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Latest & greatest articles for type 1 diabetes
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Excess Burden of Mental Illness and Hospitalization in Young-Onset Type 2 Diabetes: A Population-Based Cohort Study. Type 2 diabetes (T2D) increases hospitalization risk. Young-onset T2D (YOD) (defined as onset before age 40 years) is associated with excess morbidity and mortality, but its effect on hospitalizations is unknown.To determine hospitalization rates among persons with YOD and to examine the effect of age at onset on hospitalization risk.Prospective cohort study.Hong Kong.Adults aged (...) . The adjusted rate ratios showed increased hospitalization in YOD versus usual-onset T2D (onset at age ≥40 years) (all-cause, 1.8 [95% CI, 1.7 to 2.0]; renal, 6.7 [CI, 4.2 to 10.6]; diabetes, 3.7 [CI, 3.0 to 4.6]; cardiovascular, 2.1 [CI, 1.8 to 2.5]; infection, 1.7 [CI, 1.4 to 2.1]; P < 0.001 for all). Models estimated that intensified risk factor control in YOD (hemoglobin A1c level <6.2%, systolic blood pressure <120 mm Hg, low-density lipoprotein cholesterol level <2.0 mmol/L [<77.3 mg/dL], triglyceride
Evaluation of the long-term cost-effectiveness of once-weekly semaglutide versus dulaglutide for treatment of type 2 diabetes mellitus in the UK Glucagon-like peptide-1 (GLP-1) receptor agonists are appealing as glucose-lowering therapy for individuals with type 2 diabetes mellitus (T2DM) as they also reduce body weight and are associated with low rates of hypoglycaemia. This analysis assessed the long-term cost-effectiveness of semaglutide 0.5 and 1 mg vs dulaglutide 1.5 mg (two once-weekly (...) GLP-1 receptor agonists) from a UK healthcare payer perspective, based on the head-to-head SUSTAIN 7 trial, to inform healthcare decision making.Long-term outcomes were projected using the IQVIA CORE Diabetes Model (version 9.0). Baseline cohort characteristics, changes in physiological parameters and adverse event rates were derived from the 40-week SUSTAIN 7 trial. Costs to a healthcare payer were assessed, and these captured pharmacy costs and costs of complications. Utilities were taken from
with the dipeptidyl peptidase-4 inhibitor linagliptin versus placebo in CARMELINA (The Cardiovascular and Renal Microvascular Outcome Study With Linagliptin), a cardiovascular outcomes trial that enrolled participants with type 2 diabetes mellitus and atherosclerotic cardiovascular disease and/or kidney disease.Participants in 27 countries with type 2 diabetes mellitus and concomitant atherosclerotic cardiovascular disease and/or kidney disease were randomized 1:1 to receive once daily oral linagliptin 5 mg (...) Linagliptin Effects on Heart Failure and Related Outcomes in Individuals With Type 2 Diabetes Mellitus at High Cardiovascular and Renal Risk in CARMELINA Individuals with type 2 diabetes mellitus are at increased risk for heart failure (HF), particularly those with coexisting atherosclerotic cardiovascular disease and/or kidney disease. Some but not all dipeptidyl peptidase-4 inhibitors have been associated with increased HF risk. We performed secondary analyses of HF and related outcomes
Hypoglycaemia as a function of HbA1c in type 2 diabetes: Insulin glargine 300 U/mL in a patient-level pooled analysis of EDITION 1, 2 and 3 Basal insulin therapy often involves a compromise between achievement of glycaemic targets and avoidance of hypoglycaemia, dependent on how intensively insulin is titrated. In the Phase 3a EDITION 1, 2 and 3 studies, insulin glargine 300 U/mL (Gla-300) provided glycaemic control equivalent to that of insulin glargine 100 U/mL (Gla-100), with less (...) hypoglycaemia in individuals with type 2 diabetes mellitus (T2DM). The current study evaluated the rates of confirmed (≤3.9 mmol/L [≤70 mg/dL]) or severe hypoglycaemia over six months of treatment with Gla-300 or Gla-100 in the EDITION studies, as a function of HbA1c. Analysis was performed on patient-level data pooled from the three EDITION studies, and annualized hypoglycaemia rate as a function of HbA1c at Month 6 was fitted using a negative binomial regression model. Participants treated with Gla-300
Glycaemic Efficacy and Safety of Linagliptin compared to Basal-Bolus Insulin Regimen in Patients with Type 2 Diabetes Undergoing Non-Cardiac Surgery: A Multicenter Randomized Clinical Trial The use of incretin-based therapy instead of or complementary to insulin therapy is an active area of research in hospitalized patients with type 2 diabetes (T2D). We determined glycaemic efficacy and safety of linagliptin compared to basal-bolus insulin regimen in hospitalized surgical patients
The effect of glycemic control on cardiovascular disease in individuals with type 2 diabetes with pre-existing cardiovascular disease - a systematic review and meta-analysis The role of intensive glucose control in people with type 2 diabetes and pre-existing cardiovascular disease (CVD) is controversial. The aim of this systematic review and meta-analysis was to determine in a subset of people with type 2 diabetes and pre-existing CVD, the CV effect of intensive glucose control versus standard (...) of care. We searched Medline, the Cochrane library, EMBASE and the National Institutes of Health Trial registration database for randomized controlled trials that evaluated the effect of intensive glucose control versus standard glucose control in people with type 2 diabetes on incident CVD. Data were extracted using a structured form. When data were not available in the publications, authors were contacted. Eight trials involving 8339 participants were included. Among adults with type 2 diabetes
Metformin Improves Insulin Sensitivity and Vascular Health in Youth With Type1Diabetes Mellitus Cardiovascular disease is the leading cause of mortality in type1diabetes mellitus (T1DM) and relates strongly to insulin resistance (IR). Lean and obese adolescents with T1DM have marked IR. Metformin improves surrogate markers of IR in T1DM, but its effect on directly measured IR and vascular health in youth with T1DM is unclear. We hypothesized that adolescents with T1DM have impaired vascular (...) , fasting laboratories after overnight glycemic control, and insulin sensitivity by hyperinsulinemic-euglycemic clamp (glucose infusion rate/insulin). Adolescents with T1DM were randomized 1:1 to 3 months of 2000 mg metformin or placebo daily, after which baseline measures were repeated.Forty-eight adolescents with T1DM who were 12 to 21 years of age (40% body mass index [BMI] ≥90th percentile; 56% female) and 24 nondiabetic control participants of similar age, BMI, and sex distribution were enrolled
, we recruited patients with type 2 diabetes, moderate-to-severe periodontitis, and at least 15 teeth from four local hospitals and 15 medical or dental practices in the UK. We randomly assigned patients (1:1) using a computer-generated table to receive intensive periodontal treatment (IPT; whole mouth subgingival scaling, surgical periodontal therapy [if the participants showed good oral hygiene practice; otherwise dental cleaning again], and supportive periodontal therapy every 3 months until (...) Systemic effects of periodontitis treatment in patients with type 2 diabetes: a 12 month, single-centre, investigator-masked, randomised trial Chronic inflammation is believed to be a major mechanism underlying the pathophysiology of type 2 diabetes. Periodontitis is a cause of systemic inflammation. We aimed to assess the effects of periodontal treatment on glycaemic control in people with type 2 diabetes.In this 12 month, single-centre, parallel-group, investigator-masked, randomised trial
Sustained 52-week efficacy and safety of triple therapy with dapagliflozin plus saxagliptin versus dual therapy with sitagliptin added to metformin in patients with uncontrolled type 2 diabetes To compare the efficacy and safety of an intensification strategy of early triple combination therapy with dapagliflozin (DAPA) plus saxagliptin (SAXA) to a dual therapy strategy with sitagliptin (SITA) in patients with type 2 diabetes who are inadequately controlled with metformin (MET) monotherapy.This
DREAM5: An open-label, randomized, cross-over study to evaluate the safety and efficacy of day and night closed-loop control by comparing the MD-Logic automated insulin delivery system to sensor augmented pump therapy in patients with type1diabetes at h Previous DREAM studies demonstrated the safety and efficacy of the CE marked MD-Logic closed-loop system (DreaMed GlucoSitter) in different settings for overnight glycaemic control. The present study aimed to evaluate the system for day (...) and night use for 60 hours during the weekend at home compared to sensor-augmented pump (SAP) therapy in participants with type1 diabetes.This was a prospective, multicentre, crossover, controlled study (clinicaltrials.gov NCT01238406). All participants were connected in randomized order for one weekend to SAP therapy or the MD-Logic System. In the intervention arm only, the amount of carbohydrate was entered into the bolus calculator; the rest of insulin delivery was automated and wireless via
Development and Validation of a Simple Hip Fracture Risk Prediction Tool for Type 2 Diabetes: The Fremantle Diabetes Study Phase I To develop a type 2 diabetes hip fracture risk tool in community-based patients, to validate it in an independent cohort, and to compare its performance against the only published prediction equation to include type 2 diabetes as a risk factor (QFracture).Hip fracture hospitalizations in 1,251 participants with type 2 diabetes aged 40-89 years from the longitudinal (...) Fremantle Diabetes Study Phase I (FDS1) were ascertained between entry (1993-1996) and end-2012. Competing risk regression modeling determined independent predictors of time to first fracture over 10 years and the coefficients incorporated in a risk model. The model was validated in 286 participants with type 2 diabetes from the Busselton Health Study (BHS).Fifty FDS1 participants (4.0%) experienced a first hip fracture during 10,306 person-years of follow-up. Independent predictors of fracture were
Associations of Fenofibrate Therapy WithÂ Incidence and Progression of CKD inÂ Patients With Type 2 Diabetes. Abnormalities in lipid metabolism may contribute to the development and progression of chronic kidney disease (CKD) in patients with type 2 diabetes. Fenofibrate induces early and reversible reduction in estimated glomerular filtration rate (eGFR), but it may have protective effects on microvascular complications of diabetes. We hypothesized that randomization to fenofibrate versus (...) placebo would be associated with beneficial long-term effects on kidney outcomes in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial participants.We conducted a post hoc analysis in the ACCORD Lipid Trial to examine the association of randomization to fenofibrate versus placebo with change in eGFR and with time-to-development of microalbuminuria, macroalbuminuria, CKD, and kidney failure.We analyzed 2636 participants in the fenofibrate arm and 2632 in the placebo arm. During
Semaglutide (Ozempic) - the treatment of adults with insufficiently controlled type 2 diabetes mellitus (T2DM) as an adjunct to diet and exercise 1 Published 14 January 2019 1 SMC2092 semaglutide 0.25mg, 0.5mg and 1mg solution for injection in pre-filled pen (Ozempic®) Novo Nordisk Ltd. 9 November 2018 (Issued 7 December 2018) The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its (...) with type 2 diabetes (T2DM), the postprandial rise in endogenous GLP-1 is reduced or absent. GLP-1 receptor agonists can supplement or replace this deficiency. The submitting company has requested that SMC considers semaglutide when positioned for use in line with the current use of other GLP-1 receptor agonists, in addition to other medicinal products for the treatment of diabetes (i.e. as an add-on therapy to oral anti-diabetic drugs [OADs] or basal insulin). 3 The Semaglutide Unabated Sustainability
Ertugliflozin (Steglatro) - type 2 diabetes mellitus 1 Published 14 January 2019 1 SMC2102 ertugliflozin 5mg, 15mg film-coated tablet (Steglatro®) Merck Sharp & Dohme 7 December 2018 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its use in NHSScotland. The advice is summarised as follows: ADVICE: following a full submission ertugliflozin (Steglatro ® ) is accepted (...) , therefore hypoglycaemia is unlikely. 6 Efficacy is dependent on renal function, and is reduced in patients with moderate renal impairment and likely to be absent in severe renal impairment. Ertugliflozin is formulated as an immediate-release tablet that is taken once daily. 1 Current UK guidance recommends that SGLT-2 inhibitors used as monotherapy be considered as options for treating type 2 diabetes in adults for whom metformin is contraindicated or not tolerated and when diet and exercise alone do
300 IU/mL (Gla-300) solution is another option for adults with type1 or type 2 diabetes requiring a long-acting basal insulin. Gla-300 is a concentrated formulation of the PBS-listed Gla-100. MedicineWise News: Type 2 diabetes – when metformin is not enough Sulfonylureas are the usual add-on treatment when metformin is no longer sufficient, but are they the best? Review the evidence on efficacy, safety and outcomes for second-line type 2 diabetes treatments. NPS RADAR: Pharmacological therapies (...) of first choice for people with type 2 diabetes who have inadequate glycaemic control after 3 months of making lifestyle changes. Sulfonylurea may be used if metformin cannot be tolerated. 1-4 Only add another medicine if target blood glucose levels are not achieved after titrating metformin (or a sulfonylurea) to the highest tolerated dose. 1,2 Always check and address other factors that may interfere with control before adding a second or third glucose-lowering medicine e.g. poor self-management
KP National Heart Failure Lead KP Southern California Heart Failure Lead Reference: 1. Davies MJ, D’Alessio, DA, Fradkin, J, et al. Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2018 Oct 4. (...) Second-line Drug Therapy for Patients with Type 2 Diabetes Second-line drug therapy for patients with Type 2 Diabetes A Consensus Statement from the Kaiser Permanente National Integrated Cardiovascular Health (ICVH) Work Group November 19, 2018 The Kaiser Permanente ICVH group is aware of the new treatment recommendations published in the American Diabetes Association’s (ADA) Management of Hyperglycemia in Type 2 Diabetes 2018 Consensus Report. The ADA places newer diabetic medications
Minimed 670g - for the management of type1diabetes mellitus Search Page - Drug and Health Product Register Language selection Search and menus Search Search website Search Topics menu You are here: Summary Basis of Decision - - Health Canada Expand all Summary Basis of Decision (SBD) for Contact: Summary Basis of Decision (SBD) Summary basis of decision (SBD) documents provide information related to the original authorization of a product. The for the is located below. Updated: The following (...) table describes post-licensing activity for the . For more information on the type of information found in PLATs, please refer to the For additional information about the medical device application process, refer to the . Licence Number: Post-Licensing Activity Table (PLAT) Activity/Application Type, Application Number Date Submitted Decision and Date Summary of Activities 1 What was approved? Application Milestones: Application Milestone Date For additional information about the medical device