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107 papers 25 to 100 followers Related to managing patients with diabetes
By Michael Kelly Assistant Professor
Liana K Billings, Ankur Doshi, Didier Gouet, Alejandra Oviedo, Helena W Rodbard, Nikolaos Tentolouris, Randi Grøn, Natalie Halladin, Esteban Jodar
OBJECTIVE: In patients with uncontrolled type 2 diabetes on basal insulin, prandial insulin may be initiated. We assessed the efficacy and safety of initiating insulin degludec/liraglutide fixed-ratio combination (IDegLira) versus basal-bolus insulin. RESEARCH DESIGN AND METHODS: A phase 3b trial examined patients with uncontrolled type 2 diabetes on insulin glargine (IGlar U100) 20-50 units/day and metformin, randomized to IDegLira or IGlar U100 and insulin aspart four or fewer times per day...
February 26, 2018: Diabetes Care
Kausik Umanath, Julia B Lewis
Diabetic kidney disease and diabetic nephropathy are the leading cause of end-stage kidney disease in the United States and most developed countries. Diabetes accounts for 30% to 50% of the incident cases of end-stage kidney disease in the United States. Although this represents a significant public health concern, it is important to note that only 30% to 40% of patients with diabetes develop diabetic nephropathy. Specific treatment of patients with diabetic nephropathy can be divided into 4 major arenas: cardiovascular risk reduction, glycemic control, blood pressure control, and inhibition of the renin-angiotensin system (RAS)...
February 2, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Yang T Du, Christopher K Rayner, Karen L Jones, Nicholas J Talley, Michael Horowitz
If you haven't measured something, you really don't know much about it.-Karl Pearson (attributed)Gastrointestinal (GI) symptoms represent an important and often unappreciated cause of morbidity in diabetes, although the significance of this burden across the spectrum of patients and the underlying pathophysiology, including the relationship of symptoms with glycemic control, remain poorly defined. The relevance of GI symptoms and the necessity for their accurate assessment have increased with the greater focus on the gut as a therapeutic target for glucose lowering...
March 2018: Diabetes Care
John M Dennis, Beverley M Shields, Anita V Hill, Bridget A Knight, Timothy J McDonald, Lauren R Rodgers, Michael N Weedon, William E Henley, Naveed Sattar, Rury R Holman, Ewan R Pearson, Andrew T Hattersley, Angus G Jones
OBJECTIVE: A precision approach to type 2 diabetes therapy would aim to target treatment according to patient characteristics. We examined if measures of insulin resistance and secretion were associated with glycemic response to dipeptidyl peptidase 4 (DPP-4) inhibitor therapy. RESEARCH DESIGN AND METHODS: We evaluated whether markers of insulin resistance and insulin secretion were associated with 6-month glycemic response in a prospective study of noninsulin-treated participants starting DPP-4 inhibitor therapy (Predicting Response to Incretin Based Agents [PRIBA] study; n = 254), with replication for routinely available markers in U...
January 31, 2018: Diabetes Care
Paolo Pozzilli, Richard D Leslie, Anne L Peters, Raffaella Buzzetti, Sudha S Shankar, Zvonko Milicevic, Imre Pavo, Jeremie Lebrec, Sherry Martin, Nanette C Schloot
AIMS: Patients with a type-2-diabetes (T2D) phenotype positive for glutamic acid decarboxylase antibodies (GADA) represent the majority of latent autoimmune diabetes of the adult (LADA). The GLP-1 receptor agonist dulaglutide, recently introduced for treatment of T2D, has yet to be evaluated in LADA patients. Our primary objective was to evaluate the effect of dulaglutide on glycemic control (HbA1c ) in GADA-positive LADA vs. GADA-negative T2D patients. METHODS: A post-hoc analysis was performed using data from three randomized phase 3 trials (AWARD-2,-4,-5; patients with GADA assessment) which were part of the dulaglutide clinical development program in T2D...
January 27, 2018: Diabetes, Obesity & Metabolism
Ulla Uusitalo, Hye-Seung Lee, Carin Andrén Aronsson, Kendra Vehik, Jimin Yang, Sandra Hummel, Katherine Silvis, Åke Lernmark, Marian Rewers, William Hagopian, Jin-Xiong She, Olli Simell, Jorma Toppari, Anette-G Ziegler, Beena Akolkar, Jeffrey Krischer, Suvi M Virtanen, Jill M Norris
OBJECTIVE: To examine duration of breastfeeding and timing of complementary foods and risk of islet autoimmunity (IA). RESEARCH DESIGN AND METHODS: The TEDDY study prospectively follows 8,676 children with increased genetic risk of type 1 diabetes (T1D) in the U.S., Finland, Germany, and Sweden. This study included 7,563 children with at least 9 months of follow-up. Blood samples were collected every 3 months from birth to evaluate IA, defined as persistent, confirmed positive insulin autoantibodies (IAAs), glutamic acid decarboxylase, or insulinoma antigen-2...
January 17, 2018: Diabetes Care
Jean-Daniel Lalau, Farshad Kajbaf, Youssef Bennis, Anne-Sophie Hurtel-Lemaire, Frans Belpaire, Marc E De Broe
OBJECTIVE: This study was conducted to define a safe, effective dose regimen for metformin in moderate and severe chronic kidney disease (CKD; stages 3A/3B and 4, respectively), after the lifting of restrictions on metformin use in patients with diabetes with moderate-to-severe CKD in the absence of prospective safety and efficacy studies. RESEARCH DESIGN AND METHODS: Three complementary studies were performed: 1 ) a dose-finding study in CKD stages 1-5, in which blood metformin concentrations were evaluated during a 1-week period after each dose increase; 2 ) a 4-month metformin treatment study for validating the optimal metformin dose as a function of the CKD stage (3A, 3B, and 4), with blood metformin, lactate, and HbA 1c concentrations monitored monthly; and 3 ) an assessment of pharmacokinetic parameters after the administration of a single dose of metformin in steady-state CKD3A, 3B, and 4...
January 5, 2018: Diabetes Care
Robert R Henry, Julio Rosenstock, Douglas S Denham, Prakash Prabhakar, Lise Kjems, Michelle A Baron
OBJECTIVE: ITCA 650 is a subdermal osmotic mini-pump that continuously delivers exenatide subcutaneously for 3-6 months. The efficacy, safety, and tolerability of ITCA 650 added to diet and exercise alone or combined with metformin, sulfonylurea, or thiazolidinedione monotherapy or a combination of these drugs was evaluated in poorly controlled patients with type 2 diabetes (T2D) who were ineligible for participation in a placebo-controlled study (FREEDOM-1) because of severe hyperglycemia (HbA1c >10% [86 mmol/mol])...
January 4, 2018: Diabetes Care
Yulong Lian, Qing Sun, Suzhen Guan, Hua Ge, Ning Tao, Yu Jiang, YanXia Zhang, Li Ning, Jing Xiao, Jiwen Liu
OBJECTIVE: Little is known about the relationship between changing psychosocial work conditions and type 2 diabetes. We determined whether changing work stressors and coping resources affect the risk of type 2 diabetes. RESEARCH DESIGN AND METHODS: In this prospective cohort (2003-2014) of 3,740 workers without diabetes (OHSPIW [Occupational Health Study of Petroleum Industry Workers]), participants completed an evaluation of work-related stress and coping resources and type 2 diabetes diagnosis at baseline and 12 years follow-up (two waves)...
December 18, 2017: Diabetes Care
Oana P Zaharia, Pavel Bobrov, Klaus Strassburger, Kálmán Bódis, Yanislava Karusheva, Michaela Scholz, Daniel F Markgraf, Volker Burkart, Nanette C Schloot, Karsten Müssig, Julia Szendroedi, Michael Roden
Context and Objective: Among patients diagnosed with type 2 diabetes, autoimmune diabetes often remains undetected. Metabolic features of these patients are insufficiently characterized at present. Design, Setting, and Patients: This study compared age- and sex-matched adult (aged 41 to 62 years) humans with recent-onset diabetes: patients positive for antibodies against glutamic acid decarboxylase (GAD) and/or cytoplasmic islet-cell antigen with an insulin-free period of >6 months [antibody positive/insulin negative (ab+/ins-); previously termed latent autoimmune diabetes of adults], type 1 diabetes [antibody positive/insulin positive (ab+/ins+)], and type 2 diabetes [antibody negative/insulin negative (ab-/ins-)], as well as glucose-tolerant humans (controls) of the German Diabetes Study (n = 41/group)...
February 1, 2018: Journal of Clinical Endocrinology and Metabolism
Andrew J Ahmann, Matthew Capehorn, Guillaume Charpentier, Francesco Dotta, Elena Henkel, Ildiko Lingvay, Anders G Holst, Miriam P Annett, Vanita R Aroda
OBJECTIVE: To compare the efficacy and safety of once-weekly semaglutide 1.0 mg s.c. with exenatide extended release (ER) 2.0 mg s.c. in subjects with type 2 diabetes. RESEARCH DESIGN AND METHODS: In this phase 3a, open-label, parallel-group, randomized controlled trial, 813 subjects with type 2 diabetes taking oral antidiabetic drugs were randomized (1:1) to semaglutide 1.0 mg or exenatide ER 2.0 mg for 56 weeks. The primary end point was change from baseline in HbA1c at week 56...
February 2018: Diabetes Care
Yukiko Hasegawa, Mika Hori, Tomoko Nakagami, Mariko Harada-Shiba, Yasuko Uchigata
BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) often have hypercholesterolemia, and their serum low-density lipoprotein cholesterol (LDL-C) levels are not always well-controlled even by statin treatment. The glucose-lowering glucagon-like peptide-1 receptor agonists (GLP-1RAs) are reported to change the lipid profiles in T2DM patients, but their effects have been unclear. OBJECTIVE: We examined whether GLP-1RAs affect serum cholesterol levels in T2DM patients with/without statin treatment...
January 2018: Journal of Clinical Lipidology
Silvio E Inzucchi, Bernard Zinman, David Fitchett, Christoph Wanner, Ele Ferrannini, Martin Schumacher, Claudia Schmoor, Kristin Ohneberg, Odd Erik Johansen, Jyothis T George, Stefan Hantel, Erich Bluhmki, John M Lachin
OBJECTIVE: In the BI 10773 (Empagliflozin) Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME) trial involving 7,020 patients with type 2 diabetes and established cardiovascular (CV) disease, empagliflozin given in addition to standard of care reduced the risk of CV death by 38% versus placebo (hazard ratio [HR] 0.62 [95% CI 0.49, 0.77]). This exploratory mediation analysis assesses the extent to which treatment group differences in covariates during the trial contributed to CV death risk reduction with empagliflozin...
February 2018: Diabetes Care
Thomas Danne, Revital Nimri, Tadej Battelino, Richard M Bergenstal, Kelly L Close, J Hans DeVries, Satish Garg, Lutz Heinemann, Irl Hirsch, Stephanie A Amiel, Roy Beck, Emanuele Bosi, Bruce Buckingham, Claudio Cobelli, Eyal Dassau, Francis J Doyle, Simon Heller, Roman Hovorka, Weiping Jia, Tim Jones, Olga Kordonouri, Boris Kovatchev, Aaron Kowalski, Lori Laffel, David Maahs, Helen R Murphy, Kirsten Nørgaard, Christopher G Parkin, Eric Renard, Banshi Saboo, Mauro Scharf, William V Tamborlane, Stuart A Weinzimer, Moshe Phillip
Measurement of glycated hemoglobin (HbA1c ) has been the traditional method for assessing glycemic control. However, it does not reflect intra- and interday glycemic excursions that may lead to acute events (such as hypoglycemia) or postprandial hyperglycemia, which have been linked to both microvascular and macrovascular complications. Continuous glucose monitoring (CGM), either from real-time use (rtCGM) or intermittently viewed (iCGM), addresses many of the limitations inherent in HbA1c testing and self-monitoring of blood glucose...
December 2017: Diabetes Care
Patrice Simard, Nancy Presse, Louise Roy, Marc Dorais, Brian White-Guay, Agnès Räkel, Sylvie Perreault
BACKGROUND: Metformin presents better survival rates than other oral antidiabetics in the treatment of type 2 diabetes. However, these benefits may be dampened by inadequate treatment adherence. OBJECTIVE: We aimed to investigate the relationship between adherence level to metformin therapy and all-cause mortality over 10 years in incident metformin users. METHODS: A nested case-control study was conducted using a large cohort of beneficiaries of the Quebec public drug insurance plan, aged 45 to 85 years, who initiated metformin between 2000 and 2009...
November 1, 2017: Annals of Pharmacotherapy
J Sonya Haw, Karla I Galaviz, Audrey N Straus, Alysse J Kowalski, Matthew J Magee, Mary Beth Weber, Jingkai Wei, K M Venkat Narayan, Mohammed K Ali
Importance: Diabetes prevention is imperative to slow worldwide growth of diabetes-related morbidity and mortality. Yet the long-term efficacy of prevention strategies remains unknown. Objective: To estimate aggregate long-term effects of different diabetes prevention strategies on diabetes incidence. Data Sources: Systematic searches of MEDLINE, EMBASE, Cochrane Library, and Web of Science databases. The initial search was conducted on January 14, 2014, and was updated on February 20, 2015...
December 1, 2017: JAMA Internal Medicine
Manan Pareek, Deepak L Bhatt, Mette L Nielsen, Ram Jagannathan, Karl-Fredrik Eriksson, Peter M Nilsson, Michael Bergman, Michael H Olsen
OBJECTIVE: To examine whether the 1-h blood glucose measurement would be a more suitable screening tool for assessing the risk of diabetes and its complications than the 2-h measurement. RESEARCH DESIGN AND METHODS: We conducted a prospective population-based cohort study of 4,867 men, randomly selected from prespecified birth cohorts between 1921 and 1949, who underwent an oral glucose tolerance test with blood glucose measurements at 0, 1, and 2 h. Subjects were followed for up to 39 years, with registry-based recording of events...
November 14, 2017: Diabetes Care
Min Jun, Toshiaki Ohkuma, Sophia Zoungas, Stephen Colagiuri, Giuseppe Mancia, Michel Marre, David Matthews, Neil Poulter, Bryan Williams, Anthony Rodgers, Vlado Perkovic, John Chalmers, Mark Woodward
OBJECTIVE: To assess the association between 2-year changes in urine albumin-to-creatinine ratio (UACR) and the risk of clinical outcomes in type 2 diabetes. RESEARCH DESIGN AND METHODS: We analyzed data from 8,766 participants in the ADVANCE-ON study. Change in UACR was calculated from UACR measurements 2 years apart, classified into three groups: decrease in UACR of ≥30%, minor change, and increase in UACR of ≥30%. By analyzing changes from baseline UACR groups, categorized into thirds, we repeated these analyses accounting for regression to the mean (RtM)...
October 27, 2017: Diabetes Care
Maira Anna Deters, Anna Laven, Ana Castejon, William R Doucette, Lisiane Slveira Ev, Ines Krass, Els Mehuys, Emina Obarcanin, Holger Schwender, Stephanie Laeer
OBJECTIVE: To evaluate randomized controlled trials (RCTs) that included interventions provided by community pharmacists for patients with type 1 and 2 diabetes, the analysis of each component of the intervention(s), and the description of the training that the pharmacists received. DATA SOURCES: The literature research was conducted in PubMed and in the Cochrane Central Register of Controlled Trials (January 2000 to April 2016) for RCTs with interventions provided by community pharmacists for patients with diabetes...
February 2018: Annals of Pharmacotherapy
David M Nathan
The proliferation of new drug treatments for type 2 diabetes in the United States in the past 15 years, with more than 17 drugs approved in six new classes of antidiabetic drugs, has been promoted by several factors. First, the recognition of the importance of intensive glycemic control to reduce..
December 14, 2017: New England Journal of Medicine
2017-09-28 04:27:32
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