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…)
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, Depression, Diabetes, Diabetes Care / 26.02.2014

Steven A. Safren, Ph.D., ABPP Professor of Psychology, Harvard Medical School Director, Behavioral Medicine, Department of Psychiatry Massachusetts General Hospital, Boston, MA 02114MedicalResearch.com Interview with: Steven A. Safren, Ph.D., ABPP Professor of Psychology, Harvard Medical School Director, Behavioral Medicine, Department of Psychiatry Massachusetts General Hospital, Boston, MA 02114 MedicalResearch.com: What are the main findings of the study? Dr. Safren:  The main findings of the study are that, in patients with uncontrolled type 2 diabetes and depression, a type of psychological treatment, cognitive behavioral therapy (CBT) that addressed both self-care and depression, resulted in improvements in both depressed mood, self-care, and glucose control.  This was a randomized controlled trial, and this cognitive-behavioral treatment worked better than lifestyle adherence and nutrition counseling alone; and the effects were sustained over 8 months. (more…)
Author Interviews, Diabetes, Diabetes Care, Disability Research / 26.02.2014

Barbara H. Bardenheier PHD, MPH, MA Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention Atlanta, GAMedicalResearch.com Interview with: Barbara H. Bardenheier PHD, MPH, MA Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention Atlanta, GA MedicalResearch.com: What are the main findings of the study? Dr. Bardenheier: Our main findings were that older adults who become disabled, even mildly, are at increased risk of developing diabetes. (more…)
Author Interviews, Diabetes, Diabetes Care, General Medicine, Kidney Disease / 25.02.2014

MedicalResearch.com Interview with: Eiji Ishimura, MD, PhD, FASN, FACP Osaka City University Hospital Professor,Department of Nephrology Osaka, JAPAN MedicalResearch.com: What are the main findings of the study? Dr. Ishimura: Poor glycemic control is a major factor in the overestimation of glomerular filtration rate (GFR) in diabetic patients. We found this simple conclusion by directly measuring GFR by use of inulin clearance. We have created new formulae to accurately assess the GFR in diabetic patients, with the correction of hemoglobin A1C (HbA1C) or glycated albumin (GA) as followings; 1)      eGFRcr corrected by HbA1c=eGFRcr / (0.428 + 0.085 × HbA1c) 2)      eGFRcr corrected by GA=eGFRcr / (0.525 + 0.028 × GA) (more…)
Author Interviews, Dental Research, Diabetes, Diabetes Care / 14.02.2014

ayse_basak_cinarMedicalResearch.com Interview with: Ayse Basak Cinar, Assistant Professor The Department of Odontology The Faculty of Medical and Health Resources 2200 Copenhagen N Denmark MedicalResearch.com:  What are some of the unique or enlightening findings of this study that haven’t been published before? Answer:  To our knowledge, this is the first randomized controlled intervention study comparing the impact of individualized Health Coaching (HC) to formal Health Education (HE); applying HC as a holistic intervention for management of more than one specific type of chronic disease, namely oral health and diabetes management. The present study has two phases [the Turkish Phase, Turkey (2010-2012) and the Danish Phase, Denmark (2012- ...)]. The unique/enlightening figures from the Turkish phase as follows: The HC group compared to the HE group had significantly higher improvement at; HbA1c* (reduction: 0, 8% vs. 0%), and Periodontal Attachment Loss (PAL) (56% vs. 26%), (p≤0.01) Tooth Brushing Self-Efficacy (TBSE) (increase: 61% vs.25%) and stress (reduction: 16% vs. 1%), (p≤0.01). (more…)
Author Interviews, Diabetes, Diabetes Care, Ophthalmology / 15.01.2014

MedicalResearch.com Interview with: Dr. Eelco van Duinkerken Vrije Universiteit Medical Center, Amsterdama MedicalResearch.com: What are the main findings of the study? Answer: In our study we assessed the relationship between cerebral small vessel disease and peripheral microvascular function in type 1 diabetes patients. By MRI cerebral small vessel disease was assessed as white matter hyperintensities and lacunar infarcts (markers of ischemia) and cerebral microbleeds (expression of vascular leakage). We hypothesized that subgroups, i.e. those with (proliferative) retinopathy, are more at risk to develop cerebral small vessels disease. To this end, we selected type 1 diabetes patients with proliferative retinopathy, type 1 diabetes patients without microvascular complications and healthy controls. The main finding of our study was that only cerebral microbleeds, but not ischemic markers of cerebral small vessel disease were more prevalent in type 1 diabetes patients with proliferative retinopathy relative to the other groups. Cerebral microbleeds were also related to microvascular function in skin. This suggest that cerebral microbleeds are part of generalized microangiopathy in patients with type 1 diabetes. (more…)
Author Interviews, Diabetes, Diabetes Care, Fish / 15.01.2014

Jyrki Virtanen, PhD Adjunct Professor of Nutritional Epidemiology University of Eastern Finland Institute of Public Health and Clinical Nutrition Kuopio, FinlandMedicalResearch.com Interview with: Jyrki Virtanen, PhD Adjunct Professor of Nutritional Epidemiology University of Eastern Finland Institute of Public Health and Clinical Nutrition Kuopio, Finland MedicalResearch.com: What are the main findings of the study? Dr. Virtanen: The main finding was that serum long-chain omega-3 polyunsaturated fatty acid (PUFA) concentration, an objective biomarker of fish and long-chain omega-3 PUFA intake, was associated with a lower risk of incident type 2 diabetes during the average follow-up of 19.3 years in middle-aged and older men from Eastern Finland. The risk was 33% lower in the highest vs. the lowest quartile after adjustment for potential confounders. In contrast, hair mercury, a marker for long-term exposure to mercury, was not associated with the risk. Previously in this study population, high hair mercury content has been associated with higher risk of cardiovascular diseases and attenuation of the beneficial impact of long-chain omega-3 PUFA on the risk. Also, we did not find associations with the intermediate-chain length omega-3 PUFA alpha-linolenic acid, either, which is a plant-based omega-3 PUFA. This suggests that the findings were specific to the long-chain omega-3 PUFAs from fish. (more…)
Author Interviews, Diabetes, Diabetes Care, Pediatrics, Stanford / 11.01.2014

Naama Barnea-Goraly M.D. Center for Interdisciplinary Brain Sciences Research Stanford UniversityMedicalResearch.com Interview with: Naama Barnea-Goraly M.D. Center for Interdisciplinary Brain Sciences Research Stanford University MedicalResearch.com: What are the main findings of the study? Answer: Our main findings showed that compared with age and sex matched controls, children with type 1 diabetes have significant differences in white matter structure in widespread brain regions. Within the type 1 diabetes group, earlier onset of diabetes and longer duration were associated with greater alterations in white matter structure. In addition, measures of hyperglycemia and glucose variability, but not hypoglycemia were associated with white matter structure; however, hypoglycemia exposure and the number of severe hypoglycemia events in our sample were too small to identify statistically meaningful differences. Finally, we observed a significant association between white matter structure and cognitive ability in children with type 1 diabetes, but not in controls. (more…)
Cost of Health Care, Diabetes, Diabetes Care / 26.11.2013

dr_julie_a_schmittdielMedicalResearch.com Interview with: Julie A. Schmittdiel, PhD Kaiser Permanente Division of Research 2000 Broadway Oakland, CA 94612 MedicalResearch.com: What are the main findings of the study? Dr. Schmittdiel: We found that patients with diabetes who used mail order pharmacy were less likely to visit the emergency room than those who did not use mail order pharmacy during a 3 year follow-up period. We also did not see safety concerns associated with mail order pharmacy for most diabetes patients. (more…)
Author Interviews, Diabetes, Diabetes Care, Johns Hopkins / 21.11.2013

Caleb Alexander, MD, MS Department of Epidemiology, Bloomberg School of Public Health Center for Drug Safety and Effectiveness Johns Hopkins Bloomberg School of Public Health Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore, MarylandMedicalResearch.com Interview with: Caleb Alexander, MD, MS Department of Epidemiology, Bloomberg School of Public Health Center for Drug Safety and Effectiveness Johns Hopkins Bloomberg School of Public Health Division of General Internal Medicine, Johns Hopkins Medicine, Baltimore, Maryland MedicalResearch.com: What are the main findings of the study? Dr. Alexander:
  • There have been large shifts in the types of treatments used to treat Type 2 diabetes during the past decade in the United States.
  • We document large declines in the use of glitazones and sulfonylureas and important increases in the use of the newer DPP-4 inhibitors and GLP-1 agonists.
  • We also found large shifts in the types of insulins used, with substantial reductions in the use of regular and intermediate insulins, and large increases in the use of long-acting and ultra short-acting  therapies.
  • Costs have increased significantly over the past 5 years, driven primarily by insulin and DPP-4 inhibitors
  • All of these changes notwithstanding, biguanides continue to remain a mainstay of therapy. (more…)
Diabetes, Diabetes Care, Heart Disease / 28.10.2013

MedicalResearch.com Interview with: Marcin Sadowski Świętokrzyskie Cardiology Center, Kielce, Poland MedicalResearch.com: What are the main findings of the study? Dr. Sadowski: In multivariable analysis, diabetes was an independent risk factor of in-hospital and 1-year mortality in women treated for STEMI. In women with STEMI and diabetes one-year mortality was significantly lower in those treated with primary percutaneous coronary intervention than in those on optimal medical therapy. Early and long-term prognoses after STEMI were the worst in diabetic women, compared with non-diabetic women and diabetic men. (more…)
Author Interviews, Diabetes, Diabetes Care, Stroke / 23.10.2013

MedicalResearch.com Interview with: Stefanie Hägg, MB Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland MedicalResearch.com: What are the main findings of the study? Answer: We studied the incidence of stroke in a large cohort of patients with type 1 diabetes in Finland. During 36,680 person-years of follow-up, we found that the incidence of total stroke, and the subtypes cerebral infarction and cerebral hemorrhage was 406, 286, and 120 per 100,000 person-years, respectively, which is higher than in the Finnish general population, for whom the incidence of stroke varies between 135 and 236 per 100,000 person years. Furthermore, we studied the impact of two diabetic microvascular complications, diabetic nephropathy and severe diabetic retinopathy, on the risk of stroke, as well as for the subtypes of stroke. The incidence of stroke, cerebral infarction, and cerebral hemorrhage increased with both the presence of severe diabetic retinopathy and with advancing diabetic nephropathy. Furthermore, we found that both diabetic nephropathy and severe diabetic retinopathy increased the risk for all subtypes of stroke, independently of traditional risk factors. A novel finding was that already incipient diabetic nephropathy (microalbuminuria) increased the risk of stroke, cerebral infarction, and cerebral hemorrhage more than 3-fold, compared with patients free of renal disease. The highest risk of stroke was seen in patients with end-stage renal disease. (more…)
Author Interviews, Diabetes, Diabetes Care, Mental Health Research / 11.09.2013

MedicalResearch.com Interview with: Jean-Pierre Le Floch, MD Diabetology-Endocrinology Villecresnes Medical Hospital 94440 Villecresnes MedicalResearch.com: What are the main findings of this study? Answer: The main finding of the study is the association between classical macrovascular complications of diabetes and impaired scores of five geriatric scale scores exploring cognition, activities of daily life, instrumental activities, mood and nutrition. (more…)