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https://www.readbyqxmd.com/read/28550608/shifting-paradigms-in-the-medical-management-of-type-2-diabetes-reflections-on-recent-cardiovascular-outcome-trials
#1
Faramarz Ismail-Beigi, Etie Moghissi, Mikhail Kosiborod, Silvio E Inzucchi
An important challenge in the management of patients with type 2 diabetes is cardiovascular disease (CVD) prevention. While it is well established that intensive glycemic control prevents the onset and slows the progression of certain microvascular complications, such a strategy utilized in multiple clinical trials over the past few decades has failed to show a similar benefit with regard to cardiovascular events, including mortality. Despite this, a major hope has been the discovery of glucose-lowering medications that simultaneously improve cardiovascular outcomes...
May 26, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28549471/the-shared-health-appointments-and-reciprocal-enhanced-support-shares-study-study-protocol-for-a-randomized-trial
#2
Michele Heisler, Jennifer Burgess, Jeffrey Cass, John F Chardos, Alexander B Guirguis, Sean M Jeffery, Lorrie A Strohecker, Adam S Tremblay, Wen-Chih Wu, Donna M Zulman
BACKGROUND: Diabetes shared medical appointments (SMAs) and reciprocal peer support programs have been found in efficacy trials to help adults with diabetes improve their self-management and achieve short-term gains in clinical and patient-centered outcomes. In order to translate this evidence to system-level interventions, there is a need for large-scale, pragmatic trials that examine the effectiveness, implementation, and costs of SMAs and reciprocal peer support across diverse settings...
May 26, 2017: Trials
https://www.readbyqxmd.com/read/28549160/the-diabetes-strengths-and-resilience-measure-for-adolescents-with-type-1-diabetes-dstar-teen-validation-of-a-new-brief-self-report-measure
#3
Marisa E Hilliard, Esti Iturralde, Jill Weissberg-Benchell, Korey K Hood
 Despite the challenges of managing type 1 diabetes, many adolescents achieve optimal outcomes. A validated measure of diabetes-specific strengths is needed to measure adaptive behaviors and attitudes associated with overcoming challenges and achieving "resilient" outcomes.  Baseline data from 260 adolescents (age 14-18 years, M  = 15.7 ± 1.1, 60% female, 33% Non-Caucasian, M A1c = 9.1 ± 1.9%) and caregivers in a behavioral intervention trial were analyzed to evaluate psychometric properties of the 12-item self-report Diabetes Strengths and Resilience measure for adolescents (DSTAR-Teen)...
May 26, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/28548649/aqueous-humor-endothelin-1-and-total-retinal-blood-flow-in-patients-with-non-proliferative-diabetic-retinopathy
#4
L-A Khuu, F Tayyari, J M Sivak, J G Flanagan, S Singer, M H Brent, D Huang, O Tan, C Hudson
PurposeThe purpose of this study was to determine the association between aqueous ET-1 levels and total retinal blood flow (TRBF) in patients with non-insulin-dependent type 2 diabetes mellitus (T2DM) and early non-proliferative diabetic retinopathy (NPDR).Patients and methodsA total of 15 age-matched controls and 15 T2DM patients with NPDR were recruited into the study. Aqueous humor (~80-120 μl) was collected before cataract surgery to measure the levels of ET-1 using suspension multiplex array technology...
May 26, 2017: Eye
https://www.readbyqxmd.com/read/28548389/night-shift-work-is-associated-with-poorer-glycaemic-control-in-patients-with-type-2-diabetes
#5
Areesa Manodpitipong, Sunee Saetung, Hataikarn Nimitphong, Nantaporn Siwasaranond, Thanawat Wongphan, Chotima Sornsiriwong, Pranee Luckanajantachote, Prasitchai Mangjit, Prasit Keesukphan, Stephanie J Crowley, Megan M Hood, Sirimon Reutrakul
The circadian system plays a role in regulating metabolism. Night-shift work, a form of circadian misalignment, is associated with increased type 2 diabetes risk. This study aimed to determine if night-shift workers with type 2 diabetes experience poorer glycaemic control than non-shift workers. Patients with type 2 diabetes (104 unemployed, 85 day workers and 60 night-shift workers) participated. Sleep duration, sleep quality, morningness-eveningness preference, depressive symptoms and dietary intake were assessed using standardized questionnaires...
May 26, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28546455/objectively-measured-sedentary-time-and-cardiovascular-risk-factor-control-in-us-hispanics-latinos-with-diabetes-mellitus-results-from-the-hispanic-community-health-study-study-of-latinos-hchs-sol
#6
Xueyin Wang, Garrett Strizich, Simin Hua, Daniela Sotres-Alvarez, Christina Buelna, Linda C Gallo, Marc D Gellman, Yasmin Mossavar-Rahmani, Matthew J O'Brien, Mark Stoutenberg, Tao Wang, M Larissa Avilés-Santa, Robert C Kaplan, Qibin Qi
BACKGROUND: Cardiovascular disease (CVD) risk factor control is a cornerstone of diabetes mellitus management. Little is known about relationships of objectively measured sedentary time and physical activity with major CVD risk factor control in individuals with diabetes mellitus. We examined associations of objectively measured sedentary time and moderate-to-vigorous physical activity with reaching major CVD risk factor control goals among US Hispanic/Latino adults with diabetes mellitus...
May 25, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28545842/haemoglobin-a1c-as-a-screening-tool-for-type-2-diabetes-and-prediabetes-in-populations-of-swedish-and-middle-east-ancestry
#7
Margareta Hellgren, Kristin Hjörleifsdottir Steiner, Louise Bennet
AIMS: To explore and compare sensitivity and specificity for HbA1c ≥48mmol/mol as a predictor for type 2 diabetes mellitus (T2DM) in two populations with different ethnicity and to examine the predictive value of two levels of HbA1c (≥42mmol/mol, ≥39mmol/mol) for prediabetes in these populations. METHODS: Four cohorts were examined with an oral glucose tolerance test. (1) The MEDIM Study (n=1991 individuals of Swedish and Iraqi ancestry); (2) The Skaraborg Project (n=1327 individuals of Swedish ancestry); (3) The 4-D study (n=424 individuals of Swedish, Iraqi and Turkish ancestry); (4) The Flemingsberg study (n=212 participants of Turkish ancestry)...
May 22, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28544684/insulin-glulisine-for-continuous-subcutaneous-insulin-infusion-in-pediatric-type-1-diabetes
#8
Tatsuhiko Urakami, Yusuke Mine, Masako Aoki, Misako Okuno, Junichi Suzuki
We evaluated the efficacy and safety of insulin glulisine (GLU) used for continuous s.c. insulin infusion (CSII) in 20 children with type 1 diabetes after 1 year of GLU treatment. There were no significant differences in mean plasma glucose before breakfast and before dinner between before and after using GLU, but the levels after breakfast and after dinner significantly improved, from 192.5 ± 31.7 to 162.0 ± 27.3 mg/dL for breakfast, and from 191.1 ± 33.3 to 161.1 ± 24.5 mg/dL for dinner (P < 0...
May 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28544548/assessment-of-factors-determining-an-hba1c-concentration%C3%A2-%C3%A2-%C3%A2-7-5-in-patients-with-type-1-diabetes
#9
Eijiro Yamada, Shuichi Okada, Yasuyo Nakajima, Claire Bastie, Yuko Tagaya, Aya Osaki, Yoko Shimoda, Ryo Shibusawa, Tsugumichi Saito, Atsushi Ozawa, Masanobu Yamada
BACKGROUND: Establishing an optimal insulin regimen is crucial for maintaining glycemic control in patients with type 1 diabetes. We aimed to determine the insulin dose required to achieve a hemoglobin A1c (HbA1c) concentration ≤ 7.5% in Japanese patients with type 1 diabetes. METHODS: This multi-centered cross-sectional study was performed at 3 institutions in Japan. Among 107 patients with type 1 diabetes, 92 had no detectable endogenous insulin secretion: 39 patients had HbA1c concentration ≤ 7...
May 22, 2017: Journal of Diabetes
https://www.readbyqxmd.com/read/28544457/both-the-frequency-of-hba1c-testing-and-the-frequency-of-smbg-predict-metabolic-control-a-multicenter-analysis-of-15-199-adult-type-1-diabetes-patients-from-germany-and-austria
#10
A Schwandt, F Best, T Biester, A Grünerbel, F Kopp, D Krakow, M Laimer, C Wagner, R W Holl
BACKGROUND: The objective of this study was to examine the association between metabolic control and frequency of hemoglobin A1c (HbA1c) measurements and of self-monitoring of blood glucose (SMBG), as well as the interaction of both. METHODS: Data of 15,199 adult type 1 diabetes patients registered in a standardized electronic health record (DPV) were included. To model the association between metabolic control and frequency of HbA1c testing or of SMBG, multiple hierarchic regression models with adjustment for confounders were fitted...
May 19, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28544107/the-relationship-between-sleep-disturbance-and-glycemic-control-in-adults-with-type-2-diabetes-an-integrative-review
#11
REVIEW
Bingqian Zhu, Patricia E Hershberger, Mary C Kapella, Cynthia Fritschi
AIMS AND OBJECTIVES: To explore and synthesize current research to assess the state of science about the relationship between sleep disturbance and glycemic control in adults with type 2 diabetes (T2DM). BACKGROUND: Sleep disturbance is suggested a risk factor for T2DM. Diabetes alone is a leading cause of death, but when coupled with sleep disturbance poses additional health risks. However, little is known about the relationship between sleep disturbance and glycemic control in people with overt diabetes...
May 25, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28541572/shared-responsibility-for-type-1-diabetes-care-is-associated-with-glycemic-variability-and-risk-of-glycemic-excursions-in-youth
#12
Arwen M Marker, Amy E Noser, Mark A Clements, Susana R Patton
We examined how parent and youth responsibility for type 1 diabetes (T1D) care is related to adherence and glycemic outcomes, namely, glycemic variability and risk of glycemic excursions. One hundred thirty-five parent-youth dyads (10-16 years old; diagnosed with T1D for at least 6 months) participated in this study. Percent responsibility of T1D care attributed to the youth, parent, or shared was measured using the Diabetes Family Responsibility Questionnaire. We collected youth's hemoglobin A1c (HbA1c) and glucometer downloads to examine relationships between responsibility and HbA1c, frequency of blood glucose monitoring (self-monitoring blood glucose, SMBG), risk of glycemic excursions, and actual glycemic variability using bivariate correlations and path analysis...
May 25, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/28541137/clinical-use-of-continuous-glucose-monitoring-in-adults-with-type-2-diabetes
#13
Anders L Carlson, Deborah M Mullen, Richard M Bergenstal
Hemoglobin A1c is an excellent population health measure for the risk of vascular complications in diabetes, while continuous glucose monitoring (CGM) is a tool to help personalize a diabetes treatment plan. The value of CGM in individuals with type 1 diabetes (T1D) has been well demonstrated when compared with utilizing self-monitoring of blood glucose (SMBG) to guide treatment decisions. CGM is a tool for patients and clinicians to visualize the important role that diet, exercise, stress management, and the appropriate selection of diabetes medications can have in managing type 2 diabetes (T2D)...
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28541136/metrics-beyond-hemoglobin-a1c-in-diabetes-management-time-in-range-hypoglycemia-and-other-parameters
#14
Lorena Alarcon-Casas Wright, Irl B Hirsch
We review clinical instances in which A1C should not be used and reflect on the use of other glucose metrics that can be used, in substitution of or in combination with A1C and SMBG, to tailor an individualized approach that will result in better outcomes and patient empowerment.
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28541131/clinical-use-of-continuous-glucose-monitoring-in-adults-with-type-1-diabetes
#15
David Slattery, Pratik Choudhary
With the emphasis on intensive management of type 1 diabetes, data from studies support frequent monitoring of glucose levels to improve glycemic control and reduce glucose variability, which can be related to an increase in macro and microvascular complications. However, few perform capillary blood glucose that frequently. There are currently two available alternatives that this review will discuss, continuous glucose monitoring (CGM) and flash glucose monitoring. CGM has become an important diagnostic and therapeutic option in optimizing diabetes management...
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28540395/management-of-atherosclerosis-risk-factors-for-patients-at-high-cardiovascular-risk-in-the-real-world-practice-a-multicentre-study
#16
Arintaya Phrommintikul, Rungroj Krittayaphong, Wanwarang Wongcharoen, Sukit Yamwong, Smonporn Boonyaratavej, Rapeephon Kunjara-Na-Ayudhya, Pyatat Tatsanavivat, Piyamitr Sritara
INTRODUCTION: Atherosclerotic cardiovascular disease is a global health burden. However, there are heterogeneities among countries or regions regarding the risk factors and clinical manifestations of atherosclerotic diseases as well as their management patterns. METHODS: We collected data from 25 centres in Thailand. Patients with documented coronary artery disease or cerebrovascular disease or peripheral arterial disease, or with at least three atherosclerosis risk factors were enrolled between April 2011 and March 2014...
May 25, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28539977/human-immunodeficiency-virus-and-type-2-diabetes
#17
P Avari, S Devendra
The prevalence of diabetes is higher amongst individuals infected with HIV. The major contributor to hyperglycaemia is thought to be iatrogenic, with protease inhibitors being most commonly associated to insulin resistance. This article is to update general practitioners on the diagnosis and management of diabetes in HIV-infected patients. Specific considerations are highlighted including interactions of particular diabetic drugs with antiretroviral therapy (ART). We articulate why the use of Hemoglobin A1c (HbA1c) testing is not recommended as a diagnostic tool...
May 2017: London Journal of Primary Care
https://www.readbyqxmd.com/read/28538386/safety-and-efficiency-of-sglt2-inhibitor-combining-with-insulin-in-subjects-with-diabetes-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#18
Yingying Yang, Shi Chen, Hui Pan, Yun Zou, Bo Wang, Guixia Wang, Huijuan Zhu
BACKGROUND: We aimed to assess the safety and efficiency of the novel sodium glucose co-transporter 2 (SGLT2) inhibitor in combinations with insulin for type 1 and type 2 diabetes mellitus (T1DM and T2DM). METHODS: We searched Medline, Pubmed, Embase, and the Cochrane Collaboration Library from January 2010 to December 2016 without restriction of language. FDA data and Clinical Trials (http://www.clinicaltrials.gov) were also searched. Study selection, data extraction, and evaluation of risk of bias were performed by 2 persons independently...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28536448/consumption-of-diets-with-low-advanced-glycation-end-products-improves-cardiometabolic-parameters-meta-analysis-of-randomised-controlled-trials
#19
Estifanos Baye, Velislava Kiriakova, Jaime Uribarri, Lisa J Moran, Barbora de Courten
Studies examining the effects of consumption of diets low in advanced glycation end products (AGEs) on cardiometabolic parameters are conflicting. Hence, we performed a meta-analysis to determine the effect of low AGE diets in reducing cardiometabolic risk factors. Seventeen randomised controlled trials comprising 560 participants were included. Meta-analyses using random effects models were used to analyse the data. Low AGE diets decreased insulin resistance (mean difference [MD] -1.3, 95% CI -2.3, -0.2), total cholesterol (MD -8...
May 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28535688/sglt-2-inhibitors-is-there-a-role-in-type-1-diabetes-mellitus-management
#20
Nabila Ahmed-Sarwar, Angela K Nagel, Samantha Leistman, Kevin Heacock
OBJECTIVE: The purpose of this review is to identify and evaluate disease management of patients with type 1 diabetes mellitus (T1DM) who were treated with a sodium-glucose cotransporter 2 (SGLT-2) inhibitor as an adjunct to insulin therapy. DATA SOURCES: A PubMed (1969 to March 2017) and Ovid (1946 to March 2017) search was performed for articles published utilizing the following MESH terms: canagliflozin, empagliflozin, dapagliflozin, type 1 diabetes mellitus, insulin dependent diabetes, insulin, sodium-glucose transporter 2...
May 1, 2017: Annals of Pharmacotherapy
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