Posted by Diabetes South Texas Staff
Clinical Trial News
Friday, January 17th, 2014
Diabetes Care: January 2014
OBJECTIVE To evaluate whether intensive treatment (INT) with the goal of achieving blood glucose levels as close to the nondiabetic range as safely possible reduced the risk of onset and progression of diabetic retinopathy (DR) in subjects with type 1 diabetes (T1D) compared with conventional therapy (CON).
RESEARCH DESIGN AND METHODS The Diabetes Control and Complications Trial (DCCT) (1982–1993) was a multicenter, controlled clinical trial comparing INT with CON for onset and progression of DR. The Epidemiology of Diabetes Interventions and Complications (EDIC) study (1994–present) is an observational follow-up of the DCCT cohort. Read more
Posted by Diabetes South Texas Staff
Clinical Trial News
Friday, January 17th, 2014
Diabetes Care: October 29, 2013
Objective We examined the impact of intensive vs. conventional diabetes treatment upon menopause among women with type 1 diabetes in the Diabetes Control and Complications Trial (DCCT), a randomized controlled trial of intensive diabetes treatment, and its observational follow-up, the Epidemiology of Diabetes Interventions and Complications (EDIC) Study.
Research Design and Methods In a secondary analysis of women in DCCT/EDIC (n=657), outcomes were the cumulative incidences of natural menopause and surgical menopause. Cox regression analyses were used to examine associations with treatment group, time-varying estimates of hemoglobin A1c (HbA1c), insulin dosage, body mass index (BMI), and microvascular complications (retinopathy, nephropathy, and neuropathy). Read More
Posted by Diabetes South Texas Staff
Clinical Trials
Friday, January 17th, 2014
Diabetes Care: January 2014
OBJECTIVE Glucagon-like peptide 1 (GLP-1) is an incretin hormone that is released from the gastrointestinal tract. Treatment with GLP-1 analogs has proven to be of clinical use for patients with type 2 diabetes. Patients with type 1 diabetes, particularly those with residual β-cell function, may also respond to treatment, but the acute metabolic effects of GLP-1 analogs on these patients in reaction to both oral and intravenous glucose challenges are not well understood.
RESEARCH DESIGN AND METHODS Seventeen patients with type 1 diabetes, half of whom had residual insulin production, underwent two mixed-meal tolerance tests (MMTTs) and two intravenous glucose tolerance tests (IVGTTs), with and without pretreatment with exenatide. No exogenous bolus insulin was administered for the studies. Glucose excursions, insulin secretion rates (ISRs), and levels of glucagon, endogenous GLP-1, and gastric inhibitory polypeptide were measured after the meal or glucose loads. Read More
Posted by Diabetes South Texas Staff
News
Friday, January 17th, 2014
NEJM: 1/16/14
The relation between body weight and mortality among persons with type 2 diabetes remains unresolved, with some studies suggesting decreased mortality among overweight or obese persons as compared with normal-weight persons (an “obesity paradox”).
METHODS
We studied participants with incident diabetes from the Nurses’ Health Study (8970 participants) and Health Professionals Follow-up Study (2457 participants) who were free of cardiovascular disease and cancer at the time of a diagnosis of diabetes. Body weight shortly before diagnosis and height were used to calculate the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters). Multivariable Cox models were used to estimate the hazard ratios and 95% confidence intervals for mortality across BMI categories. Read more
Posted by Diabetes South Texas Staff
News
Friday, January 17th, 2014
Ann Intern Med.: January 14, 2014
Description: Update of the 2008 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for gestational diabetes mellitus (GDM).
Methods: The USPSTF reviewed the evidence on the accuracy of screening tests for GDM, the benefits and harms of screening before and after 24 weeks of gestation, and the benefits and harms of treatment in the mother and infant.
Population: This recommendation applies to pregnant women who have not been previously diagnosed with type 1 or 2 diabetes mellitus.
Recommendation: The USPSTF recommends screening for GDM in asymptomatic pregnant women after 24 weeks of gestation. (B recommendation)
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for GDM in asymptomatic pregnant women before 24 weeks of gestation. (I statement) Read More
Posted by Diabetes South Texas Staff
News
Friday, January 17th, 2014
Diabetes Care: January 2014
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A1C ≥6.5%. The test should be performed in a laboratory using a method that is NGSP certified and standardized to the DCCT assay. Or
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Fasting plasma glucose (FPG) ≥126 mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least 8 h. Or
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Two-hour plasma glucose ≥200 mg/dL (11.1 mmol/L) during an oral glucose tolerance test (OGTT). The test should be performed as described by the World Health Organization, using a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water. Or
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In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥200 mg/dL (11.1 mmol/L). Read More
Posted by Diabetes South Texas Staff
News
Friday, January 17th, 2014
Health Aff: January 2014
One in seven US households cannot reliably afford food. Food budgets are more frequently exhausted at the end of a month than at other points in time. We postulated that this monthly pattern influenced health outcomes, such as risk for hypoglycemia among people with diabetes. Using administrative data on inpatient admissions in California for 2000–08, we found that admissions for hypoglycemia were more common in the low-income than the high-income population (270 versus 200 admissions per 100,000). Risk for hypoglycemia admission increased 27 percent in the last week of the month compared to the first week in the low-income population, but we observed no similar temporal variation in the high-income population. These findings suggest that exhaustion of food budgets might be an important driver of health inequities. Read more
