Diabetes, Weight Research / 30.05.2014

John Wilding DM FRCP Professor of Medicine & Honorary Consultant Physician Head of Department of Obesity and Endocrinology Institute of Ageing & Chronic Disease Clinical Sciences Centre University Hospital Aintree Liverpool United KingdomMedicalResearch.com Interview with: John Wilding DM FRCP Professor of Medicine & Honorary Consultant Physician Head of Department of Obesity and Endocrinology Institute of Ageing & Chronic Disease Clinical Sciences Centre University Hospital Aintree Liverpool United Kingdom MedicalResearch: What are the main findings of the study? Dr. Wilding: This trial studied over 3700 obese people who were trying to lose weight. The main findings were that liraglutide (an injectable medication already approved for diabetes treatment at lower dose of 1.8mg) can help reduce body weight in people with obesity when used at a higher dose than is usually used in diabetes (3mg). Trial participants experienced a weight loss of 8 % from baseline compared to 2.6 % with placebo (diet and exercise alone). Some risk factors for diabetes and heart disease such as blood sugar, blood pressure and cholesterol also improved with liraglutide treatment to a greater extent than with placebo. The main side effects seen were nausea which in most cases resolved after a few weeks treatment; there were also more cases of gallstones (which could be due to weight loss) and a few more cases of acute pancreatitis in people treated with liraglutide. (more…)
Author Interviews, Diabetes, Diabetes Care, Pharmacology / 29.05.2014

MedicalResearch Interview with: Dr. Valeria Pechtner Medical Advisor, Lilly Diabetes MedicalResearch: What are the main findings of the study? Dr. Pechtner: Used as monotherapy, once-weekly dulaglutide resulted in significant, sustained glycemic lowering, as measured by HbA1c change from baseline. Both the 1.5 mg and the 0.75 mg dose were superior to metformin at the primary endpoint of 26 weeks. At 52 weeks, dulaglutide 1.5 mg continued to demonstrate superiority to metformin, with dulaglutide 0.75 mg showing non-inferiority. In addition, a majority of patients in all arms achieved the American Diabetes Association’s recommended HbA1c target of less than 7 percent, with more patients achieving this goal in the dulaglutide groups at the 26-week endpoint, and more patients achieving the target in the dulaglutide 1.5 mg group at the 52 week timepoint. Additionally, dulaglutide 1.5 mg and metformin resulted in similar weight loss. The tolerability and safety profile was comparable for both medications. (more…)
Author Interviews, Diabetes, JAMA, Yale / 24.05.2014

MedicalResearch.com Interview with: Neel M. Butala, AB Medical student at Yale School of Medicine New Haven, Connecticut MedicalResearch.com: What are the main findings of the study? Answer: We found that patients with diabetes had a disproportionate reduction in in-hospital mortality relative to patients without diabetes over the decade from 2000 to 2010. (more…)
Diabetes / 23.05.2014

Nitesh D. Kuhadiya MD, MPH Assistant Professor of Medicine Section of Endocrinology,Diabetes and Metabolism University of Buffalo, New YorkMedicalResearch.com Interview with: Nitesh D. Kuhadiya MD, MPH Assistant Professor of Medicine Section of Endocrinology,Diabetes and Metabolism University of Buffalo, New York MedicalResearch: What are the main findings of the study? Dr. Kuhadiya: This is the first randomized clinical trial to show that the addition of liraglutide 1.2 and 1.8mg to insulin significantly reduces HbA1c, mean blood glucose, total insulin doses, body weight, carbohydrate intake, C-Reactive protein (a marker of cardiovascular risk), significantly improves quality of life and reduces systolic blood pressure(top number in a blood pressure reading) in 1.8mg group in patients with type 1 diabetes over a period of 12 weeks. In 1.2mg, HbA1c fell by 0.78% from 7.84 to 7.06% and in 1.8mg group fell by 0.42% from 7.41 to 6.99% which means that more number of patients will be able to achieve HbA1c levels close to 7% and lower which is recommended by most diabetes organizations. Also the total daily dose of insulin fell by about 10-12 units in both groups.  The total daily carbohydrate intake in both the groups fell by an average of 40 grams.   There was a 5 kg weight loss in both 1.2 mg and 1.8 mg groups and both these groups on an average lowered their Body Mass Index from 29 to 28 kg/m2 .    In 1.8 mg group  there was fall in systolic blood pressure by 9 mm from  120 to 111 mm Hg. The improvements seen are important because 40 to 50 percent of people with Type 1 diabetes have the metabolic syndrome(Cluster of risk factors, including high blood pressure, large waistline, high blood sugar, low HDL ("good") cholesterol and high triglycerides (fats in the blood) which increases the chances of later developing Type 2 diabetes and heart disease. Our findings have significant implications for the future treatment of patients with Type 1 Diabetes. (more…)
Author Interviews, Diabetes, JAMA, OBGYNE / 22.05.2014

Wei Bao MD, PhD Postdoc fellow, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Rockville, MD 20852MedicalResearch.com Interview with: Wei Bao MD, PhD Postdoc fellow, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Rockville, MD 20852 MedicalResearch: What are the main findings of the study? Dr. Wei Bao: This study, to our knowledge, is the first attempt to examine the associations of physical activity and sedentary behaviors with risk of type 2 diabetes mellitus (T2DM) among women with a history of gestational diabetes mellitus (GDM), which is a high-risk population of T2DM. The main findings are: (1) Physical activity is inversely associated with risk of progression from GDM to T2DM. Each 5-metabolic equivalent hours per week increment of total physical activity, which is equivalent to 100 minutes per week of moderate-intensity physical activity or 50 minutes per week of vigorous physical activity, was related to a 9% lower risk of T2DM; this inverse association remained significant after additional adjustment for body mass index (BMI). (2) An increase in physical activity is associated with a lower risk of progression from gestational diabetes mellitus to T2DM. Compared with women who maintained their total physical activity levels, women who increased their total physical activity levels by 7.5 MET-h/wk or more (equivalent to 150 minutes per week of moderate-intensity physical activityor 75 minutes per week of vigorous physical activity) had a 47% lower risk of T2DM; the association remained significant after additional adjustment for BMI. (3) Prolonged time spent watching TV, as a common sedentary behavior, is associated with an increased risk of progression from gestational diabetes mellitus to T2DM. Compared with women who watched TV 0 to 5 hours per week, those watched TV 6 to 10, 11 to 20, and 20 or more hours per week had 28%, 41%, and 77%, respectively, higher risk of T2DM. The association was no longer significant after additional adjustment for BMI. (more…)
Author Interviews, Diabetes, Diabetologia, Heart Disease / 22.05.2014

MedicalResearch.com Interview with: Malene Nøhr Demant Department of Cardiology Copenhagen University Hospital Gentofte Hellerup, Denmark MedicalResearch: What are the main findings of the study? Dr. Demant: Our study shows that increasing severity of heart failure is associated with an increased risk of developing diabetes. Increasing loop-diuretic dosage was used as a proxy for heart failure severity. Patients with the most severe heart failure were three times more likely to develop diabetes than those with the least severe. Patients who were also being treated with ACE inhibitors (angiotensin-converting-enzyme inhibitors) had a less pronounced increase in diabetes risk. Patients who developed diabetes were 16% more likely to die than those who did not develop diabetes. (more…)
Cancer Research, Diabetes / 20.05.2014

MedicalResearch.com Interview with: Sarah P. Psutka, MD Fellow in Urologic Oncology Department of Urology, Mayo Clinic MedicalResearch: What are the main findings of each study?  Dr. Psutka: In this study we identified all diabetic patients with localized clear cell renal cell carcinomas who were surgically treated between 1990 and 2008 in our institution and matched them with nondiabetic patients. Our main findings were that, after controlling for major confounders such as age, sex, type of surgery, renal function, smoking status, performance status, and tumor grade and stage, diabetic patients had inferior overall survival than nondiabetic patients. Furthermore, among patients with clear cell carcinoma, diabetic patients also had shorter cancer-specific survival, suggesting that diabetes is a poor prognostic factor for patients with surgically treated renal cell carcinoma. (more…)
Author Interviews, Diabetes, Diabetologia, Weight Research / 17.05.2014

Hana Kahleova, MD, PhD Diabetes Centre, Institute for Clinical and Experimental Medicine 140 21 Prague Czech RepublicMedicalResearch.com Interview with: Hana Kahleova, MD, PhD Diabetes Centre, Institute for Clinical and Experimental Medicine 140 21 Prague Czech Republic MedicalResearch: What was the aim of your study? Dr. Kahleova: 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. MedicalResearch: What are the main findings of the study? Dr. Kahleova: Comparison of the effect of six vs. two meals (breakfast and lunch) with the same daily caloric restriction (-500 kcal/day) and macronutrient content, each regimen lasting 12 weeks, demonstrated a superior effect of breakfast and lunch on body weight, hepatic fat content, fasting plasma glucose, C-peptide, glucagon and insulin sensitivity. (more…)
Author Interviews, Diabetes, Diabetologia, Exercise - Fitness, Sugar / 14.05.2014

MedicalResearch Interview with: Monique Francois Teaching Fellow & Research Assistant at the University of Otago School of Physical Education, Sport and Exercise Sciences University of Otago Dunedin, New Zealand MedicalResearch: What are the main findings of the study? Answer: We found that small 'snacks' of interval exercise before the three main meals lowered postprandial blood glucose and contributed to a lower blood glucose across the day. Whereas 30 minutes of continuous moderate exercise before dinner did not lower postprandial blood glucose nor mean glucose levels the exercise day or the following day, compared to exercise snacking. Six one minute intervals as walking or a combination of walking and resistance 3x per day (before the three main meals) improved glycaemic control in individuals with insulin resistance. (more…)
Author Interviews, Diabetes, Heart Disease, Karolinski Institute, Lancet / 14.05.2014

MedicalResearch.com Interview with: Viveca Ritsinger MD Karolinska Institute, Department of Medicine, Cardiology Unit, Karolinska University Hospital, Stockholm Unit for Research and Development Kronoberg County Council, Växjö, Sweden MedicalResearch: What are the main findings of the study? Dr. Ritsinger: This is a long-term follow-up of the Swedish DIGAMI 1 study where patients with acute myocardial infarction and diabetes were randomized to either intensified insulin-based glycaemic control or to standard glucose lowering treatment. Patients and controls were followed for mortality for over 20 years and 90% of the patients died during follow up. Survival improved during a period of about 8 years. Intensified insulin-based glycaemic control increased survival time by an average of 2.3 years. (more…)
Author Interviews, Diabetes, JAMA, Pediatrics / 06.05.2014

Dana Dabelea, MD, PhD Professor and Associate Dean, Faculty Affairs Colorado School of Public Health University of Colorado Denver Aurora, CO 80045MedicalResearch.com Interview with:  Dana Dabelea, MD, PhD Professor and Associate Dean, Faculty Affairs Colorado School of Public Health University of Colorado Denver Aurora, CO 80045 MedicalResearch.com: What are the main findings of the study? Dr. Dabelea: We found that the proportion of US youth living with Type 1 Diabetes has increased by at least 21% over a period of only 8 years. This increase was seen in both boys and girls, most age-groups and race/ethnic groups.  While we do not completely understand the reasons for this increase, since the causes of Type 1 Diabetes are still unclear, it is likely that something has changed in our environment- both in the US and elsewhere in the world- causing more youth to develop the disease, maybe at increasingly younger ages. (more…)
Author Interviews, Coffee, Diabetes, Diabetologia / 04.05.2014

Dr. Frank B. Hu MD MPH PhD Professor of Nutrition and Epidemiology From the Departments of Nutrition and Epidemiology Harvard School of Public Health, Boston, MAMedicalResearch.com Interview with: Dr. Frank B. Hu MD MPH PhD Professor of Nutrition and Epidemiology From the Departments of Nutrition and Epidemiology Harvard School of Public Health, Boston, MA   MedicalResearch.com: What are the main findings of the study? Dr. Hu: We found that people who increased the amount of coffee they drank each day by more than one cup over a four-year period had a 11% lower risk for type 2 diabetes than those who made no changes to their coffee consumption, but those who decreased their coffee consumption by more than a cup per day increased their type 2 diabetes risk by 17%. (more…)
Author Interviews, Diabetes, Diabetes Care, Mental Health Research / 02.05.2014

Marianna Virtanen Finnish Institute of Occupational Health Helsinki, FinlandMedicalResearch.com Interview with: Marianna Virtanen PhD Finnish Institute of Occupational Health Helsinki, Finland MedicalResearch: What are the main findings of the study? Dr. Virtanen: We examined whether psychological distress predicts incident type 2 diabetes and if the association differs between populations at higher or lower risk of type 2 diabetes. We used a clinical type 2 diabetes risk score to assess future diabetes risk and in addition, participants’ prediabetes status. We found that psychological distress did not predict future type 2 diabetes among participants who were normoglycemic and among those with prediabetes combined with a low diabetes risk score. However, psychological distress doubled the risk of type 2 diabetes among participants with prediabetes and a high diabetes risk score. (more…)
Author Interviews, Diabetes, Lancet / 30.04.2014

Prof. Paul E O'Brien Centre for Obesity Research and Education Monash University Melbourne, AustraliaMedicalResearch.com Interview with: Prof. Paul E O'Brien Centre for Obesity Research and Education Monash University Melbourne, Australia   MedicalResearch.com: What are the main findings of the study? Prof. O'Brien: Using a randomised trial format we compared the diabetes status at two years after a program of multidisciplinary diabetes care (MDC) alone or with the addition of a Lap-Band procedure in 50 people who were overweight (BMI 25-30) and with diabetes. 52% of the Lap-Band group had remission of their diabetes as measured by glucose tolerance testing compared to 8% in the multidisciplinary diabetes care group. The Lap-Band procedures were performed as outpatients with a 2-3 hr length of stay. There were no perioperative adverse events. The surgical group had lost a mean of 11.5kg in weight. The incremental cost effectiveness ratio (ICER) for remission of diabetes was AUD $20,700. (more…)
Author Interviews, Cost of Health Care, Diabetes, JAMA / 28.04.2014

Juliana C. N. Chan, MBChB MD FHKAM FRCP Professor Juliana Chan is Professor of Medicine and Therapeutics, Director, Hong Kong Institute of Diabetes and Obesity and International Diabetes Federation Centre of Education at the Chinese University of Hong Kong, Prince of Wales Hospital and Chief Executive Officer of Asia Diabetes Foundation Hong Kong.MedicalResearch.com Interview with: Juliana C. N. Chan, MBChB MD FHKAM FRCP Professor Juliana Chan is Professor of Medicine and Therapeutics, Director, Hong Kong Institute of Diabetes and Obesity and International Diabetes Federation Centre of Education at the Chinese University of Hong Kong, Prince of Wales Hospital and Chief Executive Officer of Asia Diabetes Foundation Hong Kong. MedicalResearch.com: What are the main findings of the study? Dr. Chan: In this 1-year randomized study, we asked the question whether type 2 diabetic patients receiving team-based integrated care augmented by information technology would further improve in their glycemic control if given additional peer support through the telephone. All patients underwent comprehensive risk assessment guided by the web-based JADE portal which generated personalized risk report with attained treatment targets and decision support. After 1 year, all patients improved significantly in all risk factors including A1c with improved treatment adherence, self efficacy and psychological wellbeing. Although the peer support group did not further improve in A1c, short-stay hospitalization rates were substantially reduced by 50% , especially amongst those with emotional distress. These patients accounted for 20% of the intervention group, in whom peer support further reduced psychological distress and treatment non-adherence. (more…)
Author Interviews, Diabetes, Heart Disease / 24.04.2014

Prof. Simon R. Heller Professor of Clinical Diabetes Department of Human Metabolism University of Sheffield, Sheffield, U.K.MedicalResearch.com Interview with: Prof. Simon R. Heller Professor of Clinical Diabetes Department of Human Metabolism University of Sheffield, Sheffield, U.K. MedicalResearch.com: What are the main findings of the study? Prof. Heller: We explored the potential to hypoglycaemia to cause cardiac arrhythmias since we have previously shown that a low glucose can alter the electrocardiogram.  We had a hypothesis that alterations in heart rhythm or ectopic beats might contribute to cardiac mortality and in part explain the association between intensive diabetic therapy and increased mortality.  We therefore undertook continuous glucose monitoring and 12 lead EKG monitoring for a period of 5 days in individuals with Type 2 diabetes at increased CV risk.  We found that hypoglycaemia was fairly common and that nocturnal episodes in particular, were generally marked by a pattern whereby glucose levels dropped to low levels for some hours during which patients slept.  These periods of hypoglycemia were associated with a high risk of marked slow heart rates (bradycardia) accompanied by ectopic beats.  Our data suggest that this was due to overactivity of the vagus nerve.  We have therefore identified a mechanism which might contribute to increased mortality in individuals with Type 2 diabetes and high CV risk during intensive insulin therapy. (more…)
Author Interviews, CDC, Cost of Health Care, Diabetes, Diabetes Care / 08.04.2014

MedicalResearch.com Interview with: Dr. Rui Li Division of Diabetes Translation Centers for Disease Control and Prevention Atlanta, GA MedicalResearch.com: What are the main findings of the study? Answer: The proportion of people with diabetes facing high out-of-pocket (OOP) burden declined between 2001 and 2011. Although insurance and income related disparities have declined, almost one-fourth of all people with diabetes still face a high out-of-pocket burden. (more…)
Author Interviews, Diabetes, Diabetes Care, Ophthalmology / 06.04.2014

Massimo Porta, MD PhD Professor of Medicine Head, Unit of Internal Medicine 1 Department of Medical Sciences  University of TurinMedicalResearch.com Interview with: Massimo Porta, MD PhD Professor of Medicine Head, Unit of Internal Medicine 1 Department of Medical Sciences  University of Turin MedicalResearch.com: What are the main findings of the study? Dr. Porta: Type 2 diabetes has a slow, insidious onset and may remain undiagnosed for several years, during which complications may arise and progress. As a result, many patients already have retinopathy at the time a clinical diagnosis is finally made. Previous attempts at estimating the duration of this period of "hidden" diabetes relied upon  extrapolations of a linear correlation between known duration of diabetes and prevalence of retinopathy. This led to overestimates, because: a) the best fitting correlation may not be linear, b) series included insulin treated patients, who might have late-onset type 1 diabetes, c) patients with any mild retinopathy were included whereas we now know that up to 10% of non diabetic individuals may have minimal retinal signs. By taking these variables into account, ie including only patients not on insulin and with moderate or more severe retinopathy and applying different mathematical models, we ended up with an estimated duration preceding diagnosis of type 2 diabetes of 4-6 years, against longer than 13 years using "standard" criteria. (more…)
Author Interviews, Diabetes, General Medicine, Lancet, Lifestyle & Health / 04.04.2014

Prof Guangwei Li MD Department of Endocrinology China-Japan Friendship Hospital Center of Endocrinology and Cardiovascular Disease, National Center of Cardiology & Fuwai Hospital, Beijing, ChinaMedicalResearch.com Interview with: Prof Guangwei Li MD Department of Endocrinology China-Japan Friendship Hospital Center of Endocrinology and Cardiovascular Disease, National Center of Cardiology & Fuwai Hospital, Beijing, China MedicalResearch.com: What are the main findings of the study? Answer: Our study first shows that a six-year period of lifestyle intervention in Chinese people with IGT reduced the incidence of diabetes over a protracted time period and was ultimately associated with a significant reduction in total and cardio-vascular disease mortality. This reduction in mortality appears to be mediated in part by the delay in onset of diabetes resulting from the lifestyle interventions. (more…)
Alzheimer's - Dementia, Author Interviews, Diabetes, Mental Health Research, NIH, University of Pittsburgh / 01.04.2014

Rosebud O Roberts, M.B., Ch.B. Professor of Epidemiology Professor of Neurology Mayo ClinicMedicalResearch.com Interview with: Rosebud O Roberts, M.B., Ch.B. Professor of Epidemiology Professor of Neurology Mayo Clinic MedicalResearch.com: What are the main findings of the study? Dr. Roberts: We found that among persons 70 years and older, people with type 2 diabetes had a reduced glucose uptake (hypometabolism) in  brain cells.  We also found a similar association for people without type 2 diabetes but who had elevated hemoglobin A1c levels levels at the time of enrollment (HBA1c is a measure of glucose control, and represents the average blood glucose levels over a 3 month period). However, we did not find an association of diabetes with increased brain amyloid accumulation.  Our findings were based on an investigation of the association of type 2 diabetes with markers of brain pathology: brain hypometabolism was assessed by 18F-fluorodeoxyglucose positron emission tomography [PET] and amyloid accumulation was assessed by 11-C Pittsburgh Compound B PET imaging. (more…)
Diabetes, Diabetes Care, Mental Health Research / 31.03.2014

MedicalResearch.com Interview with: Gao-Jun Teng, MD Chair and Professor, Dept of Radiology Zhongda Hospital, Southeast University Nanjing 210009, China MedicalResearch.com: What are the main findings of the study? Answer: This current study demonstrates that the aberrant resting-state functional connectivity among default mode network (DMN) regions, especially the posterior cingulated cortex (PCC) to right middle temporal gyrus (MTG), is associated with insulin resistance and cognitive performance, which might be the key to understanding the cognitive impairment in type 2 diabetes (T2DM). (more…)
Author Interviews, Diabetes, Kidney Disease / 30.03.2014

Dr. Paolo Fiorina, MD PhD Assistant Professor, Division of Nephrology, Harvard Medical SchoolMedicalResearch.com Interview with: Dr. Paolo Fiorina, MD PhD Assistant Professor, Division of Nephrology, Harvard Medical School and Dr. Roberto Bassi Post-doctoral research fellow Nephrology Department at Children's Hospital Boston. Dr. Roberto Bassi Post-doctoral research fellow Nephrology Department at Children's Hospital Boston.   MedicalResearch.com: What are the main findings of the study? Dr. Fiorina: It is common knowledge that type 2 diabetes is a worldwide epidemic and that diabetic nephropathy has become the leading cause of renal failure in the western world. One of the main drivers and worsening factors for the diabetic kidney disease is proteinuria associated with various degrees of tubular damage, and unfortunately, therapies to halt or prevent this complication are not available so far. Our findings show that B7-1 when expressed on podocytes (a specific subset of renal cells) determines alterations in podocytes function and morphology, predisposing individuals with T2D to the loss of proteins into the urine. We also demonstrate that Abatacept, an immunomodulatory drug currently employed for the treatment of a variety of autoimmune diseases, is able to specifically target this malignant pathway, preventing podocytes cellular alterations in vitro and proteinuria development in two murine models of diabetic nephropathy in vivo. (more…)
Author Interviews, Diabetes, Diabetes Care, NIH / 28.03.2014

Michael Laxy Helmholtz Zentrum München German Research Center for Environmental Health Institute of Health Economics and Health Care Management Neuherberg, GermanyMedicalResearch.com Interview with: Michael Laxy Helmholtz Zentrum München German Research Center for Environmental Health Institute of Health Economics and Health Care Management Neuherberg, Germany MedicalResearch.com: What are the main findings of the study? Answer: In patients with type 2 diabetes a high level of self-management behavior was associated with a better glycemic control, i.e. a lower HbA1c level, in the cross-sectional perspective and a reduced mortality over a 12-year period. This effect remained robust after controlling for socio-demographic and disease related factors, including medication. (more…)
Author Interviews, Diabetes, Mayo Clinic, Neurology / 20.03.2014

Rosebud O Roberts, M.B., Ch.B. Professor of Epidemiology Professor of Neurology Mayo ClinicMedicalResearch.com Interview with: Rosebud O Roberts, M.B., Ch.B. Professor of Epidemiology Professor of Neurology Mayo Clinic   MedicalResearch.com: What are the main findings of the study? Dr. Roberts: The onset of type two diabetes in midlife (before age 65 years)  is associated with brain pathology (subcortical brain infarctions, reduced hippocampal volume, reduced whole brain volume) in late-life. Early onset of diabetes also increases the risk of developing mild cognitive impairment  which is an intermediate stage between normal cognitive aging and dementia. Our findings suggest that loss of brain volumes may be an intermediate stage or a link between diabetes and cognitive impairment. We also found that diabetes onset in late-life (after age 65 years), is also associated with brain pathology (cortical infarctions, reduced whole brain volume). Finally, onset of hypertension in midlife, but not late-life, is associated with brain pathology in late- life. (more…)
Author Interviews, Diabetes, Diabetes Care, FDA, Pharmacology / 20.03.2014

Christian Hampp PhD Senior Staff Fellow/Epidemiologist at FDA Division of Epidemiology-I, Office of Pharmacovigilance and Epidemiology, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MDMedicalResearch.com Interview with: Christian Hampp PhD Senior Staff Fellow/Epidemiologist at FDA Office of Pharmacovigilance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD MedicalResearch.com: What are the main findings of the study? Dr. Hampp: Our study described U.S. market trends for antidiabetic drugs, focusing on newly approved drugs, concomitant use of antidiabetic drugs, and effects of safety concerns and restrictions on thiazolidinedione use. We found that since 2003, the number of adult antidiabetic drug users increased by approximately 43% to 18.8 million in 2012.  During 2012, 154.5 million prescriptions for antidiabetic drugs were filled in outpatient retail pharmacies.  Since 2003, metformin use increased by 97% to 60.4 million prescriptions dispensed in 2012.  Among antidiabetic drugs newly approved for marketing between 2003 and 2012, the dipeptidyl-peptidase-4 (DPP-4) inhibitor sitagliptin had the largest share with 10.5 million prescriptions in 2012. Possibly triggered by safety concerns, the use of pioglitazone declined in 2012 to approximately 52% of its peak in 2008, when 14.2 million prescriptions were dispensed in outpatient retail pharmacies and the use of rosiglitazone use decreased to fewer than 13,000 prescriptions dispensed in retail or mail-order pharmacies in 2012. (more…)
AHA Journals, Author Interviews, Diabetes, Heart Disease, OBGYNE / 18.03.2014

Erica P. Gunderson, PhD, MS, MPH Senior Research Scientist, Cardiovascular and Metabolic Section Division of Research, Kaiser Permanente Northern California Oakland, CA 94612-2304MedicalResearch.com Interview with: Erica P. Gunderson, PhD, MS, MPH Senior Research Scientist, Cardiovascular and Metabolic Section Division of Research, Kaiser Permanente Northern California Oakland, CA 94612-2304 MedicalResearch.com: What are the main findings of the study? Dr. Gunderson: The study found that: -   Gestational diabetes is a pregnancy complication that reveals a woman’s greater risk of future heart disease. -   Women who experience gestational diabetes face an increased risk of subclinical atherosclerosis (early heart disease) even if they do not develop type 2 diabetes or the metabolic syndrome years after pregnancy. -   Study participants with a history of gestational diabetes who did not develop diabetes or metabolic syndrome showed a greater carotid artery wall thickness (marker of early atherosclerosis) compared to those who never experienced gestational diabetes.  The vessel narrowing also could not be attributed to obesity or other risk factors for heart disease that were measured before pregnancy. -   Weight gain and blood pressure elevations in women with gestational diabetes were responsible for these differences in the artery wall thickness. (more…)
Compliance, Diabetes, Diabetes Care, Vanderbilt / 15.03.2014

Chandra Y. Osborn, PhD, MPH Assistant Professor of Medicine & Biomedical Informatics Division of General Internal Medicine & Public Health Center for Health Services Research Vanderbilt University Medical Center  Nashville, TN 37232-8300MedicalResearch.com Interview with: Chandra Y. Osborn, PhD, MPH Assistant Professor of Medicine & Biomedical Informatics Division of General Internal Medicine & Public Health Center for Health Services Research Vanderbilt University Medical Center Nashville, TN 37232-8300 MedicalResearch.com: What are the main findings of your study? Dr. Osborn:  We found that knowing how to take your diabetes medications (e.g., what to do if a dose is missed), believing medications are good for you, and having the appropriate skills to take them regardless of the situation (e.g., when life is busy, when in public) accounts for 41% of why people successfully take their diabetes medications, which, in turn, explains 9% of their glycemic control. (more…)
Author Interviews, Biomarkers, Diabetes, Diabetologia, Kidney Disease / 14.03.2014

Prof Samy Hadjadj: Université de Poitiers, UFR Médecine Pharmacie, Centre d’Investigation clinique, CHU de Poitiers, Centre d’Investigation clinique, Poitiers, FranceMedicalResearch.com Interview with: Prof Samy Hadjadj: Université de Poitiers, UFR Médecine Pharmacie, Centre d’Investigation clinique, CHU de Poitiers, Centre d’Investigation clinique, Poitiers, France MedicalResearch.com: What are the main findings of the study? Prof: Hadjadj: The study helps to establish sTNFR1 as a valid biomarker not only for renal outcomes in type 2 diabetes but also for all cause death. Interestingly the addition of sTNFR1 concentration to the UKPDS model outcome equation showed to add some clinical prognostic value to this model for all-cause death. (more…)
Author Interviews, Diabetes, Emergency Care, JAMA / 11.03.2014

Andrew I. Geller, MD Medical Officer in the Division of Healthcare Quality Promotion at CDC.MedicalResearch.com Interview with: Andrew I. Geller, MD Medical Officer in the Division of Healthcare Quality Promotion at CDC. MedicalResearch.com: What are the main findings of the study? Dr. Geller: Using CDC’s national medication safety monitoring system, we estimated that, each year, there were about 100,000 visits made to U.S. emergency departments (EDs) for insulin-related hypoglycemia and errors during 2007-2011, or about half a million ED visits over the 5-year study period.  This is important because many of these ED visits for insulin-related hypoglycemia may be preventable. We also found these ED visits were more common with increasing age:  every year, 1 in 49 insulin-treated seniors (aged 65 years or older) visited the ED because of hypoglycemia while on insulin or because of a medication error related to insulin. Among the very elderly (aged 80 years or older), this number was 1 in 8 annually. (more…)