The State of Type 1 Diabetes Research Today -

The State of Type 1 Diabetes Research Today -

CV screening in diabetes

Ali When and how Clinical Diabetes 2006

Roelker Screening for Coronary Artery Disease in Patients With Diabetes 2008 Diabetes spectrum

McGuire Diabetes and Heart Failure in Patients With Coronary Disease: Separating Markers From Mediators  Diabetes Care

Hypoglycemia, Diabetes, and Cardiovascular Events Desouza, Fonseca,  DC2010

Screening for Asymptomatic Coronary Artery Disease in Patients With Type 2 Diabetes

Taishiro Chikamori  JAMA 2009      correspondence concerning ad DIAD

Bax: Screening for Coronary Artery Disease in Patients With Diabetes,  DC2007

 Screening for coronary heart disease in patients with diabetes mellitusUPTODATE cf authors+refs

 

Comparative Effectiveness and Safety of Medications for Type 2 Diabetes: An Update Including New Drugs and 2-Drug Combinations

 

article 

Abstract

Background: Given the increase in medications for type 2 diabetes mellitus, clinicians and patients need information about their effectiveness and safety to make informed choices.

Purpose: To summarize the benefits and harms of metformin, second-generation sulfonylureas, thiazolidinediones, meglitinides, dipeptidyl peptidase-4 (DPP-4) inhibitors, and glucagon-like peptide-1 receptor agonists, as monotherapy and in combination, to treat adults with type 2 diabetes.

Data Sources: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched from inception through April 2010 for English-language observational studies and trials. The MEDLINE search was updated to December 2010 for long-term clinical outcomes.

Study Selection: Two reviewers independently screened reports and identified 140 trials and 26 observational studies of head-to-head comparisons of monotherapy or combination therapy that reported intermediate or long-term clinical outcomes or harms.

Data Extraction: Two reviewers following standardized protocols serially extracted data, assessed applicability, and independently evaluated study quality.

Data Synthesis: Evidence on long-term clinical outcomes (all-cause mortality, cardiovascular disease, nephropathy, and neuropathy) was of low strength or insufficient. Most medications decreased the hemoglobin A_1c level by about 1 percentage point and most 2-drug combinations produced similar reductions. Metformin was more efficacious than the DPP-4 inhibitors, and compared with thiazolidinediones or sulfonylureas, the mean differences in body weight were about −2.5 kg. Metformin decreased low-density lipoprotein cholesterol levels compared with pioglitazone, sulfonylureas, and DPP-4 inhibitors. Sulfonylureas had a 4-fold higher risk for mild or moderate hypoglycemia than metformin alone and, in combination with metformin, had more than a 5-fold increased risk compared with metformin plus thiazolidinediones. Thiazolidinediones increased risk for congestive heart failure compared with sulfonylureas and increased risk for bone fractures compared with metformin. Diarrhea occurred more often with metformin than with thiazolidinediones.

Limitations: Only English-language publications were reviewed. Some studies may have selectively reported outcomes. Many studies were small, were of short duration, and had limited ability to assess clinically important harms and benefits.

Conclusion: Evidence supports metformin as a first-line agent to treat type 2 diabetes. Most 2-drug combinations similarly reduce hemoglobin A_1c levels, but some increased risk for hypoglycemia and other adverse events. 

Primary Funding Source: Agency for Healthcare Research and Quality.

 

 

ISPUB - Using analogy-building to initiate insulin

ISPUB - Using analogy-building to initiate insulin: "This paper focuses on the importance of analogy-building as a tool for insulin initiation in persons with diabetes. It discusses the parts of an effective analogy, and details examples of useful analogies which can be used to motivate people with diabetes to accept insulin therapy."

ISPUB - Initiating Insulin Therapy in Patients with Type 2 Diabetes: A Practical Approach

ISPUB - Initiating Insulin Therapy in Patients with Type 2 Diabetes: A Practical Approach: "Initiating Insulin Therapy in Patients with Type 2 Diabetes: A Practical Approach"

ISPUB - ADA-EASD

ISPUB - ADA-EASD: "ADA-EASD" t2DM treatment

concise summary of 2008 recommendations

Exenatide Lowers HbA1c More Than Oral Antidiabetics or Insulin Glargine

Exenatide Lowers HbA1c More Than Oral Antidiabetics or Insulin Glargine: "Once-Weekly Exenatide Lowers HbA1c More Than Daily Oral Antidiabetics or Insulin Glargine"

Hyperglycemic Crises in Adult Patients With Diabetes: Introduction

Hyperglycemic Crises in Adult Patients With Diabetes: Introduction: "Hyperglycemic Crises in Adult Patients With Diabetes"

7: Old Dog, Old Tricks - Journeys in Survey Research

7: Old Dog, Old Tricks - Journeys in Survey Research: "Old Dog, Old Tricks: Using SPSS Syntax to Avoid the Mouse Trap"

Are we losing the battle against cardiometabolic disease? The case for a paradigm shift in primary prevention.

BioMed Central Full text Are we losing the battle against cardiometabolic disease? The case for a paradigm shift in primary prevention.: "Are we losing the battle against cardiometabolic disease? The case for a paradigm shift in primary prevention
Lutz E Kraushaar and Alexander Krämer"

Preventing type 2 diabetes: can we make the evidence work? -- Yates et al. 85 (1007): 475 -- Postgraduate Medical Journal

Preventing type 2 diabetes: can we make the evidence work? -- Yates et al. 85 (1007): 475 -- Postgraduate Medical Journal: "Review
Preventing type 2 diabetes: can we make the evidence work?
T Yates1, M Davies1, K Khunti2"

Increases in Waist Circumference and Weight May Predict Incident Diabetes

Increases in Waist Circumference and Weight May Predict Incident Diabetes: "Increases in Waist Circumference and Weight May Predict Incident Diabetes CME"

Defining and Characterizing the Progression of Type 2 Diabetes — Diabetes Care

Defining and Characterizing the Progression of Type 2 Diabetes — Diabetes Care: "Defining and Characterizing the Progression of Type 2 Diabetes"

Defining and Characterizing the Progression of Type 2 Diabetes — Diabetes Care

Defining and Characterizing the Progression of Type 2 Diabetes — Diabetes Care: "Defining and Characterizing the Progression of Type 2 Diabetes
Vivian A. Fonseca, MD"

fulltext

PREVENCIA DIABETES MELLITUS 2. TYPU

SAMEDI: "Interná medicína 2009 / 4
PREVENCIA DIABETES MELLITUS 2. TYPU
Vladimír Uličiansky, Zbynek Schroner"


Interná medicína 2009 / 4
PREVENCIA DIABETES MELLITUS 2. TYPU
Vladimír Uličiansky, Zbynek Schroner

Diabetes mellitus (DM) predstavuje skupinu metabolických ochorení, ktoré sú charakterizované hyperglykémiou. Hyperglykémia je následkom poruchy sekrécie inzulínu a/alebo účinku inzulínu. DM 2. typu má výraznú genetickú zložku. Ochorenie je polygénne a multifaktoriálne. Faktory vonkajšieho prostredia (obezita, výživa, fyzická aktivita) na základe genetickej náchylnosti modulujú fenotyp.V rámci projektu „Prevalencia diabetes mellitus na Slovensku“ Mokáň a kol. zistili 7,0 % prevalenciu diabetes mellitus (DM), pričom v 5,3 % išlo o známy DM, 1,2 % novozistený DM podľa kritérií Americkej diabetologickej asociácie (ADA) a 0,5 % o ďalšie nové prípady DM po vykonaní orálneho glukózo-tolerančného testu (oGTT) u respondentov s potvrdenou hraničnou glykémiou nalačno. Plán Medzinárodnej diabetickej federácie (IDF) pre prevenciu DM 2. typu je založený na kontrole modifikovateľných rizikových faktorov. Môže byť rozdelený do dvoch cieľových skupín: ľudia s vysokým rizikom vývoja DM 2. typu a celá populácia. IDF navrhuje 3-stupňový plán prevencie: 1. identifikácia tých, ktorí môžu byť vo vyššom riziku (dotazník na určenie rizika DM 2. typu, glykémia nalačno, orálny glukózo-tolerančný test), 2. určenie miery rizika a 3. intervencia na prevenciu DM 2. typu (úprava životného štýlu, hmotnosť, fyzická aktivita, farmakologická intervencia). Plán IDF je veľmi podobný odporúčaniam Americkej diabetologickej asociácie a Slovenskej diabetologickej spoločnosti. Kľúčové slová: diabetes mellitus 2. typu - prevencia - životný štýl - metformín

PREVENTION OF TYPE 2 DIABETES MELLITUS

Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Type 2 DM has a strong genetic component. The disease is polygenic and multifactorial since in addition to genetic susceptibility, enviromental factors (obesity, nutrition and physical activity) modulate the phenotype. In the project „Prevalence of diabetes mellitus in Slovakia“ Mokan et al. confirmed 7.0 % prevalence of diabetes mellitus, including 5.3 % of known DM, 1.2 % of new DM according to ADA criteria and 0.5 % of additional new cases of DM after oGTT in respondents with impaired fasting glucose. The plan of International Diabetes Federation (IDF) on Type 2 DM prevention is based on controlling modifiable risk factors and can be divided in two target groups: people at high risk of developing Type 2 DM and the entire population.The IDF proposes a three-step plan for the prevention: 1. indentification of those who may be at higher risk (type 2 diabetes risk assessment form, fasting plasma glucose, oral glucose tolerance test), 2. measurement of risk and 3. intervention to prevent the development of Type 2 DM (lifestyle changes, weight, physical activity, pharmacological intervention). Plan IDF is very similar to the recommendations of The American Diabetes Association and The Slovakian Diabetes Society. Key words: Type 2 Diabetes Mellitus - prevention - lifestyle - metformin

Interná med. 2009; 9(4): 181-187

CODHy: Debate Rages on HbA1c for Diabetes Diagnosis - in Meeting Coverage, CODHy from MedPage Today

Medical News: CODHy: Debate Rages on HbA1c for Diabetes Diagnosis - in Meeting Coverage, CODHy from MedPage Today: "CODHy: Debate Rages on HbA1c for Diabetes Diagnosis"

center for evidence based medicine

CEBM > Home: "Welcome to CEBM
Welcome to the web site of the Centre for Evidence-Based Medicine in Oxford in the UK.

Our broad aim is to develop, teach and promote evidence-based health care and provide support and resources to doctors and health care professionals to help maintain the highest standards of medicine.
Learn more about EBM and the CEBM."

Prediction of Type 1 Diabetes in the General Population — Diabetes Care

Prediction of Type 1 Diabetes in the General Population — Diabetes Care: "Prediction of Type 1 Diabetes in the General Population"

Real-Time Hypoglycemia Prediction Suite Using Continuous Glucose Monitoring — Diabetes Care

Real-Time Hypoglycemia Prediction Suite Using Continuous Glucose Monitoring — Diabetes Care: "Real-Time Hypoglycemia Prediction Suite Using Continuous Glucose Monitoring
A safety net for the artificial pancreas"

TULIP - Tubingen lifestyle intervention program

Ziele: DIABETES PREVENTION
METABOLIC, VASCULAR, FUNCTIONAL STUDIES


"Hintergrund
Der Alterszucker (Diabetes mellitus Typ 2) hat in den vergangen Jahren dramatisch zugenommen. In Deutschland sind etwa 6% der Erwachsenen betroffen, d.h. mehr als 4 Mio. Menschen. Wir gehen davon aus, daß im Jahr 2010 diese Zahl 8 Mio. erreichen wird. Diese Zunahme der Erkrankungshäufigkeit (die nur von AIDS in einigen afrikanischen Ländern übertroffen wird) hängt mit unserem modernen Lebenstil zusammen: mehr sitzende Berufe und weniger körperliche Bewegung, sowie leichter Zugang zu zuviel kalorienreichen Nahrungsmitteln. Das heimtückische am Diabetes sind die früh und schleichend beginnenden Gefäßschäden."