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Michael Laxy, Gabriella Knoll, Michaela Schunk, Christa Meisinger, Cornelia Huth, Rolf Holle
OBJECTIVE: Little is known about the development of the quality of diabetes care in Germany. The aim of this study is to analyze time trends in patient self-management, physician-delivered care, medication, risk factor control, complications and quality of life from 2000 to 2014. METHODS: Analyses are based on data from individuals with type 2 diabetes of the population-based KORA S4 (1999-2001, n = 150), F4 (2006-2008, n = 203), FF4 (2013/14, n = 212) cohort study...
2016: PloS One
Irina Odnoletkova, Dirk Ramaekers, Frank Nobels, Geert Goderis, Bert Aertgeerts, Lieven Annemans
BACKGROUND: People with diabetes have a high risk of developing micro- and macrovascular complications associated with diminished life expectancy and elevated treatment costs. Patient education programs can improve diabetes control in the short term, but their cost-effectiveness is uncertain. Our study aimed to analyze the lifelong cost-effectiveness of a nurse-led telecoaching program compared to usual care in people with type 2 diabetes from the perspective of the Belgian healthcare system...
2016: PloS One
Katherine E Beaney, Claire E Ward, Dauda A S Bappa, Nadine McGale, Anna K Davies, Shashivadan P Hirani, KaWah Li, Philip Howard, Dwaine R Vance, Martin A Crockard, John V Lamont, Stanton Newman, Steve E Humphries
BACKGROUND: The coronary risk in diabetes (CoRDia) trial (n = 211) compares the effectiveness of usual diabetes care with a self-management intervention (SMI), with and without personalised risk information (including genetics), on clinical and behavioural outcomes. Here we present an assessment of randomisation, the cardiac risk genotyping assay, and the genetic characteristics of the recruits. METHODS: Ten-year coronary heart disease (CHD) risk was calculated using the UKPDS score...
October 3, 2016: Cardiovascular Diabetology
J E Varney, D Liew, T J Weiland, W J Inder, G A Jelinek
BACKGROUND: Type 2 diabetes (T2DM) is a burdensome condition for individuals to live with and an increasingly costly condition for health services to treat. Cost-effective treatment strategies are required to delay the onset and slow the progression of diabetes related complications. The Diabetes Telephone Coaching Study (DTCS) demonstrated that telephone coaching is an intervention that may improve the risk factor status and diabetes management practices of people with T2DM. Measuring the cost effectiveness of this intervention is important to inform funding decisions that may facilitate the translation of this research into clinical practice...
September 27, 2016: BMC Health Services Research
Herath Mudiyanselage Meththananda Herath, Thilak Priyantha Weerarathna, Ranasinghe Bethmi Arachige Thilini Dulanjalee, Madumekala Rupasinghe Jayawardana, Udara Priyadarshani Edirisingha, Madushanka Rathnayake
INTRODUCTION: Risk assessment tools used to calculate the Cardiovascular Disease (CVD) risk such as the Framingham Risk Score (FRS), United Kingdom Prospective Diabetes study (UKPDS) risk engine and the World Health Organization (WHO) risk score have not been tested on their ability to detect subclinical atherosclerosis in most developing countries. AIM: To study the association between the calculated CVD risk scores using each of these tools and Carotid Intima Medial Thickness (CIMT), a surrogate marker of atherosclerosis, in a group of patients with Type 2 diabetes (T2DM) in Sri Lanka...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Alena Adamíková
UNLABELLED: Chronic long term hyperglycemia plays a key role in the pathogenesis of micro and macrovascular complications. The UKPDS study and its further analysis has proved that reduction of the value of glycated hemoglobin by 1 % leads to a 14 % reduction of the risk of myocardial infarction and a 37 % reduction of the risk of microvascular complications. Effective control of glycaemia, optimal value of pre-prandial, postprandial glycaemia, and low variability from the start of the disease has a long term beneficial impact...
2016: Vnitr̆ní Lékar̆ství
Abeer Anabtawi, John M Miles
OBJECTIVE: Metformin is the most commonly prescribed drug for the treatment of type 2 diabetes because of its apparent robust effects in reducing cardiovascular risk. This review examines the current literature regarding the nonglycemic effects and potential novel indications for metformin. METHODS: Review of the literature, with a focus on metformin use in Stage 3 chronic kidney disease (CKD-3) and heart failure (HF). RESULTS: The United Kingdom Prospective Diabetes Study suggests that metformin reduces the risk of myocardial infarction, and more recent retrospective studies have shown an association between metformin use and a reduction in stroke, atrial fibrillation and all-cause mortality...
August 2016: Endocrine Practice
M A Riddell, J A Dunbar, P Absetz, R Wolfe, H Li, M Brand, Z Aziz, B Oldenburg
BACKGROUND: The 2013 Global Burden of Disease Study demonstrated the increasing burden of diabetes and the challenge it poses to the health systems of all countries. The chronic and complex nature of diabetes requires active self-management by patients in addition to clinical management in order to achieve optimal glycaemic control and appropriate use of available clinical services. This study is an evaluation of a "real world" peer support program aimed at improving the control and management of type 2 diabetes (T2DM) in Australia...
2016: BMC Public Health
René Rodríguez-Gutiérrez, Victor M Montori
BACKGROUND: We sought to determine the concordance between the accumulating evidence about the impact of tight versus less tight glycemic control in patients with type 2 diabetes mellitus since the publication of UKPDS (UK Prospective Diabetes Study) in 1998 until 2015 with the views about that evidence published in journal articles and practice guidelines. METHODS AND RESULTS: We searched in top general medicine and specialty journals for articles referring to glycemic control appearing between 2006 and 2015 and identified the latest practice guidelines...
September 2016: Circulation. Cardiovascular Quality and Outcomes
Giulia Buonaiuto, Valentina De Mori, Alessandra Braus, Annalisa Balini, Denise Berzi, Rita Carpinteri, Franco Forloni, Giancarla Meregalli, Gian Luca Ronco, Antonio C Bossi
OBJECTIVES: The UK Prospective Diabetes Study (UKPDS) Risk Engine (RE) provides the best risk estimates available for people with type 2 diabetes (T2D), so it was applied to patients on persistent sitagliptin treatment. DESIGN: A 'real-world' retrospective, observational, single-center study. SETTING: The study was performed in a general hospital in Northern Italy in order: (1) to validate UKPDS RE in a cohort of Italian participants with T2D without prespecified diabetes duration, with/without cardiovascular (CV) disease, treated with sitagliptin; (2) to confirm CV risk gender difference; (3) to evaluate the effect on metabolic control and on CV risk evolution obtained by 'add-on' persistent sitagliptin treatment...
2016: BMJ Open Diabetes Research & Care
Eugene Chang, Jun-Ichi Abe
Type II diabetes mellitus (DM) is a common comorbidity in patients with cardiovascular disease (CVD). Epidemiological studies including the Framingham, UKPDS, and MRFIT studies have shown diabetes to be an independent risk factor for cardiovascular disease associated with increased incidence of morbidity and mortality. However, major randomized controlled clinical trials including ADVANCE, VAD, and ACCORD have failed to demonstrate a significant reduction in CVD complications from longstanding DM with strict glycemic control...
May 2016: Metabolism: Clinical and Experimental
E Bonora, B Bryzinski, B Hirshberg, W Cook
BACKGROUND AND AIMS: To assess the efficacy and safety of saxagliptin 2.5 and 5 mg/d in patients with type 2 diabetes mellitus (T2DM) and high risk of coronary heart disease (CHD) or stroke as estimated by the United Kingdom Prospective Diabetes Study (UKPDS) risk engine. METHODS AND RESULTS: Post hoc analysis of data pooled from 5 previously reported phase 3, randomized, placebo-controlled, 24-week studies was conducted. Patients were stratified into subgroups by UKPDS 10-year CHD and/or stroke risk ≥20% and CHD and stroke risk <20%...
May 2016: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
Edoardo Mannucci
Insulin has direct effects on vascular walls which, depending on experimental models, can be either predominantly antiatherogenic or proatherogenic. In observational studies, insulin therapy is usually associated with an increase in the incidence of major cardiovascular events. However, this result is probably determined by the effect of confounders. In clinical trials performed in the acute phase of coronary syndromes, the benefits observed with insulin therapy are probably due to the improvement of glycemic control, rather than to direct effects of insulin on the cardiovascular system...
March 2016: Giornale Italiano di Cardiologia
Markolf Hanefeld, Louis Monnier, Oliver Schnell, David Owens
UNLABELLED: Dysglycemia results from a deficit in first-phase insulin secretion compounded by increased insulin insensitivity, exposing β cells to chronic hyperglycemia and excessive glycemic variability. Initiation of intensive insulin therapy at diagnosis of type 2 diabetes mellitus (T2DM) to achieve normoglycemia has been shown to reverse glucotoxicity, resulting in recovery of residual β-cell function. The United Kingdom Prospective Diabetes Study (UKPDS) 10-year post-trial follow-up reported reductions in cardiovascular outcomes and all-cause mortality in persons with T2DM who initially received intensive glucose control compared with standard therapy...
June 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Samit Ghosal, Binayak Sinha
The issue related to macrovascular outcomes and intensive glycemic control was hotly debated after the publication of landmark trials like ACCORD, ADVANCE, and VADT. The only benefits seem to come from intervening early on in the disease process as indicated by the 10-year UKPDS follow-up. To complicate matters USFDA made it mandatory for modern drugs to conduct cardiovascular safety trials in high-risk populations after the 2008 rosiglitazone scare. This led to all the modern group of drugs designing cardiovascular safety trials (gliptins, GLP-1 agonists, and SGLT-2 inhibitors) to meet USFDA regulatory requirements...
2016: Journal of Diabetes Research
Herath M Meththananda Herath, Thilak Priyantha Weerarathna, Dilini Umesha
INTRODUCTION: Patients with type 2 diabetes mellitus (T2DM) are at higher risk of developing cardiovascular diseases, and assessment of their cardiac risk is important for preventive strategies. PURPOSE: The Ministry of Health of Sri Lanka has recommended World Health Organization/International Society of Hypertension (WHO/ISH) charts for cardiac risk assessment in individuals with T2DM. However, the most suitable cardiac risk assessment tool for Sri Lankans with T2DM has not been studied...
2015: Vascular Health and Risk Management
P McEwan, V Foos, M Lamotte
No abstract text is available yet for this article.
November 2015: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
M Charokopou, F J Sabater, R Townsend, M Roudaut, P McEwan, B G Verheggen
OBJECTIVE: To identify and compare health-economic models that were developed to evaluate the cost-effectiveness of treatments for type 2 diabetes mellitus (T2DM), and their use within Health Technology Assessments (HTAs). METHODS: In total, six commonly used databases were searched for articles published between October 2008 and January 2013, using a protocolized search strategy and inclusion criteria. The websites of HTA organizations in nine countries, and proceedings from five relevant conferences, were also reviewed...
2016: Current Medical Research and Opinion
Antonio Rodriguez-Poncelas, Gabriel Coll-de-Tuero, Marc Saez, José M Garrido-Martín, José M Millaruelo-Trillo, Joan Barrot de-la-Puente, Josep Franch-Nadal
BACKGROUND: Some authors consider that secondary prevention should be conducted for all DM2 patients, while others suggest that the drug preventive treatment should start or be increased depending on each patient's individual CVR, estimated using cardiovascular or coronary risk functions to identify the patients with a higher CVR. The principal objective of this study was to assess three different cardiovascular risk prediction models in type 2 diabetes patients. METHODS: Multicentre, cross-sectional descriptive study of 3,041 patients with type 2 diabetes and no history of cardiovascular disease...
2015: BMC Cardiovascular Disorders
James A Black, Rebecca K Simmons, Clare E Boothby, Melanie J Davies, David Webb, Kamlesh Khunti, Gráinne H Long, Simon J Griffin
INTRODUCTION: Individuals with screen-detected diabetes are likely to receive intensified pharmacotherapy to improve glycaemic control and general cardiometabolic health. Individuals are often asymptomatic, and little is known about the degree to which polypharmacy is present both before, and after diagnosis. We aimed to describe and characterize the pharmacotherapy burden of individuals with screen-detected diabetes at diagnosis, 1 and 5 years post-diagnosis. METHODS: The prescription histories of 1026 individuals with screen-detected diabetes enrolled in the ADDITION-UK trial of the promotion of intensive treatment were coded into general medication types at diagnosis, 1 and 5 years post-diagnosis...
2015: BMJ Open Diabetes Research & Care
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