Diabetes
02 Oct Medicare Part D Spent $22 Billion on Diabetes Medications in 2017
Posted at 23:11h
in Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Diabetes, JAMA
MedicalResearch.com Interview with:
[caption id="attachment_51730" align="alignleft" width="200"] Dr. Sumarsono[/caption]
Andrew Sumarsono, MD
UT Southwestern Medical Center
MedicalResearch.com: What is the background for this study?
Response: There are currently 12 types of medications used to treat type 2 diabetes. With approximately 30 million adults living with diabetes in the United States, the rising cost of insulin has raised concerns about the affordability of diabetes care.
We evaluated trends in total spending and number of prescriptions of all diabetes therapies among Medicare Part D beneficiaries between 2012 and 2017.
28 Sep Study Finds Need For Increased Diabetes Screening in Rural Communities
MedicalResearch.com Interview with:Phoebe Tran
Doctoral Student
Department of Chronic Disease Epidemiology
Yale School of Medicine
MedicalResearch.com: What is the background for this study?
Response: As the prevalence of diabetes risk factors such as obesity, high blood pressure, high cholesterol, and physical inactivity are considerably higher in US individuals residing in rural areas compared to their urban counterparts, rural residents face increased risk of developing diabetes. Diabetes screening is a useful tool that can be used to identify people with newly developed type 2 diabetes and offer them early treatment. In this study, we examined whether there are differences in diabetes screening levels between rural and urban areas across the US using nationally representative survey data from 2011, 2013, 2015, and 2017.
23 Sep Almost 2 Million Diabetics Gained Health Insurance Under Affordable Care Act
MedicalResearch.com Interview with: [caption id="attachment_51566" align="alignleft" width="133"] Dr. Myerson[/caption]
Rebecca Myerson, PhD
Assistant Professor, Population Health Sciences
School of Medicine and Public Health
University of Wisconsin, Madison
MedicalResearch.com: What is the background for this study?
Response: Many people with diabetes are undiagnosed, and those who are diagnosed often are untreated and uncontrolled. Increasing access to health insurance for patients with health care needs was a goal of the Affordable Care Act.
We analyzed information from 11 years of the National Health and Nutrition Examination Survey, which gathers data that are nationally representative of the civilian population. The biennial survey includes biomarkers, including HbA1c, a measure of blood-sugar control. Using the NHANES data allowed the researchers to identify those with undiagnosed diabetes.
18 Sep How Do Puberty, Menopause and BCPs Affect Risk of Diabetes?
MedicalResearch.com Interview with:Dr Sopio Tatulashvili
Avicenne Hospital
Bobigny, France
MedicalResearch.com: What is the background for this study?
Response: Diabetes and pre-diabetes are associated with increased cardiovascular morbidity and mortality. Early screening and the treatment of glucose metabolism disorders could lower the risk of further complications. Furthermore, type 2 diabetes can be prevented. For this purpose, it is of major importance to better identify the risk factors of type 2 diabetes. Hormonal factors are increasingly suspected to play a role in the etiology of type 2 diabetes. The aim of this study was to determine the associations between various hormonal factors and the risk of incident type 2 diabetes in the large prospective female E3N (Etude Épidémiologique de Femmes de la Mutuelle Générale de L’Education Nationale) cohort study. Based on a very detailed set of information available in 83,799 women from the large prospective E3N cohort study followed for 22 years, we have been able to clarify the relationships between various hormonal factors and type 2 diabetes risk.
10 Sep SGLT2 Inhibitors Reduced Risk of Heart Failure Hospitalization in Patients with Type 2 Diabetes
Posted at 22:09h
in AstraZeneca, Author Interviews, Brigham & Women's - Harvard, Diabetes, Heart Disease
MedicalResearch.com Interview with:
[caption id="attachment_51229" align="alignleft" width="200"] Dr. David Berg[/caption]
Dr. David Berg MD
Senior Fellow in Cardiovascular Medicine and
Critical Care Medicine
Brigham and Women’s Hospital
Postdoctoral Research Fellow with the TIMI Study Group.
MedicalResearch.com: What is the background for this study?
Response: Heart failure is a frequent and important complication of type 2 diabetes mellitus (T2DM), but there are limited tools for identifying which patients with T2DM are at the highest risk of developing heart failure.
In this study, we developed and validated the TIMI Risk Score for Heart Failure in Diabetes [TRS-HF(DM)], a novel clinical risk score that identifies patients with T2DM who are at heightened risk for hospitalization due to heart failure.
Fortunately, the risk score also identifies patients who have the greatest absolute reduction in the risk of hospitalization for heart failure with a new class of glucose-lowering therapies called sodium-glucose cotransporter-2 (SGLT2) inhibitors.
08 Sep THEMIS-PCI Trial: Ticagrelor in Patients with Diabetes and Stable CAD with History of PCI
Posted at 00:30h
in Author Interviews, Brigham & Women's - Harvard, Clots - Coagulation, Diabetes, Heart Disease, Lancet
MedicalResearch.com Interview with:
[caption id="attachment_51192" align="alignleft" width="133"] Dr. Deepak L. Bhatt[/caption]
Deepak L. Bhatt, MD, MPH, FACC, FAHA, FSCAI, FESC
Professor of Medicine, Harvard Medical School
Executive Director of Interventional Cardiovascular Programs,
Brigham and Women’s Hospital Heart & Vascular Center
MedicalResearch.com: What is the background for this study?
Response: Dual antiplatelet therapy (DAPT) is known to improve outcomes in patients with acute coronary syndromes (ACS), prior myocardial infarction (MI), or recent coronary stenting. What was unknown is whether patients with diabetes and stable coronary artery disease – a group generally believed to be at high ischemic risk – would benefit from initiation of long-term DAPT with low-dose aspirin plus ticagrelor versus low-dose aspirin (plus placebo). This is what THEMIS was designed to test, with THEMIS-PCI designed prospectively to examine those patients specifically who had a history of previous percutaneous coronary intervention (PCI).
06 Sep Post-MI Infarction in Patients with Diabetes: HealthCare Resource Use and Clinical Outcomes
MedicalResearch.com Interview with: [caption id="attachment_51176" align="alignleft" width="200"] Dr. Nicolau[/caption]
Jose Carlos Nicolau, MD PhD
Heart Institute
University of Sao Paulo Medical School,
Sao Paulo, Brazil
MedicalResearch.com: What is the background for this study?
Response: There are few evidence about the late phase (1-3 years) of patients with diabetes and myocardial infarction, especially regarding quality of life (qol) and health resource utilization. Our study showed that the population with diabetes (dm), compared with the population without diabetes, have worse quality of life, more hospitalizations, and when hospitalized showed a longer hospital stay. Additionally, as expected, dm population have worse outcomes, including the composite of cv death, myocardial infarction or stroke, and all-cause death.
06 Sep Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure
MedicalResearch.com Interview with: [caption id="attachment_51168" align="alignleft" width="136"] Prof. John McMurray[/caption]
Prof. John McMurray
Professor of Cardiology
Institute of Cardiovascular & Medical Sciences
University of Glasgow
MedicalResearch.com: What is the background for this study?
Response: SGLT2 inhibitors prevent the development of heart failure (HF) in patients with type 2 diabetes (T2D) – can they be used to treat patients with established heart failure? Also, although introduced as a glucose-lowering treatment for T2D, experimental evidence suggests these drugs may have non-glucose mediated benefits. So, might they be a treatment for HF even in patients without diabetes?
06 Sep Diabetes and Heart Failure After Acute Myocardial Infarction: The FAST-MI Programme
MedicalResearch.com Interview with: [caption id="attachment_51165" align="alignleft" width="200"] Prof. Danchin[/caption]
Nicolas Danchin MD, FESC
Professor of Medicine, Consultant Cardiologist
Intensive Cardiac Care Unit
Hôpital Européen Georges Pompidou
Paris, France
MedicalResearch.com: What is the background for this study?
Response: FAST-MI is a programme of nationwide French surveys, carried out every 5 years in France since 2005 in patients hospitalised with STEMI or NSTEMI. Patients are included consecutively for one month and 10-year follow-up is organized. We can thus analyse patients' outcomes in relation with their profile. Knowing that diabetic patients represent a large proportion of patients with AMI, we thought it would be worthwhile determining whether they suffered specific complications, and in particular, heart failure, both at the acute stage and in the subsequent months.
06 Sep Bacterial Microbiome Could Enhance Effects of Metformin
MedicalResearch.com Interview with:Prof. Dr. Christoph Kaleta
Institute for Experimental Medicine
Institute for Experimental Medicine, Kiel University
Kiel, Germany
MedicalResearch.com: What is the background for this study?
Response: Even though Metformin is the first-line treatment option in type-2 diabetic patients, its specific mechanism of action has remained elusive so far. Moreover, metformin is of particular interest as an anti-aging drug since it's usage has been shown to be associated with a lower incidence of several aging diseases in type-2 diabetic patients taking metformin when compared to matched healthy controls.
While previous work was able to show pronounced changes in the microbiota of patients taking metformin and a health-promoting effect of metformin-adapted microbiota, how this beneficial effect could be mediated has remained unclear.
23 Aug Omega-3 Supplements Did Not Protect Agains Diabetes
MedicalResearch.com Interview with: [caption id="attachment_50975" align="alignleft" width="133"]
Dr. Hooper[/caption]
Lee Hooper PhD, RD
Reader in Research Synthesis, Nutrition & Hydration
Norwich Medical School
University of East Anglia
England, UK
MedicalResearch.com: What is the background for this study?
Response: The World Health Organization asked us to carry out a set of studies (systematic reviews of randomised controlled trials) assessing health effects of omega-3 and omega-6, which are polyunsaturated fats. This is because the WHO are planning to update their dietary guidance on fats in the near future.
Worries about effects of long chain omega-3 on control of diabetes have long existed, and some experimental studies have suggested that omega-3 supplementation and diets high in PUFA and omega-3 raise fasting glucose. Pollutants such as methylmercury and polychlorinated biphenyl levels exceeding recommended thresholds are rarer now, but have been reported in seafoods and fish oil supplements; elevated mercury levels interrupt insulin signalling, raising fasting glucose, in mouse models. Body concentrations of organic pollutants are correlated with prevalence of diabetes in the US, but other cross sectional studies have suggested either no association with or benefits of eating fish on glycaemic control. Systematic reviews of observational studies have suggested both positive and negative associations with glucose metabolism, but strong evidence shows that omega-3 supplements reduce raised triglycerides and have little or no effect on body weight. Theories suggest that omega-3 and omega-6 fats compete in some metabolic pathways so that the omega-3/omega-6 ratio is more important than absolute intakes of either.
21 Aug Meaningful PTSD Improvement Associated with Lower Risk of Diabetes
MedicalResearch.com Interview with: [caption id="attachment_50945" align="alignleft" width="174"] Dr. Jeff Scherrer[/caption]
Jeff Scherrer, Ph.D.
Associate professor; Research director
Department of Family and Community Medicine
Saint Louis University Center for Health Outcomes Research
MedicalResearch.com: What is the background for this study?
Response: This study was part of a larger NIH grant to determine if PTSD is associated with poor health behaviors and subsequently whether PTSD remains an independent risk factor for diabetes and heart disease. Our second focus of the grant was to measure if those patients who experience clinically meaningful PTSD improvement have improved health behaviors (e.g. seeking help to lose weight) and a lower risk for diabetes and heart disease.
The rationale for this study of PTSD improvement and lower risk for diabetes is supported from other investigators' findings that PTSD treatment completion is often followed by improvement in sleep, depression, pain and general physical complaints and lower blood pressure. Because we have found the association between PTSD and incident diabetes is largely explained by obesity, depression and other comorbid conditions that are more common in patients with vs. without PTSD, we hypothesized that improvements in PTSD would be associated with lower risk of diabetes either directly or due to improvements in these comorbid diabetes risk factors.
12 Aug Fewer Than 25% of Diabetics Achieve ADA Diabetes Care Goals
MedicalResearch.com Interview with: [caption id="attachment_50615" align="alignleft" width="180"] Dr. Kazemian[/caption]
Pooyan Kazemian, Ph.D.
Instructor in Medicine
Massachusetts General Hospital
MedicalResearch.com: What is the background for this study?
Response: Advances in diabetes care can meaningfully improve outcomes only if they effectively reach the populations at risk. However, it is not known if recent innovations in diabetes treatment and care models have reached the United States population at risk.
09 Jul Type 1 Diabetes in Children Alters Brain Growth and Function
MedicalResearch.com Interview with: [caption id="attachment_50178" align="alignleft" width="150"] Dr. Mauras[/caption]
Nelly Mauras, MD
Chief, Division of Pediatric Endocrinology,
Nemours Children’s Health System
Professor of Pediatrics
Mayo College of Medicine
MedicalResearch.com: What is the background for this study?
Response: Keeping blood sugars close to normal in young children with diabetes is often limited by parental fears of the risks of low blood sugars and impaired cognitive development. Dr. Nelly Mauras, at the Nemours Children’s Health System in Jacksonville FL, along with Dr. Allan Reiss at Stanford University are co-principal investigators of the Diabetes Research in Children Network, a 5-center consortium performing studies in children with diabetes, also including the University of Iowa, Washington University St Louis and Yale University.
The investigators recruited 144 children with type 1 diabetes who were 4-7 years old and performed brain imaging (MRIs), did special cognitive tests, and monitored blood sugars using continuous glucose monitors. These studies were repeated after 18 months, approximately 54 months and 74 months, to examine changes in the brain and compare the results with those of 70 children the same age who do not have diabetes.
09 Jul What Accounts for Increase in National Spending on Antidiabetic Drugs?
MedicalResearch.com Interview with: Xiaohui Zhuo, PhD Division of Diabetes Translation National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention, Atlanta, GA MedicalResearch.com: What is the background for this study? Response: Prescription drug spending (spending from families and individuals, their medical providers (doctors, hospitals, pharmacies, etc.) and employees across the United States) has increased at a much higher rater than other components of the total medical expenditure associated with diabetes. The share of spending on prescription drugs in per capita annual excess expenditure due to diabetes increased from 27% to 41% between 1987 and 2011, according to a previous study using national data from the Agency for Healthcare Research and Quality Medical Expenditures Panel Surveys. In this most recent study, CDC researchers estimated the increase in the national spending on antidiabetic drugs from 2005 to 2016 in total and by drug class and broke down the increase in total national spending by examining what factors have contributed to the increase estimating the magnitude of each factor’s contribution.
25 Jun Statins May Double Risk of Diabetes
Individuals who used statins for the longest period of time (more than 2 years) had an even greater risk (3 times greater) for developing type 2 diabetes mellitus, after adjusting for confounding factors....
24 Jun FARXIGA (dapagliflozin) Reduced Kidney Function Decline in Type II Diabetes
MedicalResearch.com Interview with: [caption id="attachment_49957" align="alignleft" width="200"] Dr. Khan[/caption]
Naeem Khan MD
Vice President at AstraZeneca
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A pre-specified exploratory analysis of renal data from the DECLARE-TIMI 58 trial, the largest SGLT-2 inhibitor (SGLT-2i) cardiovascular outcomes trial (CVOT) conducted to date, showed that FARXIGA (dapagliflozin) reduced the composite of kidney function decline, end-stage renal disease (ESRD) or renal death by 47% in patients with type 2 diabetes (T2D).
Additionally, FARXIGA reduced the relative risk of a cardio-renal composite of kidney function decline, ESRD, or renal or cardiovascular (CV) death by 24% compared to placebo.
The analysis evaluated 17,160 patients with type 2 diabetes and predominantly preserved renal function, irrespective of underlying atherosclerotic CV disease (ASCVD).
18 Jun Type 2 Diabetes More Aggressive in Youth
MedicalResearch.com Interview with: Dr. Ellen Leschek MD Program Director: Division of Diabetes, Endocrinology, and Metabolic Diseases The National Institute of Diabetes and Digestive and Kidney Diseases Health Information Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Type 2 diabetes (T2D) is thought to be characterized by a progressive loss of pancreatic beta cell (insulin producing/releasing cell) function. For this reason, T2D medications eventually stop working and individuals with T2D require treatment with insulin. The Restoring Insulin Secretion (RISE) Consortium was established by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) to evaluate the effects of treatment and treatment withdrawal on the loss of pancreatic beta cell function. In the RISE Study, progression of disease was assessed by the measurement of pancreatic beta cell function in youth and adults who had either impaired glucose tolerance (IGT; prediabetes) or recently diagnosed Type 2 diabetes before, during and after treatment with study medications. Importantly, the RISE Pediatric Medication Study and the RISE Adult Medication Study were designed in tandem to allow direct comparison of the effects of two pharmacologic treatment regimens (the only two FDA-approved medications for Type 2 diabetes in youth) on disease progression in youth and adults. For more information about the RISE Study, please visit https://rise.bsc.gwu.edu/web/rise.
16 Jun Insulin Costs Rise But Mostly Not Paid For Out-of-Pocket by Patients
The major driver for increases in average total payments for a 30-day supply of insulin were explained by increases in payments for existing products and not by changes in the market share of insulin types....
12 Jun Islet Cell Transplantation Can Give Some Diabetics Long Term Glucose Control
MedicalResearch.com Interview with: [caption id="attachment_49716" align="alignleft" width="200"] Dr. Alejandro[/caption]
Dr. Rodolfo Alejandro, MD
Professor of Medicine
University of Miami Miller School of Medicine
Co-Director of the Cell Transplant Center
Director/Attending Physician of the Clinical Cell Transplant Program
Diabetes Research Institute
www.DiabetesResearch.org
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In type 1 diabetes, the insulin-producing islets cells of the pancreas have been mistakenly destroyed by the immune system, requiring patients to manage their blood sugar levels through a daily regimen of insulin therapy. Islet transplantation has allowed some patients to live without the need for insulin injections after receiving a transplant of donor cells. Some patients who have received islet transplants have been insulin independent for more than a decade, as DRI researchers have published. Currently, islet transplantation remains an experimental procedure limited to a select group of adult patients with type 1 diabetes.Although not all subjects remain insulin independent, like the subjects described in this presentation, after an islet transplant a significant number of them continue with excellent graft function for over 10 years that allows them to have near-normal glucose metabolism in the absence of severe hypoglycemia on small doses of insulin.
In 2016, the National Institutes of Health-sponsored Clinical Islet Transplantation Consortium reported results from its Food and Drug Administration (FDA)-authorized Phase 3 multi-center trial, of which the DRI was a part, indicating that islet transplantation was effective in preventing severe hypoglycemia (low blood sugar levels), a particularly feared complication in type 1 diabetes that can lead to seizures, loss of consciousness and even death.
The study was a significant step toward making islet transplantation an approved treatment for people with type 1 diabetes and reimbursable through health insurance, as it is in several other countries around the world.
11 Jun Apple or Pear? Body Shape Not Determined Just by Fat
MedicalResearch.com Interview with: [caption id="attachment_49712" align="alignleft" width="133"]![MedicalResearch.com Interview with: Kalypso Karastergiou, MD, PhD Assistant Professor, Medicine, Endocrinology, Diabetes and Bone Disease Diabetes, Obesity and Metabolism Institute Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: Multiple studies, epidemiological as well as clinical, have established that body shape is an important and independent predictor of cardiovascular and metabolic disease risk and ultimately total mortality. Subjects that preferentially store weight in the abdominal area (often described as android, upper-body or apple-shape obesity) are at increased risk, whereas those who preferentially store weight in the lower body, in the gluteofemoral area (gynoid, lower-body or pear-shape), appear to be protected. The former is more common in men, whereas the latter in women, especially premenopausal women. The overarching questions in the field are: •What factors determine body shape? • Why are subjects with lower-body shape protected? • Can we exploit the physiological and pathophysiological mechanisms involved to improve stratification, prevention or treatment of obesity and related diseases? MedicalResearch.com: What are the main findings? Response: Up to date, studies in body shape have focused on the distribution of the adipose (fat) tissue. This report seeks to expand the investigation to other tissues as well. During the period from 1999-2006, 14,005 participants in the National Health and Nutrition Examination Survey (which represents the United States population), 20-69 years old, had a DXA test that allows total and regional estimation of fat, lean and bone tissue mass. This preliminary analysis shows that body shape is determined by coordinated changes in the head, trunk and limbs that involve the fat, as well as the other tissues. MedicalResearch.com: What should readers take away from your report? Response: This is an observational study that doesn’t allow us to draw conclusion as to cause and effect or prediction of future risk. It does suggest that body shape is a whole-body feature with systematic, coordinated changes in all body compartments and tissues. The observations should be replicated in other populations and in prospective studies. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: This report generates more questions than it answers. • First of all, are there differences in the function of tissues that determine body shape between subjects with upper- versus lower body shape? • Which tissues drive differences in physiology and disease risk? • Can we identify the underlying molecular pathways? • Does any of these pathways represent a viable mechanistic target to prevent or treat disease and improve quality of life? Dislosures The study is partly funded by grants from the MSHS Translational Science Hub at Icahn School of Medicine at Mount Sinai (KL2TR001435) and the Einstein-Sinai Diabetes Research Center in New York City. Citation: ADA 2019 abstract 277-OR: Lean Tissues as Novel Determinants of Pear vs. Apple Body Shape and Metabolic Health in Humans KALYPSO KARASTERGIOU Diabetes 2019 Jun; 68(Supplement 1): -.https://doi.org/10.2337/db19-277-OR [wysija_form id="3"] [last-modified] The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.](https://medicalresearch.com/wp-content/uploads/Dr-Kalypso-Karastergiou-1.jpg)
Dr. Karastergiou[/caption]Kalypso Karastergiou, MD, PhD
Assistant Professor, Medicine, Endocrinology, Diabetes and Bone Disease
Diabetes, Obesity and Metabolism Institute
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study?
Response: Multiple studies, epidemiological as well as clinical, have established that body shape is an important and independent predictor of cardiovascular and metabolic disease risk and ultimately total mortality. Subjects that preferentially store weight in the abdominal area (often described as android, upper-body or apple-shape obesity) are at increased risk, whereas those who preferentially store weight in the lower body, in the gluteofemoral area (gynoid, lower-body or pear-shape), appear to be protected. The former is more common in men, whereas the latter in women, especially premenopausal women.
The overarching questions in the field are:
- What factors determine body shape?
- Why are subjects with lower-body shape protected?
- Can we exploit the physiological and pathophysiological mechanisms involved to improve stratification, prevention or treatment of obesity and related diseases?
09 Jun The Vitamin D and Type 2 Diabetes Study
MedicalResearch.com Interview with: [caption id="attachment_49667" align="alignleft" width="142"] Dr. Pittas[/caption]
Anastassios G. Pittas, M.D MS
Professor
Co-Director, Diabetes and Lipid Center;
Tufts Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Observational studies have consistently reported an association between low blood vitamin D level and development of type 2 diabetes. However, whether vitamin D supplementation lowers risk of developing diabetes is not known. We designed and conducted the Vitamin D and diabetes (D2d) study to answer this question. We randomized 2,423 people with prediabetes to 4,000 IU/day of vitamin D3 or placebo and followed them for new-onset diabetes with blood tests every 6 months for an average of 2.5 years. About 80% of participants had sufficient vitamin D level at baseline (25-hydroxyvitamin D level >= 20 ng/mL). The trial was designed to show a reduction of 25% or more in diabetes risk with vitamin D.
The study was unable to show a reduction of 25% or more. At the end of the study, there was a 12% reduction in risk of developing diabetes with vitamin D, which missed statistical significance (hazard ration 0.88; 95% confidence interval 0.75 to 1.04). In a small subgroup of participants with vitamin D deficiency at baseline (25-hydroxyvitamin D level < 12 ng/mL) there was 62% reduction in risk of diabetes with vitamin D (hazard ration 0.38; 95% confidence interval 0.18 to 0.80).
09 Jun Midlife Type 2 Diabetes Mellitus Linked to Increased Risk of Ischemic Stroke
MedicalResearch.com Interview with: Rongrong Yang, PhD candidate Tianjin Medical University MedicalResearch.com: What is the background for this study? Response: Worldwide, cerebrovascular disease (CBD) and type 2 diabetes mellitus (T2DM) are common disorders that have become among the top ten leading causes of death, killing approximately 8 million people in 2016. Both T2DM and CBD are complex genetic and lifestyle-related disorders. Genetic and familial environmental factors (e.g. foetal environment, maternal smoking and childhood socioeconomic status) have been shown to be involved in the development of both conditions. Accumulating evidence from previous studies suggests that T2DM is independently associated with an increased risk of CBD, especially ischemic CBD.
20 May Teleretinal Imaging Improves Detection of Diabetic Retinopathy in Low Resource Setting
MedicalResearch.com Interview with: [caption id="attachment_49207" align="alignleft" width="150"] Mr. Thulasiraj[/caption]
Thulasiraj Ravilla
Executive Director – LAICO &
Director – Opeations
Aravind Eye Care System
Tamilnadu, India
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Diabetic Retinopathy (DR) is a visual consequence of diabetes and various other studies have reported that in India, 10% to 30% of adults with diabetes have DR, with higher rates found in older people and urban areas. Undetected DR leads to vision loss and eventually blindness. Thus early identification of DR is critical to initiate appropriate treatment to reduce the rate of vision loss.
Conventional approaches of requesting diabetologists to refer patients with diabetes to an ophthalmologist has been ineffective due to compliance issues, both by the diabetologists and the patients. Similarly screening through outreach eye camps have not been found to be effective in India and other developing countries owing to inadequate eye care resources. Teleretinal screening for Diabetic Retinopathy is increasingly being used in India. Evidence from randomized clinical trials on the benefits of teleretinal screening is limited. Whatever evidence is there are from high income countries, which often have little relevance to developing countries.
17 May FDA Approves EYLEA (aflibercept) To Treat All Stages of Diabetic Retinopathy, With Two Dosing Options
MedicalResearch.com Interview with: [caption id="attachment_38910" align="alignleft" width="300"] Illustration depicting diabetic retinopathy[/caption]
Robert L. Vitti, MD, MBA
Vice President and Head, Ophthalmology
Regeneron Pharmaceuticals
Dr. Vitti discusses the recent announcement that the FDA has approved EYLEA to treat all stages of diabetic retinopathy.
MedicalResearch.com: Can you provide additional background on this approval? Would you briefly explain diabetic retinopathy and it's impact on patients?
Response: The FDA has approved EYLEA (aflibercept) Injection to treat all stages of diabetic retinopathy (DR). DR is the leading cause of blindness among working-aged American adults. Approximately 8 million people live with DR, a complication of diabetes characterized by damage to the blood vessels in the retina (per 2010 data).
The disease generally starts as non-proliferative diabetic retinopathy (NPDR) and often has no warning signs or symptoms. Over time, NPDR often progresses to proliferative diabetic retinopathy (PDR), a stage in which abnormal blood vessels grow on the surface of the retina and into the vitreous cavity, potentially causing severe vision loss.
17 May Drivers with Diabetic Neuropathy May Need Assistance Controlling Accelerator Pedal
MedicalResearch.com Interview with:Monica Perazzolo
Research Centre for Musculoskeletal Science and Sports Medicine
School of Healthcare Science, Faculty of Science and Engineering,
Manchester Metropolitan University, Manchester, UK
Department of Biomedical and Neuromotor Sciences
University of Bologna, Bologna, Italy
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our research on motor control in diabetes focussed on the effect of diabetic peripheral neuropathy on driving. Drivers with diabetic peripheral neuropathy showed a less well controlled use of the accelerator pedal and sometimes larger, faster steering corrections needed to stay in lane when driving a simulator compared to healthy drivers and people with diabetes but no neuropathy.
Despite these negative findings, an important result is that drivers with diabetic peripheral neuropathy demonstrated an improvement in their driving with practice.
24 Apr Small Increased Risk of Diabetes with Common Drug for Prostate Enlargement
MedicalResearch.com Interview with: [caption id="attachment_48763" align="alignleft" width="128"] Dr. Andrew[/caption]
Professor Ruth Andrew PhD
Chair of Pharmaceutical Endocrinology
University/BHF Centre for Cardiovascular Science
Queen's Medical Research Institute
University of Edinburgh
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our research group has been interested for a number of years in how stress hormones (called glucocorticoids) influence the risk of heart disease and diabetes. Glucocorticoids help us control stress and regulate how the body handles its fuel, for example the carbohydrate and fat we eat. However exposure to high levels of glucocorticoids, can increase the risk of diabetes, obesity and high blood pressure.
We studied men with prostate disease who took 5α-reductase inhibitors, because over and above the beneficial actions of these drugs in the prostate, they also slow down inactivation of glucocorticoids. We had carried out some short term studies with the drugs in humans and found that they reduced the ability of insulin to regulate blood glucose. Therefore in the study we have just published in the BMJ, we examined how patients receiving these drugs long-term responded and particularly we were able to show that over an 11 year period that there was a small additional risk of developing type 2 diabetes, the type of disease common in older people, compared with other types of treatments.
23 Apr Metformin More Effective For Weight Loss Maintenance Than Lifestyle Alone
MedicalResearch.com Interview with: Kishore M. Gadde, MD, Professor Fairfax Foster Bailey Endowed Chair in Heart Disease Prevention Medical Director, Clinical Services Pennington Biomedical Research Centre Baton Rouge, LA 70808 MedicalResearch.com: What is the background for this study? Response: Around 20 years ago, the Diabetes Prevention Program, DPP, enrolled 3,234 adults with excess body weight and impaired glucose tolerance. The idea was to compare the efficacy of either an intensive lifestyle intervention or metformin relative to placebo in preventing diabetes. Over approximately 3 years, both lifestyle and metformin were effective, but lifestyle intervention was better for weight loss as well as in reducing the risk of diabetes. After the blinded treatment phase ended, the researchers continued to follow this cohort in their originally randomised groups.
18 Apr Most Diabetes Apps Do Not Provide Real Time Decision Support (yet)
MedicalResearch.com Interview with: [caption id="attachment_48552" align="alignleft" width="150"] Prof. Car[/caption]
Associate Professor Josip Car
MD, PhD, DIC, MSc, FFPH, FRCP (Edin)
Associate Professor of Health Services Outcomes Research,
Director, Health Services Outcomes Research Programme and Director
Centre for Population Health Sciences
Principal Investigator, Population Health & Living Laboratory
MedicalResearch.com: What is the background for this study?
Response: In 2018, almost 8% of people with diabetes who owned a smartphone used a diabetes app to support self-management. Currently, most apps are not regulated by the US Food and Drug Administration (FDA). We downloaded and assessed 371 diabetes self-management apps, to see if they provided evidence-based decision support and patient education.