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https://www.readbyqxmd.com/read/28432748/future-challenges-and-therapeutic-opportunities-in-type-2-diabetes-changing-the-paradigm-of-current-therapy
#1
REVIEW
D R Owens, L Monnier, A H Barnett
Most algorithms for type 2 diabetes mellitus (T2DM) do not recommend treatment escalation until glycated haemoglobin (HbA1c) fails to reach the recommended target of 7% (53 mmol/mol) within approximately 3 months on any treatment regimen ('treat to failure'). Clinical inertia and/or poor adherence to therapy contribute to patients not reaching glycaemic targets when managed according to this paradigm. Clinical inertia exists across the entire spectrum of anti-diabetes therapies, although it is most pronounced when initiating and optimizing insulin therapy...
April 21, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28432746/impact-of-baseline-hba1c-diabetes-duration-and-bmi-on-clinical-outcomes-in-the-lixilan-o-trial-testing-iglarlixi-insulin-glargine-lixisenatide-titratable-fixed-ratio-combination-versus-insulin-glargine-and-lixisenatide-monocomponents
#2
M J Davies, L A Leiter, B Guerci, G Grunberger, F J Ampudia-Blasco, C Yu, W Stager, E Niemoeller, E Souhami, J Rosenstock
To determine whether baseline characteristics impact clinical outcomes in the LixiLan-O trial (N = 1170), the efficacy and safety of iGlarLixi, a titratable fixed-ratio combination of insulin glargine 100 U (iGlar) and lixisenatide (Lixi) was compared with iGlar or Lixi alone in patients with uncontrolled type 2 diabetes mellitus (T2DM) on oral therapy. Subgroups according to baseline glycated haemoglobin (HbA1c; <8%, ≥8% [<64, ≥64 mmol/mol]); T2DM disease duration (<7, ≥7 years) and body mass index (BMI; <30, ≥30 kg/m(2) ) were investigated...
April 22, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28430381/continuous-subcutaneous-insulin-infusion-csii-therapy-at-derby-teaching-hospitals-sustained-benefits-in-glucose-control
#3
U Anyanwagu, H Olaoye, P Jennings, S Ashton-Cleary, S Sugunendran, D Hughes, I Idris, E G Wilmot
AIM: In the short term, continuous subcutaneous insulin infusion (CSII) has been associated with improved glycaemic control, reduced hypoglycaemia and improved quality of life (QOL). However, limited data are available on its long-term benefits, particularly in the UK. We aimed to assess the impact of CSII on longer term outcomes. METHOD: Patient-level data were obtained for CSII users at Derby Teaching Hospitals, UK. Patient confidence and satisfaction questionnaires using the Likert scale were used to assess confidence in self-management...
April 21, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28429780/insulin-analogues-in-type-1-diabetes-mellitus-getting-better-all-the-time
#4
REVIEW
Chantal Mathieu, Pieter Gillard, Katrien Benhalima
The treatment of type 1 diabetes mellitus consists of external replacement of the functions of β cells in an attempt to achieve blood levels of glucose as close to the normal range as possible. This approach means that glucose sensing needs to be replaced and levels of insulin need to mimic physiological insulin-action profiles, including basal coverage and changes around meals. Training and educating patients are crucial for the achievement of good glycaemic control, but having insulin preparations with action profiles that provide stable basal insulin coverage and appropriate mealtime insulin peaks helps people with type 1 diabetes mellitus to live active lives without sacrificing tight glycaemic control...
April 21, 2017: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/28419855/a-randomized-trial-of-silymarin-for-the-treatment-of-non-alcoholic-steatohepatitis
#5
Wah-Kheong Chan, Nik Raihan Nik Mustapha, Sanjiv Mahadeva
BACKGROUND & AIMS: Silymarin is a complex mixture of 6 major flavonolignans and other minor polyphenolic compounds derived from the milk thistle plant Silybum marianum; it has shown anti-oxidant, anti-inflammatory and anti-fibrotic effects, and may be useful in patients with non-alcoholic fatty liver disease (NAFLD). We aimed to study the efficacy of silymarin in patients with non-alcoholic steatohepatitis (NASH)-the more severe form of NAFLD. METHODS: We performed a randomized, double-blind, placebo-controlled trial of consecutive adults with biopsy-proven NASH and a NAFLD activity score (NAS) of 4 or more at a tertiary care hospital in Kuala Lumpur, Malaysia, from November 2012 through August 2014...
April 15, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28419661/cognitive-behavioural-therapy-stabilises-glycaemic-control-in-adolescents-with-type-1-diabetes-outcomes-from-a-randomised-control-trial
#6
Christina Wei, Ruth J Allen, Patricia M Tallis, Fiona J Ryan, Linda P Hunt, Julian Ph Shield, Elizabeth C Crowne
BACKGROUND: To compare the impact of cognitive behavioural therapy (CBT) with non-directive supportive counselling (NDC) on glycaemic control and psychological well-being in adolescents with type 1 diabetes mellitus (T1DM). MATERIALS AND METHODS: Participants aged 11 to 16 years with T1DM (duration ≥1 year) from 4 UK-based paediatric diabetes centres were randomised to receive either 6 weekly sessions of 1-to-1 CBT (n = 43) or NDC (n = 42), with 2 further sessions at 6 and 12 months...
April 17, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28419565/evolution-of-silent-myocardial-ischaemia-prevalence-and-cardiovascular-disease-risk-factor-management-in-type-2-diabetes-over-a-10-year-period-an-observational-study
#7
A Sultan, F Perriard, V Macioce, D Mariano-Goulart, C Boegner, J-P Daures, A Avignon
AIMS: To assess the evolution of silent myocardial ischaemia prevalence and of cardiovascular disease risk factor management over 10 years in people with Type 2 diabetes. METHODS: This repeated cross-sectional study prospectively included 770 people with Type 2 diabetes who presented at our centre in the period 1999-2009. All had at least one additional cardiovascular disease risk factor, no history of coronary disease and were screened for silent myocardial ischaemia using myocardial perfusion imaging...
April 18, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28416496/long-term-cost-reduction-of-routine-medications-following-a-residential-programme-combining-physical-activity-and-nutrition-in-the-treatment-of-type-2-diabetes-a-prospective-cohort-study
#8
Charlotte Lanhers, Guillaume Walther, Robert Chapier, Bruno Lesourd, Geraldine Naughton, Bruno Pereira, Martine Duclos, Agnès Vinet, Philippe Obert, Daniel Courteix, Frédéric Dutheil
OBJECTIVES: To demonstrate that lifestyle modifications will reduce the cost of routine medications in individuals with type 2 diabetes (T2D), through a mechanism involving glycaemic control. DESIGN: A within-trial cost-medication analysis with a 1-year time horizon. SETTING: Controlled environment within the spa resort of Chatel-Guyon, France. PARTICIPANTS: Twenty-nine participants (aged 50-70 years) with T2D. INTERVENTIONS: A 1-year follow-up intervention, beginning with a 3-week residential programme combining high exercise volume (15-20 hours/week), restrictive diet (-500 kcal/day) and education...
April 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28415103/p673improvement-of-arterial-stiffness-and-myocardial-deformation-in-patients-with-poorly-controlled-diabetes-mellitus-type-2-after-optimization-of-antidiabetic-medication
#9
I Ikonomidis, G Pavlidis, V Lambadiari, F Kousathana, H Triantafyllidi, M Varoudi, D Vlastos, S Vlachos, G Dimitriadis, J Lekakis
Background: Arterial stiffness is associated with increased risk for cardiovascular disease. The purpose of this study is to investigate the arterial stiffness and myocardial deformation in patients with poorly controlled diabetes mellitus type 2 before and after glycemic control by optimal medication. Methods: In 50 patients with uncontrolled type 2 diabetes(age:52±10years)and 25 controls of similar age and sex and no atherosclerotic risk factors we measured at baseline and 6 months after glycemic control a) carotid-femoral pulse wave velocity(PWVc m/sec-Complior SP ALAM),central systolic blood pressure(cSBP -mmHg),augmentation index(AI%), of the aortic pulse wave(ArteriographTensioMed) b)S',E'(m/sec)andE'/A'of mitral annulus by Tissue Doppler c)LV longitudinal strain(GLS-%),systolic(LongSr-l/sec)and diastolic(LongSrE-l/sec)strain rate, twisting(Tw-deg),peak twisting(Tw)and untwisting(unTw-deg/sec)velocity using speckle tracking echocardiography...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28406066/telemedicine-consultation-for-patients-with-diabetes-mellitus-a-cluster-randomised-controlled-trial
#10
Ajay Sood, Sharon A Watts, Julie K Johnson, Stacey Hirth, David C Aron
Introduction There is a widening discrepancy between the increasing number of patients with diabetes mellitus and the health care resources available to manage these patients. Telemedicine has been used in a number of instances to improve and deliver health care where traditional care delivery methods may encounter difficulty. We conducted a cluster randomised controlled trial of telemedicine consultation to manage patients with diabetes mellitus. Methods Eleven primary care centres attached to one Veteran Administration tertiary care centre were randomised to provide patients with diabetes consultation referral either by usual consultation in diabetes clinic or telemedicine consultations via videoconference...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28401444/fixed-ratio-combinations-of-glucagon-like-peptide-1-receptor-agonists-with-basal-insulin-a-systematic-review-and-meta-analysis
#11
Paraskevi Liakopoulou, Aris Liakos, Despoina Vasilakou, Eleni Athanasiadou, Eleni Bekiari, Kyriakos Kazakos, Apostolos Tsapas
PURPOSE: Basal insulin controls primarily fasting plasma glucose but causes hypoglycaemia and weight gain, whilst glucagon like peptide 1 receptor agonists induce weight loss without increasing risk for hypoglycaemia. We conducted a systematic review and meta-analysis of randomised controlled trials to investigate the efficacy and safety of fixed ratio combinations of basal insulin with glucagon like peptide 1 receptor agonists. METHODS: We searched Medline, Embase, and the Cochrane Library as well as conference abstracts up to December 2016...
April 12, 2017: Endocrine
https://www.readbyqxmd.com/read/28400862/an-audit-of-clinical-practice-in-a-single-centre-in-kuwait-management-of-children-on-continuous-subcutaneous-insulin-infusion-and-cardiovascular-risk-factors-screening
#12
Dina Omar, Hala Alsanae, Mona Al Khawari, Majedah Abdulrasoul, Zahraa Rahme, Faisal Al Refaei, Kazem Behbehani, Azza Shaltout
OBJECTIVES: To audit the current clinical practice of continuous subcutaneous insulin infusion (CSII) for the treatment of type 1 diabetes mellitus (T1D) in children and adolescents attending a single centre in Kuwait. METHODS: A one year retrospective audit was performed in children and adolescents with T1D on CSII, who attended the paediatric diabetes clinic, Dasman Diabetes Institute during 2012. The primary outcome measure was glycaemic control as evidenced by glycated haemoglobin (HbA1c) level and the secondary outcome measures were the frequency of monitoring of the risk for microvascular complications and occurrence of acute complications and adverse events...
2017: Open Cardiovascular Medicine Journal
https://www.readbyqxmd.com/read/28397334/a-nurse-led-education-and-cognitive-behaviour-therapy-based-intervention-among-adults-with-uncontrolled-type-2-diabetes-a-randomised-controlled-trial
#13
Lisa C Whitehead, Marie T Crowe, Janet D Carter, Virginia R Maskill, Dave Carlyle, Carol Bugge, Chris M A Frampton
RATIONALE, AIMS AND OBJECTIVES: Diabetes mellitus is associated with significant morbidity, mortality, and escalating health care costs. Research has consistently demonstrated the importance of glycaemic control in delaying the onset, and decreasing the incidence, of both the short-term and long-term complications of diabetes. Although glycaemic control is difficult to achieve and challenging to maintain, it is key to reducing negative disease outcomes. The aim of this study was to determine whether a nurse-led educational intervention alone or a nurse-led intervention using education and acceptance and commitment therapy (ACT) was effective in reducing hemoglobin A1c (HbA1c ) in people living with uncontrolled type 2 diabetes compared to usual care...
April 11, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28395981/mechanisms-linking-empagliflozin-to-cardiovascular-and-renal-protection
#14
Pasquale Perrone-Filardi, Angelo Avogaro, Enzo Bonora, Furio Colivicchi, Paola Fioretto, Aldo Pietro Maggioni, Giorgio Sesti, Ele Ferrannini
In patients with type 2 diabetes mellitus (T2DM), the main cause of morbidity and mortality is cardiovascular (CV) disease. Diabetic kidney disease, which develops in approximately 40% of patients with T2DM, further increases the risk of CV-related morbidity and mortality. The sodium glucose co-transporter 2 (SGLT2) inhibitor empagliflozin, which provides effective glycaemic control as either monotherapy or as an add-on to other glucose-lowering agents in patients with T2DM, was also shown to improve CV and renal outcomes in the large, randomised, placebo-controlled EMPA-REG OUTCOME trial in patients with T2DM at high risk of CV events...
March 23, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28395938/perceptions-of-general-practitioners-on-initiation-and-intensification-of-type-2-diabetes-injectable-therapies-a-quantitative-study-in-the-united-kingdom
#15
Daniel Sterzi, Sébastien Auziere, Divina Glah, Marie Markert Jensen
Most diabetes care is done by general practitioners (GPs) in the UK. This study aimed to determine GPs' comfort level in initiating and intensifying injectable therapies, identifying any associated barriers, and assessing reasons for referral to specialists. This web-interview included 128 general practitioners (GPs) experienced in type 2 diabetes (T2D) management, as well as 57 specialists and 30 nurses who were studied for secondary objectives. GPs felt more comfortable initiating the 1st injectable therapy - typically the glucagon-like peptide-1 receptor agonists (GLP-1 RA) - than the 2nd...
April 7, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28391607/children-s-experiences-of-managing-type%C3%A2-1-diabetes-in-everyday-life-a-thematic-synthesis-of-qualitative-studies
#16
D Rankin, J Harden, R Jepson, J Lawton
AIMS: To explore the everyday experiences of children (aged ≤ 12 years) with Type 1 diabetes to identify factors that help or hinder diabetes self-management practices. METHODS: Eight databases (Embase, Medline, CINAHL, Web of Science, PsychInfo, ASSIA, ERIC and ProQuest Dissertations) were searched in 2016 to identify qualitative studies exploring children's views about self-managing diabetes. Data were extracted, coded and analysed using thematic synthesis...
April 9, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28387008/predictors-of-poor-glycaemic-control-in-type-2-diabetic-elderly-patients-with-depressive-syndrome
#17
Malgorzata Gorska-Ciebiada, Maciej Ciebiada
No abstract text is available yet for this article.
April 7, 2017: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
https://www.readbyqxmd.com/read/28386990/consistent-findings-in-glycaemic-control-body-weight-and-hypoglycaemia-with-iglarlixi-insulin-glargine-lixisenatide-titratable-fixed-ratio-combination-versus-insulin-glargine-across-baseline-hba1c-bmi-and-diabetes-duration-categories-in-the-lixilan-l-trial
#18
C Wysham, R C Bonadonna, V R Aroda, M Puig-Domingo, C Kapitza, W Stager, C Yu, E Niemoeller, E Souhami, R M Bergenstal
AIM: To assess the impact of baseline characteristics on clinical outcomes in the LixiLan-L trial, a randomized open-label trial designed to evaluate the efficacy and safety of iGlarLixi, a novel fixed-ratio combination of insulin glargine 100 U (iGlar) plus lixisenatide, in comparison with iGlar over 30 weeks in a population of patients with type 2 diabetes mellitus (T2DM) inadequately controlled on a previous regimen of basal insulin alone or in combination with one or two oral glucose-lowering drugs...
April 6, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28385659/efficacy-and-safety-of-once-weekly-semaglutide-versus-once-daily-sitagliptin-as-an-add-on-to-metformin-thiazolidinediones-or-both-in-patients-with-type-2-diabetes-sustain-2-a-56-week-double-blind-phase-3a-randomised-trial
#19
Bo Ahrén, Luis Masmiquel, Harish Kumar, Mehmet Sargin, Julie Derving Karsbøl, Sanja Hald Jacobsen, Francis Chow
BACKGROUND: Semaglutide is a novel glucagon-like peptide-1 (GLP-1) analogue, suitable for once-weekly subcutaneous administration, in development for treatment of type 2 diabetes. We assessed the efficacy and safety of semaglutide versus the dipeptidyl peptidase-4 (DPP-4) inhibitor sitagliptin in patients with type 2 diabetes inadequately controlled on metformin, thiazolidinediones, or both. METHODS: We did a 56-week, phase 3a, randomised, double-blind, double-dummy, active-controlled, parallel-group, multinational, multicentre trial (SUSTAIN 2) at 128 sites in 18 countries...
April 3, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28385658/glycaemic-control-and-weight-loss-with-semaglutide-in-type-2-diabetes
#20
Sten Madsbad, Jens J Holst
No abstract text is available yet for this article.
April 3, 2017: Lancet Diabetes & Endocrinology
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