Posted by Staff
News
Sunday, September 22nd, 2013
Diabetes Care: September 11, 2013
OBJECTIVE There are no formal prognostic models predicting adverse outcomes (excessive length of stay or mortality) in hospitalized patients with diabetes. In this study, we aimed to develop a prediction model that will help identify patients with diabetes who are most likely to have an adverse event during their hospital stay.
RESEARCH DESIGN AND METHODS Analysis was based on 25,118 admissions with diabetes to University Hospital Birmingham, Birmingham, U.K., over 4 years (2007–2010). Adverse events are defined as either excessive length of stay or inpatient mortality. Key predictors were variables that are often available in the first 72 h of admission and included demographic characteristics, clinical pathological test results, and use of insulin. Models were constructed using logistic regression, discrimination and calibration assessed, and internal validation carried out. Read mor
Posted by Staff
Clinical Trials
Sunday, September 22nd, 2013
The Journal of Clinical Endocrinology & Metabolism: September 1, 2013
Context: Transplantation with stem cells has been reported as a potential treatment for diabetes. However, there are few reports examining transplantation with umbilical cord blood (UCB) in type 2 diabetes (T2DM).
Objective: The aim of the study was to evaluate the efficacy of intrapancreatic UCB transplantation in patients with T2DM.
Design and Setting: Three patients were enrolled in the study, which was performed in a hospital setting from 2010 to 2012, and the duration of follow-up was approximately 6 months. Read more
Posted by Staff
News
Thursday, September 19th, 2013
Population Health Metrics: 9/18/13
Although diabetes is one of the most costly and rapidly increasing serious chronic diseases worldwide, the optimal mix of strategies to reduce diabetes prevalence has not been determined.
Methods
Using a dynamic model that incorporates national data on diabetes prevalence and incidence, migration, mortality rates, and intervention effectiveness, we project the effect of five hypothetical prevention policies on future US diabetes rates through 2030: 1) no diabetes prevention strategy; 2) a “high-risk” strategy, wherein adults with both impaired fasting glucose (IFG) (fasting plasma glucose of 100–124 mg/dl) and impaired glucose tolerance (IGT) (2-hour post-load glucose of 141–199 mg/dl) receive structured lifestyle intervention; 3) a “moderate-risk” strategy, wherein only adults with IFG are offered structured lifestyle intervention; 4) a “population-wide” strategy, in which the entire population is exposed to broad risk reduction policies; and 5) a “combined” strategy, involving both the moderate-risk and population-wide strategies. We assumed that the moderate- and high-risk strategies reduce the annual diabetes incidence rate in the targeted subpopulations by 12.5% through 2030 and that the population-wide approach would reduce the projected annual diabetes incidence rate by 2% in the entire US population. Read more
Posted by Staff
News
Thursday, September 19th, 2013
Diabetes Care: September 11, 2013
Aims To describe treatment regimens in youth with type 2 diabetes, and examine associations between regimens, demographic and clinical characteristics, and glycemic control.
Methods This report includes 474 youth with a clinical diagnosis of type 2 diabetes who completed a SEARCH for Diabetes in Youth study visit. Diabetes treatment regimen was categorized as lifestyle alone; metformin monotherapy; any oral hypoglycemic agent (OHA) other than metformin, or two or more OHAs; insulin monotherapy; and insulin plus any OHA(s). Association of treatment with demographic and clinical characteristics (fasting C-peptide [FCP], diabetes duration and self-monitoring of blood glucose [SMBG]), and glycated hemoglobin (A1C) were assessed by chi-square and analysis of variance. Multiple linear regression models were used to evaluate independent associations of treatment regimens and A1C, adjusting for demographics, diabetes duration, FCP and SMBG. Read More
Posted by Staff
News
Thursday, September 19th, 2013
Circulation Research: 9/13/13
Diabetes and obesity have emerged as global epidemics. At present more than 150 million individuals worldwide are living with diabetes and this number is expected to increase by 30% by 2015 and double to 300 million by 2025. In the US alone, there are 18.2 million diabetics (6.3% of the total population) and an estimated 1.3 million new cases are expected to be diagnosed each year.1 Diabetes and insulin resistance, fueled by pandemic obesity, has emerged as an explosive worldwide epidemic that encompasses all ethnicities, economic classes, and age groups.2–4 While diabetes affects several organs systems and disease processes, heart disease is the leading cause of death in diabetics. Both diabetes and cardiovascular disease share a common set of risk factors, and therefore it has been suggested that the two diseases share a similar etiology (the “common soil” hypothesis) and that diabetes and cardiovascular disease share overlapping, if not identical, molecular and cellular mechanisms. Not only does insulin resistance originate from cardiovascular dysfunction, but cardiovascular tissues are the primary targets of diabetes and obesity. Read mor
Posted by Staff
News
Thursday, September 19th, 2013
Diabetes Care: September 11, 2013
Aims To describe treatment regimens in youth with type 2 diabetes, and examine associations between regimens, demographic and clinical characteristics, and glycemic control.
Methods This report includes 474 youth with a clinical diagnosis of type 2 diabetes who completed a SEARCH for Diabetes in Youth study visit. Diabetes treatment regimen was categorized as lifestyle alone; metformin monotherapy; any oral hypoglycemic agent (OHA) other than metformin, or two or more OHAs; insulin monotherapy; and insulin plus any OHA(s). Association of treatment with demographic and clinical characteristics (fasting C-peptide [FCP], diabetes duration and self-monitoring of blood glucose [SMBG]), and glycated hemoglobin (A1C) were assessed by chi-square and analysis of variance. Multiple linear regression models were used to evaluate independent associations of treatment regimens and A1C, adjusting for demographics, diabetes duration, FCP and SMBG. Read more
Posted by Staff
News
Thursday, September 19th, 2013
Diabetes Care: September 11, 2013
Objective To evaluate the cost-effectiveness of a genetic testing policy for HNF1A, HNF4Aand GCK-MODY in a hypothetical cohort of type 2 diabetes patients 25-40 years old with a MODY prevalence of 2%.
Research Design and Methods We used a simulation model of type 2 diabetes complications based on UKPDS data, modified to account for the natural history of disease by genetic subtype, to compare a policy of genetic testing at diabetes diagnosis versus a policy of no testing. Under the screening policy, successful sulfonylurea treatment of HNF1A-MODY and HNF4A-MODY was modeled to produce a glycosylated hemoglobin reduction of -1.5%, compared to usual care. GCK-MODY received no therapy. Main outcome measures were costs and quality-adjusted life years (QALYs), based on lifetime risk of complications and treatments, expressed as the incremental cost-effectiveness ratio (ICER, $/QALY). Read more
