Diabetes
19 Sep Rates of Gestational Diabetes Higher in Summer
MedicalResearch.com Interview with: Anastasia Katsarou PhD LUND University MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study is using data from the Mamma study which screened pregnant women during 2003-2005. During this period, we gathered results from the oral glucose tolerance tests that the women underwent at the 28th week of pregnancy. We used data on the 2hour blood glucose levels from these tests and the frequency of women who were diagnosed with gestational diabetes and grouped them into months and seasons. We gathered also data on the mean monthly temperatures from the Swedish Meteorological and Hydrological Institute. We observed that the 2hour glucose levels and the frequency of women diagnosed with gestational diabetes were statistically significantly higher during the summer months.19 Sep New Onset Diabetes, Especially In Lean Patients, Can Be Marker of Pancreatic Cancer
MedicalResearch.com Interview with: Dr. Pavel Škrha Charles University, Prague Czech Republic MedicalResearch.com: What is the background for this study? What are the main findings? Response: Incidence of pancreatic cancer (PAC) is still increasing. The main problem is in the late diagnosis of the cancer. It was found, that diabetes mellitus was much more frequent in the pancreatic cancer patients than in the general population. DM can be already the first symptom of the disease (secondry T3cDM). In our study nearly 80 % of all the pancreatic cancer patients had DM/prediabetes and it was of new-onset (less than 2 years before the cancer diagnosis) in 73 % out of them. We have measured the current marker of PAC (CA 19-9) together with serum microRNA-196 and -200 (that we have chosen in the previous pilot study). All the markers were significantly elevated in the pancreatic cancer patients, without any difference between the subgroups according to DM presence/absence. While the sensitivity of CA 19-9 alone (to detect the cancer) was 85 % (specificity 73 %), combining all the three markers improved it to 95 % (specificity 77 %). In the pancreatic cancer group, there were only six patients with T1 or T2 stage (others had an advanced stage of the disease - T3, T4). While CA 19-9 alone identified only 2 patients of them, the combined test identified all the six patients (data not shown in the poster).16 Sep Socio-Economic Factors Influence Genetic Tendency Toward Obesity
MedicalResearch.com Interview with: [caption id="attachment_27851" align="alignleft" width="200"]
Prof. Timothy Frayling[/caption]
Professor Timothy Frayling PhD
Professor of Human Genetics
University of Exeter Medical School
Exeter, UK
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We know that genes and environmental factors influence our Body mass index. We know less about if and how they interact.
We wanted to answer the question of whether or not aspects of the environment and our lifestyles accentuate any genetic predisposition to obesity. The question is important as it may highlight aspects of the environment that cause some people to be particularly susceptible to gaining weight. Previous, separate, studies have suggested that specific aspects of the environment are to blame. These included sugary drinks, fried food and TV watching.
16 Sep Can Vitamin D Reduce Insulin Resistance in Muscles of Type 2 Diabetics?
[caption id="attachment_27954" align="alignleft" width="133"]
Elisa Benetti, PhD[/caption]
MedicalResearch.com Interview with:
Dr. Elisa Benetti PhD
Department of Drug Science and Technology
University of Turin
Turin, Italy
MedicalResearch.com: What is the background for this study?
Response: The idea for this study comes from the debate on the role of vitamin D supplementation in the prevention or progression of type 2 diabetes (T2DM). Epidemiological data point at a strong association between vitamin D deficiency and T2DM prevalence, however a causal relationship is still lacking.
Here we wanted to explore the effect of vitamin D administration on insulin-sensitivity, particularly focusing on skeletal muscle, which is a crucial tissue in the maintenance of glucose homeostasis and which was suggested to be a tissue target of vitamin D.
Using a murine model of insulin-resistance induced by a High Fat-High Sugar Diet (HFHS), we demonstrated that a vitamin D supplementation (7 μg•kg-1, i.p. three times/week) was able to revert the deleterious effects evoked by the diet, including the increase in body weight and in the HOMA-IR (a parameter of insulin resistance) and the glucose tolerance impairment. Consistently, at the muscle level, vitamin D increased the insulin sensitivity by reducing tissue inflammation and fat accumulation (myosteatosis).
These effects are due, at least in part, to the inhibition exerted by vitamin D on carboxymethyl-lysine (CML) production, one of the main Advanced Glucose End-products (AGEs), and on its receptor RAGE.
Collectively, our data indicate the ability of vitamin D to reduce the development of muscle insulin resistance, the primary defect in T2DM patients.
16 Sep Standardized Clinical Interview Evaluates Depression in Diabetes Patients
MedicalResearch.com Interview with: [caption id="attachment_27956" align="alignleft" width="173"]
Prof. Cathy Lloyd[/caption]
Dr Cathy E. Lloyd
Professor of Health Studies
School of Health, Wellbeing and Social Care
Faculty of Wellbeing, Education and Language Studies
The Open University
Milton Keynes UK
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We know from earlier epidemiological research that people with diabetes have an increased risk of developing depression and other mental health problems compared to those without diabetes. However the impact of this and what treatment and care should be provided is still unclear, in particular in countries other than the US or the UK.
Our study aims to redress that imbalance, collecting data on diabetes and depression in 16 countries across the globe.
Ours is the first study to measure depressive symptoms but also use a standardised clinical interview to diagnose depression according to ICD criteria.
Overall 10.6% received a diagnosis of Major Depressive Disorder (MDD), however prevalence rates differed widely between countries with 1% diagnosed with MDD in Uganda and nearly 30% in Bangladesh. Twenty-five percent reported subthreshold levels (PHQ-9 score 5 -9) of depression. Those with MDD were significantly more likely to be female and living in an urban rather than rural location (p<0.001). Age and duration of diabetes did not significantly differ between those with and without MDD. Multi-variable analyses demonstrated that while controlling for country, a diagnosis of MDD was significantly associated with female sex, lower education, taking insulin, less exercise, higher levels of diabetes-related distress and a previous diagnosis of MDD. A negligible proportion of those with either MDD or subthreshold levels of depression had a diagnosis or any treatment for their depression recorded in their medical records.
16 Sep Progressive Incremental Benefits of Targeting Lower HbA1c on Type 2 Diabetes Complications Rates
MedicalResearch.com Interview with: [caption id="attachment_27951" align="alignleft" width="125"]
Dr. Samiul Mostafa[/caption]
Dr. Samiul Mostafa
Honorary Clinical Lecturer
Diabetes Trials Unit
University of Oxford
MedicalResearch.com: What is the background for this study?
Response: In managing people with Type 2 diabetes mellitus (T2DM), international guidelines recommend individualisation of HbA1c (glucose) targets for long term maintenance; however, few data are available on the potential
benefits that different blood sugar control targets might achieve.
Therefore, there is a need to learn more about the incremental benefits
of progressively lowering blood sugar levels.
In this computer modelling study, we used the UKPDS Outcomes Model
version 2.0 to estimate 10-year event rates for myocardial infarction
(MI, heart attack), stroke, blindness and amputation by entering
baseline risk factor variables (for example, weight, height,
LDL-cholesterol, systolic blood pressure) taken from a for a current
population of 5766 people with T2DM. Complication rates were estimated
with HbA1c levels held constant at 10%, 9%, 8%, 7% and 6% for each
individual whilst maintaining their risk factors at their baseline
values. Standard statistical methods were used to calculate relative
risk reductions of complications at each HbA1c level.
09 Sep Severe Periodontitis Associated with Insulin Resistance
MedicalResearch.com Interview with: [caption id="attachment_27775" align="alignleft" width="159"]
In-Seok-Song[/caption]
In-Seok Song, DDS, PhD
Clinical Assistant Professor
Oral and Maxillofacial Surgeon
Department of Dentistry, Korea University Anam Hospital,
Seoul, Republic of Korea
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Periodontitis is a well-known cause of various systemic diseases including cardiovascular disease, type 2 diabetes. As for type 2 diabetes, insulin resistance is responsible for the low-grade systemic inflammation, which can deteriorate body function throughout pancreatic β-cell dysfunction and impaired fasting glucose. There are emerging evidences that insulin resistance is a cause of periodontal disease progression among Korean adults as well as other citizens including American, French, Finnish, and the British.
In this study, we hypothesized that insulin resistance aggravates the severity of periodontitis. We investigated the associations between type 2 diabetes, insulin resistance, and severe periodontitis. The associations between severe periodontitis and insulin resistance in non-obese adults with normal body mass index (BMI) or waist circumference (WC) were also evaluated.
We found that non-abdominal obese adults with insulin resistance were more likely to have severe periodontitis compared to metabolically healthy adults with normal waist circumference. Insulin resistance without abdominal obesity can be considered an independent risk factor of severe periodontitis.
02 Sep Intensive Diabetes Treatment Extends Life On Average 8 Years, Free of Serious Complications
MedicalResearch.com Interview with: Oluf Pedersen, MD Specialist in Internal Medicine and Endocrinology, The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Peter Gæde and Jens Oellgaard Department of Cardiology and Endocrinology Slagelse Hospital Copenhagen MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Steno-2 study was the attempt to investigate the effect of an intensified, multifactorial intervention in type 2 diabetes simultaneously targeting risk factors such as hyperglycaemia, hypertension, dyslipidaemia, blood platelet aggregation, and elevated urinary albumin excretion rate as well as life style factors such as smoking, diet and a sedentary lifestyle. On top of that patients were by a dedicated team of care givers offered continued education and motivation. A total of 160 Danish type 2 diabetes patients with microalbumuria (a biomarker of generalized vascular damage) were originally randomized either to intensified multifactorial treatment at Steno Diabetes Center, Copenhagen or to conventional multifactorial treatment at their general practitioners. The trial ended after 8 years, and patients in both of the original treatment arms were for the following 13 years given intensified multifactorial treatment as the one originally given to the intensified intervention group only. Three previous milestone reports from the Steno-2 trial published in Lancet and New England Journal of Medicine have provided unprecedented evidence that this targeted and multifaceted approach reduces the risk of diabetic late complications such as kidney, eye or nerve disease as well as cardiovascular disease and total mortality with around fifty percent.02 Sep Comparable Diabetes and Heart Disease Care Provided By Physicians and Advanced Care Providers
Posted at 01:37h
in Author Interviews, Baylor College of Medicine Houston, Diabetes, Health Care Systems, Heart Disease
MedicalResearch.com Interview with:
Salim S. Virani, MD, PhD and
Julia Akeroyd MPH
Health Services Research and Development
Michael E. DeBakey Veterans Affairs Medical Center
Houston
MedicalResearch.com: What is the background for this study?
Response: Given the increase in the number of Americans seeking primary health care due to the Affordable Care Act, combined with current and anticipated physician shortages in the US, there is a growing need to identify other models of primary care delivery to address chronic diseases.
30 Aug Cardioprotective Effect of Metformin in Diabetes Determined
MedicalResearch.com Interview with: [caption id="attachment_27474" align="alignleft" width="164"]
Dr. Jolanta Weaver[/caption]
Jolanta U Weaver, FRCP MRCS PhD CTLHE
Senior Lecturer in Diabetes Medicine
Honorary Consultant Diabetologist
Newcastle
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Vascular stem cells, which are associated with an improvement of heart disease, are improved in type 1 diabetes by repurposing metformin, known to reduce heart disease in type 2 diabetes.
We treated patients with type 1 diabetes with metformin for 8 weeks. The metformin dose varied between 500 mg a day to 2000 mg a day, depending on what patients were happy to take. Subjects were requested to keep diabetic control unchanged to study the direct effect of metformin on heart disease. Circulating endothelial progenitor cells (vascular stem cells) count, Hill’s colonies and pro angiogenic cells function (in test tube) improved in comparison to patients, who did not take metformin but remained on standard therapy.
Endothelial cells associated with vascular damage, on the other hand, were reduced following metformin therapy confirming improved vascular health. The glycaemic control remained unchanged (as planned at the onset of the study) to allow us to examine the effect of metformin ALONE on vascular health. Patients did not suffer any serious side effects.
25 Aug Metformin Can Stop Weight Gain Seen With Some Autism Spectrum Disorder Medications
MedicalResearch.com Interview with: [caption id="attachment_27380" align="alignleft" width="200"]
Dr. Evdokia Anagnostou[/caption]
Evdokia Anagnostou MD
Canada Research Chair (Tier II) in Translational Therapeutics in Autism
Senior Clinician Scientist and co-lead of the Autism Research Centre
Holland Bloorview Kids Rehabilitation Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Researchers from Holland Bloorview Kids Rehabilitation Hospital / University of Toronto (Canada), Ohio State University, University of Pittsburgh, Columbia University, and Vanderbilt University, led a double-blind, placebo-controlled randomized clinical trial to examine whether metformin, a common type-2 diabetes drug, may be effective in counteracting weight gain commonly seen with the use of atypical antipsychotic medications, indicated by the FDA for the treatment of irritability in children and youth with autism spectrum disorder (ASD).
Results showed that metformin was effective in helping overweight children and adolescents with autism spectrum disorder (ASD) who take antipsychotic medications lower their body mass index (BMI).
Both FDA-approved antipsychotic medications for treating irritability and agitation symptoms in children and adolescents with ASD can cause a significant increase in weight gain, which in addition to increasing BMI, enhances long-term risk of diabetes. This complicates an already challenging issue as adolescents with autism spectrum disorder are ~ two times more likely to be obese than adolescents without developmental disabilities. Findings of this research are important, especially for families of children with ASD, as managing long-term physical health while also treating irritability/agitation symptoms, can help ensure that their child can participate fully in life (school, etc.).
25 Aug Simple Changes in Cooking Methods May Reduce Inflammatory Stress and Decrease Insulin Resistance
MedicalResearch.com Interview with: [caption id="attachment_27302" align="alignleft" width="125"]
Dr. Jaime Uribarri[/caption]
Jaime Uribarri, MD
Professor, Nephrology
Icahn School of Medicine
Mt. Sinai Medical Center
MedicalResearch.com: What is the background for this study?
Response: We have been doing research in the area of dietary advanced glycation end-products (AGEs) for many years.
AGEs are chemical compounds that form normally in the body in small amounts and also in food when cooking under high heat and dry conditions; a percent of AGEs in food is absorbed and part of it is retained in the body leading to increased smoldering inflammation and oxidative stress that eventually produce most of modern chronic diseases such as diabetes, cardiovascular disease, dementia, etc. We have previously demonstrated that a diet low in AGEs, which essentially means changing the cooking methods to include less application of heat, plenty of water,etc, decreases inflammation of oxidative stress in people with diabetes, chronic kidney disease and in healthy subjects. In the current study we applied the same low dietary AGE intervention to a group of obese patients with the so-called Metabolic syndrome, a risk factor for Diabetes Mellitus.
24 Aug Patients With Psoriasis Have Coronary Calcium Scores Comparable to Diabetes
Posted at 21:00h
in Author Interviews, Dermatology, Diabetes, Heart Disease, JAMA, Medical Imaging, NIH
MedicalResearch.com Interview with:
Nehal N. Mehta, .MD., M.S.C.E. F.A.H.A.
Lasker Clinical Research Scholar
Section of Inflammation and Cardiometabolic Diseases
NIH
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Psoriasis is associated with accelerated cardiovascular (CV) disease; however, screening for CV risk factors in psoriasis remains low. Coronary artery calcium (CAC) score estimates the total burden of atherosclerosis. Psoriasis has been associated with increase CAC score, but how this compares to patients with diabetes, who are aggressively screened for CV risk factors, is unknown.
19 Aug Maternal Gestational Diabetes Increased Risk of Childhood Obesity
MedicalResearch.com Interview with: [caption id="attachment_26918" align="alignleft" width="200"]
Dr. Gang Hu[/caption]
Dr. Gang Hu, Associate Professor
LSU’s Pennington Biomedical Research Center & Director
Chronic Disease Epidemiology Lab
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Some studies have found that maternal gestational diabetes mellitus (GDM) places offspring at increased risk of long-term adverse outcomes, including obesity. However, most of studies are from high income countries, with limited data from low to middle income countries. The present study, conducted at urban and suburban sites in 12 countries, found that the increased risk for children of GDM mothers compared with non-gestational diabetes mellitus mothers was 53% for obesity, 73% for central obesity, and 42% for high body fat.
19 Aug Closed-Loop Insulin Delivery During Pregnancy Improves Glucose Control
MedicalResearch.com Interview with: Professor Helen Murphy and Dr Zoe Stewart Institute of Metabolic Science University of Cambridge MedicalResearch.com: What is the background for this study? Response: Controlling blood glucose levels is a daily challenge for people with Type 1 diabetes and is particularly crucial during pregnancy. Previous research shows that women with type 1 diabetes spend only 12 hours per day within the recommended glucose target levels, leading to increased rates of complications including preterm delivery and large for gestational age infants. National surveys show that one in two babies suffer complications related to type 1 diabetes in the mother. The hormonal changes that occur in pregnancy make it difficult for women to predict the best insulin doses for every meal and overnight. Too much insulin causes low glucose levels harmful for the mother and too little causes problems for the developing baby. The artificial pancreas automates the insulin delivery giving better glucose control than we can achieve with currently available treatments. Previous studies show that the closed-loop system also known as artificial pancreas can be used safely in children and adults and our study aimed to investigate whether or not it was helpful for women with type1 diabetes during pregnancy.12 Aug Intracoronary Antiplatelet Abciximab Bolus May Improve Outcomes of Primary PCI in STEMI patients with Diabetes
MedicalResearch.com Interview with: Raffaele Piccolo, MD Department of Cardiology Bern University Hospital University of Bern Bern, Switzerland MedicalResearch.com: What is the background for this study? Response: Over the past two decades, the prevalence of diabetes mellitus has doubled in Western countries and future projections are even worse by showing a 55% increase by 2035 when approximately 592 million of people are expected to live with diabetes all over the world. Acute myocardial infarction still represents the most common diabetes-related complication and its occurrence is associated with a higher risk of mortality. Timely recanalization of the occluded coronary vessel with primary percutaneous coronary intervention (PCI) represents the therapy of choice for acute ST-segment elevation myocardial infarction (STEMI). Our study investigated whether the direct application of an intracoronary bolus of abciximab, which is an antiplatelet drug blocking the glycoprotein IIb/III a receptor, at the time of primary PCI improves the outcomes at 1-year follow-up compared with the standard intravenous route. The study was in individual patient-level pooled analysis of 3 randomized trials including 2,470 patients, of whom 473 (19%) had diabetes.10 Aug Clinical Course of Diabetic Kidney Disease Has Changed Over Past 30 Years
MedicalResearch.com Interview with: [caption id="attachment_26816" align="alignleft" width="133"]
Dr. Ian de Boer[/caption]
Ian de Boer, MD, MS
Associate Professor of Medicine
Adjunct Associate Professor of Epidemiology
Division of Nephrology and Kidney Research Institute
University of Washington, Seattle, WA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: From the perspective of patients with diabetes, kidney disease can be a devastating complication, leading to end stage renal disease requiring dialysis or kidney transplantation and markedly increasing the risks heart disease, stroke, peripheral vascular disease, and amputation. From a public health perspective, diabetes is the most common cause of end stage renal disease in the US, so understanding, preventing, and treating diabetic kidney disease is critical to reduce the numbers of people needing dialysis and kidney transplants. There have been major changes in the treatment of patients with diabetes over the last 30 years, so we were interested in evaluating how diabetic kidney disease was changing in this context.
We observed that the clinical manifestations of kidney disease have indeed changed among US adults with diabetes over the last 30 years. Albuminuria, or elevated levels of albumin in the urine, has traditionally been thought of as the first evidence of kidney damage for people with diabetes. Reduced GFR, or a reduced ability of the kidneys to filter out waster products, has typically been thought of as a late stage of diabetic kidney disease. But from 1988 to 2014, we saw a significant decrease in the prevalence of albuminuria accompanied by a significant increase in reduced GFR.
09 Aug Preconception Counselling Resource Improves Pregnancy Care in Women With Diabetes
MedicalResearch.com Interview with: [caption id="attachment_26855" align="alignleft" width="174"]
Dr. Valerie Holmes[/caption]
Dr Valerie Holmes
Senior Lecturer
Centre for Public Health
School of Medicine, Dentistry and Biomedical Science
Queen's University Belfast
Belfast
MedicalResearch.com: What is the background for this study?
Response: Women with diabetes, type 1 diabetes and type 2 diabetes, are advised to plan for pregnancy as there are higher risks of complications for both the mother and baby when compared to the general maternity population. Careful planning in partnership with diabetes care teams, especially in relation to achieving optimum blood glucose control and taking folic acid can significantly reduce the risks. However, while most women know that they should plan for pregnancy, they are unaware as to why this is important or how to engage with the process, and thus the majority of women (up to two thirds of women) enter pregnancy unprepared. This study describes the implementation of a regional preconception counsellng resource, in the format of a DVD, into routine care in Northern Ireland to raise awareness of pregnancy planning. The authors assessed if the introduction of this resource improved pregnancy planning among women with diabetes in the region.
08 Aug New Anti-Diabetic Compound May Avoid Bone Loss Seen With Current Medications
MedicalResearch.com Interview with: [caption id="attachment_26825" align="alignleft" width="133"]
Dr. Patrick Griffin[/caption]
Patrick Griffin, PhD
Professor
Department of Molecular Therapeutics
The Scripps Research Institute Florida Campus
MedicalResearch.com: What is the background for this study?
Response: Over the past decade, our laboratory and that of TSRI Associate Professor Theodore Kamenecka, have focused on molecules that increase sensitivity to insulin. Using newly discovered information, we have made significant advances in developing a family of drug candidates that target a receptor known as peroxisome proliferator-activated receptors gamma (PPARγ), a key regulator of stem cells controlling bone formation and bone resorption and a master regulator of fat.
04 Aug Obesity Raises Risk of Diabetes But Not Heart Attacks in Twins
MedicalResearch.com Interview with: [caption id="attachment_26704" align="alignleft" width="150"]
Prof. Peter Nordstrom[/caption]
Prof. Peter Nordström PhD
Department of Community Medicine and Rehabilitation
Geriatrics, Umeå University
Umeå, Sweden
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Numerous studies has shown an association between BMI, CVD and death. However, it is not known to what extent genetic factors influence this relationship. We used over 4000 monozygous twin pairs that had different BMI. This mean that the difference in BMI must be due to environmental factors since the genetic setup is similar in monozygous twins.
Since the fatter twin did not have a higher risk of myocardial infarction (MI) or death, environmental factors that increase BMI is very unlikely to increase the risk of myocardial infarction or death. By inference the strong association between BMI, MI and death must be explained by the fact that the same genes control both obesity, MI and death. By contrast, the fatter twin had a higher risk of diabetes.
29 Jul Increased Number of People With Diabetes Primarily Due To Type 2 Diabetics Living Longer
MedicalResearch.com Interview with: Dr. Stephanie Read, PhD University of Edinburgh, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: The number of people living with type 2 diabetes in Scotland is increasing. We wanted to identify to what extent this trend was due to people living longer with type 2 diabetes or due to increasing numbers of new cases each year.26 Jul For Selected Patients, Telehealth Offers Better Control of Diabetes
MedicalResearch.com Interview with:
Brian McKinstry MD
Professor of primary care e-health and General practitioner
MacKenzie Medical Centre
Edinburgh
MedicalResearch.com: What is the background for this study?
Response: The prevalence of diabetes is rising as the population ages and becomes more obese. Clinical services are increasingly stretched, so much so that it will be difficult for doctors and nurses to continue to look after patients using the same service delivery they have used in the past. Increasingly patients are being asked to self-manage long-term illnesses, but particularly with type 2 diabetes they find this stressful. One solution is to encourage self-management but with monitoring at a distance through telehealth.
We performed a randomised controlled trial in family practices in four regions of the United Kingdom among 321 people with type 2 diabetes and glycated haemoglobin (HbA1c) ( a measure of control over the previous three months) >58 mmol/mol. The supported telemonitoring intervention involved self-measurement and transmission to a secure website of twice weekly morning and evening glucose for review by family practice clinicians. The control group received usual care, with at least annual review and more frequent reviews for people with poor glycaemic or blood pressure control in the context of incentives in family practice based on a sliding scale of financial rewards for achieving glycaemic and blood pressure control targets. HbA1c assessed at nine months was the primary outcome. Intention-to-treat analyses were performed.
25 Jul What is Risk of Hypoglycemia When Adding Sulphonylurea to Metformin for Diabetes Control?
MedicalResearch.com Interview with: [caption id="attachment_26452" align="alignleft" width="147"]
Dr. Andersen[/caption]
Stig Ejdrup Andersen MD, PhD
Clinical Pharmacology Unit
Zealand University Hospital
Roskilde Denmark
MedicalResearch.com: What is the background for this study?
Response: For decades, we have used sulphonylurea derivates in the medical treatment of type 2 diabetes. Although several newer drugs have become available, adding an SU is still a recommended and acceptable strategy when metformin monotherapy fails. The SUs are among the cheapest glucose lowering drugs on the marked but the risk of hypoglycaemia make clinicians prefer a newer oral drug such as a DPP-IV inhibitor or a SGLT-2 inhibitor to ansulphonylurea because even mild hypoglycaemia may affect the patients’ quality of life negatively.
Several meta-analyses have examined the effectiveness and safety of noninsulin antidiabetic drug, all of which have considered the SUs a homogenous drug class. Pharmacologically, however, the SU agents are quite different. In 2004, a randomized controlled trial by Shernthaner et al. indicated that in comparison with glimepiride, gliclazide MR is equally effective and is associated with fewer hypoglycaemic episodes. Still, head-to-head comparisons of the SU-agents as add-on to metformin are few. In the absence of robust designed comparative trials, we decided to compare the relative risk of hypoglycaemia among the newer SU-agents in a network meta-analysis.
25 Jul Breastfeeding May Correct Metabolic Abnormalities Linked To Diabetes
MedicalResearch.com Interview with: Dr. Sandra Hummel and Dr. Daniela Much Institute of Diabetes Research Helmholtz Center Munich German Research Center for Environmental Health Munich MedicalResearch.com: What is the background for this study? What are the main findings? Response: Gestational diabetes mellitus is associated with a seven-fold increased risk of developing type 2 diabetes postpartum. In 2012, we published that type 2 diabetes risk was markedly reduced up to 15 years after delivery in women with gestational diabetes if they breastfed for more than 3 months. However the underlying biological mechanisms are still unclear to date. Aim of this biomarker study was to identify the mechanism underlying the protective effect of prolonged lactation. At our study site in Munich, we enrolled 197 women with previous gestational diabetes participating in a postpartum assessment of glucose tolerance at a median time of 3.6 years after delivery. By using a targeted metabolomics approach (including a broad spectrum of lipids and amino acids), we identified lactation-associated biochemical changes in maternal plasma samples. Most interestingly, these metabolite signatures have been described with decreased risk for type 2 diabetes previously. Our results indicate that lactation-associated alterations persisted up to 11 years post-lactation.21 Jul Non-Diabetics With High Blood Sugar May Face Increased Heart Disease Risk
MedicalResearch.com Interview with: Dr Fiona Bragg Clinical Research Fellow Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population Health University of Oxford MedicalResearch.com: What is the background for this study? Response: Diabetes is known to be a risk factor for cardiovascular disease. It is less clear, however, whether higher blood glucose levels in individuals without diabetes are also associated with higher risk for cardiovascular diseases. It is important to examine this association because it may help us to understand the mechanisms underlying these diseases as well as appropriate approaches to preventing them. We therefore looked at this association in the China Kadoorie Biobank study of 0.5 million Chinese adults, examining the relationship between blood glucose levels and the subsequent risk for cardiovascular diseases among participants with no history of diabetes at the time of recruitment to the study.20 Jul Almost 20% US Adolescents Have Diabetes or Pre-Diabetes
MedicalResearch.com Interview with: [caption id="attachment_17266" align="alignleft" width="135"]
Dr. Andy Menke[/caption]
Andy Menke PhD
Social & Scientific Systems, Inc.
Silver Spring, MD, 20910
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Limited information was available on the prevalence of diabetes among adolescents in the US, particularly the percentage that are undiagnosed and unaware of the condition. We found that 0.8% of adolescents 12-19 years of age had diabetes and 18% had prediabetes. Of those with diabetes, 29% overall were unaware of it and this increased to 40% among Hispanic adolescents and 50% among non-Hispanic black adolescents.
20 Jul Study Evaluates Effects of Polyunsaturated Fats on Development of Diabetes
MedicalResearch.com Interview with: [caption id="attachment_26248" align="alignleft" width="200"]
Dr. Fumiaki Imamura[/caption]
Dr. Fumiaki Imamura Ph.D.
MRC Epidemiology Unit
University of Cambridge
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There was insufficient evidence for effects of polyunsaturated fatty acids (PUFA) intake or blood biomarkers on the development of type 2 diabetes. For instance, previous studies using PUFA biomarkers had a maximum of only 673 type 2 diabetes cases. In the EPIC-InterAct Study - a large European collaborative, prospective study where 12,132 diabetes cases were ascertained during its follow-up - we found diverse associations of blood levels of different types of PUFAs with incidence of type 2 diabetes.
Despite this diversity, clinically relevant results were observed for major polyunsaturated fatty acids. Higher blood levels of total omega-6 PUFAs and the major omega-6 PUFA (linolenic acid) were associated with a lower risk of developing type 2 diabetes. Likewise, levels of alpha linolenic acid, known as a plant-origin omega-3 PUFA, were associated with lower type 2 diabetes risk. Marine-origin omega-3 PUFAs, including docosahexaenoic acid (DHA), showed inconsistent associations with type 2 diabetes risk.
19 Jul Diabetes Medications: No Clear Difference in Effect on Life Expectancy or Heart Disease
[caption id="attachment_26204" align="alignleft" width="143"]
Dr. Suetonia Palmer[/caption]
MedicalResearch.com Interview with:
Principal investigator A/Prof Suetonia Palmer PhD
University of Otago, New Zealand
[caption id="attachment_26202" align="alignleft" width="142"]
Dr. Giovanni Strippoli[/caption]
Senior investigator
Prof. Giovanni Strippoli
MD, PhD, MPH, MM
University of Sydney, Australia and Diaverum, Sweden
MedicalResearch.com: What is the background for this study?
Response: Network meta-analysis is a new technique that allows us to evaluate ALL medical therapies for a specific clinical problem. We wondered whether any of the usual drugs used to treat glucose levels in people with diabetes were safest or most effective.
15 Jul More Meals At Home Linked To Reduced Risk of Obesity and Diabetes
Posted at 01:33h
in Author Interviews, Brigham & Women's - Harvard, Diabetes, Nutrition, PLoS, Weight Research
MedicalResearch.com Interview with:
Dr. Qi Sun Sc.D, M.D., M.M.S.
Dr. Geng Zong, Ph.D., a research fellow
Assistant Professor in the Department of Nutrition
Harvard T.H. Chan School of Public Heath
Boston
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There is growing trend of eating meal prepared out of home in many countries. For example, energy intake from out-of-home meals has increased from less than 10% in mid 60s to over 30% in 2005-2008 among Americans, and average time spent on cooking has decreased by one third. In the meantime, the prevalence of diabetes and obesity of this country keep on growing. In the current study, we followed nearly 100 thousands middle-aged men and women for 26 years. In 1986, we asked people how often their lunch and dinner were prepared at home per week, which will be 14 meals in maximum, and updated this information during follow-up.
We found men and women with 11-14 meals prepared at home per week had 14% lower risk of diabetes compared to those had 6 or less meals prepared at home. If we look at lunch and dinner separately, people with 5 or more lunch prepared at home per week had 9% lower risk of diabetes, and those with 5 or more dinner prepared at home had 15% lower risk of diabetes compared to the group who had 2 or less than lunch or dinner at home per week.
We further investigated whether people with more meals prepared at home had lower risk of obesity or weight gain in our study. In the first eight years of follow-up, participants with 11-14 meals prepared at home had 14% lower risk of developing obesity compared to people had 0-6 meals prepared at home. For men, these people had 1.2kg less weight gain, and for women they had 0.3 kg less weight gain. Furthermore, we found potential impact of having meals at home and risk of diabetes became weaker. This suggest that weight gain could be one gearwheel that links eating meals prepared at home and diabetes risk.