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Current Diabetes Reports

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https://www.readbyqxmd.com/read/27909958/using-group-medical-visits-with-those-who-have-diabetes-examining-the-evidence
#1
REVIEW
Laura M Housden, Sabrina T Wong
The number of people with diabetes is expected to rise to over 592 million by the year 2035. Past work provides evidence that the conventional method of primary care delivery may not meet many patients' needs. An alternative to the conventional one-on-one appointment is care offered to a group of patients through group medical visits (GMVs). Group medical visits for diabetes have a positive impact on physiologic and self-care outcomes including improved HbA1c, blood pressure control and self-management skills...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27844276/micrornas-in-type-1-diabetes-complex-interregulation-of-the-immune-system-%C3%AE-cell-function-and-viral-infections
#2
REVIEW
Sonia R Isaacs, Jie Wang, Ki Wook Kim, Congcong Yin, Li Zhou, Qing Sheng Mi, Maria E Craig
Since the discovery of the first mammalian microRNA (miRNA) more than two decades ago, a plethora of miRNAs has been identified in humans, now amounting to more than 2500. Essential for post-transcriptional regulation of gene networks integral for developmental pathways and immune response, it is not surprising that dysregulation of miRNAs is often associated with the aetiology of complex diseases including cancer, diabetes and autoimmune disorders. Despite massive expansion of small RNA studies and extensive investigation in diverse disease contexts, the role of miRNAs in type 1 diabetes has only recently been explored...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27841014/the-role-of-retinal-imaging-and-portable-screening-devices-in-tele-ophthalmology-applications-for-diabetic-retinopathy-management
#3
REVIEW
Delia Cabrera DeBuc
In the years since its introduction, retinal imaging has transformed our capability to visualize the posterior pole of the eye. Increasing practical advances in mobile technology, regular monitoring, and population screening for diabetic retinopathy management offer the opportunity for further development of cost-effective applications through remote assessment of the diabetic eye using portable retinal cameras, smart-phone-based devices and telemedicine networks. Numerous retinal imaging methods and mobile technologies in tele-ophthalmology applications have been reported for diabetic retinopathy screening and management...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27812962/implications-of-the-empa-reg-trial-for-clinical-care-and-research
#4
REVIEW
Angeliki M Stamatouli, Silvio E Inzucchi
EMPA-REG OUTCOME was a multicenter, randomized placebo-controlled trial that examined the effect of empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor in addition to standard of care in patients with type 2 diabetes and established cardiovascular (CV) disease. The primary goal was to assess CV safety, as mandated by the US Food and Drug Administration since 2008 for all new glucose-lowering agents. Secondary goals were to examine the effects of empagliflozin on microvascular outcomes and, in particular, kidney disease...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27796780/prevention-and-care-programs-addressing-the-growing-prevalence-of-diabetes-in-china
#5
REVIEW
Junmei Yin, Alice P S Kong, Juliana C N Chan
According to a 2010 national survey, 11 % of adults in China have diabetes, affecting 109.6 million individuals. The high prevalence of diabetes has been attributed to the aging of the population, the rapid adoption of energy-dense foods, and a reduction in physical activity. Collectively, these secular changes have created an obesogenic environment that can unmask diabetes in subjects with a genetic predisposition. The growing prevalence of maternal obesity, gestational diabetes, childhood obesity, and early-onset disease can lead to premature morbidity and mortality...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27796779/clinical-components-of-telemedicine-programs-for-diabetic-retinopathy
#6
REVIEW
Mark B Horton, Paolo S Silva, Jerry D Cavallerano, Lloyd Paul Aiello
Diabetic retinopathy is a leading cause of new-onset vision loss worldwide. Treatments supported by large clinical trials are effective in preserving vision, but many persons do not receive timely diagnosis and treatment of diabetic retinopathy, which is typically asymptomatic when most treatable. Telemedicine evaluation to identify diabetic retinopathy has the potential to improve access to care, but there are no universal standards regarding camera choice or protocol for ocular telemedicine. We review the literature regarding the impact of imaging device, number and size of retinal images, pupil dilation, type of image grader, and diagnostic accuracy on telemedicine assessment for diabetic retinopathy...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27796778/operational-components-of-telemedicine-programs-for-diabetic-retinopathy
#7
REVIEW
Mark B Horton, Paolo S Silva, Jerry D Cavallerano, Lloyd Paul Aiello
Diabetic retinopathy is a leading cause of new-onset vision loss worldwide. Treatments supported by large clinical trials are effective in preserving vision, but many persons do not receive timely diagnosis and treatment of diabetic retinopathy, which is typically asymptomatic when most treatable. Telemedicine evaluation to identify diabetic retinopathy has the potential to improve access to care and improve outcomes, but incomplete implementation of published standards creates a risk to program utility and sustainability...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27778251/biomarkers-of-diabetic-retinopathy
#8
Daniel Shu Wei Ting, Kara-Anne Tan, Val Phua, Gavin Siew Wei Tan, Chee Wai Wong, Tien Yin Wong
Diabetic retinopathy (DR), a leading cause of acquired vision loss, is a microvascular complication of diabetes. While traditional risk factors for diabetic retinopathy including longer duration of diabetes, poor blood glucose control, and dyslipidemia are helpful in stratifying patient's risk for developing retinopathy, many patients without these traditional risk factors develop DR; furthermore, there are persons with long diabetes duration who do not develop DR. Thus, identifying biomarkers to predict DR or to determine therapeutic response is important...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27778250/metabolomic-biomarkers-in-the-progression-to-type-1-diabetes
#9
Anne Julie Overgaard, Simranjeet Kaur, Flemming Pociot
Metabolomics is the snapshot of all detectable metabolites and lipids in biological materials and has potential in reflecting genetic and environmental factors contributing to the development of complex diseases, such as type 1 diabetes. The progression to seroconversion to development of type 1 diabetes has been studied using this technique, although in relatively small cohorts and at limited time points. Overall, three observations have been consistently reported; phospholipids at birth are lower in children developing type 1 diabetes early in childhood, methionine levels are lower in children at seroconversion, and triglycerides are increased at seroconversion and associated to microbiome diversity, indicating an association between the metabolome and microbiome in type 1 diabetes progression...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27778249/targeting-tie2-for-treatment-of-diabetic-retinopathy-and-diabetic-macular-edema
#10
Peter A Campochiaro, Kevin G Peters
Tie2 is a tyrosine kinase receptor located predominantly on vascular endothelial cells that plays a central role in vascular stability. Angiopoietin-1 (Angpt1), produced by perivascular cells, binds, clusters, and activates Tie2, leading to Tie2 autophosphorylation and downstream signaling. Activated Tie2 increases endothelial cell survival, adhesion, and cell junction integrity, thereby stabilizing the vasculature. Angiopoietin-2 (Angpt2) and vascular endothelial-protein tyrosine phosphatase (VE-PTP) are negative regulators increased by hypoxia; they inactivate Tie2, destabilizing the vasculature and increasing responsiveness to vascular endothelial growth factor (VEGF) and other inflammatory cytokines that stimulate vascular leakage and neovascularization...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27766584/presence-and-risk-factors-for-glaucoma-in-patients-with-diabetes
#11
Brian J Song, Lloyd Paul Aiello, Louis R Pasquale
Diabetes mellitus represents a growing international public health issue with a near quadrupling in its worldwide prevalence since 1980. Though it has many known microvascular complications, vision loss from diabetic retinopathy is one of the most devastating for affected individuals. In addition, there is increasing evidence to suggest that diabetic patients have a greater risk for glaucoma as well. Though the pathophysiology of glaucoma is not completely understood, both diabetes and glaucoma appear to share some common risk factors and pathophysiologic similarities with studies also reporting that the presence of diabetes and elevated fasting glucose levels are associated with elevated intraocular pressure-the primary risk factor for glaucomatous optic neuropathy...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27766583/optical-coherence-tomography-angiography-in-diabetes
#12
Jessica Lee, Richard Rosen
Diabetic retinopathy is a progressive microvascular disease that leads to increased vessel permeability, retinal ischemia, and retinal neovascularization. Optical coherence tomography angiography (OCTA) is a novel angiography technique that has the capability to advance our understanding of diabetic eye disease by providing high-resolution images of retinal and choroidal microvasculature blood flow and structure. Using OCTA, the vascular changes of diabetic retinopathy including microaneurysms, retinal non-perfusion, intraretinal microvascular abnormalities, and neovascularization can be clearly visualized...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27766582/vascular-endothelial-growth-factor-inhibitors-for-diabetic-retinopathy
#13
Dilsher S Dhoot, Robert L Avery
The prevalence of diabetes is growing at epidemic rates in the USA. Diabetic retinopathy develops in a large proportion of patients and is a leading cause of blindness worldwide. Systemic management of diabetic retinopathy has included glycemic, hypertension, and lipid control. Local ophthalmic treatment in the form of focal/grid or panretinal laser photocoagulation has been shown to prevent vision loss in diabetic edema and proliferative diabetic retinopathy, respectively. The introduction of anti-vascular endothelial growth factor for diabetic macular edema and retinopathy has provided clinicians with improved clinical outcomes with potentially less damaging effects than laser...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27766581/redesigning-diabetes-care-defining-the-role-of-endocrinologists-among-alternative-providers
#14
Samir Malkani, Sheri A Keitz, David M Harlan
The current diabetes epidemic threatens to overwhelm the healthcare system unless we redesign how diabetes care is delivered. The number of endocrinologists is grossly inadequate to provide care for all individuals with diabetes, but with the appropriate utilization of the primary care workforce and alternative healthcare providers working together in teams, effective diabetes care can be provided to all. We propose a patient-centered, goal-based approach with resources devoted to care coordination, measurement of outcomes, appropriate use of technology, and measurement of patient satisfaction...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27766580/urogenital-autonomic-dysfunction-in-diabetes
#15
Barbara H Braffett, Hunter Wessells, Aruna V Sarma
This review details the epidemiology, possible mechanisms, and risk factors associated with urogenital autonomic dysfunction in diabetes. Autonomic neuropathy in diabetes is associated with various urological complications including bladder and sexual dysfunction. Several studies have reported the high prevalence of bladder and sexual dysfunction in both men and women. The DCCT/EDIC UroEDIC study examined the association between cardiovascular autonomic neuropathy and bladder and sexual dysfunction in a large cohort of participants with type 1 diabetes and was the first to report significant associations...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27766579/a-plethora-of-glp-1-agonists-decisions-about-what-to-use-and-when
#16
Susan L Samson, Alan J Garber
Incretin-based therapies are important addition to our armamentarium for the treatment of type 2 diabetes (T2DM). There are six Glucagon-like peptide-1 receptor agonists (GLP-1RAs) which have received regulatory approval for clinical use. The short-acting GLP-1RAs include exenatide twice daily, liraglutide once daily, and lixisenatide once daily. The approved long-acting GLP-1RAs are administered weekly and are exenatide, albiglutide, and dulaglutide. Although all of these therapies lower hemoglobin A1C (HbA1C), there also are unique features of GLP-1RAs that have been made manifest from clinical trial data with regard to weight-loss efficacy, fasting and post-prandial glucose control, cardiovascular safety and protection, and gastrointestinal and injection adverse effects...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27752931/pharmacological-management-of-gestational-diabetes-mellitus
#17
Riki Bergel, Eran Hadar, Yoel Toledano, Moshe Hod
Gestational diabetes mellitus (GDM) is one of the most common morbidities complicating pregnancy, with short- and long-term consequences to the mothers, fetuses, and newborns. Management and treatment are aimed to achieve best possible glycemic control, while avoiding hypoglycemia and ensuring maternal and fetal safety. It involves behavioral modifications, nutrition and medications, if needed; concurrent with maternal and fetal surveillance for possible adverse outcomes. This review aims to elaborate on the pharmacological options for GDM therapy...
November 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27747490/marijuana-use-and-type-2-diabetes-mellitus-a-review
#18
Stephen Sidney
Marijuana is used by millions of people, with use likely to increase in the USA because of the trend towards increased decriminalization and legalization. Obesity and diabetes mellitus (DM) rates have increased dramatically in the USA over the past 30 years, with a recent estimate of 29 million individuals with DM. Because there is a plausible link between marijuana use and diabetes due to the known effects of cannabinoids on adipose tissue and glucose/insulin metabolism, it is important to study and understand how marijuana use is related to obesity and diabetes...
November 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27730517/heart-failure-a-major-cardiovascular-complication-of-diabetes-mellitus
#19
Gül Bahtiyar, David Gutterman, Harold Lebovitz
Heart failure (HF) is a major cardiovascular complication of diabetes mellitus (DM). The greatest risk factor for HF is age, and data indicate that 6 to 10 % of individuals over the age of 65 years suffer from HF. Patients with DM have a 2.5-fold increased risk for developing HF than individuals without DM. The 25 to 40 % of patients with HF who have DM have worse outcome (death from cardiovascular disease or hospitalization for worsening HF) than patients without DM. Hyperglycemia is a risk factor for the development of HF with an increase in incidence of HF rising from 10 % at hemoglobin A1c (HbA1c) 8...
November 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27718171/update-on-clinical-utility-of-continuous-glucose-monitoring-in-type-1-diabetes
#20
Nalani Haviland, John Walsh, Ruth Roberts, Timothy S Bailey
Since the early 2000s, continuous glucose monitoring (CGM) technology has advanced to become a standard of care in the treatment of type 1 diabetes. Unfortunately, CGM use is not commonly integrated into practice. This article will review the history, technology, and need for systematic training in CGM. Additionally, it will review recent clinical trial data demonstrating the benefits that CGM offers to all people with type 1 diabetes and the clinicians who care for them.
November 2016: Current Diabetes Reports
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