illness 4 7.1. Using sick day doses on pump therapy 7 7.2. Management of infections usually associated with hypoglycaemia eg. gastroenteritis ... 7 8. References 8 9. Appendix: Patient Advice Leaflet…………………………………………………………………...10 Clinical Guideline Management of Type 1 Diabetes Mellitus during illness in children and young people under 18 years
Effects of Light Therapy on Mood and Insulin Sensitivity in Patients With Type2Diabetes and Depression: Results From a Randomized Placebo-Controlled Trial Depression is common in patients with type2diabetes and adversely affects quality of life and diabetes outcomes. We assessed whether light therapy, an antidepressant, improves mood and insulin sensitivity in patients with depression and type2 diabetes.This randomized, double-blind, placebo-controlled trial included 83 patients (...) with depression and type2diabetes. The intervention comprised 4 weeks of light therapy (10,000 lux) or placebo light therapy daily at home. Primary outcomes included depressive symptoms (Inventory of Depressive Symptomatology [IDS]) and insulin sensitivity (M-value derived from the results of a hyperinsulinemic-euglycemic clamp). Secondary outcomes were related psychological and glucometabolic measures.Intention-to-treat analysis showed that light therapy was not superior to placebo in reducing depressive
Cumulative Risk of End-Stage Renal Disease Among Patients With Type2Diabetes: A Nationwide Inception Cohort Study To estimate long-term cumulative risk of end-stage renal disease (ESRD) after diagnosis of type2 diabetes.This nationwide population-based inception cohort study included 421,429 patients with type2diabetes diagnosed in 1990-2011; patients were followed until the end of 2013. Data linkage between several national health care registers in Finland, covering 100% of the population (...) , enabled the inclusion of almost all inhabitants who started taking diabetes medication or were hospitalized for diabetes. Cumulative risk of ESRD and hazard ratios [HR] for ESRD and death were estimated according to age, sex, and time period of diabetes diagnosis.Among 421,429 patients with type2diabetes, 1,516 developed ESRD and 150,524 died during 3,458,797 patient-years of follow-up. Cumulative risk of ESRD was 0.29% at 10 years and 0.74% at 20 years from diagnosis of diabetes. Risk was higher
Type2Diabetes, but Not Insulin (Analog) Treatment, Is Associated With More Advanced Stages of Breast Cancer: A National Linkage of Cancer and Pharmacy Registries To investigate whether women with type2diabetes (T2D) develop a more advanced stage of breast cancer and whether treatment with insulin (analogs) is associated with specific breast cancer characteristics.For this nested case-control study, women with breast cancer diagnosed in 2002-2014 were selected from the linked Netherlands (...) , metastasis), morphology, grade, estrogen receptor and progesterone receptor (PR), human epidermal growth factor receptor 2, and molecular subtype.Women with T2D (n = 1,567) were more often diagnosed with a more advanced tumor stage (odds ratio 1.28 [95% CI 13-1.44]) and a higher grade (1.22 [1.08-1.39]) though less often with a PR-negative breast tumor (0.77 [0.67-0.89]) than women without diabetes (n = 6,267). No associations were found for the other breast cancer characteristics. Women with T2D using
Automated insulin dosing guidance to optimise insulin management in patients with type2diabetes: a multicentre, randomised controlled trial. Insulin therapy is most effective if dosage titrations are done regularly and frequently, which is seldom practical for most clinicians, resulting in an insulin titration gap. The d-Nav Insulin Guidance System (Hygieia, Livonia, MI, USA) is a handheld device that is used to measure glucose, determine glucose patterns, and automatically determine (...) the appropriate next insulin dose. We aimed to determine whether the combination of the d-Nav device and health-care professional support is superior to health-care professional support alone.In this multicentre, randomised, controlled study, we recruited patients from three diabetes centres in the USA (in Detroit MI; Minneapolis, MN; and Des Moines IA). Patients were eligible if they were aged 21-70 years, diagnosed with type2diabetes with a glycated haemoglobin (HbA1c) concentration of 7·5% or higher (≥58
2019LancetControlled trial quality: predicted high
Association of Type 1 Diabetes With Standardized Test Scores of Danish Schoolchildren. Type 1 diabetes has been associated with cardiovascular disease and late complications such as retinopathy and nephropathy. However, it is unclear whether there is an association between type 1 diabetes and school performance in children.To compare standardized reading and mathematics test scores of schoolchildren with type 1 diabetes vs those without diabetes.Population-based retrospective cohort study from (...) , and 51% were male; 2031 had a confirmed diagnosis of type 1 diabetes. Overall, the mean combined score in math and reading was 56.11 (SD, 24.93). There were no significant differences in test scores found between children with type 1 diabetes (mean, 56.56) and children without diabetes (mean, 56.11; difference, 0.45 [95% CI, -0.31 to 1.22]). The estimated difference in test scores between children with and without type 1 diabetes from a linear regression model with adjustment for grade, test topic
Metformin?s role in type 1 diabetes: the removal trial Metformin’s Role in Type 1 Diabetes: the REMOVAL Trial – Clinical Correlations Search Metformin’s Role in Type 1 Diabetes: the REMOVAL Trial February 14, 2019 5 min read By William Plowe Peer Reviewed Metformin has been the first-line drug in type2diabetes for over a decade, but its possible benefit in type 1 diabetes (DM1) is still a matter of study. The American Diabetes Association lists metformin as an investigational agent that may (...) reduce insulin requirements in DM1, but it is not FDA-approved for that use. REMOVAL, a 2017 multicenter double-blind placebo-controlled study, studied metformin in adults with DM1. It is biologically plausible that metformin could have a role in DM1. Metformin, a biguanide, works by several mechanisms, including inhibition of gluconeogenesis and reducing insulin resistance. Importantly, in the UKPDS 34 study . Insulin resistance, the hallmark of type2diabetes, is often present in patients
OurPath app for management of type2diabetes OurPath app - Health Technology Wales > OurPath app OurPath app Topic Status Incomplete OurPath app for management of type2diabetes Summary Health Technology Wales researchers searched for evidence on whether the use of the OurPath app is an effective alternative to GP referral to weight-loss programmes in people deemed to be at ‘high-risk’ of type2diabetes. The evidence is insufficient in quality and quantity to enable an appraisal by Health
The renoprotective effects of sodium-glucose cotransporter 2 inhibitors versus placebo in patients with type2diabetes with or without prevalent kidney disease: A systematic review and meta-analysis We undertook a systematic review and meta-analysis to assess the efficacy and safety of sodium-glucose cotransporter 2 inhibitors (SGLT2is) concerning kidney outcomes in patients with type2diabetes mellitus (T2DM), with or without prevalent kidney disease.PubMed, Web of science, Embase (...) patient characteristics (age, BMI, HbA1c, eGFR level), but were influenced by drug administration (treatment duration, type, dosage of SGLT2is). Subgroup analyses showed that the relative effects on renal outcomes of SGLT2is vs placebo were similar across eGFR subgroups (P heterogeneity >0.05).SGLT2is slowed eGFR decline, lowered albuminuria progression, improved adverse renal endpoints and reduced all-cause mortality, but increased risk of genital infections vs placebo in patients with T2DM
A whey/guar "preload" improves postprandial glycaemia and glycated haemoglobin levels in type2diabetes: A 12-week, single-blind, randomized, placebo-controlled trial To evaluate the effects of 12 weeks of treatment with a whey/guar preload on gastric emptying, postprandial glycaemia and glycated haemoglobin (HbA1c) levels in people with type2diabetes (T2DM).A total of 79 people with T2DM, managed on diet or metformin (HbA1c 49 ± 0.7 mmol/mol [6.6 ± 0.1%]), were randomized, in single-blind
A randomized, multicentre trial evaluating the efficacy and safety of fast-acting insulin aspart in continuous subcutaneous insulin infusion in adults with type 1 diabetes (onset 5) To evaluate the efficacy and safety of fast-acting insulin aspart (faster aspart) vs insulin aspart (IAsp) used in continuous subcutaneous insulin infusion (CSII) in participants with type 1 diabetes (T1D).This was a double-blind, treat-to-target, randomized, 16-week trial investigating CSII treatment with faster (...) % confidence interval [CI] 0.14; 1.87) or 0.09% (95% CI 0.01; 0.17; P < 0.001) for non-inferiority (0.4% margin; P < 0.02 for statistical significance in favour of IAsp). Faster aspart was superior to IAsp in change from baseline in 1-hour postprandial glucose (PPG) increment after a meal test (ETD -0.91 mmol/L [95% CI -1.43; -0.39] or -16.4 mg/dL [95% CI -25.7; -7.0]; P = 0.001), with statistically significant reductions also at 30 minutes and 2 hours. The improvement in PPG was reflected in the change
Comparative effectiveness and harms of long-acting insulins for type 1 and type2diabetes: A systematic review and meta-analysis To review evidence comparing benefits and harms of long-acting insulins in patients with type 1 and 2 diabetes.MEDLINE and two Cochrane databases were searched during February 2018. Two authors selected studies meeting inclusion criteria and assessed their quality. Comparative studies of adult or paediatric patients with diabetes treated with insulin degludec (...) , detemir or glargine were included. Meta-analysis was used to combine results of similar studies, and the I2 statistic calculated to assess statistical heterogeneity.Of 2534 citations reviewed, 70 studies met the inclusion criteria. No statistically significant differences in HbA1c were seen between any two insulins or formulations. Hypoglycaemia was less probable with degludec than with glargine, including nocturnal hypoglycaemia in type 1 (rate ratio 0.68, 95% CI 0.56-0.81) and type2diabetes (rate
Pegbelfermin (BMS-986036), PEGylated FGF21, in Patients with Obesity and Type2Diabetes: Results from a Randomized Phase 2 Study Obesity and type2diabetes mellitus (T2DM) are risk factors for nonalcoholic fatty liver disease, including nonalcoholic steatohepatitis. This study assessed pegbelfermin (BMS-986036), recombinant PEGylated human fibroblast growth factor 21 (FGF21), in patients with obesity and T2DM predisposed to fatty liver.In this randomized, double-blind, placebo-controlled
The effects of incretin-based therapies on beta-cell function and insulin resistance in type2diabetes: A systematic review and network meta-analysis combining 360 trials To evaluate the comparative effects of incretin-based therapies, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dipeptidyl peptidase-4 inhibitors (DPP-4Is), on β-cell function and insulin resistance in patients with type2diabetes mellitus (T2DM).Medline, Embase, the Cochrane Library
Prediction of individual life-years gained without cardiovascular events from lipid, blood pressure, glucose, and aspirin treatment based on data of more than 500 000 patients with Type2diabetes mellitus Although group-level effectiveness of lipid, blood pressure, glucose, and aspirin treatment for prevention of cardiovascular disease (CVD) has been proven by trials, important differences in absolute effectiveness exist between individuals. We aim to develop and validate a prediction tool (...) for individualizing lifelong CVD prevention in people with Type2diabetes mellitus (T2DM) predicting life-years gained without myocardial infarction or stroke.We developed and validated the Diabetes Lifetime-perspective prediction (DIAL) model, consisting of two complementary competing risk adjusted Cox proportional hazards functions using data from people with T2DM registered in the Swedish National Diabetes Registry (n = 389 366). Competing outcomes were (i) CVD events (vascular mortality, myocardial