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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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Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial. 12684363 2003 04 09 2003 05 01 2016 10 17 0098-7484 289 14 2003 Apr 09 JAMA JAMA Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial. 1833-6 Weight loss programs on the Internet appear promising for short-term weight loss but have not been studied for weight loss in individuals at risk of type 2 diabetes; thus (...) , the longer-term efficacy is unknown. To compare the effects of an Internet weight loss program alone vs with the addition of behavioral counseling via e-mail provided for 1 year to individuals at risk of type 2 diabetes. A single-center randomized controlled trial conducted from September 2001 to September 2002 in Providence, RI, of 92 overweight adults whose mean (SD) age was 48.5 (9.4) years and body mass index, 33.1 (3.8). Participants were randomized to a basic Internet (n = 46) or to an Internet
Routine hospital admission versus out-patient or home care in children at diagnosis of type 1 diabetes mellitus. BACKGROUND: In many places, children newly diagnosed with type 1 diabetes mellitus are admitted to hospital for metabolic stabilisation and training, even if they are not acutely ill. Out-patient or home based management of these children could avoid the stress associated with a hospital stay, could provide a more natural learning environment for the child and its family, and might (...) reduce costs for both the health care system and the families. OBJECTIVES: To assess the effects of routine hospital admission compared to out-patient or home-based management in children newly diagnosed with type 1 diabetes who are not acutely ill, on metabolic control, wellbeing and self-efficacy of the patient and his/her family. SEARCH STRATEGY: We searched the Cochrane Library (including the Cochrane Controlled Trials Register), Medline, Embase, Cinahl, and the British Nursing Index
Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetesmellitus. BACKGROUND: Metformin is an oral anti-hyperglycemic agent used in the treatment of type 2 diabetesmellitus. The results of the UK Prospective Diabetes Study indicate that metformin treatment is associated with a reduction in total mortality compared to other anti-hyperglycemic treatments. Metformin, however, is thought to increase the risk of lactic acidosis, and is considered to be contraindicated (...) in many chronic hypoxemic conditions that may be associated with lactic acidosis, such as cardiovascular, renal, hepatic and pulmonary disease, and advancing age. OBJECTIVES: To assess the incidence of fatal and nonfatal lactic acidosis with metformin use compared to placebo and other glucose-lowering treatments in patients with type 2 diabetesmellitus. A secondary objective was to evaluate the blood lactate levels for those on metformin treatment compared to placebo or non-metformin therapies
Nut and peanut butter consumption and risk of type 2 diabetesin women. CONTEXT: Nuts are high in unsaturated (polyunsaturated and monounsaturated) fat and other nutrients that may improve glucose and insulin homeostasis. OBJECTIVE: To examine prospectively the relationship between nut consumption and risk of type 2 diabetes. DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort study of 83 818 women from 11 states in the Nurses' Health Study. The women were aged 34 to 59 years, had no history (...) of diabetes, cardiovascular disease, or cancer, completed a validated dietary questionnaire at baseline in 1980, and were followed up for 16 years. MAIN OUTCOME MEASURE: Incident cases of type 2 diabetes. RESULTS: We documented 3206 new cases of type 2 diabetes. Nut consumption was inversely associated with risk of type 2 diabetesafter adjustment for age, body mass index (BMI), family history of diabetes, physical activity, smoking, alcohol use, and total energy intake. The multivariate relative risks
Coffee consumption and risk of type 2 diabetesmellitus. Coffee is a major source of caffeine, which has been shown to acutely reduce sensitivity to insulin, but also has potentially beneficial effects. We prospectively investigated the association between coffee consumption and risk of clinical type 2 diabetesin a population-based cohort of 17111 Dutch men and women aged 30-60 years. During 125774 person years of follow-up, 306 new cases of type 2 diabeteswere reported. After adjustment (...) for potential confounders, individuals who drank at least seven cups of coffee a day were 0.50 (95% CI 0.35-0.72, p=0.0002) times as likely as those who drank two cups or fewer a day to develop type 2 diabetes. Coffee consumption was associated with a substantially lower risk of clinical type 2 diabetes.
Exercise training and the cardiovascular consequences of type 2 diabetesand hypertension: plausible mechanisms for improving cardiovascular health. The coexistence of type 2 diabetesand hypertension is especially damaging to cardiovascular health. Most trials of exercise training for these conditions have focused on glycemic control and blood pressure reduction. Less is known about the effects of exercise on the cardiovascular consequences of diabetes and hypertension. This article reviews (...) the available evidence and plausible mechanisms by which exercise training may improve the cardiovascular health of persons with type 2 diabetesand hypertension and provides practical guidelines for exercise prescription. A MEDLINE search was performed for January 1985 to June 2002. Bibliographies from relevant articles, professional society clinical practice guidelines, and books were also reviewed. Because few large, randomized trials exist on these topics, meta-analyses, smaller trials, nonrandomized
Increase in nocturnal blood pressure and progression to microalbuminuria in type 1 diabetes. BACKGROUND: Patients with type 1 diabetes mellitus and microalbuminuria often have elevated blood pressure while they are asleep, but it is not known whether the elevation develops concomitantly with microalbuminuria or precedes it. METHODS: We monitored 75 adolescents and young adults who had had type 1 diabetes with normal urinary albumin excretion and blood pressure for more than five years (...) of microalbuminuria was 70 percent lower (95 percent confidence interval, 44 to 110 percent) in subjects with a ratio of 0.9 or less than in those with a ratio higher than 0.9 (P=0.01). CONCLUSIONS: In persons with type 1 diabetes, an increase in systolic blood pressure during sleep precedes the development of microalbuminuria. In those whose blood pressure during sleep decreases normally, the progression from normal albumin excretion to microalbuminuria appears to be less likely. Copyright 2002 Massachusetts
Diet and risk of coronary heart disease and type 2 diabetes. A high intake of saturated fat is an important risk factor for coronary heart disease (CHD) and type 2 diabetes. However the declining rates of CHD in many affluent societies and the steady increase in type 2 diabetesworldwide suggest that these important causes of serious morbidity and premature mortality have differing risk or protective factors worldwide. Changed macronutrient composition, reduced cigarette smoking, and improved (...) at lowering rates of obesity are the changes most likely to reduce the epidemic numbers of people with type 2 diabetesand CHD.
Tests of glycemia for the diagnosis of type 2 diabetesmellitus. This paper discusses tests of glycemia for the diagnosis of type 2 diabetesmellitus, with particular reference to the 1997 diagnostic criteria of the American Diabetes Association. The potential benefits of the lower diagnostic threshold for fasting plasma glucose are not well defined. However, the change in the diagnostic cut-off for diabetes mellitus affects as many as 1.9 million persons in the United States; therefore (...) , the medical and social costs of the lower threshold may be considerable. Type 2 diabetesmellitus is defined by a threshold imposed on the continuous distribution of glycemic levels, typically with respect to risk for microvascular complications. However, the burden of type 2 diabetesrelates more to macrovascular than microvascular complications. Because no clear threshold exists for macrovascular complications, a formal balancing of direct and indirect costs with both microvascular and macrovascular
Adiponectin and development of type 2 diabetesin the Pima Indian population. Adiponectin is a collagen-like circulating protein secreted by adipocytes that is proposed to mediate obesity-related resistance to insulin. In a case-control series, we assessed the role of adiponectin in later development of type 2 diabetesin 70 patients who later developed type 2 diabetesand 70 controls, matched for body-mass index, age, and sex. Cases and controls were taken from the longitudinal study of health (...) in the Pima Indian population. At baseline, the concentration of adiponectin was lower in cases than in controls (p=0.01) and individuals with high concentrations of this protein were less likely to develop type 2 diabetesthan those with low concentrations (incidence rate ratio 0.63 [95% CI 0.43-0.92]; p=0.02).
Predictors of acute complications in children with type 1 diabetes. CONTEXT: Diabetic ketoacidosis and severe hypoglycemia are acute complications of type 1 diabetes that are related, respectively, to insufficient or excessive insulin treatment. However, little is known about additional modifiable risk factors. OBJECTIVE: To examine the incidence of ketoacidosis and severe hypoglycemia in children with diabetes and to determine the factors that predict these complications. DESIGN, SETTING (...) , AND PARTICIPANTS: A cohort of 1243 children from infancy to age 19 years with type 1 diabetes who resided in the Denver, Colo, metropolitan area were followed up prospectively for 3994 person-years from January 1, 1996, through December 31, 2000. MAIN OUTCOME MEASURES: Incidence of ketoacidosis leading to hospital admission or emergency department visit and severe hypoglycemia (loss of consciousness, seizure, or hospital admission or emergency department visit). RESULTS: The incidence of ketoacidosis was 8 per
Cost-effectiveness of intensive glycemic control, intensified hypertension control, and serum cholesterol level reduction for type 2 diabetes. CONTEXT: Several treatment interventions can reduce complications of type 2 diabetes, but their relative cost-effectiveness is not known. OBJECTIVE: To estimate the incremental cost-effectiveness of intensive glycemic control (relative to conventional control), intensified hypertension control, and reduction in serum cholesterol level for patients (...) with type 2 diabetes. DESIGN, SETTING, AND PATIENTS: Cost-effectiveness analysis of a hypothetical cohort of individuals living in the United States, aged 25 years or older, who were newly diagnosed as having type 2 diabetes. The results of the United Kingdom Prospective Diabetes Study (UKPDS) and other studies were used to create a model of disease progression and treatment patterns. Costs were based on those used in community practices in the United States. INTERVENTIONS: Insulin or sulfonylurea therapy
Patients with multiple sclerosis and risk of type 1 diabetes mellitus in Sardinia, Italy: a cohort study. BACKGROUND: Individuals from Sardinia, Italy, are at high risk of developing multiple sclerosis and type 1 diabetes mellitus. We attempted to assess the prevalence in this region of type 1 diabetes mellitus in individuals with multiple sclerosis, and to ascertain disease risk factors. METHODS: We did a cohort study to assess prevalence of type 1 diabetes in 1090 people (...) : Diabetes prevalence in people with multiple sclerosis was, respectively, about three-fold and five-fold that in their healthy siblings (p=0.001) and in the general population (p<0.0001). Presence of other relatives with multiple sclerosis conferred increased risk of type 1 diabetes to healthy siblings of individuals with multiple sclerosis (odds ratio=3.41, p=0.0019). Diabetes risk was six-fold higher in patients with relatives having multiple sclerosis than in healthy siblings of multiple sclerosis
Comparison of cardiovascular risk between patients with type 2 diabetesand those who had had a myocardial infarction: cross sectional and cohort studies. OBJECTIVE: To compare risks of cardiovascular outcomes between patients with type 2 diabetesand patients with established coronary heart disease. DESIGN: Cross sectional study and cohort study using routinely collected datasets. SETTING: Tayside, Scotland (population 400 000) during 1988-95. SUBJECTS: In the cross sectional study, among (...) patients aged 45-64, 1155 with type 2 diabeteswere compared with 1347 who had had a myocardial infarction in the preceding 8 years. In the cohort study 3477 patients of all ages with newly diagnosed type 2 diabeteswere compared with 7414 patients who had just had a myocardial infarction. MAIN OUTCOME MEASURES: Risk ratios for death from all causes, cardiovascular death, and hospital admission for myocardial infarction were calculated by Cox proportional hazards analysis and adjusted for age and sex
Identification of persons at high risk for type 2 diabetesmellitus: do we need the oral glucose tolerance test? BACKGROUND: The standard method of identifying persons at high risk for type 2 diabetesmellitus involves detection of impaired glucose tolerance, which requires a costly and inconvenient 2-hour oral glucose tolerance test. Because clinical trials have indicated that diabetes is preventable by using behavioral or pharmacologic interventions, less expensive methods of identifying high (...) total, low-density lipoprotein, and high-density lipoprotein cholesterol levels; and triglyceride level. RESULTS: For prediction of 7.5-year incidence of type 2 diabetes, the area under the receiver-operating characteristic (ROC) curve for a multivariable model involving readily available clinical variables was significantly (P < 0.001) greater than the area under the ROC curve for the 2-hour glucose value alone (84.3% vs. 77.5%). Impaired glucose tolerance represents a single point on the latter
Effect of 6-week course of glucagon-like peptide 1 on glycaemic control, insulin sensitivity, and beta-cell function in type 2 diabetes: a parallel-group study. BACKGROUND: Glucagon-like peptide 1 (GLP-1) has been proposed as a treatment for type 2 diabetes. We have investigated the long-term effects of continuous administration of this peptide hormone in a 6-week pilot study. METHODS: 20 patients with type 2 diabeteswere alternately assigned continuous subcutaneous infusion of GLP-1 (n=10 (...) -1 could be a new treatment for type 2 diabetes, though further investigation of the long-term effects of GLP-1 is needed.
Dietary patterns and risk for type 2 diabetesmellitus in U.S. men. BACKGROUND: The role of diet in the development of type 2 diabetesmellitus remains unsettled. OBJECTIVE: To examine the association between major dietary patterns and risk for type 2 diabetesmellitus. DESIGN: Prospective cohort study. SETTING: United States. PARTICIPANTS: 42 504 male health professionals, 40 to 75 years of age, without diagnosed diabetes, cardiovascular disease, or cancer at baseline. MEASUREMENTS: Using (...) ), physical activity, and cigarette smoking. RESULTS: During 12 years of follow-up (466 508 person-years), we documented 1321 cases of type 2 diabetes. The prudent dietary pattern score was associated with a modestly lower risk for type 2 diabetes (relative risk for extreme quintiles, 0.84 [CI, 0.70 to 1.00]). In contrast, the western dietary pattern score was associated with an increased risk for type 2 diabetes (relative risk, 1.59 [CI, 1.32 to 1.93]; P < 0.001 for trend). A high score
Oral antihyperglycemic therapy for type 2 diabetes: scientific review. CONTEXT: Care of patients with type 2 diabeteshas been revolutionized throughout the past several years-first, by the realization of the importance of tight glycemic control in forestalling complications, and second, by the availability of several unique classes of oral antidiabetic agents. Deciphering which agent to use in certain clinical situations is a new dilemma facing the primary care physician. OBJECTIVE (...) : To systematically review available data from the literature regarding the efficacy of oral antidiabetic agents, both as monotherapy and in combination. DATA SOURCES: A MEDLINE search was performed to identify all English-language reports of unique, randomized controlled clinical trials involving recently available oral agents for type 2 diabetes. Bibliographies were also reviewed to find additional reports not otherwise identified. STUDY SELECTION AND DATA EXTRACTION: Studies (63) were included in the analysis
Oral antihyperglycemic therapy for type 2 diabetes: clinical applications. Oral agents are the mainstay of pharmacologic treatment for type 2 diabetes, and physicians now have a number of agents to choose from. However, more choices translate into more complex decision making. Many patients with diabetes have associated comorbidities, and most diabetic patients will require more than 1 agent to achieve good glycemic control. This article illustrates several of the pharmacologic approaches (...) to type 2 diabetesthrough 4 situations that use principles of evidence-based medicine. The scenarios also highlight some of the difficulties in choosing the optimal pharmacologic treatment regimen for individual patients. Physicians should also recognize that type 2 diabetesis a multisystem disorder that requires multidisciplinary care, including education and ongoing counseling for effective patient self-management of the disease. Finally, patient preferences are a vital component of informed decision making
Resistin, central obesity, and type 2 diabetes. Resistin, an adipocyte-derived cytokine, causes insulin resistance and glucose intolerance in mice. We investigated whether resistin expression was higher in human abdominal adipose tissue than other adipose tissue depots. We extracted RNA from 32 adipose tissue samples (13 subcutaneous abdominal, seven omentum, six thigh, and six breast). Quantitative PCR was used to determine resistin mRNA expression. Resistin mRNA concentrations were similar (...) in both the subcutaneous abdominal and omental depots. The abdominal depots showed a 418% increase in resistin mRNA expression compared with the thigh. Increased resistin expression in abdominal fat could explain the increased risk of type 2 diabetesassociated with central obesity.