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Latest & greatest articles for type 2 diabetes
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on type 2 diabetes or other clinical topics then use Trip today.
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Community groups or mobile phone messaging to prevent and control type2diabetes and intermediate hyperglycaemia in Bangladesh (DMagic): a cluster-randomised controlled trial Strategies are needed to prevent and control type2diabetes and intermediate hyperglycaemia, which together affect roughly a third of adults in Bangladesh. We aimed to assess the effects of mHealth and community mobilisation on the prevalence of intermediate hyperglycaemia and diabetes among the general adult population (...) in rural Bangladesh, and to assess the effect of these interventions on the incidence of type2diabetes among people with intermediate hyperglycaemia within the study population.DMagic was a three-arm, cluster-randomised trial of participatory community mobilisation, mHealth mobile phone messaging, and usual care (control) in 96 villages (population roughly 125 000) in Bangladesh. Community mobilisation involved 18 monthly group meetings, led by lay facilitators, applying a participatory learning
Effectiveness of smartphone-based self-management interventions on self-efficacy, self-care activities, health-related quality of life and clinical outcomes in patients with type2diabetes: A systematic review and meta-analysis To review the evidence and determine the effectiveness of smartphone-based self-management interventions on self-efficacy, self-care activities, health-related quality of life, glycated hemoglobin, body mass index (BMI), and blood pressure (BP) levels of adults (...) with type2diabetes mellitus .A systematic search of five databases (PubMed, Embase, Cochrane, CINAHL and Scopus) was conducted. Studies published in English from January 2007 to January 2018 were considered. Only randomized controlled trials (RCTs) of smartphone-based self-management interventions for patients with type2diabetes mellitus that reported any of the study outcomes were included. Two reviewers independently screened the studies, extracted data and assessed the quality of the studies
Effect of Additional Oral Semaglutide vs Sitagliptin on Glycated Hemoglobin in Adults With Type2Diabetes Uncontrolled With Metformin Alone or With Sulfonylurea: The PIONEER 3 Randomized Clinical Trial. Phase 3 trials have not compared oral semaglutide, a glucagon-like peptide 1 receptor agonist, with other classes of glucose-lowering therapy.To compare efficacy and assess long-term adverse event profiles of once-daily oral semaglutide vs sitagliptin, 100 mg added on to metformin (...) with or without sulfonylurea, in patients with type2 diabetes.Randomized, double-blind, double-dummy, parallel-group, phase 3a trial conducted at 206 sites in 14 countries over 78 weeks from February 2016 to March 2018. Of 2463 patients screened, 1864 adults with type2diabetes uncontrolled with metformin with or without sulfonylurea were randomized.Patients were randomized to receive once-daily oral semaglutide, 3 mg (n = 466), 7 mg (n = 466), or 14 mg (n = 465), or sitagliptin, 100 mg (n = 467
Effect of a Behavioral Intervention Strategy on Sustained Change in Physical Activity and Sedentary Behavior in Patients With Type2Diabetes: The IDES_2 Randomized Clinical Trial. There is no definitive evidence that changes in physical activity/sedentary behavior can be maintained long term in individuals with type2 diabetes.To investigate whether a behavioral intervention strategy can produce a sustained increase in physical activity and reduction in sedentary time among individuals (...) with type2 diabetes.The Italian Diabetes and Exercise Study 2 was an open-label, assessor-blinded, randomized clinical superiority trial, with recruitment from October 2012 to February 2014 and follow-up until February 2017. In 3 outpatient diabetes clinics in Rome, 300 physically inactive and sedentary patients with type2diabetes were randomized 1:1 (stratified by center, age, and diabetes treatment) to receive a behavioral intervention or standard care for 3 years.All participants received usual
Overall Quality of Care Predicts the Variability of Key Risk Factors for Complications in Type2Diabetes: An Observational, Longitudinal Retrospective Study An association between variability in clinical parameters (HbA1c, blood pressure, cholesterol, and uric acid) and risk of complications in type2diabetes has been reported. In this analysis, we investigated to what extent such variability is associated with overall quality of care.The quality of care summary score (Q-score) represents (...) a validated, overall quality of care indicator ranging between 0 and 40; the higher the score, the better the quality of care provided by the diabetes center. We identified patients with five or more measurements of clinical parameters after the assessment of the Q-score. Multiple linear regression analyses assessed the role of the Q-score in predicting the variability of the different parameters.Overall, 273,888 patients were analyzed. The variability of all the parameters systematically increased
Effect of SGLT2 inhibitors on cardiovascular, renal and safety outcomes in patients with type2diabetes mellitus and chronic kidney disease: a systematic review and meta-analysis The use of sodium glucose co-transporter 2 (SGLT2) inhibitors in patients with type2diabetes mellitus (T2DM) and chronic kidney disease (CKD) has been limited, primarily because glycaemic efficacy is dependent on kidney function. We performed a systematic review and meta-analysis to assess the efficacy and safety
Effects of Light Therapy on Mood and Insulin Sensitivity in Patients With Type2Diabetes and Depression: Results From a Randomized Placebo-Controlled Trial Depression is common in patients with type2diabetes and adversely affects quality of life and diabetes outcomes. We assessed whether light therapy, an antidepressant, improves mood and insulin sensitivity in patients with depression and type2 diabetes.This randomized, double-blind, placebo-controlled trial included 83 patients (...) with depression and type2diabetes. The intervention comprised 4 weeks of light therapy (10,000 lux) or placebo light therapy daily at home. Primary outcomes included depressive symptoms (Inventory of Depressive Symptomatology [IDS]) and insulin sensitivity (M-value derived from the results of a hyperinsulinemic-euglycemic clamp). Secondary outcomes were related psychological and glucometabolic measures.Intention-to-treat analysis showed that light therapy was not superior to placebo in reducing depressive
Antisense Inhibition of Glucagon Receptor by IONIS-GCGRRx Improves Type2Diabetes Without Increase in Hepatic Glycogen Content in Patients With Type2Diabetes on Stable Metformin Therapy To evaluate the safety and efficacy of IONIS-GCGRRx, a 2'-O-methoxyethyl antisense oligonucleotide targeting the glucagon receptor (GCGR), and the underlying mechanism of liver transaminase increases in patients with type2diabetes on stable metformin therapy.In three phase 2, randomized, double-blind (...) studies, patients with type2diabetes on metformin received weekly subcutaneous injections of IONIS-GCGRRx (50-200 mg) or placebo for 13 or 26 weeks.Significant reductions in HbA1c were observed after IONIS-GCGRRx treatment versus placebo at week 14 (-2.0% 200 mg, -1.4% 100 mg, -0.3% placebo; P < 0.001) or week 27 (-1.6% 75 mg, -0.9% 50 mg, -0.2% placebo; P < 0.001). Dose-dependent increases in transaminases were observed with IONIS-GCGRRx, which were attenuated at lower doses and remained mostly
Cumulative Risk of End-Stage Renal Disease Among Patients With Type2Diabetes: A Nationwide Inception Cohort Study To estimate long-term cumulative risk of end-stage renal disease (ESRD) after diagnosis of type2 diabetes.This nationwide population-based inception cohort study included 421,429 patients with type2diabetes diagnosed in 1990-2011; patients were followed until the end of 2013. Data linkage between several national health care registers in Finland, covering 100% of the population (...) , enabled the inclusion of almost all inhabitants who started taking diabetes medication or were hospitalized for diabetes. Cumulative risk of ESRD and hazard ratios [HR] for ESRD and death were estimated according to age, sex, and time period of diabetes diagnosis.Among 421,429 patients with type2diabetes, 1,516 developed ESRD and 150,524 died during 3,458,797 patient-years of follow-up. Cumulative risk of ESRD was 0.29% at 10 years and 0.74% at 20 years from diagnosis of diabetes. Risk was higher
Type2Diabetes, but Not Insulin (Analog) Treatment, Is Associated With More Advanced Stages of Breast Cancer: A National Linkage of Cancer and Pharmacy Registries To investigate whether women with type2diabetes (T2D) develop a more advanced stage of breast cancer and whether treatment with insulin (analogs) is associated with specific breast cancer characteristics.For this nested case-control study, women with breast cancer diagnosed in 2002-2014 were selected from the linked Netherlands (...) , metastasis), morphology, grade, estrogen receptor and progesterone receptor (PR), human epidermal growth factor receptor 2, and molecular subtype.Women with T2D (n = 1,567) were more often diagnosed with a more advanced tumor stage (odds ratio 1.28 [95% CI 13-1.44]) and a higher grade (1.22 [1.08-1.39]) though less often with a PR-negative breast tumor (0.77 [0.67-0.89]) than women without diabetes (n = 6,267). No associations were found for the other breast cancer characteristics. Women with T2D using
A Randomized Controlled Trial on the Safety and Efficacy of Exenatide Therapy for the Inpatient Management of General Medicine and Surgery Patients With Type2Diabetes This multicenter, open-label, randomized trial examined the safety and efficacy of exenatide alone or in combination with basal insulin in non-critically ill patients with type2diabetes (T2D).A total of 150 patients with blood glucose (BG) between 140 and 400 mg/dL, treated at home with diet, oral agents, or insulin at a total (...) in a higher proportion of BG levels in target range between 70 and 180 mg/dL compared with exenatide and basal-bolus (78% vs. 62% vs. 63%, respectively, P = 0.023). More patients in the exenatide and exenatide plus basal groups experienced nausea or vomiting than in the basal-bolus group (10% vs. 11% vs. 2%, P = 0.17), with three patients (6%) discontinued exenatide owing to adverse events. There were no differences in hypoglycemia <54 mg/dL (2% vs. 0% vs. 4%, P = 0.77) or length of stay (5 vs. 4 vs. 4
The ups and downs of low-carbohydrate diets in the management of Type 1 diabetes: a review of clinical outcomes Dietary management has been a mainstay of care in Type 1 diabetes since before the discovery of insulin when severe carbohydrate restriction was advocated. The use of insulin facilitated re-introduction of carbohydrate into the diet. Current management guidelines focus on a healthy and varied diet with consideration of glycaemic load, protein and fat. As a result of frustration (...) with glycaemic outcomes, low-carbohydrate diets have seen a resurgence in popularity. To date, low-carbohydrate diets have not been well studied in the management of Type 1 diabetes. Studies looking at glycaemic outcomes from low-carbohydrate diets have largely been cross-sectional, without validated dietary data and with a lack of control groups. The participants have been highly motivated self-selected individuals who follow intensive insulin management practices, including frequent blood glucose
Automated insulin dosing guidance to optimise insulin management in patients with type2diabetes: a multicentre, randomised controlled trial. Insulin therapy is most effective if dosage titrations are done regularly and frequently, which is seldom practical for most clinicians, resulting in an insulin titration gap. The d-Nav Insulin Guidance System (Hygieia, Livonia, MI, USA) is a handheld device that is used to measure glucose, determine glucose patterns, and automatically determine (...) the appropriate next insulin dose. We aimed to determine whether the combination of the d-Nav device and health-care professional support is superior to health-care professional support alone.In this multicentre, randomised, controlled study, we recruited patients from three diabetes centres in the USA (in Detroit MI; Minneapolis, MN; and Des Moines IA). Patients were eligible if they were aged 21-70 years, diagnosed with type2diabetes with a glycated haemoglobin (HbA1c) concentration of 7·5% or higher (≥58
Association of Type 1 Diabetes With Standardized Test Scores of Danish Schoolchildren. Type 1 diabetes has been associated with cardiovascular disease and late complications such as retinopathy and nephropathy. However, it is unclear whether there is an association between type 1 diabetes and school performance in children.To compare standardized reading and mathematics test scores of schoolchildren with type 1 diabetes vs those without diabetes.Population-based retrospective cohort study from (...) , and 51% were male; 2031 had a confirmed diagnosis of type 1 diabetes. Overall, the mean combined score in math and reading was 56.11 (SD, 24.93). There were no significant differences in test scores found between children with type 1 diabetes (mean, 56.56) and children without diabetes (mean, 56.11; difference, 0.45 [95% CI, -0.31 to 1.22]). The estimated difference in test scores between children with and without type 1 diabetes from a linear regression model with adjustment for grade, test topic
Metformin?s role in type 1 diabetes: the removal trial Metformin’s Role in Type 1 Diabetes: the REMOVAL Trial – Clinical Correlations Search Metformin’s Role in Type 1 Diabetes: the REMOVAL Trial February 14, 2019 5 min read By William Plowe Peer Reviewed Metformin has been the first-line drug in type2diabetes for over a decade, but its possible benefit in type 1 diabetes (DM1) is still a matter of study. The American Diabetes Association lists metformin as an investigational agent that may (...) reduce insulin requirements in DM1, but it is not FDA-approved for that use. REMOVAL, a 2017 multicenter double-blind placebo-controlled study, studied metformin in adults with DM1. It is biologically plausible that metformin could have a role in DM1. Metformin, a biguanide, works by several mechanisms, including inhibition of gluconeogenesis and reducing insulin resistance. Importantly, in the UKPDS 34 study . Insulin resistance, the hallmark of type2diabetes, is often present in patients
OurPath app for management of type2diabetes OurPath app - Health Technology Wales > OurPath app OurPath app Topic Status Incomplete OurPath app for management of type2diabetes Summary Health Technology Wales researchers searched for evidence on whether the use of the OurPath app is an effective alternative to GP referral to weight-loss programmes in people deemed to be at ‘high-risk’ of type2diabetes. The evidence is insufficient in quality and quantity to enable an appraisal by Health
Prediction of individual life-years gained without cardiovascular events from lipid, blood pressure, glucose, and aspirin treatment based on data of more than 500 000 patients with Type2diabetes mellitus Although group-level effectiveness of lipid, blood pressure, glucose, and aspirin treatment for prevention of cardiovascular disease (CVD) has been proven by trials, important differences in absolute effectiveness exist between individuals. We aim to develop and validate a prediction tool (...) for individualizing lifelong CVD prevention in people with Type2diabetes mellitus (T2DM) predicting life-years gained without myocardial infarction or stroke.We developed and validated the Diabetes Lifetime-perspective prediction (DIAL) model, consisting of two complementary competing risk adjusted Cox proportional hazards functions using data from people with T2DM registered in the Swedish National Diabetes Registry (n = 389 366). Competing outcomes were (i) CVD events (vascular mortality, myocardial
The renoprotective effects of sodium-glucose cotransporter 2 inhibitors versus placebo in patients with type2diabetes with or without prevalent kidney disease: A systematic review and meta-analysis We undertook a systematic review and meta-analysis to assess the efficacy and safety of sodium-glucose cotransporter 2 inhibitors (SGLT2is) concerning kidney outcomes in patients with type2diabetes mellitus (T2DM), with or without prevalent kidney disease.PubMed, Web of science, Embase (...) patient characteristics (age, BMI, HbA1c, eGFR level), but were influenced by drug administration (treatment duration, type, dosage of SGLT2is). Subgroup analyses showed that the relative effects on renal outcomes of SGLT2is vs placebo were similar across eGFR subgroups (P heterogeneity >0.05).SGLT2is slowed eGFR decline, lowered albuminuria progression, improved adverse renal endpoints and reduced all-cause mortality, but increased risk of genital infections vs placebo in patients with T2DM