Posted by Diabetes South Texas Staff
News
Wednesday, July 16th, 2014
JAMA: 6/30/14
Importance Type 2 diabetes mellitus is common, and treatment to correct blood glucose levels is standard. However, treatment burden starts years before treatment benefits accrue. Because guidelines often ignore treatment burden, many patients with diabetes may be overtreated.
Objective To examine how treatment burden affects the benefits of intensive vs moderate glycemic control in patients with type 2 diabetes.
Design, Setting, and Participants We estimated the effects of hemoglobin A1c (HbA1c) reduction on diabetes outcomes and overall quality-adjusted life years (QALYs) using a Markov simulation model. Model probabilities were based on estimates from randomized trials and observational studies. Simulated patients were based on adult patients with type 2 diabetes drawn from the National Health and Nutrition Examination Study. Read more
Posted by Staff
Minority Diabetes Reports
Wednesday, July 16th, 2014
Springer: July 2014
Abstract
It is believed that diabetes risk scores need to be ethnic specific. However, this prerequisite has not been tested. We examined the performance of several risk models, developed in various populations, in a Europid and a South Asian population. The performance of 14 published risk prediction models were tested in two prospective studies: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study and the Mauritius non-communicable diseases survey. Eight models were developed in Europid populations; the remainder in various non-Europid populations. Model performance was assessed using area under the receiver operating characteristic curves (discrimination), Hosmer–Lemeshow tests (goodness-of-fit) and Brier scores (accuracy). In both AusDiab and Mauritius, discrimination was highest for a model developed in a mixed population (non-Hispanic white and African American) and lowest for a model developed in a Europid population. Read More
Posted by Staff
Minority Diabetes Reports
Wednesday, July 16th, 2014
Springer: July 2014
Abstract
Aims/hypothesis
MTNR1B is a type 2 diabetes susceptibility locus associated with cross-sectional measures of insulin secretion. We hypothesised that variation in MTNR1B contributes to the absolute level of a diabetes-related trait, temporal rate of change in that trait, or both.
Methods
We tested rs10830963 for association with cross-sectional diabetes-related traits in up to 1,383 individuals or with rate of change in the same phenotypes over a 3–5 year follow-up in up to 374 individuals from the family-based BetaGene study of Mexican Americans. Read More
Posted by Staff
Minority Diabetes Reports
Wednesday, July 16th, 2014
Ingentaconnec: 6/1/14
Abstract:
The highest prevalence of low vitamin D levels are among Hispanics and non-Hispanic Blacks. Evidence suggests that low vitamin D levels may contribute to increased risk for diabetes and its complications. Hispanics are at greater risk for vitamin D deficiency. To address the relationship between vitamin D, diabetes, and Hispanics, this research is described. Evidence supports an association between low vitamin D and risk for diabetes, but there remains insufficient evidence to suggest whether treatment of low vitamin D can prevent or improve diabetes. In addition, there is limited research regarding vitamin D deficiency in the Hispanic population. Factors such as obesity, dark skin pigmentation, northern geographical latitude, and prevalence of renal insufficiency may place Hispanics at greater risk for low vitamin D levels. Nurses need to understand the signs and symptoms of vitamin D deficiency and treatment recommendation guidelines, which are also described. This information will allow nurses to improve the health outcomes and decrease the disparities amongst adult Hispanics with diabetes. Read More
Posted by Staff
Clinical Trial News
Wednesday, July 16th, 2014
Springer: August 2014
Abstract
Aims/hypothesis
The aim of the study was to compare the effect of six (A6 regimen) vs two meals a day, breakfast and lunch (B2 regimen), on body weight, hepatic fat content (HFC), insulin resistance and beta cell function.
Methods
In a randomised, open, crossover, single-centre study (conducted in Prague, Czech Republic), we assigned 54 patients with type 2 diabetes treated with oral hypoglycaemic agents, both men and women, age 30–70 years, BMI 27–50 kg/m2 and HbA1c 6–11.8% (42–105 mmol/mol), to follow two regimens of a hypoenergetic diet, A6 and B2, each for 12 weeks. Randomisation and allocation to trial groups (n = 27 and n = 27) were carried out by a central computer system. Individual calculations of energy requirements for both regimens were based on the formula: (resting energy expenditure × 1.5) − 2,092 kJ. Read More
Posted by Staff
Clinical Trial News
Wednesday, July 16th, 2014
Springer: July 2014
For many years, the randomised controlled clinical trial (RCT) has been the gold standard for evaluating the efficacy, tolerability and safety of drugs. The modern framework for RCTs was developed in the mid-20th century through the leadership of the UK Medical Research Council and the US National Institutes of Health in collaboration with academic clinical researchers and scientists, among others [1]. Adoption of the RCT by regulatory agencies, including the US Food and Drug Administration (FDA) and the European Medicines Agency, as a requirement for the approval of most new drugs significantly shifted the clinical trial landscape. Today, the majority of patients who participate in RCTs do so in studies sponsored by pharmaceutical and device companies. The advantages of RCTs are well known to most clinical researchers and clinicians. Read More
Posted by Staff
Clinical Trial News
Wednesday, July 16th, 2014
Springer: July 2014
Abstract
Aims/hypothesis
The aim of this study was to investigate whether small doses of intense exercise before each main meal (‘exercise snacks’) would result in better blood glucose control than a single bout of prolonged, continuous, moderate-intensity exercise in individuals with insulin resistance.
Methods
Nine individuals completed three exercise interventions in randomised order. Measures were recorded across 3 days with exercise performed on the middle day, as either: (1) traditional continuous exercise (CONT), comprising 30 min moderate-intensity (60% of maximal heart rate [HRmax]) incline walking before dinner; (2) exercise snacking (ES), consisting of 6 × 1 min intense (90% HRmax) incline walking intervals 30 min before each meal; or (3) composite exercise snacking (CES), encompassing 6 × 1 min intervals alternating between walking and resistance-based exercise, 30 min before meals. Read more
